Licensing Forms


The Department provides Fill-in and Electronic Submission Forms for your convenience. These forms are not to be altered or changed in any way. Persons that are suspected of altering any forms and submitting them to DOB will be reported to the proper authorities.


LIC1 Agency License Application

Use this form to apply for the following licenses: Concrete Testing Laboratory, Elevator Inspection Agency, Testing Laboratory.

 

LIC2 License Application

Use this form to apply, renew, or make changes to the following licenses: Elevator Inspector, Elevator Co-Director, Engineer, Hoisting Machine Operator, Master Plumber, Oil Burning Equipment Installer, Rigger, Sign Hanger, Site Safety Manager/Coordinator, Welder, and Master Fire Suppression Piping Contractor.

 

Instructions for Master Plumber & Master Fire Suppression Piping Contractor

 

Instructions for Master/Special Rigger & Master/Special Sign Hanger

 

Instructions for Oil Burner Equipment Installer

 

Instructions for Stationary/Portable Engineer

 

LIC3 License Application

Use this form to apply for a Construction Superintendent or a Concrete Safety Manager registration.

 

LIC4 License Application

Use this form to provide all necessary information regarding work history in a standardized format.

 

LIC5: Work History for Civil Service Electrician

Use this form to provide relevant information about your work history as a Civil Service Electrician.

 

LIC6: General Contractor Registration Form

Use this form to apply for a General Contractor registration.

 

LIC7: Safety Registration Form

Use this form to apply for a Safety Registration number.

 

LIC8: Filing Representative Application

Use this form to apply, renew, or change information on your Filing Representative Registration.

 

LIC9: Professional/Agency Identification Card Application

This form is for Professional/Inter-Agency Personnel requiring Identification card in order to do business with the Department.

 

LIC33: Business Address Verification

Use this form to verify your business address.

 

LIC34: Licensing Supplemental Affidavit

Use this form to indicate any convictions or fines.

 

LIC35: Sustainable Contractor Application

Use this form to apply for a Sustainable Contractor Designation.

 

LIC38: Electrical License Renewal Application

Use this form to renew Master and Special Electrician licenses.

 

LIC41: Written Exam Application

Use this form to apply for the written exam for the following license types: Master and Special Electrician, Master Plumber, Master Fire Suppression Piping Contractor, Master Rigger, Master Sign Hanger, High Pressure Boiler Operating Engineer, Oil Burner Equipment Installer, Tower/Climber Crane Rigger, Site Safety Manager, and Private Agency Elevator Director and Inspector.

 

LIC42 Practical Exam Application

Use this form to apply for the practical exam for the following license types: Master and Special Electrician, Master Plumber, Special Rigger, Master Rigger, Special Sign Hanger, Master Sign Hanger, High Pressure Boiler Operating Engineer, Oil Burner Equipment Installer, Tower/Climber Crane Rigger.

 

LIC50 Authorization for Service of Process by Agent

Use this form to designate an Agent to accept service of Notices of Violation (NOV)/Summonses issued by the Department.

 

LIC51 Voluntary Authorization for Service of Process by Email

Use this form to voluntarily agree to accept Department-issued service of Notices of Violation (NOV)/Summonses by email.


LIC60: Visual Acuity Examination Form for Welders

Examination must be completed by an Ophthalmologist, Optometrist, Medical Doctor, Registered Nurse or Certified Physician's Assistant.

 

LIC61: Physical Examination Form

Physical Examination form for Riggers and Hoist Machine Operators only. It must be completed by a physician after a medical examination.

 

LIC62: Physical Examination Form

Use this form to show proof of fitness qualification for the following license/registration: Welders; Site Safety Professionals; Private Elevator Inspection Agency Directors and Inspectors; Sign Hangers; High-Pressure Boiler Operating Engineers; Oil Burning Equipment Installers; Plumbers; Construction Superintendents; Concrete Safety Managers; Electricians; and Fire Suppression Piping Contractors. It must be completed by a physician after a medical examination.

 

LIC70: Designated Foreman Form

Use this form to designate, or renew foremen performing work for licensed Master/Special Riggers and Sign Hangers. This form will also be used when a foreman has been terminated or removed.

 

AFFIDAVIT: Lost/Stolen License

Use this form to request a replacement Department-issued card(s) if your license was lost or stolen. The affidavit must be submitted with a police department incident report indicating the license was either lost or stolen.

