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Construction Code Determination Form CCD1 - New York

Construction Code Determination Form Form. This is a New York form and can be used in Department Of Buildings City Of New York New York Local County .
 Fillable pdf Last Modified 10/29/2015
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CCD1: Construction Code Determination Form Must be typewritten. Do not use this form for Zoning Resolution determination requests - use ZRD1 form Orient and affix BIS job number label here 1 Location Information Required for all requests on filed applications. House No(s) Borough Block Street Name Lot BIN CB No. 2 Applicant Information Required for all requests on filed applications. Last Name Business Name Business Address City E-Mail License Type P.E. R.A. RLA State Zip First Name Middle Initial Business Telephone Business Fax Mobile Telephone License Number DOB PENS ID # (if available) 3 Attendee Information Required if different from Applicant in section 2 or no Applicant. Relationship to the property: Last Name Business Name Business Address City E-Mail State Zip Attorney Filing Representative (Class 2) First Name Other Middle Initial Business Telephone Business Fax Mobile Telephone License/Registration # (if P.E./R.A./R.L.A./Attorney) 4 Nature of Request Required for all requests. Only one request may be submitted per form. Determination request is for: Determination request issued to: Job associated with this request? Job #: ___________________ Determination Predetermination Technical Affairs No Borough Commissioner's Office Yes (provide job # / doc # / obj # / examiner name below) Document #: ______ Objection #: ________ Examiner: _________________________________ Yes (attach all denied request form(s) and attachment(s)) No Has this request or a similar one been previously denied? Enter short description of Technical Topic (5 words or less): ____________________________________________________________________ Construction Code (if applicable): 2014 Code 2008 Code 1968 Code Prior to 1968 Code Enter All Control #(s) for related CCD1/ZRD1 requests:________________________________________________________________________ TPPN, Memo: _____________________________ Zoning District(s): _______________________________________________________________ Zoning Overlay(s): _______________________________________________________________ Special District(s): _______________________________________________________________ MDL: _____________________________ BBs: _____________________________ Other: _____________________________ ZR Section: ___________________________ Code Section: _________________________ Rule #: _____________________________ Indicate all Buildings Department officials that you have previously reviewed this issue with (if any): Borough Commissioner Deputy Borough Commissioner Code & Zoning Specialist Chief Plan Examiner Other General Counsel's Office ADMINISTRATIVE USE ONLY Control #: Appointment Scheduled With: Comments: Review Team Members: Appointment date: Reviewed By: Date American LegalNet, Inc. www.FormsWorkFlow.com 2/16 CCD1 5 Description of Request (utilize page 3 / section 7 if additional space is needed to properly describe this request) This is a request for: Interpretation or clarification PAGE 2 Variation of Building Code or Rules per § 28-103.3 (please state in detail the practical difficulty that is specific to this project, and provide the analysis as to equally safe alternative, as per NYC Charter Section 645(b)(2)) Variation of Multiple Dwelling Law (MDL) § 277.16 for Article 7B Buildings (please state in detail the practical difficulty that is specific to this project and provide the analysis as to equally safe alternative, as per NYC Charter Section 645(b)(2)) Note: Variations of any other MDL provisions must be filed with the Board of Standards and Appeals (BSA) per MDL § 310. Please itemize all attachments, including plans/sketches, submitted with this form. (attachment may not be larger than 11" x 17") If request is based on a plan examiner objection, type in the applicable objection text exactly as it appears on the Objection sheet and include a copy of the Objection sheet in the submitted Pdf. Note: Buildings Department Determination will be issued on the CCD1 Response Form 6 Statements and Signature Required for all requests (If Attorney, include "Esquire" or "Esq." in signature) Name (please print) I hereby state that all of the above information is correct and complete to the best of my knowledge. Falsification of any statement is a misdemeanor and is punishable by a fine or imprisonment, or both. It is unlawful to give to a City employee, or for a City employee to accept, any benefit, monetary or otherwise, either as a gratuity for properly performing the job or in exchange for special consideration. Violation is punishable by imprisonment or fine, or both. Signature Date P.E. / R.A. Seal (apply seal, then sign and date over seal ­ not required for Attorneys on unfiled applications) ADMINISTRATIVE USE ONLY Reviewed By: Control #: Date: 2/16 American LegalNet, Inc. www.FormsWorkFlow.com CCD1 7 Description of Request (use this section if additional space is required for description) PAGE 3 Note: Buildings Department Determination will be issued on the CCD1 Response Form 8 Statements and Signature Required for all requests (If Attorney, include "Esquire" or "Esq." in signature) Name (please print) I hereby state that all of the above information is correct and complete to the best of my knowledge. Falsification of any statement is a misdemeanor and is punishable Signature by a fine or imprisonment, or both. It is unlawful to give to a City employee, or for a City employee to accept, any benefit, monetary or otherwise, either as a gratuity for properly performing the job or in exchange for special consideration. Violation is punishable by imprisonment or fine, or both. Date P.E. / R.A. Seal (apply seal, then sign and date over seal ­ not required for Attorneys on unfiled applications) ADMINISTRATIVE USE ONLY Reviewed By: Control #: Date: 2/16 American LegalNet, Inc. www.FormsWorkFlow.com
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