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 ' APPLICATION FORM FOR WORK ON DESIGNATED PROPERTIES F-2

This application will not be deemed complete until it is so certified by the Landmarks cr Preservation Commission. An application consists of an application form and the materials i? necessary to describe the project fully. If being 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 N.A-

I DOCKET. 0 DATE REC9 DATE CERT. AS COMPLETE BLDG. DEPT. I & DATE STAFF

0 INOMDUAL O SCENIC O INTERIOR .YPE Of DESIGNATION HISTORIC DISTRICT

PMW 0 ONE 0 C OF A 0 REPORT ,ACTION OCHER WORK TYPE

I3'L7 Ct6cLtkff) Exterior (lei) ADDRESS FLOOR OR APARTME"T DESIGNATED

PROPERTY Manhattan BOROUGH q Z. BLOCK 3/LOT ZOMNG DETAILED DESCRIPTION Removal of debris (cleaning) from the collapse P of the.WTC OFPROPOSEDWORK 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 (II oppfica el RS ((Sall CO-OP SHAREHOLDER ADDRESS APT t CRY• STATE. ZIP CODE

NIA ARCHITECT/ NAME, ITTLE & FIRM ff opa+aaael d~+ioNE (dovt ENGINEER If applicable ADOflESS CRY, STATE. ZIP CODE

Trio Asbestos Removal Corp. (718) 961-4100 CONTRACTOR NAME, TITLE & FRM ff OppEc PtiONE (dovt 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 NAMEnn-E&FIRM(itopptbobie) R4ONE(dayt e.g. Managing Agent- etc. 59-17 Junction Boulevard, 8th Floor Corona . New York 11368 ADDRESS Cm STATE ZIP ODE

ARE YOU APPLYING TO ANY OF THE FOLLOWING? O Buildings Department ❑ City Planning Commission O 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 the best of my knowledge. OWNER For applications for work on or in a cooperative or condominium building. the -owner is the Co-op Board or Condominium Association. An officer of the Co-op Board or Condominium Association must sign This application Please consult the Instructions for Filing for additional lrdormatlon.

SIGNATURE 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 applcatton.

NYC-WTC 000093914