Ed16A Form – Fill Out and Use This PDF

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Ed16A Form – Fill Out and Use This PDF

The Ed16A form, known formally as the Electrical Permit Application, is a critical document for ensuring compliance with Section 27-3018(b), which mandates obtaining a permit before commencing any electrical work. This form, which must be filled out completely and either printed in ink or typewritten, requires the signature and seal of a licensed electrician. Additionally, it serves as a gateway to legal electrical operations, facilitating everything from service/meter work to new or amended Certificates of Occupancy, under the scrutiny of New York City's Department of Buildings. Click the button below to start filling out the form, ensuring all electrical work adheres to legal and safety standards.

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Ed16A Form PDF Details

The Ed16A form serves as a comprehensive electrical permit application, essential for individuals and businesses planning to undertake electrical work within New York City's jurisdiction. Before initiating any electrical projects, it is mandated by law, specifically section 27-3018(b), to obtain the necessary permits, underscoring the importance of this document in maintaining regulatory compliance. The form requires detailed input, including licensee information, the category of the work intended, construction permit details, and specifics about the job location. Applicants must indicate whether the electrical work pertains to service/meter tasks, new or amended certificates of occupancy, or any other designated categories. Additionally, the form calls for information on the job's scope, from general wiring to specialized installations like sustainable energy systems. Ensuring accuracy and completeness when filling out this form is crucial, as any omission or error can result in the application being returned. Furthermore, it's imperative for the application to be signed and sealed by a licensed electrician and submitted alongside any required certifications or authorizations, particularly when the work involves major alterations or installations that could impact the building's electrical infrastructure. The Ed16A form reflects the city's commitment to safety and regulatory adherence, outlining a structured pathway for electrical work approvals while making clear the responsibilities of both the applicants and the regulatory body overseeing electrical installations.

Question	Answer
Form Name	Ed16A Form
Form Length	5 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min 15 sec
Other names	work electrical yes sample, s electrical permit get, work application electrical form, s electrical permit

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ED16A: Electrical Permit Application

Obey the Law-Obtain Permit before starting work

Section 27-3018(b)

INSTRUCTIONS:
1.	This form must be completed fully, clearly printed in ink or typewritten.	4.
2.	Licensed Electrician must sign and seal the application.
3.	Mail the application or deliver it in person to NYC Department of Buildings, Electrical	5.
	Division, 280 Broadway 4th Floor, New York, NY 10007.

For Service/Meter work or a new or amended Certificate of Occupancy, certify that you have written Owner’s Authorization. See section 13 All incomplete applications will be returned to the applicant. Only authorized versions of this application will be accepted.

1 Licensee Information

Electrical Firm Name	License #	Firm #

Address

Email Address	Telephone #	Fax #

2Category of Work Check only one box

Construction Permit Information

Is this Job C of O (Certification of Occupancy) related?

Yes

If work is C of O related or New Building please provide DOB

Construction/ BIS Job Number ____________________________

Is this job regulated by the NYC Energy Conservation Code?

Yes

Please provide DOB Construction/ BIS Job Number ___________

If yes, check Lighting Work in section 6 – Work to be Done

Owner/Occupant ECB Violation or Owner/Occupant Objection Removal

Removal of Violation or Owner/

List Violation or Objection #s

Occupant Objection

Job Location

Borough

House No./ Street Name

Floor/Room/Apt. No.

Zip Code

Special Place Name

Work started or filed by others?

Yes

Contractor’s Comments (printed on work permit)*

Work to be performed by licensed firms as a joint venture as per	Lic.# _________________________	Firm # ________________________
#27-3013.13. Provide firm and license no. of additional firms.
	Lic.# _________________________	Firm # ________________________
Job Start Date (MM/DD/YYYY) _________________________	Completion Date (MM/DD/YYYY) __________________________________

6Work to be Done Check all boxes that apply

1. Service Work /Notify Utility

Elevator/Escalator/

Fire Damage

HVAC Wiring

(complete Section 10 #8)

Material Lift

2. Temporary Construction Service

Amusement Rides

General Wiring

Boiler/ Burner Wiring

T. Temporary Light & Power

W. Sidewalk Shed Wiring & Lighting (If W is selected, no other selections are allowed)

S. Sustainable Energy Installs

L. Lighting Work

Other:

Removing objection(s) issued to another licensed firm. Application(s) # (s) (Max. 3)

7 Special Certification/Approval Required Check all boxes that apply

Application #__________________

07/12

ED16A

PAGE 2

8Advisory Board Approval Required

Is advisory board approval required? Yes No (If yes, complete the following)

Approval No.

