NYC 9/11 Public Portal Document
THE CITY OF NEW YORK LANDMARKS PRESERVATION COMMISSION
I CENTRE STREET. 9TH FLOOR, NEW YORK, NEW YORK, 10007.
• 3 TEL (212) 669- 7700 FAX: (212) . ':7960
APPLICATION FORM*
FOR WORK ON DESIGNATED PROPERTIES
r-2
• This application will not be deemed complete until it is so certified by the Landmarks
Preservation Commission. An application consists of an replication form and the materials
necessary to describe the project fully. If being submitted In t espont;e to a Warning Letterer
Notice of Violation.please enter the numberbelow.
Please print or type all Items. If not applicable, mark NA
PC DOCKET • ATE REOD DAM CERL AS COMPLETE BLDG. DEPL • A DATE stiff
CT tKJoivsuM O scpec O INTERIOR
REPORT CT
OTHER WORK TYPE
DESIGNATED
-5 7
ADORES
Mct~e,2f4 L/ 57 eer FLOOR OR AMRTF
Exterior (ooF4 FICA
PROPERTY Manhattan /33 Jy
BOROUGH BLOCK LOT ZOKM
DETAILED
DESCRIPTION Removal of debris (cleaning) from the collapse of the WTC
Or PROPOSED WORK from 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/ wwE MU&R M(adpplk.mel wfolvE Ida9
CO-OP SHAREHOLDER
AOdtisS nrT. CTt. SWE 3PCOOE
NIA
ARCHITECT/ NME. TIRE & FILM Ia coplcobfl P OIK IdwT
ENGINEER
If applicable
ADORES arc Suds.sa
Fiber Control, Inc. (516) 781-3000
CONTRACTOR NAME, TIRE & W" fa aopscabb) PHONE (ape,
If applicable
3010 Burns Avenue Wantagh, New York 11793
nGOREss an sTATE, ZIP CODE
PERSON FILING NYC Department of Environmental Protection (718)
595-3718
APPLICATION W AC TIRE & HRM m app lcodel AC14 (dal
e.g. Expeditor. Attorney.
Monoging Agent etc. 59-17 Junction Boulevard. 8th Floor Corona
AOORESS CITY. STATE. ZIP_
New York 11368
ARE YOU APPLYING TO ANY OF THE FOLLOWING?
0 Buildings Department 0 City Planning Commission 0 Board of Standards & Appeals
lam 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 knowledge.
OWNER
For apptlatkuts for wait on or 5,a
Cooperative or condomiMum bilYdq.
5/ 1Jrn,rc &eo
OWNERS WA* 0KI TIRE (please type or pnrttl
2/2 -94 a ,f
Ole 'owner- b the Copp Bout or PHONE Woe)
Condominium Assodetion. An ofbc.r of
V e Co-op Board or CatdomfnWm
Association must sign this application
Please consult the Inabud ions for Fsitg
for additional kdormadon.
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,
s. W.
NYC-WTC 000094035
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