Forms

COVID-19: DOB Response


Plan/Work & Permits Forms

Technical Forms

Amusement Rides

Builders Pavement Plan

Concrete Enforcement

Construction Safety Compliance (CSC)

Cranes & Derricks

DOB Violations

Easements & Restrictive Declarations

Administrative Enforcement Unit (AEU)

Electrical

Elevator

Facades

Inspection Requests

Licensing

Notification Forms

Padlocks

Plumbing

Retaining Walls

Signs

 


Plan/Work & Permits Forms

Borough Intake Form
The Borough Intake Form is used to submit manual applications to the Borough Office. The form improves tracking of submitted requests and allows the Department to send denial notifications electronically. The form must be submitted with the following applications: PW1 PAA, PW1 Withdrawal, PW2, PW6, and PW7.
Download Form - Rev. 7/17


PW1 Plan/Work Approval Application
The PW1 is the first document filed with the Department to begin the application process.
Download Form - Rev. 8/19 or Electronically File
Download the PW1 User Guide
Download the Fee Equity FAQ


PD1 Plot Diagram
The PD1 form allows the Department to collect plot diagram information in a uniform way for all applications. When a plot diagram is required, it is must be completed and submitted at time of Pre-Filing.
Download Form - Rev. 12/14
Download Instructions


ZD1 Zoning Diagram
The ZD1 is an 11"x17" title block for drawing that graphically summarizes the proposed zoning bulk, yards and street plantings. The ZD1 includes diagrams for site plans and other projections (3D or Axonometric as required) describing vertical dimensions. It will be required prior to approval with all initial filings for New Building and Alteration Enlargement applications. All applicable Post Approval Amendments (PAAs) will also require the ZD1.
Download Form - Rev. 7/09
Download Guide


PW1A Schedule A: Occupancy/Use
Provides supplemental occupancy/use information to PW1.
Download Form - Rev. 12/14
Download Instructions

Only for jobs filed prior to December 31, 2014
Download Old 2008 Form


PW1B Schedule B: Plumbing /Sprinkler/Standpipe
Provides supplemental information involving plumbing, sprinkler and standpipe systems.
Download Form - Rev. 12/14
Download Instructions

PW1C Schedule C: Heating and Combustion Equipment
Provides supplemental information involving heating and combustion equipment.
Download Form - Rev. 9/16
Download Instructions

PW2 Work Permit Application
Filed (with authorization of owner) by contractor or licensee in order to obtain a permit to perform work.
Download Form - Rev. 11/20 or Electronically File
Download Instructions

PGL1 Project Specific General Liability Insurance Summary and Affirmation
To create a PGL1 form for submission, use the DOB Tool. For additional information on Project Specific General Liability Insurance Requirements, read more here.

PW3 Cost Affidavit
Must be filed to certify estimated and actual costs, in order to obtain a work permit. View information on PW3 Requirements, the Fee Structure & List of Applications Requiring a PW3 as well as information on New Building Related/In-conjunction Filings.
Download Form - Rev. 12/14
Download Instructions

PW4 Equipment Use Application/Permit
To be filed for all equipment specified in §28-116.4.1 of the Building Code of the City of New York.
Download Form - Rev. 2/15
Download Instructions

PW5 After-Hour Work Permit Application
To be filed by applicant requesting a permit to engage in construction activities at any time other than on weekdays between the hours of 7:00 AM and 6:00 PM.
Download Form Rev. 5/17 or Electronically File
Download Instructions

PW6 Certificate of Occupancy Application
This form shall be filed in order to initiate inspections required prior to issuance of a Certificate of Occupancy. The applicant (Professional Engineer, Registered Architect or Superintendent of Construction) shall complete the Statement of Compliance in accordance with section 27-221 of the Building Code of the City of New York.
Download Form - Rev. 4/11
Download Instructions


PW7 Letter of Completion Request
This form is required for BIS A2/A3 submissions requesting a Letter of Completion only.
Download Form - Rev. 3/21


