Applying for a Building Permit: Required Forms

1. Town of Residence
2. Plan Requirements
3. Required Forms
4. Permit Application

Acceptable Forms of Insurance

Please choose the appropriate form listed below, and submit with your permit application.

The NYS Compensation Board requires any municipality issuing permits to verify the applicant has Worker's Compensation and Disability Insurance or that they are exempt.

Workers' Compensation Forms for Contractors

• CE-200 (12-08) — for NYS Entities and Out of State Entities with no employees (exempt)
  • This must be stamped as received by the NYS workers’ compensation board
• These forms are received from the insurance carrier. Warren County must be listed as a certificate holder!
  • C-105.2 (9-07) or U-26.3 — Certificate of Workers’ Compensation Insurance
  • SI-12 or GSI-105.2 — Certificate of Participation in Workers’ Compensation Self-Insurance

Disability Forms

• CE-200 (12-08) — Exemption Form from above will cover this for Contractors with no employees
• These forms are received from the insurance carrier. Warren County must be listed as a certificate holder!
  • DB-120.1 (5-06) — Certificate of Disability Benefits Insurance
  • DB-155 — Certificate of Disability Benefits Self-Insurance

We cannot accept acord forms or liability certificates. They do not count as disability or workers compensation forms.

Next: Building Permit Application