NYC 9/11 Public Portal Document
KIOIWTC
КОК СТY DЕРAТИ,
SРБNОЕР
Нанесрусмя раротсто
www.nyc.gov/der.
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
Asbestos Control Program
59-17 Junction Boulevard, 8* Floor, Corona, NY 11368-5107
TaLZIMNOZ
Bullding Dept or TRU No
FOR OFFICIAL USE ONLY
ASBESTOS PROJECT NOTIFICATION
(ASBESTOS INSPECTION REPORT)
1.
MYCDEP
(Sed 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_182 BROADWAY
AKA 2 JOHN STREET
Borough
_ 3. Block
MN
65
Zip
.4. Lot19
5. Type of Facility COMMERCIAL
_6. Name of Building
II. BUILDING OWNER
7. Name_EOTHAM
ESTATES
• "8. Contact Person_RICHARO MARCUS
9. Tel.# -
Fax#
10. Address_
City _
State _
__Zip_
IlI. GENERAL CONTRACTOR
11. Name_
Tel.#
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name BENIAMIN KUEZBAN É SON COUTROL
_13. Contact Person_ LOUIE LANNICO
14. Federal Employer ID.#LPI
_ 15. Tel. # (718)531-2900
_Fax#(718)309-1808
16. Address_1248
RALPH
_AVENUE
_CityBRoOKUeN
_State NY_. Zip 11236
V. THIRD PARTY AIR MONITOR
17. Name WARREN & PANZER
ENGINEERS INC.
__18. Contact Person MICHAEL
NOLAN
19. Federal Employer ID. #.
PlI
=20.Tel.# (212)922-0027
_Fax#(212) 922-0630
21. Address 228 EAST 45TH STREET
City_ NEw YeRK
_State_N$_Zip 10017
22. Sample Analysis Laboratory_.
23. NYS DOH ELAP #_
VI. PROJECT INFORMATION
24. Starting date for this portion of work_ 7/21/02
Projected completion date _
8/21/02
Asbestos work schedule
Shift from:
800
If other,
specify
MMonday [Z Tuesday [Xl Wednesday [X ThursdayLZ Friday
, IX Saturday Z Sunday
X am pm to
8°
_D am Kpm
110
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
23227
Square Feet, and/or
_ Linear Feet
RECEIVED
J!I! 17 2002
CORAN
3STOSITA
PROGRAM
TRUG
ACP•
2/200
:.
DEPRONPENTA
...rn
NYC-WTC_000122947
OCR can misread numbers and units. Confirm readings against the page image before using them.
NYC-WTC_000122947Source: NYC Law Department, mirrored locally