Information for the applicant

All communications to be addressed to:

The General Manager Telephone:

(02) 6836 5888

Cobar Shire Council Facsimile:

(02) 6836 3964

36 Linsley Street Email: mail@cobar.nsw.gov.au

PO Box 223 Website: www.cobar.nsw.gov.au

COBAR NSW 2835 ABN: 71 579 717 155

APPLICATION FOR CONSTRUCTION CERTIFICATE

Environmental Planning & Assessment Act 1979 (Section 6.4)

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OFFICE USE ONLY

Construction Certificate Application No.

Date lodged

Information for the applicant

•

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.

• Once completed, this application form should be submitted to a certifying authority for determination. Certifying

authorities are either private accredited certifiers, the local council, or the consent authority for the development (if

the council is not the consent authority). Private accredited certifiers may be either an individual or a company.

• View a list of private accredited certifiers at http://www.bpb.nsw.gov.au/page/for-consumers/find-a-certifier/

• A construction certificate has no effect if it is issued after the building work or subdivision work to which it relates

is physically commenced on the land to which the relevant development consent applies.

An application for a construction certificate may only be made by a person who has the benefit of the development

consent. An application may not be made by person who will carry out the building work or subdivision work unless

that person owns the land on which the work is to be carried out.

SECTION A. Details of the Applicant

Mr Ms Mrs Dr Other:

First Name

Family Name

Company (if applicable)

ABN (if applicable)

Unit/Street No.

Street Name

Suburb or Town

State

Postcode

Daytime Telephone

Fax

Mobile

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SECTION C. Description of the Building Work or Subdivision Work to be Carried Out

Briefly describe the development. For example, if a dwelling is proposed, include information such as the type of building

(house, townhouse, villa etc), th

e number of floors, the number of bedrooms, the major building material (brick, brick veneer,

timber clad etc).

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

SECTION D. 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.

NOTE: If the reasonable market cost of the labour and materials is valued over $20,000 (incl GST) Home Owners Warranty

Insurance is required. A copy of the Owners Builder’s Permit (OBP) and/or Home Owners Warranty (HOW) Insurance must

be provided to Council before work is allowed to proceed. Visit www.fairtrading.nsw.gov.au to find out more about OBP

and HOW.

SECTION E. Development Consent

Date of development consent (if already granted)

Development consent reference no.:

Name of consent authority:

Name of applicant for development consent:

Provide:

A copy of the development consent, including:

• approved plans endorsed by the consent authority

• conditions of development consent

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

SECTION B. Location and Title Details of the Land where the Building Work or Subdivision

Work is to be Carried Out

Unit/Street No.

Street Name

Suburb or Town

State

Postcode

Lot No.

Section

DP / SP No.

Volume/Folio

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SECTION F. Planning Agreements

If the development or the land upon which the development is to be carried out is subject to a planning agreement as referred

to in section 7.4 Environmental Planning & Assessment Act, provide a copy of the planning agreement.

SECTION G. Attachments Relating to the Proposed Development

Applicants must provide the documents listed below that are relevant to the type of development that is proposed. Please

place a cross in the appropriate box(s) to indicate the type of development involved. Confirm from the certifying authority

how many copies are required prior to lodging this application.

1. Does the application relate ONLY to a FIRE LINK CONVERSION? Yes No

If Yes - provide:

A document that describes the design and construction and mode of operation of the new fire alarm communication link.

2. Does the development involve SUBDIVISION WORK? Yes No

If Yes - provide:

Appropriate subdivision work plans and specifications, which include copies of:

(a) details of the existing and proposed subdivision pattern (including the number of lots and the location of roads)

(b) details as to which public authorities have been consulted with as to the provision of utility services to the land

concerned

(i) earthworks

(ii) roadworks

(iii) road pavement

(iv) road furnishings

(v) stormwater drainage

(vi) water supply works

(vii) sewerage works

(viii) landscaping works

(ix) erosion control works

(d) copies of any compliance certificates to be relied on.

