NYC 9/11 Public Portal Document
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NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
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~ M Asbestos Control Program
59-17 Junction Boulevard, 8" Floor, Corona, NY 11368-5107 7a/ 97N
•.ONLY
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D20P o+ ASBESTOS PROJECT NOTIFICATION
Building Dept. or TRU No
FOR OFFICIAL VSE ONLY
~~ FORMS WILL BE S IN wrLL r ~ (ASBESTOS INSPECTION REPORT)
ACCEPTED . ur ae 1.
LJ (See Ie schedule)
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reuarr r9 When submitting this form at the NYC Department of Buildings, the original form and three (3) copies with original
signatures are required. Submittal at the NYCDEP requires one copy of the form with original signatures. This
form must be submitted to the NYC DEP not less than one week in advance of the start of abatement activities.
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I. FACILITY
2. Address 125 Cedar Street Borough Manhattan Zip 11201
3. Block 52 4. Lot 21
5. Type of Facility residential 6. Name of Building
II. BUILDING OWNER
7. Name •120 Liberty LLC 8. Contact Person Mr. Joe Messino
9. Tel. # (718) 830-0131 Fax #
10. Address 97-77 Queens Blvd City Flushing State NY Zip 11374
Ill. GENERAL CONTRACTOR
11. Name n/a Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name Fiber Control Inc. 13. Contact Person Mr. Anthony Costa --
14. Federal Employer ID. # ._... _P11_ _ 15. Tel. # (516) 781-3000 Fax # (516) 781-3085
16. Address 3010 Bums Avenue City Wantagh State NY Zip 11793
V. THIRD PARTY AIR MONITOR
17. Name A.T.C. Associates 18. Contact Person Mr. Fred Burkhardt
19. Federal Employer ID. # P11 _ 20. Tel. # (212) 353-8280 Fax # (212) 353-8306
21. Address 104 East 25th Street City New York State NY Zip 10010
22. Sample Analysis Laboratory A.T.C. Associates 23. NYS DOH ELAP # 10879
VI. PROJECT INFORMATION
24. Starting date for this portion of work 10/5/02 Projected completion date 1017/02
Asbestos work schedule 0 Monday 0 Tuesday 0 Wednesday 0 Thursday 0 Friday 0 Saturday_] Sunday
Shift from: ______Dam ❑pm to Dam ❑pm
If other,
specify
Access to inspect the premises must be pnwided during the work schedule indicated in this Item. ~ :
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25. Total amount of asbestos-containing material to be abated during this work
2.346 Square Feet, and/or 0 Linear Feet
Or
ACP 7
2/2001
NYC-WTC 000108264
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