The Massachusetts Chimney Sweep Guild

Please print and fill out the application for membership. Please mail to the address shown on the application and enclose a check for your membership fee.

Massachusetts Chimney Sweep Guild


Application for Membership

2017

Applicant Name:      __________________________________________                    


Company Name:      __________________________________________                  


Email:                       __________________________________________                       


Mailing Address:       __________________________________________               


Website:                   __________________________________________          


Work Phone:            __________________________________________               


Home Phone:           __________________________________________               


Cellular Phone:        __________________________________________                              




Membership Status:           (Membership runs from January 1st to December 31st.)


(please circle one)      Sweep               Out-of-State Sweep               Associate


Sweep Membership Dues are $150. Any member company doing business in the Commonwealth of Massachusetts that evaluates, repairs and / or sweeps chimneys is considered a Sweep Member and holds full voting rights.


Out-of-State Sweep Membership Dues are $150. Any member company doing business outside of the Commonwealth of Massachusetts that evaluates, repairs and / or sweeps chimneys is considered a Sweep member and holds full voting rights.


Associate Membership Dues are $150. Any member company that manufacturers and / or supplies materials or components to the sweeping trade is considered an Associate member. Associate members have no election or ballot question voting rights.


(please circle one)      New Member     or     Renewal (was a member last year)     or     Returning Previous Member


(please check only one of the folowing and attach any required additional paperwork)     


          __________ Use Towns Serviced List from Last Year (no town list required)     


          __________ Add the following Additional Towns to Last Years List (list to be attached)    


          __________ Remove the following Towns from Last Years List (list to be attached)


          __________ New Town List (attach the Official MCSG Towns Serviced List) - Only required for new or returning previous members


Membership Dues enclosed: $__________   Optional tax deductible donation to the MCSG enclosed: $__________    


          For full 2017 membership benefits and listing, applications are due by December 10, 2016 (applications can be sent in after the due date)


Please make check payable to:  Massachusetts Chimney Sweep Guild


Mail your check, fully completed and signed application to: David Hannah 582 Pleasant St. Apt. 1M, Holyoke, MA. 01040


If you have any questions, please contact David Hannah  Phone: (217) 685-8844 Email: davehannah@comcast.net  


Membership Eligibility Requirements:


Questions 1-7 are not required for either an Out of State Sweep (unless performing chimney work in the state of Massachusetts)

or an Associate Membership.


All applicants must sign and date the application at the bottom!


New (never enrolled as a member before) sweep memberships have a one calendar year grace period to fulfill the eligibility requirements; they will be considered (unlisted or listed as) a prospective member until the eligibility requirements have been met. They must enclose a request letter asking for a grace period from the board of directors.


All “Sweep” memberships must have line numbers 1 through 4 completely filled out to be eligible for membership.

Incomplete applications will be denied and returned. (Unless requesting a "grace period" see paragraph above.)


1. CSIA, MCSG or CCP Certification # __________ Name ____________________________________ Current (yes or no)  __________


          (MCSG Certification / Equivalency Testing is a free option to applicants and must be re-taken every two years.)

                                                    

               If your CSIA certification is not current, did you have your certification for 10 or more years (yes or no) __________


       If your CSIA certification is not current you are required to enter your valid MA CSL number on line #5


2. Enter your required liability policy # (& enclose or email a certificate of insurance) ____________________________________


3. Enter your MA required workman’s comp. policy # (& enclose or email a certificate of insurance) _________________


     or initial here ______________     I certify that I am exempt from having worker’s comp. insurance as I am a sole proprietor with absolutely no employees (no

                                                                 relatives working for me either).


4. Enter your MA required MA HIC#      ____________________     Name ______________________________


          or initial here ______________     I certify that I am exempt from having an HIC Registration as I never, under any circumstance have an invoice over $1000 and I

                                                                 never hire subcontractors.


The following optional questions will affect how your company is listed by the MCSG: “Sweeping Only Co.” or a “Sweeping

and Repair Co.”. Also if you omit an answer to # 5, you must not be advertising any type of "repair" work.


5. Enter your MA required MA CSL#      ____________________     Name ______________________________

              (Please attach another sheet for any other CSL’s you would like posted as a “job site foreman”.)


6. Do you work on public property on bids valued over $10,000 ?

Yes      __________     

No      __________     If no, you are done with the eligibility portion, skip step #7 and proceed below.


7. Enter your MA required OSHA 10 # ____________________      Name _____________________________


The Massachusetts Chimney Sweep Guild Code of Ethics:  


I accept and acknowledge that membership in the Massachusetts Chimney Sweep Guild carries with it certain responsibilities and obligations. In this regard, all in my firm and I pledge the following:


I accept the responsibility of cultivating by perception and example in my service community the enlightened use of solid-fuel heating appliances and of developing in my clients as well as the general public a respect for safety in the installation, operation and maintenance of all combustion appliances and their venting systems.  


I agree to conduct business in a decent, respectful and professional manner and to continually update and expand the knowledge, skill and technique of myself and of my entire staff.


I agree to run my company in compliance with all codes and regulations applicable to the chimney industry in our service areas and I agree to clean and inspect chimneys by the professional standards set for the chimney industry in NFPA 211.


I accept my role as a well informed and articulate professional. I agree to represent my company in an honest and fair manner, refrain from engaging in deceptive practices or making any deceptive statements and will admit openly when I am unsure of the proper course to follow.  I endeavor to develop a respect for precision and accuracy in performing my duties and to ensure to the best of my knowledge and ability that all I have claimed to do has been done.  


