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Home My WebLink AboutBP25-227 N Ln N o • ^N o\o W a a h+ l 4.T N -- � 00 b N W a O W a �J-4" w „ � b U 44 0-4 v � CL LL O � .N c w w ti 1 O ~ A > ° 3 aj W rxLeirA = hi) c Q � ►-+ z $ '° cud ° C _ �/ `O �• u A W Q Q O (� �, ++ O CO Fi F 3 ° W O1-4 S y a C rTl a �-i bA VI-�J �j 9 ° //•-i F °� Z D 0 W ti W. o0 � O. � cn O Q 0-4 A O w > a a"i ° 0 V v 0 , z c C s T-.q W 00 x H a � W Q oo W u -. O ►-1 U Z v .d � O 0 1-4 -04 OZ H c� A v IV, C� -oc) F O zo a° A V d w d U oo ti ab . ;, U d U ° >0Z w 1.0 W F ° O H z O H O ,��' za3 : Q N x (no 0 z N w U O U v z °' o Q°'a z _ �= 04 z_ 1-4 ~" O U PO 0.4 Q ' BUILDING DEPARTMENT D �� /n I� 2 VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 MAR 18 2025 "-Nvw.n,ebrook.org VILLAGE OF RYE BROOK BUILDING DEPARTMENT FOR OFFICE USE NL1 y. Approval Date: J Pvr # AP95—g p 2 Ve- 7 Application # AJZ&&j 5_04JOCQ Approval Signature: ARCHITECTURAL REVIEW BOARD: Disapproved: Date: BOT Approval Date: Case# Chairman: PB Approval Date: Case# nn secretary: ZBA Approval Date: Case#d Other: _ Application Fee: D Permit Fees:6L_c) 70 -'bu�o' EXTERIOR BUILDING PERMIT APPLICATION Application dated: 12/15/23 is hereby made to the Building Inspector of the Village of Rye Brook,NY,for the issuance of a Permit for the construction of buildings,structures,additions,alterations or for a change in use,as per detailed statement described below. 1. JobAddress: 10 Maple Court 2. Parcel ID#: 135.66/1/72 Zone: R10 3. Proposed Improvement(Describe in detail): Build a garage and mud room addition. 4. Property Owner: __ Jocelyn Dial Address: 10 Maple Court Rye Brook, NY 10573 Phone# Cell# 917-981-1271 e-mail jdiaz610@gmail.com List All Other Properties Owned in Rye Brook: Applicant: --- Jocelyn Dial -- ---- -- -- -- -- --- -- - -- - -- - — --- Address: 10 Maple Court Rye Brook, NY 10573 Phone# Cell# 917-981-1271 e-mail jdiaz610 gmail.eom Architect: Frederick F. Grippi/RMG Associates Address: 350 Theodore Fremd Ave., Rye, NY 10580 Phone# 914-698-5589 Cell# 914-260-6608 e-mail info@rmgarchiteets.com Engineer: Address: Phone# Cell# e-mail General Contractor: 1 ' a,' eau•` — Address: rouse.;^ /� Phone# 91 11—t100 - 3tt Z B Cell# o `z3 7} — &7 S Z e-mail�j.,.ir�� ere 66—Inc . o (J (1) 8/12/2021 5. Occupancy; (1-Fam.,2-Fam.,Commercial.,etc...)Pre-construction: 1 Family Post-construction: 1 Family 6. Area of lot: Square feet: 11,250 Acres: 0.25 7. Dimensions from proposed building or structure to lot lines: front yard: 30.7 rear yard: 82.25' right side yard: 7•7' left side yard: NA other: 8. If building is located on a corner lot,which street does it front on: NA 9. Area of proposed building in square feet: Basement: 1'fl: 2nd fl: 3'fl: 10. Total Square Footage of the proposed new construction: 420 11. For additions,total square footage added:Basement: I-fl: 420 2°d fl: 3`d fl: 12. Total Square Footage of the proposed renovation to the existing structure: 0 13. N.Y. State Construction Classification: 5B N.Y. State Use Classification: 1 Family 14. Number of stories: 1 1/2 Overall Height: 14' Median Height: 10•83' 15. Basement to be full,or partial: NA finished or unfinished: NA 16. What material is the exterior finish: Hardie Plank 17. Roof style;peaked,hip,mansard,shed,etc: Gable Roofing material: Asphalt Shingles 18. What system of heating: Gas 19. If private sewage disposal is necessary,approval by the Westchester County Health Department must be submitted with this application. 