Article Guide
The NYC Lic 60 form is a crucial document for individuals seeking to obtain or renew a welder's license in New York City. This form is specifically designed to ensure that all applicants undergo a comprehensive visual acuity examination, which is essential for maintaining safety standards in welding operations. To be eligible, applicants must have their eye examination conducted within one year prior to submitting their application. A qualified professional, such as an ophthalmologist, optometrist, medical doctor, registered nurse, or certified physician’s assistant, must perform the eye exam. The results must demonstrate that the applicant meets the near vision acuity requirement of Jaeger J2 at a distance of 12 inches or more. Incomplete forms or results that do not meet the specified standards will not be accepted by the Department of Buildings. Therefore, it is vital for applicants to ensure that all sections of the form are filled out accurately and that they keep a copy for their records. The Lic 60 form not only streamlines the application process but also plays a significant role in ensuring that welders can perform their duties safely and effectively.
Preview - Nyc Lic 60 Form
VISUAL ACUITY EXAMINATION FORM
Instructions
Applicants: This form must be submitted for all welder original and renewal applications.
Be sure to keep a copy of this form for your records. Your application for an original or renewal license will not be accepted unless a completed Visual Acuity Examination Form is submitted.
The examination must occur and this form must be completed 1 year (12 months) prior to the date of application for an original or renewal welder license. One of the following is required to administer the eye examination: Ophthalmologist, Optometrist, Medical Doctor, Registered Nurse or Certified Physician’s Assistant.
All applicants must pass an eye examination, with or without corrective lenses, to prove near vision acuity on Jaeger J2 at 12 inches or greater (≥30.5 cm). Examination results must be documented on this form and submitted with your appli- cation.
The Department of Buildings will not accept forms that are incomplete or test results that do not comply with fitness requirements.
1
Applicant/ Licensee Information
|
Application Type: |
Original Welder License |
Renewal Welder License |
|
|
|
|
|
First Name |
|
Last Name |
|
|
|
|
|
License # |
|
|
|
|
|
|
THE FOLLOWING TWO SECTIONS ARE TO BE COMPLETED BY THE EYE EXAMINER
2
Vision Acuity
|
|
Please verify the applicant’s near vision acuity to Jaeger J2 specifications at a distance of |
|
|
12 inches or greater (≥30.5 cm): (please check one of the following) |
|
|
|
|
___ |
Both eyes require corrected vision to J2 |
|
|
|
|
___ |
Only one eye needs corrected vision to J2 |
|
|
|
|
___ |
No correction is required. |
|
|
|
3
Examiner
|
Applicants Name |
|
|
|
Date of Eye Examination |
||
|
|
|
|
|
|
|
|
|
Examiner Name |
|
|
|
Telephone Number |
||
|
|
|
|
|
|
|
|
|
Examiner Address |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
City |
|
State |
|
|
|
Zip |
|
|
|
|
|
|
|
|
|
Examiner Professional Status (please select only one) : |
|
|
|
|
||
|
|
|
|
|
|
|
|
|
Ophthalmologist |
Optometrist |
Medical Doctor |
Registered Nurse |
|
Certified Physician’s Assistant |
|
|
|
|
|
|
|
|
|
|
Examiner Signature |
|
|
|
|
|
|
|
and Stamp (If |
|
|
|
State/Prov. |
|
|
|
Stamp is Available) |
______________________________ Date |
_________ |
License # |
___________________ |
||
|
|
|
|
|
|
|
|
LIC 60 12/11
Form Characteristics
| Fact Name | Description |
|---|---|
| Submission Requirement | The NYC Lic 60 form must be submitted for all original and renewal applications for a welder license. A completed form is mandatory for acceptance. |
| Examination Timeline | The visual acuity examination must take place no more than 12 months prior to the application date for either an original or renewal license. |
| Qualified Examiners | Only qualified professionals, including ophthalmologists, optometrists, medical doctors, registered nurses, or certified physician’s assistants, may administer the eye examination. |
| Vision Standards | Applicants must demonstrate near vision acuity on Jaeger J2 at a distance of 12 inches or greater, with or without corrective lenses, to meet the fitness requirements. |
More PDF Templates
Education Construction - An official declaration by a contracting entity verifying the submission of sign-out logs for a specific SCA project.
Nyc Ubt Estimated Tax - Payment instructions are clearly outlined to ensure funds are directed appropriately to the NYC Department of Finance.
What Is Lease Renewal - Outlines any separate charges that will be applied to the monthly rent, including air conditioning or appliance fees.