3. Buildings

3.1 Does the development involve building work (in relation to a dwelling house or building or

structure ancillary to a dwelling house?) Yes No

If Yes - provide:

(1) A detailed description of the development, indicating:

(a) for each proposed new building:

(i) the number of storeys (including underground storeys) in the building

(ii) the gross floor area of the building (in square metres)

(iii) the gross site area of the land on which the building is to be erected (in square metres)

(b) for each proposed new residential building:

(i) the number of existing dwellings on the land on which the new building is to be erected

(ii) the number of those existing dwellings that are to be demolished in connection with the erection of

the new building

(iii) the number of dwellings to be included in the new building

(iv) whether the new building is to be attached to any existing building

(v) whether the new building is to be attached to any other new building

(vi) whether the land contains a dual occupancy

(vii) the materials to be used in the construction of the new building by completing the table in

SECTION M

(2) Appropriate building work plans and specifications, which include copies of:

(a) detailed plans, drawn to a suitable scale and consisting of a block plan and a general plan, that show:

(i) a plan of each floor section

(ii) a plan of each elevation of the building

(iii) the levels of the lowest floor and of any yard or unbuilt on area belonging to that floor and the levels

of the adjacent ground

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(iv) the height, design, construction and provision for fire safety and fire resistance (if any)

(b) specifications for the development:

(i) that describe the construction and materials of which the building is to be built and

the method of

drainage, sewerage and water supply, and

(ii) that state whether the materials to be used are new or second-hand and (in the case of second-hand

materials) give particulars of the materials to be used

with (if an alternative solution, to meet the performance requirements, is to be used)

(d)

a description of any accredited building product or system sought to be relied on for the purposes of section

4.1.5 (3A) of the Environmental Planning and Assessment Act 1979 (EP&A Act)*

(e) copies of any compliance certificate to be relied on

(f)

if the development involves building work to alter, expand or rebuild an existing building, a scaled plan of

the existing building

(g) if a BASIX certificate has been obtained for the development, such others matters as the BASIX certificate

requires to be included in the plans and specifications.

NOTE: s.4.1.5 (3A) EP&A Act provides that a consent authority must not refuse to grant consent to development on the ground that any

building product or system relating to the development does not comply with a requirement of the Building Code of Australia if the

building product or system is accredited in respect of that requirement in accordance with the EP&A regulation 2000.

3.2 Does the development involve building work (other than work in relation to a dwelling-house

or a building or structure that is ancillary to a dwelling-house or work that relates only to fire

link conversion)? Yes No

If Yes - provide:

(a) A list of any existing fire safety measures provided in relation to the land or any existing building on the

land.

(b) A list of the proposed fire safety measures to be provided in relation to the land and any building on the

land as a consequence of the building work.

3.3 Does the development involve an alternative solution under the Building Code of Australia

(“BCA”) in respect of a fire safety requirement? Yes No

If Yes - provide:

Either or both of the following from a “fire safety engineer” (a private accredited

certifier holding Category C10

accreditation):

(a) A compliance certificate (as referred to in s.6.18 EP&A Act) that certifies that the alternative solution

complies with the relevant performance requirements of the BCA.

(b) A written report that includes a statement that the alternative solution complies with the relevant

requirements of the BCA.

NOTE: The above requirement only applies to building work in respect of:

(a) a class 9a building that is proposed to have a total floor area of 2000 square metres or more

(b) any building (other than a class 9a building) that is proposed to have:

(i) a fire compartment with a total floor area of more than 2000 square metres or

(ii) a total floor area of more than 6000 square metres

that involves an alternative solution under the BCA in respect of

the requirements set out in EP1.4, EP2.1, EP2.2, DP4 and DP5 in Volume 1 of the BCA.

