FDNY Bureau of Fire Prevention Violation Order form, date unknown

NYC 9/11 Public Portal Document

A-17 (3/88) H,-8B0294-R25 INVESTIGATION OF COMPLAINT REPORT □ INTERIM REPORT B-RNAL REPORT DIV. BATT. CO. D.O. COMPLAINT zj-j COMPLAINT / NUMBER V 4: O__________ DATEREC’D

HOW RECEIVED: □VERBAL □card-letter □ bur. of f.p. &0TSP. □other PREMISES LOCATION ___ f bqrq zIP CODE /

Type of Occupancy/Bldg. <2 ~ Bldg. Owner Name.

Construction Height ^2_____ Area Bldg. Agent Name of Officer (If Corp.) 212______ Title /161' / Occupant Mailing Address Boro. Zip Code

Complainant’s Name Telephone.

Complainant’s Address Boro. Zip Code

ITEM FILL IN ROOM/ NATURE OF COMPLAINT FLOOR LOCATION NO. ITEM NO. 1 RUBBISH — COMBUSTIBLE_______________________ 2 CERTIFICATE OF FITNESS REQUIREMENTS__________ 3 INCINERATOR CLOGGED/DEFECTIVE_______________ 4 DEFECTIVE OIL BURNER____________ _____________ 5 REQUIRED SELF CLOSING DOOR — DEFECTS_______ 6 EXITS — BULKHEAD DOORS LOCKED______________ 7 BLOCKED — OBSTRUCTED EXITS/HALLS___________ 8 FIRE ESCAPE OBSTRUCTIONS 9 DEFECTIVE ELECTRICAL FIXTURES/OUTLETS/WIRING 10 WATER LEAKS (NEAR ELECTRIC WIRING/FIXTURES) 11 VACANT BUILDING (BOARD UP)____________________ 12 LIGHTING IN HALLWAY/STAIRS 13 ILLEGAL OCCUPANCY

r7T,N0-CAUSE FOR ACTION TAKEN: □V.O. ISSUED □A-S □SPECIAL REPORT □SUMMONS ISSUED ‘^COMPLAINT REMARKS:_________________________________________________________________________________________

INVESTIGATED BY: UNIT 2 SIGNED RANK date 3 /7 1^^ UNIT 22^ OFFICER ON DUTY _ RANK GROUP

BATTALION CHIEF BATT. GROUP. DATE //

DEPUTY CHIEF DIV.. GROUP DATE i/ ENTRIES: LEGIBLY PRINTED, USING BALL POINT PEN OR TYPEWRITER

NYC-WTC_000166012