Free Dlt L 59 Form Access This Document Now

Free Dlt L 59 Form

The DLT L 59 form is an application required by the Rhode Island Department of Labor and Training for obtaining a permit to install a boiler. This form must be completed by the installer before the installation begins and submitted along with the necessary installation fee and boiler drawings. To ensure compliance with state regulations, it is crucial to fill out this form accurately and completely.

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The DLT L 59 form is a crucial document for anyone involved in the installation of boilers in Rhode Island. This application, issued by the Department of Labor and Training’s Division of Occupational Safety, must be completed by the installer before any boiler installation takes place. It serves multiple purposes, including providing essential information about the boiler, the installer, and the intended installation site. The form requires details such as the manufacturer, model, and specifications of the boiler, as well as the installation date and location. Additionally, it asks for confirmation that the boiler room meets all necessary code requirements, including proper ventilation and clearance around the boiler. Accompanying the application, the installer must submit boiler drawings and pay the required installation fee, which varies depending on whether the unit is classified as high or low pressure. By signing the form, the installer certifies compliance with state laws governing boiler installations, acknowledging the potential penalties for non-compliance. This form is not just a bureaucratic step; it plays a vital role in ensuring safety and regulatory adherence in boiler installations throughout the state.

How to Use Dlt L 59

Filling out the DLT L 59 form is a crucial step in obtaining the necessary permit for boiler installation. Once completed, the form must be submitted along with the required installation fee and any accompanying drawings to the Rhode Island Department of Labor and Training. Below are the steps to guide you through the process of filling out the form accurately.

  1. Owner/User Information: Enter the name of the owner or user of the boiler. Provide the address and telephone number of the owner/user.
  2. Installer Information: Fill in the name of the installer, along with their address and telephone number.
  3. Approximate Installation Date: Indicate the expected date for the boiler installation.
  4. Location: Specify the location where the boiler will be installed.
  5. Boiler Details:
    • Manufactured By: Write the name of the manufacturer.
    • Type of Boiler: Check whether it is a steam boiler or circulating hot water (H.W.) boiler.
    • Condition: Indicate if the boiler is new or used.
    • Year Manufactured: Enter the year the boiler was made.
    • NB Number and Manufacturer Serial Number: Fill in these numbers as applicable.
    • Construction Type: Specify if it is steel, watertube, or firetube.
    • Hot Water Tank: If applicable, indicate this as well.
    • Maximum Allowable Working Pressure (MAWP): Enter the pressure in PSI.
    • Minimum Safety Valve Relief Capacity: Provide the relevant details.
    • Heat Input: Specify in BTU/Hour.
    • Steam Generating Capacity: Indicate in LB/Hour.
    • Water Heating Capacity: Enter in BTU/LB/Hour.
  6. Safety Appurtenances Included: List any safety features included with the boiler, such as Firomatic Switch, Low Water Cut Off (L.W.C.O.) Safety Valve(s), and Remote Switch.
  7. Boiler Room Information: Indicate whether the boiler room is new or existing.
  8. Code Compliance: Answer whether the boiler room meets all code requirements by checking "Yes" or "No." If "No," provide comments explaining the deficiencies.
  9. Installation Fee: Calculate the installation fee based on the type of boiler: $300 for high-pressure units or $120 for low-pressure units.
  10. Certification: Sign and date the certification statement, acknowledging compliance with state laws regarding boiler installations.

After completing the form, ensure that all required documents and the payment are included before sending it to the appropriate address. This will help facilitate the approval process for your boiler installation permit.

Documents used along the form

The DLT L 59 form is essential for obtaining a permit to install a boiler in Rhode Island. Along with this form, several other documents are commonly required to ensure compliance with safety regulations and installation standards. Below is a list of these documents, each serving a specific purpose in the installation process.

