Form POC1 "Professional and Owner Certification" - New York City

What Is Form POC1?

This is a legal form that was released by the New York City Department of Buildings - a government authority operating within New York City. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 16, 2014;
  • The latest edition provided by the New York City Department of Buildings;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form POC1 by clicking the link below or browse more documents and templates provided by the New York City Department of Buildings.

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Download Form POC1 "Professional and Owner Certification" - New York City

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Job Number
(Affix Label)
Professional and Owner Certification
Please file three (3) originals
1. Professional’s Certification
"I hereby state that I have exercised a professional standard of care in certifying that the filed
application is complete and in accordance with applicable laws, including the rules of the
Department of Buildings, as of this date. I am aware the Commissioner will rely upon the truth
and accuracy of this statement.
I have notified the owner that this application has been
professionally certified. If an audit or other exam discloses non-compliance, I agree to notify the
owner of the remedial measures that must be taken to meet legal requirements. I further realize
that any misrepresentation or falsification of facts made knowingly or negligently by me, my
agents or employees, or by others with my knowledge, will render me liable for legal and
disciplinary action by the Department of Buildings and other appropriate authorities, including
termination of participation in the professional certification procedures at the Department of
Buildings."
Professional’s Seal
______________________
_______________________________
Professional’s License No.
Professional’s Signature & Date
2. Owner’s Statement
“I have read and am fully aware of the applicant’s above statement that this job will be
professionally certified, and agree to bring into compliance any construction which is found
not to comply with all applicable laws and regulations.”
_______________________________
Owner’s Signature & Date
3. Applicant’s Contact Information
Fax Numbers
Email Addresses
Applicant
____________________
_____________________________
Owner
____________________
_____________________________
Filing Representative
____________________
_____________________________
POC1, dated 1/16/04
Job Number
(Affix Label)
Professional and Owner Certification
Please file three (3) originals
1. Professional’s Certification
"I hereby state that I have exercised a professional standard of care in certifying that the filed
application is complete and in accordance with applicable laws, including the rules of the
Department of Buildings, as of this date. I am aware the Commissioner will rely upon the truth
and accuracy of this statement.
I have notified the owner that this application has been
professionally certified. If an audit or other exam discloses non-compliance, I agree to notify the
owner of the remedial measures that must be taken to meet legal requirements. I further realize
that any misrepresentation or falsification of facts made knowingly or negligently by me, my
agents or employees, or by others with my knowledge, will render me liable for legal and
disciplinary action by the Department of Buildings and other appropriate authorities, including
termination of participation in the professional certification procedures at the Department of
Buildings."
Professional’s Seal
______________________
_______________________________
Professional’s License No.
Professional’s Signature & Date
2. Owner’s Statement
“I have read and am fully aware of the applicant’s above statement that this job will be
professionally certified, and agree to bring into compliance any construction which is found
not to comply with all applicable laws and regulations.”
_______________________________
Owner’s Signature & Date
3. Applicant’s Contact Information
Fax Numbers
Email Addresses
Applicant
____________________
_____________________________
Owner
____________________
_____________________________
Filing Representative
____________________
_____________________________
POC1, dated 1/16/04