NYC 9/11 Public Portal Document
For Ell. Use Only: L.8adPsla / / InWala (
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M.S. Account Na I I I I I I I I I I I I I . UNIT PHONE».
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Unit: HCVDO
Nonei or MoumoN
ENVIRONMENTAL CONTROL BOARS
CITY OF NEW YORK ANB HIARIMQ JiyK>MTiowMal0144034 L
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ISI'illMel/ibiMfll
Respondent is: ffowner
IiJl I' I I □I tenaijtj
□ managing agent
I I I , □I'l I I certer
I I I gIdriycare
dty agency
I I I I I I I ip
B
11 nr
II I# k 11
Place of occurrence (Pre Address,
Slreef Number LLUllllJ Prefix |_U Street Name
I I I I I
LU Suffix LU Zip Code 1114-4111 ~1____________
J__ I Boro Code
Type [ 1 1-Man; 2>Bx; 3-81; 4-BMyn; 5-Qna
AKA
Malling Address (If diftorent from premli ddi >»•)
Street Number I
Type I
I I I I I I I Prefix I I
suffix LU Zipcodel 11.1
I Street Name
I 14
in I I I H I I I I I I
Bora Coda 1-Man; 2-Bx; 3-SI; 4-BMyn: S-Qna; e-Out of City
Add Into ................................ Ill II111111111111111
lotice of Violation and Order to Correct and Certify Correction:
PLEASE 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
orrected 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 (Gold Copy).
The Certificate of Correction and all proof of compliance MUST BE RECEIVED by the Bureau of Fire Prevention, Enforcement Unit, 250 Livingston Street, BrooMyn, New Mark
1201-5884 [TEL 718-403-1372) by close ol business on | U| XXJ Q / I Flmf offenders who properly certify correction shall avoid a hearing and penalty. All other respondents
rust appear at the Environmental Control Board (ECB) healing in^cated below. ’
lotice ol Hearing:
If the Certificate of Correction JSy NOT RECEIVED by the date indicated above OR if no data Is Indtcated . ths respondent MUST-APPEAR M a hearing on
.£1 'K I at □B:30am, jX10:30am, Qi:30pm, □3:00pm al the ECB Hearing Office located in OBrooWyn * " DOueens □Staim Wan address for
ach location is provided on the reverse side of this form.) This hearing Is your opportunity to answer and defend the set forth below. If y&r’ito not youwIHbe
eld in default and subiect to maximum penaltlea.
REPEAT OFFENDERS MUST appear al the hearing on the scheduled date.
Upon investigalion, 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
tdministralivB Code and/or Fire Department Rule(s) cited below:
ule 1 Buckets and/or Hre Extinguishers Rule 17 Certificates of Fitness
□ Failed Io Pt>**de buckets filled with (sand/water) and/or ' Q
approved, operative fire extinguishers at ______ pttoiwi______ “ required.' '•
izomsr
Failed to (obtain/pravide) a (Ceitificala of FItneas/CartMcata Holdar on Duty)
for
■van--------------------------
ule 2 Waste Receptacles Ruleia Cortlflcalaa of AppravaVOo 7/Qualtficatlon/Llcenae
p Failed to provide ________ approved receptacles for waste at Q] Failed to (oblaln/provide) a Certificate of (Approval/Occupancy/QuaHficatlon/
______________________________ as required. License) tor___________________ as required.
LocAnoN
lule 3 No Permit Rule 19 AffidavltaZDociiinentatioiimana/AppUcatlona
□ (Sold/Stored/Used/Manufacturedniansported) (combustibles/flammables/
explosives) without required valid permit. □ Failed to provide (affidavit/documentatlon/plarVapplicalion) far
__________________from________________ ______________ AS required.
lule 4 Quantities in Excess of Permit
□ (Sold/Stored/Usod/ManufacturedHtensponed)
of.
PHiSiWcf'
in excess of amount stated on permit.
