NYC 9/11 Public Portal Document
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
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~ Asbestos Control Program
59-17 Junction Boulevard, 8"' Floor, Corona, NY 11368-5107
Building Dept. or TRU Ni
FOR OFFICIAL USE ONLY
TYPEW " MAInot~~
ASBESTOS PROJECT NOTIFICATION
FOR (ASBESTOS INSPECTION REPORT)
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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.
I. FACILITY
2. Address 130 William St Borough Manhattan Zip I CC) 38
AKA - 3. Block 77 4. Lot 15
5. Type of Facility 6. Name of Building
II. BUILDING OWNER
7. Name 13 William LLC, do Craven Mgt 8. Contact Person
9. Tel. # Fax #
10. Address City State Zip
111. GENERAL CONTRACTOR
11. Name Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name Benjamin Kurzban & Son Control 13. Contact Person Louie lannico
14. Federal Employer ID. 15. Tel. # (718) 531-2900 Fax # (718) 209-1808
16. Address 1248 Ralph Avenue City Brooklyn State NY Zip 11236
V. THIRD PARTY AIR MONITOR
17. Name Warren PanztiER ><f t g1cEQS 18. Contact Person _k i C4QAt_L %o t,.A
19. Federal Employer ID. f" P11 20. Tel. # (212) 922-0077 Fax# (212) 922-0630
21. Address 228 East 45th St city New york State NY Zip 10017
22. Sample Analysis Laboratory 23. NYS DOH ELAP #
VI. PROJECT INFORMATION
24. Starting date for this portion of work I O '25 1 02. Projected completion date i l 251c 2.
Asbestos work schedule ® Monday I Tuesday ® Wednesday I I Thursday I I Friday I Saturday I Sunday
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Shift from: Z3 _ ~am El pm to 8 ❑ am ®pm
If other,
specify
Access to inspect the pmes must be provided dung the work schedule indicated in this item.
25. Total amount of asbesto ontaining material to be abated during this work
33 5S Square Feet, and/or 0 Linear Feet >Ru 1
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• 2/2001
NYC-WTC 000110472
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