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CITY OF ALBANY DEPARTMENT OF BUILDINGS & REGULATORY COMPLIANCE 200 Henry Johnson Boulevard Albany, NY 12210 Phone (518) 434-5995 [EMAIL REDACTED] CLASS B ELECTRICIAN’S LICENSE APPLICATION This form is for individuals seeking a Class B electrician’s license and must be accompanied by an application for a permit to do the work for which the Class B license will be issued. This application must be submitted in person so that Department staff may confirm the identity of the applicant and properly notarize the application. The fee for a Class B license application is $400. APPLICANT INFORMATION NAME: ADDRESS: EMAIL: PHONE: JOB SITE ADDRESS FOR WHICH LICENSE IS SOUGHT: MUNICIPALITY WHERE APPLICANT IS LICENSED: LICENSE NO.: HOW WOULD YOU LIKE TO RECEIVE YOUR LICENSE (PLEASE CHOOSE ONE): PICK UP OR BY MAIL IF YOU WOULD LIKE TO RECEIVE YOUR LICENSE BY MAIL, PLEASE INCLUDE A STAMPED SELF-ADDRESSED ENVELOPE. ADDITIONAL DOCUMENTATION IN ORDER TO PROCESS THIS APPLICATION, WE NEED 1) A COPY OF YOUR LICENSE, 2) A COPY OF YOUR INSURANCE, AND 3) A COPY OF YOUR GOVERNMENT ISSUED ID (DRIVER’S LICENSE, PASSPORT, ETC.). AFFIDAVIT THIS APPLICATION HAS BEEN FILLED OUT BY ME AND THE INFORMATION CONTAINED HEREIN IS CORRECT TO THE BEST OF MY KNOWLEDGE. IF I AM GRANTED A CLASS B LICENSE, I AGREE TO FULLY COMPLY WITH ALL APPLICABLE LAWS, CODES, AND ORDINANCES, INCLUDING AND ESPECIALLY THOSE OF THE CITY OF ALBANY. SIGNATURE STATE OF NEW YORK : COUNTY OF ALBANY : ON THIS DAY OF BEFORE ME CAME TO ME KNOWN TO BE THE PERSON DESCRIBED IN AND TO HAVE EXECUTED THE FOREGOING INSTRUMENT. NOTARY PUBLIC OR COMMISSIONER OF DEEDS STAFF USE ONLY PERMIT NO.: APP. FEE: REC’D BY: DATE REC’D: DATE ISSUED: ASSIGNED TO: SCANNED BY: BRC Form 027 Rev’d: 6/2017 Page 1 of 2 ---PAGE BREAK--- STAFF USE ONLY A CLASS B LICENSE IS HEREBY GRANTED TO THE ABOVE INDIVIDUAL FOR WORK RELATED TO PERMIT NO. THE FOLLOWING ADDITIONAL CONDITIONS APPLY TO THIS APPROVAL: GRANTED BY: DATE: TITLE: Class B License Information Duration. Class B electrician’s licenses are limited to work on a specific permit and terminate upon completion of the work allowed by that permit. Class B license holders are expected to comply with all applicable laws related to work they are licensed to do. Class A Licenses. Licenses are granted by the Electrical Examining Board, not by this Department, on a yearly basis. Applications for Class A licenses are available from our office and we will put you in contact with the relevant board should you wish to pursue a Class A license. Inspections. All projects are subject to a rough and a final inspection and no inspection may occur until all the necessary materials have 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 without express confirmation from our inspector. Stop Work Orders. If it is determined that work has been done beyond what is allowed in a permit or in violation of any conditions above, the applicant will be subject to a stop work order and concomitant fee of $300 per violation. Project Commencement. Work on a project may not be commenced prior to issuance of the permit except in emergency situations where the applicant has secured the explicit approval of the inspector assigned to the permit. If work begins prior to the permit being issued, the applicant will be at risk of receiving a stop work order and may be required to redo noncompliant work. Project Completion. Upon completion of your project, the applicant must to contact BRC to schedule a closing inspection to ensure that the work done was in fact legal and code compliant. 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. Insurance. For work being done in the City, 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 an electrical 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. Code Justification Letter. For complex projects, code justification letters are strongly encouraged and will greatly expedite the issuance of your permit. BRC Form 027 Page 2 of 2