ࡱ>  XbjbjAA ++yl VVNNNbbb8| b")D4EE*Eflm(q‹‹‹‹‹‹$?Ns_fssVVE*E׎zzzsVEN*Ezszz<h2 Ejds0Xt Nsszssssswssssssssssssssss :  Please note that the applicant(s) must be the owner(s) of the property. Please include all joint owners. Please read the Councils Guidance Notes and Approved Standards for Houses in Multiple Occupation, available at: http://www. http://www.argyll-bute.gov.uk/licences/house-multiple-occupancy-licence where the detail of the relevant fees can be obtained.For Official UseHMO Licence Number: FORMTEXT      Date Received: FORMTEXT      Date Paid: FORMTEXT      Fee Paid: FORMTEXT      Receipt No: FORMTEXT      Check (Variation) FORMTEXT      Date to Officers: FORMTEXT        This application form can be used to apply for a New Licence, Validation of an existing licence or a Variation of an existing licence. Please indicate which type of application you are making by checking ( the appropriate box below. New HMO Licence FORMCHECKBOX Renewal of Existing Licence FORMCHECKBOX Variation of Existing/Pending Licence FORMCHECKBOX  Existing Licence Number (in the case of a Renewal or Variation)HMO/ FORMTEXT       If a Variation Application please check each appropriate box ( Change of ownership (New and Pending Applications Only) FORMCHECKBOX Change of day to day manager  FORMCHECKBOX Change of occupancy FORMCHECKBOX Change of physical layout  FORMCHECKBOX If the Variation is for a change to the physical layout of the property, please describe the change below FORMTEXT       FORMTEXT        This section refers to the property for which the application is being made. Name of Premises (if applicable) FORMTEXT      AddressPostcode FORMTEXT       FORMTEXT      Flat No and/or LocationNo of storeys (floors) within this dwelling (flat or house) FORMTEXT       FORMTEXT      Occupancy capacity of the property FORMTEXT      Total number of bedrooms FORMTEXT      Number of bedrooms to be occupied by one person FORMTEXT      Number of bedrooms to be occupied by two or more people FORMTEXT      Number of living rooms FORMTEXT      Number of bathrooms FORMTEXT      Number of separate toilets FORMTEXT      Number of kitchens FORMTEXT      Other rooms (specify) FORMTEXT      Do you intend to provide meals for the residence? YES  FORMCHECKBOX  NO  FORMCHECKBOX Will the residence be selfcatering? YES  FORMCHECKBOX  NO  FORMCHECKBOX Will there be employees working in the premises?YES  FORMCHECKBOX  NO  FORMCHECKBOX  If this property was previously licensed as an HMO by a previous owner, what date did you conclude the purchase? FORMTEXT       Please confirm the name of the previous ownerPrevious HMO licence number FORMTEXT      HMO/ FORMTEXT      Have any of the current owners of this property been refused a similar licence in the last 2 years?YES  FORMCHECKBOX  NO  FORMCHECKBOX If the answer to the question above is YES, please give details below: FORMTEXT       FORMTEXT         TitleSurnameFirst Name FORMTEXT       FORMTEXT       FORMTEXT      Middle Name(s)Maiden Name (if applicable)Date of Birth FORMTEXT       FORMTEXT       FORMTEXT      Place of Birth FORMTEXT      Male  FORMCHECKBOX  Female  FORMCHECKBOX Home Address FORMTEXT      Postcode FORMTEXT       Home Telephone NumberMobile Telephone NumberWork Telephone Number FORMTEXT       FORMTEXT       FORMTEXT      Email Address FORMTEXT      Landlord Registration Number (if applicable) FORMTEXT      Will this applicant be carrying out day to day management of the HMO?YES  FORMCHECKBOX  NO  FORMCHECKBOX   Please provide details for all Joint Owners (all those listed on the Title Deeds). The address provided for an individual owner should be their permanent residential address. (If more than 2 joint owners, please use separate sheet at Section14). Number of Joint Owners (including Main Applicant) FORMTEXT       TitleSurnameFirst Name FORMTEXT       FORMTEXT       FORMTEXT      Middle Name(s)Maiden Name (if applicable)Date of Birth FORMTEXT       FORMTEXT       FORMTEXT      Place of Birth FORMTEXT      Male  FORMCHECKBOX  Female  FORMCHECKBOX Home Address FORMTEXT      Postcode FORMTEXT      Home Telephone NumberMobile Telephone NumberWork Telephone Number FORMTEXT       FORMTEXT       FORMTEXT      Email Address FORMTEXT      Landlord Registration Number (if applicable) FORMTEXT      Will this applicant be carrying out day to day management of the HMO?YES  FORMCHECKBOX  NO  FORMCHECKBOX  TitleSurnameFirst