NYC 9/11 Public Portal Document
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
/
Asbestos Control Program
59-17 Junction Boulevard, 8" Floor, Corona, NY 113685107 7Ra/ 976N44'4
ONLY
`" ^: TYPEWRITTEN '
(tDP ASBESTOS PROJECT NOTIFICATION
Building Dept. or TRU No
FOR OFFICYLL USE ONLY
FORMS WILL BE Nru j (ASBESTOS INSPECTION REPORT)
a._ ACCEPTED id. 1.
(See schedule)
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 NYCOEP 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 .
I. FACILITY
2. Address 125 Cedar Street Borough Manhattan Zip 11201
AKA 3. Block 5 2 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
111. 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. #._._._._._._PII 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. # P!!--------- _ 20. Tel. # (212) 353-8280 12) 353-8306
Fax # _(1)
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 10/5102 Projected completion date 10/7/02
Asbestos work schedule 0 Monday 0 Tuesday 0 Wednesday ❑ Thursday ❑ Friday 0 Saturday Sunday
Shift from: ______Dam ❑pm to Dam ❑pm
If other,
specify
Access to inspect the premises must be provided doming the work schedule Indicated in this Item.
25. Total amount of asbestos-containing material to be abated during this work b ~WSa
- 2,346 Square Feet, and/or 0 Linear Feet
/ . ACP 7
2!2001
NYC-WTC 000108300
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