202 BROADWAY 1001221, 79/19

NYC 9/11 Public Portal Document - 124 (Te atom, NYE DEPARTMENT OF ENVIRONMENTAL PROTECTION i ‘ J D=P 59-17 Junction Boulevard, 8” Floor, Corona, NY 11388-5107 a a a “x. ga? ASBESTOS PROJECT NOTIFICATION thle ites il (ASBESTOS INSPECTION REPORT) 1 2. wwwiaye. goe/ dep ‘ eae nye gon) aen (Ses 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 nol less than one week in advance of the start of abatement activities . 1. FACILITY 2. Address 202 BROADWAY Borough ___.MAN Zip AKA Bi NG a in 4.Lot 19 -_ 5. Type of Facility COMMERCIAL 6. Name of Building | il. BUILDING OWNER 7. Narne ‘_” 8. Contact Person 9. Tel. # Fax# 10. Address City State _ Zip . lL GENERAL CONTRACTOR 11, Name Tel. # _ IV. ASBESTOS ABATEMENT CONTRACTOR 12. Name _GENIAMIN KUeZBAN & SON CoNnTeCh 13. Contact Person Lovie JAnnice canes 14. Federal Employer ID. # Pil 7 15. Tel. # LHe) S3i-29C0 Fax# (118) 2¢9- 1@06 16. Address (248 RALPH AVENE City Be@cowiyn _ State NY Zip it 236 . V. THIRD PARTY AIR MONITOR 17. Name _Waeeen § PANZER ENGINEERS 18. Contact Person Micwaeu NOLAN 2 19. Federal Employer iD. Bho eesesnen a Pil i 20. Tel # (22) 922- OO7T Fax # (212) O22~ C630 24. Address 226 EAST AGTH SREECT City Nee fee! State BY Zip SOT 22, Sample Analysis Laboratory. _ ete 2A NYS DOH ELAR Re ee ne VI. PROJECT INFORMATION 4 / 13 Oz Projected completion date / > IC 2- 24. Starting date for this per cn ¢* work ¢ at Le semaines Asbestos work schedule Monday Tuesday Wednesday Thursday Friday 4) Saturday i] Surday wt Shitt from: __& am Cl om to é Oak om {fother, £16) < 101] en _ a . Access to inspect the premises must be provided during the work schedule indicated in this tem. 28 Total amount of asbestes-containing material to be abated during this work 14550 __ Square Feet, and/or 2 Linear Feet NYC-WTC_000123234