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Lift Installation Request Form A

The document is a request form for installing or altering a lift at MGS Health & Wellness in Solan, Himachal Pradesh. It includes details such as the applicant's information, type of lift, specifications like speed, capacity, and construction details. The form is submitted to the authorized officer as per section 3 of the relevant Act.

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0% found this document useful (0 votes)
30 views3 pages

Lift Installation Request Form A

The document is a request form for installing or altering a lift at MGS Health & Wellness in Solan, Himachal Pradesh. It includes details such as the applicant's information, type of lift, specifications like speed, capacity, and construction details. The form is submitted to the authorized officer as per section 3 of the relevant Act.

Uploaded by

hrm
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Form 'A'

[See rule 3(2)]


To
(The officer authorized under section 3 of the Act).
Respected Sir,
I am willing to install a lift or to make additions / alterations to a lift
already installed at MGS Health & Wellness, Village Chharot & Gatoli, Tehsil & District
Solan, Himachal Pradesh – 173229. Therefore, I request you to kindly permit me to
install the same. The necessary particulars/ documents as required under section 3 of
the Act are as under. -
1. Full name and address of the applicant. : MGS Health & Wellness, Village
Chharot & Gatoli, Tehsil & District
Solan, Himachal Pradesh – 173229.
2. Name and address of Agent, if any : N.A.
3. Whether a license has been previously :
granted. (Details to be given) NA

4. Type of lift proposed to be erected. (A : MRL elevator (IM24091B05) P5L (05)


sketch of the lift and erection plans
should be attached

5. The rated maximum speed of the lift. : 1 mls (60m/min)

6. The maximum number of passengers in : 13 persons


addition to the lift operator which the
lift can carry.

7. The total weight of the lift cage carrying : 884 Kg


the maximum load.

8. The weight of the counterweight. : 1574 Kg

9. The number, description, weight and : 6 No’s (8 mm & dia)


size of the supporting cables.

1 The depth of the pit from lowest part of : 1550 mm


0. the lift cage when at the lowest floor.

1 Details of the construction of the : Overhead RCC beams casted (hight


1. overhead arrangements with the weight 4282mm)
and sizes of the beams

Place ___________________ Signature of applicant

Date ____________________
Form 'A'

[See rule 3(2)]


To
(The officer authorized under section 3 of the Act).
Respected Sir,
I am willing to install a lift or to make additions / alterations to a lift
already installed at MGS Health & Wellness, Village Chharot & Gatoli, Tehsil & District
Solan, Himachal Pradesh – 173229. Therefore, I request you to kindly permit me to
install the same. The necessary particulars/ documents as required under section 3 of
the Act are as under. -
1. Full name and address of the applicant. : MGS Health & Wellness, Village
Chharot & Gatoli, Tehsil & District
Solan, Himachal Pradesh – 173229
2. Name and address of Agent, if any : N.A.
3. Whether a license has been previously :
granted. (Details to be given) NA

4. Type of lift proposed to be erected. (A : MRL elevator (IM24146D02P1)


sketch of the lift and erection plans
should be attached

5. The rated maximum speed of the lift. : 1MLS(60M/MIN)

6. The maximum number of passengers in : 10 persons


addition to the lift operator which the
lift can carry.

7. The total weight of the lift cage carrying : 680 Kg


the maximum load.

8. The weight of the counterweight. : 1401 Kg

9. The number, description, weight and : 4 No’s (8 mm & dia)


size of the supporting cables.

1 The depth of the pit from lowest part of : 1610 mm


0. the lift cage when at the lowest floor.

1 Details of the construction of the : Overhead RCC beams casted (hight


1. overhead arrangements with the weight 4282mm) from FFL
and sizes of the beams

Place ___________________ Signature of applicant

Date ____________________
Form 'A'

[See rule 3(2)]


To
(The officer authorized under section 3 of the Act).
Respected Sir,
I am willing to install a lift or to make additions / alterations to a lift
already installed at MGS Health & Wellness, Village Chharot & Gatoli, Tehsil & District
Solan, Himachal Pradesh – 173229. Therefore, I request you to kindly permit me to
install the same. The necessary particulars/ documents as required under section 3 of
the Act are as under. -
1. Full name and address of the applicant. : MGS Health & Wellness, Village
Chharot & Gatoli, Tehsil & District
Solan, Himachal Pradesh – 173229
2. Name and address of Agent, if any : N.A.
3. Whether a license has been previously :
granted. (Details to be given) NA

4. Type of lift proposed to be erected. (A : MRL elevator (IM24146D02P2)


sketch of the lift and erection plans
should be attached

5. The rated maximum speed of the lift. : 1MLS(60M/MIN)

6. The maximum number of passengers in : 10 persons


addition to the lift operator which the
lift can carry.

7. The total weight of the lift cage carrying : 680 Kg


the maximum load.

8. The weight of the counterweight. : 1401 Kg

9. The number, description, weight and : 4 No’s (8 mm & dia)


size of the supporting cables.

1 The depth of the pit from lowest part of : 1610 mm


0. the lift cage when at the lowest floor.

1 Details of the construction of the : Overhead RCC beams casted (hight


1. overhead arrangements with the weight 4282mm) from FFL
and sizes of the beams

Place ___________________ Signature of applicant

Date ____________________

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