Premise No. Inspection Date:
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Floor Zip Borough Block Lot Squad # Badge #
awF FAG►vss 10038 1 N/A A020
Inspector Building Type Basis of Inspection Photos Taken
Dennis Antzoulatos WTC Survey Ye No
Contractor's Name Sample Number
Benjamin Kurzban & Son Control N/A
Address City Sample Number
1248 Ralph Avenue, Brooklyn N/A
State Zip Phone Sample Number
NY 11236 (718)531-2900 N/A
Laboratory Name Owner's Name
Warren & Panzer Engineers Inc.
Address City Address City
228 East 45 Street New York
State Zip Phone State Zip Phone
NY 10017 (212)922-0077
Contact Person. c,t Iac*u-t.ea S~o2E Time of Inspection from:
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MONDAY 1uL 1 22 2o02 tI : 0o PM
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8Y NATIONAL. MAL$TEWAM E INC 183 Stu r 1.at.tOu) R,oAD OLD S ntPA6,E
Ny 11804 0516) 249- 86O C. Cc cT : 300A.Tt 81tu4ou 7 . A PYIoTo6WMN
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NYC-WTC 000122843
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NYC-WTC_000122843Source: NYC Law Department, mirrored locally