Contract permit application form, Oct 2001

NYC 9/11 Public Portal Document

" ,~,iiewYorkCUy APPLT(.A77ON FOR CONTRACT PEkTIT of Trrnspolt won ■ o[Prrdt Mman®mt and Coo n ction Control M11 (RE7.8-98) FRONT

PERM T N Th ER': T (nW #: 124 TO CONTRACT #: g,

BOROUGH: EgM OB OQ OX ❑S DC ❑BNEC OQEC OBXEC OREC OCMC# SPONSORING )GENCY: EaDFO? QDDC ODOT QNYSDEC QNYSEDC DD QPARKS OSCA Q1M OPA Of NTLNJ

PROJECT ENGINEER NAME: R. R t\ ~ N rt-1 K R I S i-I N A N P. C. TELEPHONE #: (7 l 3 ) S O S- 2 7( 8 1 NAME OF CONTRACTOR: FSENSAMiN KUR2ARn1 CSO~ Cat,1120LTF.I.EPHORIE #: (71~)53i -2.QOO BUSINESS ADDRESS:12~1S 9,RLPFt AVE~tttt I IZOO .L -/hl N.J 1 i 23(n RESIDENT ENGINEER. NAME: TELEPHONE #: t )

PROJECT DESCRIPTION:g_ttDirl(: C OQ CFIEAN UP AGT:V IT:ES TO tYEMOVE Oee, s G'ROM C.A 1.(- A S 56 o - —Ti7TZ • CONTRACT START DAZE: 5 1 15 o 2- CONTRACT COMPLETION DATE: 9 (I z 2- 10 TYPE OF PAVEIENNT: ROADL7LY: STTIC:QLLE:

TYPE OF PERT (S) REQAESTED (Check All Applicable): 0111-MAJOR INSTALI?.ION-SERER 0126-TEST PITS, CORES OR BORING CRANE/SHOVEL ON STREET 0112-RAPID TRANSIT CONSTRUCTION 0132-INSTALL FE2iE 0205-PLACE SHANTY/TRATT.ER ON 0113-REPAIR wk=R 0135-FOAL RESTORATION STREET 0114-REPAfl SEIER D136-DEP-MAJOR INSTaTLLATTONS- 0208-~lPORARY PEDESTRIAN SALK 0115-REPAIR S01TER/SERER TULTER 0211-TEMPORARY ROADWAY CLOSING 0116-FUEL OIL LINE 0137-DEP-MAJOR INSTALLATIONS- 0214-PLACE CONTAINER ON STREET 0118-RESET,REPAIR OR REPLACE SEWER 0215-TEMPORARY SIDEWALK CLOSING CURB 0201-PLACE TAL ON STREET D401-REPAIR SIMERAT.X 0119 -PAVE STREET 0202 -CROSSING SIDEWALK 0402-CONSTRUCT NEW SIDEFALK 0120-TREE PIT 0203-PLACE CRANE/SHOVEL ON 0403 -REPLACE SIDEWALK 0121-CONSTRUCT OR ALTER MANHOLE STREET VE NTIIATORS AND/OR CASTING 0204-PLACE EQIIZPMENT OTHER THAN

OTHER TYPE OF P T:

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SPE 1L STfP~.LTIOES

OCMC APPROVAL BY: DATE: ❑MMORE LOCATIONS ON REVERSE 1'BE PERT T TO BE GRANTED SUBJECT TO THE FOLLOWING CONDITIONS: TEE APPLICANT AGREES TO COMPLY RITE ALL LASS AND RULES OF TEE DEPARTI NY AND OTBII2 APPLICABLE LAWS AND ROLES. NO PERMIT SHALL BE ISSUED UNLESS THE APPLICANT HAS ON FILE ALL INSURANCE(BONDS).

APPROVED FOR THE COMMISSIONER BY: SUBMITTED BY: DATE:

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NYC-WTC 000111836