Fillable Design Professional/Licensee Form Seal and Signature Form For (City of New York)

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Design Professional/Licensee Form Seal and Signature Form For (City of New York)

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Design Professional Seal and Signature Form for
DOB NOW: Build
(DP-1 Form)
June 2016
2 Seal and Signature Statement
By personally sealing and signing this document and then submitting a scanned copy to the Department of Buildings, I intend for the image of this seal
and signature to be used as my official professional seal and signature where I so indicate in electronic documents to be submitted to the Department
of Buildings.
This form shall expire one year from the date signed and sealed below.
Last Name First Name Middle Initial
Business Name Business Telephone
Business Address Business Fax
City State Zip Mobile Telephone
E-Mail
License Number (for
existing licensees only)
Choose one: Electrical Contractor
Gas Work Qualification Only*
Journeyman Fire Suppression Contractor*
Journeyman Plumber*
Master Fire Suppression Contractor
Master Plumber
Oil Burner Installer
Professional Engineer
Registered Architect
Registered Landscape Architect
Welder*
1 Personal Information Required for all applications filed in DOB NOW
Affix seal and signature in accordance with all regulations
applicable when applying signature and seal to official
documents filed with the Department of Buildings.
*Seal not required (signature only).
Name (printed) Date
November 2018
Design Professional/Licensee Form Seal and
Signature Form For DOB NOW (DPL-1 Form)
*NO seal is required for the Journeyman, Gas Qualification and Welder trades .
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Design ProfessionalLicensee Form Seal and Signature Form For (City of New York)

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Completed 6 June 2021

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