Safety & Health Forms and Publications

Forms & Publications

 

TopicDocumentDescription
General Safety And HealthDOSH Crisis Response Assistance (P199)Information about resources to support the safety and health needs of emergency responders.
Aerial Acts, Amusement Devices, 
Viewing Stands And Tents 
(Used At Carnivals, Fairs 
And Amusement Parks)
Aerial Act Location Notice (SH78)Use this form to notify the Department of Labor of all events where you will be performing aerial acts.
Aerial Acts, Amusement Devices, 
Viewing Stands And Tents 
(Used At Carnivals, Fairs 
And Amusement Parks)
Guide for Amusement Device Operators in New York State (P217)Fact Sheet
Aerial Acts, Amusement Devices, 
Viewing Stands And Tents 
(Used At Carnivals, Fairs 
And Amusement Parks)
Amusement Devices, Viewing Stands and Tents – Permit Information (SH81)

Information on obtaining permits for:

  • amusement rides & devices
  • viewing stands
  • tents

at carnivals, fairs, and amusement parks.

Aerial Acts, Amusement Devices, 
Viewing Stands And Tents 
(Used At Carnivals, Fairs 
And Amusement Parks)
SH80 -- Application For Amusement Device, Viewing Stand and/or Tent Permit (SH 80)

Use this form to apply for a permit for an:

  • amusement device
  • viewing stand

tent permit

Aerial Acts, Amusement Devices, 
Viewing Stands And Tents 
(Used At Carnivals, Fairs 
And Amusement Parks)
Location Notice (SH87)

Use this form to notify DOL of the location of:

  • amusement devices
  • viewing stands
  • tents

at carnivals, fairs and amusement parks.

Aerial Acts, Amusement Devices, 
Viewing Stands And Tents 
(Used At Carnivals, Fairs 
And Amusement Parks)
Equipment Inventory (SH87.1)

Use this form to list the

  • amusement rides & devices
  • viewing stands
  • tents

that need inspection before use at a carnival, fair or amusement park.

Aerial Acts, Amusement Devices, 
Viewing Stands And Tents 
(Used At Carnivals, Fairs 
And Amusement Parks)
Daily Inspection & Test of Amusement Device (SH86)An amusement device must be inspected and tested on each day it is to be used. Immediately after each inspection and test record the results on this SH 86 form.
Aerial Acts, Amusement Devices, 
Viewing Stands And Tents 
(Used At Carnivals, Fairs 
And Amusement Parks)
বিনোদন যন্ত্রের দৈনন্দিন পরিদর্শন ও পরীক্ষা (SH86BN)একটি বিনোদন যন্ত্রকে সেটি ব্যবহারের প্রতিটি দিনে পরিদর্শন ও পরীক্ষা করানো আবশ্যক। প্রতিবার পরিদর্শন ও পরীক্ষার পর এই SH 86 ফর্মে ফলাফলগুলি লিপিবদ্ধ করুন।
Aerial Acts, Amusement Devices, 
Viewing Stands And Tents 
(Used At Carnivals, Fairs 
And Amusement Parks)
游乐设施的日常检查和测试 (SH86C)计划使用的游乐设施必须在使用当天例行检查和测试。 每次完成检查和测试后,立即将结果记录在此SH 86表上。
Aerial Acts, Amusement Devices, 
Viewing Stands And Tents 
(Used At Carnivals, Fairs 
And Amusement Parks)
Enspeksyon ak Tès Chak Jou Aparèy Amizman (SH86HC)Yon aparèy amizman dwe enspekte ak teste chak jou ke yap itilize li. Touswit aprè chak enspeksyon ak tès anrejistre rezilta yo sou fòm SH 86 sa a.
Aerial Acts, Amusement Devices, 
Viewing Stands And Tents 
(Used At Carnivals, Fairs 
And Amusement Parks)
놀이 기구의 일별 검사 및 테스트 (SH86K)

놀이 기구는 매일 사용 전에 검사와 테스트를 받아야 합니다.

각 검사 및 테스트 직후에 이 SH 86 양식에 결과를 기록하십시오.

