Industrial And Commercial Abatement Program Form

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NEW YORK CITY DEPARTMENT OF FINANCE • TAX & PARKING PROGRAM OPERATIONS DIVISION
I I N N D D U U S S T T R R I I A A L L A A N N D D C C O O M M M M E E R R C C I I A A L L
TM
A A B B A A T T E E M M E E N N T T P P R R O O G G R R A A M M
Finance
PRELIMINARY APPLICATION FOR CERTIFICATE OF ELIGIBILITY
Mail to: NYC Department of Finance, Industrial and Commercial Abatement Program, 59 Maiden Lane, 22nd Floor, New York, NY 10038
This Preliminary Application, when duly filed, will fulfill the requirement that an application be made before issuance of a building permit,
but does not confer the right to any benefit. Return the completed application and the required attachments to the address above.
SECTION I APPLICANT INFORMATION
Type or print all information
1.
Name of Applicant:
_______________________________________________________________________________________________________________________
Contact person
________________________________________________________________________________________________
(if other than applicant):
PRINT FIRST NAME
PRINT LAST NAME
________________________________________________________________________________________________________
Address:
NUMBER AND STREET
CITY
STATE
ZIP CODE
Telephone
Fax
Email
Number:
Number: ___________________________
Address: _____________________________________________
______________________________
Applicant’s Employer
Applicant’s Social
OR
Identification Number:
Security Number:
2.
Name of Representative
(If a representative is designated below, correspondence will be sent only to the representative):
Representative Firm Name:
_____________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________
Name:
PRINT FIRST NAME
PRINT LAST NAME
________________________________________________________________________________________________________
Address:
NUMBER AND STREET
CITY
STATE
ZIP CODE
Telephone
Fax
Email
Number:
Number: ___________________________
Address: _____________________________________________
______________________________
SECTION II SITE INFORMATION
1.
Borough:
Block:
Lot(s):
_____________________________
_______________________________
__________________________________________________
2.
Site Address:
___________________________________________________________________________________________________________________________
NUMBER AND STREET
CITY
STATE
ZIP CODE
SECTION III PROJECT INFORMATION
8.
Date of commencement or
/
/
1.
Total floor area: _________________________________ square feet
projected commencement:
________
________
________
9.
Will the project require any zoning change, other
2.
Type of project (check all that apply):
K
K
variance or consent from a government agency?
YES
NO
K
K
K
New building
Alteration
Addition to existing space
If "yes," describe: __________________________________________
3.
________________________________________________________
Proposed use (check all that apply):
K
K
K
10.
Has an application been made for any other
Industrial
Commercial
Retail
New York City Exemption or Abatement
K
K
K
Hotel
Residential
Utility
Program, for example J-51, lease abatement,
K
K
ECSP, prior ICIP, ICAP etc.?
YES
NO
4.
Retail square footage: ______________________________________
If "yes," specify: ___________________________________________
K
K
5.
Estimated cost of construction: $ ______________________________
If “no”, will you be applying for any
YES
NO
K
K
11.
This application is for (check all that are applicable):
6.
Will proposed work require a building permit?
YES
NO
K
K
K
Industrial
Commercial
Additional Industrial
If "no," continue with question #9.
Abatement
Abatement
Abatement
K
K
7.
Has a building permit been issued?
K
K
YES
NO
12.
Are you planning to subcontract?
YES
NO
/
/
If "yes," give date: ________
________
________
If "yes," please list all trades: _________________________________
________________________________________________________
ICAP Prelim. App. 06.01.11

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