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Cranes & Derricks

 Mast Climber Forms

CD1 Crane / Derrick / Mobile Work Platform Prototype Application
To be used for approval of any construction equipment model (crane, derrick, mast climber, multi-point suspension and multi-platform scaffold, angular scaffold, etc.). Supportive documents to include manufacturer's and engineering designs, plans, calculations, test results and standards.
 Download Form - Rev. 12/03
 Download Instructions


CD2 Crane / Derrick / Mobile Work Platform Approval and Operation Application / Certificate
To be used for the initial registration and the subsequent annual inspection of any construction equipment regulated by the NYC Department of Buildings. All applicable fields must be completed. Applicant and Owner Name must be an actual person name fully legible. Prototype number must be entered where applicable.
 Download Form - Rev. 8/05
 Download Instructions


CD3 Crane Approval and Operation Application / Certificate
To be used only for the registration and subsequent annual inspection of truck cranes with boom lengths more than 50 feet and less than 135 feet and capacity of up to 3 tons.
 Download Form - Rev. 12/03
 Download Instructions

CD4 Tower & Mobile Crane / Derrick / Mast Climber / Pile Driver On-Site Inspection Application / Certificate
This form is the Crane Notice (CN) application to obtain an on-site inspection by a Cranes and Derricks inspector or Professional Engineer (PE). This application must be filed by a New York State PE
 Download Form - Rev. 7/09
 Download Instructions

CD5 Suspended Scaffold Application - (Formerly known as the Notification of Staging and Outrigger Beam Use By Special Riggers form)
This form is to be used for the installation of a 2-point suspension scaffold on outrigger beams. It must be submitted by a NYC licensed master rigger or a licensed special rigger.
 Download Form - Rev. 6/12

CD6 Crane / Derrick and Work Platform Plumbness And Torque Notification / Anchor Bolt Pull Out Test
To be used to notify the Cranes and Derricks division of the results of the mandatory work platform plumbness and torque test and anchor bolt pull test by a qualified professional.
 Download Form - Rev. 12/03

CD7 Notification of Erecting, Jumping or Dismantling of a Climber or Tower Crane Form
To be used to notify the Cranes and Derricks division before raising or lowering a tower crane.
 Download Form - Rev. 7/07

CD8 Technical Report: Statement of Responsibility
To be submitted with a Crane Notice (CN) application subject to an inspection by a NYS P.E. or R.A. under the provisions of Directive 14 of 1975 as applied to cranes and derricks.
 Download Form - Rev. 12/03

CD10 Amendment for Crane / Derrick / Workplatform
To be used to submit any change made after the original application has been entered.
 Download Form - Rev. 6/12

CD11 Equipment Owner Identification Form
To be submitted with the registration form CD-2 or CD-3 to record the equipment description and the equipment owner with first and last name entered legibly.
 Download Form - Rev. 12/03

CD12 Designation of Safety Coordinator
To be used to designate the site safety coordinator on installations not subject to a crane notice (CN) application.
 Download Form - Rev. 12/03

CD13 Class "C" Hoisting Machine Operator License Examination
To be used by any person applying to take the test for the Hoist Machine Operator class C license. Call the Licensing Division for the additional forms to be completed.
 Download Form - Rev. 12/03

CD16 Cranes and Derricks Division Applicants Statement of Notification to Community Boards
To be completed as indicated and submitted to the respective Community Board for the job location.
 Download Form - Rev. 12/03

CD21 Request for Inspections (After Hours)
To be completed to request after hour Inspections.
 Download Form - Rev. 2/05

CD22 Annual, Assembled and Unassembled Cranes and Derricks Inspection Request
To request inspection for Assembled/Unassembled Cranes, Derricks, and Mobile Work Platforms.
 Download Form - Rev. 11/13

CD24 Contingency DOT Form/Letter
To be used to request authorization to proceed with Department of Transportation permitting process.
 Download Form - Rev. 7/09


CD25 Limited Use Application
To be used to request an exemption from a Certificate of On-Site Inspection for equipment that satisfies the conditions listed in Reference Standard 19-2, Sections 8.1.3 and 8.3, such as a service crane, clamshell rig, pile driver or a crane meeting the requirements of a 48 hour exemption. This form is formerly known as an On-Site Waiver.
 Download Form - Rev. 3/12

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