Submittal No.

K 1000 KVA Service

S Special Permission

N Manuf. Wiring System (article # 604 and # 605)

Z Other

9 Residential or Commercial Use Check only one box

A One Family

C Three Family

F Factory

O Office Bldg

L Five or more Family

J Theater

B Two Family

E Four Family

G Garage

H Hotel

W School

I Hospital or Health facility

K Commercial (indicate type)

Z Other: ____________________

Commercial/Residential # of Apts______ # of Stores______

________________________________

10 Work Description

Item

Quantity

Cost

Fee amount

Indicate number and size

1. Service Switches

A Up to 100 amps

@8.00

B 101 to 200 amps

@30.00

C 201 to 600 amps

@105.00

D 601 to 1200 amps

@225.00

E Over 1200 amps

@375.00

2. Ser. Ent. & FDR Cond. (Each Set)

A Up to #2 conductor

@15.00

B Over #2 to 1/0

@30.00

C Over 1/0 to 250 MCM

@45.00

D Over 250 MCM

@75.00

3. Panels

A 1Ø up to 20-1 or 10-2 pole brkrs

@15.00

B 1Ø over 20-1 or 10-2 pole brkrs

@37.50

C 3Ø up to 225 amps

@50.00

D 3Ø over 225 amps

@75.00

4. Elevators, Escalators, Material Lifts

A Total no. of Elevators, etc

@125.00

B Each additional 10 floors or less

@83.00

5. Boiler Controls

@12.00

6. Signs

Print additional tag #’s where indicated

Additional tag numbers

filing fee only

1 _____________

6 _____________

A Field Connection (tagged only)

B Shop Inspection (complete page 4)

$15.00

2 _____________

7 _____________

C Field Inspection (tag required) (complete page 4)

3 _____________

8 _____________

Up to 30 sq. ft. $65.00

31 to 60 sq. ft. $90.00

$______

Sign fee

4 _____________

9 _____________

Over 60 sq. ft. $115.00

Sub total

5 _____________

10 ____________

Application #__________________

07/12

ED16A		PAGE 3

10	Work Description (Continued)

7. Floor Descriptions

Each outlet, fixture, HP or fraction thereof a motor, each KW or fraction thereof a heater, each HP or fraction thereof an air

conditioner installed, altered or repaired shall be assigned the value of ONE UNIT

Each floor and apt. no. (if applicable) where the work is being performed must be provided below, along with the component detail for each floor/ apt. no.

Check if additional floor descriptions are attached (Please use form ED16As for a maximum of 100 floors)

Floor

Apt. no.

Number of Outlets

No. of

Motors/Generators

Heaters

Transformers

Fixtures

Receptacles

Switch

No.

Total HP KW

No.

Total KW

No.

Total KVA

ATT

A/C

Building Totals

Electric use

(A)

(B)

(C)

(D)

(E)

(F)

(G)

(H)

Total units

No. of

units in excess of 10

x 25¢

Units fee total

Application #

8. Service/Meter Equipment

Must be completed for Service Meter Work

No. of 3 wire	No. of 4 wire	No. of 10 pt

	Number of meters

Existing meters ______ (+) New meters ______ (-) Removed meters ______ (=) Total ______

Filing fee	Standard	$40
choose	Minor Work only $15
choose
one
one	#1-6 Fee total
	#1-6 Fee total
	#7 Units fee total
	Total all fees

__________________

07/12

ED16A	PAGE 4
DOB/BIS# ___________________________________________	Required for each sign mounted outdoors before sign is inspected at shop or field.

11Electric Sign Inspection Information Must be completed if page 2 section 10 #6 B or C applies

Shop Location

Borough		House No./ Street name

Location Comments			Shop Telephone No.

