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VILLAGE (�WYRYE BROOK
WESTCHESTER COUNTY, NEW YORK
NO: 25-003
Certificate of Occupaurp
This is to certify thatjoba4ha-,'-2 F /
of, &O N having duly filed an application on
Jt 20 requesting a Certificate of Occupancy for the premises known as,
Rye Brook,NY, located in a RPT Zoning
District and shown on the most current Tax Map as Section: f Block: __L Lot: ,
and having fully complied with the requirements of the Building Code and the Zoning Ordinance under Building
Permit No. , issued `'/ 19 Q0, such authority and permission is hereby granted
to the property owner to lawfully occupy or use said premises or building or part thereof listed under the following
New York State Classifications, Use: Construction:
for the following purposes: -6 e M
Subject to all the privileges, requirements, limitations, and conditions prescribed by law, and subject also to the
following:
This certificate does not in any way relieve the owners or any person or persons in possession or control of the premises,
building,or any part thereof from obtaining such other permits or licenses as may be prescribed by law for the uses or purposes
for which the building or premises is designed or intended. Furthermore, it does not relieve such owners or persons from
complying with any lawful order issued with the object of maintaining the premises or building in a safe and lawful condition.
No changes or rearrangement in the structural parts of the building or in the exit facilities shall be made,and no enlargement,
whether by extending on any side or by increasing in height shall be made,nor s e building be moved from one location
to another until a permit to accomplish such change ha uilding Inspector.
%7r
Building Inspector,Village of Rye Brook: Date: JAN 0 6 2025
i BUILD �MENT For use on
N - 2 2025 1 VIL _ OK
ff JAN ISSUED: — 5—
L� 938 KiNc STRE `'' t YoRK 10573 DATE:
VILLAGE OF RYE BROOK ' FEE: /5 C� PAM
BUILDING D1=PARTMFNT
APPLICATION FOR CERTIFICATE OF OCCUPANCY, CERTIFICATE OF COMPLIANCE,
AND CERTIFICATION OF FINAL COSTS
TO BE SUBMITTED ONLY UPON COMPLETION OF ALL WORK, AND PRIOR TO THIS FINAL INSPECTION
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Address: 27 Brookridge Court, Rye Brook, NY 10573
Occupancy/Use: Residential Parcel ID#: 141.43-1-54 Zone:
Owner: Jonathan &Amy Goldberg Address: 27 Brookridge Court, Rye Brook, NY 10573
P.E./R.A.or Contractor: Address:
Person in responsible charge: Address:
Application is hereby made and submitted to the Building Inspector of the Village of Rye Brook for the issuance of a
Certificate of Occupancy/Certificate of Compliance for the structure/construction/alteration herein mentioned in accordance
with law:
STATE OF NEW YORK,COUNTY OF WESTCHESTER as:
Jonathan &Amy Goldberg beingduly swom,deposes and says that he/she resides at 27 Brookridge Court, Rye Brook, NY 10673
(Print Name of Applicant) (No.and Street)
in Village of Rye Brook ,in the County of Westchester in the State of NY ,that
(Cityrrown/village)
he/she has supervised the work at the location indicated above,and that the actual total cost of the work,including all site improvements,
labor,materials,scaffolding,fixed equipment,professional fees,and including the monetary value of any materials and labor which may
have been donated gratis was:S Unknown
for the construction or alteration of. Single Family Residence -Temporary Certificate of Occupancy was issued 5/19/1995;
however, Final Certificate of Occupancy for this unit was never issued.
Deponent further states that he/she has examined the approved plans of the structure/work herein referred to for which a Certificate of
Occupancy/Compliance is sought,and that to the best of his/her knowledge and belief,the structure/work has been erected/completed in
accordance with the approved plans and any amendments thereto except in so far as variations therefore have been legally authorized,and
as erected/completed complies with the laws governing building construction.Deponent further understands that it shall be unlawful for an
owner to use or permit the use of any building or premises or part thereof hereafter created,erected,changed,converted or enlarged,wholly
or partly,in its use or structure until a Certificate of Occupancy or Certificate of Compliance shall have been duly issued by the Building
Inspector as per§250-10.A.of the Code of the Village of Rye Brook.
Sworn to before me this Swom to before me this w
day of January ,20 25 Adayonuary , 2025
Signature perry Owner A I' t
Jonathan &A Gol Iber Jonatha Amy Gold g
Print Name of Prope y Owner Print Na rof
Lop
Notary Public Notary Pub
JOSEPH W. JO NTO
Notary Public, SkvACINTO
le of New York Notary Puew York 6/1/2024
No. 02D19822692 No. 02 D I9822692
Qualified in Westchester County Qualified in Westchester County
Commission Expires February 28, 2027 Commission Expires February 28,2027
QyE BRC�v�
198,2 BUILDING DEPARTMENT
❑BUILDING INSPECTOR
❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK
❑CODE ENFORCEMENT OFFICER 938 KING STREET • RYE BROOK,NY 10573
(914) 939-0668 FAx (914) 939-5801
www.ryebrook.org
- - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - -
ADDRESS : DATE:
PERMIT# ISSUED: � SECT: BLOCK: LOT:
LOCATION: OCCUPANCY:
❑ VIOLATION NOTED THE WORK IS... ❑ ACCEPTED ❑ REJECTED/ REINSPECTION
❑ SITE INSPECTION REQUIRED
❑ FOOTING
❑ FOOTING DRAINAGE
❑ FOUNDATION
❑ UNDERGROUND PLUMBING NOTES ON INSPECTION:
❑ ROUGH PLUMBING
❑ ROUGH FRAMING
❑ INSULATION
❑ NATURAL GAS
❑ L.P. GAS
❑ FUEL TANK
❑ FIRE SPRINKLER
❑ FINAL PLUMBING
❑ CROSS CONNECTION
❑ FINAL
❑ OTHER
QyE BRC�k,
1982 BUILDING DEPARTMENT
A BUILDING INSPECTOR
❑ASSISTANT BUILDING INSPECTOR VILLAGE OF RYE BROOK
❑CODE ENFORCEMENT OFFICER 938 King Street • Rye Brook,NY 10573
(914) 939-0668 FAx (914) 939-5801
www ryebrook.org
- - - - - - - - - - - - - - - - - - - - INSPECTION REPORT - - - - - - - - - - - - - - - - - - - -
ADDRESS : � N \ooL 2't 1 1 DATE: Z 4 L \
PERMIT# 4 ISSUED:( (j SECT: BLOCK: LOT:
LOCATION: \ C� �_ .t.0
�!' � OCCUPANCY:
❑ Violation Noted THE WORK IS... ❑ PASSED FAILED REINSPECTION
❑ SITE INSPECTION / REQUIRED
❑ FOOTING
❑ FOOTING DRAINAGE
❑ FOUNDATION
❑ UNDERGROUND PLUMBING NOTES ON INSPECTION:
❑ ROUGH PLUMBING
❑ ROUGH FRAMING
❑ INSULATION \
❑ Natural Gas
❑ L.P. Gas
❑ FUEL TANK ` r
❑ FIRE SPRINKLER ` Ae
❑ FINAL PLUMBING
❑ ,CROSS CONNECTION �J
ej FINAL . ( `� 1 1 �!�L �/` Uoc�
❑ OTHER I �,
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