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

A PPLI CATI ON FORM FOR WORK ON DESIGNATED PROPERTIES Fz 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.

ism Use Ord

DOCKET f DATE RECT) DATE CERT. AS COMPLETE BLDG. DER. C • DATE SUMP

❑ NDMDUAL ❑ SCENIC C NTEROR

PMW 7 CNE 0 C OF A 0 REPORT iION OTHER WORK TYPE

Exterior DESIGNATED ADDRM FLOOR OR AMRiklf NT

PROPERTY Manhattan BOROUGH BLOCK LOT ZONING DETAILED 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/ ,&m is fk(Tf2M (B aopacablel PHONE (day( CO-OP SHAREHOLDER ADDRESS APT I CITY STATE ZIP COOE NIA ARCHITECT/ NAME TITLE S FIRM(B opdcoael PHONE tdayt ENGINEER If applicable ADDRESS CITY STATE ZIP CODE

Fiber Control, Inc. (516) 781-3000 CONTRACTOR l%k% E. ME s Frx~ ro apd+cable) waNE (dart If applicable 3010 Burns Avenue Wantagh, New York 11793 ADDRESS CITY, STATE. ZIP CODE

PERSON FILING NYC Department of Environmental Protection (718) 595-3718 APPLICATION NAK*- TITLE& FIRM m opdreolNel PHONE (dart e.g. Expedllor.AnernRK c. Managing Agent. etc. 59-17 Junction Boulevard, 8th Fl oor Corona _ Nmw Ynrk 11368 ADDRESS CITY. STATE. ZIPOOE

ARE YOU APPLYING TO ANY OF THE FOLLOWING? 0 Buildings Department O City Planning Commission 0 Board of Standards & Appeals lam the owner of the above listedproperty. I am familiar with ;, e ...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 applicanam for work on or BIB 000peraeve or condominium buldmg. OANERS NAS.E and TITLE (please 'ape or panto PHONE (soy( ese •owner a the Co-op Board or Condominksm Association. An alficer of the Co-op Board or Condominium COMMJJY. CORPORATION. ORGAMZATON (a oppucoaiol Association must sign thin applk'atsm Please sonsua the Instnudlons for Fling for addnionat Information. ADDRESS CIrY STATE. ZIP COOK

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

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

NYC-WTC 000093896