Sign Description

Sign Dimensions (feet)		Total Sq. feet of sign	Total circuits in sign

Total lamps	Watts (lamps)		Number of transformer(s)

V.A. of each transformer			Total watts or V.A. (Volt Ampere)

(American wire) AWG gauge of wire			No. of sockets per circuit

Material and gauge used in sign construction (give details)

Make of sign		Manufacturer of sign

Manufacturer address

Sketch of sign

(Give reading matter contained)

Application #__________________

07/12

ED16A				PAGE 5

12	Owner’s Information

	Last name	First Name	M.I.	Title

	Business name/ agency		Phone

	Address	City	State	Zip

	Authorized representative Last name		First name

Authorized representative, state relationship to building owner

13 Certification of Owner Authorization for Electrical Work

Please answer the following questions. Where the answer to the question(s) below is yes, the following certification(s) by the license shall apply.

Does the application involve authorization to power or energize a meter? Yes No

This Electrical Permit Application involves the energizing of a meter. I certify that I have obtained a signed certification from the building owner, or his or her authorized representative, affirming that the intended use or purpose of the new, additional or existing meter(s) indicated in the Service/Meter Equipment section of this application will be in compliance with Section 27-3018 of the NYC Electrical Code and acknowledging that the energizing of electrical work without a valid permit, or other required authorization set forth by Department of Buildings (“Department”) Rules, is a violation of Section 27-3020 of the NYC Electrical Code. I also certify that this signed certification is available upon request by the Department.

Licensee Signature __________________________________________________________

Date________________________________

Does the application involve a new or amended Certificate of Occupancy and/or service or meter work? Yes No

This Electrical Permit Application includes Service/Meter Work and/or work that will result in the issuance of a new or amended Certificate of Occupancy. I certify that I have obtained a signed authorization from the building owner, or his or her authorized representative, who has authorized the work to be performed as indicated herein, and has acknowledged that upon completion of such electrical work (including any minor amendment of the work indicated herein), pursuant to Section 27-3018(b) of the NYC Electrical Code, the Department of Buildings (“Department”), or its certified representative, will be allowed access to inspect such work. I also certify that this signed authorization is available upon request by the Department.

Licensee Signature __________________________________________________________

Date________________________________

14 Responsible Representative (“R.R.”) / Licensee Statement

I, the undersigned Responsible Representative (or License associated with such business acting pursuant to an accepted written delegation), or Special Electrician, submit this Electrical Permit Application to the Commissioner of the NYC Department of Buildings for issuance of a permit to perform electrical work as described herein and in so doing acknowledge that all electrical work to be performed as described under this application will be done under my supervision and in complete accordance with all applicable codes and regulations, including but not limited to, the NYC Energy Conservation Code. I further acknowledge that I have received Electrical Advisory Board approval

for all electrical work described herein where such approval is required under the Department’s

code and regulations.
This application involves a NYCHA Fee Exempt property ?	Yes	No

I also acknowledge that the information provided on this application is true to the best of my knowledge.

Name (please print)

Licensee Seal

Signature of Authorized Licensed Representative

Date

PENALTY FOR FALSIFICATION: Falsification on any statement made herein with in- tent to defraud or deceive is a misdemeanor (Sec. 27-3017 (b), (c) of NYC Adm. Code) SUBSTANTIAL REVISIONS to this application will require the filing of a new application. with the appropriate fee.

Internal Use Only

Approved	Denied	Reviewer’s Initials: _________________ Date: ________________

Application #__________________

07/12

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Completing section 1 of s electrical permit online

2. Just after the previous section is done, go on to enter the suitable details in all these - Work to be performed by licensed, Lic Firm, Lic Firm, Job Start Date MMDDYYYY, Completion Date MMDDYYYY, Work to be Done Check all boxes, Service Work Notify Utility, ElevatorEscalator, Fire Damage, Material Lift, Temporary Construction Service, Amusement Rides, General Wiring, HVAC Wiring, and Boiler Burner Wiring.

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B Over to, C to amps, and B to amps of s electrical permit online

5. To conclude your form, the particular area involves a couple of extra fields. Filling out B Each additional floors or less, Boiler Controls, Signs, Print additional tag s where, Additional tag numbers, A Field Connection tagged only, B Shop Inspection complete page, C Field Inspection tag required, Up to sq ft to sq ft Over sq, filing fee only, Sign fee, Sub total, and c a t i o n is going to finalize the process and you'll be done before you know it!

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N New Building

R Rehabilitation, Extensions, New Circuitry

Sign Shop Inspection

M Minor Work (see instructions) $15 Filing Fee

Field Sign Inspection (see page 2 Section 10 #6C)