➨

Fillable Nyc Dep Noise Mitigation Plan Form in PDF

The NYC Department of Environmental Protection (DEP) Construction Noise Mitigation Plan form is a crucial document designed to help manage and reduce noise pollution during construction activities in New York City. While it does not need to be filed with the DEP, it must be accessible to inspectors at the construction site. This plan outlines the responsibilities of the construction team and details the measures taken to mitigate noise, ensuring compliance with local regulations.

Access This Form Online

Access This Form Online

Article Guide

The NYC Department of Environmental Protection (DEP) has established a Construction Noise Mitigation Plan form designed to help manage and reduce noise during construction activities. This form is essential for ensuring that construction projects comply with local noise regulations. While it does not need to be filed with the DEP, it must be posted at the construction site and made accessible to inspectors. The responsible party must provide accurate information about the project, including the work site location, contact details, and the approximate distance to the nearest noise receptor. The form also requires a detailed timeline for various construction phases, such as demolition, excavation, and finishing work. Additionally, it includes a checklist of construction devices to be used, allowing for the identification of quieter alternatives that may mitigate noise. If specific devices are used, the form outlines whether noise barriers are necessary. Ultimately, this plan serves as a proactive measure to balance construction needs with community peace, reflecting the city's commitment to environmental compliance and public well-being.

Preview - Nyc Dep Noise Mitigation Plan Form

THE CITY OF NEW YORK	Construction Noise Mitigation Plan
DEPARTMENT OF ENVIRONMENTAL PROTECTION	Rev 04/2023
DEPARTMENT OF ENVIRONMENTAL PROTECTION
Bureau of Environmental Compliance
59-17 Junction Boulevard, 9th Floor, Flushing, New York 11373
Records Control (718) 595–3855
CONSTRUCTION NOISE MITIGATION PLAN

MUST PRINT AND POST ON WORKSITE

The responsible party shall be liable for the accuracy of the document and compliance with all applicable rules in Title 15 Rules of the City of New York - RCNY Chapter 28.

CONTACT INFORMATION

NAME OF RESPONSIBLE PARTY AS DEFINED IN TITLE 15 RCNY §28-109 EMAIL

PHONE NUMBER

WORK SITE ADDRESS

BUSINESS ADDRESS

CITY

STATE

ZIP

BOROUGH

BLOCK LOT

CONSTRUCTION INFORMATION

Approximate Distance to Closest Receptor (defined in Title 15 RCNY §28-109)

NORMAL WORK HOURS (AS DEFINED IN NYC ADMINISTRATIVE CODE §24-222)

Do you anticipate having to work at any time other than 7am to 6pm Monday to Friday?

A. ______________________ feet		 YES  NO

B. ______________________ feet	If YES, please fill out Construction Alternative Noise Mitigation form and explain what phase[s] do you
C. ______________________ feet	anticipate needing an After Hour Variance:
	 Demolition	 Excavation	 Foundation
D. ______________________ feet
	 Superstructure	 Finishing

Other_________________________________________________________________

	PHASES AND DURATION DATES			NYC DEP DEMOLITION REGISTRATION #			NYC DOT DEMOLITION PERMIT #		NYC DOB PERMIT NUMBERS
	Demolition	From	To					WORK		DEMOLITION
	Demolition
PHASE
	Excavation	From	To	Estimated Depth of Excavation:
	Excavation			SOIL _______________ FEET + BEDROCK _______________ FEET = TOTAL					0		FEET
									0		FEET

CONSTRUCTION	Foundation	From	To	Pumping Operation:			If YES,
	Foundation			 YES  NO			NUMBER OF INDIVIDUAL TRUCKS __________________________ PER HOUR
	Superstructure	From	To	Number of Floors / Stories:	Describe How	Flooring Will Be Laid:
	Superstructure				 CONCRETE PUMP  PREFAB  OTHER: __________________________________

	Finishing	From	To	COMPLETED EXTERIOR BEFORE BEGINNING INTERIOR WORK
	Finishing			COMPLETED EXTERIOR BEFORE BEGINNING INTERIOR WORK
				INTERIOR WORK BEFORE EXTERIOR WALLS / WINDOWS ARE IN.
	Other	From	To	Explain:
	Other

Page 1 of 3

CONSTRUCTION DEVICES

List of §102 construction devices to be used at the site. When the additional devices listed below each category are utilized, the use of barriers as set forth in section IV herein is not required unless the NYC Department of Environmental Protection receives complaints as set forth in §28-102(C) of Title 15 of the RCNY for each device. If however, the specific devices listed below each main category of devices are not checked, and you are using any of the main devices listed below, then the use of barriers set forth in Section IV herein shall be utilized. However, if you specified “other” in a category, you shall be required to utilize barriers as set forth in Section IV herein.