Aerial Acts, Amusement Devices, 
Viewing Stands And Tents 
(Used At Carnivals, Fairs 
And Amusement Parks)
odzienna kontrola i test urządzenia rozrywkowego (SH86P)CUrządzenie rozrywkowe musi być sprawdzane i testowane każdego dnia, w którym ma być używane. Natychmiast po zakończeniu każdej kontroli i testu, wyniki należy zanotować na formularzu SH 86.
Aerial Acts, Amusement Devices, 
Viewing Stands And Tents 
(Used At Carnivals, Fairs 
And Amusement Parks)
Ежедневные проверки и тестирование оборудования аттракционов (SH86R)Оборудование аттракционов должно проходить проверки и тесты/испытания каждый день, в который его планируется использовать. Непосредственно после каждой инспекции и тестирования результаты должны фиксироваться в данной форме SH 86.
Aerial Acts, Amusement Devices, 
Viewing Stands And Tents 
(Used At Carnivals, Fairs 
And Amusement Parks)
Inspección y prueba diaria de dispositivos de entretenimiento (SH86S Spanish)Use este formulario para notificar al Departamento de Trabajo acerca de la ubicación de dispositivos de entretenimiento, puestos de exhibición o carpas utilizados en ferias ambulantes, ferias y parques de diversiones.
Aerial Acts, Amusement Devices, 
Viewing Stands And Tents 
(Used At Carnivals, Fairs 
And Amusement Parks)
Statement of Load Test For Passenger Carrying Amusement Device (SH88)A required test to certify that an amusement device meets the conditions of Industrial Code Rule 45.
Aerial Acts, Amusement Devices, 
Viewing Stands And Tents 
(Used At Carnivals, Fairs 
And Amusement Parks)
Application for Examination of Plans (SH700)Application for DOL Engineering Unit to examine plans for viewing stands and tents.
Asbestos - CR 56Asbestos - Effective 3/21/2007 (CR56)This revised regulation went into effect on March 21, 2007.
Asbestos - CR 56Petition For an Asbestos Variance (SH752)Use this form to apply for relief from Code Rule 56 provisions
Asbestos - CR 56CR56 Asbestos - Guidance DocumentSupplements CR 56 and helps with the application of the amended regulation.
Asbestos - CR 56Asbestos in New York State - Facts and Responsibilities (P224)This booklet explains the dangers of asbestos and the requirements for safe abatement.
Asbestos Handler Certificate 
(For Workers Handling Asbestos.)
Instructions for Asbestos Certificate Applications (SH442)This form gives the qualifications for an Asbestos Certificate. It also tells what training, documents, and fees needed.
Asbestos Handler Certificate 
(For Workers Handling Asbestos.)
Asbestos Certificate Application (SH440)Use this to apply for a new certificate or to renew an existing certificate.
Asbestos Handler Certificate 
(For Workers Handling Asbestos.)
Appendix to a License Application (GO1)This child support obligation form must be completed and sent in with your application.
Asbestos Handler Certificate 
(For Workers Handling Asbestos.)
Request for Photo ID Card (ID5 DOL)

Use this form to request a photo ID from the New York State Department of Motor Vehicles if you do not have:

A New York State Drivers License

or

 A non-driver ID

Asbestos License 
(For Companies Working With Asbestos.)
Instructions on Applying for any Asbestos Handling License (SH433)How to apply for an Asbestos Handling License.
Asbestos License 
(For Companies Working With Asbestos.)
Required Insurance (SH439)Describes which documents are acceptable as proof of workers' compensation and disability insurance.
Asbestos License 
(For Companies Working With Asbestos.)
Application for an Asbestos Handling License (SH430)Use this form to apply for a new license or to renew an existing license.
Asbestos Project NotificationAsbestos Project Notification (SH483)You must complete this notification and send it to the Asbestos Control Bureau before beginning any project where you might release asbestos.
Asbestos Project NotificationEmergency Asbestos Project Notification (SH483.1)Complete and email or fax this form to the Asbestos Notification Unit for approval to start an emergency project, instead of calling to request the approval.
Asbestos Project NotificationAsbestos Project Notification Fee Waiver Request & Certification (SH483.2)This form is to be submitted by contractors working for municipalities where properties meet the criteria established in Section 904(2-a) or Section 904(2-b).
Guidance for Documenting Asbestos Work AreasGuidance for Documenting Asbestos Work Areas (SH752.1)This guidance describes items which must be included when submitting a petition for asbestos variance or amending a variance decision.
Boiler InspectionPart 4 – Low Pressure Boilers (CR4)Details the requirements for installing, inspecting and maintaining low pressure boilers.
Boiler InspectionPart 14 – High Pressure Boilers (CR14)Details the requirements for installing, inspecting and maintaining high pressure boilers and for constructing unfired pressure vessels.
Boiler InspectionPetition For a Variance or Other Relief (SH751)Use this form to apply for relief from the provisions of CR 4 and CR 14.
Blaster Certificate Of CompetencePossession, Handling, Storage and Transportation of Explosives (CR39)This document has the text part 39 of department of labor regulations regarding possession, handling, storage and transportation of explosives.
Blaster Certificate Of CompetenceOccupational Licensing and Certification Part 61 of Title 12 of the Official Compilation of Codes, Rules, and Regulations of the State of New York (Cited as NYCRR 61) (CR61)

