WTC debris clean-up application form, June 2002

NYC 9/11 Public Portal Document I t:tNLK1 S"tx r, 9TH FLOOR, NEW YORK, NEW YUtuc, IUUVf. . . - to TEL: (212) 669- 7700 FAX: (212) 669-7960

~~ APPLICATION FORM FOR WORK ON DESIGNATED PROPERTIES R2 •

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 NA.

OAIE CERT. AS COMPt.EIE SIDG. OEot. • to DAIS SW+

DESIGNATED "°° OR ,MEM I PROPERTY Manhattan SO5OU 44 133 BLOCK OO LOT 20M G DETAILED DESCRIPTION Removal of debris (cleaning i from the collapse of the WTC OF PROPOSED WORK from exterior building surfaces as per scope of work Use back of form H necessary Y reviewed and approved by NYCLPC. previously

COST OF PROJECT WARNING LETTER / NOV # NIA TENANT/LESSEE/ P01.E.551&FIRMtpdppscaoiel Pi+orrEroil CO-OP SHAREHOLDER ADDRESS AFr ♦ arY, SIAIE, aP CODE NIA ARCHITECT/ NAME. NU a FIRM Ir aaolicceret neoNE tdoyl ENGINEER If applicable ADDRESS 0111 stA1E.. DP CODE

Fiber Control, Inc. (516) 781-3000 CONTRACTOR N4.f.11REaFIRMaal7asooble1 wtonEtdaA if applicable 3010 Burns Avenue Wantagh, New York 11793 ADDRESS Cr,. SLATE. ffi CODE PERSON FILING NYC Department of Environmental Protection (718) 595-3718 APPLICATION NM.£ml.EaFAMpaadcabtel AIDrEpvq e.g. Exnedngentetey Monop+np !pent etc. 59-17 Junction Boulevard, 8th Floor Corona NPw York 11368 AcrX1ESS Cm STATE. 54 &OOE

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 fisted property I am familiar w0f. :he r.-ark proposed to be carried out on my property and give my permission for this application to oe riled. The information entered is correct and complete, to the best of my knowledge. OWNER ► For apphc.Gpn br vimk a an N a cooperate at cond ninkom bu". — AI- T(e k) L )J O0tE55 NAME and Still IplaaFe IYPe a P4KI PICNE taarl tM 'owner a the Coop 9esro m Gontlmnh4m Anodation. M alse., of aq C000p 6o.roaa . ..•^.^^`.Rase^^^•Aea,•.e.e,e.•• .-.•••^....--.-.-.--,-. .-.- CWomtikan - Ae.odeaon root sign aft aopiC,tbn Plsaw mneue the InsltuWons far Fakq i br aemlbnal wmmason. P L _ _ _ _____ _.-_........................ / SIGNATURE acewuRE OF l7ArF t

Note: Section 25-317 of the Admkdstrative Code of the City of New Yak makes it. punishable offense to wdduay make (alse statements on !his application a- on.

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