form 2sf: solid fuel heating appliance | version: 23 | issued: 1 july 2020 | page 1 of 4
Form 2SF
Application for building consent to
install a solid fuel heating appliance
Please read this first
This form will be scanned by electronic equipment. It is important that you:
use a blue or black pen to mark your answers; and
print clearly.
tararua district council
26 gordon street
po box 115
dannevirke 4942
06 374 4080
info@tararuadc.govt.nz
Section 33 or 45, Building Act 2004
Council use
Building consent Receipt
Debtor number
Amount paid
$
NAR Date received
/ /
Application
I request that you issue a:
Project Information Memorandum
Building Consent
Amendment to a Building Consent
Value of the solid fuel appliance and installation (including goods and services tax)
$
Property details
Street/Rapid number Street/Road name
Legal description: Lot number Section
DP Block
Valuation number
/
Building name
Location of building within site/block (includes nearest street access)
Number of levels (include ground level and any levels below ground)
Level/Unit number
page 2 of 4 | form 2sf: solid fuel heating appliance | version: 23 | issued: 1 july 2020
The owner (Please print in CAPITALS)
Title: Mr Mrs Miss Ms
Name of owner
Contact person
Postal address
Town Postcode
0
-
0
-
0
-
Landline number Fax number Mobile number
Email
The following evidence of ownership is attached to this application (please tick):
Rates Demand
Lease Agreement
Agreement for Sale and Purchase
Agent Authorisation
I hereby authorise (print name of agent) to act on my behalf.
/ /
2 0
Signature Date
The applicant (only required if the applicant is not the owner)
Relationship to owner: (please tick) Lessee Agent
Contact person
Postal address
Town Postcode
0
-
0
-
0
-
Landline number Fax number Mobile number
Email
First point of contact for communications with the Council building consent authority: (please tick)
Agent Owner
Invoice to be made out to: (please tick)
Agent Owner
click to sign
signature
click to edit
form 2sf: solid fuel heating appliance | version: 23 | issued: 1 july 2020 | page 3 of 4
Signature
Signature of: (tick one)
Owner Agent on behalf of and with the authority of the owner
Name
/ /
2 0
Signature Date
Installation of the solid fuel appliance
Manufacturer’s name
Model
Type of installation and fee: (Note: fee is required to be paid together with lodgment of the application.)
Free standing
$330.00 including gst
Inbuilt
$425.00 including gst
Is this a new or secondhand appliance? Is a wetback being installed?
New Secondhand (must be veried by a qualied engineer
that appliance meets specied standard – please contact
a building ofcer if you require further information)
Yes No
The installer (Please print in CAPITALS)
Name of installer
Postal address
Town Postcode
0
-
0
-
0
-
Landline number Fax number Mobile number
Email
Building consent compliance
The building work will comply with the building code as follows: (if you’re not sure which clauses are applicable, talk to the Building
Consent Authority, designer or your architect)
Clause
P Tick relevant clause numbers of Building
Code
Means of Compliance
Refer to the relevant Compliance document(s)
or detail of alternative solution in the plans and
specications; if not applicable, put n/a
Waiver/Modication Required
State nature of waiver or modication f Building
Code required; if not applicable, put n/a
B1 Structure(chimneys/ues
and hearths)
(Continued over page)
click to sign
signature
click to edit
page 4 of 4 | form 2sf: solid fuel heating appliance | version: 23 | issued: 1 july 2020
Building consent compliance (continued from previous page)
Clause
P Tick relevant clause numbers of Building
Code
Means of Compliance
Refer to the relevant Compliance document(s)
or detail of alternative solution in the plans and
specications; if not applicable, put n/a
Waiver/Modication Required
State nature of waiver or modication of Building
Code required; if not applicable, put n/a
B2 Durability (Maintenance)
C/AS1 Fire
E2 External Moisture (including
roofpenetrationashing
details)
G12 Water Supplies (installation
of wetback and tempered
hot water)
Tick box will comply with the following STANDARD: AS/NZS 2918:2001
Attachments
Thefollowingplansandspecicationsareattachedtothisapplication(induplicate):
Council
check
(All plans and specications must meet the minimum requirements set out in the regulations or required by the
Building Consent Authority.)
Make and Model Type
InstallationInstructions/ManufacturerSpecications
Appliance clearances
Applianceoorprotectivetype
Applianceuesystemtype
Roofpenetrationashingdetails
Floor plans and smoke detector location(s) in accordance with F7 Clause 3.1 NZ Building Code
Plans must be accurate and clear
Wetback details (if applicable)
Pipe work, cylinder position
Details and registration number of registered plumber undertaking plumbing work
Ministry for the Environment Approved Wood Burner
(If site is greater than 2ha, the wood burner does not require Ministry for the Environment approval.)
guidelines | form 2sf: solid fuel heating appliance | version: 22 | issued: 1 july 2019 | page i of i
Guidelines
Applicant copy
Please detach this page and keep for your reference.
1. Plans – one copy
All plans shall be drawn in black ink. All plans should have text
thatisclearandreadable.Plansmustshowthecompleteoor
layout of the house. This shall include the location of the solid
fuel appliance, windows, doors, and smoke alarms.
2. Installation instructions – one copy
The installation instructions are to be provided for the make
and model of solid fuel heater appliance that is being installed.
This will show the clearances required by the manufacturer for
that appliance.
3. Other documents
Attach any Producer Statement applications. Original copies
only will be accepted and they must be completed in full.
4. Fees and charges
The cost of this application will be due for payment at the time
of lodgement. This will be the only fee charged unless the
application and/or development differs from that originally
represented or assessed in which case additional fees will be
charged.
5. Claim and confidentiality
PleasediscusswithaCouncilOfcerifthereisanyclaim
forcondentialityofaplanorspecicationtosafeguardits
copyright or because of any requirements of the owner relating
tothesecurityofthebuilding.Inpractice,condentialityrarely
applies to private residences.
6. Wetbacks
If this application includes a wetback installation, to ensure that
theplumbingttingsandxturesareinaccordancewiththe
NewZealandBuildingCode,thebuildingofcialswillprocess
the application.
7. Documentation required on completion of
installation
When the appliance has been installed, documentation
required by Tararua District Council is as follows:
a. ApplicationforCodeComplianceCerticate
b. Either a Producer Statement/Construction from the
Installation Technician (ps3), or proof that Council
undertook inspection(s)
c. If a wetback was installed, a Producer Statement –
Construction from the Plumber (ps3), or proof that
Council undertook inspection(s)
8. Smoke detector(s)
Smoke detector(s) are to be installed in accordance with
f7 Clause 3.1 of the NZ Building Code before the Code
ComplianceCerticateisissued.
9. Installation
Thereappliance(s)shallbeinstalledtomanufacturers
specications.
Please Note: Some information from this application form is deemed public information and may be used by third parties.
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