This document contains SubParts:      

  • 61-1 General Provisions
  • 61-2 Special Provisions for Pyrotechnicians
  • 61-3 Special Provisions for Crane Operators
  • 61-4 Special Provisions for Blasters
  • 61-5 Special Provisions for Mobile Laser Operators
Blaster Certificate Of CompetenceFingerprint Screening Instructions (SH881)Fingerprinting instructions and information on who needs to be fingerprinted.
Blaster Certificate Of CompetenceInformation and Instruction for Applicants (SH811)Information and instructions on applying for a Blaster Certificate of Competence.
Blaster Certificate Of CompetenceApplication for a Blaster’s Certificate of Competence (SH810)Use this application to apply for a new, or to renew an existing Blaster’s Certificate of Competence.
Blaster Certificate Of CompetenceRequest for Photo ID Card (ID5 DOL)If you do not have a New York State Drivers License or non driver ID you should use this form to request a photo ID from the New York State Department of Motor Vehicles.
Boiler Inspector Certificate Of CompetenceApplication for Boiler Inspector Certificate of Competence (SH332) Use this form to apply for Application for Boiler Inspector Certificate of Competence
Boiler Quality Control System ReviewQuality Control System Review Information Sheet (SH381)This information sheet gives the requirements you must meet for a quality control system review. It also explains how to apply and schedule a quality control system review.
Boiler Quality Control System ReviewApplication for a Quality Control System Review (SH380)Use this form to apply for a quality control system review for obtaining authorization to perform welded repairs on boilers in New York State.
Boiler Quality Control System ReviewApplication for Permission to Install a Second-Hand Boiler (SH310)Use this form to apply for permission to install a second-hand boiler. Do not buy or install until NYS grants permission.
Boiler Quality Control System ReviewWelded Repair/Alteration Report (SH386)Use this form to report all welded repairs and/or alterations to the Boiler Safety Bureau
Crane Operator Certificate Of CompetenceSubpart 23-8 - Mobile Cranes, Tower Cranes and Derricks (CR23)This document has the text of Subpart 23-8 of Department of Labor regulations regarding mobile cranes, tower cranes and derricks.
Crane Operator Certificate Of CompetenceOccupational Licensing and Certification Part 61 of Title 12 of the Official Compilation of Codes, Rules, and Regulations of the State of New York (Cited as NYCRR 61) (CR61)

This document contains SubParts:      

  • 61-1 General Provisions
  • 61-2 Special Provisions for Pyrotechnicians
  • 61-3 Special Provisions for Crane Operators
  • 61-4 Special Provisions for Blasters
  • 61-5 Special Provisions for Mobile Laser Operators
Crane Operator Certificate Of CompetenceInformation & Instructions For Applicants (SH831)Information on who should apply, and how to apply for a crane operator’s certificate of competence.
Crane Operator Certificate Of CompetenceApplication for Crane Operator's Certificate of Competence (SH830)Use this application to apply to take the crane exam or for upgrading an existing Crane Operator's Certificate of Competence.
Crane Operator Certificate Of CompetenceRenewal Application for Crane Operator's Certificate of Competence (SH847)Use this application to renew an existing Crane Operator's Certificate of Competence.
Crane Operator Certificate Of CompetenceCrane Operator's Certificate of Competence License Renewal Written Exam Application (SH832)Use this form to sign up for the Certificate of Competence License renewal written test.
Crane Operator Certificate Of CompetenceAppendix to a License Application (GO1)You must fill out this form regarding child support obligations and send it in with your application.
Crane Operator Certificate Of CompetenceRequest for Photo ID Card (ID5 DOL)If you do not have a New York State Drivers License or non driver ID you should use this form to request a photo ID from the New York State Department of Motor Vehicles.
Elevators and Other ConveyancesApplication for Approval or Revision of an Elevator and Other Conveyances: Continuing Education Training Course (SH115)Use this form to apply for approval as a New York State Elevator/Conveyance Training Provider.
Elevators and Other ConveyancesOnline Elevator Continuing Education Course Requirements (SH116)Training providers who wish to apply to offer an online elevator continuing education course must meet these requirements for a live online course.
Elevators and Other ConveyancesElevator and Other Conveyances Continuing Education Course: Curriculum Information (SH118)The Elevator and Other Conveyances Continuing Education Course is applicable for the renewal of all elevator license types.
Elevators and Other ConveyancesApplication for Approval of Plans (SH706)Use this form to apply for approval of plans for aerial tramway, chain/gondola, J-bar, T-Bar, Rope Tow, Poma Life, Skimobile, etc.
Explosives LicensesExplosives Laws, Part 39 of Title 12 of the Official Compilation of Codes, Rules and Regulations of the State of New York (CR39)    

