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Local Law 58 of 1987 Accessibility Waiver Request Internal Use Job Number Application Must Be Typewritten Affix Label 1 Filing Information 2 Location Borough Block House No s. Street Name Lot s BIN C. B. No* Apt/Condo No s. Special Place Name Floor s 3 Applicant Last Name First Name M. I. Business Name Business Phone Address City P. E* R*A. 4 Objections Lic* No* Other Use one line for each objection* Attach additional sheets if necessary 5 Basis of Waiver per 27-292. 6 of Building Code 5A...
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