‘A.complete application nctudes this ferm CAppicabon For’) and materia needed to describe the project and is effec onthe landmark propery. Pieese ‘ead the instructions of tis form carefily. and provide all the Information requested for ALL 6 sectons. LPC staff uses thi informatio 1 Getermne i the ‘application meets LPC's rues for approval by sa or wil requis a review by the ful Commission ata Puble Hearing. Failure to submit compete, plications with required materials wil result in delays inthe review and processing of your aopicaion. Fting may be done in person or by mato the ‘address above. 1. PROPERTY INFORMATION auth pee ‘mores Gos -4is Cast SAM Stee [Foor BOROUGH Maw darren [BOK Tysy [OR [awe 2. PROPOSED WORK (CHECK ALL THAT APPLY) el is BINTERIOR ALTERATIONS foe Aa UI PLACE OF ASSEMBLY/CERTIFICATE OF OCCUPANCY! NO WORK PROPOSED {D RECREATE WISSING ARCHITECTURAL FEATURES. RESTORATION & OTHER FAGADE WORK. [DEXTEROR REPAIRS (chek a ht a9) Clowns Secreted cut Weare, vNTLATON 8A concroNNe | SHEL MRODIVL OWENS THER AC EQUPMENTna a al i) mer, (Q.THRU-WALL HVAC EQUIPMENT: D Street fagade C) Rear or side farade IEOTMER WEHIEALEOUPUIENT © Walon You foe xt Gormtr TDRERACE WHOM Get oy {1 Sesnag aio aera ronal tc tate WINDOW & DOOR WORK [CLNEWIMODIFY WINDOW OPENING(S) (check al hat apy): (Steet‘acing agaders Rear or sde non atoning fade (2{REPLACE D0OR(S) of MODIFY DOORS) NEW BUILDING [CLROOFTOP ADDITION (eek a nat apply: ‘ADDITIONS & NEW CONSTRUCTION ‘C Mechanical Equipment, StalrorEevatorBukhead Cl Occupable Ci Solar LCLREAR YARD ADDITION (eneck al that app): ‘C Deck i Oceuplabie Bos CIINFILL TUGHTING EISIGNAGE CAWMNINGS OD SECURITY GATE EXCAVATION (check al thet eppii: Cl Underpinning C1 No Underpinning i |DISDEWALK PAVING (check al hat appv: Concrete Stone 1 Tree Pt EXCAVATIONS, SIDEWALKS AND SITEWORK | 5 SUBSURFACE UTILITIES (check lhl app: Restle C1 Other (G STREET PAVINGISTREETBED WORK TD TEMPORARY INSTALLATIONS.C Sign 0 her - DINEW UNENCLOSED SIDEWALK CAFE C1 RENEW SIDEWALK CAFE LICENSE dicts FENCES AND GATES: CIBARRIER FREE ACCESS (ADA) OTHER (eecrte): ‘STOREFRONTS: {3 ADDITIONAL INFORMATION ‘Ace you fing to corrector legalize work done without an LPC permit? (YES If Ves, Waming Letie/NOVe (if YES, please incude photos of work in vlaton) Hee ‘A you fing fora signof oro arena pet? TIVES Vee, Dooketr (UVES, pease inclu photos of completed exterior work) ‘Are you applying to any ofthe folowing? GFDept. Of Bulaings 1D City Pienning D Board of Standards and Appeals ‘easement onthe propery? CIES (if Yes, plaase provide coract information for easement holds?)Landmarks Preservation ‘Commission ‘TATTAGH WATERIALS NEEDED TO COMPLETE THE APPLICATION Required matecais must be submited to compete the appicaton. These materials include documentation that explains the ening and Dreposed conditions and clear ilstrates how the proposed work does or does not moet LPC Rules. Depending on the type of woxk proposed ‘ese materials may include drawings, photographs, photo-moniages, material samples and writen specications. Fr a complet ist of materials required forthe most common work ypes, please refer tothe Permit Application Guide ae you complete the application. LPC Rules and gues are availabe on tho website: wwew.nvc.covlandmarks. An applction that incedes al ofthe required materials an often be expedited Incomplete submissions wil cause delays. PLEASE NOTE THAT A PERMIT CANNOT BE ISSUED UNTIL THE REQUIRED MATERIALS ARE SUBMITTED AND STAFF HAS DETERMINED ‘THAT THE APPLICATION IS COMPLETE, YOU MAY CONTACT LPC IF YOU NEED INFORMATION ABOUT THE APPLICATION PROCESS, DETAILS ABOUT THE TYPES OF DRAWINGS OR OTHER MATERIALS THAT MAY BE REQUIRED, OR FOR GENERAL GUIDANCE, ‘TEL: (212) 680-7817/ E-MAIL INFO@LPC NYC. GOV. ‘AN APPLICATION MAY BE COMPLETED BY THE OWNER, TENANT, LESSEE, CO-OP SHAREHOLDER, ARCHITECT, ENGINEER, ‘CONTRACTOR, OR OTHER INDIVIDUAL OR FIRM. PLEASE LIST ALL RELEVANT CONTACTS BELOW, AND CHECK THE PRIMARY CONTACT. [5. CONTACTINFORMATION (Fil out allthat apply and indicate who the primary contact should be) COPRIMARY CONTACT TENANTILESSEICO-OP SHAREHOLDER : CompanyiGorporationlOrearization sRCHTECTENGNEEICONTRAGTOR UF APLGABLE) - Nome Lsbert I Warshetsks Ja Mie Si auoles Naw Tel sens Prove VSD 539 081) _ oe : PERSON FLING APPLICATION (E.G, EXPEDITOR, ATTORNEY, MANAGING AGENT) Cl PRMARY CONTACT Nene Cas Stachel hery ones tern eee Magi ay uapeheoh «ftinlic ir WU anges Serave: (UN EL PER ew yout, WY 1? lon a Phone Ema UL LAY Gyo «lh ‘6. OWNER'S INFORMATION, CONSENT, AND SIGNATURE {Tam the over of the abovelsied propery. For applcalions fer work on or ha Cooperalve of condominium bling, the “owner ie the Co-op Board or Condominium Associaton. An ofcer ofthe Co-op Board or Condominium Aagociaton most signe apioation. am famiar wth tha wore proposed to be cares out on my propery ne give my permission for is application tobe fled. The information ener e corect and complete toto best of my krowedge IMPORTANT: The managing agent of a cooperative or condominium association must be an officer ofthe board to sign this application NAME: g wl (ore me open) CYC VP ants COMPANY, CORPORATION, OR ORGANIZATION (it appleabiey _ Ai waune aooress 1/0 Willi) S7IZET , 6°" Eludy cory, stare, 2 cove_A/PW YOVk NY 10036 pocent Reveed 7/26