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Pedestal Installation Form

* Indicates required fields

Date:

Location/GPS Information

Borough*

Company*

Submitted By*

Email*

Pedestal ID / Reference #*

Do you have an approximate address?* Yes No

On Street

Side of Street

Cross Street 1

Cross Street 2

Community Board Number/District*

Latitude:*

Longitude:*

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Pedestal Review

Reason/Justification for pedestal installation (Supplementary documentation must be attached)*

Dimensions

Height (Minimum: 27 inches, Maximum: 48 inches)*

Length- parallel to the curb (Maximum: 72 inches)*

Width- perpendicular to the curb (Maximum: 28 inches)*

Area (in Square Feet):

Exisiting Pedestal Structures on Blockfront (Maximum 2)*

Distance of nearest existing pedestal on blockfront (Minimum: 100 feet)*

Sidewalk clearance between cabinet and property
(Minimum: 4 feet)*

Clearance from corner
Pedestal must be 20 feet or more from the "corner" (the corner = the box formed by extending the property lines to the curbs)
(Minimum: 20 feet)*

Nature of Site * Multiple Dwelling Unit (MDU) Park/Open Land Residential Institutional Commercial Industrial

Number of homes to be serviced by the pedestal

Electronics to be placed in proposed pedestal* Power Supply Node Amplifiers Other

Potential off street locations and reasons for rejection

Address 1

Building Number

Street Name

Management/Owner

Telephone

Owner Denied BLDG Attachment Owner Denied Access into Easement Inaccessible Location Other (This must be filled if previous fields are empty.)

Address 2

Building Number

Street Name

Management/Owner

Telephone

Owner Denied BLDG Attachment Owner Denied Access into Easement Inaccessible Location Other

Address 3

Building Number

Street Name

Management/Owner

Telephone

Owner Denied BLDG Attachment Owner Denied Access into Easement Inaccessible Location Other

Site Criteria

Subway Entrance (open side) (Minimum Clearance: 15 feet)

Sidewalk Cafes (Minimum Clearance: 15 feet)

Newsstand (Minimum Clearance: 15 feet)

Bus stop (with / without shelter) (Minimum Clearance: 15 feet)

Fire Hydrant / Standpipe (Minimum Clearance: 10 feet)

Driveway (Minimum Clearance: 10 feet)

Bicycle Racks (including bicycles) (Minimum Clearance: 8 feet)

Street Tree (Minimum Clearance: 5 feet)

Bench (Minimum Clearance: 5 feet)

Principal Building Entrance (Minimum Clearance: 5 feet)

Ramp intended to provide access for people with disabilities (Minimum Clearance: 5 feet)

Subway Entrance (closed end or side) (Minimum Clearance: 5 feet)

Public Telephone (Minimum Clearance: 5 feet)

Planters on the sidewalk not adjacent to the building façade (Minimum Clearance: 5 feet)

Mail Box (Minimum Clearance: 4 feet)

Street Lights (Minimum Clearance: 4 feet)

Parking Meters (Minimum Clearance: 4 feet)

Edge of Tree Pit (Minimum Clearance: 3 feet)

Street signs (Minimum Clearance: 3 feet)

Utility Hole Covers, Cellar Doors, Areaways (Minimum Clearance: 3 feet)

Transformer Vault, Sidewalk Gates (Minimum Clearance: 3 feet)

All other Legal Steet Furniture (Minimum Clearance: 5 feet)

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