JKJ 105:1/2

FACTORIES AND MACHINERY ACT, 1967 J.K.J 105

FACTORIES AND MACHINEY (NOTIFICATION, CERTIFICATE OF FITNESS AND

INSPECTION) REGULATIONS 1970 – REGULATION 7 (1)

Application for –

(a) permission to install machinery under section 36 (1) of the Act; and
(b) issue of certificate of fitness in respect of steam boiler, unfired pressure vessel, or hoisting
machine not being a hoisting machine driven by manual power

SECTION 36 OF THE ACT

I/We the undersigned, hereby apply for permission to install machinery, the particulars of which are
as follow:

A. Particulars of Factory:
1. Name of factory or
intended factory or
premises in which
machinery is to be installed

2. Location of factory or
intended factory or
premises in which
machinery is to be installed

B. Particular of occupier or owner:

1. Name

2. Postal address

3. Telephone Number

I/We submit herewith dimensioned sketch/plan/drawings showing details of proposed layout of

machinery.

I/We submit a list of machinery in the attached form(s) and declare that the said machinery
complies with the requirements of the Act and the relevant regulations made thereunder.

Date …………………………………… ………………………………………….

Signature of intended user of machinery
or occupier of factory

To:

The Inspector of Factories and Machinery,

………………………………………….

………………………………………….
 JKJ 105: 2/2
LIST OF MACHINERY

Item Description of machinery Manufacture Serial No. Year of Horse R.P.M Type of drive FOR BOILERS AND UNFIRED FOR Remarks
manufacture power e.g., electrical/ PRESSURE VESSELS HOISTING
diesel/others MACHINE

*heating Working Reg. No. or Safe

surface pressure file ref. and working
or date of load
capacity approval of
design

*Heating surface for boilers to be given in square metre; capacity for unfired pressure vessels to be given in cubic metre