NYC 9/11 Public Portal Document
NYC DEPARTMENT OF ENVIRONMENTAL PROTE /
L a`•'°"'"rr,M bestoe Control Program 1
39r1r,tt Bouvud, e'' Floor, Corona, NY 113118.51 9uiarnotleor. No
_ ` FOR OFFI W UIX OKY
,' ASBEST S PROJECT NOTIFICATION
TVPEVVRIT7EN 4rio7rA !'"'`"
FORMS WILL 8E Ag $INSPECTION REPORT) 1, 1
ACCEPTED
t~t0hrentof BuNdInga. the original form and three (3)oopleswMh original
wbxnrithq this form at the NYC
a ." y QEP requires one copy d the form with odgins signatures. This
~ sy
to .r. . '== - ess also one week in advance of the start of abatement activities .
I FACILITY
1 1 5 West Broadway Ber gh Manhattan Zip 10012
2 Address
3. Bfodc 14 6 4, Lai 1101
AKA
6. Name of Building
5. Type of Facitityr
II. BUILDING OWNER
8.ContactPersort Eileen Bosman
Building Corp.
7. Name Andrews
529-5688 Fax# (212)
529-7987
9. Tel. # (21 2)
12th Floor City New York State NY Zip 1001 2
14 Address 666 Broadway
Ill. GENERAL CONTRACTOR
Tel. #
11. Name
IV. ASBESTOS ABATEMENT CONTRACTOR
Paul Napolitano
Interior Services, Inc. 13.ContactPerson
12. Name 192 Branch _
15.TOI.# (631 )563-7300 Fax# (631 )563-7389
14. Federal EmployerID.# P11
City Holbrook. Stated`_ Zip 1 1
—___7 41
16. Address 101-2 Colin Drive
V. THIRD PARTY AIR MONITOR
Brendan Broderick
J.C. Broderick & Associates 18. Contact Person
17.Name
PII 20. Tel.# (631 )419-0913 Fax#(631)584-3395 —
19. Federal Employer ID. # l-
brook
City Holbrook State NY lip 1 1 741 —
21.Address 101-4 Colin Drive
Island Analytical 23. NYSDOH ELAP # 1 1 693
22. Sample Analysis Laboratory Long
Vi. PROJECT INFORMATION
01 Projected completion date 11 / 1 9 /01
24. Starting date for this portion of work 11/1 6 /
® Sunday
Asbestos work schedule 0 Monday 0 Tuesday 0 Wednesday 0 Thursday ® Friday ® S.iturday
8:00 ❑ am K] pm
Shift from: 8 : 00 1.3 am ❑ pm to
If other, [rt f'
specify ; cc aN.a
Access to inspect the premises must be provided during the work schedule indicated in this item.
y i 2`:u1 `~—
be abated during this work
25. Total amount of asbestos-containing material to
3 , 00 p 0 Linear Feet 19
Square Feet, and/or r \ ACP
s l 1 ~ yla
NYC-WTC 000126053
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