20. Will the proposed project require the installation of a new,or an extension/modification to an existing automatic f e suppression system?(Fire Sprinkler,ANSL System,FM-200 System,Type I Hood,etc...) Yes: No:V (if yes,applicant must submit a separate Automatic Fire Suppression System Permit application&2 sets of detailed engineered plans) 21. Will the proposed project disturb 400 sq.ft. or more of land,or create 400 sq.ft, or m9re of impervious coverage requiring a Stormwater Management Control Permit as per§217 of Village Code? Yes: No: Area: 22. Will the proposed projec require a Site Plan Review by the Village Planning Board as per§209 of Village Code? Yes: NO: V (f yes,applicant must submit a Site Plan Application,&provide detailed drawings) 23. Will the proposed project require a Steep Slopes Permit as per§213 of Village Code Yes: No: (if yes,you must submit a Site Plan Application, &provide a detailed topographical survey) 24. Is the lot located within 100 ft. of a Wetland as per§245 of Village Code? Yes: No: (f yes,the area of wetland and the wetland buffer zone must be properly depicted on the survey&site plan) 25. Is the lot or any portion thereof located in a Flood Plane as per the FIRM Map dated 9/28/07? Yes: No: (f yes,the area and elevations of the flood plane must be properly depicted on the survey&site plan) 26. Will the proposed project require a Tree Removal Permit as per§235 of Village Code? Yes: No: (fyes,applicant must submit a Tree Removal Permit Application) 27. Does the proposed project involve a Home-Occupation as per§250-38 of Village Code? Yes: No: Indicate: TIER I: TIER II: TIER III: (if yes, a Home Occupation Permit Application is required 28. List all zoning variances granted or denied for the subject property: 29. What is the total estimated cost of construction: $ 150,000 Note.The estimated cost shall include all site improvements, labor,material,scaffolding,fixed equipment,professional fees, including any material and labor which may be donated gratis.If the final cost exceeds the estimated cost,an additional fee will be required prior to issuance of the GO. 30. Estimated date of completion: (2) 8/12/2021 BUILDING DEPARTMENT VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 (914) 939-0668 RESIDENTIAL LOT AREA COVERAGE .address: 10 Maple Court Section: 135.66 Block: 1 Lot: 72 PERMITTED COVERAGE RATIOS IN RESIDENTIAL DISTRICTS (Local Law 3-88) YOUR ZONE AREA IN MAIN ACCESS. DECK ZONE DISTRICT SO. FEET BLDG. BLDG. MAX. CHECK MAX. R-35 35,000 14% 4% 5% R-25 25,000 14% 3.5% 4% R-20 20,000 14% 3.5% 4% R-15 15,000 16% 3.5% 4% R-15A 15,000 12% 3.5% 4% R-12 12,500 17% 4% 4% R-10 10,000 20% 4.5% 3.5% R-7 7,500 23% 4.5% 3.5% R-5 5,000 30% 5% 3.5% R-2F 5,000 30% 5% 3.5% Existinq: Proposed: 1. AREA OF LOT 11 ,250 Sq. Ft. 11 ,250 Sq. Ft. 2. AREA OF HOUSE a. Coverage of Main Building (Including Attached Garage or Accessory Building) 1587 Sq. Ft. 2007 Sq. Ft. b. Area of 1 st Floor Divided By Area of Lot x 100 14.1 1 % 17.84 % 3. AREA OF ACCESSORY BUILDING (Includes Detached Garages,Tool Shed, Playhouses) 72 Sq. Ft. 72 Sq. Ft. a. Coverage of Accessory Building Area of Accessory Building Divided By Area of Lot x 100 .64 % .64 % 4. AREA OF DECK 