Lic7 Safety Form – Fill Out and Use This PDF

The LIC7 Safety Registration Form is a crucial document required by the New York City Department of Buildings for individuals or entities seeking to conduct construction, demolition, or concrete work within the city. This comprehensive application necessitates detailed information about the business, including legal names, addresses, contact information, and details concerning corporate officers or stakeholders. For those ready to ensure compliance and secure their registration, click the button below to start the process.

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Lic7 Safety Form PDF Details

In the bustling city of New York, ensuring the highest standards of safety in construction, demolition, and concrete work takes center stage with the introduction of the Lic7 Safety Registration Form. This crucial document, a staple for professionals in the industry, lays down a comprehensive framework for both new applicants and those seeking renewal or reissuance of safety registrations. It meticulously requires information ranging from the type of application, existing safety registration numbers, to detailed business information including legal names, trade names, addresses, and essential contact information. Designed for individual proprietors, corporations, and partnerships alike, the form delves deeper into the structure of the applying entity by asking for specifics on primary business contacts, corporate officers, partners, stakeholders, and any affiliations the business might have with other entities, especially those involved with the Department of Buildings or other city agencies. Moreover, it does not shy away from assessing past or present associations that could influence the safety standards of the work undertaken. Completeness, accuracy, and honesty are the pillars upon which this application stands, underscored by the applicant's attestation to the truthfulness of the provided information, backed by the legal consequence of perjury. The form acts as a gateway not only to maintaining the integrity of New York's buildings but also to safeguarding the lives of those who both build and inhabit them.

Question	Answer
Form Name	Lic7 Safety Form
Form Length	2 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	30 sec
Other names	safety form application, lic7 2 online, form safety online, safety form printable

Form Preview Example

LIC7: Safety Registration Form

Application must be typed.

Must Apply In Person At : New York City Department of Buildings Licensing Unit

280Broadway, 6th Floor New York, NY 10007

Application Type

Safety Registration Number (existing tracking number)

Original

Renewal

Change/ Reissue

Safety Registration Endorsement Type Select all that apply

Construction

Demolition

Concrete

Type of Business

Individual / Sole Proprietor

Corporation

Partnership

Business Information Required for all applications. Business fax and mobile telephone are optional. Email is required.

Legal Name of Business

Business’s Trade or Doing-Business-As (DBA) Name*

Business Address

Business Telephone

City

State

Zip

Business Fax

E-Mail

EIN

6Primary Business Contact Home address required if applicant is an individual /sole proprietor. Contact must be director, officer or principal.

Last Name		First Name	Middle Initial

Social Security No			Date of Birth (m/d/y)

Home Address			Home Telephone

City	State	Zip	Mobile Telephone

E-Mail			% Control

7Corporate Officers, Partners and Any Stakeholders (Include Stakeholders that own ten percent or more and primary applicant)

Last Name	First Name	Middle Initial

Social Security No	% Control	Title

Date of Birth (m/d/y)		Telephone

E-mail		Emergency Contact	Yes	No

Last Name	First Name	Middle Initial

Social Security No	% Control	Title

Date of Birth (m/d/y)		Telephone

E-mail		Emergency Contact	Yes	No

Last Name	First Name	Middle Initial

Social Security No	% Control	Title

Date of Birth (m/d/y)		Telephone

E-mail		Emergency Contact	Yes	No

Last Name	First Name	Middle Initial

Social Security No	% Control	Title

Date of Birth (m/d/y)		Telephone

E-mail		Emergency Contact	Yes	No

Last Name	First Name	Middle Initial

Social Security No	% Control	Title

Date of Birth (m/d/y)		Telephone

E-mail

Emergency Contact

Yes

9/09

LIC7			PAGE 2

8	Business Affiliation Information

	Yes	No	Is any person named on this application an employee, participant in the management of, or own a controlling interest for any other
	Yes	No
			entity which files for permits with the Department? If “YES” you MUST complete the section below.

	Yes	No	Any current or former association with another General Contracting company in the last 5 years not mentioned on this application?
	Yes	No
			If “YES” you MUST complete the section below.
	Yes	No	Has any person named on this application ever been employed by DOB or another City agency? If “YES” provide details in
	Yes	No
			Section 9.

Name of Individual			% Control

Legal Name of Business			Title

Business’s Trade or Doing-Business-As (DBA) Name*

Business Address			Business Telephone

City	State	Zip	EIN

Name of Individual			% Control

Legal Name of Business			Title

Business’s Trade or Doing-Business-As (DBA) Name*

Business Address			Business Telephone

City	State	Zip	EIN

Name of Individual			% Control

Legal Name of Business			Title

Business’s Trade or Doing-Business-As (DBA) Name*

Business Address			Business Telephone

City	State	Zip	EIN

9 Comments

10 Applicant Statements and Signatures

I have read and I understand all the items contained in this document. I state that the above information is correct and complete to the best of my knowledge. I understand it is unlawful to make a false statement to the Department; or to give to a city employee, or for a city employee to accept, any benefit, monetary or otherwise, either as a gratuity for properly performing the job or in exchange for special consideration. Such actions are punishable by imprisonment, fine and/or loss of registration.

Name (print)

Signature

Date

Notarization

State of New York, County of:

Sworn to or affirmed under penalty of perjury

Day of

Notary Signature

Notary Seal

Internal Use Only

Date received:		Fee Paid:	$
Reviewed by:
Reviewed by:
Comments:
Comments:	Status:	¨ Satisfactory	¨ Unsatisfactory

9/09

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A way to fill out safety registration number step 1

2. The subsequent stage is usually to complete all of the following fields: Date of Birth mdy, Email, Last Name, Social Security No, Date of Birth mdy, Email, Last Name, Social Security No, Date of Birth mdy, Email, Last Name, Social Security No, Date of Birth mdy, Email, and Last Name.

Filling in segment 2 of safety registration number

3. Completing Business Affiliation Information, Yes No, Is any person named on this, Yes No Any current or former, If Yes you must complete the, Yes No Has any person named on, Section, Name of Individual, Legal Name of Business, Businesss Trade or DoingBusinessAs, Business Address, City, Name of Individual, Legal Name of Business, and State is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

safety registration number conclusion process described (step 3)

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Stage # 4 in filling in safety registration number

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Lic7 Safety Form – Fill Out and Use This PDF

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