A433 Form PDF Details

Ensuring compliance with local fire safety regulations is crucial for any building project within New York City, and the A433 form plays a pivotal role in this process. Specifically designed for the inspection of electric wiring and devices related to fire alarm systems, this form serves as an application to the Fire Department's Bureau of Fire Prevention, Fire Alarm Inspection Unit. Applicants must provide comprehensive details about the premises, including its location, ownership, and the nature of the occupancy, alongside a meticulous description of the fire alarm system installed, altered, or repaired. It is mandatory that all information is typed and all questions answered, with a separate application required for each system installed. Additionally, the submission of electrical floor plans, unless already on file with the Fire Department, is required to aid in the inspection process. The form also outlines the necessary steps for buildings exceeding a certain number of floors, emphasizing the importance of adhering to the specified procedures to ensure the safety and compliance of fire alarm systems. Through its structured format, the A433 form facilitates a rigorous inspection process, aiming to make buildings in New York City safer for all occupants.

QuestionAnswer
Form NameA433 Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesform nyc ext fill in, a433 fdnyh form, a 433 form, a433 form

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OBEY THE LAW—FILE BEFORE STARTING WORK

FIRE DEPARTMENT CITY OF NEW YORK

BUREAU OF FIRE PREVENTION

FIRE ALARM INSPECTION UNIT (ELECTRICAL)-ROOM 3N-1

9 METROTECH CENTER, BROOKLYN, N.Y. 11201-3857

TELEPHONE: (718) 999-2466

APPLICATION A-433

(ALL INFORMATION MUST BE TYPED)

NOTE: SYSTEMS(S) SHALL BE TESTED AND MADE FREE OF ALL DEFECTS PRIOR TO REQUESTED FOR INSPECTION

Application No. _______________________

F.D. Folder No. _______________________

F.D. Plan No. _______________________

In accordance with the Administration building Code and Fire Code of the City of New York, application is hereby made for inspection of the electric wiring and appliances installed, altered or repaired in premises located at:

Premises

 

 

Borough of

Zip

 

 

 

 

Owner’s

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Owned by

 

Address

 

 

Boro

 

Zip

 

Occupied by

 

 

 

Used as

 

 

 

NOTICE: 1. All questions must be answered. Reverse side must be itemized. May modify device column if necessary. Use a SEPARATE application for each system installed.

2.One (1) set of electrical floor plans with the component parts located thereon and performance specifications are required. Plans NOT REQUIRED if Fire Department approved plans are on file.

3.Please Note: For buildings over the allotted floors, use a second A433 form.

4.Contractor to provide required information on back of form.

PLEASE CHECK ALL BOXES WHICH APPLY. Character of Work:

 

New

Alteration

 

Repair

 

Other

Type of systems filed for:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Building Department Application No.

List Other Systems here:

Authorized Central Office Company

 

 

 

 

 

 

 

 

 

Affix Department of Buildings

 

 

 

 

 

 

 

 

 

Location of Panels/Control Boards

 

 

 

 

 

 

 

 

Electrical Contractor Seal here

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of Electrical Co.

 

 

Telephone No.

 

Address

 

 

Date of Application

 

 

 

 

 

 

 

Zip Code

 

 

License No.

 

Signature of Licensee

 

 

Date of Expiration

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APPLICANT--DO NOT WRITE BELOW THIS LINE

 

 

 

 

 

 

 

 

 

 

 

 

RECOMMENDATION:

 

System

 

Installed as per Plan No.

 

 

 

 

 

 

 

 

Date

 

 

Inspector’s Signature

 

 

 

 

 

 

 

 

 

 

Print Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INSPECTIONS

System

Date

Report Recommend

Inspector

System

Date

Report Recommend

Inspector

REMARKS:

V.O. NUMBER

Form ___ of ___

DATE ISSUED

RECOMMEND DISMISSAL 

EXAMINER

SG A433 II (Updated 03/16/12, Revised 12/20/12, Original 07/11/11)

Indicate No. of

T

 

B.S.A.,

 

 

O

 

M.E.A.,

Wire

Insulation/

Proposed Devices

T

Manufacturer

C.O.A. or

Gauge

WireType

on all Floors

A

 

Agency

 

 

 

 

L

 

 

 

 

 

Approval #

 

 

 

 

 

 

 

Initiating

Supervisory

Signals Control

Communication

 

& Control

Panels

Fire

 

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