NYC 9/11 Public Portal Document
vic NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
tO Asbestos Control Program
59-17 Junction Boulevard, 8°i Floor, Corona. NY 11368-5107 40-01.,Bu ng Dept. or TRU
ONLY ..I FOR OFFICIAL USA[ ONLY
ASBESTOS PROJECT NOTIFICATION
.n * nyc,{ov/deP
(ASBESTOS INSPECTION REPORT) C. Gj
(Sef tM 90"O.Ae)
When submitting this form at the NYC Department of Buildings, the original form and three (3) copies w+th original
signatures are required. Submittal at the NYCDEP requires one copy of the form with original signatures. This
form must be submitted to the NYC DEP not less than one week in advance of the start of abatement activities .
I. FACILITY
2. Address 118 Na au Street Borough Manhattan Zip
AKA 3. Block 92 . 4. Lot 26
5. Type of Facility 6. Name of Building
11. BUILDING OWNER
(.Name - Vincent Mazzola — 8. Contact Person
9. Tel.# Fax#
10. Address City State Zip
Ill. GENERAL CONTRACTOR
11. Name Tel. #
r
IV. ASBESTOS ABATEMENT CONTRACTOR
42. Name Benjamin Kurzban & Son Control____ ._____13. Contact Person Louie lannico
14. Federal Employer ID. # .-.-.-.PI I-.-.-. 15. Tel. # (718) 531-2900 Fax # (718) 209-1808
16. Address 1248 Ralph Avenue City Brooklyn State NY Zip 11236
V. THIRD PARTY AIR MONITOR
17. Name Warren & Panzie2 EU' I ra ; I 1C 18. Contact Person I Aim OLA*1
PII
19. Federal Employer ID. h------------------------ 20. Tel. # (212) 922-0077 Fax # (212) 922-0630
21. Address 228 East 45th St _ City New York State NY Zip 10017 --
22. Sample Analysis Laboratory 23. NYS DOH ELAP #
VI. PROJECT INFORMATION
1
24. Starting date for this portion of work (o i4' //? Projected completion date _~ ! 3o JZ
Asbestos work schedule ❑ Monday 0 Tuesday 0 Wednesday ❑ Thursday ❑ Friday 0 Saturday ❑ Sunday
L
Shift from: ❑ am ❑ pm to 0 am 0 pm
sf other.
specify ~~, ~~d~ryac
~I L
2 4 2002
Access to inspect the premises must be provided during the work schedule indicated in this item.
f .P/BANHM
25. Total amount of asbestos-containing material to be abated during this work ST~S/i
_s3T 'Square Feet, and/or 0 Linear Feet
212001
NYC-WTC 000098779
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