NYC-WTC_000111229
NYC DEP Asbestos Project Notification form for inspection report submission.
8 shared non-person entities · 1 shared topics · Same agency, volume and box · similarity 0.999
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Asbestos Project Notification form, Nassau Street
Machine-extracted title · confidence 95%NYC DEP Asbestos Project Notification form for facility at Nassau Street.
NYC-WTC_000111346–000111373Folder label: “Zone I Copies”
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NYC 9/11 Public Portal Document
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program 59-17 Junction Boulevard, 8°i Floor, Corona, NY 11368-5107 1 111 ti Building Dept. or TRU No FOR OFFICIAL USE 1LY ASBESTOS PROJECT NOTIFICATION . i_i i. ILL BE (ASBESTOS INSPECTION REPORT) vy 1. I (See ((a 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.
1. FACILITY
2. Address 127 Fulton St Borough Manhattan Zip 1 ca38 AKA 42 Ann St. 3. Block 91 4. Lot 12
5. Type of Facility—_ 6. Name of Building II. BUILDING OWNER
7. Name Collegiate Church Corp, 8. Contact Person PfrJID RiJUAK
9. Tel. # (212) 233-1960 Fax #
10. Address 45 Joao S1c-€T City N 4' State 1.1Y Zip 1eO38
Ill. GENERAL CONTRACTOR
11. Name_ Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name Benjamin Kurzban & Son Control 13. Contact Person Louie lannioo
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 & Panzine Er tI ERS _18. Contact Person _
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 -' 8 -'22-C 'Z. Projected completion date _ ?:2..? - ° Z Asbestos work schedule I Monday ® Tuesday ® Wednesday ® Thursday ® Friday ® Saturday. I Sunday Shift from: __9_ I am ❑ pm to _ 8` Y'_ ❑ am l pm
If other, specify
Access to inspect the premises must be provided during the work schedule indicated in this item.
25. Total amount of asbestos-containing material to be abated during this work T28 T Square Feet, and/or_. 0 Linear Feet ACP 7 2/2001
NYC-WTC 000111372
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NYC-WTC_000111372Source: NYC Law Department, mirrored locally
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NYC-WTC_000094344
Asbestos inspection report form and project notification to NYC Department of Environmental Protection requiring original and three copies.
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