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Document / 13 pages

Asbestos project notification form, Corona NY, Oct 2001

Machine-extracted title · confidence 90%

Project notification form for asbestos abatement activities submitted to the NYC Department of Environmental Protection.

NYC-WTC_000109630–000109642

Folder label: “115 West Broadway

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Scanned page image, NYC-WTC_000109630
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NYC 9/11 Public Portal Document

NYC DEPARTMENT OF ENVIRONMENTAL PROTECTI bestos Control Program 59j l7' u Boulgiird. 8" Floor. Corona, NY 1136851 ,y o,p or No . r ,~fc3 FOROFACOLIMOKY ASBEST S PROJECT NOTIFICATION FORMS WILL BE (AS 810S INSPECTION REPORT) 1, $1 .200.00 (See fee schedule) ACCEPTED LUPtU orIginal w submitting this form at the NYC nlent of Buildings, the orIginal form and three (3 copies with . This CDEP requires form with si — .. _ less than one week in advance of the dad of abatement activities. fc AJ ! I. FACILITY Borough Manhattan Zi p 10012 2_ Addrss e 115 West Broadway 3. Block 14 6 4. Lot 11 01 AKA 6. Name of Building 5. Type of Facility II. BUILDING OWNER 8.Contactperson Eileen Bosman Building Corp. 7. Name Andrews (21 2) 529-5688 (212) 529-7987 9. Tel. # Fax# York State NY Zip 10012 10. Address 666 Broadway 12th Floor may New

III. GENERAL CONTRACTOR Tel. # 11. Name

IV. ASBESTOS ABATEMENT CONTRACTOR Paul Napolitano Branch Interior Services, Inc. 13. Contact Person 12. Name 192 P _ 15. Tel. # (631 ) 5 6 3- 7 3 0 0 Fax # (6 31)563-7389 14. Federal Employer ID. # 11 City uo brnnk Stat Y Zip 11741 18. Address 1 01-2 Colin Drive

V. THIRD PARTY AIR MONITOR Brendan Broderick J.C.Broderick & Associates 18. Contact Person 17. Name .._._._._._._._._._._._._._._._._._._._._._; ~ ~1 )419-0913 Fax # (6 31 )584-3395----- 19. Federal Employer ID. # - - -P- - ;_ 20. Tel # State_ NY Zipiil41-- Drive City Holbrook 21.Address 101 4 Colin Long Island Analytical 1 _ 23. NYS DOH ELAP # 1 1 693 22. Sample Analysis Laboratory

VI. PROJECT INFORMATION 16 / 01 projected completion date 11 / 19/ 01 Pro 24. Starting date for this portion of work 11 / Friday ® Saturday ® Sunday Asbestos work schedule 0 Monday 0 Tuesday 0 Wednesday ❑ Thursday ®

Shift from: 8:00 ®am❑pm to 8:00 ❑am®pm

If other, specify 1 R~cEN n+ Access to inspect the premises must be provided during the work schedule indicated In this Item. i

material to be abated during this work 25. Total amount of asbestos-containing 3, 00 0 Square Feet, andlor 0 Linear Feet g r ACP U2

I NYC-WTC 000109630

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NYC-WTC_000109630Source: NYC Law Department, mirrored locally

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