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Project Specific General Liability Insurance Tool
Learn more about the additional project-specific insurance requirements when obtaining permits.
Job Location
Please enter the following information about the Location where the work will take place.
*Borough *House Number *Street Name
*Block *Lot *BIN CB No.
Project Specific Insurance
*Is a Tower Crane to be used?  Yes  No
Applicant Statement
*Applicant Name: 
*Registration/Tracking Number: 
The information in this application is correct and complete to the best of my knowledge and I assume responsibility for all statements on this form. I understand that if I am found after hearing to have knowingly or negligently made a false statement on this or any other document submitted to the Department, I may be subject to fine, imprisonment, and/or barred from filing further documents with the Department. I also understand it is unlawful to give to a city employee, or for a city employee to accept, any benefit, monetary or otherwise, either as a gratuity for properly performing the job or in exchange for special consideration.