Building (Specified Systems, Change the Use, and Earthquake-prone Buildings) Regulations 2005

Schedule 3 Form

r 9(2)(a)

Schedule 3: inserted, on 1 July 2017, by regulation 9 of the Building (Specified Systems, Change the Use, and Earthquake-prone Buildings) Amendment Regulations 2017 (LI 2017/136).

EPB notice

Section 133AL, Building Act 2004

Earthquake-prone building

Notice under section 133AL of the Building Act 2004

Select the statement that applies.

Earthquake rating is [insert earthquake rating]

or

Earthquake rating has not been determined

†[Name of territorial authority] has previously issued a written notice under section 124(2)(c)(i) of the Building Act 2004.

†Delete if inapplicable.

Select the statement that applies.

This notice is for the building situated at [address], [legal description of land where building is located].

or

This notice is for the following part of the building situated at [address], [legal description of land where building is located]: [specify the part, eg, by description and location within building].

Select the statement that applies.

The building/part of the building* has been determined by [name of territorial authority] to be earthquake prone.

or

[Name of territorial authority] has not determined if the building/part of the building* is earthquake prone (because the owner has not provided an engineering assessment), but is proceeding as if it had determined the building/part of the building* to be earthquake prone.

*Select one.

Select the statement that applies.

The building/part of the building* is a priority building (as defined in section 133AE of the Building Act 2004).

or

The building/part of the building* is not a priority building (as defined in section 133AE of the Building Act 2004).

*Select one.

The owner of the building/part of the building* is required to carry out building work to ensure that the building/part of the building* is no longer earthquake prone (seismic work). The owner is required to complete seismic work by [date].

*Select one.

The owner of the building/part of the building* may apply to [name of territorial authority], under section 133AN of the Building Act 2004, for an exemption from the requirement to carry out seismic work. The building/part of the building* must have certain characteristics to be granted an exemption (see also the Building (Specified Systems, Change the Use, and Earthquake-prone Buildings) Regulations 2005).

*Select one.

Delete the following statement if inapplicable.

The building/part of the building* is a heritage building to which section 133AO of the Building Act 2004 applies. The owner may apply to [name of territorial authority] under section 133AO of the Building Act 2004 for an extension of time to complete seismic work.

*Select one.

In the event that [name of territorial authority] determines or is satisfied, in accordance with section 133AQ of the Building Act 2004, that the building/part of the building* is not earthquake prone, the owner is not required to complete seismic work.

*Select one.

Signature:

Position:

On behalf of: [name of territorial authority]

Date: