NYC 9/11 Public Portal Document
D ~,«nOEa~pr NYC DEPARTMENT,OP ENVIRONMENTAL PROTECTION
Asbestos Control Program
59-17 Junction Boulevard, 8th Floor, Corona, NY 11368-5107 O a1
orP ASBESTOS PROJECT NOTIFICATION
t
uilding Dept. or T
FOR OFFICIAL USE ONLY
No
MAL `~~
WILL BE P/~ (ASBESTOS INSPECTION REPORT)
EPTED C..w.^v .aov ee C
( e 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 86 Nassau St Borough Manhattan Zip
AKA 3. Block 78 4. Lot 40
5. Type of Facility__— _—__. 6. Name of Building
II. BUILDING OWNER
7. Name HBS Equities LLC 8. Contact Person
9. Tel. # (212) 963-0241 Fax#
10. Address G _ h~_~je t E1 ^ --_—_ City State ~r ` Zip
III. GENERAL CONTRACTOR
11 Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name Benjamin Kurzban & Son Control 13. Contact Person Louie lannico
14. Federal Employer ID. P11 15. Tel. # (718) 531 2900 --~ Fax it (718) 209-1808
16. Address 1248 Ralph Avenue _ City Brooklyn State NY Zip - 11236
V. THIRD PARTY AIR MONITOR
17. Name warrenPanz42a l Contact Person
19. Federal Employer ID. #----- 20 Tel. # (212) 9220077 --_ Fax # (212) 922-0630 __—Y
21. Address 228 East 45th St City New york State NY Zip 10017
22. Sample Analysis 23. NYS DOH ELAP #
VI PROJECT INFORMATION
24. Starting date for this portion of work C C 2 IO2 Projected completion date -CF I C t_1L%2 _
Asbestos work schedule Monday 'Tuesday
c5o
X
Wednesday Thursday 0 Friday Saturday Sunday
Shift from: $ am ❑ pm to 0 am $pm 1 2
If other, `~' .4
specify
-------- —
'i'.wti..sCU
Access to inspect the premises must be provided during the work schedule indicated in this item. —
J r1j Q 2
U 2002
25. Total amount of asbestos-containing material to be abated during this work o .117p NHM
M
6I2-- $ Square Feet, and/or—_ 0 Linear Feet
s
2uG u
ACP 7
212001
NYC-WTC 000099307
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