NYC Buildings Form BO9 PDF Details

Maintaining the safety and compliance of boilers in New York City involves the meticulous process of inspections and renewals, as mandated by the city's regulations. The NYC Buildings BO-9 form plays a critical role in this process, serving as both the DOB Boiler Inspection Report and the DEP Boiler Renewal Request. This comprehensive document ensures adherence to local laws and provides a streamlined approach for boiler owners to comply with the requirements of both the Department of Buildings (DOB) and the Department of Environmental Protection (DEP). Available online for convenience, the form requires detailed information about the premises, boiler specifications, and inspection outcomes. Its structure allows for the simultaneous fulfillment of filing obligations to both agencies, simplifying the renewal procedure for existing boilers. Moreover, specifics about new boiler installations guide users towards the correct forms needed, distinguishing between installations with differing BTU outputs. Sections related to the boiler's operation, ownership details, inspection reports, and fee calculations underline the importance of accurate and honest reporting. Penalties for late filings, falsifications, or bribery are clearly outlined, emphasizing the legal implications of non-compliance. By navigating the completion of the entire form or only select sections as needed, boiler owners and agents are better equipped to ensure the safe operation of boilers within the city, highlighting the BO-9 form's essential role in maintaining public safety and environmental standards.

QuestionAnswer
Form NameNYC Buildings Form BO9
Form Length1 pages
Fillable?Yes
Fillable fields1
Avg. time to fill out27 sec
Other namesbo9_old nycdep boiler testing form

Form Preview Example

DOB BOILER INSPECTION REPORT/ DEP BOILER RENEWAL REQUEST

Legibly printed, typewritten and web-based fill-in forms accepted.

Fill-in form available online at: http://www.nyc.gov/html/dob/html/forms/forms.shtml

To file DOB Boiler Inspection Report: complete sections 1-6 and 8.

To file DEP Boiler Renewal Request: complete 1-3 and 7-8.

You may fulfill filing requirements for both agencies by completing the entire form.

Use this form for renewal of existing boilers only. For new boiler installations, file DEP Form APC 5-0 (>2.8mBTU) or Form

APC 501 (<2.8mBTU) and DOB Form 900A, PW-1 and PW-1C.

1 Premises Address

Borough

Block

Lot(s)

BIN

House No.

Street Name

 

ZIP

Special Place Name:

2 Building Occupancy

□ Multiple Dwelling □ Commercial

 

□ Mixed Use □ Other

_______________

Total No. of Residential Units ___________

 

 

 

 

 

 

 

 

 

 

3 Owner

□ Check here if change in owner since last filing

 

 

 

 

 

 

Name

 

 

 

 

Business Phone (

)

 

 

Address

 

 

 

City

State

ZIP

 

E-mail

 

Contact Person

 

 

 

Relationship to owner

 

 

Business Phone (

)

Address

 

 

 

City

State

ZIP

 

E-mail

 

 

 

 

 

 

 

 

 

 

 

4 DOB Inspection Report

Inspection completed on:

 

 

 

Type of inspection □ Internal

□ External

If Fee Exempt, check type of acceptable proof □ Real Estate $0.00 tax bill

□ Verification Letter from Department of Finance

DOB Boiler

 

DEP Installation

 

 

 

Pressure

 

Violations Found: “NV” for No Violation or

 

Number(s)/Expiration

 

Boiler Make & Model

 

Floor

Number(s)

 

 

 

 

 

enter Description(s)

 

Date

 

 

 

Hi/Lo

PSI

 

 

 

 

 

 

 

 

 

 

 

#

 

 

 

 

 

 

 

 

 

 

Exp.

 

 

 

 

 

 

 

 

 

 

#

 

 

 

 

 

 

 

 

 

 

Exp.

 

 

 

 

 

 

 

 

 

 

#

 

 

 

 

 

 

 

 

 

 

Exp.

 

 

 

 

 

 

 

 

 

 

#

 

 

 

 

 

 

 

 

 

 

Exp.

 

 

 

 

 

 

 

 

 

 

#

 

 

 

 

 

 

 

 

 

 

Exp.

 

 

 

 

 

 

 

 

Number of boilers inspected __________ X $30 each = $__________ (DOB Total Fee- to be entered in Section 8, line a, on reverse)

Boilers to be inspected in accordance with requirements of NY State Labor Law Section 204, NY State Department of Labor Rules and Regulations 12 NYCRR 4, and New York City Building Code, Title 27, Chapter 1, Subchapters 7 and 14 and Reference Standard RS-14.

5 Boiler Insurance Company (Complete only if insurance company performs inspection.)

Insurance Company

Contact Person

 

Business Phone (

)

Address

City

State

ZIP

 

Policy Holder Name

Certificate/Policy No.

 

Expiration Date

 

Address

City

State

ZIP

 

INTERNAL USE ONLY

DOB Audit – Inspector’s Name

 

Badge Number

Inspection Date

Initials

□ Violation issued

□ No Violation Found

Comments

 

 

Audit Results

□ Passed □ Failed

 

 

 

 

Data entry date

 

 

 

 

 

NYC Department of Buildings/NYC Department of Environmental Protection

BO-9 (8/05)

 

Page 1 of 2

6 Authorized NYC Boiler Inspector

SEAL

Name

License No.

