ZONING LOT DESCRIPTION AND

OWNERSHIP STATEMENT BY

BUILDING DEPARTMENT PERMIT APPLICANT

__________________________ , a New York Corporation, having its principal office
at _____________________________________ , an applicant for present or future permits pursuant to the Zoning Resolution of the City of New York, effective as of December 15, 1961, and as subsequently amended, states that the zoning lot to which the aforementioned permit or permits pertain are shown on the Tax Map of the City of New York , County of _____________ , as Lots _______ in Block ______ as shown on the Tax Map of the City of New York, ____________ County, and is more particularly described as:

BEGINNING at a point

. . . . . . . . . . . . . . .

. . . . . . . . . . . . . . .

. . . . . . . . . . . . . .

to the point or place of Beginning.

That said premises are known as and by street address(es) _________________ __________________________ and _________________________________ , as shown on the following Diagram:

 

N.

1. Show distance from corner

2. Show Block and Lot Nos.

and dimensions of each lot.

3. North point of the diagram

must agree with the north arrow.

The above described zoning lot is presently owned by:

BLOCK________ TAX LOT__________ NAME__________ ADDRESS

IN WITNESS WHEREOF the applicant for permit has executed this instrument this ____ day of _______________ , 19 ____ .

[Add signature block and acknowledgment]

Note: Section C26-110.2 Subdivision (a) Paragraph (1) of the Administrative Code requires submission of an accurate lot diagram in accordance with an attached boundary survey made by a licensed surveyor, which need not be recorded but which must be submitted with the application for the permit.