NYC 9/11 Public Portal Document
THE CITY OF NEW YORK LANDMARKS PRESERVATION COMMISSION
1 CENTRE STREET, 9TH FLOOR, NEW YOR1C, NEW YORK. 10007.
• ~ , TEL: (212) 669- 7700 FAX: (212) 669-7960
APPLICATION FORM
FOR WORK ON DESIGNATED PROPERTIES
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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 Lattr or
Notice of Violation. please enter the number below.
Please print or type all items. If not applicable, mark NA
oOCal • DAta RECD DATE CERT. AS COMPLETE BLDG. PLC tk Di T5 STAFF
D NDMaYu 0 ScI#4 C Rion
PMW A 0 REPORT
OTHER CRE rwE
<° ,c k (o l -P Exterior ( ieoo
DESIGNATED ADDRESS FIDOR OR ARAMM R
PROPERTY Manhattan (~
IOR H BLOCK tot 20tatsP.
DETAILED
DESCRIPTION Removal of debris (cleanings from the collapse of the WTC
F D WORK from exterior building sur f aces as per scope of work
OUePRObackPOS
f form If
previously reviewed and approved by NYCLPC.
COST OF PROJECT WARNING LETTER / NOV #
NIA
TENANT/LESSEE/ f'ME.pits lMto- aoiel PF *
CO-OP SHAREHOLDER
ADDRESS APT ♦ cir SLATE SP
NIA
ARCHITECT/ NAME. TfftE ! rnni to actlkmel p,ipN* T
ENGINEER
If opolicoble
ADDRESS CITY.ELSIE. LP
Fiber Control, Inc. (516) 781-3000
CONTRACTOR MU a FnM p coTxcoolel rrl6 ldoi9
If applicable
3010 Burns Avenue Wantagh, New York 11793
A00 sTArE ZIP ca
PERSON FILING NYC Department of Environmental Proter-•,ion
(718) 595-3718
APPLICATION AYNE TITLESFOMpapOacobhel F,gte
6.0. ErysOnot, AnorrW,,
MonogtneA t ATtO e. 59-17 Junction Boulevar d 8th
ADDRESS ctrr. SLATE, SF 11368
ARE YOU APPLYING TO ANY OF THE FOLLOWING?
0 Buildings Department ❑ City Planning Commission 13 board of Standards & Appeals
lam the owner of the above listedproperty lam familiar with the monk proposed to
my property and give my permission for this application to be filed. The inkxmetion be carried out on
and complete, to the best of my knowledge. entered is canoes
OWNER
For apphm om for work on at in a
aooparatne or wnaoerkYKmr brrs0.9.
M 'am»r a tM Co-op Board at
Condo rrnkmr AuodeI on. M ararr of
Or. Co-op Board at Corraerranran
Assodadon roust sign Ws oppi Caton
Pk'sw consult iha InsVuclons tat isrq
for •dank',& Ardomrseon. 7
SIGNATURE
NOW Section 25-317 of the Adrnintstrsbve Code of the City of New York makes do punishable
offense to wiafuty melte lake sislemenO on Bits appticalion
A,. w
NYC-WTC 000093921
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