Part 39 of New York State's code, rules and regulations for explosives:

  • possession
  • handling
  • storage
  • transportation
Explosives LicensesExplosives Laws - Article 16 of the Labor Law Sections 450 through 465 and Part 39 of Title 12 of the Official Compilation of Codes, Rules and Regulations of the State of New York (SH60)    

This Explosives Laws booklet has both:

  • Part 39 of Title 12 of the Official Compilation of Codes, Rules and Regulations of the State of New York and
  • Article 16 of the Labor Law Sections 450 through 465
Explosives LicensesFingerprint Screening Instructions (SH 881)Fingerprinting instructions and information on who needs to be fingerprinted.
Explosives LicensesInformation and Instructions to Apply for an Explosives License to Purchase, Own, Possess and/or Transport Explosives (SH851)    This form has information and instructions on how to apply for an explosives license to purchase, own, possess and/or transport explosives.
Explosives LicensesApplication for License to Purchase, Own, Possess and/or Transport Explosives (SH850)Use this application to apply for a license to purchase, own, possess and/or transport explosives.
Explosives LicensesApplication for License to Deal in or Manufacture Explosives (SH860)Use this application to apply for a license, or to renew an existing license, to deal in or manufacture explosives.
Explosives LicensesRequired Insurance (SH439)This form lists the acceptable proof of Workman’s Compensation and Disability Insurance.
Explosives LicensesHow to Apply To Deal in or Manufacture Explosives (SH861)Read this form to learn general information and instructions on how to apply for an Explosives License. This information is not valid in New York City.
Explosives LicensesExplosives Storage Information (SH51)You must have two completed copies of this form with your application for a new, or to renew an existing, explosives license.
Laser Registrations And NotificationsRegistration of Mobile Lasers and Laser Installations (SH280)Use this application to register mobile lasers and laser installations.
Laser Registrations And NotificationsNotice of Intent to Use Mobile Lasers at Temporary Job Site(s) (SH281)Use this form to notify the department of mobile laser displays at temporary sites.
Mobile Laser Operator Certificate Of CompetenceMobile Laser Operator Certificate of Compliance (CR50)This document has the text Part 50 of DOL regulations regarding mobile laser certificates of competence.
Mobile Laser Operator Certificate Of CompetenceOccupational Licensing and Certification Part 61 of Title 12 of the Official Compilation of Codes, Rules, and Regulations of the State of New York (Cited as NYCRR 61) (CR61)

This document contains SubParts:      

