Form PERM39-4SB "Additional Vehicle Configuration Attachment Sheet for a Special Hauling Permit" - New York

What Is Form PERM39-4SB?

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

Form Details:

  • Released on April 1, 2009;
  • The latest edition provided by the New York State Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form PERM39-4SB by clicking the link below or browse more documents and templates provided by the New York State Department of Transportation.

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Download Form PERM39-4SB "Additional Vehicle Configuration Attachment Sheet for a Special Hauling Permit" - New York

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INSTRUCTIONS
PERM 39-4SB (04/09)
STATE OF NEW YORK DEPARTMENT OF TRANSPORTATION
USE ONLY FOR PILOT STATEWIDE BLANKET PERMIT
ADDITIONAL VEHICLE CONFIGURATION ATTACHMENT SHEET
FOR A SPECIAL HAULING PERMIT
This form should only be used with the PERM 39SB form, Application for a Pilot Statewide Blanket Special Hauling Permit, if more than one trailer is to be
attached to the power unit(combination), which will result in different axle spacings, manufacturers tire ratings and/or axle ratings( configuration).
If all spacings, tire ratings, and axle ratings are identical, please use the PERM 99 form.
Note : ALLOWED WEIGHTS ARE NOTED ON THE REQUIREMENTS PAGES
PLEASE PRINT OR TYPE
CARRIER / POWER UNIT INFORMATION
OFFICIAL USE ONLY
CUSTOMER No. : ____________________________
PERMIT NUMBER _______________________
POWER UNIT STATE/JURIS: _________________________
PAGE ________ of ___________
POWER UNIT LICENSE No. : _________________________
Reviewers Initials _______________
VEH. CONFIGURATION NO. ______ TRAILER LICENSE NO. __________________ STATE/JURIS ______
AXLE
STEER
2
3
4
5
6
7
8
9
AXLE WT
RATINGS
SUM OF TIRE
RATINGS
SPACING
1-2
2-3
3-4
4-5
5-6
6-7
7-8
8-9
BETWEEN AXLES
(FT-IN)
VEH. CONFIGURATION NO. ______ TRAILER LICENSE NO. __________________ STATE/JURIS ______
AXLE
STEER
2
3
4
5
6
7
8
9
AXLE WT
RATINGS
SUM OF TIRE
RATINGS
SPACING
1-2
2-3
3-4
4-5
5-6
6-7
7-8
8-9
BETWEEN AXLES
(FT-IN)
VEH. CONFIGURATION NO. ______ TRAILER LICENSE NO. __________________ STATE/JURIS ______
AXLE
STEER
2
3
4
5
6
7
8
9
AXLE WT
RATINGS
SUM OF TIRE
RATINGS
SPACING
1-2
2-3
3-4
4-5
5-6
6-7
7-8
8-9
BETWEEN AXLES
(FT-IN)
VEH. CONFIGURATION NO. ______ TRAILER LICENSE NO. __________________ STATE/JURIS ______
AXLE
STEER
2
3
4
5
6
7
8
9
AXLE WT
RATINGS
SUM OF TIRE
RATINGS
SPACING
1-2
2-3
3-4
4-5
5-6
6-7
7-8
8-9
BETWEEN AXLES
(FT-IN)
INSTRUCTIONS
PERM 39-4SB (04/09)
STATE OF NEW YORK DEPARTMENT OF TRANSPORTATION
USE ONLY FOR PILOT STATEWIDE BLANKET PERMIT
ADDITIONAL VEHICLE CONFIGURATION ATTACHMENT SHEET
FOR A SPECIAL HAULING PERMIT
This form should only be used with the PERM 39SB form, Application for a Pilot Statewide Blanket Special Hauling Permit, if more than one trailer is to be
attached to the power unit(combination), which will result in different axle spacings, manufacturers tire ratings and/or axle ratings( configuration).
If all spacings, tire ratings, and axle ratings are identical, please use the PERM 99 form.
Note : ALLOWED WEIGHTS ARE NOTED ON THE REQUIREMENTS PAGES
PLEASE PRINT OR TYPE
CARRIER / POWER UNIT INFORMATION
OFFICIAL USE ONLY
