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CITY OF ALBANY DEPARTMENT OF BUILDINGS & REGULATORY COMPLIANCE 200 Henry Johnson Boulevard Albany, NY 12210 Phone (518) 434-5165 Fax (518) 434-6015 SIDEWALK & BARRICADE PERMIT A sidewalk barricade permit is required whenever a project will affect a public right of way such as a road or sidewalk. If we can be of any assistance in completing this application, please let us know. GENERAL INFORMATION JOB SITE ADDRESS: APPLICANT: 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. OWNER: (IF DIFFERENT) EMAIL: PHONE: PROJECT INFORMATION DATES FOR WHICH THE PERMIT WILL BE NEEDED: TO THE PROPOSED PROJECT WILL INVOLVE THE FOLLOWING: (CHECK ALL THAT APPLY) BLOCKING A SIDEWALK WORK ADJACENT TO A SIDEWALK STORING OF MATERIALS IN A RIGHT OF WAY OPENING A STREET OR SIDEWALK IF SO, A SEPARATE PERMIT FROM THE DEP’T OF GENERAL SERVICES WILL BE REQUIRED. USE OF A LIFT, LADDER, OR SCAFFOLD IF SO, PLEASE STATE THE HEIGHT FT A SKETCH OF THE PROPOSED WORK INDICATING THE DIMENSIONS, PLACEMENT AND NATURE OF THE PROPOSED PROJECT IS REQUIRED WITH THIS APPLICATION AND MAY BE PROVIDED IN THE DESIGNATED SPACE ON THE REVERSE SIDE OF THIS FORM. IMPORTANT INFORMATION REGARDING SIDEWALK & BARRICADE PERMITS ●NO LIFTS OR SCAFFOLDING WILL BE PERMITTED WITHIN 10’ OF NATIONAL GRID WIRING WITHOUT THE WIRING BEING WRAPPED OR THE POWER DIVERTED BY NATIONAL GRID ●THE GRANTEE MUST TAKE ALL PRECAUTIONS TO PREVENT ACCIDENTS AND MUST PLACE BARRICADES AND LIGHTS ON ALL OPENINGS OR BRIDGE OPENINGS WHERE NECESSARY. ●TREES MUST BE PROTECTED WITH BARRICADES ●BARRICADES MUST COMPLY WITH INDUSTRIAL CODE RULE 23 ●MEMBERS OF THE ALBANY POLICE DEPARTMENT AND BUILDINGS AND REGULATORY COMPLIANCE WILL ENFORCE THE PROVISIONS OF THIS PERMIT ●WORK MUST COMPLY WITH THE LAW AND THE PLANS SUBMITTED WITH THIS APPLICATION ●THE FEE FOR THIS PERMIT APPLICATION, WHICH MAY BE PAID AT OUR OFFICE BY CHECK OR CREDIT CARD, IS $75 OR $50 IF ASSOCIATED WITH ONGOING PERMITTED WORK (CONTINUED ON BACK) STAFF USE ONLY PERMIT GRANTED: PERMIT EXPIRES: PERMIT NO.: SEE BACK FOR CONDITIONS. APPROVED BY: AS NEEDED TRAFFIC SAFETY: DATE: BUILDINGS & REG. COMP. NATIONAL GRID: DATE REC’D: APP. FEE: REC’D BY: SCANNED BY: BRC Form 013 Rev’d: 12/2016 Page 1 of 2 ---PAGE BREAK--- IMPORTANT INFORMATION REGARDING SIDEWALK & BARRICADE PERMITS (CONTINUED) ●AN ADA COMPLIANT, UNOBSTRUCTED PEDESTRIAN WALKWAY MUST BE MAINTAINED BY THE CONTRACTOR AT ALL TIMES THROUGH OR AROUND THE WORK ZONE OR OBJECT/CONTAINER/SERVICE VEHICLE THE APPLICANT IS SHOWING IN THIS PERMIT APPLICATION. ●BUILDING MATERIALS SUCH AS BLOCK OR WOOD SHALL NOT BE STORED IN THE ROADWAY OR SIDEWALK