WTC debris clean-up application form, June 2002

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

la M4 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 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 end the materials necessary to describe the project fully. If being submitted in response to a Warning Letterer Notice of Violation, please enterthe number below. Please print or type all items. If not applicable, mark NA

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Exterior DESIGNATED ADORM FwoR OR AMRB.ENr

PROPERTY Manhattan BOROUGH BLOCK LOT ZONING DETAILED DESCRIPTION Removal of debris (cleanin g , from the collapse of the WTC OF PROPOSED WORK from exterior building surfaces Use back of torn it necessary as per scope of work previously reviewed and approved by NYCLPC.

COST OF PROJECT WARNING LETTER / NOV # NIA TENANT/LESSEE/ NAME. lm.E & FIRM it dPOGcabiel loan CO-OP SHAREHOLDER ADDRESS APT • CITY, STATE ZIP CODE NIA ARCHITECT/ NA QE, TITLE & FIRM (a aodcr ble) PHONE RkM ENGINEER If applicable ADDRESS CITY SWE ZIP CODE

Fiber Control, Inc. (516) 781-3000 CONTRACTOR NAME, TITLE & FIRM N applicable) PHONE (ooy( If applicable 3010 Burns Avenue Wantagh, New York 11793 ADDRESS Cm: STATE ZIP CODE

PERSON FILING NYC Department of Environmental Protection (718) 595-3718 APPLICATION NnNE. ITRE & FIRM III apptcouiei PHONE tdpyl e.g. Expeditor, Attorney, Monogng Agent. etc. 59-17 Junction Boulevard, 8th Floor CoronAT NPw Ynrk 11368 ADDRESS CITY STATE, ZIP

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 wirt. ,'e .; xk proposed to be carried out on my property and give my permission for this application to oe filed. The information entered is correct and complete, to the best of my knowledge. OWNER For applications for work on or in a 000perative or Condominium boidmq. ONVNERS NAME and inTE (please type or phi PHONE (doll the •owner a the Co-op Board or Condominium Association. An ofeeer of the Co-op Board or Condon*Utmt COMPANY, CORPORATION, ORGANIZATION (s dppicoblel Association must sign oft appacation P'Mase consun the InaltuWons for Fling for additional information ADOEESS 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 a- ITV.

NYC-WTC 000093894