267 Sq. Ft. 267 Sq. Ft. a. Coverage of Deck Area of Deck Divided By Area of Lot x 100 2.37 % 2.37 I attest to the b st of in e and belief,the above infonnation is correct. rc tectI Si (3) 8/12/2021 BUILDING DEPARTMENT VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 (914) 939-0668 IMPERVIOUS COVERAGE RATIOS RESIDENTIAL DISTRICTS Address: 10 Maple Court Section: 135.66 Block: 1 Lot: 72 Zone: R-10 IMPERVIOUS SURFACES (Definition): All buildings, as defined herein, and all areas on the ground or elevated above the ground which are comprised of materials through which water cannot readily flow, including, but not limited to asphalt, concrete, masonry, wood, gravel and clay, and which consist of elements including, but not limited to, court yards, sports courts, swimming pools, patios, sidewalks,ramps, terraces and driveways. TOTAL MAXIMUM PERMITTED MAX. PERMITTED COVERAGE Zoning IMPERVIOUS LOT AREA BY IMPERVIOUS SURFACES District COVERAGE IN FRONT (sq.ft.) For Base Lot For Lot Area YARD(%) Area (sq.ft.)* Over Base R-35 15 Lot Area % R-25 20 0 to 4,000 0 55 R-20 30 4,001 to 6,000 2,200 35 6,001 to 12,000 2,900 27 R-15 35 12,001 to 16,000 4,520 26 R-15A 35 16,001 to 20,000 5,560 25 R-12 40 20,001 to 30,000 6,560 24 30,001 to 40,000 8,960 23 R-10 45 40,001 & larger 11,260 22 R-7 40 R-5 30 *"Base Lot Area"is the minimum end of the lot size R2-F 30 range in the"Lot Area" column Area of lot: 11,250 s .ft. Existing Allowed Proposed Total impervious coverage = 3450 S .ft. 4317.23 S . ft. 3639 S .ft. Front impervious coverage = 29.9 % 45 % 32.35 % I attest t k ef,the above information is correct. rchite is ignature (4) 8/12/2021 BUILDING DEPARI'MENT VILLAGE OF RYE BROOK 938 KING STREET RYE BROOK,NY 10573 (914)939-0668 BULK REGULATIONS IN RESIDENTIAL DISTRICTS Address: 10 Maple Court Section: 135.66 Block: 1 Lot: 72 MAXIMUM GROSS FLOOR AREA USE FORMULA: Maximum Gross Floor Area = 4,000 + [ (Lot Area -21,780) x 0.11478421 ]: a. Allowed = 2791 .32 Sq. Feet b. Existing = 2438 Sq. Feet c. Proposed = 2858 Sq. Feet HEIG FIT/SETBACK RATIOS FOR RESIDENTIAL DISTRICTS DEFINITION: A standard designed to regulate the height of a building in relation to the average grade of the corresponding portion of the lot line from which it is set back. The ratio modifies the maximum permitted Height of Building by forming an inclined plane beginning at the average grade along the portion of the lot line from which the setback is measured and rising toward the building at the specified ratio above which no part of any building, other than minor architectural features such as chimneys, skylights and dormer windows not covering more than 10% of the entire roof area, shall be permitted to extend. Height and Setback shall be calculated using the formula; Height/Setback =X, where X is the required side or front yard ratio for the zoning district in which a property is located as specified in Article VIII of Chapter 250. A complete elevation view for the proposed improvement must be included on the drawings. FILL IN YOUR RATIOS: ZONE EMS77NO PROPOSED RE04VIRED FRONT: FRONT: FRONT: .44 /P4IrS SIDE: SIDE: SIDE: 1.20 FRONT: FRONT: FRONT: .48 "S SIDE: SIDE: SIDE: 1.30 FRONT: FRONT: FRONT: .60 /Pi20 SIDE: SIDE: SIDE: 1.60 FRONT: FRONT: FRONT: .60 R f5 SIDE: SIDE: SIDE: 1.60 FRONT: FRONT: FRONT: .80 RLISA SIDE: SIDE: SIDE: 2.40 FRONT: FRONT: