Created by gemini-2.0-flash on 2025-04-29

Here's a description of the image:

The image shows a form from the Tenement House Department of the City of New York. It's a document used for reporting or requesting reinspections of premises regarding potential violations. The form contains fields for information like the street address, borough, and date. It's addressed to the Chief Inspector of the Old Building Bureau. A section is dedicated to reporting on violations, with columns labeled "N.C.W.", "NOT PROPERLY C.W.", and "C.W." There's a space for the inspector's name and district number at the bottom. The form number is indicated as "Form 167." at the bottom of the left corner.

Created by gemini-2.0-flash-lite on 2025-04-29

The image is a vintage form from the Tenement House Department of the City of New York. The form is designed for requesting a reinspection of premises, likely to check for compliance with housing regulations.

Here's a breakdown of the form's elements:

• Header: It includes the department's name ("Tenement House Department of The City of New York"), and blank fields for the street, number, and district of the premises.
• Request for Reinspection: It includes a section asking the chief inspector to reinspect the premises to determine if the violation has been resolved. If not, the details of the remaining issues should be stated.
• Reporting Section: A table is provided for the inspector to report on the "N.C.W." (Not Corrected), "Not Properly C.W." and "C.W." (Corrected Work) conditions or violations.
• Signature & Date Fields: There are spaces for the inspector's signature and the date of the inspection.
• Form Information: The bottom includes a Form number and the inspector's name/identifier.