Pw2 Work Permit Application Form PDF Details

Navigating through the complexities of acquiring a work permit, the PW2: Work Permit Application emerges as a crucial document designed to formalize and kick-start various construction-related projects within specific jurisdictions. This form, which must be completed meticulously and typewritten, demands detailed information from applicants to ensure compliance with all necessary regulatory standards. At its core, the PW2 form serves multiple purposes, catering to initial permit applications as well as renewals, with or without changes to the original plan. Applicants are required to input foundational details such as the expected work start date, location specifics including house number, street name, and borough, alongside property identifiers like block and lot numbers. The form further delves into the type of permit sought—ranging from alterations, boiler installations, constructions, to more specialized permits like those for fire suppression systems or scaffolding—which necessitates a comprehensive understanding of the planned work's scope. Additionally, it asks for detailed applicant and contractor information, highlighting the necessity for a rigorous verification of qualifications and licensing, especially for tasks demanding specialized knowledge such as plumbing, electrical work, or demolition. Insurance requirements underscore the significance of liability coverage, while sections dedicated to construction superintendents, site safety coordinators, or managers emphasize the overarching priority of maintaining safety standards on-site. In this regard, the PW2 form embodies a meticulous approach to permitting, seeking to ensure that every aspect of construction work is accounted for, regulated, and executed within the bounds of safety and compliance, thereby safeguarding the interests of both the workforce and the broader public.

QuestionAnswer
Form NamePw2 Work Permit Application Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namespw2, pw2 dob form, nyc dob pw2, work permit indicates get

Form Preview Example

PW2: Work Permit Application

Orient and affix BIS

job number label here

Must be typewritten.

BIS Document No., required:

1 Reason For Filing Required for ALL applications.

Initial Permit Complete all sections. Expected work start date:

No Work Permit

Renewal Permit with changes Complete all sections.

Renewal Permit without changes 1, 3, 4, 7 - 12

2Location Information Required for ALL applications.

House No(s)

Street Name

 

 

 

 

 

 

 

 

Borough

Block

Lot

BIN

C.B. No.

 

 

 

 

 

Work on Floor(s)

 

 

 

Apt. / Condo No(s)

 

 

 

 

 

3 Type of Permit Choose ONE and complete any appropriate sub-choices or other information.

Alteration

Boiler

Construction Equipment

Chute

Fence

Sidewalk Shed 3A

Supported Scaffold

Curb Cut

Demolition and Removal

Fire Alarm

Fire Suppression System

Foundation / Earthwork

Area of site (sq. ft):

Fuel Burning

Gas

Oil

Fuel Storage

Mechanical / HVAC

New Building 3B

Plumbing

3C

3A

Electrical application no. for shed lighting:

Sign

 

 

 

Sprinkler

3C

 

 

3B

Related fence job no.

Standpipe

3C

 

3C Secondary permit description (if applies):

3D

Other:

Yes

Yes

Yes

Yes

Earthwork Only

No Are you adding more than three stories?

No Are you performing work in 50% or more of the area of the building?

No Are you performing a vertical or horizontal enlargement adding more than 25% of the area of the building?

No Are mechanical means* to be used?

Yes

Yes

Yes

No

Are you removing one or more stories? If yes, 8

No

Are you demolishing 50% or more of the area of the

 

building? If yes, 8

No

Does your approved work include concrete?

 

If yes, is your concrete work completed?

 

Yes

No complete section 9

4Applicant / Contractor Required for ALL applications. (* Indicates optional.)

Last Name

 

 

 

First Name

 

Middle Initial

 

 

 

 

 

 

 

 

 

Business Name

 

 

 

 

 

Business Telephone

 

 

 

 

 

 

 

 

 

Business Address

 

 

 

 

 

*Business Fax

 

 

 

 

 

 

 

 

City

 

State

Zip

 

*Mobile Telephone

 

 

 

 

 

 

 

 

 

*E-Mail

 

 

 

 

 

Taxpayer ID

 

 

 

 

 

 

 

General Contractor

4A, 4B

4A Provide registration or tracking number:

 

 

 

 

 

 

 

 

 

Fire Suppression Contractor

4C,4D

4B

Does work require a HIC license?

