Use this form to apply for both your company and personal Mold Remediation Contractor License. Note: If approved, only one Mold Remediation Contractor License per company will be issued. To license another individual please use the Application for a Mold Abatement Worker or Supervisor License, SH 127, available on our website.
You must provide personal information to complete this form. The authority to collect this information is found in the New York State (NYS) Labor Law. This information will be maintained and used to process the application you are filing with the Division of Safety and Health, License and Certificate Unit. Failure to provide this information may result in our inability to process your application.
Note: By signing this form, you are granting permission to the commissioner of Labor to provide access to your Unemployment Insurance benefit file.
Please see pages 2 and 3 for how to submit your application, fees and required documents.