NYC 9/11 Public Portal Document
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
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or Asbestos Cprrtroi Program
59-17 Jgnction Boulevard, 8m Floor, Corona, NY 11368-5107 a aJ-
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ASBESTOS PROJECT NOTIFICATION
Building Dept. RU No
FOR OFFICIAL USE ONLY
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MS WILL BE ~~4p'~'Mt (ASBESTOS INSPECTION REPORT)
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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 j1chae1 Pildes et al 8. Contact Person
9. Tel. # C2 t2) 26S 232 Fax # _ —_ -------- -
10. Address P11 City P11 r State„!j.l. Zip P11
III. GENERAL CONTRACTOR
11. Name_ --- ------------------- Tel. # _— -----------
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name Benjamin Kurzban & Son Control 13. Contact Person Louie lannico
14. Federal Employer ID. - - - --P ~- - - - - ? 15. Tel. # (718) 531-2900 __---_ Fax #
16. Address 1248 Ralph Avenue — — City Brooklyn _—_-- State !Y_ Zip 11236
V. THIRD PARTY AIR MONITOR
17. Name Warren Pa zt-m ENE, tEE j/JCS—____ 18. Contact Person _lvli_Ci 1 REZ ~Oc Ats _
19. Federal Employer ID. A. I 20. Tel. # . . Fax # (212) 922-0630 -v---
21. Address 228 East 45th St __-- l---- City New york _v-- State .!Y_ 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 CT ( O'er ( © . Projected completion date
Asbestos work schedule Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Shift from: 6 am 0 pm to ❑ am. pm
If other, N/ S"
specify --------- -----~~~-- — ------
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Access to inspect the premises must be provided during the work schedule indicated in this item.
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25. Total amount of asbestos-containing material to be abated during this work J O
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Square Feet, and/or ______.......J2. Linear Feet -!' TPF2G
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212001
NYC-WTC 000099255
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