WTC debris clean-up application form, June 2002

NYC 9/11 Public Portal Document

COMMISSION THE CITY OF NEW YORK LANDMARKS PRESERVATION YORK, NEW YORK,10007 .t, ,•: . J}rC 1 CENTRE STREET, 9TH FLOOR, NEW ` 3 TEL: (212) 669- 7700 FAX: (212) 669-7960

APPLICATION FORM PROPERTIES WORK ON FOR DESIGNATED so certified by the Landmarks This application will not be deemed complete until it is application form and the materials Preservation Commission. An application consists of an response to a Warning Letter or necessary to describe the project fully. If being submitted in Notice of violation. please enterthe numberbelow.

Please print or type all Items. if not applicable, mark N.A.

7lo Hod)Exterior IQrS 5, I , 30,332 ADDRM DESIGNATED PROPERTY Manhattan Z0 LOT ZONING BOPOl1GH BLOCK DETAILED DESCRIPTION Removal of debris (cleaning) from the collapse of the.WTC OF PROPOSED WORK from exterior building surfaces as per scope of work Use back of form if necessary previously reviewed and approved by NYCLPC.

COST OF PROJECT WARNING LETTER / NOV # NIA si iss. tm5 & FIRM moppfcoblel PHONE (dart TENANT/LESSEE/ CO-OP SHAREHOLDER ADDRESS APT k CITY. STATE ZIP CODE

NIA PHONE toaA ARCHITECT! NAAC. T[RE & FIRM m oppl l ENGINEER If applicable CITY STATE ZIP CODE AIXNlEss Trio Asbestos Removal Corp. (718) 961-4100 NAME TffIE & FIRM of opdk oble) (dart PHCP CONTRACTOR If applicable 14-20 129 Street College Point, New York 11356 ADDRESS CITY• STATE ZIP CODE

PERSON FILING NYC Department of Environmental Protection (718) 595-3718 APPLICATION isAME miE & Fart td opdic obtei Idail e.g. Es ed+to.ent. Corona. N w yn k 11368 MpnOging Ag Anomey. efc. 59-17 Junction Boulevard, 8th Floor faTY, STATE ZIP OD: ADDRESS

ARE YOU APPLYING TO ANY OF THE FOLLOWING? ❑ Buildings Department O City Planning Commission O Board of Standards & Appeals carried out on I am the owner of the above listed property. lam familiar with the work proposed to be information entered is correct my property and give my permission for this application to be filed. The and complete, to the best of my knowledge. ------------- -1-1-1--------------------- - OWNER For applrcations for work on or Ina come o ve or tare o-op Bo or the owner is the Co-op Board or _. " 1 ..._ '-!- ✓, II ._._._._._._._._._._._._._._._._. ._

Condominium Association. An officer of the Co-op Board or Condominium Association must sign this application .. .- Please consult the Instructions for Filing for additional Information. NYC DEP for owner ___ gj- bL SIGNATURE SGNAnmEOF o L` to willfully make false statements on this application. Note: Section 25.317 of the Administrative Code of the City of New Your makes it a punishable offense w. a uc

NYC-WTC 000093912