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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 11/6/2015
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ZRD1: Zoning Resolution Determination Form Must be typewritten. Use this form only to request Zoning Resolution determination (use CCD1 for all other requests) 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 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: ___________________________________ No Has this request or a similar one been previously Denied? Yes (attach all denied request form(s) and attachment(s)) Enter short description of Technical Topic (5 words or less): ___________________________________________________________________ Enter All Control #(s) for related CCD1/ZRD1 requests: _______________________________________________________________________ TPPN, Memo: _____________________________ Zoning District(s): _______________________________________________________________ MDL: _____________________________ Zoning Overlay(s): _______________________________________________________________ BBs: _____________________________ Special District(s): _______________________________________________________________ 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 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. (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 ZRD1 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 ZRD1 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 ZRD1 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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