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• "00 FAX (212) 669-7960
APPLICATION FORM
FOR WORK ON DESIGNATED PROPERTIES
F-2
This application will not be deemed complete until k Is so certified by the Landmarks
Preservation Commission. An application consists of an application form and the materials .N
necessary to describe the project fully. If being submitted in response to a Warning Letter or
Notice ofViolation, please enter the number below
Please print or type all Items. If not applicable, mark NA
(~cio,¢cAGC)
DESIGNATED
PROPERTY Manhattan
SOQOUGH
/q
BLOCK
7563
LOT ZONING
DETAILED
DESCRIPTION: Removal of debris (cleaning) from the collapse of th•a WTC
OF PROPOSED YORK from exterior building
Use back of form H necessary surfaces as per scope of work
previously reviewed and approved by NYCLPC.
COST OF PROJECT WARNING LETTER / NOV #
NIA
TENANT/LESSEE/ NME imsa FRM to oopbooblel Idol?
CO-OP SHAREHOLDER
ADOM s APT • OTST , P E
NIA
ARCHITECT/ NMtE, ihIE & Fo IC opopcodel PHONE (doi
ENGINEER
If applicable
ADDIS CITY SWE. ZIP
Fiber Control, Inc. (516) 781-3000 ?
CONTRACTOR NAE. MIE & FRM Pr apdkableI PHONE tdol?
If applicable
3010 Burns Avenue Wantagh, New York 11793
.soolrss cm
PERSON FILING NYC Department of Environmental Protection (718)
595-3718
APPLICATION NM.E. TITLE & FEIM ( r"ICablel PHONE Idol)
e.g. Expeditor, Attorney.
Monogng Agent etc. 59-17 Junction Boulevard, 8th Floor Corona NPw York 11368
ADOaEss CITY STATE ZIP
ARE YOU APPLYING TO ANY OF THE FOLLOWING?
0 Buildings Depart-ient 0 City Planning Commission 0 Board of Standards & Appeals
i .:rn the owner of the above listed property. lam 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 knowiedge
OWNER
For applkaims, br work on or ma
t»operasve or Condominium busdkq.
fiksr ofobc (!otlba
NnnE orta TITLE
'
(Please Noe or ortrrtl PHONE tow
the 'owner' is the Coop Board or
Condominium Assodation. An olbnsr of
the Co-op Board or condonbi m
Association must sign this applkation
Pleas. aonsuh the Inetrttdfprts br Faalg
br additional kdomtaoon.
SIGNATURE
Note: Section 25-317 of the AdmlMslrotive Code of the City of New York makes it a punishable offense to wtdfuty make false
statements on this appbaetion
NYC-WTC 000094034
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