Nyc Buildings Form Pw1 – Fill Out and Use This PDF

PW1: Plan / Work Application

Orient and affix BIS	
 job number label here

Initial Filing 5, 7, 11, 12A, 25-26

Review is requested under which Building Code?

		2008					1968		Prior to 1968
						Standard Plan Examination or Review
Choose
		one:				Professional Certification PC1, POC1
						Professional Cert. of Objections AI1

Prior to Approval Actions 25-26

			Amend Existing Filing 4A
			Subsequent Filing 6-7,	8A (Alt-2 only), 11
	Post Approval Amendment (PAA) 4A, 6, 24-25
	Will PAA affect filing fees?					Yes		No

New (Superseding) Applicant 4A, 25-26

Reinstatement 24-26

Withdrawal 26

Specified in 4A and 6

Entire Job

4A Indicate existing document number affected by filing:

6A		BL - Boiler PW1C				FS - Fuel Storage PW1C					PL - Plumbing PW1B
		FA - Fire Alarm				FP - Fire Suppression					SD - Standpipe PW1B
		FB - Fuel Burning PW1C				MH - Mechanical					SP - Sprinkler PW1B
6B		EQ - Construction	6C		OT/GC - General		6D			OT - Other, describe:
		Equipment 15				Construction

6E CC - Curb Cut 16

6F OT/ANT - Antenna

OT/BPP - Builders Pavement Plan 8D

OT/FPP - Fire Protection Plan

OT/MAR - Marquee 8E, 26B

8A WT		Cost	WT	Cost	WT	Cost

8G Total Construction Floor Area:

sq. ft.

8B Is a building enlargement proposed?							8C	Estimated Job Cost $
			No enlargement is proposed				8D	Street Frontage:		linear ft.
			Yes 12, PD1				8E	Height:	ft. Width:	ft.
				Horizontal		Vertical
							8F	Name of cluster or development below:
			Additional Construction Floor Area:
						sq. ft.
								Project lead job no.

15 Construction Equipment

	Chute	Sidewalk Shed			Construction Material:
	Fence	Size:		linear ft. BSA/MEA Approval No.
	Supported Scaffold	Other:

16 Curb Cut Description

Size of cut (with splays):			ft.
Distance to nearest corner:			ft.
to street:

17 Tax Lot Characteristics

Original tax lots being merged or reapportioned (if applicable):

Tentative tax lot numbers (new tax lots only):

18 Fire Protection Equipment

Existing Proposed

Yes No Yes No

Fire Alarm

Fire Suppression

Sprinkler

Standpipe

	Existing		Proposed			Existing		Proposed
Plaza Area					Arcade Area
		sq. ft.		sq. ft.			sq. ft.	sq. ft.
Parking Area		sq. ft.		sq. ft.	Parking Spaces
Loading Berths		sq. ft.		sq. ft.	Loading Berths

Yes No

Tidal / Fresh Water Wetlands

Urban Renewal

Fire District

Flood Hazard Area

Purpose:

Type:

Estimated Cost: $

Advertising

Illuminated 23A

Total Square Feet:

Non-Advertising

Non-Illuminated

Height above Curb:

ft.

in.

Wall Height above Roof:

Location:

Ground

Roof 23B

ft.

in.

Yes No

Is sign inside building line?

If no, sign projects by:

ft.

in.

Designed for changeable copy? If no, 23C

Does an OAC have an interest in this sign or location? If yes, 23G

Within 900’ and within view of an arterial highway? If yes, 23D

Within 200’ and within view of a park 1/2 acre or more? If yes, 23E

If answer is “yes” to either of the above two questions and this is an advertising sign, OAC sign number is required in section 23F

23A	Illuminated type:							Direct		Flashing	Indirect
	Yes No
						If sign projects beyond building line, is owner
						billed for annual permit? If no, specify in 26B
23B						Is roof sign tight, closed or solid?
23C	Sign wording. If extensive, provide only key wording.
23D	Distance from Arterial Highway:										ft.
23E	Distance from Park 1/2 acre or more:										ft.
23F	OAC Sign Number:
23G	OAC Registration Number:

Yes No

For initial New Building and Alteration 1 applications filed under the 2008 NYC Building Code only: does this building qualify for high-rise designation?

