NYC 9/11 Public Portal Document
) 24 NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
/ Z.- an
Of""ww, Asbestos Control Program
"—• • t+ P 4 59-17 Junction Boulevard, 8' Floor, Corona. NY 11368-5107
ONLY
TYP
D~
~ + ASBESTOS PROJECT NOTIFICATION
~►"~`~c (ASBESTOS INSPECTION REPORT)
A
E •••.• 1. or/o••
with original
Department of Buildings, the original form and three (3) copies
When submitting this form at the NYC the NYCDEP requiresw one copy of the form with original signatures. This
signatures are required. Submittal at abatement activities.
~~. • than one week in advance of the start of
form must be submitted to the NYC DEP not less
1. FACILITY
Street Borough ManhattanZip 11201
2. Address 125 Cedar
3. Block 52 4. Lot 21
AKA
Facility____Residential 6. Name of Building
5. Type of
II. BUILDING OWNER
8. Contact Person Joe Messino
7. Name 120 Liberty L L - C
718_830_0131 Fax#
9 Tel #
NY zip 11374
Address97-77 Queens Blvd. City Flushi ng State
10.
III. GENERAL CONTRACTOR
Tel. #
11. Name
CONTRACTOR
IV. ASBESTOS ABATEMENT
13. Contact Person Peter
Grande
12. Name Fiber Control Inc.
PI I __ 15. Tel # 516_781_3000 Fax # 51 6_781-3085
1A Foriarai Emolover ID. #
11793
City
Wantagh State NY zip
16. Address 3010 Burns Avenue
V. THIRD PARTY AIR MONITOR
Fred Burkhardt
A.T.C. Associates 18. Contact Person
17. Name 212-353-8306
PII 20. Tel.# 212-353-8280 Fax#
19. Federal Employer ID. # ._.-._._._._._._._._._._._._._._._-
104 East 25th Street City
New York State NY zip 10010
21. Address
0879
A T C Associates 23. NYS DOH ELAP # 1
22. Sample Analysis Laboratory
VI. PROJECT INFORMATION
Projected completion date lG 7
24. Starting date for this portion of work
/ O
Friday 13 Saturday. . Sunday
Asbestos work schedule © MondayY ® Tuesday 13 Wednesday ® Thursday ~.,
~ ❑am© pm 1
Shift from: ® am ❑ pm to
If other,
specify /ji tp
Fi~ ~Q
schedule indicated in this item. ; 1
Access to inspect the premises must be provided during the work
abated during this work
25. Total amount of asbestos-containing material to be
Square Feet, and/or ___ 0 Linear Feet 8 ;'
ACP 7
NYC-WTC 000108262
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