345 Carlingview Drive
Toronto, ON M9W 6N9
Tel.: 416.734.3300
Form Revision: 20-Aug-2024B44-2019
Cab Alteration Worksheet
Minor B (8.7.2.14 Alteration)
General
100
Submitter (Company name and address)
Tel:
email:
110
TSSA Installation No(s):
1
2
3
4
5
6
120
Submitter's Specification No.
130
Elevating Device Class
Elevating Device Type
Elevating Device Type
180
Building Address
Postal Code
1340
Type of Drive
185
Work Completion Date
250
Contractor Registration No.
520
Capacity (kg)
Car weight details
Original Car Wt: from crosshead or Zero if missing
kg
Original Car Wt: if being Reset or Previously Reset by P.Eng
kg
NOTES: If resetting original car weight, use this box to provide rationale for the reset.
Total weight changes all previous Aux. Data Tags
+
kg
Unrecorded weight changes (Calculated)
+
0
kg
Car Weight (as weighed)
=
kg
5%(Original Car Weight + Capacity)
0.01
kg
Cumulative Wt Change All Alterations
0
kg
Final Car Weight
0
kg
NET ZERO weight Change Alteration
Cab finishes and weight details
| Lining | Flame Rating | Smoke Dev. | 960 Wt added | 960 Wt Removed | ||||
|---|---|---|---|---|---|---|---|---|
| Cab Modernization per B44-19 & DO 295/22. Alteration to 8.7.2.14.2 | 0 | 0 | kg | |||||
Mark 'X' if glass and/or mirror
Glass per 2.14.1.8
Mirror per 2.14.1.8
[visible marking on each piece per 2.14.1.8.3 & labelled according to CAN/CGSB-12.1 cl. 5.6]
Net Change this alteration
0
kgSelect a Drive Type Box 1340
Counterweight
as weighed
kg
Weight added or removed from Counterweight this alteration
kg
Enter a permissible Percent overbalance range to meet traction requirements (ref 2.24.2.3.)
Overbalance%>
Lower Limit
PRIOR toAFTER
Upper Limit
Registration Stamp
Contractor's Statement - All parts added, replaced, rebuild or adjusted, and all features affected by this alteration are in compliance with the Technical Standards and Safety Act and O.Reg 209/01
310
Submitter's Official Capacity in Company
320
Name
340
Mechanics Name Optional
330
Date
Mechanics Certificate Number Optional
Mechanics EDM Designation Optional
P.Eng Seal
Alteration scope reference — the matched row is highlighted from the Cumulative Wt Change
| 8.7.2.15*1 | Minor B | Cumulative decrease <5% |
| 8.7.2.15.2 | Major | Cumulative decrease ≥5% |
| 8.7.2.15*1 | Minor B | Cumulative increase ≤115kg & <5% |
| 8.7.2.15*2 | Minor A | Cumulative increase >115kg & <5% |
| 8.7.2.15.2 | Major | Cumulative increase ≥5% |
Recreated from the TSSA "Cab Mod & Weight Change (MinB/MinA/Maj)" worksheet, form revision 20-Aug-2024 (B44-2019). All calculations run in your browser; nothing is submitted to or stored on a server. This is not an official TSSA document — verify results against the original form before filing.