NYC 9/11 Public Portal Document
FROM : SEAY YARBROUGH INC PHONE NO. : 2128689293 Jun. 24 2602 0454PM P4
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APPLICATIONS WILL
eE ACCEPTED
NOT AN ASBESTOS PROJECT FOR GFFICE taURPOSES ONLY
NOTE: THIS FORM IS TO 8E COMPLETED -IF THERE I8, NO -FRIABLE ASBESTOS CONTAINING MA`rERIAt Wf e.t' . tie.
PRESENT OR IF THE TOTAL AMOUNT OF FRIA8L'E ASBESTOS CONTAINING MATERIAL IS 10 SQUARE
FEET OR LESS, OR 25 LINEAR FEET OR, LESS, .OR, IF NORMALLY NONFRIABLE ACM (AS PER 4A CFR AGP5 Fee $
PART 61.141) IS PRESENT, IN ANY AMOUNT NYC clepL or Em*omeMd P abMian
2. FACILITY ADDRESS 47 Broadway Manhattan 10005
BORO CODE
23 Trinity Place, al-OCK# 20 4. LOT# 12
AKA .3.
5. BUILDING OWNER 47 Realopp Carp 212 569 - 2620
TEL, #(
560 5th Avenue ZIP
6. ADDRESS STATE N.Y. CODE10036
7. CONTACT PERSON Gary Tr i ma rc h i 212 560 - 1610
8. TEL.#
B.DESCRIPTION OF ENTIRE SCOPE OF WORK No W__
10. ESTIMATED START DATE A N/ ESTIMATED COMPLETION DATE N/A OF THE ENTIRE SCOPE OF WORK.
11. I Leroy Shaw , HAVE CONDUCTED AN ASBESTOS INVESTIGATION ON 5/30/2002
im- dN
_______ IN ACCORDANCE WITM THE
PROCEDURES REQUIRED BY THE NYC DEP ASBESTOS CONTROL PROGRAM REGULATIONS AND DECLARE THAT AT SAID
FACILITY ADDRESS, THE
❑ a. premises to be demolished are free of any asbestos containing material (ACM)
❑ b. premises to be demolished contain 10 square feet or less or 25 linear feet or less of friable ACM or of normally nonfrieble ACM that
demolition forces may make friable: all ACM shall be removed according to the NYS DOL ICR 56 or the NYC DEP Asbestos
Regulations
t'] c. cumulative surfaces of relevant structure(s) affected by an alteration or plumbing repair are free of any friable ACM and free of
normally nonfriable ACM that alteration or plumbing repair tortes may make friable
❑ d. cumulative surfaces of relevant structures) affected, by an alteration or plumbing repair contain 1Q square feet or less or 25 linear feet
. or less of friable ACM or of normally nonfriable ACM that alteration or plumbing repair forces may make friable: removal as in b.
e. normally nonfriable A hall be disturbecirernoved in accordance with the NYS DOL ICR 56 or the NYC DEP Asbestos
Regulations: Sq. Ft. _4 _ (Roof area)
Of. friable-ACM and/or normally nonfriable ACM will NOT oe disturbed during alteration/plumbing repair/modification/renovation:
Friable ACM Sq Ft Un Ft : Nontriable ACM Sq Ft
12. COMPLETE AND THOMOUGH ASBESTOS INVESTIGATION PERFORMED OF
STORY' DESCRIBE SECTION OF FLOOR ALL FRIABLE SURFACING MATERIALS NUMBER ASBESTOS
(bn nds cefar (e.g. entire, cast wing, room M INCULIOING FRIABLE ACV AND OF SAMPLES PRESENT
and basement boiler room, lobby, etc.) NORMALLY NONFRIAB E ACIA ANALYZED. YES RO
Entire Chrysotile ACM 1% 7 X•
C..S......tst:.. 1 TRIr'
NYC-WTC 000105525
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