WTC debris clean-up application form, June 2002

NYC 9/11 Public Portal Document THE CITY OF NEW YORK LANDMARKS PRESERVATION COMMISSION 1 CENTRE STREET,9TH FLOOR,NEW YORK,NEW YORK,10007. •3 TEL: (212) 669- 7700 FAX: (212) 669-7960

APPLICATION FORM FOR WORK ON DESIGNATED PROPERTIES F2

• 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 Letterer Notice of Violation, please enter the number below. Please print or type all items. If not applicable, mark N.A.

Exterior DESIGNATED ADDRESS HO+atAMR

PROPERTY Manhattan BOROUGH sLOCK LOT ZONINCs DETAILED DESCRIPTION Removal of debris (cleaning i from the collapse of the WTC OF PROPOSED WORK from exterior building surfaces Use back of form If necessary as per scope of work previously Y reviewed and approved by NYCLPC.

COST OF PROJECT WARNING LETTER / NOV # NIA TENANT/LESSEE/ Na,E.TtttE&FKfkfItt lcobtel PHOnEioon CO-OP SHAREHOLDER ADDRESS APT • CM• STATE. DP CODE NIA ARCHITECT/ N.Me TITLE a Fu21d (a op NE MO ENGINEER If applicable ADDRESS ar. STATE. LP CODE Fiber Control, Inc. (516) 781-3000 CONTRACTOR MM ME & F ro oodCabtet PHONE boyt If applicable 3010 Burns Avenue Wantagh, New York 11793 AOORESS Cry. sw5. LP CODE

PERSON FILING NYC Department of Environmental Protection (718) 595-3718 4PPLICATION NEE. nu & Fr.i tK dppicoblej PHONE Idoh e.g. E ngA gAtrotnay Nbnogmg Agent. etc. 59-17 Junction Boulevard, 8th Floor Corona NPw York 11368 ADDRESS City. STATE. ZIP &CJCE

ARE YOU APPLYING TO ANY OF THE FOLLOWING? 0 Buildings Department 0 City Planning Commission 0 Board of Standards &Appeals lam the owner of the above listed property. I am familiar wift• ;9 „ork 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 applicetans for work on or H a caoperatlee w condomisi m bukomg. OWNER'S NAME old TITLE (Weose ripe a pmnl PHONE (boot are •owner is the Co-op Board or Condominium Am, Ilon. An Dialer of the Coo Co-op Board w Condominium COW.. WA CORPORATION. ORGAMWION fs oppcodiel Association must sign this apptkahon Please o asult the Instructions for Faitp for addnbnsl knomytlon.

NYC DEP for owner SIGNATURE SIGNATURE OF OWNER

Note: Section 25-317 of the Administrative Code of the City of New York makes 08 pun.shable offense to willfully make false statements on this application D. wa.

NYC-WTC 000093893