AI1 Additional Information
Multipurpose form for applicants to provide additional information on jobs. Do not use this form for any  Determination requests. Instead, use the Determination request forms (ZRD1 and CCD1).
Download Form for Jobs with Scanned (BSCAN) Plans - Rev. 3/09

AO1 Administrative Objections Form
This form will be used to capture the reasons why an application could not be processed prior to approval. This new form will accommodate B-SCAN so the applicant will be able to view the disapproval reasons online.
Download Form - Rev. 12/14

Attachment A: Local Law 26/04 14 Year / Final Sprinkler Report & Application for Extension
Download A Attachment Form - Rev. 12/17

Attachment B: Local Law 26/04 Final Sprinkler Report
Download Attachment B Form - Rev. 6/19

Certificate of Occupancy Worksheet
This form is required for occupancy requests for BIS and DOBNOW jobs. The worksheet must be completed in order to obtain a final Certificate of Occupancy, Temporary Certificate of Occupancy or renewal of a Temporary Certificate of Occupancy in DOBNOW.
Download Form - Rev. 3/21


Construction Safety Enforcement Appointment Request Form
Use the Construction Safety Enforcement Appointment Request form to request an appointment for Stop Work Order Re-inspections, Partial Stop Work Order Re-inspections and DOB Violation Removals. Once completed send the form to cseappointments@buildings.nyc.gov.
Download Form - Rev. 9/18


DS1 Demolition Submittal Certification Form
Must be submitted by the professional preparing demolition submittal plans – required prior to permit when performing full or partial demolition work as per BC 3306.5. This certification form must be submitted together with the plans.
Download Form - Rev. 12/14
Download Instructions


MDL1 Registration of Dwelling Units for Other than Permanent Residence Purposes
Use this form to register Class A multiple dwelling units within dwellings currently operating as hotels for other than a permanent residence purposes. This form and the supporting documentation must be submitted to and processed by the Department by January 12, 2011.
Download Form - Rev. 2/11
Download Instructions
View Service Notice

OP96 Builder Certification For Temporary Certificate of Occupancy
Used by developer when seeking Temporary Certificate of Occupany for a 1, 2 or 3 family dwelling to certify that escrow funds will be deposited on behalf of homeowner to ensure completion of the dwelling.
Download Form - Rev. 9/05

OP97 Escrow Agent/Attorney Letter
Used by escrow agent for developer seeking Temporary Certificate of Occupany for a 1, 2 or 3 family dwelling to certify that escrow funds were or will be deposited on behalf of homeowner to ensure completion of the dwelling.
Download Form - Rev. 8/05

PA1 Place of Assembly Application
Must be filed (with plans) to obtain approval for a new Place of Assembly space.  Must be filed (with plans, if applicable) to obtain approval for all changes to a Place of Assembly space (including change of owner/lessee or name of establishment).
Download Form - Rev. 6/15
Download Instructions


B Form 10H Manufacturer's Statement
Required prior to permit if the application proposes the installation of structural masonry.
Download Form - Rev. 7/08

B Form 10J Supplier's Statement
Submit prior to signoff if the work included the installation of structural masonry.
Download Form - Rev. 4/04

B Form 20SS Preliminary Affidavit By Fabricator / Erector
Submit prior to permit if the application proposes the use of structural steel.
Download Form - Rev. 4/04

B Form 24SS Final Certification By Fabricator / Erector
Submit prior to signoff if the work included the installation of structural steel.
Download Form - Rev. 4/04

DPL-1 Form: Design Professional / Licensee Form Seal and Signature Form for DOB NOW
Used in DOB NOW by Design Professionals and Licensees with seals in order to complete a filing submission.
Download Form - Rev. 11/18

ER1 Emergency Response Agencies C/O Notification Affidavit (Prior to C/O or Sign-off)
Notification Affidavit to certify that applicant has provided a site plan to the Emergency Response Agencies (NYPD, FDNY, EMS, and Department of City Planning).
Download Form - Rev. 3/02

