Form Lic 38 PDF Details

The Lic 38 form serves as a critical document for individuals in the electrical profession seeking to obtain, renew, reissue, or change their electrical license. This comprehensive application is required to be filled out with typewritten responses, ensuring clarity and legibility for the processing entities. It encompasses various sections, including the type of application (original, renewal, reissue, or change), the license type (master or special), and detailed applicant information. This information includes the applicant's name, home address, contact numbers, date of birth, social security number, and email. A notable requirement is the designation of a Responsible Representative, if applicable, underlining the necessity of accountability within electrical businesses. The form further requires business information, outlining the need to specify if the license will be utilized by an individual or on behalf of a corporate entity, partnership, or trade. Additional sections demand details about partners or officers, convictions, fines, and an affirmation of compliance with all relevant Administrative Code Provisions, Department Rules, Regulations, and Directives. The dire consequences of falsification, including misdemeanor charges, fines, or imprisonment, emphasize the seriousness with which this application must be approached. Lastly, the necessity for notarization reiterates the legal binding of the information provided, culminating in a document that is fundamental for those within the electrical sector to legally practice their trade.

QuestionAnswer
Form NameForm Lic 38
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other nameslic 38 nyc dob, lic38 renewal, nyc electrical license, lic 38

Form Preview Example

LIC38: ELECTRICAL LICENSE APPLICATION

Application must be typewritten.

1

Application Type

2 License Type

3

License Number

Original

Renewal

Reissue

Change

Master

Special

4Applicant Information Required for all applications. (*Indicates optional.)

First Name

 

Middle Initial

Last Name

Home Address

 

 

Home Telephone

 

 

 

 

City

State

Zip

*Mobile Telephone

 

 

 

 

Date of Birth (m/d/y)

 

Social Security No.

E-Mail

5Responsible Representative (Note: There can be ONLY ONE Responsible Representative)

 

Are you the Responsible Representative for the business?

YES

NO

 

 

 

 

 

 

 

Responsible Representative Only: Are there additional licensees in the business?

YES

NO

 

 

 

 

 

If so, please print their names: (for additional space, attach a second sheet)

Do you authorize this person(s) to file electrical applications

 

First Name

Last Name

License Number

under the business name?

 

 

 

 

 

 

 

 

 

 

 

 

YES

NO

Initial here

 

 

 

 

 

 

 

 

 

 

 

YES

NO

Initial here

 

 

 

 

 

 

 

6

Business Information

 

Business Name

 

 

 

Firm No.

 

 

 

 

 

 

 

 

 

Office Address

 

 

Office Telephone

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

State

Zip

Office Fax

 

 

 

 

 

 

 

 

 

 

 

E-Mail

 

 

 

 

 

 

7

License Use Choose One:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Individual/Sole-Proprietor

 

On Behalf of a Corporation

On Behalf of a Partnership

On Behalf of a Trade

 

 

 

 

 

 

 

MASTER

8

Partner or Officer Information

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

State

Zip

City

State

Zip

 

 

Name

 

 

Name

 

 

 

 

Address

 

Title(s)

Address

 

Title(s)

 

 

 

 

 

 

 

 

 

 

Name

 

 

Name

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

Title(s)

Address

 

Title(s)

 

 

 

 

 

 

 

 

 

 

 

 

City

State

Zip

City

State

Zip

9

Convictions and Fines If you answer “Yes” to either of these questions, you must complete and attach form LIC34.

 

 

 

 

 

 

 

 

Yes

No

Have you ever been convicted of a crime (for renewals, convicted since your last renewal) ?

 

 

 

Yes

No

Do you as licensee or the master electrician business have outstanding notices of violation owed to the Department?

 

Yes

No

Does any company associated with your Department-issued Electrician’s license currently have any unpaid firm account (permit and/

 

 

 

or application) fees?

 

 

 

 

 

10 Applicant Statements and Signatures

As a condition of being granted a license from the Department of Buildings, I hereby agree to comply with all Administrative Code Provisions and Department Rules, Regulations and Directives regarding how licensees conduct their specific trades. I affirm compliance with Section 27-3013(a) and the definition of responsible representative found in Section 27-3004, when the designated responsible representative of the business is submitting this renewal application. Falsification of any statement is a misdemeanor under section 28-211.1, 28-201.2.1.2, and 28-203.1.1 of the Administrative Code and is punishable by a fine or imprisonment, or both. Bribery is a crime: A person who gives or offers a bribe to any employee of the City of New York or an employee who takes or solicits a bride, is guilty of a felony punishable by imprisonment, a fine, or both.

 

Name (print)

Signature

 

Date

 

 

 

 

 

 

 

 

 

Electrician’s Seal

Notarization

 

Notary Seal

 

 

 

 

State of New York, County of:

 

 

 

 

 

 

 

 

 

 

 

 

Sworn to or affirmed under penalty of perjury

 

 

 

 

 

 

 

 

 

 

 

 

Day of

20

 

 

 

 

 

 

 

 

 

 

Internal Use Only

 

Notary Signature

 

 

 

 

 

 

 

 

 

 

 

Clerk’s Signature

Date

Fee Paid

Year

 

 

 

 

 

 

 

 

 

 

 

 

 

 

08/14

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Enter the appropriate data in the area IndividualSoleProprietor, On Behalf of a Corporation, On Behalf of a Partnership, On Behalf of a Trade, R E T S A M, Partner or Officer Information, Name, Address, City, Name, Address, City, State, State, and Titles.

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