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Zoning Resolution Determination Form ZRD 1 - New York

Zoning Resolution 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 12/8/2009
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ZRD1: Zoning Resolution Determination Form Must be typewritten. 9 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. 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 Filing Representative Attorney First Name Other: Middle Initial Business Telephone Business Fax Mobile Telephone License/Registration # (if P.E./R.A./Attorney) DOB PENS ID # (if available) 4 Nature of Request Required for all requests. Only one request may be submitted per form. Note: Use this form only to request Zoning Resolution determination (for all other requests, use CCD1 form) Determination request issued to: Job associated with this request? Borough Commissioner's Office Technical Affairs No Yes (provide job#/doc#/examiner name below) Job Number:___________________ Document Number:________ Examiner:__________________________________ Has this request been previously denied? Yes (attach all denied request form(s) and attachment(s)) No Indicate total number of pages submitted with this request, including attachments: Indicate relevant Zoning Resolution section(s): (attachment may not be larger than 11" x 17") 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 General Counsel's Office Other: ADMINISTRATIVE USE ONLY Reference #: Appointment Scheduled With: Comments: Appointment date: Appointment time: Reviewed By: Date Time: 6/09 American LegalNet, Inc. www.FormsWorkFlow.com ZRD1 5 Description of Request (additional space is available on page 3) PAGE 2 Note: Buildings Department officials will only interpret or clarify the Zoning Resolution. Any request for variations of the Zoning Resolution must be filed with the Board of Standards and Appeals (BSA) or the Department of City Planning (DCP). Please itemize all attachments, including plans/sketches, submitted with this form. If request is based on a plan examiner objection, type in the applicable objection text exactly as it appears on the objection sheet. Note: Buildings Department Determination will be issued on the ZRD1 Response Form ADMINISTRATIVE USE ONLY Reviewed By: Date: Time: 6/09 American LegalNet, Inc. www.FormsWorkFlow.com ZRD1 6 Description of Request (use this section if additional space is required for description) PAGE 3 Note: Buildings Department Determination will be issued on the ZRD1 Response Form 7 Statements and Signature Required for all requests 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: Date Time: 6/09 American LegalNet, Inc. www.FormsWorkFlow.com
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