Household Extension with Listed Building Application
Please note that the application form cannot be completed
on-screen and must be printed before completion.
Help Completing the Form
1. Applicant Name and Address
Please enter the Applicant Details, including full name and
title. Please also enter the house/flat number and/or name (if
applicable) and street name in the Street address field. The town,
county, country and full postcode should also be entered.
If the application is being submitted by an agent (i.e. someone
who is acting on the applicant's behalf) all correspondence,
including the decision letter, will be sent to him/her.
2. Agent Name and Address
Please enter the Agent Details, including full name and title.
Please also enter the house/flat number and/or name (if applicable)
and street name in the Street address field. The town, county,
country and full postcode should also be entered.
If the application is being submitted by an agent (i.e. someone
who is acting on the applicant's behalf) all correspondence,
including the decision letter, will be sent to him/her.
3. Description of Proposed Works
Please describe the proposal accurately and concisely. State the
number of storeys proposed and the position of any extensions.
Example: ‘erection of a single storey rear extension, two-storey
side extension and dormer window to rear’
4. Site Address Details
Please enter the full postal address of the site. Enter the
house/flat number and / or name (if appropriate) and street name in
the Street address field. The town, county, country and full
postcode should also be entered. If the application relates to open
ground describe its location as clearly as possible (e.g. ‘Land to
rear of 12 to 18 High Street’ or provide a grid reference).
When you submit a location plan, it is recommended that this is
at a scale of 1:1250 or 1:2500, showing at least two named roads
and surrounding buildings. The properties shown should be numbered
or named to ensure that the exact location of the application site
is clear.
The application site must be edged clearly with a red line on
the location plan. It should include all land necessary to carry
out the proposed development (e.g. land required for access to the
site from a public highway, visibility splays (access around a road
junction or access, which should be free from obstruction),
landscaping, car parking and open areas around buildings).
A blue line must be drawn on the plan around any other land
owned by the applicant, close to or adjoining the application
site.
All plans must be to a metric scale and any figured dimensions
given in metres and a scale bar should be included. Each plan
should show the direction of North.
5. Pre-application Advice
The local authority may be able to offer (possibly for a fee)
pre-application discussions before a formal application is
submitted in order to guide applicants through the process. This
can minimise delays later in processing the application.
Pre-application discussions can also help you and the planning
authority identify areas of concern about your proposed development
so that you can give consideration to amending your proposal before
the application is submitted. The advice and guidance given to you
at the pre-application stage is given in good faith. However, it
does not guarantee or supply a definitive undertaking as to whether
your proposal is likely to be acceptable.
If you have received pre-application advice from the planning
service please indicate the reference/date of any correspondence or
discussion and the name of the officer. If you do not know these
details then please state ‘Unknown’.
This will assist the Council in dealing with your application as
quickly as possible.
6. Pedestrian and Vehicle Access, Roads and Rights of Way
You must indicate on your form whether you propose any new or
altered vehicular or pedestrian access to or from the public
highway, and show the location of these on your plans. Any public
footpath that crosses or adjoins the site or is affected must be
shown clearly on the plans, including any proposals that may
require a closure or diversion. Legal procedures for diversion or
closures must be completed prior to works commencing on site.
If you are proposing to undertake any works that will affect the
pavement or roadway then it is advisable to seek advice from the
local highways authority.
7. Trees and Hedges
Please mark on a scaled plan the position of all trees and
hedges on your own property and those on adjoining land which are
within falling distance of your proposed development (i.e. where
the distance from the development to the trees and hedges is less
than (or equal to) their height). This should include all trees and
hedges that are within falling distance of any trenches or
foundations that you propose to dig as part of the proposal.
This information will help us consider how your proposal might
affect these trees and hedges. If you know what species the trees
are, please name them. Number the ones that you will need to remove
or prune in order to carry out your proposal.
[PLEASE NOTE this is an application for planning permission. It
is not an application or notification to remove or prune protected
trees (i.e. trees which are included in a tree preservation order
or located in a conservation area).
