Manchester, CT · Hartford County
Workers’ Compensation Building Permit Forms 7A, 7B, and 7C
This Connecticut Workers’ Compensation Commission packet helps property owners, sole proprietors, general contractors, and principal employers document workers’ compensation coverage when applying for a building permit.
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
Manchester’s building permit directions explain which form to provide based on whether the applicant is a property owner, sole proprietor, general contractor, or principal employer, and whether they will act as the employer or have excluded themselves from coverage. Forms 7B and 7C include affidavits for applicants who attest they will require proof of workers’ compensation insurance from workers on the project. Submit the applicable form and any required coverage certificate to the building official.
Who needs it
Property owners, sole proprietors, general contractors, or principal employers applying for a building permit use the applicable form to document coverage or an exemption.
How to get this notarized
- 1
Download the Forms
Download the 7A, 7B, and 7C directions and forms from the City of Manchester.
- 2
Choose and Complete the Applicable Form
Follow the directions to select the form that matches your role and workers’ compensation coverage situation.
- 3
Book an Online Notary
If signing a 7B or 7C affidavit, arrange notarization and confirm the building official accepts online notarization.
- 4
Sign on Video
Sign the affidavit during the online notary session; do not sign it beforehand.
- 5
Submit to the City
Provide the applicable form and any required insurance certificate to the building official.
Preview the form
The blank PDF straight from Manchester. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I complete the notarized affidavit?
- Complete the applicable form and sign its affidavit in front of the notary. The form says the signer swears they will require proof of workers’ compensation insurance from workers on the project.
- Do I need a notary for every form in the packet?
- No. The instructions require a notary for the 7B or 7C affidavit, if applicable. Form 7A is for an owner or sole proprietor who will not act as general contractor or principal employer.
- Can I sign the affidavit with a commissioned online notary?
- Connecticut authorizes remote online notarization for its own notaries under Public Act 23-28, effective October 1, 2023. Confirm the building official will accept an online-notarized affidavit before signing.
- Where do I submit the completed form?
- The directions say to give the applicable form and required workers’ compensation insurance certificate to the building official to obtain a building permit. Confirm with the town clerk if unsure.