Rule 20 IMZInepectlon
Failed to conduct required (equipment/iystem) (tesUnapection) of
_______________ 1 as required.
lule 5 Produce Permit and/or Record Rule 21 Contalnera
p Failed to produce (permit/record) regarding ------------- BBEHnm---------------- Q Failed to provide approved containers for.
as required.
at -------------------------M required, jj Tanks/Supports
loeaiBN
8 ™^to(pro6l^
•SiSv
Failed to
rpg Vas h^uli^.^ul* 23 Storage . , •
at
V PI Failed to provide (vaulls/cablneta/room/area) for the storage of
lule 7 Laiwis/Marfca/Stamps —non------
______________________________________as required.
□ Failed to provide (Labela/Marks/Statnps) for
at
lOGfVION
as required.
Rule 24 Racto
Q Failed to provide appropriate recks al
izsissr
lule 8 Obstructlons/Accumulatlons .__ —»
□ Failed to remove all (obstructions/accumulatlons of rubbish or storage) of _ p-f
_____________ _______________ from___________ n_________________
luu-iiu
LJ
UJBXnON
• Failed to (provide/protect/malntaln)
.
electrical equipment as required.
TW
as required.
Rule 2* Approved Refrigeratlon/Heating Devices or Units
lule 8
22
/kdequate Egress/Alsle Space/Ciearance
Failed to provide adequate (egress/Bisle space/dearanca) at
_______________________ _ ___________________________as required.
□ Failed to (provide/protect/malntaln)
(refrigeration/heating) devices as required.
TW
□xsmBN Rule 27 Approved Ughting Devices
lule 10
22
Operating Contrary to C of O
Operated
treerr
.contrary to the certificate of occupancy.
□ Failed to (provide/protect/malntaln)_______________ ______
lighting devices as required. Specify type of protection'requlred:
lule 11 General Maintenance
□ Failed to maintain
condition as required.
i
TWSF
in a proper
Rule 28 Exposed Hames or Sparks
p] < (Unlawfully allowed/failed to protect) exposed flame or spark at
. UbMM------------ '------------------- - ------------- ' as required.
lule 12 Maintenance of Sprinkler, Standpipe, Alarm, Suppression Systems
□ Failed to properly (provide/maintain)
as required. Describe below.
system or part thereof
Rule 28 Designated Areas
PI Failed to (provldo/malntaln) designated arsa/premlses tor
lule 13 Fire Retardent Material ------!------ ------ “TTmOTV-------------------- ’--------------------------------------- 'jas required.
□ Failed to provide/maintain non-combustlble material______ juiii______
at TBismBir or provide affadavit that combustible material
Rule 30 Hre Safoty In Office Bulldinga/Hotela/Motels
□ Failed to comply with the fire safety requirements for (office buHdingsZ
has been treated with flame retardant as required. hotels/motels). Specify: ___________ _□________ _____
lule 14 Fireproof Doors/WIndows
22 Failed to (provide/maintain) (self-closing fireproof doors/windows) at
as required. Repeat Violation (915-228)
pi Failed to correct Rule(s) as previously cited on NOV
lule 15 Fireproof Partitions or Walls sracw
22) Failed to (provide/maintain) fireproof partitions or wails at #______________ (Respondent must appear at tha hearing.)
as required. Fuse Certification (915-220.1)
lule 16 Ventilation
□ Failed to provide (approved vents/adequate ventilation) at
LDCAnOH
□ Willfully falsified Certificala of Correction for NOV #.
(Respondent must appear at hearing.)
------------------------------ - -------------- CBOTIBB---------- as required. □
__ Other Code Sectlon/Rule IDescribe offense below.
Ascription of Violation: 1^/0 ppooR 5 •
personally observed the commission of the above offense(s) or personally reviewed tf# office fiords Indicating the offense(s) charged above.
UI statements made herein are affirmed under penalty of perjury. Date of Offense: If o . Tima: ; a.m7p.m. Q .
INSPECTOR’S SIGNATURE _22L_22.^_DeLat
nspector's Tax Registry Number PH PRINT NAME . U.CP'WnKpay 2
.|a 99MO.I0-1030769
NYC-WTC_000168909
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