HomeMy WebLinkAboutMP25-100 W
: f!
N N O w y
: O Nfq
i w 1y FF
� r- o-rA+
cr
H M oi
w U q o ate,
z n o � -15 x �
wv U . x
Rv
05,
W
010
v>
4-4W rl Q V00
00
Cs
CID 4
w w i y Q t Z
O c7 en v o
o
LZ
cN
Iu-1 O 0-4
A 0
V F F = N �° ct�
x w �'•+ d E� ° z z a v t8 u
y
a
qi
pC x V ROvvvU
y
z E�
0 > °
U W °.s pv (5
A "C s
_
a
BUILDB
MENT � v `�
VIL E OK 1UN 2 6 2025
938 KING E ,NY 10573
av VILLAGE OF RYE BROOK
BUILDING DEPARTMENT
APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE
HEATING, VENTILATION AND/OR A CONDITIONING E1QUIPMENT
FOR OFFICE USE ONLY: PERMIT#: ���� J
Approval Date: Permit Fee: $
Approval Signature: Other:
Disapproved:
(fees are non-refundable)
DO NOT START WORK or CONSTRUCTION IL A PERMIT HAS BEEN ISSUED BY 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$750.00
REQUIREMENTS FOR RELEASE OF PERMIT&CERTIFICATE OF COMPLIANCE:
l. Properly completed& Signed Application.
2. Site/Staging Plan if Required by the Building Inspector.
3. Copy of Licensed Contractor's Liability Insurance. (Village of Rye Brook must be listed as certificate holder) & Workers
Compensation Insurance on a NYS Board form(Form#C 105.2 or Form#U26.3/or NY State Workers Compensation Waiver)
4, Payment of Fees/Unit: RESIDENTIAL=$200.00/unit • COMMERCIAL =$450.00/unit.
5. Complete specifications for each unit being installed.
6. Inspection by the Building Department for removal and/or installation. (48 hour notice required
7. Electrical work requires a separate Electrical Permit& Electrical Inspection.
8. Plumbing/Gas work requires a separate Plumbing Permit& Plumbing Inspection.
Application dated, ~J is hereby made to the Building Inspector of the Village of Rye Brook for a permit for the
installation and or removal of the HVAC equipment as listed below.The applicant and property owner,by signing this document
agrees that said equipment will be installed and/or removed in conformance with all applicable Local,County, State&Federal laws,
codes,rules and regulations. ``-- Q
I. Address: T 2 t SBL: / 7,7/"/ Zone:
2. Property Owner: T G. Address: 372 Coun+n
Phone#:�Il'1. �'b'S_ t��2 Cell#: email: ( j .
3. Contractor: 6win me_rh Fy I c, 1 Address: in o 1 Ct)rh
Phone#1 4, q 3 . Lip 1 Cell#:Q 11. 1-11'7.3 7?� email: +rC j Q) Q rC,4 C Me 11L '04
4. Scope of Work: New Installation( )•Replacement • Removal( )•Other( ):
5. List Equipment: Cned���>a t't _rX Go, n 4r e
6. Location of Equipment: A4+iC ISjckt1QlZh
7. Method of Installation/Removal(list all equipment needed to perform job):
1
6/1/2025
STATE OF NEW YORK�,COUNTY OF WESTCHESTER ) as:
1-t-) Ln"� ,being duly sworn,deposes and states that he/she is the applicant above named,
(print name of individual signing as the applicant)
and further states that(s)he is the Heating,Ventilation and/or Air Conditioning Contractor for the legal owner and is duly
authorized to make and file this application.
That all statements contained hereinn 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 b Sworn to before me thi
day of 20 day o a 211:a5—
u t
�3ignature of Proper—ty}�O.w,n�er ignature of Ap /scant
ame of Property Owner Print a of Applicant
Nft6 Public Notary Public
SHARI MELILLO
Notary Public,State of New York UNA WHALEN
No.OIME6160063 1~IoWy Public, State of New York
Qualified In Westchester County No.01 WH6394580
Commission Expires January 29,20 0 Qualified in Westchester County
Commission Expires July 8,2027
This application must be properly completed in its entirety and must include the notarized signature(s)of
the legal owner(s)of the subject property, and the applicant of record in the spaces provided. Any
application not properly completed in its entirety and/or not properly signed shall be deemed null and void
and will be returned to the applicant.
