BUILDING CONTROL ACT, 1990

APPLICATION FOR A DISPENSATION FROM, OR RELAXATION OF, A REQUIREMENT OF BUILDING REGULATIONS

OFFICIAL USE

To _______________________________

(Insert name of building control authority))

Received on

Ref. No:

Entered in register on

_____________

_____________

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Application is hereby made under Section 4 of the Building Control Act, 1990, for the grant of a dispensation from, or a relaxation of a requirement of the Building Regulations, l997, as specified below, in connection with the works or building shown on the accompanying plans.

1. Address (or other necessary identification) of proposed works or building to which the application relates

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2. Nature of proposed works or building

(a) Classification (please tick as appropriate)—

• Construction of new building

• Material alterations

• Material change of use

• Extension to a building

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(b) Brief description

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3. In the use of a material change of use, the—

(a) Existing use of the building

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(b) Proposed use of the building

___________________

4. Has the work already been carried out?

___________________

5. Decision sought (please tick as appropriate)

• dispensation

• relaxation

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6.

Requirement(s) or Building Regulations concerned

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7.

Grounds for the application

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8.

Name and address of person/s or firm/s responsible for preparation of plans, calculations and specifications.

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APPLICANT

FULL NAME

____________________________

ADDRESS

____________________________

SIGNATURE

____________________________

TELEPHONE NO

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DATE

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