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Document / 14 pages

Contract permit application form, Oct 2001

Machine-extracted title · confidence 95%

Application for street work permits including sewer installation and pavement repair at a World Trade Center site.

NYC-WTC_000111833–000111846

Folder label: “NO LICENSE AGREEMENTS

Page image
Scanned page image, NYC-WTC_000111834
OCR text

OCR status: ok · source: pdftotext

NYC 9/11 Public Portal Document

Y ~ APPLICA77ON FOR CONTRACT PERMIT o(Ttaasportation o(Pct t Min t id ComII notion Control )C.1 (REV. 9-98) ITtONT

PERMT NU ER: PERtit1 (Ii #: 124 TO CONTRACT #: R or - R £M2 BOROUGH: 19M OB OQ OX Os OMEC OBNEC OQEC OBXEC OREC OCMC11 SPONSORING AGENCY: RDEP ODDC ODOT ONYSDEC ONYSEDC OHPn OPARES Osc . OMM OPA of NYLNJ

PROJECT ENGIZNEER NAME: R. R A D W A K R~ S RNAN P. (:. TELEPHONE #: (7 (13 ) 5 9 5- 7( S

NAME OF CONTRACTOR: BENSAMiN KUQZPSHN coN (owt&oL EPEONE #: (11 )S3i -2800

BUSINESS ADDRESS: 12.416 "L P 4 AVEOLL P, Roc L-i r4 r(. 4 1 1 23(0 RESIDENT ENGINEER 2A2g: PHONE #: (

PROJECT txT~~tNoR ( CAO.uP AC.TNVtT%ES 10 REMOVE Del .t$ G'ROM LOI.LA C o WTZ.- CONTRACT START DATE: 5 1 i5 I0 Z - CONTRACT COMPLETION DATE: 9 f [ 2-10 2-

TYPE OP PAVEMENT: ROADW : L SIDEid(IS.:

• TYPE Or PERHIT(S) REQUESTED (Check All Applicable) : 0111 .7OR INSTAll IION-SERER 0126 -TEST PITS; CORES OR BORING CRAM/SHOVEL ON STREET 0112-RAPID TRANSIT CONSTRUCTION 1 ❑132=INSTALL FENCE 0205-PLACE SHANTY/TRAILER ON j 0113 -REPAIR. iaLTER `~ r ❑135-FINAL RESTORATION STREET 0114-REPAIR SEWER - D136-DEP-3OR INSTALLATIONS- 0208 -TEMPORARY PEDESTRIAN W1LK ❑115-REPAIR'W /SERER ¼ AXER 0211-TEMPORARY ROADWAY CLOSING 0116'FUEL+OIL LINE ^ D137-DEP-MWOR ENSTAr.L IONS- D214-PLACE CONTAINER ON STREET 0118-RESET,REPAIR OR REPLACE- SERER O215-TEMPORARY SIDEWALK CLOSING CURB 0201 -PLACE MAMEPIAL ON STREET ❑401-REPAIR. SIDESAIK ❑119TRAVE STREET • 9202-CROSSING SIDEWALK 0402-CONSTRUCT NEW SIDEWALK J 0120 -TREE PIT t 17203-PLACE CRANE/SHOVEL ON 0403-REPILACE SIDEWALK 0121-CONSTRUCT OR ALTER MANHOLE STEO T • VENTILATORS NAND/OR CASTING j 0204-PLACE EQUIPMElTT OTHER THAN

OTHER TYPE OF PERMIT:

ON sTRt1T -77ECA VOR C LARK ( . FROI STE ST ro STREET TF= sTBRS E®

t ~J,A-IONS:

R!TIC .zptu-:oNs: F1

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RIC sTZFrx:a.s:

SPECS1L s2IP0L7TI09S

OC?iC APPROVAL BY: DATE: DMMORE LOCATIONS ON REVERSE TBE PERMIT TO BE GRANTED SUBJECT TO T5E FOLLOWING CONDITIONS: TIM AP=C+NT Al .ESS TO COMPLY WITS ALL LAWS AND RUNES OF YES DEPARTMENT AND OTffi t APPLICABLE LAWS AND RULES. NO 2 T SHALL BE ISSUED UNLESS TEE APPLICANT HAS ON FILE ALL INSURANCE(BONDS).

APPROVED FOR THE CO~IISSIONER BY: SUBMITTED BY: DATE:

DATE: SIGNED BY:

NYC-WTC 000111834

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NYC-WTC_000111834Source: NYC Law Department, mirrored locally

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