UNLESS ON A PALLET AND PLACED AGAINST THE BUILDING OR OUTSIDE OF THE PUBLIC RIGHT OF WAY ●LOOSE, GRANULAR MATERIAL SUCH AS CRUSHER RUN OR OTHER FILL MATERIALS SHALL NOT BE STORED IN THE ROADWAY OR SIDEWALK UNLESS SECURED INSIDE OF A CONTAINER OR OUTSIDE OF THE PUBLIC RIGHT OF WAY. ●IN THE EVENT THE WORK OUTLINED IN THIS PERMIT REQUIRE LANE CLOSURES, A MAINTENANCE AND PROTECTION OF TRAFFIC PLAN SHALL BE SUBMITTED WITH THE APPLICATION FOR REVIEW AND APPROVAL. ANY APPROVED LANE CLOSURES SHALL ONLY OCCUR BETWEEN THE HOURS OF 9AM-3PM UNLESS OTHERWISE APPROVED IN WRITING BY TRAFFIC ENGINEERING. WHEN FLAGMEN ARE REQUIRED AS PART OF THE MAINTENANCE AND PROTECTION OF TRAFFIC PLAN, THEY SHALL BE DEDICATED TO THAT TASK ●CONSTRUCTION VEHICLES, CONSTRUCTION CONTAINERS, DUMPSTERS, AND MOVING CONTAINERS MUST HAVE REFLECTIVE TRAFFIC CONTROL DEVICES PLACED AROUND THEM WHEN THEY ARE WITHIN THE PUBLIC RIGHT OF WAY. ●CONSTRUCTION VEHICLES AND TRAILERS MUST NOT OBSTRUCT TRAFFIC AT ANY TIME. ●CONSTRUCTION CONTAINERS, DUMPSTERS, MOVING CONTAINERS AND LIFTS MUST BE REMOVED DURING DECLARED SNOW EMERGENCIES. ●CONSTRUCTION CONTAINERS AND MOVING CONTAINERS SHALL REMAIN FOR NO LONGER THAN 14 DAYS PER GENERAL CITY ORDINANCE ●PARKING RESTRICTIONS IN METER PARKING AREAS, THERE IS A FEE OF $15 PER DAY PER METER PAYABLE TO THE ALBANY PARKING AUTHORITY ONCE APPROVED BY TRAFFIC ENGINEERING, NOT ALL REQUESTS WILL BE APPROVED. FOR APPROVAL, CALL [PHONE REDACTED] SEVENTY-TWO HOURS PRIOR TO THE FIRST DATE PARKING IS NEEDED. PLEASE HAVE THE PARKING METER NUMBERS FOR THE SPACES NEEDED WHEN YOU CALL. ●THIS PERMIT IS NOT A PARKING PERMIT. TO OBTAIN TEMPORARY PARKING ARRANGEMENT, CALL [PHONE REDACTED] THREE BUSINESS DAYS PRIOR TO FIRST DATE PARKING IS NEEDED. ●CONSTRUCTION CONTAINERS, DUMPSTERS, AND MOVING CONTAINERS SHALL NOT BE PLACED ON PUBLIC STREETS IN HANDICAP PARKING AREAS, BLOCKING FIRE HYDRANTS, LOADING ZONES, OR OTHER AREAS WHERE THEY CAUSE AN OBSTRUCTION AND PUBLIC HAZARD ●LIFTS AND CRANES MUST HAVE REFLECTIVE STRIPES, CONSTRUCTION CONES OR CONSTRUCTION BARRELS AROUND THEM AT ALL TIMES WHEN WITHIN THE PUBLIC RIGHT OF WAY. A GROUND MAN MUST BE STATIONED AT THE LIFT ASSURING SAFETY UNDER THE OPERATING BASKET. BRC Form 013 Page 2 of 2 DESCRIPTION OF WORK (PLEASE PROVIDE A BRIEF DESCRIPTION OF THE WORK BEING DONE AT THE PROPERTY AND WHETHER A LIFT WILL BE USED): DIAGRAM PLEASE PROVIDE A ROUGH SKETCH OUTLINING THE DIMENSIONS AND LOCATION OF THE OBSTRUCTION AND THE NAME AND LOCATION OF ANY AND ALL RIGHTS OF WAY TO BE OBSTRUCTED. THIS SPACE IS PROVIDED FOR YOUR CONVENIENCE. IF YOU WISH TO SUBMIT YOUR DIAGRAM ON A SEPARATE PIECE OF PAPER, FEEL FREE TO DO SO.