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) 669-7900

APPLICATION FORM FOR WORK ON DESIGNATED PROPERTIES 4 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 Hems. If not applicable, mark NA

DATE CERT. A9 COMPLETE e1DG. PLC & CAR I le -

DESIGNATED PROPERTY Manhattan 90ROUS, /33 BLOCK for ZONW. - DETAILED DESCRIPTION Removal of debris (cleaning, from the collapse of the OF PROPOSED WORK irom exterior building WTC Use back 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/ N1ME. TIRE a FtaN fit 000rcmei caa CO-OP SHAREHOLDER ADDres5 AGT f M. SWE 2P CODE NIA ARCHITECT/ NAMETTE&FrtMfrcmcaae+ ENGINEER If applicable CIrC SWE Dv CODE

Fiber Control, Inc. (516) 781-3000 CONTRACTOR NN+& nU a FUN fa o0pkoobia) "40* looyl If applicable 3010 Burns Avenue Wantagh, New York 11793 AOO SS CRK sWE. rp CODE PERSON FILING NYC Department of Environmental Protection (718) 595-3718 4PPLICATION NAME l5&t aootkeodet Elow e.g. Eapeodtx.Attorn. Monop no Agent erc. 59-17 Junction Boulevard. 8th Floor c ornnn NPw V Yorkk 11368 ADO em: stATe, zro

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 wif.:,he &:-Jrk 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 eppktxtiom for wort on or ln. 000perawe or Condom rikrm b ig. Gh1 ~T h L'.til OWN6rs NAME ono TIRF tateore MDe or Pmtl rte 'owner n the Coop Board or PNDNE tots 1 CSWomkrkrm Assooason. An deoer of a,. Co-epBoardorCondominkon ._._._._._._._._._._._._. A..06.e0n must slpn Oils epplls en Phase 05+504 the tnajuetlom br Faep b ,,d , klfOrnYtkm. ,1,r5fEt _._._._._._._. ._._._. ._._. _.-- _._Y.' ._._._._. ._._._._—.~_._._._._. ._._._._._._._. ._._._._.-. r NY C,T,DEP - --- LV(r+Ar/rFor owr~e SIGNATURE w ~ Note: Section 25-317 of the Adnrrdatntive Code of the City of New York makes it a punishable offense to willfully make false statements on dds application

NYC-WTC 000093926