Permit application for DEP work, 63 Nassau Street, Sept 2002

NYC 9/11 Public Portal Document

NYC DEPARTMENT OF EIAVIRONMENTAL PROTECTION Asbestos Control Program 59-17 Junction Boulevard, 8'" Floor, Corona, NY 11368-5107 (3Z/-1& \ Ct$' ,DP, ASBESTOS PROJECT NOTIFICATION Building Dept. or TRU No' FOR OFFICIAL USE ONLY

t VRI1TEN ~~Mt ruran°car 'YRMS WILL BE (ASBESTOS INSPECTION REPORT) jlh ACCEPTED "." `'°•rar.. (See fee

original When submitting this form at the NYC Department of Buildings, the original form and three (3) copies with This signatures are required. Submittal at the NYCDEP requires one copy of the form with original signatures. form must be submitted to the NYC DEP not less than one week in advance of the start of abatement activities.

I. FACILITY —S E 1 Borough MAN -- Zip _ X(? 38 —_ 2. Address_ F3_tjASSAU 3. Block _ 65 —__ 4. Lot __?--__-

5. Type of Facility_- SAM R ct AL - ------- 6. Name of Building

II. BUILDING OWNER Rc.~LTY CO.. — --_ 8. Contact Person tcr+a,2D MARC.;S 7. Name_ UL-LMA~t

9. Tel. # C2t2)- ^i i 93 Y __ Fax # - -----------

10. Address _ _______ City — Ni p—Yat.K ---_ State _J! _ Zip _ 1003 L• ___

Ill. GENERAL CONTRACTOR

11. Name_____________ Tel. #

IV. ASBESTOS ABATEMENT CONTRACTOR KIJQZI3AN 5c (..c;NflcL 13. Contact Person _Loft iE I At'1JI Cc 12. Name _rtlk-NUAM 1 n0 < tt8) S?lt_290b__-- Fax # 1!~1_20~- IE3L~G —__ 14. Federal Employer ID. # ' _._P11._._._._._._._.__ 15. Tel. # AQC00E __----- City —a9cekL-L,N __—_ State N4 Zip Lfek3rn --_ 16. Address _ 12 A 8 RALPW

V. THIRD PARTY AIR MONITOR

17. Name A __$__~AN_z ~ EuG:t ra~E~S _ 18. Contact Person _ft!CNAEL _MOLAN ----

19. Federal Employer ID. # P11 i 20. Tel. # _t212 1322— — Fax #

21. Address _ 22$ EAST_ ASTN Sz¢ ET ----- City IJt u 1~fue _—__-- State N4 _ Zip _ 100I ( --

22. Sample Analysis Laboratory 23. NYS DOH ELAP #

VI. PROJECT INFORMATION 24. Starting date for this portion of work Projected completion date 10 1118 1O Z __

Asbestos work schedule ® Monday I Tuesday I Wednesday I Thursday 12 Friday I Saturday •0. Sunday

G cl~ ® ~ L • \~ Shift from: _— 0 am ❑ pm to _ 8 __ ❑ am 8 G pm

If other, specify ------------------------- ------------ item. Access to inspect the premises must be provided during the work schedule indicated in this

25. Total amount of asbestos-containing material to be abated during this work

---74 QO Square Feet, and/or _—_0 -- Linear Feet ACP 7 2/2001 A!•,. '~ r e

NYC-WTC 000099875