Lic51 Form

[Christina Smith]

Asof November 13, 2018, all new applications, reissuances, and renewals for Gas Work Qualifications (Full & Limited), Journeyman Registrations (Plumber & Fire Suppression), and Welder Licenses are required to be submitted in DOB NOW: Licensing. Any forms that pertain to Welders below should be completed and uploaded into DOB NOW.

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.

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

Elevator Directors must complete this form to attest to the fact that an applicant for an Elevator Agency Technician/Restricted Elevator Agency Technician or Elevator Agency Helper is qualified and is under their direct and continuing supervision.

Due to the COVID-19 pandemic, all new applicant testing for Written and Practical exams is suspended until further notice. LIC41 and LIC42 applications are still being accepted, however, please expect processing delays until test sites re-open.

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, Private Agency Elevator Director/Inspector, and Gas Work Qualification.

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.

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.

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.

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.

Until the required Department-approved training courses for Class 1 and Class 2 Filing Representative registrations become available, submit this Affidavit in lieu of a Certificate of Completion when applying for or renewing a Class 1 or Class 2 Filing Representative registration.

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.

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

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

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.

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.

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.

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.

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

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.

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.

To become a Site Safety Manager, you must also successfully pass a background investigation by submitting the required documents listed in this section as scanned PDFs via the DOB NOW Portal. Applicants that do not currently have an eFiling account will need to create an account by completing the registration form.

Once all documentation is submitted and approved by the Licensing Backgrounds Unit, you will be able to schedule an appointment within the DOB NOW Portal to take a picture and receive the Site Safety Manager certification card.

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Safety Registration Number renewal applications must be submitted online through DOB NOW at .nyc.gov/dobnow. To be eligible for online renewal submission, applicants must authenticate or create an eFiling account using the eFiling portal located at .nyc.gov/dobefiling.

LIC 50 Authorization for Service of Process by Agent This form must be completed and notarized by the applicant or licensee when they apply for a license or registration and their home address is outside of New York City 5 boroughs (ex. Long Island, New Jersey, Pennsylvania).

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The applicant must have the current *NCCCO Certification(s) to complete the renewal process. See the National Crane Certification Requirements for NYC Hoist Machine Operator Licenses page for information about which certifications are required. During the one (1) year immediately prior to renewal, the Licensee must successfully complete a Department-approved 8-hour Refresher Course. For the HMO Refresher Course registration go to

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