Construction Certificate application

Under section 6.4 of the Environmental Planning and Assessment Act 1979 Incorporating appointment of Principal Certifier

Office use only

Application number Total fees paid Receipt number Date

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• This form may be used to apply for a Construction Certificate (a “certificate”) to carry out building work or subdivision work.

• To minimise delay in receiving a decision about the application, please fill in all sections and ensure all relevant information and documents are provided.

• A Construction Certificate has no effect if it is issued after the building work to which it relates is physically commenced on the land to which the relevant development consent applies.

• Before commencement of works, a Principal Certifier will need to be appointed and a contract with that Principal Certifier will need to agreed upon. You can appoint MidCoast Council as your Principal Certifier at the same time as you lodge this application to save delay.

Part A Information for the applicant

This is a contract for certification work in accordance with Section 73A of the Building Professionals Act 2005. Appointment and service agreement is attached. We offer a choice of certification packages to suit your needs. Please select either:

All inclusive package (determination of Construction Certificate, appointment of Principal Certifier and Occupation certificate) Complete Parts A & B

Construction Certificate only Complete Part A

Construction certificate application - V3 - June 2020

Modify a Construction Certificate - Construction Certificate number Complete Part A

Lot number Section Number Deposited/Strata Plan Number

PostcodeSuburb

Address

Location and title details of the land where the building work is to be carried out

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Description of the building work to be carried outBriefly describe the development. For example, if a dwelling is proposed, include information such as the type of building (house, townhouse, villa etc), the number of floors, the number of bedrooms, the major building material (brick, brick veneer, timber clad etc). For modifications, briefly describe the modification being sought.

Estimated cost of the development

$

The contract price, or if there is no contract a genuine and accurate estimate, for all labour and material costs associated with all demolition and construction required for the development, including the cost of construction of any building and the preparation of a building for the purpose for which it is to be used (such as the costs of installing plant, fittings, fixtures and equipment). GST is also to be included.

Development consentDate of Determination (if already granted)Development Consent No.

Name of consent authority Name of applicant for development consent

Class(s) of building(s) under the Building Code of Australia

Construction Certificate application - V3 - June 2020

Email Phone Mobile

PostcodeSuburb

Address

Company (if applicable) ABN (if applicable)

SurnameFirst name

Applicant details

If the applicant is not the owner of the land, the owner(s) must sign the following statement. As the owner(s) of the above property, I/we consent to the certifying authority, or an accredited certifier, council or consent authority, to enter the subject property at any reasonable time for the purpose of carrying out an inspection in connection with the assessment of this application. I/we undertake to take all necessary steps make access available to the property to enable the inspection to be carried out.

Date

Name(s)

Owner signature(s)

Delivery of the applicationApplications for Construction Certificates must be delivered by hand, by post or transmitted electronically to the principal office of the certifying authority. Applications MAY NOT be sent by fax.

Signature of applicant(s)

Applicant signature(s)

Name(s)

Date

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A certifying authority must not issue a construction certificate for development on a site which affects an existing building unless the certifying authority, or an accredited certifier, council or consent authority on behalf of the certifying authority, has carried out an inspection of the site of the development. If the applicant is the owner of the land, by signing this application authority is given to the certifying authority, or an accredited certifier, council or consent authority, to enter the subject property at any reasonable time for the purpose of carrying out an inspection in connection with the assessment of this Application. The Applicant undertakes to take all necessary steps make access available to the property to enable the inspection to be carried out.

Authority to enter and inspect land

Please provide: • Structural details for the proposal including footing and floor slab design, framing and bracing details

and other details addressing relevant Building Code of Australia requirements; • Specifications. Specifications are a statement of building requirements describing the loading

conditions, design practices, materials and finishes. Specifications are typically drafted by architect/draftsperson or specification booklets can be purchased from some newsagents; and

• Other documents referenced by the development consent that are relevant to this application.

Construction Certificate application - V3 - June 2020

Building work detailsWho will be doing the building work? (please select one option)

Not determined at this time (this information will be required prior to work commencing)

Owner-Builder (see notes below)

Licenced builder

Builder's name

Builder's licence no

Builder's address

Suburb Postcode

Email Mobile

Notes • If a licenced builder is not engaged and the value of any residential work exceeds $10,000 a copy of an Owner-Builder

Permit must be submitted to the Principal Certifier prior to work commencing.

• Where Owner-Builder work is proposed and the value of the proposed work is over $20,000 you must have either completed an approved owner-builder course, or can satisfy the approved equivalent qualifications.

• Evidence that an application has been lodged is required before NSW Fair Trading will issue an Owner-Builder Permit.

• Further information about Owner-Builder Permits can be obtained from the Fair Trading website

• Demolisher's details can be inserted as Builder's details where the application is for demolition.

Long Service Levy

If the value of work is $25,000 or more (inclusive of GST), the Building and Construction Industry Long Service Levy must be paid before a Construction Certificate can be forwarded or delivered.

The levy can be paid online through the Long Service Payments Corporation website or alternatively, the levy can be paid to Council, who are agents for the Long Service Payments Corporation, or to the Corporation when lodging this application. Partial levy exemptions may be applicable in some instances, for further information on the long service levy please contact the Corporation.

Has the Long Service been paid?

Yes (please ensure you have attached a copy of the levy payment receipt)

No (the Long Service Levy must be paid prior to the Construction Certificate being forwarded or delivered)

Long Service Levy not required

Home Building Compensation Fund (HBCF) Insurance

If you are using a licenced builder for residential building work exceeding $20,000 a certificate of Home Building Compensation (HBCF) must be provided to confirm that it has been obtained. For more information, refer to the Home Building Compensation Fund Insurance website.

