WTC debris clean-up application form, June 2002

NYC 9/11 Public Portal Document

THE CITY OF NEW YORK LANDMARKS PRESERVATION COMMISSION ~a9 1 CENTRE STREET, 9TH FLOOR, NEw YORK, NEW YORK, 10007.. : 3 TEL: (212) 669- 7700 FAX: (212) 669-7960

APPLICATION FORM Fz FOR WORK ON DESIGNATED PROPERTIES 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 Letter or Notice of Violation. please enter the number below. Please print or type all items. If not applicable, mark N.A.

PC DOCKET • DATE RECD DATE CERT. AS COMPLETE BLDG. DEPT. • & DATE STAFF

O INDIVIDUAL ❑ SCENIC 0 INTERIOR

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

Z Exterior ( IQ/5 S 11j, 3033 DESIGNATED ADDR FLOOR OR APARTMENT PROPERTY Manhattan 2,0 BOROUGH BLOCK LOT ZOMNG DETAILED Removal of debris (cleaning) from the collapse of the. WTC OF PROPOSED WORK from exterior building surfaces as per Use back of form if necessary scope of work previously Y reviewed and approved by NYCLPC.

COST OF PROJECT WARNING LETTER / NOV # NIA TENANT/LESSEE/ NAME, TmE& FIRM[I opocoogi PH E(dat1 CO-OP SHAREHOLDER ADDRESS APT C CITY, STATE, ZIP CODE

NIA ARCHITECT! NAME. TITLE & FIRM (I oppliCoblel ?MOTE (dart ENGINEER If applicable ADDRESS CITY, STATE ZIP CODE Trio Asbestos Removal Corp. (718) 961-4100 CONTRACTOR NAME mu & FM (If oppllcoble) PtK7hS (Oar) If applicable 14-20 129 Street College Point, New York 11356 ADDRESS CTTY, STATE, ZIP CODE

PERSON FILING NYC Department of Environmental Protection (718) 595-3718 APPLICATION NAME. mLE & FeM m oppticoblel A4CNE (drn7 e.g. Expeditor, Aftomey. Morlogmg Agent etc. 59-17 Junction Boulevard, 8th Floor Corona NPw York 11368 ADDRESS CITY, STATE ZIP &ODY

ARE YOU APPLYING TO ANY OF THE FOLLOWING? ❑ Buildings Department ❑ City Planning Commission ❑ 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 filed. The information entered is correct and complete, to the best of my knowledge. OWNER For appkeatbns for work on or in a GtCo~'c ~C t uS'i'YL Q ` PI I -•-_._.+ ._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._._ cooperative or condominium building, "' the'o is the Coop Board or i I I Condominium Assoctation. An placer of the Co-op Board or Condominium Association must sign this application i Please consul the instructions for Filing (or addKbnalinfomatbn '-'71O01TESS_._._._._._.-'-'-'-._._._._._._.-' -'-

NYC DEP / , for owner g DZ SIGNATURE SIGNATURE OF OWN DI 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 application. .,e. rw

NYC-WTC 000093923