Form Dlt L 59 PDF Details

Form Dlt L 59 is a document that businesses in Louisiana use to file a waiver of foreign corporation qualifications. This document allows a business to be registered as a Louisiana company, rather than as a foreign company. There are several benefits to registering as a Louisiana company, including tax incentives and simplified filing procedures. To find out if Form Dlt L 59 is the right choice for your business, consult with an experienced business attorney.

QuestionAnswer
Form NameForm Dlt L 59
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesdltL59Boiler riboiler unit form

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DLT-L-59 (Rev. 10/2002)

STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS

Department of Labor and Training - Division of Occupational Safety

1511 Pontiac Avenue, P. O. Box 20157 Cranston, RI 02920-0942

(401) 462-8570 | www.dlt.ri.gov/occusafe/boiler.htm

BOILER UNIT

Benjamin P.Anthony Chief Inspector

Application for Permit to Install BoilerS

PERMIT #

TO BE COMPLETED BY INSTALLER PRIOR TO BOILER INSTALLATION, THEN FORWARDED TO ABOVE ADDRESS ACCOMPANIED BY INSTALLATION FEE.* BOILER DRAWINGS MUST ACOMPANY THIS APPLICATION.

1. Owner/User:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Installer:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tel. No.:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tel. No.:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Approx. Installation Date:

 

 

 

 

 

 

 

 

 

 

 

Location:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. BOILER Manufactured By:

 

 

 

 

 

 

 

 

 

 

 

Steam:

 

 

 

 

 

Circulating H.W.:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

New:

 

 

Used:

 

 

 

 

 

Yr. Manuf.

 

 

 

 

 

 

NB#

 

 

 

 

 

Manuf. Ser. No.

 

 

 

 

 

 

C. I.:

 

 

 

Steel:

 

 

 

 

 

Watertube:

 

 

 

 

 

 

Firetube:

 

 

 

 

 

H.W. Tank:

 

 

 

 

 

 

 

 

 

 

 

MAWP:

 

 

 

 

 

 

 

 

 

 

 

PSI

 

 

 

 

 

 

 

Min. Safety Valve Rel. Cap.

 

 

 

 

 

 

 

 

 

 

 

 

Heat Input:

 

 

 

 

 

 

BTU/Hour:

 

 

 

Steam Generating Capacity:

 

 

 

LB/Hour

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Water Heating Capacity:

 

 

 

 

 

 

BTU/LB/Hour:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. SAFETY APPURTENANCES INCLUDED:

 

 

Firomatic Switch:

 

 

 

 

 

 

L.W. C. O.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Safety Valve(s):

 

 

 

 

 

Remote Switch:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4. BOILER ROOM:

 

 

 

 

 

 

 

 

 

New:

 

 

 

 

 

 

Existing:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5. Does Boiler Room meet all code requirements?

 

 

 

 

 

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ex. (a) Proper ventilation:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(b)Three (3) foot clearances on all sides and top of boiler(s) and aceiling or piping for boilers with manholes.

(If no, use comment space at bottom to explain.)

 

 

 

 

* Each High Pressure Unit $300.00

Pipefitter Master I License Number:

 

Each Low Pressure Unit $120.00

 

 

 

CERTIFICATION

I,

 

certify that the boiler mentioned above will be installed in compliance with all state

law pertaining to boiler installations. I also recognize that failure to adhere to said state laws may result in a fine of up to $500.00 and imprisionment of up to 3 months or both, as set forth in 28-25-10 of the Rhode Island General Laws.

STATE OF RHODE ISLAND

DEPT. OF LABOR & TRAINING

BOILER UNIT

Date:

Amount:

Receipt #:

Check #:

PERMIT APPROVED BY:

INSTALLATION APPROVED BY:

DATE:

IF INSURED, BY WHOM:

COMMENTS:

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This document will need particular data to be entered, so ensure you take whatever time to provide what's requested:

1. To start off, while filling in the Form Dlt L 59, start out with the form section that features the following blanks:

Form Dlt L 59 completion process explained (portion 1)

2. The next part would be to fill out these particular fields: MAWP, Heat Input, PSI, Min Safety Valve Rel Cap, BTUHour, Steam Generating Capacity, LBHour, Water Heating Capacity, BTULBHour, SAFETY APPURTENANCES INCLUDED, Firomatic Switch Safety Valves, LW C O Remote Switch, BOILER ROOM Does Boiler Room, Existing Yes, and New.

Step number 2 of submitting Form Dlt L 59

When it comes to MAWP and Firomatic Switch Safety Valves, be sure that you review things in this current part. Those two are certainly the most significant ones in this PDF.

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