Yes

No If yes, HIC license number:

 

 

 

 

 

 

 

 

Master Plumber

4C,4D

4C

License Number:

 

 

 

 

Oil Burner Installer

4C,4D

4D Is applicant responsible for all work on this application?

Yes

No

Sign Hanger

4D

 

If no, describe work responsibility:

 

 

 

 

Professional Engineer

4C, 6

 

 

 

 

 

 

 

Registered Architect

4C, 6

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Homeowner*

*DOB approval required.

*Mechanical equipment other than handheld devices to be used for demolition or removal of debris (BC §3306.4).

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PW2

PAGE 2

5Filing Representative Complete if different from applicant specified in section 3. (* Indicates optional.)

Last Name

 

First Name

Middle Initial

 

 

 

 

Business Name

 

 

Business Telephone

 

 

 

 

Business Address

 

 

*Business Fax

 

 

 

 

City

State

Zip

*Mobile Telephone

 

 

 

 

*E-Mail

 

 

Registration Number

 

 

 

 

6Insurance P.E. / R.A. only (* indicates required for all permits)

Liability Insurance (NB permits only)

 

Workers’ Compensation Insurance*

 

Disability Insurance *

7 Construction Superintendent, Site Safety Coordinator, Site Safety Manager Required if applicable. (* Indicates optional.)

I, the applicant / contractor, hereby declare the scope of work filed under this permit application requires: (choose one)

 

Construction Superintendent

Site Safety Coordinator

Site Safety Manager

 

 

 

 

Last Name

 

First Name

Middle Initial

 

 

 

 

Business Name

 

 

Telephone

 

 

 

 

Address

 

 

*Fax

 

 

 

 

City

State

Zip

*Mobile Telephone

 

 

 

 

*E-Mail

 

 

Registration Number

I, the undersigned, will perform, on behalf of the Contractor, all of the functions required of a Construction Superintendent, or Site Safety Coordinator, or Site Safety Manager (identified above) as set forth in the Department of Buildings rules and regulations.

Name (print)

Signature

Date

Notarization

State of New York, County of:

Sworn to or affirmed under penalty of perjury

day of

20

Notary Signature

Notary Seal

8Demolition Subcontractor Required if applicable. (* Indicates optional.)

Yes

No

Is the applicant/contractor named in section four performing the demolition work for this permit? If no, complete this section.

 

 

 

 

Last Name

 

First Name

Middle Initial

 

 

 

 

Business Name

 

 

Telephone

 

 

 

 

 

 

Address

 

 

*Fax

 

 

 

 

 

 

City

State

Zip

*Mobile Telephone

 

 

 

 

 

 

*E-Mail

 

 

Registration Number

 

 

 

 

 

I, the undersigned, will perform, on behalf of the Contractor, all of the functions required of a Demolition Subcontractor as set forth in the Department of Buildings rules and regulations.

Name (print)

Signature

Date

Notarization

State of New York, County of:

Sworn to or affirmed under penalty of perjury

day of

20

Notary Signature

Notary Seal

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PW2

PAGE 3

9Concrete Information Choose and complete any appropriate sub-choices.

9A

Yes

No

Are you requesting to exclude concrete work at

9B

Yes

No

Does your approved work include 2,000 cubic

this time from this permit? If no, 9B

yards or more of concrete? If yes, 10 and 11

10Concrete Subcontractor Required if applicable. (* Indicates optional.)

 

 

Yes

 

No

Is the applicant/contractor named in section four performing the concrete work for this permit? If no, complete this section.

 

 

 

 

 

 

 

 

 

 

Last Name

 

First Name

Middle Initial

 

 

 

 

 

 

 

 

Business Name

 

 

Telephone

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

*Fax

 

 

 

 

 

 

 

 

 

 

 

 

City

State

Zip

*Mobile Telephone

 

 

 

 

 

 

 

 

 

 

 

*E-Mail

 

 

Registration Number

 

 

 

 

 

 

 

 

I, the undersigned, will perform, on behalf of the Contractor, all of the functions required of a Concrete Subcontractor as set forth in the Department of Buildings rules and regulations.

