NYC 9/11 Public Portal Document
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DEPARTMENT OF ENVIRONMENTAL PROTECTION
Asbestos Control Program
59-17 Junction Boulevard, 8th Floor, Corona, NY 11368-5107
Building Dept. or TRU No
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TYPEWRITTEN off' ASBESTOS PROJECT NOTIFICATION
FORMS WILL BE (ASBESTOS INSPECTION REPORT) 1, j200.00
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(See fee schedyl)
When submitting this form at the NYC Department of Buildings, the original form and three (3) copies with" .
signatures are required. Submittal at the NYCDEP requires one copy of the form with original signatures. This
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form must be submitted to the NYC DEP not less than one week In advance of the start of abatement activities.
I. FACILITY
69 Murray Street Manhattan Zip 10007
2. Address Borough
AKA _ 3. Block 132 4. Lot
5. Type of Facility 6. Name of Building
II. BUILDING OWNER
7. Name 69 Murray Corp. 8. Contact Person Howard Berman
9.Tel.# (212)925-2999 Fax# (212)925-3799
10. Address 69 Murray Street City New York State NY Zip10 0 0 7
III. GENERAL CONTRACTOR
11. Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
Branch Services, Inc. Paul Napolitano
12. Name 13. Contact Person
14. FederalEmployerlD.# P11 15. Tel.# (631 )563-7300 Fax# (212)563-7389
16. Address 101-2 Colin Drive City Holbrook, NY State NY: Zip 11741
V. THIRD PARTY AIR MONITOR
J.C. Broderick & Associates Brendan Broderick
17.Name 18. Contact Person
19. Federal Employer ID. #, PIT ;"__ 20. Tel. # (631 ) 419-091 3 Fax# ( 631 ) 584-3395
21.Address 101-4 Colin Drive city Holbrook State NY Zip 11741
22. Sample Analysis Laboratory Long Island Analytical 23. NYS DOH ELAP # 11693
VI. PROJECT INFORMATION
24. Starting date for this portion of work 10/16/01 Projected completion date 10/19/01
Asbestos work schedule ® Monday IN Tuesday IN Wednesday ® Thursday J Friday I Saturda' ❑ Sunday
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Shift from: 8:00 12 am 0 pm to 6:00 ❑ am ® pm
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If other,
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specify
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Access to inspect the premises must be provided during the work schedule indicated in this item.
7 DEC 14 2001
25. Total amount of asbestos-containing material to be abated during this work ,`9
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4,30 *~:uRAit
0 Square Feet, and/or 0 Linear Feet
ACP 7
212001
NYC-WTC 000100522
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