NYC 9/11 Public Portal Document
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ASBESTOS PROJECT NOTIFICATION S
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Aluany, NY s22a
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"itr,l i..... ..- i i[ m:nde3 l,ot,",c.a.;urd ati::;n al '• sections Comple:ed and amended i°er75II Circicil.
anecilhd eta Scwt n CI and attach copy of initial notification ur ip; to all sections.
r ;, iF ~ n~.✓ 1'~ru must fi rst Gall the Pro rant Manager's office of the Asbestos Control Bureau rat :118 4 -4 7-1255
El for pmusr afirst ac l of Pr i nen t:ftu , then eoanplcte and return this form Includinlg-
P ce t } Tuti ( i Err:tif~Zer?Ly 5r,rrss tir,-ir:tcd
:ut; ^r,xed 'g .... lFrram Asb:atus Conrro' 3°,arca'.4j
D. CONTRACTOR IfMF'OR.MATION
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n ngdale, Nevv York 11735
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$anle !?onaldGok!
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title r+tce Pr @Sid i t
6 3„ 752.22898 Name _..___
Phone No, `
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7. Perk, for N V v:. Bzi: rgPerE:a,^,r'.rr Narr
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Provrdr 411 Wor as c mWesN 1bo1vw/br the $M1 i tt awalt.h +tAd arb1* pr~*s hilt 8.
8, Project Location: County 1 ow York
Name of building
ROUR 014 W40*1 '. 7
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b.,,"• ~ I 110. ~ _~ {
xC 1A •.' ~ 11~51•~ b"'t•:~e~
Squat AddIVIA
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City, town or Village „~ .,, __
9. Buiidiny tnfom tion
Curront tae. Commiio4 Building ago
Prior U CO (rpj111~.~..~.,~.,~,... Building size
10, Building Repreacntadvo/Slte Contact: Namcp!jaflafl
N.M. Qzenbum phonaNa. ' Z0 4814
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NYC-WTC 000134440
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