Name (print)

Signature

Date

Notarization

State of New York, County of:

Sworn to or affirmed under penalty of perjury

day of

20

Notary Signature

Notary Seal

11Concrete Safety Manager Required if applicable. (* Indicates optional.)

Last Name

 

First Name

Middle Initial

 

 

 

 

Business Name

 

 

Telephone

 

 

 

 

Address

 

 

*Fax

 

 

 

 

City

State

Zip

*Mobile Telephone

 

 

 

 

*E-Mail

 

 

Registration Number

 

 

 

 

I, the undersigned, will perform, on behalf of the Contractor, all of the functions required of a Concrete Safety Manager (identified above) as set forth in the Department of Buildings rules and regulations.

Name (print)

Signature

Date

Notarization

State of New York, County of:

Sworn to or affirmed under penalty of perjury

day of

20

Notary Signature

Notary Seal

12 Applicant / Contractor Statements and Signatures Required for ALL applications.

The information in this application is correct and complete to the best of my knowledge and I assume responsibility for all statements on this form. I understand that if I am found after hearing to have knowingly or negligently made a false statement on this or any other document submitted to the Department, I may be subject to fine, imprisonment, and/or barred from filing further documents with the Department. I also understand 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.

I will comply with all applicable laws, rules and regulations including all insurance requirements, and, in addition.

I hereby state if a Construction Superintendent, Site Safety Coordinator, Site Safety Manager, Demolition Subcontractor, Concrete Subcontractor, or Concrete Safety Manager is required for this application I have hereby advised the individual listed herein he or she is designated as such and hereby certify he or she is registered and in good standing with the NYC Department of Buildings.

I hereby state this renewal application with no change to Applicant, Filing Representative, Construction Superintendent, Site Safety Coordinator, Site Safety Manager, Subcontractors, Concrete Safety Manager or insurance is for the work as originally filed or as officially amended.

In accordance with §28-104.8 of the Administrative Code, I hereby declare I am authorized by the owner of the above-referenced premises to make this application for a permit to perform the work described herein. In accordance with Rule 101-16, I will post the permit in a conspicuous and visible location.

Check here if the work authorized by this permit does NOT require adjacent property insurance.

Name (print)

Signature

Date

Notarization (required if not licensee) State of New York, County of:

Sworn to or affirmed under penalty of perjury

day of

20

Notary Signature

Licensee Seal or Notary Seal

07/10

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Be mindful while filling out this form. Ensure each blank is filled out accurately.

1. The work permit indicates form requires specific details to be typed in. Make certain the subsequent fields are filled out:

Ways to fill out work permit concrete stage 1

2. Once your current task is complete, take the next step – fill out all of these fields - Yes No Are you adding more than, Yes No Are you removing one or, Yes No Are you performing work in, Yes No Are you demolishing or, area of the building, building If yes, Yes No Are you performing a, Yes No Does your approved work, enlargement adding more than of, If yes is your concrete work, Yes No Are mechanical means to be, Applicant Contractor Required, Last Name, Business Name, and Business Address with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

work permit concrete conclusion process shown (portion 2)

3. The following section is related to Filing Representative Complete if, Last Name, Business Name, Business Address, City, EMail, State, First Name, Middle Initial, Zip, Business Telephone, Business Fax, Mobile Telephone, Registration Number, and Insurance PE RA only indicates - complete each of these empty form fields.

Part no. 3 in filling in work permit concrete

4. This next section requires some additional information. Ensure you complete all the necessary fields - day of, Date, Notary Signature, Demolition Subcontractor Required, Yes No, Is the applicantcontractor named, Last Name, Business Name, Address, City, EMail, State, First Name, Middle Initial, and Zip - to proceed further in your process!

Part # 4 for filling out work permit concrete

5. Now, this final subsection is what you should finish prior to finalizing the document. The blank fields here include the following: A Yes No, Are you requesting to exclude, Yes No, Does your approved work include, Concrete Subcontractor Required, Yes No, Is the applicantcontractor named, Last Name, Business Name, Address, City, EMail, State, First Name, and Middle Initial.

A Yes No, Does your approved work include, and Business Name inside work permit concrete

You can potentially make a mistake while completing your A Yes No, therefore make sure to look again before you decide to send it in.

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