ER2 Emergency Response Agencies C/O Notification Affidavit (Prior to Approval)
Notification Affidavit to certify that applicant has provided a site plan to the Emergency Response Agencies (NYPD, FDNY, EMS, and Department of City Planning).
Download Form - Rev. 3/02

HC4 Sewer Self Certification House Connection Proposal
To propose new and existing sewer connection for 1, 2 and 3 family dwellings without commercial use.
Download Form - Rev. 10/06
Download Instructions

HC7 Sewer Self Certification Site Connection Proposal
To propose sewer site connection by providing all calculations, plans and pertinent information pertaining to the disposal of all storm and sanitary discharge.
Download Form - Rev. 10/06
Download Instructions

HIC1 Home Improvement Contractor Affidavit
To request for waiver of license requirement for obtaining a permit when filing for a Alteration 1, 2, and 3 applications for 1, 2, 3 or 4 family homes, co-op units, condo units or rented apartment units.
Download Form - Rev. 9/07

HPD1 Anti-Harassment Area Checklist
This form shall be filed to satisfy the Anti-Harassment Area Checklist required item. The form indicates certification with or exemption from anti-harassment provisions in Hudson Yards, West Chelsea, Garment Center (P2) and Greenpoint-Williamsburg.
Download Form - Rev. 12/14
Download Instructions


HPD2 Clinton Special District  Anti-Harassment Checklist
This form shall be filed to satisfy the Clinton Special District Anti-Harassment Area Checklist required item. The form indicates certification with or exemption from anti-harassment provisions in Hudson Clinton Special District.
Download Form - Rev. 4/08
Download Instructions


HPD3 Single Room Occupancy Multiple Dwelling
(SRO MD) Anti-Harassment Checklist
Replacing SRO1 SRO Intake Form

This form is required for all alternations or demolitions of buildings identified as single room occupancy multiple dwellings except for Alteration 3 applications for sheds, fences or curb cuts. This form assist the applicant in determining whether a certification of no harassment from the Department of Housing Preservation and Development is required to be submitted.
Download Form - Rev. 12/14


HPD4 CONH Pilot Program Building Anti-Harassment Checklist
This form must be submitted for all filings on Department of Housing Preservation and Development Pilot Program buildings.
Download Form - Rev. 5/21


HRT1 High Rise Initiative - Program Request
Used by public to request participation in the High Rise Initiative program, available to New Building and Alteration 1 Enlargement high rise projects. Request form will be reviewed. If the applicant is eligible to join the program, a 1-hour appointment will be scheduled. Please review the Administrative Items Check List and the Drawing Submission Guideline for the list of documents the applicant has to provide during the meeting.
Download Form - Rev. 4/13
Download Administrative Items Check List
Download Drawing Submission Guideline

L2 Requests for Overrides, Reductions, or Waivers of Civil Penalties for Work Without a Permit and Stop Work Order Violations
This form must be completed by the owner, or authorized designee, of the subject premises in order to request an override, reduction, or waiver of civil penalties for work without a permit or stop work order violations. Requests for reductions in civil penalty must be accompanied by at least four (4) photos of the area.
Download Form - Rev. 7/19
Download Instructions


Letter of No Objection (LNO) or Letter of Verification (LOV) Application
A Letter of No Objection (LNO) may be issued if no CO is available, or if the building (or part of the building) has a different use than that listed on the CO or noted in the available records. A LNO may be issued if the proposed/actual use belongs to the same Use Group (UG) as defined by the Zoning Resolution and the same Occupancy Group (OG) as defined by the 2008 Building Code and the occupancy load and egress is substantially unchanged.
Download Form - Rev. 5/14


Local Law 92/94 of 2019 Sustainable Roof Zone
Use this form to certify compliance with the sustainable roofing zone requirements of Local Law 92 and Local Law 94 of 2019.
Download Form - Rev. 11/19


Local Law 104 of 2019 Request for Exception to Permit Restriction
Use this form to obtain a permit in BIS on a building flagged with LL 114/19 Permit Restriction.
Download Form - Rev. 3/21
View Service Notice


