NYC 9/11 Public Portal Document
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
PAID
Asbestos Control Program
59-17 Junction Boulevard, &" Floor. Corona, NY 1138&5107
Buildin
F0R0gDeptor a0r' IRU Y
ONLY LWW I FOFr C1PFliIXAL U9B or~Y
TYPEWRITTEN ASBESTOS PROJECT NOTIFICATION
FORMS WILL BE (ASBESTOS INSPECTION REPORT)
ACCEPTED J . $1200 _
(See to sdredule)
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 not less than one week in advance of the start of abatement activities.
1. FACILITY
2. Address 114 Libe~trr Sums( _ _ ------ _ __ _ _ Borough Manhattan -- Zip 1000fi
+_~_ ___ _ ------_- — 3. Block 52 __.____--- 4. Lot 1P? --- -
5. Type of Fatdlfty COndOmin1UP/CornmerCiai _-_ 6. Name of Building 114 Liberty Street
IL BUILDING OWNER
7. Name Liberty, LLC oho Epic,LLC ~_- a. Contact Person Ms. Denise Sweeney ----
9. Tel. # (212) 633.6500 -- --~A Fax# (212) 727-8969
10. Address 12 East 44th Street City Neer York State NY__. Zi 10017
Ill. GENERAL CONTRACTOR
11. Name WA ~~ -- Tel. #
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name ETS Contracting, Inc. __ _ _-13. Contact Person Mr. Robert Middleton
____13.
14. Federal Employer ID. # 13-3691797 15. Tet. # (718) 706-6300 Fax # (718) 706-1032
18. Address 160 CIytreet City g!00k1Yfl State M' Zip _1122
V. THIRD PARTY AIR MONITOR
17. Name Ambient Group, Inc. 18. Contact Person Mr. Jack Springston
19. Federal Emptoyer iD. # t P11 20. Tel # (212} fr4•a-4615 —
West 39th Street
21, Address City New York -----.--- State NY Zip J20!
22. Sample Analysis Laboratory Ambient Group, Inc. 23. NYS DOH ELAP # 10865 .
V1. PROJECT INFORMATION
24. Starting date for this portion of work 10/2/03 Projected completion date 11 /30/03
Asbestos work schedule a Monday 0 Tuesday El Wednesday ® Thursday ® Friday 0 Sat ,~ rSunday
Shift from: 7:00 -.. ® am tJ pm to 6.00 - ❑ am ® pm
if other, /
specify - _ ----- _.~
Access to Inspect the premises must be provided during the weir schedule Indicated In this item.
25. Total amount of asbestos-containing material to be abated during this work
—_ 43,000 Square Feet, and/or Linear Feet
__2..
NYC-WTC 000155261
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