NYC 9/11 Public Portal Document
I For E.U. Use C =P1MS Date / / Initials
] Agency Code No. I I I I
F.P.I.M.S..Accounl Nd. I I I I I 1-1.J—I
Illi c.a • LU UNIT PHONE tt___________________________
environmental OONTIIOL BOARD
CITY OF NEW YORK
NOTICE OF VIOLATION
ANDHCARINO I vioLATioM MO. 10 2656 56 R
5i i i i i n......... ..
Respondent is; □ owner □ managing agent □ tenant Deity agency □ daycare center
Place of Occurrence (PremlsM Address)
Street Number I ^1 I I I I 1 I Prefix I__ I__ 1 Street Name rU'Vfi I I I
Suffix I I I Zip Code I I I__ 1__ 1__ I J__ I
[___________ Boro Code
Type 1—I—L / 1=Man: 2-Bx, 3-SI: 4=Bklyn: 5=Qns
akaU I I 1 I 1 I 1 I 1 I I I 1 I 1 1 I 1 I I I I 11 I I I I 1 H I 1
Malling Address (If different from premises address)
Street Number
I I 111 I 1 I Prefix I I 1 Street Name
1 I I I I I I I I I I I I I I
Type I-----
_ _J Suffix I I I Zip Code I I I I I I ~ L
I Boro Code 1=«Man; 2=Bx; 3-SI; 4=Bklyn; 5-Qns; 6-Out of City
Add Info I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I
Notice of Violation and Order to Correct and Certify Correction:
PLE/\SE TAKE NOTICE that the premises cited above is in violation of the requirements of law. It is further ORDERED by the FIRE COMMISSIONER that these violations be
corrected and certified to be in compliance with the requirements of law within 35 days of the date of issuance. Certification must be made on the Certificate of Correction (Qbld Copy).
The Certificate of Correction and all proof of compliattce MUST BE^RtfBVED by the Bureau of Fire Prevention, Enforcement Unit, 250 Livingston Street, Brooklyn, New York
11201-5884 (TEL 718-403-1372] by Close of business on | / \’2'^ \ArFitst offenders who properly certify correction shall avoid a hearing and penalty. All other respondents
must appear at the Environmental Control Board (ECB) hearing indicated (below.
Notice of Hearing:
If the Certificate of Correction IS NOT RECEIVED by the date indicated above OR if no date is indicated above, the respondent MUST APPEAR at a hearing on
I 2- 11 fl-''' I at D.8:30am, □l0:30am, QrSOpm, □3:00pm at the ECB Hearing Office located in □ Brooklyn □Manhattan □ Queens OStaten Island. (The address for
each location is provided on the reverse side of this form.) This hearing is your opportunity to answer and defend the allegations set forth below. // you do not appear, you will be
held in default and subject to maximum penalties.
REPEAT OFFENDERS MUST appear at the hearing on the scheduled date. _____________________________ __________________ _____________________ _______
Upon investigation, it has been determined by the above named Petitioner that there is reasonable cause to believe that the above named Respondent is in violation of the
Administrative Code and/Or Fire Department Rule(s), "3 RCNY §§1^1, 1802, 16-03;"
Rule 1 Buckets and/or Fire Extinguishers Rule 17 Certificates of Fitness
□ Failed to provide fire buckets filled with (sand/water) and/or
approved, operative lire extinguishers at ______ rTunYirn
LOCATIOI
______ required.
□ Failed to (obtain/provide) a (Certificate of Fitness/Certificate Holder on Duty)
for_________ :_________________________________________________ •
SPECIFV
Rule 2 Waste Receptacles Rule 18 Certificates of Approval/Quallflcatlon/Ucense
Q Failed to provide approved receptacles for waste al Q Failed to (obtain/provide) a Certificate of (Approval/Oualification/License)
NUMBER
----------------------------- as required. for
------------------------------------------ as required.
Rule 3 No Permit Rule 19 Certificate of Occupancy/Publlc /Assembly Permlt/Affldavlts/Documentation/
□ (Sold/Stored/Used/Manufactured/Transported) (combustibles/flammables/
explosives) without required valid permit.
□
Plans/Appllcations
Failed to provide for
SPECIFY
Rule 4 Quantities In Excess of Permit __________________ from .as required.
□ (Sold/Stored/Used/Manufactured/Transported) Rule 20 Test/lnspecflon
Signatory
Rule 5
of. pAoducr
Produce Permit and/or Record
in excess of amount stated on permit.
