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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
Proposed Electrical Work/Fixture Count 3rd Party Electrical Inspection Agency
200AMP SERVICE UPGRADE SWIS
Master Electrician/Licensed Installer Information
Name Lic# Address email Phone# Cell# Company Name Company Address
NICHOLAS CUCCIA 1661
Electrical Permit Application,page 1/1
�yC BRnvt VILLAGE OF RYE BROOK
938 King St Rye Brook,NY 10573kv
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Q Y Phone:(914)939-0668 1 www.ryebrook.gov
Building Department
Electrical/Panel(Repair) Permit
Permit Set 17 DORAL GREENS DR W P#RB 25-0004 R#129.34-1-26
PERMIT INFORMATION
Address Permit number Date issued
17 DORAL GREENS DR W RB 25-0004 11/03/2025
REVIEWED BY
If you have any questions regarding the review of these drawings please contact:
Zoning review Application in general
Steven Fews Steven Fews
stevefews@ryebrook.org 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
Proof of Insurance 4-5
Proof of Insurance 6
Electrical License-Photo-Westchester County 7
Proof of Insurance 8-9
Electrical Permit Application 10
Building Department.938 King St Rye Brook,NY 10573/Phone:(914)939-0668
VILLAGE OF RYE BROOK
938 King St Rye Brook,NY 10573
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Phone:(914)939-0668 1 www.ryebrook.gov
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��• 02• ? Building Department
INSTRUCTIONS
THE PERMIT HOLDER AND/OR PROPERTY OWNER IS RESPONSI BLE FOR ENSURI NG THAT ALL REQU IRED/APPLICABLE INSPECTIONS ARE SCHEDULED AND THAT
THE PERMIT IS COMPLETE
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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.
Rough Electric Rough Electric
Final Electric Final Electric
STATE WIDE INSPECTION SERVICES, INCI
Service With Integrity —
••• OFFICECdSWISNY.COM
SWIS • : APPLICATION tel 845.202.72240. •
Office Use Elect.Permit# Date 6/4/2025
Bldg Permit# Scl Ft
Plumbing Permit#
Final Certificate#
City/Village Rye Brook Zip 10573 Building Dept. Rye Brook County Westchester
Address 17 Doral Green West Cross Street Section 129.34 Block 1 Lot 26
Owner Name/Address(If different than above) Jeffery Kralstein Contact Number 973-462-4969
❑✓ 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
Amt Amps
Range(s) Cooktop(s) Oven(s) Dishwashers Refrigerator Disposal Microwave Luminaires Generator Transfer Switch
SERVICE
Amperage #Panels 1P I 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 Junction Box Combiner Box Load Center PV Monitor Energy Storage System DC Disconnect
❑Legalization ❑ Safety Inspection ❑Consultation
Scope of Work
Panel Change& GFI Protect Outlet
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.
Email Address NICK.CUCCIA@BRUCAMINC.COM Name NICHOLAS CUCCIA
License# 1661 Date 6/4/25 Signature ,
Address 100 GRASSLANDS RD City/State ELMSFORD NY zip Code 10523
Company BRUNI &CAMPISI INC. Phone# 914-847-6741
RD
(-� � (r (1 n/J �c? State Wide Inspection Services
/ � FC EC � `/ L1080 Main Street
C ID Fishkill, NY 12524
EC - 1 2025 845 202-7224 Phone
914-219-1062 Fax
STATF WIDE INSVFC T,ON SFRVICt% Email: office@swisny.com
VILLAGE OF RYE BROOK Website: www.swisny.com
Semite With Integrity BUILDING DEPARTMENT
BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES
CERTIFIES THAT:
Upon the application of: Upon Premises Owned by:
Bruni &Campisi Jeffrey Kralstein
100 Grasslands Rd 17 Doral Greens Drive West
Elmsford, NY 10523 Rye Brook,NY 10573
Located at: 17 Doral Greens Drive West, Rye Brook, NY 10573
Section: Block: Lot: Electrical Permit Number: RB 25-0004
129.34 � 1 ] 26 1
Certificate Number: 2025-8359 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: 17 Doral Greens Drive West, Rye Brook, NY 10573
The Garage 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 26"' Day of November 2025.
Name Quantity Rating Circuit Type
Sub Panel 01 200 Amp
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.
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