NYC 9/11 Public Portal Document
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THE CTTY 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.2
This application will not be deemed complete until It is so certified by the t.andmarks
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 Letterer
Notice of Violation, please enter the number below.
Please print or type all items. If not applicable, mark NA
DOCKET • DATE REC9 DATE CERT. AS COMPI EtE BLDG. OEVL C h DAIS STAFF
ci tNONtou & ❑ SCEMC D SITERtOR
PMW ❑ CNE REPORT
ION OTHER WORK TYPE
'/ 9 /'( en i' si Q r
PC=ORAatRTMENIT
Exterior
DESIGNATED ADDS
PROPERTY Manhattan
BOROUGH
/33 75j3
BLOCK LOT ZONING
DETAILED
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
Y reviewed and approved by NYCLPC.
COST OF PROJECT WARNING LETTER / NOV #
NIA
TENANT/LESSEE/ NAME TITLE & FIRM It applicable) PHONE (day)
CO-OP SHAREHOLDER
ADDRESS APT • CITY, STATE. ZIP COOS
NIA
ARCHITECT/ NAME, TITLE & FIRM N applicable) PHONE (doff
ENGINEER
If applicable
ADDRESS cm: StME ZIP CODE
Fiber Control, Inc. (516) 781-3000
CONTRACTOR NNE. TITLE & FtRM N appdoble) PHONE tdarT
If applicable
3010 Burns Avenue Wantagh, New York 11793
ADDRESS CTTh. STATE ZIP CODE
PERSON FILING NYC Department of Environmental Protection (718) 595-3718
APPLICATION NAME. TITLE & FIRM (M opplicobtel PHONE tdayl
e.g. Expeditor, Attorney,
Managing Agent. etc. 59-17 Junction Boulevard, 8th Floor Corona. New York 11368
F LESS CRY, STATE. ZIPOOE
ARE YOU APPLYING TO ANY OF THE FOLLOWING?
❑ Buildings Department ❑ City Planning Commission ❑ Board of Standards & Appeals
lam the owner of the above listed property. i em familiar with the work proposed to be carried out on
my property and give my permission for this application to be filed. The information enteredis correct
and complete, to the best of my knowledge.
OWNER
For application• for work on or In a
cooperative or condominium bNWnq.
the •owner Is the Co-op Board or
Condominium Association. An officer of
the Coop Board or Condominium
Association must sign St. application
Please consult the instructions for Filing
for additional information.
279
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
ow r„c•.
NYC-WTC 000094036
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