Has a Certificate of Insurance under the HBCF been provided?

HBCF Insurance not required

No (a copy of the HBCF Certificate of Insurance must be submitted to the PCA prior to building work commencing. The PCA may not be able to carry out inspections if the HBCF Certificate of Insurance has not been provided. )

Yes (please ensure you have attached a copy of the HBCF Certificate of Insurance)

Page 4 of 5Construction Certificate application - V3 - June 2020

Forster | 4 Breese Parade | PO Box 450 Forster 2428 | 6591 7222

Gloucester | 89 King Street | PO Box 11 Gloucester 2422 | 6538 5250 Taree | 2 Pulteney Street | PO Box 482 Taree 2430 | 6592 5399

www.midcoast.nsw.gov.au

Privacy: This information is required to process your application and will not be used for any other purpose without seeking your consent, or as required by law. Your application will be retained in Council's Records Management System and disposed of in accordance with current legislation. Your personal information can be accessed and corrected at any time by contacting Council.

Gross site area (m2)

Gross floor area of existing building (m2)

Gross floor area of new building work (m2)

Number of pre-existing dwellings on the site

How many storeys will the building have

What are the current uses of the building

What will be the new building area (if changed)

Number of dwellings to be demolished

Number of dwellings to be constructed

Will the new building be attached to an existing building

Does the site contain a dual occupancy

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Not specified (90)

Other (80)

Aluminium (70)

Steel (60)

Timber (40)

Frame

Not specified (90)

Other (80)

Timber (40)

Concrete/slate (20)Tiles (10)

Concrete/slate (20)

Fibre cement (30)

Steel (60)

Aluminium (70)

Other (80)

Not specified (90)

Not specified (90)

Other (80)

Timber/weatherboard (40)

Aluminium cladding (70)

Steel (60)

Curtain glass (50)

Timber (40)

Fibre cement (30)

Concrete/stone (20)

Brick (veneer) (12)

Brick (double) (11)

Floor (code)Roof (code)Walls (code)

Development statistics

Construction Certificate application - V3 -June 2020

How to lodge this formCompleted form can be: • lodged electronically using the "Submit" button with attached supporting documents as required. Payment by credit card or

EFT can be arranged; or • forwarded by post with payment; or • lodged at our Customer Service Counter - Monday to Friday (excluding Public Holidays).

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Please continue to next page for

Notice of appointment of MidCoast Council as Principal Certifier.

Notice of appointment of MidCoast Council as

Principal Certifier Division 6.6 of Environmental Planning & Assessment Act

Property details - location of proposed developmentLot number Section NumberDeposited/Strata Plan Number

PostcodeSuburb

Address

Description of proposed development

This application is a contract for certification work in accordance with Section 73A of the Building Professionals Act 2005.

Part B Introduction • Use of this form applies where you wish to appoint MidCoast Council as Principal Certifier, and where you have

previously obtained either a Construction Certificate or a Complying Development Certificate from MidCoast Council but had not appointed a Principal Certifier. MidCoast Council is a certifying authority and employs accredited certifiers who are authorised to undertake the functions of the Principal Certifier on behalf of Council.

• This form is not to be used where replacement of the Principal Certifier is being considered. The legislation provides limited opportunities and specific requirements that must be satisfied in this regard. For further information please refer to the Building Professionals Board website www.bpb.com.au

Please provide a description of the proposed works

MidCoast Council approves approvals to which this Principal Certifier appointment applies (please complete all applicable). As a minimum, you must have applied for either a Development Consent and Construction Certificate or a Complying Development Certificate before completing this form to appoint MidCoast Council as Principal Certifier.

Complying Development Certificate NoConstruction Certificate NoDevelopment Consent No

Approval reference

Page 1 of 2Notice of appointment of MidCoast Council as Principal Certifier - V3 - June 2020

PhoneEmail address

Name (or company & contact person)

Signature Date

Applicant (appointer's) detailsOnly the owner or person having the benefit of the Development Consent or Complying Development Certificate can appoint a Principal Certifier. Note: any builder, contractor or other person who will carry out the work cannot appoint the Principal Certifier unless that person is also the owner of the land.

Applicant must sign declaration in following section

PostcodeSuburb

Address

Appointer's declarationAs the owner or person having the benefit of the Development Consent or Complying Development Certificate stated on this form, I appoint MidCoast Council as the Principal Certifier.

• I declare that all the information provided in this application is, to the best of my knowledge, true and correct.

• I understand that I am entering into a contract with Council as required by Section 31of the Building and Development Certifiers Act 2018.

• I agree to appoint MidCoast Council to carry out all necessary certification work relevant or related to the development.

• I have read, understood and accept the terms and conditions contained in Building Services' Certification Appointment and Service Agreement.

• I have freely chosen to engage MidCoast Council as Principal Certifier.

• I have read the contract and any document accompanying the contract and understand my role and responsibilities and the certifiers role and responsibilities.

Note: A copy of Building Services Certification Appointment and Service Agreement is availalbe in our Forms Library on our website.

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CouncilApplication form satisfactorily completed and relevant approval referenced

DateSignatureOfficer name

Forster | 4 Breese Parade | PO Box 450 Forster 2428 | 6591 7222

Gloucester | 89 King Street | PO Box 11 Gloucester 2422 | 6538 5250 Taree | 2 Pulteney Street | PO Box 482 Taree 2430 | 6592 5399

www.midcoast.nsw.gov.au

Privacy: This information is required to process your request and will not be used for any other purpose without seeking your consent, or as required by law. Your application will be retained in Council's Records Management System and disposed of in accordance with current legislation. Your personal information can be accessed and corrected at any time by contacting Council.

Notice of appointment of MidCoast Council as Principal Certifier - V4 - June 2020