Landmarks Preservation Commission application form, WTC debris, 2002

NYC 9/11 Public Portal Document

THE CITY OF NEW YORK LANDMARKS PRESERVATION COMMISSION "` "' jO I CENTRE STREET, 9TH FLOOR, NEW YORK, NEW YORK, 10007 .tT TEL: (212)669-7700 FAX: (212) 669-7960 xx

APPLICATION FORM FOR WORK ON DESIGNATED PROPERTIES F2

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 cs Notice of Violation, please enter the number below. Please print or type all items. If not applicable, mark NA

DOCKET ♦ DATE RECID DATE CERT. AS COMPLETE BLDG. DEPT. # & DATE STAFF

0 INDMDUAL 0 SCENIC 0 INTERIOR lyE OF DESIGNATION HBIORIC DISTRICT

PMW 0 CNE 0 C OF A 0 REPORT ACTION OTHER WORK TYPE

\'L4 G t-(A~'r13E~s `~ i 2 l Exterior ADDRESS FIOOR OR APARItrENT DESIGNATED PROPERTY Manhattan i S q BOROUGH BLOCK LOT ZONING DETAILED DESCRIPTION Removal of debris (cleaning) from the collapse of the WTC OF PROPOSED WORK 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 # N iA TENANT/LESSEE/ NAME, TITLE & FIRM (It applicable) PHONE Idayl CO-OP SHAREHOLDER ADDRESS APT # CITY, STATE, ZIP CODE NIA ARCHITECT/ NAME. TITLE & FIRM pt upplicablel PHONE Tdmnl ENGINEER If applicable ADDRESS CITY, STATE. ZIP CODE

Fiber Control, Inc. (516) 781-3000 CONTRACTOR NA E, TITLE & FIRM (a applicable( PHONE (doe If applicable 3010 Burns Avenue Wantagh, New York 11793 ADDRESS CITY, STATE ZIP CODE

PERSON FILING NYC Department of Environmental Protection (718) 595-3718 APPLICATION NAME. TITLE & FIRM (II applicable( PHONE idayl e.g. Expeditor, Attorney, Mang ng Agent, etc. 59-17 Junction Boulevard, 8th Floor Corona. Npw Ynrk 11368 ADDRESS CITY, STAIE, ZIP ODE

ARE YOU APPLYING TO ANY OF THE FOLLOWING? El Buildings Department ❑ City Planning Commission ❑ Board of Standards & Appeals

I am the owner of the above listed property. I am familiar with the work 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 _L_I r I e. I i 1 11 For applications for work on or in a cooperative or condominium building. 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 Filing for additional Information.

NYC DEP - owner --------- - SIGNATURE --- - SIGNAIURE OE OWNER DATE

Note: Section 25-317 of the Adminislrative Code of the City of New York makes it a punishable offense to willfully make false statements on this application O._ wcc

NYC-WTC 000094011