NYC 9/11 Public Portal Document
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DEPARTMENT OF ENVIRONMENTAL PROTECTION
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YC - Asbestos Control Program
59-17 Junction Boulevard, 8"' Floor, Corona, NY 11368-5107 i
Budding Dept. or TRU No
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ONLY FOR OFFICIAL USE ONLY
TYPEWRITTEN ASBESTOS PROJECT NOTIFICATION
FORMS WILL BE —.~- (ASBESTOS INSPECTION REPORT) 1, 1,200.00
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When submitting this form at the NYC Department of Buildings, the original form and three (3) copies witi I
signatures are required. Submittal at the NYCDEP requires one copy of the form with original signatur
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 69 Murray Street Borough Manhattan Zip 10007
AKA 3. Block 1 32 4. Lot 3
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 Zip1 0007
III. GENERAL CONTRACTOR
11. Name Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
Branch Services, Inc. Paul Napolitano
12. Name 13. Contact Person
14. Federal EmployerlD.# PII 15.Tel.# (631 )563-7300 Fax (212)563-7389
16. Address 101-2 Colin Drive city Holbrook, NY State NY ' Zip 11 741
V. THIRD PARTY AIR MONITOR
J.C. Broderick & Associates Brendan Broderick
17. Name 18. Contact Person
19. Federal EmployerID.# P11 20. Tel.# ( 631 )419-0913 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 # 11 693
VI. PROJECT INFORMATION
24. Starting date for this portion of work 1 0/1 6 / 01 Projected completion date 1 0/1 9 /01
Asbestos work schedule ® Monday IE Tuesday I Wednesday ® Thursday 19 Friday El Saturday ❑ Sunday
Shift from: 8 : 00 12 am ❑ pm to 6 : 00 0 am ® pm /' P273
If other,
specify
REcENE1
Access to inspect the premises must be provided during the work schedule indicated in this item.
DEC 1 4 100,
4p 25. Total amount of asbestos-containing material to be abated during this work c0
4,30 ;~ T.FitG
0 Square Feet, and/or 0 Linear Feet
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NYC-WTC 000100527
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