NYC 9111 Public Portal Document
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THE CITY OF NEW YORK LANDMARKS PRESERVATION COMMISSION `
1 CENTRE STREET. 9TH FLOOR, NEW YORK, 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. M application consists of an application form and the materials it
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.
DOCKET Q DMTE RECD DATE CERT. AS COMPLETE BLDG. OEPt I k DAM STAFF
❑ atow Ol1AL O Scstec O pittptOe
PMW 0 ca CI C OP A 0 REPORT
TION OTHER WORK TYPE
/2
ADoa a
l/Fscy Seer Exterior ~RooP ,' 9 4be'
DESIGNATED FLOOR OR Anwn.@1T /
PROPERTY Manhattan IF~'
BOROUGH BLOCK LOT ZONN1G
DETAILED
DESCRIPTION Removal of debris: (cleaning) from the collapse of the WTC
OF PROPOSED WORK frcra exterior building
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/ NAT+E ME & FYTM tdappkcoblel MCI* tdaj
CO-OP SHAREHOLDER
ADDWss APT • CRY STATE ZIP CODE
NIA
ARCHITECT/ I1wutE- TIRE a Rout M applicable) PHCta(dcm
ENGINEER
If applicable
AD 3RKSS Cn' STATE 2P CODE
Fiber Control, Inc. (516) 781-3000
CONTRACTOR NAkrE. Th E&FMtsnoccanei PHONE wort
Ifapplicoble
3010 Burns Avenue Wantagh, New York 11793
bi5i 55 CITY. 51*3E. DP ca,E
PERSON FILING NYC Department of Environmental Protection (718)
595-3718
APPLICATION Nom. mie a mM IP appkcabiei PHONE fdwl
e.g EypedItot.Aflo,ney
Managing Agent etc. 59-17 Junction Boulevard, 8th Floor Corona NPw York 11368
ADOPESS CITY STATE ZIP
ARE YOU APPLYING TO ANY OF THE FOLLOWING?
0 Buildings Department 0 City Planning Commission 0 Board of Standards & Appeals
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lam the owns' r, '.r, above listed pma . _m familiar with the work proposed to be carried out on
my property and give my permission. nor this application to be filed. The information entered is correct
and complete, to the best of my knowledge.
OWNER
For appttcatrons for work on or ki a
moperstlw or eondomkitsm bWdnk.
the'aener is pie Coop Board or
It')' C L6& Yes
OM'NER5 NAME Ohio TITLE (please type a prsdi
A5 oc,*m .) - _
z,., -2 7- lo6y(.
PHONE WW1
Condomhk.m Auod.tlon. An cram of
the Coop Board or Condominkan
Association must sign this appkcation
Please eonsuti the Instructions nor FWrp
lot additional Itch nytlon.
SIGNATURE
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 000094000
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