2
6/l/2025
110 c
N
O
a
O � v
N oY
_L v „ o, o
EWE I T, � L = > u
• _ a
O Q C
"/ CU
L m a Ln
L
v N ii
y (y
SJ
CD C C
a a
a� E
W m
a, v a�
-0 a w NEB LL
O x oao w
W N Y - L c
m v f0 y a >
CY) 0
a�
Hcu
W u ^
�
Z O W �' :EY 7 o
W N
00 L i H Z v o
� z N � } QO �' y 10,
aZ `o C ao 0 ~ o > o Ly
3 a m
W Y -C _0 N W W a oY oo ,c
O D o L Or-i W Z N Y g_ LU o
Z 3 � p a m o v uu v a
0
-i W o
L •m OO m J N o o E o
NU O � 0 $ aa; c � `o
a
m � a` 0r-. >1 Z)
0 i 66 >= c ` c fl
> o Q -
Y W — 0 0� O Z Y
OWco D 00 Q a 0^^ E^ cE� % Q
0No V) O a -1 0
U) T-q N Wl- -a >OLa
�
Y
WZCl) 0W � +. a) .. a �
LL Y NT �_ �- LU 0 °b U 0 aci a>,
O c)i o` 4--� u m 0 , a, E L
W x W F- W N a Lam) i y o a w
W Z Q o
.� v� c c a, c
LL 0 Q vi ry LEI T W ; Q E E moo E
L m I to 0 �q C
J_ O ,�N J � � m0 � � -va
� Ln V m W W 12 j �° p=p �
H CY) Lm � U d' 0 �, � v woo
Z O Z W } c V) -,Yu ,c
Z oo vJO as a >- 0
N 0 w 'u Q> N 0 a0 °�' 3 m
OO u of (D U > � 2u Qj axiom > 0)Ln M Q mL1 NZ � N ON o i $
V N E a '� 6
(za �
• i+ V Q a Y
W � ofl � � =
V wE � � � �
O m 00 lG c
C O "- tom i
NEWYp oo � c E a,
�
0 > E - .=� W N � � .N = (z °D
aGC CZ)
W O (uO• N
Q a o ~ avvC
Q a a x vai FL- v y
Electrical Permit Application Village of Rye Brook
938 King St Rye Brook, NY 10573
Phone: (914)939-0668 1 www.ryebrook.gov
Building Department
Project Information
SBL Zone
29.74 and 1-35
Proposed Electrical Work/Fixture Count 3rd Party Electrical Inspection Agency
Replace Old attic furnace and coil,condenser SWIS
Master Electrician/Licensed Installer Information
Name Lic# Address email Phone#
Francisco J Barajas 1868 24 Walnut Street New Rochelle NY 10801 info@jbgelectriccorp.com 914-383-9276
Cell# Company Name Company Address
JBG ELECTRIC CORP 24 Walnut Street New Rochelle NY 10801
Address of Work?
Homeowner Information
Work Address
Electrical Permit Application,page 1/1
13K VILLAGE OF RYE BROOK
p y� 938 King St Rye Brook,NY 10573 ,
W
Q Y Phone:(914)939-0668 1 www.ryebrook.gov ❑
-1• 1 62• t� Building Department
Electrical/New Fixtures And Wiring(Remodel) Permit
Permit Set 37 COUNTRY RIDGE CIR P#RB 25-0058 R#129.74-1-35
PERMIT INFORMATION
Address Permit number Date issued
37 COUNTRY RIDGE CIR RB 25-0058 10/17/2025
REVIEWED BY
If you have any questions regarding the review of these drawings please contact:
Application in general
Steven Fews
stevefews@ryebrook.org
INSTRUCTION AND ATTENTION
It is the responsibility of the Applicant to print full size the entire approved permit package and provide at the time of inspection.
TABLE OF CONTENTS
Cover page 1
Building Permit 2
Required Inspections 3
3rd Party Electrical Inspection Form 4
Copy of Health Dept.Paperwork&Insurance Card 5
Electrical Permit Application 6
Building Department.938 King St Rye Brook,NY 10573/Phone:(914)939-0668
�y BR�k VILLAGE OF RYE BROOK
0 Z 938 King St Rye Brook,NY 10573
W
Q Phone:(914)939-0668 1 www.ryebrook.gov
�O
��. 42• t Building Department
INSTRUCTIONS
THE PERMIT HOLDER AND/OR PROPERTY OWNER IS RESPONSIBLE FOR ENSURING THAT ALL REQU IRED/APPLICABLE INSPECTIONS ARE SCHEDULED AND THAT
THE PERMIT IS COMPLETE
REQUIRED INSPECTIONS
Name Description
Final Electric Final Electric
STATE WIDE INSPECTION SERVICES, IRV
Cook) Service With Integrity 1
SWIS JOB 0'0 • •
APPLICATION0• •
Offi ce Use Elect. Permit ~ uaty
Bidg Pe,mrt ---
Sq Ft
Plumbing Fe,- - ----- - --- - —
Fina; Ccrtifivate
Gty! V!lags ��s 7\7:�(OO C- Z,� 1(:)S 13 (Budding Dept. County
Address 3-1 ClO.uw` , ` (�, Goss Street Section - B!oc� --- ---- --
Owner Name r Address aNr r+;(c;:z.ao,... 0 v L i Wbb Contact Nunper 7/L1,_ G/ _2� ..
❑Basement ❑ 1st Fi ❑Znd FI ❑3rd FI ❑More Tnan 3 FF. []Garage Att c ❑Outside l� es dertiial V ❑JCommeraal
Receptacles Special Recept GFCI AFCI Sv-itches Dimmerz. Smoke Alarms C!O Detector Hoof 'rasr'conroact
Amt Amps
Range(s) Cooktop(s) Oven(s; Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switc,
SERVICE
Anlu-aq, ::Panel<_ ! sP r filet ' - ;�ar_r,rri_• ❑Underground ❑ FJew ❑ Reconnect ❑ Repair
❑Overnead ❑ Upgrade ❑ Disconnect
Utility ID= !vYSEG ❑Central Hudson ❑ Orange , Rockland
PHOTOVOLTAIC SYSTEM
PV Modules inverter<; I A( Discur neet l.,nchor B C "in ne:r BuA ;-oau Center P'-Monitor Energv Storage System DC Disconrec!
❑Legalization ❑ Sntety Inspection ❑ . ri,iltitnpr
j
Emaii Addrr•
Lice; & �� -- Date �Z� Signature —
Address 9 t, 1* (fit CT &114'c - C.[, Statr me� "Q�v*L Zip Code (O
Company G• �V t�l K 1 ����. Phone v — I