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HomeMy WebLinkAboutEP25-143 x M Cl _ o : 00 m N s m C7 w 0 x a G� 00 o o H _ O z o � v c c x A = N �--+ o w � PLO 00 w w � OC� w � NCf) z U cn zo M z W , z �} � 4 i �" a H PLq Gl 1�1 C7 I� w w v w ? W = z w a M W U w Q w >'. Cn x � ° q x wA oZ , 0 p © H s Cl) w U WC� Q ZO x Z w z H a 0 C= Z p4 v k �+ A a W .. _ 0 Z w o d = : BUIL ik D.EPARTMENT !(, VILLAGE OF RYE BROOK 938 KING STREET RYE BRooK,NY 10573 28 2025(9i4)939-0668 If__ - \��ti`�.ryebrooknv.lpov VILLAGE 01: RYE BROOK ELECTRICAL PERMIT APPLICATI^�2LDI1,,'G DEPARTMENT Westchester County Master Electricians License Required 121 FOR OFFICE USE ONLY BP EP#: 1 t �!. 3 Approval Date: May 3 0 70 Permit Fee: $ Approval Signature: Other: DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSUED BV THE BUILDING INSPECTOR. THE ADMINISTRATIVE FEE FOR WORK PROGRESSED OR COMPLETED WITHOUT A PERMIT IS 12%OF THE TOTAL COST OF CONSTRUCTION WITH A MINIMUM FEE OF S750.00 Application dated, ",5-- is hereby made to the Building Inspector of the Village of Rye Brook NY,for the issuance of a Permit to install and/or remove electrical equipment,wiring, fixtures,or to perform other high or low voltage electrical work as per the detailed statement described below. By signing this document, the applicant & property owner agree that all electrical work performed will be in conformance with all applicable Federal, State,County and Local Codes. {} / Q 1.Address: �� N. P 5�- SBL:13St 4 2—/—9 zone.,) 2.Property Owner: Be-ViYI t-a<e.%l -t-Here, Address: 11 N• R�44 sk- ✓-�� Phone#: Cell#: rl to" 6616 J (pQ 7 to email: T•C ttr10..LQ T�'lO�tf 41MQ1�•Cb�tY) 3.Master Electrician/Licensed Installer: cTO-If. ".Qoa,r i a%eZ Address: 15' C low— R a - Lic.#: 2044 Phone#: Cell#: 9W- f mailyieoe�Y\S%LQZO?Y%yCori^e)eCaliCC-CDM Company Name: W JQW C1-� CW;Cgl, (os�-s_Address: 1 5- GjpYG Q Z► IA\%rAe a►rs I b60 3 4.Proposed Electrical Work/Fixture Count: l2'k.Q7P\ACe eX is")V3 st'I V'CCr Seome_ . ()c hdC\k-iDi%%k lo(Kd. 5.31 Party Electrical Inspection Agency: 15WV9 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: TIC ki. t YS GtiEL .being duly sworn,deposes and states that he/she is the applicant above named,and does further (print name of individual sffning as the applicant) state that(s)he is the 9ftLeLf Eke r iCI%Y) for the legal owner and is duly authorized to make and file this application. (Master Electrician/Licensed Installer) The undersigned further states that all statements contained herein are true to the best of his/her knowledge and belief,and that any work performed,or use conducted at the above captioned property will be in conformance with the details as set forth and contained in this application and in any accompanying approved plans and specifications,as well as in accordance with the New York State Uniform Fire Prevention&Building Code,the Code of the Village of Rye Brook and all other applicable laws,ordinances,and regulations. Sworn to before me this 2 Sworn to before me this day,o.f Mft\l 20 day of 20 5 Signature of Property Owner nature of Applican Prin ame of Property Owner Pr t L �AUREN BUCCI ��YUB��CctATE OF NEW YORK Notary Public-State of New Notary.P Public No.0 1 B U6293236 �l �ed in Westchester County Qualified in Westchester Ccunty My 2trnission Expires: II, 00k_P - My Commission Expires December 09,26?� STATE WIDE INSPECTION SERVICES, INC. Service Willi Integrity • 0 • • SWIS JOB APPLICATION0. • Office Use Elect. Permit# �1 Date s I21 125 Bldg Permit Scl Ft Plumbing Permit# Final Certificate# City/Village Zip Building Dept. co County Address ( Cross Street Section Block Lot Owner Name/Address(if di event than above) —7—h f wX Contact Number 21asement ❑ Ist FI, ❑2nd FI. ❑3rd Fl. ❑More Than 3 FL ❑Garage ❑Attic 'Outside residential Commercial Receptacles Special Recept GFC1 AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash Compact Amt Amps Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch SERVICE Amperage #Panels 3 PP 3P # Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair 100 , X I 9-clverhead QFlpgrade ❑ Disconnect Utility ID# _ Q R-Con Ed ❑ NYSEG ❑Central Hudson ❑ Orange J Rockland l� PHOTOVOLTAIC SYSTEM PV Modules Inverters AC Disconnect ]unction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect ❑Legalization [g--S fety Inspection ❑Consultation 4R e-pAace r cc e . }`1 o a MAY 2 8 2025 VILLAGL (_. = KY E BROOK BUILDI;JG r' :,-�FITMENT I This application is valid for one(1)year from the date received by SWIS.This application is intended to cover the above listed items to be inspected,if at anytime of inspection additional items have been installed,you are authorized to make the inspection and adjust the fee for the additional items inspected.The applicant declares that there is no open applications for the above address with any other inspection company.The applicant, owner or authorized agent agrees to all the above terms and conditions asset forth for the application. Email Address (t,6.6 qQZ t(1 COS w\ Name e—vqve2 License# o!{ Date Zr Signature Address IS Cttj City/State W\_n;\C— � Zip Code 60 CI ON 1 N t ec��C I QlC !� Phone# Q11 O _