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Elevator Appointment Form

The Elevator Appointment Form is the industry's tool for requesting an inspection from the Elevator Division to sign off an Elevator Dismantled, Removed, Installation or Modernized Application.

In order to receive a Service Request number for this application, the Installer must provide an email address so an appointment can be scheduled within 14 business days.

For Mac Users: This request form may not function property with your Safari web browser. We are hoping to resolve this problem soon. In the meantime, please download the free Mozilla Firefox web browser in order to use this form in the interim. For more information on Mozilla Firefox please visit http://www.mozilla.org/. To download the current version of Mozilla Firefox for Macs, please click on the following link: http://www.mozilla.org/en-US/firefox/all.html.

Elevator Application permits must be valid at the time of the request. No appointment can be scheduled with an expired permit.


Date: All Fields are Required

1. Appointment Reference Information

 

2. Type of Inspection

 
  EA or EBN # (as written in application)
 

3. Document Requirements:
Note: Upload file cannot be bigger than 3 MB. Read Upload Instructions.

Upload Files:
Elevator Application

Payment Invoice     

 

4. Device Information

 

A. Borough

B. Block:     Lot:

C. Address:

D. Number of Devices to Inspect:

E. Device Number(s):
Devices 1 Devices 2 Devices 3 Devices 4 Devices 5
Devices 6 Devices 7 Devices 8 Devices 9 Devices 10


5. Applicant Information

 

A. First Name:   Last Name: 

B. Company Name:

C. Street Address:
City:   State:   Zip: 

D. Work Phone:

E. Email:  

F. *License Number:
*Please complete this field if your elevator application was filed on or after 1/1/12 except for device type W and V.


6. Acknowledgements

 

I confirm that the installation of this device will be in conformance with the NYC Building Code requirements.

I understand that no elevator or related devices is to be put into operation until a certification is issued by a New York City Department of Buildings Elevator Inspector.

I understand that all test cancellations not communicated to the Department 24 hours prior to the scheduled test is subject to a $200 penalty.

I understand that any scheduled appointment missed due to unprepared or now show will be subjected to a $200 penalty.

I acknowledge and have attached payment proof of the expedited test for this request.


7. Comments

 


   
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