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STATE WIDE INSPEC'TION SE"ICES, INC.
Service With Inlegrio
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SWIS JOB APPLICATION tel +2.7224 1 fax 914.219.1062 1 SWISNYcoml SWISTRAINING.COM
Elect, Permit# r 10 Date 12-30-2025
Bldg Permit# Scl Ft
Plumbing Permit#
Final Certificate#
City/Village Rye Brook Zip 10573 Building Dept, County Westchester
Address 1186 King St, Cross Street Section 124.48 Block 1 Lot 3
Owner Name/Address(If different than above) Cerebral Palsy of Westeheste Contact Number (914) 384-4060
❑Basement ❑ 1st FI. 0 2nd Fl. ❑3rd H. ❑More Than 3 FI. ❑Garage ❑Attic ❑Outside ❑Residential ✓❑Commercial
Receptacles Special Recept GFCI AFCI Switches Dimmers Smoke Alarms C/O Detector Hood dash 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# El 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
-Replace (1) Emergency light ELL,
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- Replace (1) 2-prong receptalce to a quad receptalce
As per Fire Department Inspection.
5DC 31 2425
[---..- r___
VILLAGE OF RYE BROOK
rUILbING DE-PARTMENT
This application is valid for one(t i year from the dare received by SWIS.This application is intended to cover the above listed items to be inspected,if at anytime of Inspection additional items have been insia led.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 a II the above terms and conditions as set forth for the application.
Email Address info@agelectricny.com Name Andres Gonzalez
License# E-1708 Date 12/30/20 Signature
Address 40 Rutland St. City/State Mount Kisco Zip Code 10549
Company AG Electric, Inc. phone# (914)292-0110
State Wide Inspection Services
L ...... 1080 Main Street
C Fishkill, NY 12524
RECEIVED 845 202-7224 Phone
ILN 914-219-1062 Fax
STATE WIDE INSPECTION SERVICES Email: Q11({ice0bswisny.com
Service With Integrity
VILLAGE OF RYE BROOK Website: www.swisny.com
BUILDING DEPARTMENT
BY THIS CERTIFICATE OF COMPLIANCE STATE WIDE INSPECTION SERVICES
CERTIFIES THAT:
Upon the application of: Upon Premises Owned by:
AG Electric Inc Cerebral Palsy of Westchester
Andres Gonzalez 1186 King Street
40 Rutland Street Rye Brook, NY 10573
Mount Kisco, NY 10549
Located at: 1186 King Street, Rye Brook, NY 10573
Section: Block: Lot: Electrical Permit Number: EP 26-001
124.48 1 3
Certificate Number: 2026-0695 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: 1186 King Street, Rye Brook, NY 10573
The was inspected in accordance with the NYS and NFPA 70-2023 and the detail of the installation, as
set forth below, was found to be in compliance on the 41h day of February 2026.
Name Quantity Rating Circuit Type
Emergency Light 01
Quad Receptacle 01
J r'
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%vork performed on the date of inspection only.