NYC 9/11 Public Portal Document
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'NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
Asbestos Control Program
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TYPEWRITTEN ~~q_. /oj' ASBESTOS PROJECT NOTIFICATION
FORMS WILL B (ASBESTOS INSPECTION REPORT)
ACCEP 7T~E
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]~ When submitting this form at the NYC Department of Buildings, the original form and three (3) copies with original
t_ 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 53 Nassau Street
_ Borough Manhattarizip 10005
AKA 3. Block 64 4. Lot 5
5. Type of Facility__ 6. Name of Building _
II. BUILDING OWNER
7. Name Century Realty, Inc.
8. Contact Person
9. Tel. # 212-267-7778 Fax #
10. Address _City State Zip
Ill. GENERAL CONTRACTOR
11. Name__ Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name Trio Asbestos Removal Corp. 13. Contact Person Chris Horan
14. Federal Employer ID.
PII._______r— 15. Tel. # 718-961-4100 Fax# 71 8-961-41 03
16. Address 14-20 1 29th Street _ CityCollege Point - State NY Zip 11 356
V. THIRD PARTY AIR MONITOR
Warren & Panzer Engineers, P.C. _18.
17. Name Contact Person Michael Nolan
19. Federal Employer ID. # 20. Tel. # 212-922-0077 Fax# 21 2-922-0630
21.Address_228 East 45th Street City New York State NY Zip 10 01 7
22, Sample Analysis Laboratory Warren & Panzer Engineers 23. NYS DOH ELAP # 1 1 251
VI. PROJECT INFORMATION
24. Starting date for this portion of work 1 f33 0Z Projected completion date 7 i8 0 Z
Asbestos work schedule Monday .CL Tuesday 1J Wednesday_ ' Thursday 'Vriday Saturday Sunday
Shift from: _$am ❑pm to []am m \•~~`y `,~~j_1~~/~
If other,
specify //. ,/
Access to inspect the premises must be provided during the work schedule indicated in this
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item.1 (JUL052
25. Total amount of asbestos-containing material to be abated during this work
1,200
Square Feet, and/or Linear Feet
ZL > 7
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NYC-WTC 000099535
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