I endorse the use of liability insurance to assure protection for my clients, my business and myself.  


I dedicate myself to these principles, confident in the belief that professionalism and honesty ultimately will prevail in the free marketplace. I understand that failure to abide by these ethical obligations is a violation of MCSG policy and may result in disciplinary action. I agree to hold harmless the MCSG organization and its officers from any liability including but not limited to liability resulting from any disciplinary and or legal action taken against me and or my company.


Signed:  ____________________________________________________________________________________     Date: ________________________________________

Medford

Medway

Melrose

Mendon

Merrimac

Methuen

Middleborough

Middlefield

Middleton

Milford

Millbury

Millis

Millville

Milton

Monroe

Monson

Montague

Monterey

Montgomery

Mount Washington

Nahant

Nantucket

Natick

Needham

New Ashford

New Bedford

New Braintree

New Marlborough

New Salem

Newbury

Newburyport

Newton

Norfolk

North Adams

North Andover

North Attleborough

North Brookfield

North Reading

Northampton

Northborough

Northbridge

Northfield

Norton

Norwell

Norwood

Oak Bluffs

Oakham

Orange

Orleans

Otis

Oxford

Palmer

Paxton

Peabody

Pelham

Pembroke

Pepperell

Peru

Petersham

Phillipston

Pittsfield

Plainfield

Plainville

Plymouth

Plympton

Princeton

Provincetown

Quincy

Randolph

Raynham

Reading

Rehoboth

Revere

Richmond

Rochester

Rockland

Rockport

Rowe

Rowley

Royalston

Russell

Rutland

Salem

Salisbury

Sandisfield

Sandwich

Saugus

Savoy

Scituate

Seekonk

Sharon

Sheffield

Shelburne

Sherborn

Shirley

Shrewsbury

Shutesbury

Somerset

Somerville

South Hadley

Southampton

Southborough

Southbridge

Southwick

Spencer

Springfield

Sterling

Stockbridge

Stoneham

Stoughton

Stow

Sturbridge

Sudbury

Sunderland

Sutton

Swampscott

Swansea

Taunton

Templeton

Tewksbury

Tisbury

Tolland

Topsfield

Townsend

Truro

Tyngsborough

Tyringham

Upton

Uxbridge

Wakefield

Wales

Walpole

Waltham

Ware

Wareham

Warren

Warwick

Washington

Watertown

Wayland

Webster

Wellesley

Wellfleet

Wendell

Wenham

West Boylston

West Bridgewater

West Brookfield

West Newbury

West Springfield

West Stockbridge

West Tisbury

Westborough

Westfield

Westford

Westhampton

Westminster

Weston

Westport

Westwood

Weymouth

Whately

Whitman

Wilbraham

Williamsburg

Williamstown

Wilmington

Winchendon

Winchester

Windsor

Winthrop

Woburn

Worcester

Worthington

Wrentham

Yarmouth

Abington

Acton

Acushnet

Adams

Agawam

Alford

Amesbury

Amherst

Andover

Aquinnah

Arlington

Ashburnham

Ashby

Ashfield

Ashland

Athol

Attleboro

Auburn

Avon

Ayer

Barnstable

Barre

Becket

Bedford

Belchertown

Bellingham

Belmont

Berkley

Berlin

Bernardston

Beverly

Billerica

Blackstone

Blandford

Bolton

Boston

Bourne

Boxborough

Boxford

Boylston

Braintree

Brewster

Bridgewater

Brimfield

Brockton

Brookfield

Brookline

Buckland

Burlington

Cambridge

Canton

Carlisle

Carver

Charlemont

Charlton

Chatham

Chelmsford

Chelsea

Cheshire

Chester

Chesterfield

Chicopee

Chilmark

Clarksburg

Clinton

Cohasset

Colrain

Concord

Conway

Cummington

Dalton

Danvers

Dartmouth

Dedham

Deerfield

Dennis

Dighton

Douglas

Dover

Dracut

Dudley

Dunstable

Duxbury

East Bridgewater

East Brookfield

East Longmeadow

Eastham

Easthampton

Easton

Edgartown

Egremont

Erving

Essex

Everett

Fairhaven

Fall River

Falmouth

Fitchburg

Florida

Foxborough

Framingham

Franklin

Freetown

Gardner

Georgetown

Gill

Gloucester

Goshen

Gosnold

Grafton

Granby

Granville

Great Barrington

Greenfield

Groton

Groveland

Hadley

Halifax

Hamilton

Hampden

Hancock

Hanover

Hanson

Hardwick

Harvard

Harwich

Hatfield

Haverhill

Hawley

Heath

Hingham

Hinsdale

Holbrook

Holden

Holland

Holliston

Holyoke

Hopedale

Hopkinton

Hubbardston

Hudson

Hull

Huntington

Ipswich

Kingston

Lakeville

Lancaster

Lanesborough

Lawrence

Lee

Leicester

Lenox

Leominster

Leverett

Lexington

Leyden

Lincoln

Littleton

Longmeadow

Lowell

Ludlow

Lunenburg

Lynn

Lynnfield

Malden

Manchester-by-the-Sea

Mansfield

Marblehead

Marion

Marlborough

Marshfield

Mashpee

Mattapoisett

Maynard

Medfield


Official MCSG Towns Serviced List


Below, place a number in front of each town you service, in order of importance

(1 being your most important town).

No two towns can have the same number.


The towns you service will be listed for you on our website

to direct people to the appropriate MCSG members