Appointment Request Form for Re-consideration and Pre-consideration Appointments Appointment Type: Re-consideration Pre-consideration Complete all sections below and fax completed form to 212.566.5575 – Manhattan Borough Office Number of attachments to this document ______. Appointment Requested By: Property Information: First and Last Name:__________________________ House #: ___________________________________ Relationship to the property : Owner Applicant Expediter Other _______ _______ Bin #: ____________________________________ Block: ________ Lot: __________ Job/Document #: __________________________ (must be included for re-consideration requests) Reason for Requesting Appointment: Building Code Interpretation/Reconsideration Multiple Dwelling Law Interpretation TPPN Interpretation Zoning Code Interpretation Other (explain): ___________________________ Contact information: Business phone #: ___________________________ ___________________________________________ Fax: ______________________________________ Cell phone #: _______________________________ E-mail address: _____________________________ Detailed description of issue or objection to be discussed: Code/Zoning Section (s): Indicate everyone with whom you have discussed this issue: Borough Commissioner Deputy Borough Commissioner Code/Zoning Specialist TCU Auditor Borough Manager Chief Plan Examiner Plan Examiner Borough Inspections Manager For Internal Use Only Appointment granted: Yes No Date: / / Time: ________ Scheduled By: ___________________________ Comments:__________________________________________________________________________________________ ____________________________________________________________________________________________________ OP-101 (9/04) American LegalNet, Inc. www.FormsWorkflow.com