BermanApplication

TOWNSHIP OF WEST ORANGE APPLICATION FORM FOR THE PLANNING BOARD OR ZONING BOARD OF ADJUSTMENT A.APPLICANT INFORMATION Full Legal Name: __ Estate of Rita Berman (Last) (First) Mailing Address: c/o Robert Berman, 129 Fairway Avenue, West Orange, NJ 07052 (Street) (City) (State) (Zip) Telephone Number: (973) 908-5170 Email: robertbermannj@gmail.com Is the Applicant an: Individual, Corporation, 1 Partnership, 1 Other _ Estate If the Applicant is a corporation or partnership, a list of the names and addresses of persons having a 10% interest or more in the corporation or partnership must be attached. Relationship of the applicant to the property: x Owner, 11 Tenant or Lessee, 1) Purchaser under contract (with consent of owner, 1) Other (please specify) If the applicant is not the owner of the property in question, the applicant must submit an affidavit with the owner(s) authorization to proceed with this process. B. PROPERTY OWNER INFORMATION = X Check here if same as applicant. If the owner is not the applicant, please complete the following: Owner’s Name: Address: Telephone Number: Email: C.PROPERTY INFORMATION Street Address: _17 Fairway Avenue Block Number: 179.03 Lot Number: _9 Tax Plate: ; Zone of Property: _R-6 The location of the property is at the intersection of Fairway Avenue and Barbara Avenue (closest intersection) Has there been any previous Zoning Board of Adjustment or Planning Board hearings involving this property? O Yes, Date(s): X No If yes, please attach copies of the written decisions adopted by the Board to each application. Please attach a list of all contiguous or adjacent property owned by the applicant or owner. X None Is this property listed in “The Historic Sites Survey” prepared by Robert Guter 7/9/1992 X No