If you are granted full planning permission, you will not need
to obtain separate consent for tree works which are required to
implement the planning permission. However, works to protected
trees which are not required to implement the planning permission
must be the subject of a separate application or notification using
the tree works form.]
8. Materials
Please describe the materials you wish to use for walls, roofs,
etc, including the type, colour and name of all materials to be
used.
Additional information may also be provided in a supporting
statement or shown on drawings/plans.
9. Demolition
If you have answered ‘Yes’ to the total or partial demolition of
a listed building then you will need to indicate whether it is
total or partial demolition of the listed building or buildings
within the curtilage of the listed building.
If it is partial demolition you will need to provide details of
the volume of the listed building and part to be demolished. You
should calculate the cubic content figure on the basis of the
external dimensions of the property.
10. Listed Buildings Alterations
A written explanation of the proposed works should include:
an assessment of the impact of the works on the significance of
the asset a statement of justification explaining why the
works are desirable or necessary (this should include development
appraisal where appropriate)
an archaeological assessment or field evaluation and a
mitigation strategy where important archaeological remains may
exist, and
(when works include significant elements of demolition or
rebuilding,) a structural report by an engineer familiar with
heritage assets, which identifies defects and proposes remedies
For demolition of heritage assets and designated heritage
assets, including listed buildings, scheduled monuments, buildings
in conservation areas, etc, please refer to:
Planning Policy Statement 5 (Planning for the Historic
Environment)
http://www.communities.gov.uk/publications/planningandbuilding/pps5
and the accompanying practice guide PPS5 Planning for the
Historic Environment: Historic Environment Planning Practice Guide
http://www.english-heritage.org.uk/publications/pps-practice-guide/pps5practiceguide.pdf
11. Listed Building Grading
When buildings are listed they are placed on statutory lists of
buildings of 'special architectural or historic interest' compiled
by the Secretary of State for Culture, Media and Sport under the
Planning (Listed Buildings and Conservation Areas) Act 1990, on
advice from English Heritage.
Listed buildings are graded to show their relative
importance:
- Grade I buildings are those of exceptional interest
- Grade II* are particularly important buildings of more than
special interest
- Grade II are of special interest, warranting every effort to
preserve them
Please confirm the grade of the listed building which is the
subject of this application. If you are unsure as to the grade of
the building please contact the planning authority.
12. Immunity from Listing
When permission is being sought or has been granted, any person
may apply to the Department for Culture, Media and Sport (dCMS) for
a 'Certificate of Immunity'.
If a certificate is granted, the building cannot be listed (and
the local authority cannot issue a building preservation notice)
for a period of five years.
If the certificate is not granted, the building will normally be
added to the statutory list.
An application for a certificate may be made only where an
application (whether pending or granted) has been made for planning
permission for development, which involves the alteration,
extension or demolition of the building, although the applicant for
that permission and the applicant for immunity from listing need
not be the same person.
Applications for a certificate of immunity should normally be
accompanied by a plan showing the position of the building or
buildings involved and photographs of each elevation of the
building; any notable interior features should be supplied together
with details of the approximate date of its construction, the
architect (if known) and any available information about the
architectural or historic interest of the building.
View further details on Certificates of Immunity from the dCMS
website.
13. Parking
Please specify the total number of existing parking spaces and
the total number of proposed parking spaces (including spaces
retained) by vehicle type. Please include garage spaces.
If no parking spaces are to be provided you should show on your
plans or describe in a supporting statement where vehicles are to
be parked.
The diagram below shows the minimum size of car parking spaces.
However, further advice and guidance should be sought from your
planning authority.
Minimum size of parking spaces
14. Council Employee / Member
You must declare whether the applicant or agent is a member of
the council’s staff, an elected member of the Council or related to
a member of staff or elected member of the Council.
