Executed PB Application 4904 1062 97512

J. VERIFICATION AND AUTHORIZATION SIGNATURE IS REQUIRED FOR ALL OF THE FOLLOWING: APPLICANT’S VERIFICATION I hereby certify that the above statements made by me and the information contained in the papers submitted in connection with this application are true. I am aware that if any of the foregoing statements are willfully false, I am subject to punishment. Date: uf? » 208 S ( ¢ 525 Northfield Ave., LLC By: Arbol By Gomes LLG, its argo Applicant’s Signature: £ Pedro gape eens Manage CONTINUANCE fe Should the Planning Board/Zoning Board of Adjustment have a full and heavy agenda, or discussion and meeting regarding this application requiring carrying the matter past the statue time limit, the applicant grants permission for such an extension. 525 Northfield Ave., LLC a By: Arbol By Gomes LLCHits Marfager Applicant’s Signature: Date: / 7 / sf 4 25° Pedro G a OWNER’S AUTHORIZA — MUST BE SIGNED Pedro Gomes hereby certifies that By Gomes Northfield. LLC has a mailing address of 91 Kossuth Street. Newark. NJ.0710 in the County of Essex and the State of New Jersey; and that it is the owner of all that certain lot, piece or parcel of land known as Block 159.04: Lot 1.01 (formerly Lots 1.01. 1.02 & 1.03) on the Tax Map of West Orange which property is the subject of the above application, and that said application is hereby authorized by me. Furthermore, J authorize inspection of the site which is the subject of this application. By Gomes Northfield, LLC By: 525 Northfield Ave., LLC_ts-Manager By: Arbol By Gomes LL&; its Mdnager _ Owner’s Signature: By: po Date: VA C /2 Za Z Pedro Cc / / THIS APPLICATION DOES NOT RELIEVE THE APPLICANT FROM COMPLYING WITH OTHER TOWNSHIP ORDINANCES SUCH AS THE TREE REMOVAL ORDINANCE AND OBTAINING THE NECESSARY APPROVALS AND PERMITS UNDER SUCH ORDINANCES.