NYC 9/11 Public Portal Document
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THE CITY OF NEW YORK LANDMARKS PRESERVATION COMMISSION"
• ~v 1 CENTRE STREET, 9TH FLOOR, NEW YORK, NEW YORK. 10007 "•;' Ir}Y?. : `, r 1''
a~ TEL: (212)669-7700 FAX: (212) 669-7960
s Q- APPLICATION FORM F-2
FOR WORK ON DESIGNATED PROPERTIES
This application will not be deemed complete until it is so certified by the Landmarks
Preservation Commission. An application consists of an application form and the materials
necessary to describe the project fully. If being submitted in response to a Warning Letter or
Notice of Violation, please enterthe number below.
Please print or type all items. If not applicable, mark N.A.
PC DOCKET r DATE RECD DATE CERT. AS COMPLETE BLDG. DEPT. # & DATE STAFF
0 INDIVIDUAL ❑ SCENIC ❑ INTERIOR
WE OP DESKENATTON HISTORIC DISTRICT
PMW 0 CNE 0 C OF A 0 REPORT
ACTION OTHER WORK TYPE
Exterior
ADDRESS FLOOR OR APARTMENT
DESIGNATED
PROPERTY Manhattan
BOROUGH BLOCK LOT ZONING
DETAILED
DESCRIPTION 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
previously reviewed and approved by NYCLPC.
COST OF PROJECT WARNING LETTER / NOV #
NIA
TENANT/LESSEE/ NAME. TITLE & FIRM (If opplcoblel PHONE (davl
CO-OP SHAREHOLDER
ADDRESS APT is CTTY, STATE. ZIP CODE
NIA
ARCHITECT/ NAME. TITLE & FIRM It apphcoblet PHONE (davt
ENGINEER
If applicable
ADDRESS CITY, STATE. ZIP CODE
Benjamin Kurzban and Son Control, Inc. (718) 531-2900 1
CONTRACTOR NAME. TITLE & FIRM (It apphccblel PHONE (dovl
If applicable
1248 Ralph Avenue Brooklyn, New York 11236
ADDRESS CITY. STATE, ZIP CODE
PERSON FILING .NYC Department of Environmental Protection (718) 595-3718
APPLICATION NAME. TITLE & FIRM (If apdkcobiel PHONE Novi
e.g. Expeditor, Attorney,
Managing Agent etc. 59-17 Junction Boulevard 8th Floor Coma New York 11368
ADDRESS CITY STATE, ZIP t]DE
ARE YOU APPLYING TO ANY OF THE FOLLOWING?
❑ Buildings Department ❑ City Planning Commission ❑ Board of Standards & Appeals
I am the owner of the above listed property. I am 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 or In a
cooperative or condominium building. OWNERS NAME and TITLE (please type or txrntl PHONE (davl
the 'owner is the Co-op Board or
Condominium Association. An officer of
the Co-op Board or Condominium COMPANY, CORPORATION. ORGANIZATION (If opplicablel
Association must sign this application
Please consul the Instructions for Filing
for additional Information. ADDTFESY "" ' CITY STATE. ZiP CODE
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.
Pe mw
NYC-WTC 000093889
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