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BUILDING DEPARTMENT �.D rI C E � V E
f
VILLAGE OF RYE BROOK �° - -----
938 KING STREET RYE BRootc,NY 10573 MAY 2 3 20Z5
(914)939-�0668
N�.I-yehrookny.gQv ; VILLAGE OF RYE BROOK
ELECTRICAL PERMIT APPLICATIO BUILDING DEPARTMl�r
Westchester County Master Electricians License Required
FOR OFFICE USE ONLY BP #: EP#: C ) / ICJ
Approval Date: 5` 2 Z o Z.5— Permit Fee: s
Approval Signature: _ Other:
DO NOT START WORK or CONSTRUCTION UNTIL A PIERNII I HAS BEEN ISSUED BY THE BUILDING INSPECTOR.
THE ADMINISTRATI'4'E 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,Cl!'l zo Z-$- 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.
1.Address: 107 (Z-t 0til ve SBL: 1 -Mi4e7/ '—f—Zone:
2.Property Owner: 'C tee- Address: 9,0-e Cc ..' 0&_
Phone#: Cell#: email:
3.Master Electrician/Licensed Installer: v.1 S cs +y.r'_-' Address: Q.
_ Ma,
Lie.#: 1.2-4? Phone#: Z� 30 -06 cj, Cell#: gY's`Yg�4 S`4'�'email: e-�e CzV 7
Company Name: )eiv C®rt0 Address: C,Y
4.Proposed Electrical Work/Fixture Count:
z—
5.31"Party Electrical Inspection Agency:
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STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
OA..,►d go_t�^,0 ,being duly sworn,deposes and states that he/she is the applicant above named,and does further
(print name of individual signing as the applicant)
state that(s)he is the for the legal owner and is duly authorized to make and file this application,
IMaster 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 )-S Sworn to before me this
day of ,205-S_ day of Z ,20
�gnkuivre of Property Owner Signature of Applicant
IPIc ku e I t s*_ r/ 0--. ./ :5,-6 ,,,,_C",
���Lar
Nm f Property OPT er Pri g Ak ,icant
ARI L
o rtc Notary t "f) �Yot
Notary Public No.aMEW-60063 ,No
qualified In Westchester County qualifted n estchestsr County r1
Commission Expires January 29,20Z f Commission Explres JanuafY 29,20 G—� 6/ll2024
STATE WIDE INSPECTION SERVICES, INC.
CAD Service lVilh Integrity
080 • •
APPLICATIONSWIS JOB t2.7224 1 fax 914.219.1062 1 SWISNY.coml SWI STRAIN I NG.COM
Office Use Elect. Permit# � Date
Bldg Permit# Sq Ft
Plumbing Permit#
Final Certificate#
City/Village /� Zip Building Dept7 3 . County
Address 2 Cross Street Section Block Lot
Owner Name/Address(If dlffere than above) Contact Number
❑Basement ❑ 1st FL ❑2nd FI.. ❑3rd FL ❑More Than 3 Fl. Garage ❑Attic EA Outside ❑Residential ❑Commercial
Receptacles Special Recept GFCI 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 1P 3P # Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair
ZOu 2— 'j�Overhead �2 Upgrade ❑ Disconnect
Utility ID# Con Ed ❑ NYSEG ❑Central Hudson ❑ Orange/Rockland
PHOTOVOLTAIC SYSTEM
PV Modules Inverters AC Disconnect Junction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect
❑Legalization ❑ Safety Inspection ❑Consultation
:�/U i�I\ l�C)C�i / � /�i�r�>.si 'l-t1•1M 0�
ILI
MAY 2 3 2025
VILLAGE OF RYF- BROOK
BLJILF)i\!G n'�RARTMENT
This application is valid for one{I)year from the date received by SWIS.This application is intended to cover the above listed items to be inspected,if at any time 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 -� Name UE 1-1_-/
License# f c Orr Date .5 }- Signature D
Address r� Y 3 City/State M G ;^x'>l J<-r Zip Code
Company Phone# V j le-V
D EZ C E � ,v� �� State Wide Inspection Services
1080 Main Street
Fishkill, NY 12524
TO
� JUL 2 5 2025 845 202-7224 Phone
914-219-1062 Fax
STATE WIDE INSPECTION SERVICES VILLAGE OF RYE BROOK Email: officeCa)swisny.com
BUILDING DEPARTMENT Website: www.swisny.com
Service With Integrity
BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES
CERTIFIES THAT:
Upon the application of: Upon Premises Owned by:
Power and Energy Corp Michael &Jaclyn Fisher
114 Pearl Street,Suite 1A 108 Country Ridge Drive
Port Chester, NY 10573 Rye Brook, NY 10573
Located at: 108 Country Ridge Drive, Rye Brook, NY 10573
Section: Block: Lot: Electrical Permit Number: EP25-136
129.67 1 9
Certificate Number: 2025-4006 Building Permit Number:
A visual inspection of the electrical system was conducted at the Residential occupancy described
below.The electrical system consisting of electrical devices and wiring is located in/on the premises
at: 108 Country Ridge Drive, Rye Brook, NY 10573
The Exterior was inspected in accordance with the NYS and NFPA 70-2017 and the detail of the
installation, as set forth below,was found to be in compliance on the 13`h day of June 2025.
Name Quantity Rating Circuit Type
Buch Boost Transformer 01
Service 01 200AMP
Meter 01
Panel 02
Disconnect 01
Grounding and bonding of service to current codes.
Officer: Frank J. Farina
This certificate may not be altered in any way and is validated only by the presence of a seal at the location
indicated.This certificate is valid for work performed on the date of inspection only.