Asbestos project notification form, Jan 2003

NYC 9/11 Public Portal Document

GITV OEP4 4 , NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION

0w Asbestos Control Program 59-17 Junction Boulevard, 8 s Floor, Corona, NY 11368-5107 0L-~ )o3 Building Dept. TRU No ~P FOR OFFICIAL USE ONLY ONLY a ASBESTOS PROJECT NOTIFICATION NMI vao•`O FOR (ASBESTOS INSPECTION REPORT) /Vv Fee_. 1. (See The 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. 1. FACILITY A /h 2. Address 300 lector Place - Apartment; P11 Borough Manhattan Zap 10280

AKA -----____-- 3. Block 16 4. Lot 7504

5. Type of Facility Residential Apartment Building 6. Name of Building Hudson View 1I. BUILDING OWNER 7. Name Akam Associates 8. Contact Person Don Moskovic 9. Tel. # (212) 986-0001 Fax # 10. Address 8 West 38th Street 7th I-ioor City ±IX State NY lap 10018

111. GENERAL CONTRACTOR 11. Name Termon Construction Inc. Tel. # (718) 694-0900

IV. ASBESTOS ABATEMENT CONTRACTOR 12. Name Specialty Service Contracting Inc. 13. Contact Person John A. Tancredi ------------------------, 14. Federal Employer ID. # P11 15. Tel # (201) 941-8292 Fax # (201) 941-6992

16. Address 845 Broad Ave Cy Ridgefield a State NJ ZIp 07657

V. THIRD PARTY AIR MONITOR

17. Name Athenica Environmental Services Inc. 18. Contact Person Theresa Vasquez

19. Federal Employer ID. #_ _ _ _ _ P11 20. Tel. # (718) 784-7490 Fax # (718) 784-4085

21. Address 45-09 Greenpoint Avenue City State NY Zip 11104

22. Sample Analysis Laboratory EMSL 23. NYS DOH ELAP # 11506

VI. PROJECT INFORMATION 24. Starting date for this portion of work 1/24/03 Projected completion date 1/29/03

Asbestos work schedule 21 Monday ❑ Tuesday ❑ Wednesday ❑ Thursday 0 Friday ❑ Saturday 0 Sunday

Shift from: 9.00 Ham ❑pm to 5:00 Dam ©pm

If other specify, Saturday if owner approves. Sampling Tuesday. Results Wednesday. Access to Inspect the premises must be provided during the work schedule Indicated in this item. L ~~~►® 1 ~o 25. Total amount of asbestos-containing material to be abated during this work 0 Square Feet, and/or 0 Linear Feet 'ACP 7 2/2001

NYC-WTC 000116310