Application for a Safety Certificate

PLACE DIRECTORATE APPLICATION BUILDING CONTROL Streetscene and Regulatory Services FOR A  Floor 2, Civic Centre 4 SAFETY Much Park Street COVENTRY CV1 2PY CERTIFICATE

Telephone: 024 7683 2057 or 024 7683 2058 Fax: 024 7683 2049  Email: [email protected] The Safety at Sports Ground Act 1975 The Fire Safety and Safety at Places of Sport Act 1987 The Safety of Sports Ground Regulations 1987 The Safety of Places of Sports Regulations 1988

To be completed in all cases

I hereby apply for a *(general) (special) safety certificate in respect of the sports ground/regulated stand described below to be issued to

I make the application on * (on behalf of) (as)

Of † ______

Date ______Signed ______

Address ______

Telephone No: ______Mobile: ______

† If applying on behalf of a sport club, company or some other person, insert status (e.g. Secretary) * Delete as appropriate

Under the provisions of section 3 (1) of the Safety of Sports Grounds Act 1975, a local authority receiving an application for a safety certificate have to determine whether the person to whom the certificate may be issued is likely to be in a position to prevent contravention of the terms and conditions of the certificate. The applicant should therefore furnish below the information required so as to enable the local authority to make such a determination. Under section 3 (4) of the Act the local authority may also require the applicant to submit plans and further information.

(a) Section 10A was inserted by section 24 of the Fire Safety and Safety of Places of Sports Act 1987. (b) Section 10 was inserted by section 23 (1) of the Fire Safety and Safety of Places of Sports Act 1987. (c) Safety of places of Sports Regulations 1988

"The Council will use the data you provide on this form for the purposes of the Building Regulations. It may also be shared with other Council departments and external Agencies for lawful purposes and may be disclosed in response to a request made under the Data Protection Act 1998, Freedom of Information Act 2000 or the Environmental Information Regulations 2004''. (a) Name and address of sports ground/regulated stand

(b) Name of the occupier

(d) Location and name (if any) of the sports ground/regulated stand for which the application is being made

(e) Names and addresses of any person(s) other than the proposed holder of the certificate who to his knowledge will or may be concerned in ensuring compliance with the terms and conditions of the safety certificate for which this application is being made.

Complete Part 1 only for an application for a general safety certificate (to cover activities held over an indefinite period). Complete Part 2 only for an application for a special safety certificate (to cover one occasion or a series of occasions)

Part I: General Safety Certificates

(1) List activities for which the stadium provides viewing accommodation and which are to be covered by the general safety certificate.

(2) Give the approximate date of the construction of the sports ground/regulated stand for which a application was made and details of any subsequent extension, major alterations or re-construction of the spectator accommodation on the sports ground/regulated stand, together with the relevant dates.

Give particulars of current Regulatory Reform (Fire Safety) Order assessments covering any premises on any part of sports ground:

(a) Name of issuing fire authority ______

(b) Name of holder of ______

(d) Description of premises covered by the risk assessment ______

Give particulars of any current statutory licences granted in respect of the sports ground or parts of it:

(a) Name of licensing authority ______

(b) Name of licensee ______

(e) Description of the part or parts of the sports ground covered by the licence ______

______

State maximum capacity of the accommodation in each stand for spectators to view activities at the sports ground:

(i) Maximum no. of seated spectators:-

Stand Number of spectators

------

(ii) Maximum no. of standing spectators:- ______

(iii) Any restriction on number of standing spectators

______

Activities to be covered by the General Safety Certificate

For EACH of the activities (e.g. football, rugby, cricket, athletics, horse racing) to be covered by the general safety certificate please provide the following information for the last three calendar years.

Designated Sports Ground – If you application is for a designated sports ground, exclude use of the sports ground for reserve team matches, practice sessions or community use.

Regulated Stand – If your application is for a regulated stand please include spectators who were admitted to the stand (if access is controlled on entry) or had access to it (if it is not controlled). Exclude any occasions when no charge was made for admission and occasions when the number of spectators was less than 100.

Activity Year 1 Year 2 Year 3 Year Number of occasions that took place during the year Total number of seated spectators during the year Total number of standing spectators during the year Date if event with the highest attendance in the year Highest attendance – seated spectators Highest attendance – standing spectators

Part II: Special Safety Certificate

Event or activity for which the special safety certificate is required:-

______e.g. pop concert, display, festival

Give the date(s) of the proposed event with start and finish times:-

From ______

To ______

Time from which spectators will be admitted to the sports ground/regulated stand:-

______

Maximum number of seated spectators ______

Maximum number of standing spectators ______

Details and location of any staging for the event

In the case of a regulated stand, do you propose to make any changes or adaptations to the spectator accommodation or arrangements for entry and control of spectators for this event? YES/NO/Not applicable

Similar Events

How many events of this type have taken place at the sports ground/regulated stand during the last three years? ______

Payment details

The fee must be paid to the local authority.

Fee Amount £ ______

All cheques should be made payable to Coventry City Council or an online payment may be made at www.coventry.gov.uk

DECLARATION

This section should be completed by the applicant, unless you answered "YES" to the question "Are you an agent acting on behalf of the applicant?"

Full name ______

Capacity ______

Date ______