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BUILPING DEPARTMENT
VIL ' ' E OF RYE`BROOK A AUG 1 4 2025
938 KIN ET RYE B UK.NY 10573
VILLAGE OF RYE BROOK
V19
g0VBUILDING DEPARTMENT
ELECTRICAL PERMIT APPLICATION
Westchester County Master El tricians License Required
�
FOR OFFICE USE ONLY BP#: EP#:or
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Approval Date: � Permit Fee: S /
� VT 13�___ 7_
Approval Signature: Other:
DO NOT START WORK or CONSTRUCTION UNTIL A PERMIT HAS BEEN ISSLIED 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
Application dated, 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: Z O8 lU r77 v y g id9 P DY SBL: 2�, r— Zone:
2.Property Owner: &nnd h AF1a Yl/ti e1 Address: Z Q CCu)i�k i d ff f D�
Phone#: t �� -S?, 9 Cell#: email:3.Master Electrician/Licensed Installer: to k7o Address: dko Wle
Lic. Phone#: l Cell 4: 'ski oemai, I' i/fvy
Company Name: L�S��r �l� Y((, 5���/�[t� Address: ft)
4.Proposed Electrical WorkiTixture Count:
Vc-vairs
a
5.3'd Party Electrical Inspection Agency: f
STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as:
,being duly swom,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.
(Master Electrician I 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 Sworn t fore me this
day of �- ,20 day of — 0
Signature of Property Owner Signatur o App Ic
KP„„
I-IM,
Name of Prope Own r rin ame of Applicant
Notary Pal MELILLO N Ijn.Nrilgic,State of New York
otary NPublic,State of New York No.01ME6160063
No.O1ME6160063 6/l/2024
Qualified in Westchester County —J1
Qualified In Westchester County Commission Expires January 29,2Qz�
Commission Expires January 29,20 '
STATE WIDE INSPECTION SERVICES, INC.
r•r • •
APPLICATIONSWIS JOB r2.7224 1 fax 914.219.1062 1 SWISNY.coml •
Office Use Elect. Permit# � — �.� Date
Bldg Permit# Sq Ft
Plumbing Permit#
Final Certificate #
City/Village Q Zi `� Buildin De t. County
g I jp e p i 9 P R � (. /
Address O Cross Street Section Block Lot /
Owner Name/Address(If different than above) Ke no Fyq,4 4e / Contact Number /�_s (o —53 2 3
❑Basement ❑ 1st FI. ❑2nd FL ❑3rd FL ❑More Than 3 Fl. ❑Garage ❑Attic N Outside CgResidential ❑Commercial
Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/O 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
❑Overhead ❑ Upgrade ❑ Disconnect
Utility ID# ❑Con Ed L_._l NYSEG ❑Central Hudson ❑ Orange/ Rockland
PHOTOVOLTAIC SYSTEM
PV Modules Inverters AC Disconnect ]unction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect
❑Legalization ❑ Safety Inspection ❑Consultation
Rc� pa W-S 0('M i,n f OuCaY7 ai t5 0 0 A C :4
�Ll , Di
AUG 14 2025
VILLAGE OF
RYE BROOK i
BUILDING DEr''ARTMEN
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,fat 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 Lo I E JylL' L(C 7 cow Name
License # I ✓ Date C) rq_ Signature
Address [ City/State N "Ai A, zip Co
Company �/ r I Phone# f'I — —^7 Z yJ
_D State Wide Inspection Services
1080 Main Street
Fishkill, NY 12524
a 4S AUG 19 2025 845 202-7224 Phone
914-219-1062 Fax
STATE WIDE INSPECTION SERVICES VILLAGE OF RYE BROOK Email: officeCaOswisny.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:
Laser Electric Services, LLC Kenneth & Fran Frankel
Gustavo Aquino 208 Country Ridge Drive
137 Pelham Road Rye Brook, NY 10573
New Rochelle, NY 10805
Located at: 208 Country Ridge Drive, Rye Brook, NY 10573
Section: Block: Lot: Electrical Permit Number: EP25-215
129.75 1 1
Certificate Number: 2025-5555 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: 208 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 181h day of August 2025.
Name Quantity Rating Circuit Type
*Replacement of Service Entrance Conductor and Meter Pan.
Y.
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.