Memo regarding WTC debris clean-up permit applications, June 2002

NYC 9/11 Public Portal Document THE CITY OF NEW YORK LANDMARKS PRESERVATION COMMISSION • I CENTRE STREET,9TH FLOOR,NEW YORK,NEW YORK,10007 TEL (212)669-7700 FAX:(212)669-7960

APPLICATION FORM FOR WORK ON DESIGNATED PROPERTIES f-?.

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 Warr,:ng Letterer Notice ofViolation, please enter the number below. Please print or type all items. If not applicable, mark N.A.

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DOCKET C DATE RECD DATE CERT. AS COMPLETE BLDG. DEPT. C & DATE STAFF

❑ MDMDUAL ❑ SCENIC ❑ INTERIOR YPE Of DESIGNATION HISTORIC DISTRICT

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

DESIGNATED PROPERTY Manhattan BOROUGH /,-f ', BLOCK 7563 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 Y reviewed and approved by NYCLPC.

COST OF PROJECT WARNING LETTER / NOV # NIA TENANT/LESSEE/ NAME TITLE & FIRM in opdicobol PHONE Idotl CO-OP SHAREHOLDER ADDRESS APT +1 CITY, STATE ZIP CODE NIA ARCHITECT/ NAME TITLE & FIRM in opoilcoblel PHONE ldoyl ENGINEER If applicable ADDRESS CITY, STATE ZIP CODE

Fiber Control, Inc. (516) 781-3000 CONTRACTOR NAME, TITLE & FIRM (if app icdbiel PHONE idoyl If applicable 3010 Burns Avenue Wantagh, New York 11793 ADDRESS M. STATE. ZIP CODE

PERSON FILING NYC Department of Environmental Protection (718) 595-3718 APPLICATION NAME TIRE & FIRM (if opolicoble) PI+CNE (Doti e.g. Expeditor, Attorney, Managing Agent, etc. 59-17 Junction Boulevard, 8th Floor Corona NPw York 11368 ADDRESS CITY, SLATE, ZIP &)OE

ARE YOU APPLYING TO ANY OF THE FOLLOWING? ❑ 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 caned out on my property end give my permission for this application to be riled. The information entered is correct and complete, to the best of my knowledge. OWNER For applications for work on or in a cooperatlxe or condominium building, fiKsr 4The (!ij,ilbe OWNERS NAME and TITLE (please type o, ptintl ` PHONE (ooyl the 'owner is the Co-op Board or Condominium Association. An officer of the Co-op Board or Condominium Association must sign this application. Please consult the Instructions for Famg for additional ddormatlon, 3IP63

SIGNATURE Note: Section 25-317 of the Administrative Code of One City of New York makes tie punishable offense to willfully make false statements on this application. Ow un:

NYC-WTC 000094002