  • 61-1 General Provisions
  • 61-2 Special Provisions for Pyrotechnicians
  • 61-3 Special Provisions for Crane Operators
  • 61-4 Special Provisions for Blasters
  • 61-5 Special Provisions for Mobile Laser Operators
Mobile Laser Operator Certificate Of CompetenceApplication for a Laser Operator’s Certificate of Competence (SH275)Use this application to apply for a Mobile Laser Operator’s Certificate of Competence.
Mobile Laser Operator Certificate Of CompetenceInstructions to Complete Mobile Laser Operator Application (SH276)Instructions and information on applying for a Mobile Laser Operator Certificate of Competence.
Mobile Laser Operator Certificate Of CompetenceRequest for Photo ID Card (ID5 DOL)If you do not have a New York State Drivers License or non-driver ID you should use this form to request a photo ID from the New York State Department of Motor Vehicles.
Mold Training And Licensing ProgramLicensing of Mold Inspection, Assessment, and Remediation Specialists and Minimum Work Standards (SH120)This document contains the full text of Article 32 of the New York State Labor Law. It establishes licensing requirements and minimum work standards for professionals engaged in mold assessment and remediation.
Mold Training And Licensing ProgramApplication for approval or revision of a Mold safety Training Program (SH121)Use this form to apply for initial approval or revisions to a department-approved mold safety training program
Mold Training And Licensing ProgramNYS DOL Mold Training Course Guidance (SH122)This document details what must be submitted when developing or revising a mold training course outline or agenda for department approval.
Mold Training And Licensing ProgramNYS Mold Safety Training Program Primary Notification Form (SH123)  Use this form to submit notification of a scheduled approved mold safety training course.
Mold Training And Licensing ProgramMold Training Manuals and Curricula Guidance and Attestation (SH124)This form must be submitted with proposed manuals and curricula for NYSDOL mold training.
Mold Training And Licensing ProgramApplication for a Mold Assessment Contractor License (SH125)Use this application to apply for a Mold Assessor License or Renewal for a company. If you are applying for a license for an individual, use form SH 128.
Mold Training And Licensing ProgramMold Remediation Contractor License Application (SH126)Use this form to apply for a Mold Remediation Contractor License or renewal.
Mold Training And Licensing ProgramMold Abatement Worker License Application (SH127.1)    Use this form to apply for a Mold Abatement Worker License or renewal.
Mold Training And Licensing ProgramApplication for a Mold Supervisor License (SH127.2)Use this form to apply for a Mold Abatement Supervisor License or renewal.
Mold Training And Licensing ProgramApplication for a Mold Assessor License (SH128)Use this application to apply for a Mold Assessor License or Renewal for an individual.  If you are applying for a company license, use form SH125.
Mold Training And Licensing ProgramMold Initial Course Curriculums (SH129)This form has information about initial mold training courses.
Mold Training And Licensing ProgramMold Refresher Course Curriculum Information (SH130)This form has mold refresher course curriculum information.
Mold Training And Licensing ProgramMold Contractor Complaint Form (SH140)Use this form to register complaints against mold contractors.
Mold Training And Licensing ProgramMold Assessment and Remediation in New York State (P227)This factsheet provides a brief overview of how the Department of Labor helps with residential mold issues.
Mold Training And Licensing ProgramWhat to Expect When You Hire a Mold Assessor and Mold Remediation Contractor (P228)This factsheet goes over when property owners should hire mold professionals and what those mold professionals should do when working on a mold remediation project.
Public Employee Safety & Health Publications And FormsState OSHA Annual Report (SOAR) for Federal Fiscal Year 2015 (SOAR FFY 2015)    State OSHA Annual Report (SOAR) for Federal Fiscal Year 2015
 
