NYC 9/11 Public Portal Document
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
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Asbestos Control Program
59-17 Jynction Boulevard, 8"' Floor, Corona, NY 11368-5107
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Building Dept. RU No
FOR OFFICIAL USE ONLY
RlTTEN f%~Wtur^`~ ASBESTOS PROJECT NOTIFICATION
MS WILL BE (ASBESTOS INSPECTION REPORT)
ACCEPTED .w.w <.anv'aep 1.1~ _s
( fee schedule)
When submitting this form at the NYC Department of Buildings, the original form and three (3) copies with 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 88 Nassau St Borough Manhattan Zip
AKA 3. Block 78 4. Lot 42
5. Type of Facility____—___—_ ___—__.._ 6. Name of Building
II. BUILDING OWNER
7. Name Michael Pildes et al 8. Contact Person Y PLUS u
9. Tel. # (ii?) 2185 -4Z32- Fax # —_ ;---------- -;
10. Address; P11 City;_ _____P11 ! state PI.L. Zip -.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.-.
P11
III. GENERAL CONTRACTOR
11. Name_ -- Tei. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name Benjamin Kurzban & Son Control 13. Contact Person Louie lannico
14. Federal Employer ID. # 11-2692795___ 15. Tel. # (718) 531-2900 --_ —_ Fax #
16. Address 1248 Ralph Avenue —v— _ City Brooklyn _~_-- State NY _ Zip 11236
V. THIRD PARTY AIR MONITOR
17. Name Warren Panzem ENE,1t3EoRs j ___ 18. Contact Person _ i C11 RE~L Oc Ats
19. Federal Employer ID. # 13-3470954__` 20. Tel. # (212) 922-0077--~— Fax # (212) 922-0630 _v _--
21. Address 228 East 45th St Cit
y New York State NY — Zip _ 10017 _
22. Sample Analysis Laboratory_ 23. NYS DOH ELAP #
VI. PROJECT INFORMATION
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24. Starting date for this portion of work T 1 O'j (©2 Projected completion date
Asbestos work schedule Monday Tuesday Wednesday Thursday Friday Saturday,Sunday
Shift from: am 0 pm to ❑ am 0 pm
If other, ~
specify --------- -----~~~-- — ------ RGtrG~~++
Access to inspect the premises must be provided during the work schedule indicated in this item.
2 2002
25. Total amount of asbestos-containing material to be abated during this work OEp/{11N
. , S EST0SiLELE A
PRt5ES1R1FFA
___ TD Square Feet, and/or 0 Linear Feet -f TFFUG <
ACP 7
2/2001
NYC-WTC 000099255
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