Elevator License/Renewal Application

Elevator License/Renewal Application
The annual license fee of $250 per inspector must be paid prior to the issuance of license.

License fee/renewal fee - an invoice will be sent to you via email from noreply@epl.albanyny.gov. At that time you can opt to pay the invoice online on our CSS Portal or mail a Check/Money Order to our office at 200 Henry Johnson Blvd. - Suite 1; Albany, NY 12210.

Once payment has been made, your license will be issued and emailed to you.
License Application Type*

New Inspector LicenseInspector RenewalNew Installer LicenseInstaller Renewal
License No.*
Corporation Name*
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Individual 1*

First NameLast Name
Individual 1 Phone*
Please enter a valid phone number.
Individual 2

First NameLast Name
Individual 2 Phone
Please enter a valid phone number.
Individual 3

First NameLast Name
Individual 3 Phone
Please enter a valid phone number.
Individual 4

First NameLast Name
Individual 4 Phone
Please enter a valid phone number.
Year(s) engaged in business*
Are you familiar with NYS Uniform Fire Prevention & Building Code Part 1062, RS 60, Part 1250.3*

YesNo
Do you qualify under the current ANSI/ASME QEI Standard for the Qualification of Elevator Inspectors or other relevant criteria?*

YesNo

Insurance Documents
Attached hereto and forming part of the application herein are certificates of insurance specifying the following insurance coverage.*

Workers' Compensation (or waiver)Disability InsuranceGeneral Comprehensive Liability
Personal Injury Amount of Coverage*
Property Damage Amount of Coverage*
Please upload insurance documents*

Cancelof

Has any license previously issued to applicant by the City of Albany been denied, suspended or revoked?*

NoYes
If yes, give date and reasons for such denial, suspension or revocation
Have you ever been convicted of a crime?*

NoYes
Are you presently licensed by any other municipality in New York State?*

NoYes
If yes, which one(s)
Certification
Applicant Name

First NameLast Name
I hereby apply to the Department of Buildings & Regulatory Compliance of the City of Albany for a license pursuant to Ordinance Number 60.121.98, Chapter 175 (Elevators) of the Code of the City of Albany to engage in business of installation, inspection and servicing of elevators. I understand that I will be invoiced for payment and that until such time as payment is made, no license/renewal will be issued.

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Inspector Information