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Phone: 1-516-826-4040
Fax: 1-516-826-0711

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NYCRR Title 17 Part 721.2a

NYCRR Title 17 Part 721.2 (A) Maintenance Interval Certificate
Each operator shall certify in writing to the Department as to the time & mileage intervals when company examinations and preventative maintenance will be performed.

Maintenance intervals MUST be indicated for EACH type vehicle(s) in an operator’s form.

Company examinations and preventative maintenance will be performed as follows:

Brake Inspection:  *

These intervals are based on sound preventive maintenance principles that consider current operating conditions, previous maintenance experiences, including component failure history and the final vehicle manufacturer recommended service intervals (such intervals will not exceed the mileage, engine hours or time period limits). In addition, prior to revising such examination/maintenance intervals will notify (in writing) the Regional Bus Inspection Supervisor.

Duly Authorized Representative’s

Name:   *   Title:  *
Date: *    

As an alternative, I have attached a written certification which meets the requirements are contained in NYCRR Title 17 Part 721

NYCRR Title 17 Part 721.2 (D) Maintenance Facility
The maintenance facilities used by each operator shall be adequate and shall include either suitable pit or lift in an enclosed, heated garage. If the operator arranges to use a facility not owned or leased by the operator or contra maintenance services, the Department shall be notified of such arrangement(s) in writing.

Maintenance Facility Not Owned or Leased Location:

Facility: *
Address:  *

Maintenance Service Contract



/ Yes with:  *

Organization/Business Name:  *

Duly Authorized Representative’s Name Title Date

Name:  *   Title:  *
Date:  *    

NYCRR Title 17 Part 721.2 (BX5)
The operator shall adopt and implement a procedure(s) to ensure that its drivers have reviewed a legible copy o previous driver vehicle inspection report (DVIR) and such drivers are made aware in writing, prior to dispatch, that potential safety de noted on the previous DVIR have been properly addressed by the operator and the vehicle is safe for dispatch. Authorized Department representatives shall only approve operator’s procedure(s) that satisfactorily meet this object.

As explained to me by (a duly authorized representative) of

Name:  *

A procedure is in place which appears:


Meet the objectives as contained in NYCRR Title 17 Part 721.2 (BX5).

Motor Vehicle Inspector:  *   Date:  *

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