4. Council Employee / Elected Member Interest
Are you / the applicant / applicant’s spouse or partner, a member of staff within the council or an elected
member of the council?
Yes No
Or are you / the applicant / the applicant’s spouse or partner, a relative of a member of staff in the council
or an elected member of the council or their spouse or partner?
Yes No
If you have answered yes, please provide details (name, relationship and role):
4. Certificate of Ownership
Declaration
I / We apply for listed building consent to carry out the works described in this application and the
accompanying plans
Signed _____________________________________ Date ________________
On behalf of ____________________________________________________________
Notes for Applicants
1. Any person who carries out or causes to be carried out works such as those in Paragraph 4 below
without Listed Building Consent required under the Planning Act (Northern Ireland) 2011 is guilty of
an offence.
2. Please refer to the publication:
“Explanatory Notes on applying for Planning Permission, Approval of Reserved Matters &
other Planning Consents”
Although Listed Building Consent is not a planning approval the information contained in the above
publication generally applies.
3. It is particularly important in the case of work to listed buildings to clearly define on the drawings full
details of the type of materials, finishes and colours to be used.
4. Listed Building Consent is required before the carrying out any work for demolition, alteration or
extension of a listed building (including internal works or objects attached to the structure), which
would affect its character as a building of special architectural or historical interest. The drawings
submitted with your application must adequately describe all the proposed works for which consent is
needed.
5. It may also be necessary to apply for Planning Permission for external and substantial works. If you
are in any doubt about whether or not Planning Permission should also be sought, please discuss
your proposal with your local Planning Office.
6. If you wish to discuss your proposals with the Northern Ireland Environment Agency (NIEA) – Built
Heritage they can be contacted by Tel: (028) 9054 3095, by Fax: (028) 9054 3111 or by e-mail to
bh@doeni.gov.uk .
Send your completed application to the relevant Council.
click to sign
signature
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