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Affordable Housing Plan Application Pursuant To The Inclusionary Housing Program - New York

Affordable Housing Plan Application Pursuant To The Inclusionary Housing Program Form. This is a New York form and can be used in HPD City Of New York New York Local County .
 Fillable pdf Last Modified 10/18/2013
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THE CITY OF NEW YORK DEPARTMENT OF HOUSING PRESERVATION AND DEVELOPMENT OFFICE OF DEVELOPMENT 100 GOLD STREET, NINTH FLOOR NEW YORK, NEW YORK 10038 (212) 863-5641 AFFORDABLE HOUSING PLAN APPLICATION PURSUANT TO THE INCLUSIONARY HOUSING PROGRAM 1. Name of Applicant: Address: Phone: Fax: Email: Contact Person: 2. Name of Owner (if different): Address: Phone: Fax: Email: Contact Person: 3. Name of Administering Agent: Address: Phone: Fax: Email: Contact Person: 4 Inclusionary Housing Program application 11/16/2012 American LegalNet, Inc. www.FormsWorkFlow.com 4. Name of General Contractor: Address: Phone: Fax: Email: Contact Person: 5. Name of Managing Agent: _____________________________________________________ Address: Phone: Fax: Email: Contact Person: 6. Name of Architect: Firm: Address: Phone: Fax: Email: Contact Person: 7. Name of Attorney: Firm: 5 Inclusionary Housing Program application 11/16/2012 American LegalNet, Inc. www.FormsWorkFlow.com Address: Phone: Fax: Email: Contact Person: 8. Address of the Affordable Housing Units: Street Address: Borough: Block(s): Lot(s): Community District:_______________________________ 9. Inclusionary Housing District of Affordable Housing Units: R10 Inclusionary IH Designated Area (insert name): _____________ (e.g. West Chelsea, Hudson Yards, 125th Street, etc.) Special District Yes (insert name): _______________ No Other (please explain): _______________________________________________ 10. If publicly financed, list all sources of governmental assistance, including lower income housing tax credits, bond financing, and land disposition programs: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ 11. Type of Project (check all that apply): A. 6 B. Inclusionary Housing Program application 11/16/2012 American LegalNet, Inc. www.FormsWorkFlow.com NEW CONSTRUCTION PRESERVATION SUBSTANTIAL REHABILITATION ON-SITE OFF-SITE C. Inclusionary Units RENTAL HOMEOWNERSHIP D. Non-Inclusionary Units RENTAL HOMEOWNERSHIP E. TOTAL # OF UNITS: TOTAL # OF IH UNITS: _______ _______ TOTAL # OF SUPER'S UNITS: _____ 12. Income Distribution of Affordable Housing Units: ________ Number of low-income units (equal to or less than 80% AMI) ________ Number of moderate-income units (equal to or less than 125% AMI), if any ________ Number of middle-income units (equal to or less than 175% AMI), if any 13. Tax Exemption To Be Requested: 14. Indicate below if the project will contain any mixed-use condominium, co-op or both? 15. mixed-use condominium mixed-use co-op mixed-use condominium and co-op Authorized Signature of Applicant: ________________________ 7 Inclusionary Housing Program application 11/16/2012 American LegalNet, Inc. www.FormsWorkFlow.com Print Name: ______________________________________________ Date: ______________ 8 Inclusionary Housing Program application 11/16/2012 American LegalNet, Inc. www.FormsWorkFlow.com
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