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HomeMy WebLinkAboutMP25-102 eq N Yp ) W TIV Ln N II a W H V k �. P. a to ed N4. N W Cog On p 010 ow fl 'n M O ¢ o �v 'oe �+ L O W00 p � 0vov4. 8 ~ W z V u G V w CUD z 4 v z 00 d U = a Z a U O OZ � g * N CO Up W Ca Z oo � ,4Cw U V o N : : 10 O H V ice" w o w Ho y E..i u c � � j °" � BUIa-mc ENT D VILOK JUN 3 0 2025 938 KINGNY 10573 VILLAGE OF RYE BROOK v BUILDING DEPARTMENT APPLICATION FOR PERMIT TO INSTALL AND/OR REMOVE HEATING VENTILATION AND/OR AIR CONDITIONING E UIPME/NT FOR OFFICE USE ONLY: PERMIT#: Approval Date: J U L 0X2*-� Permit Fee: $ Approval Signature: Other: Disapproved: (fees are non-refundable) DO NOT START WORK or CONSTRUCTION UNTIL 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: 1. 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#C105.2 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 - 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. p ` / 1. Address:�� bt>ral A—refn g �1 *P IdIP.S} SBL:/c� /r C� —'�'�+�• /Lone: u� r 2. Property Owner: UN D4 B r-CiOn Address: (p [ ht`Q r�Jrt°�'n k✓ Phone#:9/,/- S5 cis 357/ Cell#: email: 3. Contractor: Pt it c!H L' me'e-ha rl l Cal Address: g+oO 0. ry,)A,1 b S 1 - .0 Phone#:C1(y °13y. 3 [) Cell#: . L I email:11n.6 ---r 4. Scope of Work: New Installation( Replacement( ►• Removal( )•Other( ): 5. List Equipment: Le r)r-,b X C.jt)E)if e rt F L�_r n Me 4-coa 6. Location of Equipment: ++ 1 .tQQf,- Q!gb 7. Method of Installation/Removal(list all equipment needed to perform job): 1 6/l12025 STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: t on be g-C _,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 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. L Sworn to before me this Sworn to before me this day of �w` 20�� day of�� 20 Signa a of Property wner ign ure of A p icant it J n Name of Property Rwner Abary f A icant Notary PublicSHARI MELILLO ie Notary Public,State of New York No.01ME6160063 I.INA 1M IAl.E1V Qualified In Westchester County lliokwy Public,B HA 01 Now York COMMIssfon Expires January 29,20 Z� No.OIWH63945W ©ualified In Westchester C AV CQlrn"fission Expku 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 6/1/2025 C O • ��; N o Y 0 .— O\ r E CN a a v c v y v LZ> � o - n Q W v I L N m J.I c H _ � a a Lv v � 0 LL O x o ao w W E C �0 `° L n , O 4! 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Homeowner Information 60 DORAL GREENS DR WEST Electrical Permit Application,page 1/1 BRC�k VILLAGE OF RYE BROOK . . W P 938 King St Rye Brook,NY 10573 Phone:(914)939-0668 1 www.ryebrook.gov . 1 02. Building Department Electrical/New Fixtures And Wiring(Remodel)Permit Permit Set 60 DORAL GREENS DR W P#RB25-0080 R#129.26-1-6.1 PERMIT INFORMATION Address Permit number Date issued 60 DORAL GREENS DR W RB25-0080 10/29/2025 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 Electrical License 5 Electrical Permit Application 6 Building Department.938 King St Rye Brook,NY 10573/Phone:(914)939-0668 BRnuk VILLAGE OF RYE BROOK O 938 King St Rye Brook,NY 10573 W � Q Phone:(914)939-0668 1 www.ryebrook.gov > �O ��• b2• Building Department INSTRUCTIONS THE PERM IT HOLDER AND/OR PROPERTY OWNER IS RESPONSI BLE FOR ENSURI NG THAT ALL REQU IRED/APPLICABLE I NSPECTIONS ARE SCHEDULED AND THAT THE PERMIT IS COMPLETE ❑� ❑� REQUIRED INSPECTIONS Name Description Final Inspection Completion of all required items under the permit including the site grading and the surveyor's final grading certificate. Final Electric Final Electric STATE WIDE INSPECTION SERVICES, INC. 0.• • • SWIS JOB APPLICATION0. Office Use Elect. Permit # Date Bldg Permit # Sq Ft Plumbing Permit # Final Certificate # City/Village �J, Zip F,,Idng Dept. County Address /t� �n et Section Block Lot Owner Name/Address'If different than above) me, &-&ain Contact Number ❑Basement ❑1st FI. ❑ 2nd FL ❑3rd FL ❑More Than 3 A. ❑Garage ❑Attic ❑Outside Residential ❑Commercial Receptacl Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/O Detector Hood Trash Compact 1 Amt Amps 3 Range(s) Cooktop(s) Oven (s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer swam SERVICE Amperage #Panels 1P 3P # Meters # Disconnect ❑Underground ❑ New ❑ Reconnect ❑ Repair [—]Overhead ❑ Upgrade ❑ Disconnect Utility ID# [:]Con Ed ❑NYSEG ❑Central Hudson ❑orange/Rockland PHOTOVOLTAIC SYSTEM PV Modules Inverters AC Disconnect Juncton Box Combiner Box Load Center PV Monitor Energy Storage Systern DC Disconnect ❑Legalization ❑ Safety Inspection ❑Consultation Scope of Work U)4 2.L 00. 1 his application a vehd for one(1)year from the date received by SWIS.This application Is intended to cover the above listed Hems to be inspected,If at any time of inspection additional items have been installed,you are ._honed to make the inspection and adjust the fee for the additional Items Inspected.The applicant declares that there is no open application,for the above address with any other inspection company.The applicant owner ur authorieed agent agrees to all the above terms 7and dcconndidoonns/as set ffoortthh,°or the application. Email Address )1) tZ (v-0) Name 4K-6/?u 5-60 1 4 Q-S License # Date / �l (5��j}1 Signature' Qi7 Address 4 C�lr ll '2 City/State �J�w e Zip Code Company Jv �' e G Phone# L2