□ Failed to conduct required (equipment/system) (test/inspection) of
______________________ _____________________________ as required.
SF€CIFY
I I Failed to produce (permit/record) regarding Rule 21 Containers
Failed to provide approved containers for.
at
Ru^6 Signs/Postings/lnstru^lons
locaTOn
y 1’- /
/• —EM*.
Rule 22 Tanks/Supports
0 Fail^i to pr^i^^^i|ign^s^^lnstruc«^s) for$g|_
7^ ~ LOCATION as required.
•7 □ Failed to (provide/maintain) approved tanks/supports for
as required. SPECIFY
Rule 23 Storage
Rule 7
[ I
Labels/Marks/Stamps
Failed to provide (Labels/Marks/Stamps) for □ Failed to provide (vaults/cabinets/room/area) for the storage of
_____________________________________ as required.
SPECIFY
at______________ L_—;-------------- as required. Rule 24 Racks
Rule 8 Obstructions/ZKccumulations
LOCATION
□ Failed to provide appropriate racks at
LOCATION
□ Failed to remove all (obstructions/accumulations of rubbish or storage) of
as required.
Rule 25 Electrical Equipment
Rule 9
_______ _ _____ _ ____________ from_____________ _ ______________
as required.
Adequila^ Ejjress/AiSie Space/Clearance
LOCATK
□ Failed to (provide/protect/maintain)
electrical equipment as required.
Rule 26 Approved Refrlgeratlon/Heating Devices or Units
I I Failed Itbtjjr^ide adequdte (egress/aisle space/clearance) at
~ LOCATION
as required. □ Failed to (provide/protect/maintain)
(refrigeration/heating) devices as required.
Rule 10 Operating Contrary to C of O Rule 27 Approved Lighting Devices
□
Rule 11
Operated
General Maintenance
SPfeciFY
.contrary to the certificate of occupancy. □ Failed to (provide/protect/maintain)
lighting devices as required. Specify type of protection required:
□ Failed to maintain
condition as required.
_ in a proper Rule 26 Exposed Flames or Sparks
□ (Unlawfully allowed/failed to protect) exposed flame or spark at
Rule 12 Maintenance of Sprinkler, Standpipe, Alarm, Suppression Systems ____________________________________________________ as required.
□ Failed to properly (provide/maintain)
SPECIFY
system or part thereof
Rule 29 Designated Areas
LOCATION
as required. Describe below.
Rule 13 Fire Retardant Material □ Failed to (provide/maintain) designated area/premises for
□ Failed to provide/maintain non-combustible material.
at
SPECIFY ITEM
or provide affadavit that combustible material
------------------------------------------------------ spkBy------------------------------------------
Rule 30 Fire Safety in Office Bulldings/Hotels/Motels
.as required.
l6MISn
has been treated with flame retardant as required.
Rule 14 Fireproof Doors/WIndows
□ Failed to comply with the fire safety requirements for (office buildings/
hotels/motels). Specify:___________________________________________
□ Failed to (provide/maintain) (self-closing fireproof doors/windows) at
________________________ ________________________ as required. Repeat Violation ($15-229)
Rule IS Fireproof Partitions or Walls □ Failed to correct Rule(s) as previously cited on NOV
□
SPECIFY
Failed to (provide/maintain) fireproof partitions or walls at # _____________ (Respondent must appear at the hearirtg.)
as required. Falsa Certification ($15-220.1)
Rule 16 Ventilation
locaVi6n
□ Willfully falsified Certificate of Correction for NOV #
□ Failed to provide (approved vents/adequate ventilation) at
LdCATION
as required. □
(Respondent must appear at hearing.)
Other Code Sectlon/Rule
SPECIFY SECTION
Describe offense below.
Description of Violation:
I personally observed the commission of the above otfense(s) or personally reviewed the office records indicating the oflense(s) charged above.
All statements made herein are affirmed under penalty of perjury. Date of Offense: / .2—1 /^)l ‘ 7 Time;___ :___ a.m./p.m. /
INSPECTOR'S SIGNATURE
Inspector's Tax Registry Number^ PH PRINT NAME
M2S.19 H1-9l?7n.11-112
CERTIFICATE OF CORRECTION (COMPLETE REVERSE SIDE)
FIRE DEPARTMENT COPY
NYC-WTC_000168875
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