  • Boiler Drawings: Detailed plans of the boiler installation must accompany the DLT L 59 form. These drawings illustrate the layout, dimensions, and specifications of the boiler system, ensuring that it meets local codes and safety standards.
  • Installation Fee Receipt: Proof of payment for the installation fee is required. This receipt confirms that the installer has paid the necessary fees associated with the permit application.
  • Lease Agreement Form: This document is essential to clearly outline the terms and conditions between a landlord and tenant, providing a legal framework for rental agreements. For more information, you can visit smarttemplates.net.
  • Manufacturer's Specifications: Documentation from the boiler manufacturer provides essential information about the boiler's capabilities and safety features. This includes details on the model, safety ratings, and installation requirements.
  • Inspection Reports: If applicable, previous inspection reports may be needed to verify that the installation site meets safety standards. These reports can provide insight into any past issues or necessary improvements.
  • Licenses and Certifications: Installers must submit copies of relevant licenses and certifications. This documentation ensures that the individuals performing the installation are qualified and authorized to do so.
  • Insurance Documentation: Proof of insurance coverage is often required. This documentation protects both the installer and the property owner in case of accidents or damages during the installation process.

Gathering these documents along with the DLT L 59 form is crucial for a smooth installation process. Ensuring all paperwork is complete can help avoid delays and potential compliance issues with local regulations.

Crucial Queries on Dlt L 59

What is the DLT L 59 form used for?

The DLT L 59 form is an application for a permit to install a boiler in the state of Rhode Island. It must be completed by the installer prior to the installation and submitted to the Department of Labor and Training, along with the required installation fee and boiler drawings.

Who needs to fill out the DLT L 59 form?

The form must be filled out by the installer of the boiler. This includes providing details about the owner/user, the installation location, and specifications of the boiler being installed.

What information is required on the DLT L 59 form?

The form requires several pieces of information, including the owner/user’s name and contact details, the installer’s information, the approximate installation date, and the boiler’s specifications, such as the manufacturer, serial number, and safety appurtenances included.

Are there fees associated with submitting the DLT L 59 form?

Yes, there are fees associated with the permit application. The fee is $300 for each high-pressure boiler unit and $120 for each low-pressure unit. This fee must accompany the completed form when submitted.

What are the safety requirements for the boiler room?

The boiler room must meet specific code requirements, including proper ventilation and maintaining a three-foot clearance on all sides and above the boiler. If the boiler room does not meet these requirements, an explanation should be provided in the comments section of the form.

What happens if the installation does not comply with state laws?

Failure to adhere to state laws regarding boiler installations can result in serious consequences. These may include fines of up to $500 and imprisonment for up to three months, as outlined in Rhode Island General Laws.

How can I ensure my application is approved?

To increase the chances of approval, ensure that all sections of the DLT L 59 form are completed accurately. Include all necessary documentation, such as boiler drawings, and confirm that the boiler room meets all code requirements before submission.

Where do I send the completed DLT L 59 form?

The completed form should be sent to the Department of Labor and Training, Division of Occupational Safety, at 1511 Pontiac Avenue, P.O. Box 20157, Cranston, RI 02920-0942. Make sure to include the installation fee and any required drawings.

Dos and Don'ts

When filling out the DLT L 59 form, it’s important to follow specific guidelines to ensure accuracy and compliance. Here are eight things you should and shouldn't do:

  • Do provide complete and accurate information in all fields.
  • Do include boiler drawings with your application.
  • Do verify that the boiler room meets all code requirements.
  • Do ensure that the correct installation fee is included with the application.
  • Don't leave any sections blank; fill in all required fields.
  • Don't submit the form without checking for errors or omissions.
  • Don't ignore the certification statement; it must be signed by the installer.
  • Don't forget to provide your contact information for follow-up questions.

Key takeaways

Here are key takeaways regarding the DLT L 59 form:

  1. The DLT L 59 form is required for applying for a permit to install a boiler in Rhode Island.
  2. It must be completed by the installer before the installation of the boiler.
  3. The completed form should be sent to the Department of Labor and Training along with the installation fee.
  4. Boiler drawings must accompany the application when it is submitted.
  5. Information required includes details about the owner/user, installer, and the boiler itself.
  6. Applicants must indicate whether the boiler is new or used and provide the year of manufacture.
  7. Safety appurtenances, such as safety valves and switches, must be specified on the form.
  8. The form requires confirmation that the boiler room meets all relevant code requirements.
  9. Failure to comply with state laws regarding boiler installations can result in fines or imprisonment.
  10. The application must include a certification from the installer, affirming compliance with state laws.

