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 FIAOR, 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 and the materials necessary to describe the project fully. If being submitted in response to a Warning Letterer Notice ofViolation, please enter the number below. Please print or type all Items. If not applicable, mark NA

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BLDG. DEPT. I & DATE STAFF

E DOCKET. A DATE REM DATE CERT. AS COMPLETE

INDIVIDUAL 0 SCENIC 0 INTERIOR O l'Pk Of DESIGNATION HTSTONIC DISTRICT

PMW Cl CNE 0 C OF A 0 REPORT ACTION OTHER WORK TYPE

ADDR(SS / - 7 r>o~ak.~ FLOOR ORAPARTHPfl Exterior (aadi) DESIGNATED

PROPERTY Manhattan BOROUGH q Z. BLOCK 3/ LOT ZONING DETAILED DESCRIPTION Removal of debris (cleaning) from the collapse P 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 TENANT/LESSEE/ NAME. TITLE & FIRM ft opplE.ablel PHONE (dart CO-OP SHAREHOLDER ADDRESS APT r CRY STATE. ZIP CODE

NIA ARCHITECT/ NAME. TIRE & FIRM N opdk able( a10NE (doll ENGINEER If applicable ADDRESS CITY, STATE. ZIP CODE

Trio Asbestos Removal Corp. (718) 961-4100 CO NTRACTO R NAME, TITLE & FRM Of applicable) PHONE (doN If applicable 14-20 129 Street College Point, New York 11356 ADDRESS CITY. STATE ZIP COQ

PERSON FILING NYC Department of Environmental Protection (718) 595-3718 APPLICATION NAME TITLE & FIRM (M applicable) P<m (day)

e.g. EKpeditor. Alorrtey. MonOging Agent. etc. 59-17 Junction Boulevard, 8th Floor Corona. New York 11368 ADDRESS CITY STATE ZIPS

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 listed property. I am familiar with the work proposed to be carried out on my property and give my permission for this application to be riled. The information entered is correct and complete, to best of my knowledge. OWNER ~thee

For applications for work on or Eta L ) M r I a.dc LLC _ cooper.Wo or condominlum building. OWNE NA-ME TITLE (pieose a IJ PHONE (cloy) the -owner is tiro Co-op Board or c -r ,I L,( t IICCCC V r V u.. Condominium Assodation. M officer of or Mro Co-op Board CaMomMWm ANY. CORPORA~T ION~ORGAMLATION M opd ( t ~ t ~1 t Please 000wfltee Inns;Wons~1or Ffng tIon p~10 T C /I> , ~~ l a.e~l' I 1t;t,A.) ~„r, V ~' V Y I o o 1 — 5O tot additional l,donnatlon.

SIGNATURE NYC DEP SIGNATURE OF __i for owner__, DAI[ _Sciv 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 appircation. /u

NYC-WTC 000093914