This form is to be used by territorial authorities to request the approval of the Minister for Building and
Construction to extend the term (up to 3 years) of a designated area for emergency management of buildings.
Email the completed form to, subject line:
TArequest extension of designated area approval.
Territorial authority: [if a joint application, include all territorial authorities]
Lead contact person: [name, role, territorial authority]
Lead contact phone numbers:
Lead contact email:
Emergency event: [describe the emergency event the designation was made under]
Designation area short-name: [provide the short-name the designation is referred to as]
Area for designation extension: [clearly identify the exact area the extension of the designation is to cover, see notes]
Has the area for designation changed from the original approved area designation? Yes  No
Request for approval to
extend a designation of area
Subpart 6B of Part 2 of Building Act 2004
TA request for approval to extend a designation of area
Confirm the extension to the designation satisfies the following criteria: [tick all that apply]
 in the public interest and
necessary or desirable for the protection of: [tick all that apply]
 persons, from injury or death
 buildings, from damage or disruption to their use
 public thoroughfares, from disruption
 critical infrastructure, from damage or disruption to its operation or use
 persons or buildings, from the effects of the insanitary condition (if applicable) of a building in the relevant area
Provide any additional information to support this section: [could include any of the provisions made or available under the designation that are still
required, such as notices and signage, measures for keeping people at a safe distance and protecting the building, or directions for work required]
Indicate the consideration given to the following in extending this designation of area:
(a) The scale and degree of the impact of the emergency and of its ongoing effects on buildings: [briefly describe]
(b) The likelihood of a further emergency or any other relevant event occurring that could cause: [tick which apply]
 (i) buildings in the relevant area that pose increased or additional risks [briefly describe, if selected]
 (ii) land in the relevant area that poses a risk to a building [briefly describe, if selected]
(c) The principle that it is preferable that risks be managed, if possible without the exercise of powers: [tick to confirm
If any attachments have been provided with this application: [please list with a short description for each one]
Notes: When describing the area for designation, it is important the information can be clearly conveyed to all interested
parties. Usually this is in words identifying the names of roads or landmarks or geographical features such as a river and
preferably using commonly known terms or names that can be subsequently located on an official map. The area description
needs to identify where the designated area begins and ends, ensuring any possible ambiguity or confusion is avoided.
Aclearly marked-up map can be attached, but it is important that any public notification of the designation of area matches
theinformation stated in this application.