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The New York 1481 form is an essential application for individuals aspiring to become Code Compliance Technicians in the state of New York. This form plays a crucial role in the certification process, ensuring that candidates meet the necessary training and educational requirements. It requires applicants to provide personal information, such as their name, date of birth, and contact details, alongside their training history. Specifically, applicants must list completed courses related to code enforcement, including the Code Compliance Technician course and other relevant training modules. To streamline the application process, it’s important to attach any certificates from courses taken within the last six months. Additionally, the form must be endorsed by a fire chief or a top-ranking municipal official, confirming the applicant's assignment to the role of Code Compliance Technician. This collaborative approach not only verifies the qualifications of the candidate but also underscores the importance of teamwork in maintaining safety and compliance within communities.

Preview - New York 1481 Form

State of New York

Firefighting and Code Enforcement Personnel

Standards and Education Commission

Code Compliance Technician - Application

PLEASE PRINT OR TYPE

NAME (LAST, FIRST, MI)

STUDENT TRAINING ID NUMBER

DATE OF BIRTH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Y

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOME ADDRESS (STREET, PO BOX)

DAYTIME PHONE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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CITY

 

 

 

 

STATE

ZIP

NIGHTTIME PHONE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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DATE OF APPLICATION

 

DATE OF APPOINTMENT

FIRE DEPARTMENT NAME

 

 

 

 

FIRE DEPARTMENT CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Course Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Completion Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Code Compliance Technician (9G), or

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Introduction to Code Enforcement Practices I (9A) and

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Introduction to Code Enforcement Practices II (9B) and

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Inspection Procedures for Existing Structures (9C)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

To facilitate your application, please include copies of any certificates for courses taken within the last six months.

I affirm that I have completed the courses as shown.

SIGNATUREDATE

To be completed by fire chief, fire commissioner or top ranking municipal official.

I, __________________________________________________, do hereby assign this individual to perform the duties of

PRINT NAME

Code Compliance Technician for __________________________________________________.

JURISDICTION

RETURN TO:

 

 

 

 

SIGNATURE

DATE

STANDARDS UNIT

 

 

 

 

NYS DHSES

 

 

 

 

RANK OR TITLE

 

 

Ofice of Fire Prevention and Control

 

 

 

 

1220 Washington Avenue

 

 

 

 

NAME OF FIRE DEPARTMENT OR MUNICIPALITY

 

 

RETURN TO:

 

 

Building 7A, Floor 2

 

 

 

 

Standards Unit

 

 

 

 

Albany NY 12242

 

 

 

 

NYS Division of Homeland Security and Emergency Services

 

 

(518) 474-6746

 

 

 

 

Office of Fire Prevention and Control

 

 

 

 

99 Washington Ave, Suite 500

 

 

 

 

Albany, NY 12210-2833

 

 

 

 

(518) 474-6746

 

 

1481 (Rev. 1/04)

Additional copies of this application are available on the web at www.dhses.ny.gov/ofpc/training/fire-academy/certifications.cfm

Form Characteristics

Fact Name Description
Purpose The New York 1481 form is used to apply for the position of Code Compliance Technician.
Governing Laws This form is governed by the New York State Firefighting and Code Enforcement Personnel Standards and Education Commission regulations.
Required Information Applicants must provide personal information, including their name, training ID number, and contact details.
Course Completion Proof of course completion is necessary. Applicants should attach certificates for relevant courses taken within the last six months.
Submission Details The completed form must be returned to the Standards Unit of the NYS Division of Homeland Security and Emergency Services.
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