New York Form Hhw 1 – Fill Out and Use This PDF

Failure To Provide Heat And/Or Hot Water - Tenant Application For Rent Reduction

In New York City, the Housing Maintenance Code requires that heat must be provided from October 1 through May 31 as follows:

6 A.M. to 10 P.M.:

When the outside temperature is below 55 degrees Fahrenheit, the inside temperature must be at least 68 degrees Fahrenheit.

10 P.M. to 6 A.M.:

When the outside temperature is below 40 degrees Fahrenheit, the inside temperature must be at least 55 degrees Fahrenheit.

For information when heat must be provided outside New York City, please refer to Fact Sheet 15.

State Law requires that hot water be provided 365 days per year, 24 hours a day at a minimum of 120 degrees Fahrenheit at the tap. In New York City, if a tub or shower is equipped with an anti-scald valve that prevents the hot water temperature from exceeding 120 degrees Fahrenheit, the minimum hot water temperature for that tub or shower is 110 degrees Fahrenheit.

TENANT INSTRUCTIONS: Please note: You must attach a report from the appropriate city, municipal or county agency showing a finding of lack of heat and/or hot water. Type or clearly print all information requested. Be sure to date and sign the back of the application. Mail or deliver the original plus one copy of the signed application to the Division of Housing and Community Renewal (DHCR) address shown on the reverse side of this form. Keep one copy for your records.

Part I - General Information

1. Mailing Address of Tenant:					2. Mailing Address of Owner/Managing Agent:
	Name					Name
	Number/Street			Apt. No.		Number/Street
	City, State, Zip Code					City, State, Zip Code
Telephone No.: Bus. (			)		Telephone Number: (			)
	Res. (		)

3.Subject Building (if different from tenant's mailing address):

Number and Street

Apartment Number

City, State, Zip Code

HHW-1 / (10/13)

(SEE REVERSE SIDE)

Name of Cooperative Corp./Condo Assn.:

Managing Agent:

My building is managed by a 7-A Administrator.

Name of 7-A Administrator:

7. Section 8 Program:				None		U.S. Dept. of Housing & Community Development		N.Y.C. Housing Authority
		Housing Choice Voucher				N.Y. C. Dept. of Housing & Preservation Development
If applicable, enter Certificate/Voucher Number: __________________________________

9. Check appropriate boxes to indicate services not provided.

10. Briefly describe the conditions which resulted in the attached violation(s):

Part III - Tenant's Affirmation

I have read the information on this application and I affirm that the contents to be true of my own knowledge.

/	/
			Tenant's Signature
Date

MailordeliverthisformtotheDHCRofficelistedbelow.

DHCR, Gertz Plaza

92-31 Union Hall St., 6th Floor

Jamaica, NY 11433

HHW-1 / (10/13)