Public Employee Safety & Health Publications And FormsState OSHA Annual Report (SOAR) for Federal Fiscal Year 2016 (SOAR FFY 2016)State OSHA Annual Report (SOAR) for Federal Fiscal Year 2016
Public Employee Safety & Health Publications And FormsPublic Employee Safety and Health Complaint (PESH7)Use this form to file a complaint with the New York State Department of Labor Public Employee Safety and Health Bureau.
Public Employee Safety & Health Publications And FormsPESH Permissible Exposure Limits (Part800.5)This document describes the limits on an employee’s exposure to certain chemicals and substances.
Public Employee Safety & Health Publications And FormsTitle 12 Official Compilation or Codes, Rules and Regulations of the State of NY (Part 801-805)Title 12 Official Compilation or Codes, Rules and Regulations of the State of NY.  Part 801, 802, 803, 804 and 805
Public Employee Safety & Health Publications And FormsCR 800.6 Public Employer Workplace Violence Prevention Programs (CR800.6)This document contains the complete text of Part 800.6 of the regulations of New York State.
Public Employee Safety & Health Publications And FormsCR 800.7 Emergency Escape and Self Rescue Ropes and System Components for Firefighters (CR800.7)This document contains the full text of Part 800.7 of the Regulations of State of New York.
Public Employee Safety & Health Publications And FormsCR 820 Toxic Substances (CR820)    NYS Right-to-Know law and regulation. This document contains the full text of Part 820 of the Regulations of State of New York and Article 28 of the New York State Labor Law. It gives the requirements for training employees on handling toxic substances.
Public Employee Safety & Health Publications And FormsPetition for a permanent variance or alternative compliance agreement (SH780)Use this form to apply for a variance from, or alternate agreement to comply with, a notice of violation.
Public Employee Safety & Health Publications And FormsLog of Work-Related Injuries and Illnesses Form (SH900)Log of Work Related Injuries and Illnesses Form
Public Employee Safety & Health Publications And FormsSummary of Work-Related Injuries – Sickness (SH900.1)Use this summary to report any work related injuries or sickness.
Public Employee Safety & Health Publications And FormsClosing Conference (SH904)This form provides information for those cases in which violations were found.
Public Employee Safety & Health Publications And FormsPetition for Modification of Abatement Date (SH971)Form to petition for a modification of an abatement date.
Public Employee Safety & Health Publications And FormsField Operation Manual (FOM)Provides guidance regarding some of the internal operations of PESH.
Public Employee Safety & Health Publications And FormsRespiratory Protection in Law Enforcement (P205)Describes the types of respiratory protection used in law enforcement as well as related safety issues.
Public Employee Safety & Health Publications And FormsLabor Law Information Relating to Public Employees (P208) 
Public Employee Safety & Health Publications And FormsHighway, Street & Bridge Construction (P211)Briefly describes available safety training for road construction workers.
Public Employee Safety & Health Publications And FormsFire Protection and Ambulance Services (P212)Briefly describes available safety training for fire protection and ambulance services.
Public Employee Safety & Health Publications And FormsRefuse Collection (P213)Briefly describes the hazards of refuse collection.
Public Employee Safety & Health Publications And FormsAssistance for Healthcare Facilities (P215)Explains the technical assistance and resources available to public sector healthcare facilities.
Public Employee Safety & Health Publications And FormsLockout/Tagout (P218)Explains OSHA standards on how to properly handle dangerous equipment.
Public Employee Safety & Health Publications And FormsNoise Protection at Work: Hearing Conservation Program (P219)Briefly describes workplace noise protection, testing, and training.
Public Employee Safety & Health Publications And FormsCalibration and Bump Testing of Portable Gas Monitors (P222)Details the importance of maintaining portable gas monitoring devices.
Public Employee Safety & Health Publications And FormsElectroshock Weapon Projectile: Bloodborne Hazard Advisory (P223)Explains the hazards and safety precautions involved in handling Tasers.
