No lift axles on trailer No lift axles on trailer No lift axles on ... - NY.gov

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This form must be submitted with an Application for a New Permit, perm 61 or an ... Additional Trailer Information – Complete each section for each new trailer.
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STATE OF NEW YORK DEPARTMENT OF TRANSPORTATION 50 Wolf Road Central Permits Office, 1st Floor Albany, New York 12232

Visit our website @ www.nypermits.org for more information

ADDITIONAL TRAILER CONFIGURATION FORM – Option I Only - Perm 63 (12/15) This form must be submitted with an Application for a New Permit, perm 61 or an Amendment form, perm 64. CUSTOMER NUMBER :

EXISTING PERMIT NUMBER (If Applicable) :

POWER UNIT MAKE : POWER UNIT VIN : Additional Trailer Information – Complete each section for each new trailer. Use as many perm 63’s as needed to add all trailers. VIN: Make: Plate: Trailer Length (Inches): Model Year:

GVWR:

Unit No. (Optional):

AXLE

Lift Axle

STEERABLE / TRACKABLE

1

N/A

N/A

MANF. GROSS AXLE WEIGHT RATING (Lbs)

# Of Tires on Axle

Sum of Manf. Tire Rating (Lbs.) 2 TIRES = SINGLE RATING x 2 4 TIRES = DUAL RATING x 4

Official Use Only Gross Axle Rating # Tires

Axle Spacing (INCHES)

(1-2)

2

(2-3)

3

(3-4)

4

(4-5)

5

(5-6)

6

(6-7)

7

(7-8) Overall Wheelbase

8

No lift axles on trailer VIN:

Trailer Meets IFV :

Make:

Model Year:

Plate:

Trailer Length (Inches):

Unit No. (Optional):

AXLE

Lift Axle

STEERABLE / TRACKABLE

1

N/A

N/A

MANF. GROSS AXLE WEIGHT RATING (Lbs)

Yes

GVWR: # Of Tires on Axle

Sum of Manf. Tire Rating (Lbs.) 2 TIRES = SINGLE RATING x 2 4 TIRES = DUAL RATING x 4

Official Use Only Gross Axle Rating # Tires

Axle Spacing (INCHES)

(1-2)

2

(2-3)

3

(3-4)

4

(4-5)

5

(5-6)

6

(6-7)

7

(7-8) Overall Wheelbase

8

No lift axles on trailer VIN:

Trailer Meets IFV :

Make:

Model Year:

Plate:

Trailer Length (Inches):

Unit No. (Optional):

AXLE

Lift Axle

STEERABLE / TRACKABLE

1

N/A

N/A

MANF. GROSS AXLE WEIGHT RATING (Lbs)

Yes

GVWR: # Of Tires on Axle

Sum of Manf. Tire Rating (Lbs.) 2 TIRES = SINGLE RATING x 2 4 TIRES = DUAL RATING x 4

Official Use Only Gross Axle Rating # Tires

Axle Spacing (INCHES)

(1-2)

2

(2-3)

3

(3-4)

4

(4-5)

5

(5-6)

6

(6-7)

7

(7-8) Overall Wheelbase

8

No lift axles on trailer

Trailer Meets IFV :

Yes

AFFIRMATION - FALSE STATEMENTS MADE ON THIS APPLICATION ARE PUNISHABLE AS A CRIME UNDER PENAL LAW 210.45

Authorized Representative Signature:

Date:

Telephone #

Permit Service Name:

Co.#

Telephone #

PERM 63 (12/15)

Return to Form General Instructions

The ADDITIONAL TRAILER CONFIGURATION FORM – Option I Only (Perm 63) is used as a supplemental form to be submitted with an APPLICATION FOR A NEW DIVISIBLE LOAD OVERWEIGHT PERMIT (Perm 61) or AMENDMENT TO A DIVISIBLE LOAD OVERWEIGHT PERMIT (Perm 64). It is used for adding multiple trailers with different; axle data, ratings, length etc. when combined with the identified Power Unit. This form should ONLY be used if choosing Trailer Option I. All vehicles must be registered and maintained in accordance with New York State and Federal Vehicle and Traffic Laws Customer Number: Enter your Customer Account Number. If you are a New customer and have not yet been assigned a Customer number, please be sure to complete the Account Maintenance form and submit with this form and the completed Application form (Perm 61). Existing Permit Number (If Applicable): This only is required if submitting this form as part of an Amendment to an Existing permit. If submitting this form with an Application for a New Divisible Load Overweight Permit (Perm 61), leave this area blank. Power Unit Year, Make and VIN: Enter all of the required information of the Power Unit for which the trailers will be combined with on this application. The Power Unit information must be the same as that appears on forms PERM 61 or PERM 64. Trailer Unit Identification (Do not enter any information in the grayed out areas.) If adding trailers to existing permit(s) only list those trailers being ADDED. Unit Number (Optional Entry): For applicant’s own use to identify trailers using their unique numbering. Model Year: Enter the model year of each trailer unit being added on this application. Vehicle Identification Number (VIN): Enter the VIN of each trailer being added in this application. Make: Enter the make of each trailer being added on this application. Plate: Enter the license plate number for each trailer being added in this application. Trailer Length: Enter the length of the trailer (in inches) excluding any tongue or spill plate length. Use of fifty three (53) foot trailers is limited to Type 4,6A,6B,7 and 9 permits and only valid for operation on Designated Qualifying Access highways. The kingpin distance on 53 foot trailers shall not exceed 43 feet as measured from the center of the kingpin to the center of the last axle on the trailer. Gross Vehicle Weight Rating (GVWR): Enter the GVWR for each trailer being added as indicated by the trailer’s manufacturer. Configuration Information (Do not enter any information in the grayed out areas.) Lift Axle: Indicate any liftable axles by placing an X on the appropriate line. If all the axles on the trailer are “fixed”, meaning they do not and cannot go up and down, check the box titled, “No lift axles on trailer.” Steerable / Trackable: Place an “X” in the appropriate box. If the axle is a fixed axle, meaning it does not go up and down, leave blank. When applying for a Type 9 permit with this vehicle combination or if a trailer unit is model year 2006 or newer, any liftable axle(s) on the trailer must be steerable or trackable. No Lift Axle on Trailer: Place an “X” in this box if all axles on the trailer are fixed axles, meaning that all axles stay down and cannot be raised off the ground. Manf. Gross Axle Weight Rating (Lbs.): Enter the GAWR for each axle, in U.S. Pounds (Lbs.), starting with the steering axle (1) of the power unit and working your way to the rear most axle of the combination. Number of Tires on Axle: Enter the number of tires on each axle. Sum of Manf.Tire Rating (Lbs.): The tire rating is the maximum load, in U.S. Pounds (Lbs.), as stated by the tire manufacturer. This rating is found on the sidewall of the tire. If there are 2 tires on an axle, use the Single rating and multiply x 2. If there are 4 tires on an axle, use the Dual rating and multiply x 4. Axle Spacing: Enter the spacing in U.S.inches, from the center of an axle to the center of the next adjacent axle. Starting at the steering axle as number one (1) and working to the rearmost axle. Affirmation: This area must be typed or signed. All applicable information must be entered in the space(s) provided. Submitting this form: • Mail: (Send with a check or money order made payable to; New York State Department of Transportation) • E-mail: [email protected] (Must pre-fund your account with a credit card prior to submitting forms) • Fax: 518-457-1036 (Must pre-fund your account with a credit card prior to submitting forms)

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