NYC 9/11 Public Portal Document
r v~cci2Y r•.:
i' ;T..,•.t:'1•'r~y'.
,.- .. _ S . . SSI ,;{a ¢ ~-y
THE CITY OF NEW YORK LANDMARKS PRESERVATION COMMISSION ;; .`:'`" ~' • '
3 ~v M~ 1 CENTRE STREET, 9TH FLOOR, NEW YORK, NEW YORK, 10007
• TEL (212) 669- 7700 FAX (212) 669-7960 "-
• A
~s ~~ APPLICATION FORM Fz :
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 Letterer
Notice of Violation, please enter the number below.
Please print or type all items. If not applicable, mark N,A.
DOCKET • DATE RECD DATE CERT. AS COMPLETE BLDG. DEPT. C & DALE STAFF
ci INOMDLIAL 0 SCENE 0 INTERIOR
PMW 0 CNE 0 C FA 0 REPORT
ACTION OTHER WORK TYPE
raft tcae~
DESIGNATED
PROPERTY Manhattan ja
~. 75p 2-
BOROUGH BLOCK LOT WOMNG
DETAILED
DESCRIPTION Removal of debris (cleaning) 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 reviewed and approved by NYCLPC.
COST OF PROJECT WARNING LETTER / NOV #
NIA
TENANT/LESSEE/ NAME, TIRE & FIRM if opocabte) PHONE Nall
CO-OP SHAREHOLDER
ADDRESS APT C CF STATE. DP COOt
NIA
ARCHITECT/ NAME. MLE & FIRM IU opptcobiel PHONE (do+1
ENGINEER
If applicable
ADDRESS CRY. STATE DP Co7E
Trio Asbestos Removal Corp. (718) 961-4100
CONTRACTOR NAME, Tm.E & FIRM pf cpplk,able) r. - ,- .,
If applicable 14-20 129 Street College Point, New York 11356
ADDRESS M STATE.. ZIP COQ
PERSON FILING NYC Department of Environmental Protection (718) 595-3718
APPLICATION NAME, TITLE & FIRM ft Op el PHIDNE loan
e.g. EKpeditor, Attorney.
Managing Agent, etc. 59-17 Junction Boulevard. 8th Floor Corona New York 11368
ADDRESS CITV, STATE, ZIP O>
ARE YOU APPLYING TO ANY OF THE FOLLOWING?
0 Buildings Department 0 City Planning Commission 0 Board of Standards & Appeals
I am the owner of the above fisted properly. lam 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
o
For applications to, work on b a
cooperative or condominium brdlding•
!f~ 1.
OAfrIERS W E and R
`y h
()minittm
NPe a pmtl
1 (/J PttONE lagl
( A /
Condomink,mA~ssoocia ion Mdtbx of 0 I T V V rA W l.ld `~~_
the Co-op Board or Cor dominium OT VllW CCNPQRATION, r ( /
Association must sign this application.
Please Odnsult the Instruclions for Fainp / /~1
L (,. ( V U I
for addttbnal information.
NYC DEP 0 Z/
for owner Q
SIGNATURE esr.iAugE OF DAZE —
Note: Section 25-317 of the Administrative Code of the City of New York makes d a punishable offense to Willfully make false statements on
this application.
ar. >cc
NYC-WTC 000093907
OCR can misread numbers and units. Confirm readings against the page image before using them.