Full Text
CITY OF ALBANY DEPARTMENT OF BUILDINGS & REGULATORY COMPLIANCE 200 Henry Johnson Boulevard Albany, NY 12210 Phone (518) 434-5165 Fax (518) 434-6015 SPRINKLER PERMIT APPLICATION This permit application is intended for applicants seeking a permit to install a sprinkler system. Please note that such installation may only be done by a plumber licensed to work in the City of Albany. If we can assist you in completing this form, do not hesitate to ask. GENERAL INFORMATION JOB SITE ADDRESS: TOTAL COST OF WORK (INCLUDING COST OF MATERIALS): 1% OF TOTAL WORK COST: WHEN DO YOU NEED YOUR PERMIT? WE MAY EXPEDITE AN APPLICATION IF POSSIBLE AND APPROPRIATE. APPLICANT: LICENSE NO.: EMAIL: PHONE: HOW WOULD YOU LIKE TO RECEIVE YOUR PERMIT (PLEASE CHOOSE ONE): PICK UP OR BY MAIL IF YOU WOULD LIKE TO RECEIVE YOUR PERMIT BY MAIL, PLEASE INCLUDE A STAMPED SELF-ADDRESSED ENVELOPE WITH THIS APPLICATION. OWNER: EMAIL: PHONE: FEE CALCULATION FLAT FEE (CHECK WHAT APPLIES): COMMERCIAL OR RESIDENTIAL WITH THREE OR MORE UNITS RESIDENTIAL $100 FEE WITH 1% SURCHARGE ON TOTAL COST OF WORK & MATERIALS $50 FEE FIXTURES FEE (INDICATE HOW MANY OF EACH FIXTURE YOU WILL BE INSTALLING): 1 – 10 SPRINKLER HEADS: $5 PER HEAD FEE 11-100 SPRINKLER HEADS: $50 PLUS $2 PER HEAD OVER 11. 101 AND MORE SPRINKLER HEADS: $230 PLUS $1 PER HEAD OVER 101 TOTAL NUMBER OF SPRINKLER HEADS TO BE INSTALLED: TOTAL FIXTURES FEE: FLAT FEE + FIXTURES FEE + 1% TOTAL WORK COST SURCHARGE (IF APPLICABLE) = TOTAL FEE: INSURANCE: HAVE YOU SUBMITTED PROOF OF THE NECESSARY INSURANCE TO BRC? YES NO WORKER’S COMPENSATION: HAVE YOU SUBMITTED PROOF OF WORKER’S COMP COVERAGE? YES NO STAFF USE ONLY PERMIT NO.: APP. FEE: REC’D BY: DATE REC’D: DATE ISSUED: ASSIGNED TO: SCANNED BY: BRC Form 024 Rev’d: 3/2016 Page 1 of 2 ---PAGE BREAK--- JOB SITE ADDRESS: PROJECT DESCRIPTION (IF NEEDED, PLEASE PROVIDE A DESCRIPTION OF THE DETAILED PLANS OR OTHER DOCUMENTS ARE ATTACHED (REQUIRED): YES NO Certification: I hereby certify that I have examined this application and know the information contained therein to be correct. I understand that the granting of a permit does not grant authority to violate or ignore any law, that this permit authorizes only the work described herein and will expire, unless otherwise noted, in one year from the date of issuance. Date: STAFF USE ONLY THE FOLLOWING CONDITIONS APPLY TO THIS APPROVAL: APPROVED BY: DATE: Sprinkler Permit Instructions Licenses. Sprinkler permits will only issue a sprinkler permit to licensed sprinkler system installers. Stop Work Orders. Note that this permit, if authorized, applies only to the work described herein and that a stop work order may be issued if the work goes beyond what was applied for. Fee Calculation. The total application fee is a combination of the flat fee, fixtures fee, and, if applicable, 1% total work surcharge. The flat fee depends on whether the property is commercial or a residential property of three or more units, in which case the flat fee is $100, or a residential property of less than three units, in which case the flat fee is $50. The fixtures fee depends on the number of sprinkler heads to be installed. The fee for installing 1 to 10 heads is $5 per head. The fee for installing 11 to 100 heads is $50 plus $2 per head over 11. The fee for installing 101 or more heads is $230 plus $1 per head over 101. The 1% surcharge is a charge equal to 1% of the total cost of the project, including all work and materials, and applies only to commercial projects or residential projects of three or more units. Inspections. All projects are subject to a rough and final inspections and no inspection may occur until a complete application has been submitted to the department. Please request inspections at least 24 hours in advance and no inspection request will be accepted by voice or email. Insurance. Either the owner of the contractor is required to have a liability policy naming the City of Albany as insured or co- insured covering the work described in the permit application. This liability policy must be, at minimum, in the following amounts: a) $100,000.00 – Personal Injury – single incident b) $300,000.00 – Personal Injury – cumulative c) $ 50,000.00 – Property damage Proof of Insurance. Before we may issue a plumbing permit, we must have proof of insurance. A contractor may file an Owner’s and Contractor’s Protective Liability Policy, naming the City of Albany as an additional insured, for the individual job, in the required amounts; or the contractor may file a blanket policy with the City, covering all work to be undertaken within the period of the policy. Worker’s Compensation. As per NY GML § 125, we cannot issue a permit without proof of worker’s compensation insurance. From contractors, we will need one of the following: 1) WCB form C-105.2 or U-26.3, 2) WCB form SI-12 or GSI -105.2, 3) WCB form CE-200, and/or 4) WCB form DB 120.1 or 120.2. Ongoing Certification. Sprinkler systems must be inspected by an authorized private inspector annually per the NYS Fire Code. This inspector must submit to the Department an inspection certification form upon completing the inspection. BRC Form 024 Page 2 of 2