NYC DEP asbestos project notification form for inspection and abatement activities at 114 Liberty Street.
NYC-WTC_000102548–000102552Folder label: “SCOPE OF WORK ADDENDUMS WORK SCHEDULE”
OCR status: ok · source: pdftotext
NYC 9/11 Public Portal Document
NYC 1 PARTMENT OF ENVIRONMENTAL PROTECTION ° ~'~r : a "' Asbestos Control Program 59-17 Junction Boulevard, 8t' Floor, Corona, NY 11368-5107 Building orTRU No - w} ! ; ..•a..• y FOR OFFICI& USE ONLY ONL 7YP,E t ~ a ASBESTOS PROJECT NOTIFICATION FORM +° `f (ASBESTOS INSPECTION REPORT) 1. ACCE
When submlttin ti fgrr1 at the NYC Department of Buildings, the original form and three (3) copies with original s±g' Submittal at the NYCDEP requires one copy of the form with original signatures. This form must be submitted to theAYC DEP not less than one week in advance of the start of abatement activities.
. j ACJLITY j/ O z. Address 114 Liberty Street Borough rt7rt~r~ _ Zip 10006
AKA 3. Block 52 4. Lot 11
5. Type of Facility Residential 6. Name of Building II. BUILDING OWNER 7. Name 114 Liberty Condominium 8. Contact Person Ms. Denise Sweeny
9. Tel. # (212) 633-6500 Fax #
10. Address 114 Liberty Street City New York State NY Zip 10006
III. GENERAL CONTRACTOR 11. Name_ _ Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR 12. Name Laces Contracting Corp. ,. . . . . . . . . . . . . . .' 13, Contact Person Carlos R. Lacen P11 #---------.---_-----.-----.---.' 15. Tei. # (718)482-8400 ___Fax # (718) 482-1710 14. Federal Employer ID.
16. Address 30-51 14th Street _ City Astoria State NY Zip 11102
V. THIRD PARTY AIR MONITOR
17. Name Environmental Consulting &Management 18. Contact Person Mr. Mark Rutstein
19. Federal Employer ID. # - -•-•-•-•-•P11 - 20. Tel. # (914) 523-1523 Fax # (845) 638-0640
21. Address 10 Filmont Drive ____— City ±W City State NY Zip
22. Sample Analysis Laboratory EMSL ____ 23. NYS DOH ELAP # 11506
VI. PROJECT INFORMATION 24. Starting date for this portion of work 7/12/02 Projected completion date 7/12/02
Asbestos work schedule 0 Monday 0 Tuesday ❑ Wednesday ❑ Thursday El Friday ❑ Saturday ❑ Sunday
Shift from: 8:00 2] am 0 pm to 5:00 0 am 0 pm 9 10
If other, ~! specify M ____ {DLt+G11LD Access to inspect the premises must be provided during the work schedule Indicated in this item. N i11 1 1 20Q2 I 25. Total amount of asbestos-containing material to be abated during this work rp =' 3r.+`iri•' TS- a'1GR;.r, 100 Square Feet, and/or 0 Linear Feet ACP 7 212001
NYC-WTC 000102548
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