Form LB-0324 "Application for Permission to Install or Re-install a Second-Hand Boiler or Pressure Vessel" - Tennessee

What Is Form LB-0324?

This is a legal form that was released by the Tennessee Department of Labor and Workforce Development - a government authority operating within Tennessee. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2017;
  • The latest edition provided by the Tennessee Department of Labor and Workforce Development;
  • 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 printable version of Form LB-0324 by clicking the link below or browse more documents and templates provided by the Tennessee Department of Labor and Workforce Development.

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Download Form LB-0324 "Application for Permission to Install or Re-install a Second-Hand Boiler or Pressure Vessel" - Tennessee

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Boiler Unit
220 French Landing Drive
Nashville, TN 37243
Application for Permission to Install or Re-install a Second-Hand Boiler or Pressure Vessel
Formerly Operated in this State, another State, or Internationally Abroad of Standard Construc-
tion Equivalent to Tennessee State and so Stamped, Formerly Operated in another State
or Internationally broad.
This application must be made by owner or user, or prospective owner or user of boiler or
Pressure vessel, and the words “owner or user” in this section shall not be construed to mean
Manufacturer or seller of a boiler or pressure vessel. See Rule No. 0800-3-3-.03(6)
GIVE THE FOLLOWING DETAILED INFORMATION
CODE SYMBOL STAMPING
NATIONAL BOARD NUMBER
1. Name of new Company or individual desiring to install boiler _______________________________
(Print clearly)
2. Business address ___________________________________________________________________
3. Where is boiler to be located if allowed to be installed? ____________________________________
(City, Town, Village)
(County)
4. Present location of boiler ____________________________________________________________
5. Date boiler will be ready for inspection ______________________
6. By whom was the boiler last owned before being purchased by you? __________________________
(Do not give DEALER’S NAME)
7. If stationary, location when last used. ___________________________________________________
8. Was Boiler ever inspected under the Boiler Code of Tennessee? _____________________________
9. Date of such inspection ____________________ if certificate was issued, give following:
10. Tennessee State boiler number __________ Certificate issued by _____________ Pressure _______
(Insurance company)
11. Type of boiler _____________________ Built by ________________________________________
New Owner Signature ___________________________________
New Owner Business Address
Page 1 of 2
RDA-2155
LB-0324 (Rev. 01/2017
Boiler Unit
220 French Landing Drive
Nashville, TN 37243
Application for Permission to Install or Re-install a Second-Hand Boiler or Pressure Vessel
Formerly Operated in this State, another State, or Internationally Abroad of Standard Construc-
tion Equivalent to Tennessee State and so Stamped, Formerly Operated in another State
or Internationally broad.
This application must be made by owner or user, or prospective owner or user of boiler or
Pressure vessel, and the words “owner or user” in this section shall not be construed to mean
Manufacturer or seller of a boiler or pressure vessel. See Rule No. 0800-3-3-.03(6)
GIVE THE FOLLOWING DETAILED INFORMATION
CODE SYMBOL STAMPING
NATIONAL BOARD NUMBER
1. Name of new Company or individual desiring to install boiler _______________________________
(Print clearly)
2. Business address ___________________________________________________________________
3. Where is boiler to be located if allowed to be installed? ____________________________________
(City, Town, Village)
(County)
4. Present location of boiler ____________________________________________________________
5. Date boiler will be ready for inspection ______________________
6. By whom was the boiler last owned before being purchased by you? __________________________
(Do not give DEALER’S NAME)
7. If stationary, location when last used. ___________________________________________________
8. Was Boiler ever inspected under the Boiler Code of Tennessee? _____________________________
9. Date of such inspection ____________________ if certificate was issued, give following:
10. Tennessee State boiler number __________ Certificate issued by _____________ Pressure _______
(Insurance company)
11. Type of boiler _____________________ Built by ________________________________________
New Owner Signature ___________________________________
New Owner Business Address
Page 1 of 2
RDA-2155
LB-0324 (Rev. 01/2017
NOTE: Unless the aforementioned questions are clearly answered, this application will not be
accepted. If possible, forward last inspection report or certificate of inspection with application.
Boilers, the construction of which are not equal to the construction specified in the Tennessee
State Boiler Code will not be allowed to come into this State. See Tennessee State Boiler Code,
Title 68 Chapter 122 and Chapter 0800-3-3 Rules and Regulations.
STAMP LISTING
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
Unit may be brought into
Unit may not be brought
the State of Tennessee
into the State of Tennessee
Chief Boiler Inspector
_________________________________
___________________________________
(Date)
Comments:
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
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