HomeMy WebLinkAboutWhite Blossom HouseOriginal for Municipal Building Department
STATEMENT OF REGISTRY
To be filed in duplicate with the municipal building department or local enforcement agency
by every owner of a multiple dwelling, as defined in subdivision 33 of section 4 of the
Multiple Residence Law.
Within 30 days after the filing of this statement, the municipal building department or en-
forcement agency is required by section 300, Multiple Residence Law, to file a duplicate
copy hereof with the State Building Code Commission, 1740 Broadway, New York 19, N. Y.
1. Location of multiple dwelling:... ///. ,?,.-) '
(a) Street and number ...~....~....,.~...~......L~...'.~ ...... /..~.~ ................................
(b) Municipality ........................................................................................................
Description:
(a) Type of construction .......... ~ .......... ~ .......................................
(b) Height of building, including nu.m~e.r of stor~es ...... ~.~ ...................
(c) Type of heating facilities ........ ~........,~..~.. ...........................
(d) Number of apartments ....... j. .........................................................................
(e) Number of living rooms ..................... ~ .............................................................
(f) Number of kitchenettes ................. ~ ............................................... i ...............
(g) Number of bathrooms ~
(h) Number of water closets ............. ~ .................................................................
(i) Number of occupants for which building was designed or intended to be occupied
or used ........................ .~..~.. ....... ~ ..............................................................
(a) Date when constructed ..................................................
(b) Dates of substantial additions, alterations .or modifications of dwelling, with
dote of completion ............................................................................................
4. Use:
Describe the principal use made, or, in the case of buildings under construction, to
be made, of the multiple dwelling (such as apartment house, hotel, apartment hotel,
lodging house, boarding house, school, convalescent, old age or nursing home, pri-
vate dwelling two or more stories in height with five or more boarders, roomers or
lodgers, or other classification of multiple dwelling including those specified in sec-
tion 33, Multiple Residence Law).
Dated at ......................................... New York
.................................. ~...~.:.'. ........ 195.,~ ....
............. ...................... z64.:
(Addres~ of Owne~) /
STATEMENT OF FILING
.~T......c~.~..~..~ on the ...... ~....~_....~: ............. 195...~...
(N~e o~ ~Vlunictpaltty) (Date of l~lling)
......