NYC 9/11 Public Portal Document
A-8(9I3)91.138-Res-o4
FIRE DEPARTMENT REFERRAL nEPORT
Div. Batt. Co. D.O.
Date _ O?—/3 8
Premises Location 'i '' Z ~~..goro% ~ Zip Code /Od 'B
Bldg. Owner Name / lwc[/~ a~ _ 2, 1i Type of Occupancy/Bldg. V'~~u~ ~i "
Bldg. Agent
Occupant Mailing Address -C / tT~1O4 Boro Zip Code. ~---
ITEM FILL IN ROOM/
NUMBER ITEM NO. NATURE OF REFERRAL LOCATION
FLOOR
I-E (Defective/Improper)Electrical Wiring
2-F No Grease Filter or Extinguishing System
3-F No Sign Indicating Location of Fire Alarm Box
4-F Vacant Building Not Boarded Up
5-B Unenclosed Stairway
6-B No Certificate of Occu an
7-B Unenclosed (Hoistway/Shaft)
8-B --- No Secondary Means of E ess
9-B Defective (Cornice/Brickwork/Masonry) _ 4t/ t~GGv
10-B Hole in(Wall/Ceiling/Floor/Fire-stopping)
11-B Defective Chimney
12-B Structural Stability Affected
13-B Boiler Room Not Enclosed F.O. Acct._ No. -- QA-'E
14-B No Occupancy Sign Posted v
15-B No Floor Load Si
16-B Illegal Occupancy
17-B No Protection for Metal Floor Supports _
18-B Multiple Dwelling—More Than 8 Familities—No Supt.
19-B Water Leak in Vicinity of Electrical Wiring
72-F No Fire Dept. Permit for Fuel Oil
73-F No Fire Dept. Permit for Diesel Oil'—Emergency Generators
NU i t: .orwara separate A-tt reports for Comb. items; Fire Prev, items; each Dept. concerned.
If Combustible Violations are involved, please provide Account Number(s).
Remarks: ,v, /?/ i?
,,/~ ~} Initials of
Found By—Signe Rank) r//`~ /~PJYfUnit Officer on Duty
Company Commander Rank Unit Date
FOR BUR OF F.P. ONLY Referred
to: Dept. Date Report No,
RETURN TO: FIRE DEPARTMENT—BUR OF FIRE PREVENTION, 250 LIVINGSTON ST., BROOKLYN, N.Y. 11201
TO BE FILLED IN BY FIRE DEPT. INSPECTOR: Div. Batt. Co. D.O. Date
Owner, Agent or
Occupant—Name Premises Location
Disposition Report No.
Signed Dept. Date
NYC-WTC 000166138
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