Cranes & Derricks Forms


CD1 Crane/Derrick / Mobile Work Platform Prototype Application – To be used for approval of any construction equipment model (crane, derrick, mast climber, multi-point suspension and multi-platform scaffold, angular scaffold, etc.). Supportive documents to include the manufacturer and engineering designs, plans, calculations, test results and standards. (Instructions)


CD1-OA Crane/Derrick/Pile Driver Owner’s Prototype Amendment Application - To be used by the owner of a crane, derrick, or dedicated pile driver to apply to amend an existing Certificate of Approval (“Prototype Approval”). (Instructions)


CD2 Crane/Derrick/Mobile Work Platform Approval & Operation Application/Certificate – To be used for the initial registration and the subsequent annual inspection of any construction equipment regulated by the NYC Department of Buildings. All applicable fields must be completed. Applicant and Owner Name must be an actual person name fully legible. Prototype number must be entered where applicable. (Instructions)

 

CD3 Crane Approval & Operation Application/Certificate – To be used only for the registration and subsequent annual inspection of truck cranes with boom lengths more than 50 feet and less than 135 feet and capacity of up to 3 tons.

 

CD4 Crane or Derrick Notice Application – Required to submit a Crane Notice (CN) application. Changes include: 1) Form title 2) Data field boxes 1, 6, 7, and 8.

 

CD4-A Crane or Derrick Notice Application Amendment Replaces CD10 form for CN applications only. However CD10 form still applies for amending CD2 and CD3 forms. To be used to submit any change made after the original application has been approved.

 

CD4-EQ Designation of Multiple Equipment Users – To be used to designate multiple equipment users. If filed without a CD4, this is considered an amendment and amendment fees apply.

 

CD5 Suspended Scaffold Application (Formerly known as the Notification of Staging and Outrigger Beam Use By Special Riggers form)
This form is to be used for the installation of a 2-point suspension scaffold on outrigger beams. It must be submitted by a NYC Licensed Master Rigger or a Licensed Special Rigger.

 

CD6 Crane/Derrick & Work Platform Plumbness & Torque Notification/Anchor Bolt Pull Out Test – To be used to notify the Cranes and Derricks division of the results of the mandatory work platform plumbness and torque test and anchor bolt pull test by a qualified professional.

 

CD7 Notification of Erecting, Climbing, or Dismantling of a Climber, Tower Crane, or Derrick – To be used to notify the Department’s Cranes & Derricks Unit before raising or lowering a climber, tower crane, or derrick Changes include: Derricks have been added as an additional equipment type requiring the submission of a CD7 form when applicable.

 

CD8 Technical Report: Statement of Responsibility – To be submitted with a Crane Notice (CN) application subject to an inspection by a NYS PE or RA under the provisions of Directive 14 of 1975 as applied to cranes and derricks.

 

CD10 Tower & Mobile Crane / Derrick / Mast Climber / Pile Driver Amendment – To be used to submit any change made after the original application has been entered.

 

CD11 Equipment Identification Form – To be submitted with the registration form CD2, CD3, or MC2 to record the equipment description and the equipment owner with first and last name typewritten. Changes include: Equipment manufacturer, model number, and serial number have been added to the form as mandatory information to be provided at the time of form submittal.

 

CD12 Designation of Primary Lift Director – This form was formerly used to add additional Crane Safety Coordinator to job. Now it will be used to designate the primary lift director. If filed without a CD4, this is considered an amendment and amendment fees apply.

 

CD13 Class "C" Hoisting Machine Operator License Examination – To be used by any person applying to take the test for the Hoist Machine Operator class C license. Call the Licensing Division for the additional forms to be completed.

 

CD16 Cranes and Derricks Division Applicants Statement of Notification to Community Boards – To be completed as indicated and submitted to the respective Community Board for the job location.

 

CD21 Request for Inspections (After Hours) – To be completed to request after hour Inspections.

 

CD22 Annual, Assembled and Unassembled Cranes & Derricks Inspection Request – To request inspection for Assembled/Unassembled Cranes, Derricks, and Mobile Work Platforms.

 

CD24 Contingency DOT Form/Letter – To be used to request authorization to proceed with Department of Transportation permitting process.

 

CD25 On-Site Waiver – To be used to request an exemption from a Certificate of On-Site Inspection for equipment that satisfies the conditions listed in Exception #3 to 1 RCNY 3319-01(c)(1), such as a service crane, clamshell rig, pile driver or a crane meeting the requirements of a 48 hour exemption.

 

MC1 Mast Climber Prototype Application – For mast climber whose make and model is not yet approved for use in New York City, the mast climber’s manufacturer must submit the MC1 form. The application should include supporting documents, such as manuals, capacity charts and design certifications.

 

MC2 Mast Climber Device Application – Mast climber owners must submit the MC2 form for approval or re-registration of an individual mast climber. The MC2 should be submitted with supporting documentation, which must include a list of the mast’s critical components, the owner’s certification and a disclosure of the mast climber’s history. Owners must re-submit this application each time the mast climber is to be used in New York City. Changes include: Section 3-Additional information.

 

MC3 Installer and Remover Form – The mast climber owner must submit the MC3 form to designate the party responsible for installing or removing a mast climber at a job site.

 

MC4 Mast Climber Notice Application – The NYS-licensed engineer who prepared the mast-climber plans must submit the MC4 with the plans to notify the Department that a mast climber will be used. Changes include: Section 7 – Additional information.

 

MC5 Certificate of On-Site Inspection – The NYS-licensed engineer who prepared the mast-climber plans must submit the MC5 to sign off on a mast climber to be used in New York City. This application must be submitted with supporting documents and photos that demonstrate that the mast climber has passed all prior inspections before use.