COPY OF BLANK PROPERTY CERTIFICATE FOR WEB

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APPLICATION FORM LOCAL AUTHORITY PROPERTY CERTIFICATE 1. PROPERTY I/We hereby require a Property Certificate for:() Dwelling To:Down District Council see Council Directory overleaf Office use only: Date Received: Payment Received: Receipt No: Cash/cheque: Bank: BACS ref: Reference No: Case/File No: Cheque £60.00 ( ) Other Residential – eg. Nursing Home, Hotel, Guest house, etc ( ) Commercial – eg. Shop, Factory Unit, etc. ( ) Land Only PERIOD REQUEST (see Information for Applications, note2) () 10-year search ( ) 1973 search ( ) 10-year search from ………….… to …….……………….. ( ) Follow-on 10-year search from .………………………… 2. ADDRESS OF PROPERTY Address: Postcode: If Commercial Property: Please specify current business name: NAME OF VENDOR Telephone 3. NAMES OF PREVIOUS OWNERS (during specified period of search) 4. DETAILS OF PRESENT OCCUPIER (if not Vendor) Surname Forenames Address: Postcode: Tel: 5. DETAILS OF APPLICANT Name/ Company Address: Postcode: Tel: 028 Fax: 028 The relevant Fee is enclosed with this Application Date: Applicant’s signature: Standard Fees from 1st January 2004 Type of Certificate Standard 10-year search 1973 search Specified 10-year search Follow-on 10-year search Fee £60 £85 £60 £25 Email: Fax: Email: Antrim Borough Council The Steeple ANTRIM BT41 1BJ Tel: 028 9446 3113 Fax: 028 9446 4469 Coleraine Borough Council Cloonavin 41 Portstewart Road COLERAINE BT52 1EY Tel: 028 7034 7034 Fax: 028 7034 7026 Cookstown District Council Council Offices Burn Road COOKSTOWN BT80 8DT Tel: 028 8676 2205 Fax: 028 8676 4360 Craigavon Borough Council Civic Centre Lakeview Road CRAIGAVON BT64 1AL Tel: 028 3831 2400 Fax: 028 3831 2444 Derry City Council 98 Strand Road DERRY BT48 7NN Tel: 028 7136 5151 Fax: 028 7126 5448 Down District Council 24 Strangford Road DOWNPATRICK BT30 6SR Tel: 028 4461 0800 Fax: 028 4461 0801 Dungannon & South Tyrone Borough Council Circular Road DUNGANNON BT71 6DT Tel: 028 8772 0300 Fax: 028 8772 0368 Fermanagh District Council Town Hall ENNISKILLEN BT74 7BA Tel: 028 6632 5050 Fax: 028 6632 2024 Larne Borough Council Smiley Buildings LARNE BT40 1RU Tel: 028 2827 2313 Fax: 028 2826 0660 Limavady Borough Council 7 Connell Street LIMAVADY BT49 0HA Tel: 028 7772 2226 Fax: 028 7776 5241 Lisburn City Council Island Civic Centre The Island LISBURN BT27 4RL Tel: 028 9250 9250 Fax: 028 9250 9288 Magherafelt District Council 50 Ballyronan Road MAGHERAFELT BT45 6EN Tel: 028 7939 7979 Fax: 028 7939 7980 Moyle District Council Sheskburn House 7 Mary Street BALLYCASTLE BT54 6QH Tel: 028 2076 2225 Fax: 028 2076 2515 Newry & Mourne City Council O’Hagan House Monaghan Row NEWRY BT35 8DJ Tel: 028 3031 3031 Fax: 028 3031 3077 Newtownabbey Borough Council Mossley Mill NEWTOWNABBEY BT36 6QA Tel: 028 9034 0000 Fax: 028 9034 0200 North Down Borough Council Town Hall The Castle BANGOR BT20 4BT Tel: 028 9127 0371 Fax: 028 9127 1370 Omagh District Council The Grange Mountjoy Road OMAGH BT79 7BL Tel: 028 8224 5321 Fax: 028 8224 3888 Strabane District Council 47 Derry Road STRABANE BT82 8DY Tel: 028 7138 2204 Fax: 028 7138 1348 Ards Borough Council 2 Church Street NEWTOWNARDS BT23 4AP Tel: 028 9182 4000 Fax: 028 9181 9628 Armagh City & District Council The Palace Demesne Friary Road ARMAGH BT60 4EL Tel: 028 3752 9600 Fax: 028 3752 9601 Ballymena Borough Council Ardeevin 80 Galgorm Road BALLYMENA BT53 6LX Tel: 028 2566 0300 Fax: 028 