3.4 Does the application relate to a residential flat development for which the development

application was required under Clause 50(1A) of the EP&A Regulation to be accompanied by

a design verification from a qualified designer? Yes No

If Yes - provide:

A statement from a qualified designer which verifies that the plans and specifications achieve or improve the design quality

of the development for which development consent was granted, having regard to the design quality principles set out in Part

2 of State Environmental Planning Policy No. 65: Design Quality of Residential Flat Development (SEPP 65)

NOTE: If the development application was also required to be accompanied by a BASIX certificate with respect to any building, the

statement need not verify the design quality principles set out in SEPP 65 to the extent to which they aim to:

• reduce consumption of mains-supplied potable water, or reduce emissions of greenhouse gases, in the building or in the use of

the land that it is built on, or

• improve the thermal performance of the building.

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3.5 Has the Fire Commissioner granted an exemption under clause 188 EP&A Regulation from

compliance with any specified Category 3 fire safety provision? Yes No

If Yes - provide:

A copy of the exemption together with any conditions imposed.

3.6 Is any long service payment levy payable under s.34 of the Building and Construction

Industry Long Service Payments Act 1986? Yes No

If Yes - provide:

A copy of a receipt for any long service payment levy that has been made (or, where such a levy is payable by instalments, a

receipt for the first instalment of the levy).

NOTE: Where a council is the certifying authority, the levy may be made to the council when this application is lodged.

3.7 Does the application involve a BASIX affected development, or a BASIX optional

development for which a BASIX certificate has been obtained? Yes No

If Yes - provide:

The BASIX certificate(s) for the development (being either the BASIX certificate issued when the development consent was

granted or

some other BASIX certificate(s) that have been issued no earlier than three months before the date of the

Application being made), and such other documents as the BASIX certificate(s) for the development requires to accompany

the application.

BASIX Certificate No.

NOTE:

BASIX (Building and Sustainability Index) ensures homes are built to be more energy and water efficient. BASIX uses an online

program to assess a building’s design and compares it against energy and water reduction targets. The design must meet these targets

before a BASIX certificate can be printed. Any changes made to a building’s design after a BASIX certificate has been issued requires

another BASIX assessment and new BASIX certificate. “BASIX affected buildings” contain one or more

dwellings (but do not include

hotels or motels).

A BASIX certificate MUST be obtained for every “BASIX affected development”

, which are any of the following (other than

development that is “BASIX excluded development”):

(a) development that involves the erection (but not the relocation) of a BASIX affected building

(b) development that involves a change of building use by which a building becomes a BASIX affected building

construction cost of the development is $50,000 or more

(d)

development for the purpose of a swimming pool or spa, or combination of swimming pools and spas, that services or

service only one dwelling and that has a capacity, or combined capacity, of 40,000 litres or more.

“BASIX excluded development” is

(a) development for the purpose of a garage, storeroom, car port, gazebo, verandah or awning

(b) alterations, enlargements or extensions to a building listed on the State Heritage Register under the Heritage Act 1977

(c) alterations, enlargements or extensions that result in a space that cannot be fully enclosed (for example, a veranda that is

open or enclosed by screens, mesh or other materials that permit the free and uncontrolled flow of air),

other than a

space can be fully enclosed but for a vent needed for the safe operation of a gas appliance

(d) alterations, enlargements or extensions that the Director-General has declared, by order published in the Gazette, to be

BASIX excluded development.

A BASIX Certificate may be obtained for certain developments by an a

pplicant even though there is no obligation to do so. This is called

“BASIX optional development”. “BASIX optional development” means any of the following development that is not BASIX excluded

development:

(a) development that involves the alteration, enlargement or extension of a BASIX affected building, where the estimate of

the construction cost of the development is less than $50,000

(b) development for the purpose of a swimming pool or spa

, or combination of swimming pools and spas, that services or

service only one dwelling and that has a capacity, or combined capacity, of less than 40,000 litres.

If the proposed development involves the alteration, enlargement or extension of a BASIX aff

ected building that contains more than one

dwelling, a separate BASIX certificate is required for each dwelling concerned.

Further information about BASIX and to obtain a BASIX Certificate, go to http://www.basix.nsw.gov.au.

