Attachment 0001_SOW APPENDIX 2.7.3 JBMHH DPW Fillable Excavation Permit.pdf

This is a DPW Excavation Permit form for New York City projects. The permit is used to authorize excavation work that may disrupt underground utilities, easements, rights of way, or private activities. The form requires identification of the requesting entity through POC information, name, title, email, and phone number, along with specification of the excavation class (Class I for specific hazard or Class II for masked risk). The form mandates submission of a detailed drawing showing the excavation site's exact location, with the requirement that excavation routes be staked or flagged by the requestor every 25 feet.

The permit covers various types of work to be performed and requires additional certifications and acknowledgments from the requestor regarding responsibility for damages to property and utilities, liability for injuries, compliance with locating requirements, coordination with utility companies, and adherence to safety protocols. The form necessitates signatures from the requesting entity's POC and multiple utility company representatives, including representatives from the Plumbing Shop, Sewer Shop, Stray HVAC Shop, and NFC. A precautionary measures section is included, with a reference date of 13 April 2011. The document serves as a critical authorization mechanism ensuring proper coordination between the excavation requester and relevant utility stakeholders before underground work commences.