Directive 14 initial applications only: I certify that the construction

documents submitted and all construction documents related to this application do not require a new or amended Certificate of Occupancy as there is no change in use, exits, or occupancy.

Name (please print)

Signature

Date

P.E. / R.A. Seal (apply seal, then sign and date over seal)

Falsification of any statement is a misdemeanor and is punishable by a fine or imprisonment, or both. It is unlawful 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. Violation is punishable by imprisonment or fine or both. I understand that if I am found after hearing to have knowingly or negligently made a false statement or to have knowingly or negligently falsified or allowed to be falsified any certificate, form, signed statement, application, report or certification of the correction of a violation required under the provisions of this code or of a rule of any agency, I may be barred from filing further applications or documents with the Department. Furthermore, I understand that I am responsible for insuring that a final inspection be performed when the permitted work is complete, and that a satisfactory report of final inspection be submitted, along with all required submittal documents, so that the NYC Department of Buildings may issue a letter of completion or certificate of occupancy within the time prescribed by law.

I have authorized the applicant to file this application for the work specified herein and all future amendments. I will not knowingly authorize any work that is not in compliance with the New York City Energy Conservation Code (NYCECC).

Yes No

Fee Deferred Request Statement

I hereby request a fee deferral for the work proposed on this application and understand that all fees must be paid before issuance of any Certificate of Occupancy or job sign off.

Fee Exemption Request Statement

In accordance with §28-112.1 of the NYC Administrative Code I hereby state that the proposed work involves a building or property owned or used exclusively for the purposes indicated in such section.

Owner’s Certifications Regarding Occupied Housing

The site of the building to be altered or demolished, or the site of the new building to be constructed, contains one or more occupied dwelling units that will remain occupied during construction. These occupied dwelling units have been clearly indentified on the submitted construction documents.

The site of the building to be altered or demolished, or the site of the new building to be constructed, contains occupied housing accommodations subject to rent control or rent stabilization under Chapters 3 and 4 of Title 26 of the New York City Administrative Code. If yes, select one of the following:

The owner is not required to notify the Division of Housing and Community Renewal (DHCR) of the owner’s intention to file because the nature and scope of the work proposed, pursuant to DHCR regulations, does not require notification.

The owner has notified the Division of Housing and Community Renewal (DHCR) of its intention to file such construction documents/apply for such permit and has complied with all requirements imposed by the regulations of such agency as preconditions for such [filing/application].

Provide date DHCR notified:

Owner's Certification for Adult Establishments

I authorize and intend to create, enlarge, or extend an establishment with adult activity and/or adult material as defined in ZR §12-10 "adult establishment" or related sign at the subject premises.

Owner’s Certification for Directive 14 Applications (if applicable) I have read and am fully aware of the applicant's statement that the construction documents submitted and all construction documents related to this application will not require a new or amended Certificate of Occupancy as there is no change in use, exits, or occupancy. Furthermore, I understand that I am responsible for retaining a qualified design professional to perform a final inspection when the permitted work is complete and this professional must submit a satisfactory final inspection report to the NYC Department of Buildings within the time following inspection prescribed by Department rule.

Owner type: Individual				DCAS		HHC			NYCHA
		Partnership		DOE		HPD			NYS
		Corporation 26A				Other Government
		Condo Unit Owner or Co-Op Tenant-shareholder 26A
		Is the owner a non-profit organization?						Yes			No
Name (please print):
Relationship to Owner:
Business Name/Agency:
Street Address:
		City:		State:			Zip:
Telephone Number:				Fax:
E-Mail Address:

Signature and Date 

26A Condo/Co-Op Board or Corporation Second Officer

Name (please print):
Title:
Street Address:
City:	State:	Zip:
Telephone Number:	Fax:
E-Mail Address:
Signature and Date* 

*Signature required for authorized representative of Condo or Co-Op board. Second officer signature not required for corporations.

26B Lessee Responsible for Annual Sign or Marquee Permit

Name (please print):
Relationship to Owner:
Business Name/Agency:
Street Address:
City:	State:	Zip:
Telephone Number:	Fax:
E-Mail Address:

Internal Use Only

Pre-Filer Name:

Pre-Filer Signature:	Date:
Cost Estimate: $
Amount Due: $	Verified by ▼ Date ▼
Initial Amount Paid: $
Balance Due: $
Stamps, Certifications and Notes: