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Get Bicycle Waiver Form

Bicycle Parking Spaces Waiver Form Must be typewritten Instructions In order to apply for a waiver from the requirements of Local Law 51 of 2009 please compete this form. The form must be faxed with all relevant supporting documentation including floor plans and diagrams of the garage parking to 212-566-3796 or dropped off at Technical Affairs Unit 280 Broadway 7th Floor in Manhattan. If your business s legal structure is Sole Proprietor complete Sections 1 2 3 and 4. If your business s legal structure is NOT Sole Proprietor complete Sections 1 3 and 4. Business Information Legal name of Business The Legal name that you provide must be exactly as filed with the County Clerk or New York State Secretary of State. Business s Trade or Doing-Business-As DBA Name if applicable The DBA Name that you provide must be exactly as filed with the County Clerk or New York State Secretary of State. Business Address Other known addresses City and State Zip Code Borough Fax Number email Country Business Telephone Number DCA Garage License Number Last Name Suffix First Name Contact Mailing Information If you want DOB correspondence addressed and mailed to a contact other than the business name and address provided in section 1 please complete the information below. Contact Name and Title Mailing Address The disclosure of Social Security or Individual Taxpayer Identification numbers in sections 2 and 3 is voluntary. The request is made pursuant to the NYC Charter and administrative Code. This information may be used to enable the City of New York to maintain and update City databases to carry out the powers and duties of the Department and for other purposes requisite to promoting the general welfare of the public* Reason for waiver Required for all challenges. Indicate total number of pages submitted with challenge including supporting documents pages attachments may not be larger than 11 x 17 Indicate relevant Zoning Resolution section s below. Improper citation of the Zoning Resolution may affect the processing and review of this waiver request. Reason for the waiver in detail below For questions email bikeparkingwaiver buildings. nyc*gov* ADMINISTRATIVE USE ONLY Reviewer s Signature Waiver Granted Additional Comments Date Yes Time WO No 11/09. If your business s legal structure is NOT Sole Proprietor complete Sections 1 3 and 4. Business Information Legal name of Business The Legal name that you provide must be exactly as filed with the County Clerk or New York State Secretary of State. Business s Trade or Doing-Business-As DBA Name if applicable The DBA Name that you provide must be exactly as filed with the County Clerk or New York State Secretary of State. Business s Trade or Doing-Business-As DBA Name if applicable The DBA Name that you provide must be exactly as filed with the County Clerk or New York State Secretary of State. Business Address Other known addresses City and State Zip Code Borough Fax Number email Country Business Telephone Number DCA Garage License Number Last Name Suffix First Name Contact Mailing Information If you want DOB correspondence addressed and mailed to a contact other than the business name and address provided in section 1 please complete the information below..

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