Serving elected members or planning officers who submit their
own planning applications should play no part in their
determination and such applications should be determined by the
planning committee rather than by planning officers under delegated
powers.
For the purposes of this question, 'related to' means related,
by birth or otherwise, closely enough that a fair-minded and
informed observer, having considered the facts, would conclude that
there was a real possibility of bias on the part of the
decision-maker in the local planning authority.
15. Ownership Certificates
An ownership certificate must be completed stating the current
ownership of the land to which the application relates under
Article 12 of the Town and Country Planning (Development Management
Procedure) (England) Order 2010 & Regulation 6 of the Planning
(Listed Buildings and Conservation Areas) Regulations 1990.
It is an offence, knowingly or recklessly, to complete a false
or misleading certificate.
- Certificate A - Sole Ownership
Certificate A should only be completed if the applicant is the
sole owner of the land to which the application relates (i.e. the
applicant is the freeholder and there are no leaseholders with
seven years or more remaining on their leases).
If the application involves a leasehold flat then certificate A
does not apply as the applicant is not the sole owner. Therefore,
in this circumstance, the applicant should complete certificate B,C
or D (see details below).
- Certificate B - Shared Ownership (All other owners
known)
Certificate B should be completed if the applicant is not the
sole owner but knows the names and addresses of all the other
owners (e.g. this certificate will need to be served if the
proposals encroach onto adjoining land).
The Notice to Owners
(Notice 1) must also be completed and sent to all known
owners.
A copy of the notice must also be sent with the application to
the local authority.
- Certificate C - Shared Ownership (Some other owners
known)
Certificate C should be completed if the applicant does not own
all of the land to which the application relates and does not know
the name and address of all of the owners.
The Householder Notice to Owners
(Householder Application Notice) must be completed and sent to
all known owners.
Where any owner is unknown, the Householder Notice to Owners
(Householder Application Notice) needs to be published in a local
newspaper.
A copy of the notice must also be sent with the application to
the local authority.
- Certificate D - Shared Ownership (All other
owners unknown)
Certificate D should be completed if the applicant does not own
all of the land to which the application relates and does not know
the names and addresses of any of the owners.
The Householder Notice to Owners
(Householder Application Notice) needs to be published in
a local newspaper.
A copy of the notice must also be sent with the application to
the local authority.
16. Agricultural Holdings
All householder applications must include the appropriate
agricultural holdings certificate to be considered by the local
authority.
It is an offence, knowingly or recklessly, to complete a false
or misleading certificate.
If the land to which the application relates forms an
agricultural holding or part of an agricultural holding as defined
by the Agricultural Holdings Act 1986 and comprises land subject to
an Agricultural Tenancy all agricultural tenants must be notified
prior to the submission of an application
.
You must either
confirm that none of the land to which the application relates
is, or is part of, an agricultural holding, or
give notice to all tenants on the agricultural holding using the
Householder Notice to Agricultural Tenants
(Householder Application Notice). A copy of the notice must
also be sent with the application to the local authority.
If you are the sole tenant of the Agricultural Holding, insert
'sole tenant - not applicable' in the table under option (B).
17. Planning Application Requirements & Local Level
Requirements
There are two levels of requirements, national and local:
- National - Use the checklist to ensure that
the forms have been correctly completed and that all relevant
information is submitted.
- Local - The local planning authority will have
produced a document (usually available from their website) which
details any specific information that is required to accompany the
application in addition to the national requirements.
Failure to complete the form correctly or to supply sufficiently
detailed drawings or other relevant supporting information may
result in your application being returned as invalid.
18. Declaration
Please sign and date your application.
19. Applicant Contact Details
Please provide contact information for the applicant.
20. Agent Contact Details
Please provide contact information for the agent.
21. Site Visit
Access to the site (i.e. where the works are proposed to take
place) may be required by the case officer. Please provide contact
details in the event that an appointment needs to be made. This
will assist the Council in dealing with your application as quickly
as possible.
This webpage was updated on
7/19/2011