NYC 9/11 Public Portal Document
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NYC DEPARTMENT O ENVIRONMENTAL PROTECTI
>-' ~ses!'_00 bestbs Control Program '~
Bowl . 8e' Floor. Corona. NY 11313"1
r Y ~ _ _ ASCU op Motavo
rYPEWMTTE i ' ~w.~~. ASBEST S PROJECT NOTIFICATION
FORMS t?~ (AS OS.INSPECTION REPORT) 1. $1 , 2 0 0.0 0
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W sutxnNWq this form at the NYC of BuNdlngs. the original loan and three (3) copies with orlgMal
1,0 $ a i; COED requires one Dopy of the farm with original sipnapres. This
{M rtlf'C lEF" less than one week in advance of the start of abatement adivitles .
1. FACILITY,
115 West Broadway Ber gh Manhattan Zip 10012
2. Addr'Ass
AKA 3. Blodr 14 6 4. Lot 1101
5. Type of Fadiity 6. Name of Building
11. BUILDING OWNER
7. Name Andrews Building Corp. 8. ContactPerson Eileen Bosman
9. Tel. # (212) 529-5688 Fax # (212) 529-7987
10. Address 666 Broadway 12th Floor City New York State NY Tap _10012
Ill. GENERAL CONTRACTOR
11. Name Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
Interior Services, Inc. 13.ContadPerson Paul Napolitano
12 Name 192 Branch
14. Federal Employer 1D. 4----•- W 15. Tel. # (6 31 )563-7300 Fax # (6 31 )563-7389
16. Address 101-2 Colin Drive City Holbrook, Statd1Y—Zip 11 741
V. THIRD PARTY AIR MONITOR
J.C. Broderick -Associates 18. Contact Person Brendan Broderick
17. Name
19. Federal Employer ID. # l Y -PI - '- -- 20. Tet. # (6 31) 419-0913 Fax # (6 31>584-3395
21. Address 101-4 Colin Drive City Holbrook State NY Zip 11741 —
22. Sample Analysis laboratory Long Island Analytical 23. NYS DOH EIAP # 11693
Vt. PROJECT INFORMATION
24. Starting date for this portion of work 11 / 1 6 / 01 Projected completion date 11 / 1 9 /01
Asbestos work schedule 0 Monday 0 Tuesday 0 Wednesday 0 Thursday 0 Friday ,day ® Sunday
NQ _I li;
Shift from: 8 : 00 13 am [] pm to 8 : 0 0 0 am ® pm
If other. 4.
specify
I Access to inspect the premises must be provided during the work schedule indicated in this item. I
25. Total amount of asbestos-containing material to be abated during this work
3,00 0 0 Linear Feet
Square Feet, and/or
NYC-WTC 000126056
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