Document Preview Example

DLT-L-59 (Rev. 10/2002)

STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS

Department of Labor and Training - Division of Occupational Safety

1511 Pontiac Avenue, P. O. Box 20157 Cranston, RI 02920-0942

(401) 462-8570 | www.dlt.ri.gov/occusafe/boiler.htm

BOILER UNIT

Benjamin P.Anthony Chief Inspector

Application for Permit to Install BoilerS

PERMIT #

TO BE COMPLETED BY INSTALLER PRIOR TO BOILER INSTALLATION, THEN FORWARDED TO ABOVE ADDRESS ACCOMPANIED BY INSTALLATION FEE.* BOILER DRAWINGS MUST ACOMPANY THIS APPLICATION.

1. Owner/User:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Installer:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tel. No.:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tel. No.:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Approx. Installation Date:

 

 

 

 

 

 

 

 

 

 

 

Location:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. BOILER Manufactured By:

 

 

 

 

 

 

 

 

 

 

 

Steam:

 

 

 

 

 

Circulating H.W.:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

New:

 

 

Used:

 

 

 

 

 

Yr. Manuf.

 

 

 

 

 

 

NB#

 

 

 

 

 

Manuf. Ser. No.

 

 

 

 

 

 

C. I.:

 

 

 

Steel:

 

 

 

 

 

Watertube:

 

 

 

 

 

 

Firetube:

 

 

 

 

 

H.W. Tank:

 

 

 

 

 

 

 

 

 

 

 

MAWP:

 

 

 

 

 

 

 

 

 

 

 

PSI

 

 

 

 

 

 

 

Min. Safety Valve Rel. Cap.

 

 

 

 

 

 

 

 

 

 

 

 

Heat Input:

 

 

 

 

 

 

BTU/Hour:

 

 

 

Steam Generating Capacity:

 

 

 

LB/Hour

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Water Heating Capacity:

 

 

 

 

 

 

BTU/LB/Hour:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. SAFETY APPURTENANCES INCLUDED:

 

 

Firomatic Switch:

 

 

 

 

 

 

L.W. C. O.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Safety Valve(s):

 

 

 

 

 

Remote Switch:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4. BOILER ROOM:

 

 

 

 

 

 

 

 

 

New:

 

 

 

 

 

 

Existing:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5. Does Boiler Room meet all code requirements?

 

 

 

 

 

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ex. (a) Proper ventilation:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(b)Three (3) foot clearances on all sides and top of boiler(s) and aceiling or piping for boilers with manholes.

(If no, use comment space at bottom to explain.)

 

 

 

 

* Each High Pressure Unit $300.00

Pipefitter Master I License Number:

 

Each Low Pressure Unit $120.00

 

 

 

CERTIFICATION

I,

 

certify that the boiler mentioned above will be installed in compliance with all state

law pertaining to boiler installations. I also recognize that failure to adhere to said state laws may result in a fine of up to $500.00 and imprisionment of up to 3 months or both, as set forth in 28-25-10 of the Rhode Island General Laws.

STATE OF RHODE ISLAND

DEPT. OF LABOR & TRAINING

BOILER UNIT

Date:

Amount:

Receipt #:

Check #:

PERMIT APPROVED BY:

INSTALLATION APPROVED BY:

DATE:

IF INSURED, BY WHOM:

COMMENTS:

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Misconceptions

Here are four common misconceptions about the DLT L 59 form:

  • Only licensed professionals can submit the form. Many believe that only licensed installers can fill out and submit the DLT L 59 form. However, the form can be completed by the owner or user, as long as they provide accurate information.
  • The form is only for new boiler installations. Some think that the DLT L 59 is only necessary for new boilers. In reality, it is also required for used boilers and any modifications made to existing systems.
  • Submission of the form guarantees permit approval. There is a misconception that submitting the DLT L 59 form automatically means the permit will be approved. Approval depends on meeting all safety and code requirements, which are assessed after submission.
  • Boiler drawings are optional. Many people assume that boiler drawings can be skipped. In fact, the application must include detailed drawings of the boiler installation for it to be considered complete.