Public Employee Safety & Health Publications And FormsOccupational Exposure Associated with Fire Scene Overhaul (P226)Explains the hazards present and protection recommended during fire scene overhauls.
Public Employee Safety & Health Publications And FormsEmployee Rights and Responsibilities (P906)This form gives employees an understanding of how the NYS Public Employee Safety & Health Act of 1980 works for them.
Public Employee Safety & Health Publications And Formsকর্মীদের অধিকার ও দায়িত্বসমূহ নি উ ইয়র্ক স্টেটের সরকারি কর্মীর নি রাপত্তা এবং স্বাস্থ্য সংক্রান্ত আইন (P906BN Bengali)This form gives employees an understanding of how the NYS Public Employee Safety & Health Act of 1980 works for them. In Bengali.
Public Employee Safety & Health Publications And FormsEmployee Rights and Responsibilities (Chinese) (P906C)This form gives employees an understanding of how the NYS Public Employee Safety & Health Act of 1980 works for them. In Chinese.
Public Employee Safety & Health Publications And FormsEmployee Rights and Responsibilities (Haitian Creole) (P906HC)This form gives employees an understanding of how the NYS Public Employee Safety & Health Act of 1980 works for them. In Haitian Creole.
Public Employee Safety & Health Publications And FormsEmployee Rights and Responsibilities (Italian) (P906I)This form gives employees an understanding of how the NYS Public Employee Safety & Health Act of 1980 works for them. In Italian.
Public Employee Safety & Health Publications And FormsEmployee Rights and Responsibilities (Korean) (P906K)This form gives employees an understanding of how the NYS Public Employee Safety & Health Act of 1980 works for them. In Korean.
Public Employee Safety & Health Publications And FormsEmployee Rights and Responsibilities (Polish) (P906P)This form gives employees an understanding of how the NYS Public Employee Safety & Health Act of 1980 works for them. In Polish.
Public Employee Safety & Health Publications And FormsEmployee Rights and Responsibilities (Russian) (P906R)This form gives employees an understanding of how the NYS Public Employee Safety & Health Act of 1980 works for them. In Russian.
Public Employee Safety & Health Publications And FormsEmployee Rights and Responsibilities (Spanish) (P906S)This form gives employees an understanding of how the NYS Public Employee Safety & Health Act of 1980 works for them. In Spanish.
Public Employee Safety & Health Publications And FormsEmployer Rights and Responsibilities (P907)Gives employers a broad view of the features of the NYS PESH Act.
Public Employee Safety & Health Publications And Formsনিয়􀁅োগকর্তাদ ের অধিকার ও দায়ি ত্বসমূহ (P907BN Bengali)Gives employers a broad view of the features of the NYS PESH Act. In Bengali.
Public Employee Safety & Health Publications And FormsEmployer Rights and Responsibilities (Chinese) (P907C)Gives employers a broad view of the features of the NYS PESH Act. In Chinese.
Public Employee Safety & Health Publications And FormsEmployer Rights and Responsibilities (Haitian Creole) (P907HC)Gives employers a broad view of the features of the NYS PESH Act. In Haitian Creole.
Public Employee Safety & Health Publications And FormsEmployer Rights and Responsibilities (Italian) (P907I)Gives employers a broad view of the features of the NYS PESH Act. In Italian.    
Public Employee Safety & Health Publications And FormsEmployer Rights and Responsibilities (Korean) (P907K)Gives employers a broad view of the features of the NYS PESH Act. In Korean.
Public Employee Safety & Health Publications And FormsEmployer Rights and Responsibilities (Polish) (P907P)Gives employers a broad view of the features of the NYS PESH Act. In Polish.
Public Employee Safety & Health Publications And FormsEmployer Rights and Responsibilities (Russian) (P907R)Gives employers a broad view of the features of the NYS PESH Act. In Russian.
Public Employee Safety & Health Publications And FormsEmployer Rights and Responsibilities (Spanish) (P907S)Gives employers a broad view of the features of the NYS PESH Act. In Spanish.
PerformerAV-121 -- Applicable Variance for Aerial Performers flying over an audience (AV-121)Applicable variance for aerial performers flying over an audience.
PerformerAerial Act Location Notice (SH78)Use this form to notify the New York State Department of Labor of aerial acts. The form must be received at least 10 days before the first performance.
PyrotechnicianOccupational Licensing and Certification Part 61 of Title 12 of the Official Compilation of Codes, Rules, and Regulations of the State of New York (Cited as NYCRR 61) (CR61)

