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. TEL (212) 669- 7700 FAX (212) 669-7960

APPLICATION FORM 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 forth and the materials necessary to describe the project fully. If belr,;3 submitted in response to a Warning Letter or Notice of violation, please enter the number below. Please print or type all items. If not applicable, mark NA.

OOCKV • I TE RECD DATES CERT. AS COMPLETE SLOG. DEPL C a DATE $WF

O NDNIOU..t 0 SCENiC C a4TERsOR

PMW A 0 RE LION OTHER WORK TYPE

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

COST OF PROJECT WARNING LETTER / NOV # NIA TENANT/LESSEE/ ew&. ins rk FeRM fn aoorcmlel PHONE (day) CO-OP SHAREHOLDER ADDRESS APT I OT( SLATE. aP CODE NIA ARCHITECT/ NAME MLE a FQM (K pppacdre1 P40K (dari ENGINEER If applicable ADDRESS arc STATE.. aP CODE Fiber Control, Inc. (516) 781-3000 CONTRACTOR ►w,+E. TIRE B Ffdb a f7ppadaalel MOPE (caul II applicable 3010 Burns Avenue Wantagh, New York 11793 AooREss art STATE. a CODE PERSON FILING NYC Department of Environmental Protection (718) 595-3718 APPLICATION N AiE. ATLE ale FIRM U aoptieabrel PAW haul e.g. iopng gent ray ►Aonogng agent etc. 59-17 Junction Boulevard, 8th Floor r_nrori _ ow Ynrk 11368 ADDRESS cm STATE. i t,#

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 listedproperty. I am familiar w/th the r.wk proposed to be carried out on my property and give my permission for this application to be riled. The in!ormation enteredis correct and Complete, to the best of my knowledge. OWNER For appr¢srorw b -0A an or if. fTE2Bf~RT /"LoSe-OWTT2- 2 -L 2- -3 T9,-3Yo 000parab..a or mrdon.Ywm troMbarp. OMNFrS NM.E and TILE (Pease Noe or PWI PHONE loovl •e wwr s It.. Coop Board or aw Co-op Board or Condondnl m Asaodsdon must son Otis appawion Pw.N cones the tnstrueiona far Fain r adddtonal Morm. n. P

NYC DEP `7~wt,t~,A1r✓tJ~o f or owner oIJ~~QL SIGNATURE SrcNATutEOF L—t I NOW Section 25-317 of the Adnwnislrative Code of the Cay of New York makes if a punishable offense to wi5fuey make false statements on this application

NYC-WTC 000093919