Nyc Form Pa1 PDF Details

In the bustling metropolis of New York City, where venues come to life with gatherings, performances, and events, the Nyc Pa1 form serves as a critical document in ensuring the safety and legal compliance of places of assembly. This detailed form, which must be typewritten, bears the responsibility of capturing various aspects of an establishment, marking its purpose not only as a documentation tool but also as a regulator of standards. Whether it’s for a new filing, changes to the owner, lessee, name of the establishment, layout alterations, or use modifications, the form demands meticulous attention to detail. Essential components include location information, applicant data, filing representative credentials, and specific place of assembly space information, all tailored to adhere to the 2014 Code occupancy designations. Additionally, the form underscores the importance of legal accountability, cautioning applicants against falsification, which is punishable by fines or imprisonment. Violations related to improper benefits to city employees are similarly penalized. Thorough statements and signatures from the applicant and owner reinforce the oversight and professionalism required in managing places where people gather, reflecting the city’s commitment to safety and proper conduct within its vibrant community spaces. Clearly, the Nyc Pa1 form is an indispensable instrument in the orchestration of New York City’s dynamic event spaces, facilitating compliance with the law while supporting the city’s incessant embrace of cultural, social, and public assemblies.

QuestionAnswer
Form NameNyc Form Pa1
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesplace assembly use, pa 1 form, nyc form pa1, nyc form place assembly

Form Preview Example

PA1: Place of Assembly

Must be typewritten. Indicate reason for filing:

New Filing

Change to Owner/Lessee/Name of Estab. ONLY Change to Layouts/Use and any other information

Orient and affix BIS

job number label here

1Location Information Required for all applications.

 

House No(s)

Street Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Borough

Block

Lot

BIN

 

C.B. No.

 

 

 

 

 

 

 

 

 

 

 

 

Zoning District(s)

 

 

Overlay(s)

 

 

 

 

 

 

 

 

 

 

 

 

 

Special Dist(s)

 

 

 

Zoning Map No.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

Applicant Information

Required for all applications. Professionally certifying application?

Yes

No If yes, complete POC-1 form.

 

 

 

 

 

 

 

 

 

 

Last Name

 

First Name

 

 

Middle Initial

 

 

 

 

 

 

 

 

 

 

 

Business Name

 

 

 

Business Telephone

 

 

 

 

 

 

 

 

 

 

 

 

Business Address

 

 

 

 

Business Fax

 

 

 

 

 

 

 

 

 

 

 

City

State

Zip

 

Mobile Telephone

 

 

 

 

 

 

 

 

 

 

 

 

E-Mail

 

 

 

License Number

 

P.E.

 

 

 

 

 

R.A.

 

 

 

 

 

 

 

 

3Filing Representative Complete if different from section 2. Fax, mobile phone, and e-mail are optional info.

Last Name

 

First Name

Middle Initial

 

 

 

 

Business Name

 

 

Business Telephone

 

 

 

 

Business Address

 

 

Business Fax

 

 

 

 

City

State

Zip

Mobile Telephone

 

 

 

 

E-Mail

 

 

Registration Number

 

 

 

 

4Place of Assembly Space Information Submit comments using an AI-1 form (optional). *Use 2014 Code occupancy designations only.

Specific Floor(s) of PA Space

 

 

 

 

 

 

Occupancy

Cabaret

Number of

Description

 

 

 

 

 

 

 

Designation*

 

 

Persons

Code

NB/A1 Job No. Establishing PA

If Pre-BIS, provide BIN:

 

 

 

 

Primary

 

 

Yes

 

 

 

 

 

 

Plan

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

Prior PA No. (if applicable)

Irregular Floor Numbering?

 

Yes

 

No

Alt. 1

 

 

Yes

 

 

 

 

 

 

 

 

 

Plan

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Name of PA Establishment

 

 

 

 

 

Alt. 2

 

 

Yes

 

 

 

 

 

 

 

Plan

 

 

No

 

 

 

 

 

 

 

 

 

 

 

 

5

Statements and Signatures of Applicant and Owner PE/RA not required for change to owner/lessee/name of establishment only.

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. Applicant: I prepared or supervised the preparation of the submittal documents herewith submitted and to the best of my knowledge and belief, the submittal documents and work shown thereon comply with the provisions of the NYC Administrative Code and other applicable laws and regulations, except as set forth in the accompanying documents. I acknowledge that I have read and complied with all instructions pertaining to this application and supplementary schedules submitted. Owner: I have authorized the applicant to file this application for the work specified herein and all future amendments.

P.E. / R.A Name (print):

Signature

Date

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

Individual/Lessee Responsible for Annual Renewal of PA (if not owner)

Name (print):

Relationship to Owner:

Business Name/Agency:

Street Address:

City:

State:

Zip:

 

 

 

Telephone Number:

Fax:

 

 

 

 

E-Mail Address:

 

 

 

 

 

Owner

Condo/Co-Op

 

Partnership

HHC

NYCHA

type:

Corporation

 

DCAS

HPD

NYS

 

Individual

 

DOE

Other Government

 

Is the deed-holder a non-profit per 28-112.1?

Yes No

Name (print):

 

 

 

 

 

 

 

 

 

Relationship to Owner:

 

 

 

 

 

 

 

 

 

Business Name/Agency:

 

 

 

 

 

 

 

 

 

Street Address:

 

 

 

 

 

 

 

 

 

 

City:

 

 

State:

Zip:

 

 

 

 

 

 

Telephone Number:

 

Fax:

 

 

 

 

 

 

 

E-Mail Address:

 

 

 

 

 

 

 

 

 

Signature and Date ►

 

 

 

 

 

 

 

 

 

 

12/14

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pa1 any online conclusion process outlined (step 1)

2. Once your current task is complete, take the next step – fill out all of these fields - Filing Representative Complete if, Last Name, Business Name Business Address, City, EMail, First Name, State, Zip, Middle Initial Business Telephone, Place of Assembly Space, Occupancy Designation Cabaret, Specific Floors of PA Space NBA, If PreBIS provide BIN, Irregular Floor Numbering Yes No, and Primary Plan Alt Plan Alt Plan with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Stage number 2 of filling in pa1 any online

In terms of Filing Representative Complete if and If PreBIS provide BIN, make sure that you get them right in this current part. These two are thought to be the most important ones in the PDF.

3. Within this step, look at PE RA Seal apply seal then sign, State Fax, Zip, Name print Relationship to Owner, State Fax, and Zip. These have to be filled in with highest awareness of detail.

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