Local Law 114 of 2019 Request for Exception to Permit Denial
Use this form to obtain a permit in BIS on a building flagged with LL114/19 Permit Restriction.
Download Form - Rev. 7/20
View Service Notice


OP133 Property Profile Change Request
The OP133 allows an applicant to request a review for the removal of the NYS Department of Environmental Conservation (DEC) Wetlands flag(s) on the BISWeb Property Profile Overview. The form must be completed by a registered design professional or a licensed land surveyor and must contain a copy of the applicable NYS DEC Wetlands map(s) annotated to clearly identify the subject premises and demonstrate that the entire tax lot is outside any mapped zone or associated adjacent area.
Download Form - Rev. 7/09
Download Instructions


Open Application Cover Letter
Request for Certificate of Occupancy under Open Applications Pilot Program in Manhattan.
Download Application Cover Letter


PC1 Required Items Checklist
Used by applicants to file professionally certified applications.
Download Form - Rev. 6/16

PEO1 Local Law 58 of 1987 Accessibility Waiver Request 
Request for Waiver of Local Law 58 of 1987. Basis of waiver as per section 27-292.6 of the Building Code.
Download Form - Rev. 1/15
Download Instructions

PEO4 Local Law 5 of 1973 Informational Checklist
This checklist is to be used as an aid to the owner. The owner is responsible for full compliance with Local Law 5 of 1973.
Download Form - Rev. 7/03

PER11 Appointment and Drop Off Request Form
Used by public to request for Appointment and Drop Off.
Download Form - Rev. 10/20


PER12 SEP Form - Professional Certification Audits and Inspections Appointment Request Form
Used by public to request an appointment with the Special Enforcement Program (SEP).
Download Form - Rev. 6/14


PER20 Request for Certificate of Occupancy with Open Application(s) Cover Letter
This form is intended to summarize the supporting documentation behind it. When a person is seeking a Project Advocate's help, many documents are supplied. This is a Cover Sheet, that only some of the boroughs prefer, and it would be OPTIONAL.
Download Form - Rev. 3/07


POC1 Professional and Owner Certification
Used by applicants to file with Plan/Work Approval Application.
Download Form - Rev. 1/04

POC3 Professional and Owner Certification:
Easement Agreement or Restrictive Declaration
The POC3 form is to be used when an easement or restrictive declaration is filed in connection with a professionally certified application. The professional must sign the POC3 form, which will contain either the professional's certification: 1) that the easement or declaration materially conforms to the Department's approved form, or 2) that the easement or declaration has been reviewed and accepted by the General Counsel's Office.
Download Form - Rev. 12/14

Project Advocate Service Request Form
To request an appointment with a Project Advocate, please complete and submit the Project Advocate Service Request Form with all essential project information and submit to the respective Borough office.
Download Form - Rev. 8/19


Property Ownership Certification
Upload this form in DOB NOW: Build on the Documents tab of the Plans/Work (PW1) application. The document is required prior to permit and cannot be waived.
Download Form - Rev. 5/21
Download Supplemental Form – Rev. 5/21


RF1 Refund Request Application
Use this application to claim a refund for the amount paid to the NYC Department of Buildings. Please see instructions for additional information and the required documentation that must accompany the application.
Download Form - Rev. 2/18
Download Instructions

ST1 Street Tree Checklist
The checklist must be submitted prior to job approval to satisfy the Street Tree Checklist required item which will automatically apply to NB, A1 and A2 (enlargement) applications. The checklist shows compliance with or exemption from street tree zoning requirements and must be signed and sealed by the applicant of record.
Download Form - Rev. 8/16
Download Instructions



Technical Forms

TR1 Technical Report: Statement of Responsibility
Use this form to identify responsibility or to report the results of completed inspections or tests.
Download Form - Rev. 8/16
Download Instructions 

Only for jobs filed prior to December 31, 2014 (See Buildings Bulletin 2014-017).
Download Old 2008 Form - Rev. 10/13
Download Old 2008 Instructions