This document contains SubParts:      

  • 61-1 General Provisions
  • 61-2 Special Provisions for Pyrotechnicians
  • 61-3 Special Provisions for Crane Operators
  • 61-4 Special Provisions for Blasters
  • 61-5 Special Provisions for Mobile Laser Operators
PyrotechnicianFingerprint Screening Instructions (SH881)Fingerprinting instructions and information on who needs to be fingerprinted.
PyrotechnicianInstructions for Completing the Pyrotechnician’s Application (SH872)Information who should apply and how to apply for a Pyrotechnician Certificate of Competence.
PyrotechnicianRenewal Instructions for the Pyrotechnician Certificate of Competence (SH874)Information on how to renew your Pyrotechnician Certificate of Competence
PyrotechnicianApplication for a Pyrotechnician’s Certificate of Competence (SH870)You must have two signed copies with your application for a new or to replace an existing pyrotechnician application.
PyrotechnicianRequest for Photo ID Card (ID5DOL)    If you do not have a New York State Drivers License or non driver ID you should use this form to request a photo ID from the New York State Department of Motor Vehicles.
PyrotechnicianPyrotechnics Licensing (P220)A general overview of NYS pyrotechnics laws.
Window Cleaning EquipmentPetition for a Variance or Other Relief (SH751)Use this form to apply for relief from the provisions of CR 4 and CR 14.
Window Cleaning EquipmentApplication for Approval of Installation or Device (SH753) Use this form to request approval for an installation or device. Instructions and general information are on the back of the form.
Workplace Safety & Loss Prevention ProgramWorkplace Safety and Loss Prevention Program (CR59)Text of Part 59 New York State Department of Labor regulations.
Workplace Safety & Loss Prevention ProgramWorkplace Safety & Loss Prevention Incentive Program (Safety, Drug & Alcohol Prevention, and Return to Work Incentive Programs) (CR60)Text of Part 60 New York State Department of Labor regulations.
Workplace Safety & Loss Prevention ProgramApplication for Workplace Safety & Loss Prevention Consultant and Specialist Certifications and Renewals (SH890)Use this form to apply for a Workplace Safety & Loss Prevention Consultant and/or Specialist Certificate(s). Print, fill in and mail to the address provided.
Workplace Safety & Loss Prevention ProgramInformation on and Submittal Instructions for a Workplace Safety and Loss Prevention Consultant Certificate (SH891)Summary of requirements, application process and submittal instructions for the Workplace Safety and Loss Prevention Consultant Certificate.
Workplace Safety & Loss Prevention ProgramIndustrial Code Rule 59 - Consultant Report (SH899)Consultants must use this form to evaluate an employer's Safety program under the Mandatory Workplace Safety and Loss Prevention Program (ICR 59).  Fill out and submit to the employer.
Workplace Safety & Loss Prevention ProgramWorkplace Safety & Loss Prevention Incentive Program Safety Incentive Program - Section 1.13 Evaluation Report (SH926)Specialists should use this form to evaluate an employer's Safety program under the Workplace Safety and Loss Prevention Incentive Program (ICR 60).  Fill out and submit to the employer.
Workplace Safety & Loss Prevention ProgramWorkplace Safety & Loss Prevention Incentive Program Application for Approval (SH927)Employers should use this form to apply for a credit under the Workplace Safety and Loss Prevention Incentive Program (ICR 60).  Fill out and send to the address provided.
Workplace Safety & Loss Prevention ProgramWorkplace Safety & Loss Prevention Incentive Program Drug and Alcohol Prevention Program - Section 1.14 of ICR 60 Evaluation Report (SH928)Specialists should use this form to evaluate an employer's Drug and Alcohol Prevention program under the Workplace Safety and Loss Prevention Incentive Program (ICR 60).  Fill out and submit to the employer.
Workplace Safety & Loss Prevention ProgramWorkplace Safety & Loss Prevention Incentive Program Return to Work Program - Section 1.15 Evaluation Report (SH929)    Specialists should use this form to evaluate an employer's Return to Work program under the Workplace Safety and Loss Prevention Incentive Program (ICR 60).  Fill out and submit to the employer.
Workplace Safety & Loss Prevention ProgramWorkplace Safety and Loss Prevention Incentive Program Drug and Alcohol Prevention Program Annual Report (SH930)Employers must submit this report to receive incentive credit for the second and third years.
Workplace Safety & Loss Prevention ProgramWorkplace Safety and Loss Prevention Incentive Program Return to Work Program Annual Report (SH931)
 
Employers must submit this report to receive incentive credit for the second and third years.
Workplace Safety & Loss Prevention ProgramWorkplace Safety & Loss Prevention Incentive Program Safety Program Annual Report (SH932)Employers must submit this report to receive incentive credit for the second and third years.
Workplace Safety & Loss Prevention ProgramWorkplace Safety & Loss Prevention Incentive Program Employer Request for DOL Evaluation (SH934)Employers use this form request an evaluation by the Department of Labor. years.
Workplace Safety & Loss Prevention ProgramWorkplace Safety and Loss Prevention Incentive Program Appendix A (SH933)Use this to add further information to your application.
Workplace Safety & Loss Prevention ProgramWorkplace Safety & Loss Prevention Incentive Program Application for Approval Instructions (SH939)    Application for approval of a Workplace Safety & Loss Prevention Incentive Program form (SH 927) instructions.
Workplace Safety & Loss Prevention ProgramWorkplace Safety & Loss Prevention Incentive Program Evaluation Report Instructions (SH940)    

Instructions for filling out the following programs:

  • Safety Incentive Programs (SH 926)
  • Drug and Alcohol Prevention Programs (SH 927)
  • Return to Work Programs (SH 928)
Workplace Safety & Loss Prevention ProgramWorkplace Safety and Loss Prevention Incentive Program Employer Renewal Application (SH941)Submit this application with an annual report to the Department of Labor.