Sec. 72.3. Form and content of petition

The petition shall:

(a) contain a caption in the following form:

STATE OF NEW YORK

INDUSTRIAL BOARD OF APPEALS

 

X

 

:

In the Matter of the Application of

 

:

 

(insert name of applicant)

For a stay to permit use after issuance of an

 

Applicant,

 

:

“unsafe notice” by the Commissioner of Labor

 

:

declaring unsafe and prohibiting the use of (

identify subject in issue

)

 

:

 

—against—

 

:

The Commissioner of Labor,

 

:

 

Respondent.

 

:

 

X

(b) state the address of the applicant;

(c) state the address and location of the machinery, equipment, device or area which is the subject of the notice;

(d) describe the machinery, equipment, device or area prohibited to be used;

(e) describe the manner in which the machinery, equipment, device or area is used or operated;

(f) state whether the persons using the machinery, equipment, device or area have any special training or competence and the extent of their supervision, if any;

(g) annex a complete copy of the notice sought to be stayed, including copies of any other orders, notices and supporting documents issued in connection therewith;

(h) state the facts showing why the notice is erroneous or unreasonable and, where possible, submit affidavits or other reliable, relevant evidence to justify a stay;

(i) set forth the relief requested; and

(j) be signed and verified by applicant or an authorized representative.