TR2 Technical Report: Concrete Pouring, Sampling and Compression Test Cylinders
File this form with the TR1 upon completion of required inspections/tests.
Download Form - Rev. 12/14
Download Instructions

TR3 Technical Report: Concrete Design Mix
Use this form to indicate results of tests and final design mixture for strength of controlled concrete.
Download Form - Rev. 2/15
Download Instructions
 
TR3P Technical Report: Concrete Design Mix
This form should be used by approved producers to indicate results of tests and final design mixtures for strength of controlled concrete. This Technical Report must be filed prior to permit issuance in accordance with the New York City Building Code, Chapter 19, Concrete. Trial mixture reports and/or field experiment results must be attached when submitting the TR3P. As a reminder, additional TR3P reports should be submitted as needed for additional trial mixes.
Download Form - Rev. 2/15
 
TR4 Technical Report: Soil Inspection
File this form with the TR1 upon completion of required inspections/tests.
Download Form - Rev. 7/08
Download Instructions

TR5 Technical Report: Pile Driving
Use this form to indicate results of test report for pile driving.
Download Form - Rev. 7/08
Download Instructions

TR5H Technical Report: Helical Pile Installation
Use this form for Helical Pile installations.
This is a new form for the 2014 Codes and cannot be submitted to the Department prior to the effective date of the 2014 Codes, December 31.
Download Form - Rev. 12/14
Download Instructions

TR6 Technical Report: Periodic Inspection of Exterior Walls & Appurtenances
The TR6 Report is a required compliance filing that must be completed in DOB NOW: Safety. You must be registered in eFiling to log into DOB NOW: Safety. Register in eFiling, today! The report must be accompanied by the Engineer and/or Architect's report.
TR6 Report - Log into DOB NOW: Safety to complete
DOB NOW: Safety QEWI Manual
TR6 Instructions

TR7 Photoluminescent Report
Use this form to certify compliance with the Photoluminescent exit path marking requirements of Section BC 403.16, and 1 RCNY 1026-01 for high rise buildings constructed pursuant to the 2008 Building Code.  This report may be completed by an architect or engineer.
Download Form - Rev. 12/14

TR8 Technical Report Statement of Responsibility for Energy Code Progress Inspections
File this form with the TR1 to identify responsibility or to report the results of completed inspections or tests for compliance with the 2020 NYCECC.
Download Form - Rev. 5/20
Download Instructions

For jobs filed prior to May 12, 2020 ONLY
(See Buildings Bulletin 2020-002)
File this form with the TR1 to report the results of completed inspections or tests for compliance with the 2016 NYCECC.
Download Old TR8 Form - Rev. 9/16
Download Old TR8 Instructions


TR8 Technical Report for Energy Code Progress Inspections
The progress inspector must inspect and compile supporting documentation for all inspections noted on the original TR8: Technical Report Statement of Responsibility for Energy Code Progress Inspections and on any subsequent TR8 statements filed as a result of post-approval amendments. The reports shall include the inspections and/or testing listed in Table I and/or Table II PROGRESS INSPECTIONS FOR ENERGY CODE COMPLIANCE and address all conditions applicable to the scope of work. Complete reports shall be submitted to the department upon request. Per 1 RCNY § 101-07 Approved Agencies (b) (3) Documentation, an approved agency shall maintain records of inspections and tests for at least 6 years.
This template is provided as a guide for the level of documentation expected in a TR8 Inspection Report. The template may be filled in or a similar format may be followed, as long as the required information is included.
Download Template - Rev. 7/19

TR15 Technical Report: Potentially Structurally Compromised Buildings
The TR15 Report is a required compliance filing pursuant to Article 217 of the 2014 Building Code. This form must be accompanied by the Engineer and/or Architect's report.
Download Form - Rev. 1/19
Download Instructions

TPP1 Tenant Protection Plan
The TPP1 Form is a stand-alone form that must be submitted for all buildings being altered or demolished, containing one or more dwelling units that will remain occupied during construction.
Download Form - Rev. 11/20
Download TPP1 User Guide