Asbestos work permit application for 87 Nassau Street, Nov 2002

NYC 9/11 Public Portal Document

C;✓ C.IY NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION ( ~J YJ L) C ARI,yFN Asbestos Control Program 59-17 Junction Boulevard, 8th Floor, Corona, NY 11368-5107 Building Dept. or TRU No FOR OFFICIAL USE ONLY • ONLY-` , • , TYPEWRITTEN ' vao~`co a ASBESTOS PROJECT NOTIFICATION 1. t.4 FORMS WILL BE (ASBESTOS INSPECTION REPORT) ACCEPTED Y !0v1 . 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 _—$r !JASSAU_ S'tTLE --------- - Borough — M_X_t --- Zip ___ I OD38 -

AKA ------------------------------ 3. Block g --- 4. Lot ------

5. Type of Facility__....._...._-----N—__--- 6. Name of Building

II. BUILDING OWNER t_tY SALT- LLG 7. Name ~'/g ~c t?P c oiv, t?c~Nins — L LG ___-----_ 8. Contact Person Qavt icoFPP~.L _-----------_—_

9. Tel. # _t21'') 344212____ Fax # C2t2Z747-io68 ----

10. Address _ 575 LExt f.16ATDf4 Aa>E!± E1 —______— City -- U — State - Ny Zip

III. GENERAL CONTRACTOR

11. Na Tel. #

IV. ASBESTOS ABATEMENT CONTRACTOR

12. Name 8EAM 1 2BA(J 4 Sot C..Lit_1TReL. INC. — _13. Contact Person _ Lockl I R t-W 1 Go ------ ------- ------- ----------- 29CA_-- 209 - 180 ____ 14. Federal Employer ID. # _ PH L_ 15. Tel. # C ttf~~ s 3i - Fax # ~~

16. Address La ---- AUEN VE-- ____-- City BD zt __--_ State: _ Zip 11~

V. THIRD PARTY AIR MONITOR

WAR-QE ? z __—_18. Contact Person McLAN---- 17. Name _

19. Federal Employer ID. # PII ` 20. Tel. # Fax# 1?_ ?: 22__

21. Address _2-~8 C-AQT 45t"►t. S Tt2~EET---- City _—Blew 2___ State IL _ Zip 1001T _ _

22. Sample Analysis Laboratory, 23. NYS DOH ELAP #

VI. PROJECT INFORMATION 24. Starting date for this portion of work Og1 1161 °?_ Projected completion date do L i _~ ?

Asbestos work schedule © Monday ® Tuesday 13 Wednesday © Thursday ® Friday Sunday 00

Shift from: __S~ IS am 0 pm to _ g 0 am 13 pm

If other, specify

I Access to inspect the premises must be provided during the work schedule indicated in this item. 25. Total amount of asbestos-containing material to be abated during this work T869 __ Square Feet, and/or . _ _9_ Linear Feet ACP 7 .... 2/2001 1, tMlMr!r1F : :rt

NYC-WTC 000099351