Owner

First Name

Last Name

Phone

Construction Superintendent

First Name

Last Name

Phone

License #:

General Contractor

First Name

Last Name

Phone

License #:

Type of Building:

Residential

Commercial

Multifamily residential

Mixed use

Phase of Construction Project:

Estimated Construction Start:

Will you need a DOT Permit to store material or garbage on a parking lane?

Yes

Do you have a pre-construction survey?

Yes

Do you have a Construction Fence Plan?

Yes

Do you have an access agreement with your neighbors?

Yes

Do you have all safety equipment necessary for the job?

Yes

Do you have the following requied paperwork for the project? (Check all that apply)

Construction superintendent log

DOB competent person form

Pre-shift meeting log

OSHA log

New employee safety orientation log

Sidewalk shed scaffolding inspection log (if applicable)

Examples include: Harnesses, retractable lanyard, caution tape, safety glasses, gloves, earplugs, fire extinguishers, etc.

Proposed temporary construction equipment (for each phase):

Demolition (separate plan):

Excavation/SOE:

Foundation:

Superstructure:

Facade:

Examples include: Sidewalk shed, scaffolding, overhead protection, construction fence, construction gate locations, sliding gate standpipes, temporary stairs, waterfilled barriers, tree protection, roof protection, excavator, pile driver, mini excavator, bobcat, forklift, ladder, vertical/horizontal netting, elevator platform, washout box, cranes, hoists, etc.

Check all plans that will be emailed (or upload them here):

Construction Fence

SOE (if applicable)

Architectural

Structural

Foundation

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