1. (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

2. (b) state the address of the applicant;
3. (c) state the address and location of the machinery, equipment, device or area which is the subject of the notice;
4. (d) describe the machinery, equipment, device or area prohibited to be used;
5. (e) describe the manner in which the machinery, equipment, device or area is used or operated;
6. (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;
7. (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;
8. (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;
9. (i) set forth the relief requested; and
10. (j) be signed and verified by applicant or an authorized representative.

The petition shall: