WTC debris clean-up application form, June 2002

NYC 9/11 Public Portal Document 1 CENTRE STREET, 9TH FLOOR, NEW YOWL, NEW YORK. 10007. TEL: (212) 669-7700 FAX: (212) 669-7960

APPLICATION FORM FOR WORK ON DESIGNATED PROPERTIES t:2 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 NA.

DATE CERT. AS COMPTETE BLDG. PLC & DA3E I

DESIGNATED PROPERTY Manhattan OOROUCN /33 BLOCK 7LOT WNW. DETAILED DESCRIPTION Removal of debris (cleaning, from the collapse of the OF PROPOSED WORK irom exterior building WTC Use bark of form If necessary surfaces as per scope of work previously reviewed and approved by NYCLPC.

COST OF PROJECT WARNING LETTER / NOV # NIA TENANT/LESSEE/ 1W k. TIRE a FIRM p 000rcaC l PHONE tow CO-OP SHAREHOLDER AooRESS AFT a fm SLATE, SP CODE NIA ARCHITECT/ NAW M5&FNM ro appkcaatat KW ENGINEER If applicable AbOSS CITY SLATE DP CODE

Fiber Control, Inc. (516) 781-3000 CONTRACTOR ►+AME.nTLk&FUMNoovaoma) w,pa If applicable 3010 Burns Avenue Wantagh, New York 11793 AOss oT STATE, ZIP CODE

PERSON FILING NYC Department of Environmental Protection (718) 595-3718 4PPLICATION N 11BEaFnMnaopkraotei "40%toayl e.g. Exe0gi ltor.Attomey Hong ng Agent etc. 59-17 Junction Boulevard. 8th Floor Corr+np NPw Ynrk 11368 AT)ORE55 Cm: STATE DP

ARE YOU APPLYING TO ANY OF THE FOLLOWING? ❑ Buildings Department 0 City Planning Commission 0 Board of Standards & Appeals lam the owner of the above listed property. lam familiar wNt. ;,he i-xk 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&Wbatons for wok m or In a 000perattvs of condomMkrm b OM lily TI ch S NAME and TIRE Io1Bote MPe a rmtl ig. PNDNE faaq M 'owner a tiro Coop Board or CandomlMrm Assoaason. An dear of B,. Coop Bard or C widominkan _~~._._. _. _._~.~_~._._._._._._._._._._._._. - I Assoa4tlon moat Sir tnb avo aton PLYae cone Iha tnstruebons for Faa.5 tar adddkrrol A'dTYam . _.'_._._ . ._._.-.-. .-.-.-.-.. P I -.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.- _._._._._._._. ._._._._.~. i-.AMAM --.-.-.---._._. _._._. ._._. Ir~ v~ _._.-.-._._._._.

SIGNATURE NY D A//1For owrle ~► U1~ EP Note: Section 25.317 of the Adnrrdstrabvs Code Of the City of New York makes it a punishable offense to wdffuliy make false statements on this application ar,. W.

NYC-WTC 000093926