Request for Certificate of Occupancy under Open Applications Pilot Program in Manhattan.

Applicant’s Name: ______________________________________________________________________________

Applicant’s Address: ____________________________________________________________________________

Applicant’s E-mail address: ____________________________ Telephone #:_____________________________

Certificate of Occupancy requested for:

Block/Lot: ________________________

Address: _____________________________________________________________________________________

Briefly describe the situation:

List attached documents:_________________________________________________________________________

Date: _______________________ Applicant Signature_________________________________

NYC.gov/buildings safety service integrity

Open Applications Cover Letter