Fillable Residential Solid/ Liquid Fuel Heating Applicance (BA Form 2H) (Timaru District Council New Zealand)

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Residential Solid/ Liquid Fuel Heating Applicance (BA Form 2H) (Timaru District Council New Zealand)

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Page 1 of 4 BA Form 2H
Application for building consent for
solid / liquid fuel heating appliance
Version: 15
Date: January 2020
Code: BA Form 2H
Send or
deliver your application to: Web: www.timaru.govt.nz
Building Services, Timaru District Council, Telephone: (03) 687 7236
2 King George Place, PO Box 522, Timaru 7940 Email: building@timdc.govt.nz
A. THE BUILDING (project location)
Street or road address:
Legal description:
(state l
egal description as at the date of
application and, if the land it proposed to
be subdivided, include details of relevant lot
numbers and consent no)
Valuation number: Zone:
Lot: DP:
Section:
Building name:
(if applicable)
Location of building within site:
(include
nearest street access)
Number of levels:
(include ground level
and any below ground)
Level / unit number: (if applicable)
Area:
(total floor area (indicate area
affected by the building work if less than
the total area)
Intended use:
(include number of
occupants per level and per use if more
than one level)
Year first constructed: (insert year,
approximate date is acceptable e.g. 1920s
or 1960-1970)
B. OWNER
Landline number:
Daytime number:
Facsimile number:
Email address:
Mobile number:
After hours number:
Name of owner: (include title)
Contact person: (if different
from owner)
Mailing address:
Street address / registered office:
Contact details:
Please attach one of the following as
evidence of ownership (tick if included):
Doc # 766175
Copy of certificate and title
Lease
Agreement for sale and purchase
Other document showing full name of legal owner(s) of building
Doc # 766175 Page 2 of 4 BA Form 2H
C. AGENT (only required if application is being made on behalf of the owner)
Name of agent:
Contact person:
Mailing address:
Street address / registered office:
Landline number:
Daytime number:
Facsimile number:
Email address:
Mobile number:
After hours number:
Contact details:
Relationship to owner: (state the details
of the authorisation from the owner to
make the application on the owners behalf)
First point of contact: (state full name,
mailing address, phone numbers and email
address)
Name of contact: Mailing address:
Mobile number: Daytime number:
Email address:
D. THE APPLICATION Invoice to: Owner Agent
Signed by the owner: OR Signature:
Name:
Date:
Signed by the agent: (on behalf of, or
with authority from the owner)
Signature:
Name:
Date:
Doc # 766175 Page 3 of 4 BA Form 2H
E. THE PROJECT (applicant to tick checklist)
Installation of a SOLID FUEL heater YES NO
Model:
Second hand model (1):
Free standing: Wetback:
Multifuel Pellets
Make:
New Model:
Inbuilt:
Fuel: Wood
Clean air certificate number (2):
Is this heater replacing an existing heater:
Make: Model:
Installer: Address of installer:
If installation includes a wetback state the craftsman plumber details:
Name: Address:
Specifications Include 1 full set of manufacturer installation instructions.
Floor & Site Plans Provide 1 copy each of (a) floor plan showing location of heater and, (b) site plan showing distances
from boundary.
Smoke Detectors Show locations of smoke detectors.
Flue & Flashing Provide 1 copy showing full details of flue and roof flashings.
Second Hand Appliance Producer statement from manufacturer for durability.
The building work will comply with the Building Code as follows: Tick relevant boxes
Clause
(which of the following clauses will be involved in
the proposed work?)
Means of compliance
(refer to the relevant compliance document(s) or detail of
alternative solution in the plans and specifications)
Waiver/modification required
(state nature of waiver or
modification of building code
required, if not applicable put NA)
C1 Outbreak of Fire C/AS1 AS/NZS2918
Other
B1 Structure NZS1900 11.2 NZS3604
NZS1170 NZS4229
Other
B2 Durability B2/AS1 NZS3101
NZS3602 NZS3604
Other
E2 External Moisture E2/AS1 Specific design & testing
F3 Hazardous Substances and
Processes
F3/AS1 Other
F7 Warning Systems F7/AS1 Other
G9 Electricity G9/AS1 Other
G12 Water Supplies G12/AS1 AS/NZS3500.1
AS/NZS3500.4 Other
Doc # 766175 Page 4 of 4 BA Form 2H
E. THE PROJECT (applicant to tick checklist)
Installation of a LIQUID FUEL heating appliance YES NO
Make: Model:
New Model: Second hand model (1):
Inbuilt: Free standing: Wetback:
Fuel: Diesel Oil Other
Liquid fuel storage tank specifications
Clean air certificate number (2):
Is this heater replacing an existing heater:
Make: Model:
Installer: Address of installer:
If installation includes a wetback state the craftsman plumber details:
Name: Address:
Specifications Include 1 full set of manufacturer installation instructions.
Floor & Site Plans Provide 1 copy each of floor plan showing location of heater / boiler / radiators.
Smoke Detectors Show locations of smoke detectors.
Ventilation Show details of ventilation for boiler unit.
Storage Tank Provide full details of storage tank and location and bunding.
Flashing Provide 1 copy of full set of details of (a) all roof penetrations / flashings and, (b) all wall penetrations / flashings.
Advisory Notes for Solid Fuel Heaters
• Environment Canterbury rules relating to solid fuel heaters require that only low emission wood burners or pellet fires
currently listed on the Environment Canterbury website be installed on any property smaller than 2 hectares.
• Any enquires re solid fuel heaters and their emissions should be referred to: Environment Canterbury - Free Phone 0800
32 4636 - www.ecan.govt.nz
• Wet backs connected to Hot Water Cylinders and Heat Tempering Valves MUST BE Installed by Craftsman Plumber.
Council cannot assist with installation instructions.
• Disclaimer: Advisory notes are issued on a no-liability basis. They are to assist customers to meet compliance.
1
Special additional conditions apply to second-hand Solid/Liquid Heaters – refer to the TDC Building Unit for further information and advice.
2
Refer to: http://ecan.govt.nz/services/online-services/pages/authorised-solid-fuel-burners.aspx
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Residential Solid Liquid Fuel Heating Applicance (BA Form 2H) (Timaru District Council New Zealand)

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Completed 15 July 2020

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