FRONT: .69 AILIZ SIDE: SIDE: SIDE: 1.60 FRONT: .49 FRONT: .42 FRONT: .80 R_to SIDE: 1 SIDE: 1 .93 SIDE: 2.40 FRONT: FRONT: FRONT: .96 /R61 SIDE: SIDE: SIDE: 3.00 FRONT: FRONT: FRONT: 1.20 R-S SIDE: SIDE: SIDE: 4.00 FRONT: FRONT: FRONT: 1.20 RZZF SIDE: SIDE: SIDE: 4.00 1 attest to t o m nowledge a belief, the above information is correct. i ec s Sign (s) silzizozl ILLUSTRATION OF HEIGHT / SETBACK RATIO Setback Lkw tar— I Mexknurn HoI¢rt I / Hinman-- Setback Line � I I L�t: m'I,! .Y (n HOUSE '^ 2 POTENTIAL = 5 $p 5$p / I BUILDING c ENVELOPE E; " A/� / I I ** FROM _L Area In wl►d Avers" Grade Is Meast"d STREET Average Grade Along Property Line at Property Lk» ELEVATION PLAN ****************************************************************************************** Table R301.2.0) 2020 IRC CLIMATIC & GEOGRAPHIC DESIGN CRITERIA FOR RESIDENTIAL DISTRICTS IN RYE BROOK GROUND- WIND SPEED TOPOGRAPHIC SPECIAL WIND- SEISMIC DESIGN SNOW LOAD (mph) WIND EFFECTS WIND BOURNE CATAGORY WEATHERING REGION DEBRISZONE 20 psf 115/120 NO NO ND 0 SEVERE FROST LINE TERMITE WINTER DESIGN ICE BARRIER FLOOD AIR FREEZING MEAN ANNUAL DEPTH PROTECTION TEMP. UNDERLAYMENT HAZARDS INDEX TEMP. REDUIRED REQUIRED 47' YES 15 YES FIRM MAP 1000 52.2 38119CO27OF 9/28/07 (5a) 8/12/2021 BUILDING DEPARTMENT VILLAGE OF RYE BROOK I"- ' 938 KING STREET RYE Bitom,NY 10573 1 _ I MAR 18 2025 (914)939-0668 L N ww'.r-*ehrook.or(_)r VILLAGE OF RYE BROOK 131 liv)wc, pEPARTMENT AFFIDAVIT OF COMPLIANCE VILLAGE CODE §216 • STORM SEWERS AND SANITARY SEWERS THIS AFFIDAVIT MUST BEAR THE NOTARIZED SIGNATURE OF THE LEGAL PROPERTY OWNER AND BE SUBMITTED ALONG WITH ANY BUILDING OR PLUMBING PERMIT APPLICATION . ANY BUILDING OR PLUMBING PERMIT APPLICATION SUBMITTED WITHOUT THIS COMPLETED AND NOTARIZED FORM WILL BE RETURNED TO THE APPLICANT . STATE OF NEW YORK,COUNTY OF WESTCHESTER ) as: Jocelyn Diaz ,residing at, 10 Made Court Rye Brook, NY 10573 (Prin; ,:) a live) being duly sworn, deposes and states that(s)he is the applicant above named, and further states that(s)he is the legal owner of the property to which this Affidavit of Compliance pertains at; 10 Maple Court , Rye Brook,NY. (.lob Address') Further that all statements contained herein are true, and that to the best of his/her knowledge and belief,that there are no known illegal cross-connections concerning either the storm sewer or sanitary sewer, and further that there are no roof drains, sump pumps, or other prohibited stormwater or groundwater connections or sources of inflow or infiltration of any kind into the sanitary sewer from the subject property in accordance with all State, County and Village Codes. (Signalurc o ProP r(h i Jocelyn Diaz (Print Name Ptohen) 1+h Sw is I� day o HANTELL S SMALLS N ry Public-State of New York NO.01SM6249686 Qualified in Westchester County INoi in Puhli t Commission Expires Oct.11,2027 (6) 8/1 2!2021 This form must be properly completed & notarized by the Design Professional of record and the Property Owner. Failure to provide this complet Ln wit 4,0114: permit application will delay the permitting proce .D [E C _ N E DD F� MAR 18 2025 Notice of Utilization of Truss Type, Pre-Engineered IX agGE OF RYE BROOK or Timber Frame Construction. o itic 19 Part 1264& 1265 NY(I�_L_-DING_DEPAR T MENT To: The Building Inspector of the Village of Rye Brook. From: Frederick