Permit application for subway entrance closure at 189 Broadway, Nov

NYC 9/11 Public Portal Document

WTC Visual Survey Form Premise Address: t ~~

Block: lo 3 Residential 0 Commerciat Name of Building: Lot: t3 Mix Use Other # of Stories: ' AKA's: — 3 Building Owne /Mane ement: Telephone Number. ( ) Name: w t+n FAX: Address: t ,e' S a t •L On Site Contact: Name: * ' Telephone Number. Building Owner Management Activities Interior Survey Performed ❑ Yes Q No Exterior Survey Performed [] Yes Q No General Clean Up 0 Yes L] No Locations: ACM Clean Up ❑ Yes ❑ No Locations: Air Monitoring [r Yes 9 No Locations: Copies of All Reports and Data Requested Yes

Visual Inspection Results: Facade: Ins acted Debris North l/A Yes Q No ❑ No Visible/Fine Layer h to? 0> 1" South ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer Q34 to? 0>1' East ❑ N/A ❑ Yes ❑ No 0 No Visible/Fine Layer 934 to 1" ❑ > 1" West ❑ N/A ❑ Yes ❑ No ❑ No Visible/Fine Layer 04 to? [J> 1" Facade Description:

Roof

Debris: 0 No Visible /FineLayer i/ to? 0>? Description:

Setbacks N/A n Floor. Debris: 0 No Visible/Fine Layer ❑ 6 to V 0>1' Floor. Debris: No Visible/Fine Layer ❑ ~4 to V 0>1' Floor Debris: No Visible/Fine % to 1" ❑ >V Floor. Debris: No Visible/Fine Layer LayerB%to 1" 0> 1" Floor. Debris: ❑ No Visible/Fine Layer ❑ % to V 0>1'

Comments

Date: _( t 12002 Inspection Team: Name: '- Agency: £ N T E R Eb - Name: Agency:

NYC-WTC 000123060