WTC debris clean-up application form, June 2002

NYC 9/11 Public Portal Document THE CITY OF NEW YORK LANDMARKS PRESERVATION COMMISSION :

I CENTRE STREET,9TH FLOOR,NEW YORK,NEW YORK,10007, TEL: (212)669-7700 FAX:(212)669-7960

APPLICATION FORM FOR WORK ON DESIGNATED PROPERTIES r-2 r r ' - This application will not be deemed complete until It Is so certified by the Landmarks Preservation Commission. M 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 ofViolation, please enter the number below.

Please print or type all items. If not applicable, mark NA

Exterior DESIGNATED ADORM FLooa caAtaamMENT PROPERTY Manhattan BOROUGH BLOCK LOT 2ONWG DETAILED DESCRIPTION Removal of debris (cleaning; from the collapse of the WTC OF PROPOSED WORK from exterior building surfaces as per Use back of form If necessary scope of work previously reviewed and approved by NYCLPC.

COST OF PROJECT WARNING LETTER / NOV # NIA TENANT/LESSEE/ NAME.1WILE & HRM (t coolicablel Jowl CO-OP SHAREHOLDER ADDRESS APT • CITY. STATE SP CODE NIA ARCHITECT/ NAMEffE&FTRM(U opaiccae) RCNE food ENGINEER If applicable ADDRESS CITY STATE. DV CODE

Fiber Control, Inc. (516) 781-3000 CONTRACTOR ,t rk r M (r CoPscoblel wOT'E (aavl If applicable 3010 Burns Avenue Wantagh, New York 11793 ADDRESS Ctiv. STATE. aP CODE

PERSON FILING NYC Department of Environmental Protection (718) 595-3718 APPLICATION NAME, TOLE a FIRM In ocoroblel PAW tdoh e.g. EepedlAgen tomey Managing Agent. etc. 59-17 Junction Boulevard, 8th Floor Corona New Ynrk 11368 ADDRESS CRY. STATE. ZIP OOE

ARE YOU APPLYING TO ANY OF THE FOLLOWING? 0 Buildings Department ❑ City Planning Commission 0 Board of Standards & Appeals t am the owner of the above listed property I em familiar wire e ..,-wk 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 to a cooperative or condominkrm buttdmg, OWNERS NAME and TILE (ptaose Noe or Dnnt) PHONE (dart the •owner' Is the Co-op Board or Condominium Associatkm. An atecer of the Co-op Board or Condominum COBEANY CORPORATION. ORGANVAT)QN (e apolcaael Association must elpn this applkNron Please consult the Inauuetlona for Faahp Tor additional Information.

NYC DEP for owner - SIGNATURE SIGNATLRE OF OWNER — — DATE

Note: Section 25-317 of the Admi istrolive Code of the City of New York makes it a punishable offense to wdHuty make false statements on this application ah. M.

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