F. Grippi / RMG Associates Subject Property: 10 Maple Court SBL: 135.66/1/72 zone: R-10 Please take notice that the subject;XOne or Two Family; ❑ Commercial, ❑ New Structure )<Addition to an Existing Structure ❑Rehabilitation to an Existing Structure to be constructed or performed at the subject property will utilize; ❑ Truss Type Construction (17) ❑ Pre-Engineered Wood Construction(PW) imher Construction(TC) in the following location(s); ❑ Floor Framing, including Girders& Beams (F) oof Framing(R) ❑ loor Framing and Roof Framing(FR) Please note that prior to the issuance of the Certificate of Occupancy, the subject dwelling or building utilizing truss type, pre-engineered wood, or timber construction must be posted with a Truss Identification Sign, installed in conformance with NYCRR §t264 for Commercial Buildings, and NYCRR§1265 for One&Two Family Dwellings. J4-Lk ^P PCA-3 Y Sworn tobefare me this I Swom t2,before me this '2 day of 20 day of 20 S operty Signature of rofessional i AZ Frederick F. Grippi Print e o erty O r of Desi P essional L No. ry Public 5,me ublic ANTELL SMALLS Notary Pu ' -St a of New York NO.01SM6249686 Qualified in Westchester County JOANNA C.FELDMAN MY:ommission Expires Oct 11, 2027 Notary Public-State of New York No.02FE6103308 OualMed in Westchester County (7) Commission Expires May 9,20 This application must be properly completed in its entirety by a N.Y. State Registered Architect or N.Y. State Licensed Professional Engineer & signed by those professionals where indicated. It must also 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. Please note that application fees are non-refundable. STATE OF NEW YORK, COUNTY OF WESTCHESTER ) as: Frederick F_ Grinoi ,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 legal owner of the property to which this application pertains, or that (s)he is the Arch itect for the legal owner and is duly authorized to make and file this application. indicate architect,contractor;agent,attomev,etc-) 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. By signing this application, the property owner further declares that he/she has inspected the subject property,and that to the best of his/her knowledge there are no roof drains, sump pumps or other prohibited stormwater or groundwater connections or sourc9s of infiltration into the sanitary sewer system on or from the subject property. Swom to before me this ! Swom to before me this ` day of�, 20 0-;L �� day of , 20 Signature of tffM11Signature o pplicant Jocelyn Diaz Frederick FFrederick F. Gri�i Print Name Print Name of Applicant ELL S SMALLS a ublic-State of New York 0.01SM6249686 No Public ua.i a in Westchester County N t blic My commis ion Expires Oct 11, 2027 51 JOANNA C.FELDMAN Notary Public-State of New York No.02FE6103308 Qualified in Westchester County n p Commission Expires May 9,20 •C Q (g) 8/12/2021 C N c� O Y ` N +.+ O>, Cal > > u �--� .-� cl ` c -0 "c aLA LL :t GJ -0 C4 O cu rl \ C. a O n\jJ E 7 1..� W o � � m c CL a LLi a; " A LT x ~ o a O w w N L - ^ a w z �a L 0 > H w u L^ vL Z wF_ r ` moo C4 HZ N 30 cC4 lu 3 aZ L pa O >.- u O ._ p Y N LLI H w o x E 0 `� 0 w ° v > 3 E ct Z = � am O 4) W-0 N c a W L J N o o E o Q r- o Np OT >..o m � 3 Co OV oo > oQ a 3 Yu — �W L L pZ v) �, 6 > O w 00 } U Q Q c 0 r`a ' O � � V) OZ E aJ o v �O Y v mNp U O C c/) a w � v c 1 c N v Z p w o 0 w Z M o a o co O W } 9! �..