Asbestos project notification form for 250 South End Ave

NYC 9/11 Public Portal Document

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NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION Asbestos Control Program np 59-17 Junction Boulevard, 8&' Floor, Corona. NY 11368-5107 &-- i.ilding Dept. or FOR OFFICIAL USE T1~:J ASBESTOS PROJECT NOTIFICATION t~q FORMA (ASBESTOS INSPECTION REPORT) 1. E T .2u. 'av)dep (See fee schedule)

"W he u fitting this form at the NYC Department of Buildings, the original form and three (3) copies wit ~i Sig are required. Submittal at the NYCDEP requires one copy of the form with original signatur . ` t be submitted to the NYC DEP not less than one week in advance of the start of abatement acts I es . 1 rm, ~. 4 6;

2. Address 250 South_ End_ Avenue ----------------------- BoroughManattan- Zip ---------------- 3 AKA --------------------------------------------------------3. Block 1 6 ----------- 4. Lot 750 ------- 5. Type of Facility_ APaY'tment Bui.ldi.ng ---- --------- ------- 6. Name of Building ----------------------------- II. BUILDING OWNER

7. Name __RY Management --------------------------- 8. Contact Person John Piastra ------ 9. Tel. # 212_ 534 7771 -_____ Fax # 212 _534 61 40 ------------------ 10. Address 1619 3rd Avenue----------------- City New_York -- -----_ Statel----Zip 191 28---- I11. GENERAL CONTRACTOR

11. Name ---N/A- Tel.#---N/-A - - IV. ASBESTOS ABATEMENT CONTRACTOR Fried/ ----- 12. Name _ Environmental Management -Solutions 13. Contact Person _Bob

14. Federal Employer ID. # ._._._._._._P11 15. Tel. #914 762_ 6333 Fax # .L1.6-- --5'!8 16. Address _67 Snlosad;id~ Y~nue_____________ City _Braircliff Mandate NY Zip 1051 V. THIRD PARTY AIR MONITOR

17. Name E21V rQw$tch ______________________________18. Contact PersorAo- -Perez

19. Federal Employer ID. # --------------------20. Tel. #914 _ 632_ 3362 _____ Fax #914_ 328__1734 21. Address 1_.3.3.A__Nor_tb-_AY_> ue_ Suite_ 206city New_Rochelle ---- StateNY ___ Zip10804 22. Sample Analysis Laboratory _West_Lat________________________________ 23. NYS DOH ELAP # 1_1 459 _______

VI. PROJECT INFORMATION 24. Starting date for this portion of work _1./222.02____ Projected completion date __112A/ 02___

Asbestos work schedule ❑ Monday IN Tuesday ® Wednesday ® Thursday ❑ Friday ❑ Saturday ❑ Sunday

Shift from0700__ ® am ❑ pm to 1 2QQ_ ❑ am ❑ pm

If other, '9 specify ------------------------------------------------------------------ h l~C~i U Access to Inspect the premises must be provided during the work schedule indicated in this Item. AA p g O N t♦ v G002 0FP A111tfM 25. Total amount of asbestos-containing material to be abated during this work SpE~,5GR FAL, r 7L.__ Square Feet, and/or ------------ Linear Feet ACP 7 Gl 212001

NYC-WTC 000117405