Department of Buildings Permit Application Form, date unknown

NYC 9/11 Public Portal Document

I

8 Work 7 yp6S Submitt Gd check only those items submitted by applicant at this tinte, if any. * 9 Plans Submitted .. i MH Plumbing

Mech/HVAC PW-1B SP Sprinkler

Fire Alarm 14. PW-1B

14 ZO AR Zoning Architectural X ME Meeh jntcat

Plumbing PL

PL Boiler PW-1C EO Construction Equip. 13 ST Structural FO Foundaimn

I rB . Fuel Burning ------ PW-1C FP Fire Suppression t4 NP No Plans

rs FuelSlorage PW*-1C cc Curb Cut — 7A, Indicate total linear feet: ft.

SD Standpipe 14 OT Other Description:

10 Building Characteristics r.iit A Zoning Oistrict(s) Special District Name Map Number

Pnrl B Occupancy Classilication Ex Pr Class Name Ex Pr Class Name Ex Pr Class Name

A High Hazard F-1b Assembly (Churches, Concert Halls) J-2 Residential (Apartment Houses)

B-1 Storage(Moderate Hazard) F-2 Assembly (Outdoors) J-2 Three Family Dwelling

B 2 Storage (Low Hazard) F-3 As3embly(Museums) J-3 ResidentiaRt and 2Fam(ly Houses)

C Mercantile F-4 Assembly (Restaurants) K Miscellaneous

D-1 Industrial (Moderate Hazard) G Education Old Corin - Public Buildings

D-2 lndustriat(Low Hazard) H-1 Institutional (Restrained) Old Code - Residence Buildings

E Business H-2 Institutional (Incapacitated) X X Old Code " Commercial Buildings

F-la Assembly(Theaters) J-1 Residential (Hotels)

Multiple Dwelling Classification (required for all J-1 and J-2 classifications)

Part C Construction Classilication Ex Pr Non-Combustible Ex Pr Combustible Ex Pr Old Code l-A 4 Hour Protected ll-A Heavy Timber 1 Fireproof Structures

l-B 3 Hour Protected ll-B Protected Wood Joist X X 2 Fire-protected Structures

l-C 2 Hour Protected ll-C Unprotected Wood Joist 3 Non-fireproofed Structures

l-D 1 Hour Protected 11-0 Protected Wood Frame 4 Wood Frame Structures

l-E Unprotected ll-E Unprotected Wood Frame 5 Metal Structures

6 Heavy Timber Structures

Part D Number of Stories liO Ex Pr Fire Protection Equipment Voluntary ed

Sheet Frontage Dimension (Demolitions only) Standpipe

Height .LJ._Q2102L Sprinkler

Number of Dwelling Units NONE Fire Alarm System

Part E Silo Aioa Chaiacteiistics Open Spaces I Tidai/Fresh Water Wetlands Flood Plains Loading Berths sq. ft. Plaza ST. ft.

Ur ban Renewal Fire District Parking sq. ft. Arcade sq. f’.

total Gross Floor Area of Building sq. ft. Number of: Parking Spaces Loading Berths

11 Place of Assembly Prnpnsed Number of Persons I Old PA Number

or Individual Responsible lor Annual Permit Renewal complete if different from buiidmg owner. Name First Name M.l. Title nu$ ness Name Bu.siness Phone ( ) AH dr*SS City State ZIP

I I Illuminated 12 Signs Select One: I { Non-ltluminated

Type of Sign: I I Ground I I Wall I I RooF Roof Sign is light, closed or snitri

Height above roof level ft. in, Weight lbs.

Pfojprtion Beyond the Building Line ft. in. Total Square Footage of Sign sq. ft.

Lessee or Individual Responsible for Annual Permit Renewal Complete if different from buiidmg owner. Name First Name M.l. Title

n-'*. n^ss Name Business Phone ( ) Address City State ZIP

Revised 1 90 PW-t F^gr ?

NYC-WTC_000166095