CUSTOMER No. : ____________________________
PERMIT NUMBER _______________________
POWER UNIT STATE/JURIS: _________________________
PAGE ________ of ___________
POWER UNIT LICENSE No. : _________________________
Reviewers Initials _______________
VEH. CONFIGURATION NO. ______ TRAILER LICENSE NO. __________________ STATE/JURIS ______
AXLE
STEER
2
3
4
5
6
7
8
9
AXLE WT
RATINGS
SUM OF TIRE
RATINGS
SPACING
1-2
2-3
3-4
4-5
5-6
6-7
7-8
8-9
BETWEEN AXLES
(FT-IN)
VEH. CONFIGURATION NO. ______ TRAILER LICENSE NO. __________________ STATE/JURIS ______
AXLE
STEER
2
3
4
5
6
7
8
9
AXLE WT
RATINGS
SUM OF TIRE
RATINGS
SPACING
1-2
2-3
3-4
4-5
5-6
6-7
7-8
8-9
BETWEEN AXLES
(FT-IN)
VEH. CONFIGURATION NO. ______ TRAILER LICENSE NO. __________________ STATE/JURIS ______
AXLE
STEER
2
3
4
5
6
7
8
9
AXLE WT
RATINGS
SUM OF TIRE
RATINGS
SPACING
1-2
2-3
3-4
4-5
5-6
6-7
7-8
8-9
BETWEEN AXLES
(FT-IN)
VEH. CONFIGURATION NO. ______ TRAILER LICENSE NO. __________________ STATE/JURIS ______
AXLE
STEER
2
3
4
5
6
7
8
9
AXLE WT
RATINGS
SUM OF TIRE
RATINGS
SPACING
1-2
2-3
3-4
4-5
5-6
6-7
7-8
8-9
BETWEEN AXLES
(FT-IN)
PERM 39-4SB (04/09)
INSTRUCTIONS
The Additional Vehicle Configuration Attachment form (Perm 39-4SB) is used as an attachment sheet for the Pilot
Statewide Blanket Special Hauling Permit (Perm 39SB – Application for a Pilot Statewide Special Hauling Permit). It is
used for listing more than one trailer to the power unit which results in different configuration(s) (Option I). Axle
weights, tire ratings and or axle spacings are different than that listed on the (Perm 39SB). If additional configuration
space is needed for the same power unit, attach additional completed (Perm 39-4SB) forms.
CARRIER / POWER UNIT INFORMATION
CUSTOMER No: (Formerly NYSDOT ACCOUNT No): This is the number assigned to you by the NYSDOT Permit
Office. If you are a new applicant, please leave blank and an account number will be assigned at time of submission.
This is NOT your USDOT number.
STATE / JURISDICTION (ST / JUR): List the State the power unit is registered in. This will be the same power unit
that appears on the form Perm 39.
LICENSE No: The vehicle license plate number of the power unit.
VEHICLE CONFIGURATION
VEHICLE CONFIGURATION: Assign a sequential number to this combination for future use. Your first combination
appears on the Perm 39.
TRAILER LICENSE No: List the license plate number of the trailer for each configuration.
AXLE WEIGHT RATING: List the axle weight ratings for each axle, starting with the steering axle of the power unit.
TIRE RATING: List the total tire rating for the axle in question. Tire ratings are listed on the side of the tire in both
single and dual capacity. For any axle with one tire on each side of the axle use the single rating and multiply by 2
(total of 2 tires on the axle). For any axle with 2 tires on each side of the axle use the dual rating and multiply by 4
(total of 4 tires on the axle). List the total TIRE RATING which you have calculated for each axle.
AXLE SPACINGS: List the spacing from the center of axle to center of axle, starting with the spacing from the steering
axle of the power unit. Axles spaced less than 46” apart, center to center, are considered a single axle.
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