NYC 9/11 Public Portal Document
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THE CITY OF NEW YORK LANDMARKS PRESERVATION COMMISSION
yap 1 CENTRE STREET, 9TH FLOOR, NEW YORK, NEW YORK, 10007
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 Letterer
Notice of Violation, please enter the number below.
Please print or type all hems. If not applicable, mark NA
DOCKET I DATE RECD DATE CERT. AS COMPLETE BLDG. DEPT. I & DATE STAFF
❑ INDIVIDUAL ❑ SCENIC ❑ INTERIOR
rYPE Of DESIINA01ON HISTORIC DISTRICT
JPMW
T10N
OCHE COFA REPORT
OTHER WORK TYPE
7 t t Ecru--~~ Exterior ( de)
ADDRESS FLOOR ORAPARTPaKEIT
DESIGNATED
PROPERTY Manhattan 9Z 3/
BOROUGH BLOCK LOT ZONING
DETAILED
DESCRIPTION Removal of debris (cleaning) from the collapse 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 (It appllcoblel
CO-OP SHAREHOLDER
ADDRESS APT « CRK STATE. ZIP CODE
NIA
ARCHITECT/ NAME. TITLE & FIRM Of opotcablel PHONE bed
ENGINEER
If applicable
ADDRESS CITY. STATE. ZIP CODE
Trio Asbestos Removal Corp. (718) 961-4100
CONTRACTOR NAME. TITLE & FIRM (B apOloable) PHONE (doyl
If applicable 14-20 129 Street College Point, New York 11356
ADDRESS CITY. STATE. ZIP CODE
PERSON FILING NYC Department of Environmental Protection (718) 595-3718
APPLICATION NANe, TITIF & FMRM (d oppUGnble) P`K7h1E I0051
e.g. Expeditor, Attorney.
Managing Agent, etc. 59-17 Junction Boulevard, 8th Floor Corona NPw York 11368
ADDRESS CITY, STATE. ZIP .ODE
ARE YOU APPLYING TO ANY OF THE FOLLOWING?
0 Buildings Department 0 City Planning Commission ❑ Board of Standards & Appeals
I am the owner of the above listed property. lam 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, tto the best of my knowledge.
OWNER
' e
For applications for work on or m a ~D M L4A -r ` Lan. .. LL C.
cooperative or condominium building. O'~wIJE NAME ¢no TITLE please type or ( PHONE (dayl
the -owner is the Co-op Board or rLK •,(
Condominium Asaxiation. An officer of /C
CL © t i[C r V
the Co-op Board or Condominium C CORPORATION, ORGANIZATION (r coot I
AW
Please Consult theInstrucons for FAng
nn
OC OC 0 A ql 2.r K-e f '{& Yv Y4. Y `r f I 0 o (1 —
for additional Information. ADDRESS
NYC DEP for owner
SIGNATURE SIGNATURE OF — - DAr
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.
NYC-WTC 000093925
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