� y p com C U > car °�{ � v � Y %11 X a •x � v a� w0 aou c � a, > LL OMO� a` Licu � a J °° a wZ w a` v CN a d i o a w 00 00 D Q 0 } O O O v Q C w Q E E e4 E J /� � Z U c � �. L G = OA N c .0 i � Q/ �- J a-i � f0 > z U N u U Q � O 0 a > _ > ° m p as Ea -0E �� M Q `p ti w J O\ X cn Q 0.0 au � 3 m O � a c N 2 U Q� X �' •°' v U 1 O (n n Q O OL u LLI c N c > } Lr) � Q W e-a -0 J r-I CV o — o L Lu • N — E O vl O 4-1 m O "O 2 z g a o V � W 0 � N oa => � w V OM0 � vc NEw you o > E G n l ~ w J w O 0 -t 0. Q) w °o b a' w 0 E M y U p a = Q y L Y �d �C w p Q Q O F_ .'i' y N U Q jL Electrical Permit Application Village of Rye Brook /i 938 King St Rye Brook, NY 10573 Phone: (914)939-0668 1 www.ryebrook.gov Building Department Project Information SBL Zone 135.66-1-72 Proposed Electrical Work/Fixture Count 3rd Party Electrical Inspection Agency 14 Receptacles;12 Lights; 7 Switches Swis Master Electrician/Licensed Installer Information Name Lic# Address email Phone# Cell# Company Name Jose Campos 1889 1029 Wilcox Ave, 1A, Bronx, NY 10465 Icon Electric INC Company Address 1029 Wilcox Ave,1A, Bronx, NY 10465 Address of Work? Homeowner Information 10 Maple Ct, Rye Brook, NY 10573 Electrical Permit Application,page 1/1 y [iRCV VILLAGE OF RYE BROOK V. 938 King St Rye Brook,NY 10573 3► Q Phone:(914)939-06681 www.ryebrook.gov 1982 Building Department ❑ Electrical/New Fixtures And Wiring(New) Permit Permit Set 10 MAPLE CT P#RB25-0131 R#135.66-1-72 PERMIT INFORMATION Address Permit number Date issued 10 MAPLE CT RB25-0131 11/26/2025 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 Electrical License-Photo-Westchester County 5 Electrical Permit Application 6 Building Department.938 King St Rye Brook,NY 10573/Phone:(914)939-0668 �y BRnv� VILLAGE OF RYE BROOK 938 King St Rye Brook,NY 10573 W � Q Y Phone:(914)939-0668 1 www.ryebrook.gov O �962 Building Department INSTRUCTIONS THE PERMIT HOLDER AND/OR PROPERTY OWNER 15 RESPONSIBLE FOR ENSURING THAT ALL REQUIRED/APPLICABLE INSPECTIONS ARE SCHEDULED AND THAT THE PERMIT IS COMPLETE r 5� � 7 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. Certificate of Occupancy Completion of ALL Work,All fees Paid and Final Survey in if required) STATE WIDE INSPECTION SERVICES, INC. ••• • • *SWIS . : APPLICATION tel 845.202.7224 1 fax 914.219.1062 1 SWISNYcoml SWISTRAINING.COM Office Use Elect, Permit# Date Bldg Permit# Scl Ft Plumbing Permit# Final Certificate# City/Village Rye Brook Zip Building Dept. County Address 10 Maple Court Cross Street Section Block Lot Owner Name/Address(If different than above) Felix Diaz Contact Number ❑Basement ❑1st Fl. ❑2nd Fl. ❑3rd Fl. ❑More Than 3 Fl. ❑Garage ❑Attic ❑Outside ❑✓ Residential ❑Commercial Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/0 Detector Hood Trash compact 14 Amt Amps 7 Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch SERVICE Amperage #Panels 1P 3P #Meters #Disconnect ❑Underground Q New ❑ Reconnect ❑ Repair ❑Overhead ❑ Upgrade ❑ Disconnect Utility ID# ❑Con Ed ❑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 Scope of Work Installation of: 14 Receptacles; 12 lights; 7 switches - in house extension 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 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 as set forth for the application. 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