Asbestos project notification form, Zone III Originals

NYC 9/11 Public Portal Document

NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program ~¢~ 59.17 Junction Boulevard, 8" Floor, Corona, NY 11368-5107 Building Dept. or TRU No ONLY . D~rP~ FOR OFFICIAL USE ONLY TYPEWRITTEN'" -'- , - P% ASBESTOS PROJECT NOTIFICATION FORMS WILL BE ''""'E'^~!"O" (ASBESTOS INSPECTION REPORT) ACCEPTED j 1. (See fee 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 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 48 Beaver Street Borougtt1anhattan Zip 10004 AKA 56 Beaver Street - 3. Block 4. Lot 7501 29 5. Type of Facility 6. Name of Building II. BUILDING OWNER

7. Name Time Equities 8. Contact Person 9.Tel.# 212-206-5694 Fax# 10. Address City State Zip III. GENERAL CONTRACTOR

11. Name_ _ _ Tel. # IV. ASBESTOS ABATEMENT CONTRACTOR

12. Name Trio Asbestos Removal Corp. 13. Contact Person Chris Horan 14. Federal Employer ID. # ~._._._._._.P ~._._._._._._.' I 15. Tel. # 718 - 9 61- 41 0 0 Fax# 718-961-4103 16. Address _ 14_20 129th Street CityCollege Point __State NY Zip 11356 V. THIRD PARTY AIR MONITOR

17. Name Warren & Panzer Engineers, P.C. 18. Contact Person Michael Nolan 19. Federal Employer ID. # 20. Tel. # 21 2-922-0077 Fax# 212-922-0630 21.Address228 East 45th Street City New York State NY Zip 10017 22. Sample Analysis Laboratory Warren & Panzer Engineers 23. NYS DOH ELAP # 11251 VI. PROJECT INFORMATION

24. Starting date for this portion of work Projected completion date

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

Shift from: Elam ❑pm to Dam ❑pm

If other, specify ______—

Access to inspect (he 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

3..,_250 _ Square Feet, and/or _ Linear Feet 7 if

NYC-WTC 000111510