NYC 9/11 Public Portal Document
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
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Asbestos Control Program
59-17 Junction Boulevard, 8 Floor, Comm. NY 11368-5107
DP ASBESTOS PROJECT NOTIFICATION
Building Dept. or TRU o
FOR OFFICIAL USE ONLY
WRt ~ R~~
FORlC r- (ASBESTOS INSPECTION REPORT) 1. ~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 80 Nassau St Borough Manhattan Zip
AKA 80-84 Nassau St - 3. Block 78 4. Lot 7503
5. Type of Facility 6. Name of Building
It. 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
Ill. GENERAL CONTRACTOR
11. Name ' Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name Benjamin Kurzban & Son Control ___13. Contact Person Louie lannico
14. Federal Employer ID. # i.-.-.-.-.-. -.-.-.-.-.-.' 15. Tel. # (718) 531-2900 v Fax# (718) 209-1808
16. Address 1248 Ralph Avenue City Brooklyn State NY Zip 11236
V. THIRD PARTY AIR MONITOR
• 17. Name Warren PanzkV Ef3Cs t!J E ERS 18. Contact Person V t.IAE L W o LA N _
PII
19. Federal Employer ID. # ~~-~-~-~-~-~-~-~-~-~-~-~-~-~-~=` 20. Tel. # (212) 922-0077 Fax # (212) 922-0630
21. Address 228 East 45th St City New york State NY Zip 10017
22. Sample Analysis Laboratory _ 23. NYS DOH EIAP #
VI. PROJECT INFORMATION
24. Starting date for this portion of work 07 o t OZ Projected completion date
Asbestos work schedule Monday9-Tuesday NednesdayXThursday,Friday XSaturdayp) Sunday
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Shift from: 8 am D pm to ❑ am$ pm
If other,
specify cy ~ n
Access to inspect the promises must be provided during the work schedule indicated in this item. ,t<(f C
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25. Total amount of asbestos-containing material to be abated during this work 0)
PS T M C
D
iZ T 2 2 Square Feet, and/or 0 Linear Feet
6 ACP 7
2/2001
NYC-WTC 000099463
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