NYC 9/11 Public Portal Document
NYC DEP ACP Fax:7185953648 Feb 28 2005 17:06 P.06
FOR OFFICIAL, USE ONLY
NYC DEPARTMENT OF ENVIRONME~
Asbestos Control P r i N variancest_ ~~
'I
' 59-17 Junction Boulevard, 8'" Floor, Corona, NY 11368-5107
D' Fee Paid 21-6 U2/
ON
TYPEWRITTEN l ~ Asbestos Variance Application
FORMS WILL BE ~. .•L ! 0- Notification #
ACCEPTED o~teaC
I. FACILITY
Address 130 Cedar Street
/1/4
! dj
( Application must be
. Borough Manhattan Zi p 10607 made at least 2
weeks prior to the
II. APPLICANT start of work.
Name East Coast Haz Mat Removal, Inc. Tel # (973) 345.0022
Address 494 E. 41 Street Cl ), Paterson State NJ Zip 07504
Capacity: 0 Contractor ❑ Consultant ❑ owner D Other Contact Person Leszek Olszewski
Ill. SPECIFY ALL NYC DEP OR NYS DOL (ICR56) ASBESTOS RULE PROVISIONS FROM WHICH A VA IA CJESgEO
1 ,
SPECIFY FLOORS ANDIOR AREAS WHERE WORK INVOLVING THIS VARIANCE IS TO OCCI
'8 LI
REASONS FOR REQUEST AND DESCRIPTION FOR PROPOSED ACTION (Attachment(s) shall ubm in TRIP T.EI
Explain why the procedures required by Title 15, Chapter 1 of the Rules of the City of New York (RCN f3T 12
of New York Codes, Rules and Regulations (Subparts 56-4 through 56-17) cannot be used. (Attach Additions , , .-
State the alternative procedures that will be employed to satisfy each requirement as modified. (Attach Additional Sheets)
Provide color coded drawings identifying work area(s) and location of decontamination enclosure system(s).
IV. FEE SCHEDULE
Amount of ACM affected by this variance: 58'751 square feet t 1,700 linear feat c Total Amount of ACM 80,451
feet
If total amount of ACM If total amount of ACM
Is less than 5000 feet: Is 5000 feet or more:
Seven day notification period waiver $300 $400 See Section 1-03(e)
First sub-section (per category) $400 $600 of the NYCDEP
Each a ditional sub-section (per ca o $200 $300 Asbestos Rules for
Maximum fee $1200 $1800 category definitions.
Enter applicable fee based on schedule above Total Fees S $1,800
V. I hereby declare that the information provided herein and in any and all accompanying attachments is true and complete to the best
of my knowledge. I understand that failure to comply with conditions set forth by the Department in an approval of the application
shall render this variance null and void.
Cedar & WashingtonStreet Association East Coast -laz.Mat Rert,>tov~. in
Name of Owner Print N ' e o pli t (If of ' ner)
12/22/04 12/22/04
Date S r of Applicant Date
Work'4rfvolving a variance may not commence prior to the receipt of the Department's approval of the application. Any
violation of the terms of any variance issued pursuant to Tide 16, Chapter 1 of the RCNY Section 1-03 is considered a
violation of the lettered subdivision modified by the variance. acne
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NYC-WTC 000125081
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