NYC 9/11 Public Portal Document
J/5O/W C ADI
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
Asbestos Control Program.
59-17 Junction Boulevard, 8"' Floor, Co NYTISQS5107
Building Dept. or TRU o
oWLY FOR OFFICIAL USE ONLY
ASBESTOS PROJECT NOTIFICATION
(ASBESTOS INSPECTION REPORT)
(eq 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 80 Nassau St Borough Manhattan Zip
AKA 80-84 Nassau St 3. Block 78 7503
4. Lot
5. Type of Facility-- _ __ 6. Name of Building
II. BUILDING OWNER
7. Name Nassau St Equities LLC c/o Time Equities ---_----- 8. Contact Person
9. Tel. # 212
~_ 207-6000 Fax #
10. Address City State —~ 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. #___P..I__.__ —__ 15. Tel. # (718) 531-2900 Fax
16. Address 1248 Ralph Avenue City Brooklyn _— --_—__ State NY Zip 11236
V. THIRD PARTY AIR MONITOR
17. Name Warren Panzk-u EtJC~It`EERS ----18. Contact Person —~iGaRr~ ~lAf3
19. Federal Employer ID. c !L _ 20. Tel. # (212) 922-0077----_ Fax # (212) 922-0630 --_—_-
21. Address 228 East 45th St - City -N--ew -york --------- N
Zip - 10017----
- ----- ----- State —Y
22. Sample Analysis Laboratory___—__— — __—_—-- _— 23. NYS DOH ELAP #
VI. PROJECT INFORMATION
24. Starting date for this portion of work CY~ n %!02 Projected completion date _C i 3' t ©2_
Asbestos work schedule Monday Tuesday Wednesday ,Thursday Friday , Saturday, Sunday
X
Shift from: am ❑ pm to ❑ am m
If other,
specify -------- ~jc
17 t 1LC~
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 O S/SEA
eR R
_I?'-(2Z 1a'Square Feet, and/or _____2 Linear Feet
,c-
6 $ ACP 7
212001
NYC-WTC 000099460
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