2566 0400 Ballymoney Borough Council Riada House 14 Charles Street BALLYMONEY BT53 6DZ Tel: 028 2766 0200 Fax: 028 2766 5150 Banbridge District Council Civic Building Downshire Road BANBRIDGE BT32 3JY Tel: 028 4066 0600 Fax: 028 4066 0601 Belfast City Council City Hall BELFAST BT1 5GS Tel: 028 9032 0202 Fax: 028 9027 0232 Carrickfergus Borough Council Town Hall Joymount CARRICKFERGUS BT38 7DL Tel: 028 9335 1604 Fax: 028 9336 6676 Castlereagh Borough Council 1 Bradford Court Upper Gallwally BELFAST BT8 6RB Tel: 028 9049 4500 Fax: 028 9049 4515 PROPERTY CERTIFICATE QUESTIONS IMPORTANT NOTE: The following information given by the Council shall be read and construed in accordance with the qualifications set out in the ‘Information for Applicants’ associated with the application for this Property Certificate. SECTION ONE: Building Regulations Matters Confirm if the Council has received any application(s) for Full Plans, Building Notice, and/or Regularisation Certificate in relation to the Property within the Certificate Period. App Number Application Type Decision and Decision Date Description of Works Works Started Works Complete Do the Council’s records for the Certificate Period disclose any outstanding breach of Building Regulations? Details of above Is the Council currently contemplating any legal proceedings in respect of the Property, or have any such proceedings been instigated? Details of above Confirm if any relaxation or dispensation has been granted in relation to the Property within the Certificate Period; and if so to what extent? Details of above SECTION TWO: 2.1. Building Licensing Matters Have any Licences been granted in relation to the Property as indicated in the following table? GRANTED YES NO LICENCE TYPE Public Entertainments Licence Amusement Permit Petroleum Spirit Licence Cinematographic Licence Dog Kennels Caravans LEGISLATION Local Government (Miscellaneous Provisions) (NI) Order 1985 Betting, Gaming, Lotteries and Amusements (NI) Order 1985 Petroleum (Consolidation) Act (NI) 1929 Cinemas (NI) Order 1991 Dogs (NI) Order 1983 Caravans Act (NI) 1963 SECTION THREE: Dangerous and Ruinous Structures, Environmental Health and Other Matters 3.1. Does the Council have a record of the issue and/or non-compliance with any dangerous structure or ruinous building order(s)/notice(s) in relation to the Property, issued under the legislation indicated in the following table? LEGISLATION Towns improvement (Ireland) Act 1854 Towns Improvement (Clauses) Act 1847 Public Health Acts Amendments Act 1907 Pollution Control and Local Government (NI) Order 1978 Sections 116 & 117 Belfast Improvement Act 1878 YES NO 3.2. Is the Council, in relation to the Property, currently contemplating or has it instigated legal proceedings pursuant to any of its statutory functions as indicated in the following table:- LEGISLATION Food Safety (NI) Order 1991 Health and Safety at Work (NI) Order 1978 Industrial Pollution Control (NI) Order 1997 Pollution Control & Local Government (NI) Order 1978 Public Health (Ireland) Act 1878 Access to the Countryside (NI) Order 1983 YES NO 3.3 Is the Council currently contemplating the compulsory acquisition of the Property in connection with exercise of any of its statutory functions? YES NO 3.4 Does a Smoke Control Order affect the property? YES NO 3.5 Confirm the postal number and address of the property. Signed On Behalf Of Down District Council Date

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