DEVICE

PILE

JACKHAMMERS

HOE RAMS

BLASTING

VACUUM

DUMP

CRANES

CONCRETE

SANDBLASTING

AUGER DRILL

OTHER

_____________:

DRIVERS

EXCAVATORS

TRUCKS

SAWS

EQUIPMENT

RIGS



FOR:

 Demolition

 Excavation

 Foundation

USED

 Superstructure

 Finishing

 Other (Explain):

PHASE

MAKE (s)

 Vibratory Pile

 Quieter makes and

 Blast Mats

 Smaller Capacity

 US Made European

 Modern Hydraulic

Driver or Hydraulic

models as defined in

vac-truck as defined in

Environmental Label

Crane as defined in

Impact Pile Driver as

102(a)(2)(B)(i)

102(a)(3)(B)(i)

102(b)(1)(B)(i)

equipment or equivalent

102(d)(1)(B)(ii)

defined in

 Other (Explain):

 Noise Shroud as

 Silencer as defined

as defined in

 US Made European

DETAIL

102(a)(1)(B)(ii)

defined in

in 102(b)(1)(B)(iii)

102(c)(1)(B)(iii)

Environmental Label

 Noise Bellows as

102(a)(3)(B)(iii)

 Other (Explain):

equipment or equivalent

defined in

 Other (Explain):

as defined in

102(a)(1)(B)(viii)

102(d)(B)(1)(iii)

 Other (Explain):

FUEL TYPE

MAXIMUM NUMBER OF UNIT TO BE USED AT THE

SAME TIME:

ADDITIONAL CONSTRUCTION DEVICES

List of additional applicable construction devices to be used at the site:

 GENERATORS

 COMPRESSORS

 STREET PLATES  BACKUP ALARMS

 PUMPS

 HOIST

NOISE MITIGATION

Required to use Perimeter barrier /DOB construction fence or temporary/moveable barrier:

Noise Mitigation Barriers Utilized: If required as set forth in §28-101(g) of Title 15 of the RCNY.

YES

 NO

PILE

JACKHAMMERS

HOE RAMS

BLASTING

VACUUM

DUMP

CRANES

CONCRETE

STREET

AUGER DRILL

BACKUP

DRIVERS

EXCAVATORS

TRUCKS

SAWS

PLATES

RIGS

ALARMS



 Perimeter

 Perimeter barrier/DOB

 Perimeter

barrier/DOB

Construction Fence

barrier/DOB

Construction Fence

 Temporary barrier

Construction Fence

 Temporary barrier

 Moveable barrier

 Temporary barrier

 Moveable barrier

Page 2 of 3

CHECK ALL THAT APPLY

Please check all equipment that will be used on site. Review Rules for Citywide Construction Noise Mitigation Section 28-109. Certify that equipment has been sound tested and complies with Spec 721.560 Lmax @50 ft.

	LabelID	Equipment Description		LabelID	Equipment Description		LabelID	Equipment Description
	A	All Other Equipment > 5 HP		T	Excavator		AM	Refrigerator Unit
	B	Auger Drill Rig		U	Flat Bed Truck		AN	Rivet Buster / Chipping Gun

	C	Backhoe		V	Front End Loader		AO	Rock Drill

	D	Bar Bender		W	Generator		AP	Roller

	E	Blasting		X	Generator (<25KVA, VMS signs)		AQ	Sand Blasting
	F	Boring Jack Power Unit		Y	Gradall		AR	Scrapper

	G	Chain Saw		Z	Grader		AS	Shears (on backhoe)

	H	Clam Shovel (dropping)		AA	Grapple (on backhoe)		AT	Slurry Plant

	I	Compactor (ground)		AB	Horizontal Boring Hydr. Jack		AU	Slurry Trenching Machine
	J	Compressor (air)		AC	Hydra Break Ram		AV	Soil Mix Drill Rig

	K	Concrete Batch Plant		AD	Impact Pile Driver		AW	Tractor

	L	Concrete Mixer Truck		AE	Jackhammer		AX	Vacuum Excavator (Vac-truck)

	M	Concrete Pump Truck		AF	Man Lift		AY	Vacuum Street Sweeper
	N	Concrete Saw		AG	Mounted Impact Hammer (hoe ram)		AZ	Ventilation Fan

	O	Crane		AH	Pavement Scarafier		BA	Vibrating Hopper

	P	Dozer		AI	Paver		BB	Vibratory Concrete Mixer

	Q	Drill Rig Truck		AJ	Pickup Truck		BC	Vibratory Pile Driver
	R	Drum Mixer		AK	Pneumatic Tools		BD	Warning Horn

	S	Dump Truck		AL	Pumps		BE	Water Jet Deleading
							BF	Welder / Torch

Note: DEP will utilize the Federal Highway Administration Roadway Construction Model as a means of identifying equipment either in Section II or III, that may be the cause of a noise complaint, see §28-101(a) of Title 15 of the RCNY for compliance options.

By checking this box, I certify that the information contained in this form is true and accurate.

NAME

COMPANY

DATE

BUSINESS ADDRESS

CITY

STATE

ZIP

Page 3 of 3

Get Nyc Dep Noise Mitigation Plan PDF Form

Form Characteristics

Fact Name	Details
Governing Authority	This form is governed by Title 15 of the Rules of the City of New York, specifically Chapter 28.
Submission Requirement	It is not necessary to file the Construction Noise Mitigation Plan with the Department of Environmental Protection (DEP).
Posting Requirement	The plan must be posted on site or made accessible to inspectors at all times.
Responsible Party	The responsible party is liable for the accuracy of the document and compliance with applicable rules.
Work Site Information	Details required include the work site location, contact information, and approximate distance to the closest receptor.
Construction Phases	The form outlines various construction phases, such as demolition, excavation, and finishing, with specific date ranges.
Noise Mitigation Devices	Users must check applicable noise mitigation devices being utilized, including pile drivers and jackhammers.
Certification	The responsible party must certify the accuracy of the information by signing the form, which also requires a notary public.

Please rate Fillable Nyc Dep Noise Mitigation Plan Form in PDF Form

4.79

Perfect

19 Votes

More PDF Templates

Ny State Tax Forms - It captures a range of revenue sources, including passenger, freight, and miscellaneous transportation revenue for tax purposes.

Does Ny Tax Social Security and Pensions - It includes sections for reporting taxable interest income and ordinary dividends.