 

Background Investigation Questionnaire

All license applicants must pass a background investigation. Applicants must complete the following form and return it to the Department to begin their background investigation.

 

Child Support Certification Form

A Child Support Certification form must be completed, whether you have children or not, upon the initial application process, and for every renewal.

 

Supplemental Investigation Questionnaire

Use the below forms in addition to the Background Investigation Questionnaire for background investigation for the following license types: Hoist Machine Operator A,B & C, Master Plumber, General Contractor Registration, High Pressure Boiler Operator Engineer (Stationary), Master Fire Suppression Piping Contractor, Master and Special Rigger, Tower Crane Rigger, Oil Burner Equipment Installer, Private Elevator Agency Director and Inspector, Master/Special Electrician, Welder, Master & Special Sign Hanger.

 

SIA1 Special Inspection Agency Registration (Renewal & Change Applications Only)

Use this form to renew or make changes to your Special Inspection Agency registration. Applicants applying for their initial registration must register with the Department online.

 

SIA Document Upload Form

Use this form to upload your supporting documents for your special inspection agency registration. Provide government issued photo identification (e.g. Driver's License or Passport), Proof of NYC Address (utility bill – gas, electric, water) or NYS Secretary of State business filing, Proof of Professional Liability Insurance (PE/RA only), and Proof of Workers Compensation Insurance or Waiver (PE/RA only).

 

Class 2 Code and Zoning Representative Experience Verification Form

Use this Experience Verification form as part of the background investigation for new Class 2 Code and Zoning Representative applicants. This form must be given to each Professional Engineer or Registered Architect who is attesting to job filings you are claiming as experience.

 

Concrete Safety Manager Experience Verification Form

Use this Experience Verification form as part of the new Concrete Safety Manager application. This form must be given to each employer/supervisor noted on your application.

 

Construction Superintendent Experience Verification Form

Use this Experience Verification form as part of the new Construction Superintendent application. This form must be given to each employer/supervisor noted on your application.

 

Elevator Inspector or Elevator Director Experience Verification Form

Use this Experience Verification form as part of the background investigation questionnaire for new Elevator Inspector/Director applicants. This form must be given to each employer/supervisor noted in your background investigation questionnaire

 

High Pressure Boiler Operating Engineer/Stationary Engineer Experience Verification Form

Use this form as part of the background investigation questionnaire for new High Pressure Boiler Operating Engineer/Stationary Engineer applicants. This form must be given to each supervising licensee noted in your background investigation questionnaire

 

Hoisting Machine Operator Experience Verification Form

Use this Experience Verification form as part of the background investigation questionnaire for new Class A, B & C Hoisting Machine Operator applicants. This form must be given to each supervising licensee noted in your background investigation questionnaire.

 

Oil-Burning Equipment Installer Experience Verification Form

Use this Experience Verification form as part of the background investigation questionnaire for new Oil-Burning Equipment Installer applicants. This form must be given to each supervising licensee noted in your background investigation questionnaire.

 

Master/Special Electrician Experience Verification Form

Use this Experience Verification form as part of the background investigation questionnaire for new Master/Special Electrician applicants. This form must be given to each licensee/supervisor noted in your background investigation questionnaire.

 

Master Plumber or Master Fire Suppression Piping Contractor Experience Verification Form

Use this Experience Verification form as part of the background investigation for new Plumber/Fire Suppression applicants. You will be contacted via mail and informed when to submit this form in addition to other documents. This form must be given to each supervising licensee noted on your application.

 

Sign Hanger: Master/Special Experience Verification Form

Use this Experience Verification form as part of the background investigation questionnaire for new Special and Master Sign Hanger applicants. This form must be given to each employer/supervisor noted in your background investigation questionnaire

 

Site Safety Coordinator & Site Safety Manager Experience Verification Form

Use this Experience Verification form as part of the background investigation questionnaire for new Site Safety Coordinator or Site Safety Manager applicants. This form must be given to each employer/supervisor noted in your background investigation questionnaire.

 

Special/Master/Tower Cranes Rigger Experience Verification Form

Use this Experience Verification form as part of the background investigation for new Special, Master or Tower Cranes Rigger applicants. This form must be given to each employer/supervisor noted in your background investigation questionnaire, and submitted along with your background investigation documents listed in the Rigger section of the website.

 

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