NYC 9/11 Public Portal Document
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-' A\ NYL DEPARTMENT OF ENVIRONMENTAL?ROTEGTION
Asbestos Con;rsl Program
r•,irr Na'; 59-17 Junction Boulevard, 8th Floor, Corona, NY 11368-5107
.+u~wny vepc. or IRI
FOR OFF(CtAL USE
EWRITTEN'~'y;.~
' ASBESTOS PROJECT NOTIFICATION
FORMS WILL BE 'O~*._rna (ASBESTOS INSPECTION REPORT)
ACCEPTED - ..<. ..t.<. ;
(S 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 CEP not less than one week in advance of the start of abatement activities .
I. FACILITY
2.Address 50 Broadway __Borougt anhattan zip10004
AKA --- 3. Block 22 4. Lot 24
,
5. Type of Facility— 6. Name of Building
II. BUILDING OWNER
Colliers ABI
7. Name 50 Broadway Realty Corp. c/o 8. Contact Person
9. Tel. # 212-758-0800 Fax#
10. Address , City State Zip
Ill. GENERAL CONTRACTOR
11, Name-,_._— Tel. #________________________
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name Trio Asbestos Removal Corp. ___13. Contact Person Chris Horan
14. Federal Employer ID. 15. Tel.# 718-961-4100 Fax# 718-961-4103
16. Address 1 4 _20 1 29th Street Cit College Point - StateNY Zip 11356
V. THIRD PARTY AIR MONITOR
Warren & Panzer Engineers, P.C.
17. Name 18 r tactPerson Michael Nolan
19. Federal Employer ID. # '20.Tel.# 212-922-0077 Fax 212-922-0630
21.Address - 228 East 45th Street ci ty New York State NY Zip 1001 7
22. Sample Analysis Laboratory Warren & Panzer Engineers 23. NYS DOH ELAP # 1 1 251
Vi. PROJECT INFORMATION
-7
24. Starting date for this portion of work 7
Projected completion date 1 U Z
Asbestos work schedule ❑ Monday ❑ Tuesday ❑ Wednesday ❑ Thursday ❑ Friday ❑ Saturday ❑ Sunday
Shift from: ______[lam ❑pm to [Jam ❑pm r1
If other, "/
specify
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Access to inspect the premises must be provided during the work schedule indicated in (his item.
J 2 6 zo2
25. Total amount of asbestos-containing material to be abated during this work DEP/BAWit.'.
SgESTOS/Lc-.
5 , 770 PROSG I
Square Feet, and/or Linear Feet 3
e 2 \ 0 •
ACP 7
Z 712001
NYC-WTC 000118107
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