Landmarks Preservation Commission work application form F-2, undated

NYC 9/11 Public Portal Document :+r, '`!• •'t . Af :'F!*?i'. r. .r . 4%Yu`. ti p. "}t " t Y: - +

THE CITY OF NEW YORK LANDMARKS PRESERVATION COMMISSION • tia~Mti I CENTRE STREET, 9TH FLOOR, NEW YORK, NEW YORK, 10007 TEL (212) 669- 7700 FAX (212) 669-7960

APPLICATION FORM Fz r FOR WORK ON DESIGNATED PROPERTIES This application will not be deemed complete unto it is so certified by the Landmarks Preservation Commission. An application consists of an application form and the materials y; necessary to describe the project fully. If being submitted In response to a Warning Letter or ;•; Notice of Violation, please enter the numberbelow. Please print or type all items. If not applicable, mark N.A.

DOCKET I DATE RECD DATE CERT. AS COMPLETE BLDG. DEPT. # & DATE STAFF

❑ INDMDLIAL 0 SCENIC 0 INTERIOR

PMW 0 CNE 0 C OF A 0 REPORT TION OTHER WORK TYPE

Exterior DESIGNATED ADDS FLOOR OR AMRTMEW

PROPERTY Manhattan BLOCK LOT ZONING DETAILED Removal of debris (cleaning) from the collapse of the WTC OF PROPOSED WORK from exterior building surfaces as per scope of work Use back of form if necessary Y reviewed and approved by NYCLPC. previously

COST OF PROJECT WARNING LETTER / NOV # NIA TENANT/LESSEE/ NAME. TITLE & FIRM (n oppiiccblel PHONE(dad CO-OP SHAREHOLDER ADDRESS APT A CITY STATE. ZIP CODE

NIA ARCHITECT/ NAME TIRE & FIRM pf applicable) PFIONA (dad ENGINEER If applicable ADDRESS CRY, SWE, ZIP CODE

Trio Asbestos Removal Corp. (718) 961-4100 CONTRACTOR NAME. TITLE & FIRM (II applicable) PHONE ((toll If applicable 14-20 129 Street College Point, New York 11356 ADDRESS CITY STATE. ZIP CODE

PERSON FILING NYC Department of Environmental Protection (718) 595-3718 APPLICATION NAME. TIRE & FIRM (II applicable) PHONE (doll e.g. Expeditor. Attorney, Managing Agent. etc. 59-17 Junction Boulevard, 8th Floor Corona NPw York 11368 ADDRESS CITY, STATE, DP O~

ARE YOU APPLYING TO ANY OF THE FOLLOWING? ❑ Buildings Department 0 City Planning Commission ❑ Board of Standards & Appeals

I am the owner of the above listed property. lam familiar with the work proposed to be carried out on my property and give my permission for this application to be filed. The information entered is correct and complete, to the best of my knowledge. OWNER For applications for work on win a cooperative or condominium building. OWNER'S NAME and TITLE (please type or ptntl PHONE (Coll the is the Co-op Board or Condominium Association. An officer of the Co-op Board or Condominium COMPANY; CORPORATION. ORGANIZATION (If oppiicoblel Association must sign this application. Please consult the Instructions for Filing to additional information ADDRESS CITY STATE. ZIP COOK

NYC DEP for owner SIGNATURE SIGNATURE OF OWNER DATE -

Note: Section 25-317 of the Administrative Code of the City of New York makes it a punishable offense to willfully make false statements on this application.

NYC-WTC 000093883