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Asbestos project notification form, Corona NY, Oct 2001

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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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NYC 9/11 Public Portal Document

NYC DEPARTMENT C ENVIRONMENTAL PROTECTI lsbestibs Control Program . Boul iard, 8°1Floor, Carona, NY 11388-51 1~ _ M.. •~ F_ P_=- Y TYPEWRITTEN S PROJECT NOTIFICATION 4 INSPECTION REPORT) UMC` ] FORMS WILL BE 1, $1,200.00 ACCEPTED ww w.i 30 2001 f si~ tSee be sch.drM)

Wh n sub "Ov oft form at the NYC ht of BddMga, the original form and tlhree (3) oopiea ith odghhal EP requires one copy of the form with original signatures. This h,I °' J O 1. FACILITY, sig h s ,s required. S a tharNYcv> dish one week In advance of the start of abatement activities.

2. Address 115 West Broadway Borough Manhattan Zip 10 012

AKA 3. Block 14 6 4. Lot 11 01

5. Type of Facility 6. Name of Building

II. BUILDING OWNER

7. Name Andrews Building Corp. 8. ContactPerson Eileen Bosman

9.Tel.# (212) 529-5688 Fax# (212) 529-7987 city New York State NY Zip 10012 10. Address 666 Broadway 12th Floor, 111. GENERAL CONTRACTOR

11. Name Tel. #

IV. ASBESTOS ABATEMENT CONTRACTOR Interior Services, Inc. 13.ContactPerson Paul Napolitano 12.Name 192 Branch

14. Federal Employer ID. #1 P11 -15. Tel. # (631 )563-7300 Fax # (6 31 )563-7389

16. Address 101-2 Colin Drive City Holbrook, Stat YY _ Zip 11741

V. THIRD PARTY AIR MONITOR J.C. Broderick & Associates 18. Contact Person Brendan Broderick 17.Name

19. Federal Employer ID. # P 11 s 20. Tel. # (631 )419-0913 Fax # (6 31) 5 8 4 - 3 3 9 5 City Holbrook State_NY Zip 1.1741 21. Address 101-4 Colin Drive

22. Sample Analysis Laboratory Long Island Analytical 23. NYS DOH ELAP #_11 693

VI. PROJECT INFORMATION 24. Starting date for this portion of work 11/16/01 Projected completion date 11/1 9/01

Asbestos work schedule ❑ Monday ❑ Tuesday ❑ Wednesday 0 Thursday ® Friday ® Saturday ® Sunday

Shin from: 8 : 0 0 ® am O pm to 8 : 00 ❑ am El pm ~ ~' "'~•~~

If other, ` specify ~~tE~L . .

Access to inspect the premises must be provided during the work schedule indicated in this item. k~ ~u ( ~2 1 1`1 I J ll 25. Total amount of asbestos-containing material to be abated during this work 3,00p Square Feet. and/or 0 Linear Feet "' .4 i

NYC-WTC 000109634

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NYC-WTC_000109634Source: NYC Law Department, mirrored locally

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