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SECTION H. Cost Summary Report

Analysis of Development Costs:

Demolition and excavation $

Decontamination and remediation $

Site preparation $

Building construction $

Hydraulic, mechanical or fire services $

Sub Total - carried forward $

Preliminaries and margin $

Sub Total

Consultant fees $

Other related development costs $

Sub Total

Goods and Services Tax (GST) $

TOTAL PROPOSED COST OF DEVELOPMENT

I hereby certify that I have:

• Inspected the plans the subject of the application for development

consent or complying development certificate;

• Calculated the development costs in accordance with the definition of

proposed cost of development in clause 25J of the Environmental Planning and Assessment Regulation 2000 current

prices; and

• Included GST in the calculation of proposed cost of the development.

Signed

Name

Position & Qualification Date

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SECTION I. List of Documents

Prepare and attach a list of all of the documents provided under SECTION E, F and G.

SECTION J. Authority to Enter and Inspect Land

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 i

nspection 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.

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.

Owners Signature(s)

Name(s)

Date

SECTION K. Signature of Applicant(s)

Signature of Applicant(s)

Name(s)

Date

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SECTION L. Delivery of the Application (Information to Applicant)

Applications 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.

SECTION M. Development Statistics

The information in the schedule will be used by the Australian Bureau of Statistics to report each quarter on the building

activity that occurs in the national economy. Building statistics allow governments and businesses to accurately identify main

areas of population growth and demand for products and services.

Please complete this schedule, the information will be sent to the Australian Bureau of Statistics. Include the materials to be

used in the construction of the new building(s):

Walls Roof Floor Frame

Brick (double) 11

Tiles 10

Concrete/slate

Timber 40

Brick (veneer) 12

Concrete/slate 20

Timber 40

Steel 60

Concrete/stone 20

Fibre cement 30

Other 80

Aluminium 70

Fibre cement

Steel 60

Not specified 90

Other 80

Timber

Aluminium 70

Not specified 90

Curtain glass

Other 80

Steel

Not specified 90

Aluminium/

Cladding

Timber/

Weatherboard

Other

Not specified

Gross site area (m

) Number of dwellings to be demolished

Gross floor area of existing building (m

) Number of dwellings to be constructed

Gross floor area of new building work (m

) Will the new building be attached to an existing building

Number of pre-existing dwellings on the site Does the site contain a dual occupancy

How many storeys will the building have

What are the current uses of the building

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What will be the new building uses (if changed)

If information is missing or incomplete the application may not be valid and if so may be returned to you without

processing. Complete and competent applications will ensure prompt attention from assessment staff. Written

notification of the determination of your application will be forwarded to you by mail.

OFFICE USE ONLY – Receipting of Fees

Construction Certificate Fee

Fee Type

CONC 91619

Receipt No.

GST

Applicable

Long Service Levy

Fee Type

LSLL 91684

Receipt No.

GST – Not

Applicable

Contribution Plan s.7.11 (Dev A) Subdivision

Fee Type

91723

Receipt No.

GST – Not

Applicable

Contribution Plan s.7.11 (Dev B) Heavy Haulage

Fee Type

91724

Receipt No.

GST – Not

Applicable

Contribution Plan s.7.12 (Dev C) Development

Fee Type

SECT94A 91722

Receipt No.

GST – Not

Applicable

Contribution Plan s64 Water – Cobar & Euabalong

Fee Type

95043

Receipt No.

GST – Not

Applicable

Contribution Plan s64 Water – Nymagee

Fee Type

95035

Receipt No.

GST – Not

Applicable

Contribution Plan s64 Water – Mt Hope

Fee Type

95036

Receipt No.

GST – Not

Applicable

Contribution Plan s64 Sewerage – Cobar

Fee Type

96016

Receipt No.

GST – Not

Applicable

Plan FIRST Levy

Fee is applicable if there is no DA and for works over

50k

Fee Type

LODL 91621

Receipt No.

GST – Not

Applicable

TOTAL

DATE PAID