PREMISE NO. STREET / c ~ INSPECTION DATE
CO
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FLOOR ZIP BORO CODE : BLOCK LOT SQUAD # BADGE #
_ (g g LL I I AD t
I E R N -
PL Pi IBA19SOFINSPECrT
u D n O~ PHOTOS TAKEN YES I NO
CONTRACTORS NAME t n /~ _ _. rr2 jD ♦~ SAMPLE NO.
ADDRESS 6 -CIIT/ Ỳ~ SAMPLE NO.
C~ o Q~U P_ n)g Ifc- IA1 i ~~L
STATE ` ZIP ~' PHONE SAMPLE NO.
Iv 3 - 3 OD
LOBO A RY NAME OWNERS NAME
2 I Uts PC wa W -t C-& i
ADpRES CITY N ADDRESS CITY
S S
STATE ZIP 1 y~Q' Phi Z2 ~I ~ Q STATE ZIP
CONTACT PERSON: l V TIME OF INSPECTION FROM: 3vam1 TO:3D 0 ame)
INSPECTION DISCLOSED:
n
o Ol
n r r o
QJ
NOV a INFRACTIONS RESULT CODE
NOV # SUPERVISORS INITIALS
BORO 1 - MANHATTAN 2 - BRONX 3 - BROOKLYN 4 - QUEENS 5 =RICHMOND
BLDG TYPE A > 6 Stories B < 6 Stories C Single Family
D School E Hospital F Public Owned Property
RESULT CODES 1 = Violation Issued 2 = No Violations Issued 3 = No Access
4 = Project not Started (No NOV) 5 = Project Completed (No NOV) ACP 30193
FILE
NYC-WTC 000111911
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NYC-WTC_000111911Source: NYC Law Department, mirrored locally