Asbestos Project Notification form, Corona NY

NYC 9/11 Public Portal Document

NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program 59-17 Junction Boulevard, 8s' Floor, Corona, NY 1138b.6107 .._ ii4 0

ONLY op, ~+ euidirg ept. or TRU No FOROFPICtALUSEONLY ASBESTOS PROJECT NOTIFICATION (ASBESTOS INSPECTION REPORT) 1 ( e fee schedule) When submitting this forth at the NYC Department of Buildings, the original form end tires (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 156 William St Borough Manhattan Zip AKA 51-55 Beekman St, 73-85 Ann St 3. Block 93 4. Lot 20

5. Type of Facility 6. Name of Building II. BUILDING OWNER

7. Name 156 William St, LLC 8. Contact Person 9. Tel. # (212) 9249690 Fax #

10. Address City State Zip III. GENERAL CONTRACTOR

11. Name ^ Tel. # IV. ASBESTOS ABATEMENT CONTRACTOR

12. Name Benjamin Kurzban 8r Son Control 13. Contact Person Louie Iannioo 14. Federal Employer ID. # ! _ _ _ _ _ _PI I _ 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 Panza=iz EtJC-a to EE g.S 18. Contact Person MI CUAEL %' 0 LAt' 19. Federal Employer ID. #L 20. Tel. it (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 _7/8 ! D Z Projected completion date sJ o Z Asbestos work schedule ❑ Monday 0 Tuesday 0 Wednesday ❑ Thursday ❑ Friday ❑ Saturday ❑ Sunday

Shift from: ❑ am ❑ pm to ❑ am 0 pm 12 1 If other, A

Sperm' Access to inspect the premises must be provided during the work schedule Indicated in this item. REc niEO JIII 0 3 2002 r 25. Total amount of asbestos-containing material to be abated during this work - EPrBANHM

3.' 6, _STOS/1E : 15 .48T Square Feet, and/or 0 Unbar Feet f ROGRAM TRUG r. ACP 7 22001

NYC-WTC_00011125