DATE Fax _ 518-719-3297 APPLICATION FOR A MASTER CLASS B by runout

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									                        BOARD OF ELECTRICAL EXAMINERS
                         OF THE COUNTY OF GREENE, NY
                                   PO BOX 55
                              CATSKILL, NY 12414

DATE ___________________________________                                            Fax # 518-719-3297

           APPLICATION FOR A MASTER CLASS "B" ELECTRICIAN'S LICENSE

YOU MUST MARK BELOW WHICH APPLIES TO THIS APPLICATION

RESIDENTIAL____                    COMMERCIAL/INDUSTRIAL____                UNDER 5000 SQUARE FEET____

                                                                              OVER 5000 SQUARE FEET____

ELECTRICIANS NAME ______________________________________________________________

MAILING ADDRESS ________________________________________________________________

TOWN/VILLAGE__________________________________ STATE______________ZIP___________

COUNTY_______________________TELEPHONE NUMBER___________________________________

YOU MUST INCLUDE THE FOLLOWING:

      1.     OWNER:______________________________________________________________

               LOCATION OF JOB:____________________________________________________

               CITY/STATE/ZIP           ____________________________________________________

      2.     Brief description of Scope of Work: __________________________________

               ____________________________________________________________________

      3.    RESIDENTIAL - ONE HUNDRED FIFTY DOLLAR ($150.00) LICENSE FEE
            COMMERCIAL/INDUSTRIAL - ONE HUNDRED FIFTY DOLLAR ($150.00) LICENSE FEE
                   FOR UNDER 5000 SQUARE FEET.
            FIVE HUNDRED DOLLAR ($500.00) LICENSE FEE FOR OVER 5000 SQUARE FEET

      4.    A CURRENT CERTIFICATE OF LIABILITY INSURANCE IN THE AMOUNT OF $500,000
            WITH GREENE COUNTY BOARD OF ELECTRICAL EXAMINERS NAMED AS CERTIFICATE HOLDER.

      5.    One of the following Workers’ Compensation forms
               CE-200, C-105.2, SI-12, U-26.3, GSI-105.2

      6.    One of the following Disability Benefits Workers’ Compensation forms.
               CE-200, DB-120.1, DB-155

      7.    PHOTOSTAT OF PRESENT ACTIVE MASTER ELECTRICIAN LICENSE

      8.    LETTER FROM YOUR LICENSING BOARD STATING THAT THEY RECIPROCATE AND THAT
             YOU ARE IN GOOD STANDING AT THE TIME OF THIS APPLICATION

      9.    LEGAL SIZE SELF ADDRESSED STAMPED ENVELOPE.


APPLICANT’S SIGNATURE______________________________________________________
REVISED 12/01/08
                 BOARD OF ELECTRICAL EXAMINERS
                  OF THE COUNTY OF GREENE, NY
                            PO BOX 55
                       CATSKILL, NY 12414


                        C O U N T Y    O F   G R E E N E

                       LOCAL LAW NO. 2 OF THE YEAR 1988

                           ADOPTED MARCH 16, 1988

                      LOCAL LAW ON EXAMINATION, LICENSING

                        AND REGULATION OF ELECTRICIANS




SECTION 21. VIOLATIONS AND PENALTIES

1.   Any person who shall directly or indirectly engage in or work a the business of
Master Electrician, Special Electrician and Homeowner Electrician in the County of
Greene without the applicable license or who, having had his license suspended or
revoked, shall continue to engage in or work at the business shall be guilty of a class
“A” misdemeanor and upon conviction thereof shall be punishable by a fine of not less
than five hundred dollars ($500.00) nor more than one thousand dollars ($1,000.00) or
imprisonment for a period not exceeding one (1) year, or by both fine and imprisonment.
                 BOARD OF ELECTRICAL EXAMINERS
                  OF THE COUNTY OF GREENE, NY
                            PO BOX 55
                       CATSKILL, NY 12414




MEMO TO:    All parties that reciprocate with Greene County – B Permits Electrical

FROM:       Earl D. Snell, Chairman – Board of Electrical Examiners

SUBJECT:    $500.00 fine for starting work before obtaining B Permit for same.


Please be advised that the following addition has been made to Section F – Fees#3.
Fine Imposed of Greene County Electricians Licensing Rules: Fine imposed for starting
work before obtaining B Permit shall be $500.00 plus fee for Permit.


If you have any questions please feel free to call 518-719-3261.

								
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