Check the appropriate type:

 

□ Insurance Company Representative

□ High Pressure Boiler Operator

Authorized to perform low pressure inspections only:

□ Master Plumber

□ Oil Burner Equipment Installer

Signature

Date

This inspection report will not be accepted if the appropriate sections are incomplete. The Department of Buildings’ Boiler Division must receive this form within 30 days of the inspection date. If the report is not filed by the owner prior to January 1st, the owner shall be liable for a civil penalty, pursuant to Section 26-125 of the Administrative Code.

Falsification of any statement is a misdemeanor under Section 26-124 of the Administrative Code and is punishable by a fine, imprisonment, or both. Bribery is a crime; a person who gives or offers a bribe or gratuity to any employee of the City of New York or an employee who takes or solicits a bribe or gratuity is guilty of a felony, punishable by a fine, imprisonment, or both.

7 Department of Environmental Protection

Owners/Agents: Complete this section only in expiration year.

 

 

 

 

Insurance companies: Do not complete this section.

 

 

 

 

Select one:

□ Renew Registration

□ Renew Certificate to Operate

 

 

 

Installation #

 

Expiration Date

 

# Of Identical Units

 

Fee Enclosed

$

Installation #

 

Expiration Date

 

# Of Identical Units

 

Fee Enclosed

$

Installation #

 

Expiration Date

# Of Identical Units

 

Fee Enclosed

$

 

 

 

 

 

 

 

DEP Total Fee

 

(to be entered in Section 8, line b, below) $

If Fee Exempt, check type of acceptable proof □ Real Estate $0.00 tax bill □ Verification Letter from Department of Finance

Please provide contact information for the owner, superintendent, contractor or other authorized agent who can be contacted to schedule an inspection, provide access and operate equipment to demonstrate compliance.

Contact Person (if different than listed in section 3)

 

Telephone Number (

)

Address

Apt. No.

City

State

ZIP

 

Fax Number (

)

E-mail

 

 

 

I request renewal of the Registration/Certificate to Operate for the equipment which is the subject of the above referenced installation number and which has been inspected by the owner/owner’s agent and is ready for inspection by DEP’s Bureau of Environmental Compliance.

I am aware that if there is exposed friable asbestos in a damaged or deteriorated condition in the room/area where the equipment is located, the inspection will not be completed and a notice of disapproval will be issued.

"I hereby affirm, under penalty of perjury, that the information provided on this form is true to the best of my knowledge and belief and that the equipment will be operated in accordance with the requirements of the Air Pollution Control Code Chapter 1 of Title 24, New York City Administrative Code, and appropriate requirements of other agencies. I recognize that false statements are punishable as a misdemeanor pursuant to Section 24-190 of the Air Pollution Control Code and Section 210.45 of the Penal Law."

Owner/Representative Signature

Title

Date

P.E./ R.A. Seal & Signature

 

(Required only if filing Renewal of Certificate to Operate)

8 Fee Calculation

a)

DOB Total Fee

$

See section 4 on reverse side. Enter “0” if filing only with DEP. Do not leave blank.

 

 

 

See section 7 above. Enter “0” if this is not the year of expiration or if form is filed by an

b)

DEP Total Fee

$

insurance company. Do not leave blank.

c)

Grand Total:

$

Make check or money order payable to NYC Department of Buildings for this amount.

Submit to: Department of Buildings, 280 Broadway, 6th Floor, New York, New York 10007

Attention: CFB - Boilers

NYC Department of Buildings/NYC Department of Environmental Protection

BO-9 (8/05)

 

Page 2 of 2

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Part no. 1 in completing Nyc Buildings Form Bo 9

2. Your next step would be to complete these blank fields: Exp, Exp, Exp, Exp, Exp, Number of boilers inspected X, Boiler Insurance Company Complete, Contact Person City, State, State, Business Phone ZIP Expiration, L A N R E T N, Y L N O, DOB Audit Inspectors Name, and Badge Number.

Part number 2 of completing Nyc Buildings Form Bo 9

3. Within this stage, examine Authorized NYC Boiler Inspector, Name License No, Check the appropriate type, Insurance Company Representative, Authorized to perform low pressure, Master Plumber, Oil Burner Equipment Installer, Signature Date This inspection, Department of Environmental, Select one Renew Registration, and Renew Certificate to Operate. All of these need to be filled out with utmost focus on detail.

Stage number 3 in filling in Nyc Buildings Form Bo 9

4. This specific subsection arrives with the next few form blanks to enter your specifics in: Select one Renew Registration, Renew Certificate to Operate, Installation, Installation, Installation, Expiration Date, Expiration Date, Expiration Date, Of Identical Units, Of Identical Units, Of Identical Units, Fee Enclosed, Fee Enclosed, Fee Enclosed, and If Fee Exempt check type of.

Nyc Buildings Form Bo 9 completion process detailed (step 4)

5. And finally, this final segment is what you will need to complete before submitting the document. The blanks under consideration include the following: Fee Calculation, a DOB Total Fee, b DEP Total Fee, c Grand Total, See section on reverse side Enter, Make check or money order payable, Submit to Department of Buildings, Attention CFB Boilers, NYC Department of BuildingsNYC, and BO Page of.

Nyc Buildings Form Bo 9 conclusion process detailed (part 5)

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