Name FORMTEXT       FORMTEXT       FORMTEXT      Middle Name(s)Maiden Name (if applicable)Date of Birth FORMTEXT       FORMTEXT       FORMTEXT      Place of Birth FORMTEXT      Male  FORMCHECKBOX  Female  FORMCHECKBOX Home Address FORMTEXT      Postcode FORMTEXT      Home Telephone NumberMobile Telephone NumberWork Telephone Number FORMTEXT       FORMTEXT       FORMTEXT      Email Address FORMTEXT      Landlord Registration Number (if applicable) FORMTEXT      Will this applicant be carrying out day to day management of the HMO?YES  FORMCHECKBOX  NO  FORMCHECKBOX     Company FORMCHECKBOX Charity FORMCHECKBOX Trust FORMCHECKBOX Partnership FORMCHECKBOX  Please indicate below which type of trust owns the property. (If you are unsure, please check with your solicitor to confirm the type of trust that you have). Please check the appropriate box. Incorporated Trust (Trust and Trustees must be licensed). Please complete Section 5.2 and provide the details of all Trustees in Section 5.3. FORMCHECKBOX Non Incorporated Trust (the named trust must be licensed). Please complete Section 5.2. FORMCHECKBOX   Full name of Company, Charity, Trust or Partnership (including postcode) FORMTEXT      Name of Secretary or responsible person FORMTEXT      Address of principal office FORMTEXT      Telephone number FORMTEXT      E-mail address FORMTEXT      Landlord Registration Number FORMTEXT        If more than four, please use separate sheet at Section 14 TitleSurnameFirst Name FORMTEXT       FORMTEXT       FORMTEXT      Middle Name(s)Maiden Name (if applicable)Date of Birth FORMTEXT       FORMTEXT       FORMTEXT      Place of Birth FORMTEXT      Male  FORMCHECKBOX  Female  FORMCHECKBOX Home Address FORMTEXT      Postcode FORMTEXT      Home Telephone NumberMobile Telephone NumberWork Telephone Number FORMTEXT       FORMTEXT       FORMTEXT      Email Address FORMTEXT      Landlord Registration Number (if applicable) FORMTEXT      Will this applicant be carrying out day to day management of the HMO?YES  FORMCHECKBOX  NO  FORMCHECKBOX  TitleSurnameFirst Name FORMTEXT       FORMTEXT       FORMTEXT      Middle Name(s)Maiden Name (if applicable)Date of Birth FORMTEXT       FORMTEXT       FORMTEXT      Place of Birth FORMTEXT      Male  FORMCHECKBOX  Female  FORMCHECKBOX Home Address FORMTEXT      Postcode FORMTEXT      Home Telephone NumberMobile Telephone NumberWork Telephone Number FORMTEXT       FORMTEXT       FORMTEXT      Email Address FORMTEXT      Landlord Registration Number (if applicable) FORMTEXT      Will this applicant be carrying out day to day management of the HMO?YES  FORMCHECKBOX  NO  FORMCHECKBOX  TitleSurnameFirst Name FORMTEXT       FORMTEXT       FORMTEXT      Middle Name(s)Maiden Name (if applicable)Date of Birth FORMTEXT       FORMTEXT       FORMTEXT      Place of Birth FORMTEXT      Male  FORMCHECKBOX  Female  FORMCHECKBOX Home Address FORMTEXT      Postcode FORMTEXT      Home Telephone NumberMobile Telephone NumberWork Telephone Number FORMTEXT       FORMTEXT       FORMTEXT      Email Address FORMTEXT      Landlord Registration Number (if applicable) FORMTEXT      Will this applicant be carrying out day to day management of the HMO?YES  FORMCHECKBOX  NO  FORMCHECKBOX  TitleSurnameFirst Name FORMTEXT       FORMTEXT       FORMTEXT      Middle Name(s)Maiden Name (if applicable)Date of Birth FORMTEXT       FORMTEXT       FORMTEXT      Place of Birth FORMTEXT      Male  FORMCHECKBOX  Female  FORMCHECKBOX Home Address FORMTEXT      Postcode FORMTEXT      Home Telephone NumberMobile Telephone NumberWork Telephone Number FORMTEXT       FORMTEXT       FORMTEXT      Email Address FORMTEXT      Landlord Registration Number (if applicable) FORMTEXT      Will this applicant be carrying out day to day management of the HMO?YES  FORMCHECKBOX  NO  FORMCHECKBOX   This section identifies who will be responsible for the day to day management of the licensed property. Please ensure questions 6.1 and 6.2 are completed where a company, including a named individual within the company, is carrying out the day to day management. Questions 6.3 or 6.4 should be completed where the day to day manager is an applicant or other individual.  YES  FORMCHECKBOX  NO  FORMCHECKBOX  If the answer to the above question is YES, please provide the details of the company and the names of ALL the Directors or partners below. If the answer is NO, please go to question 6.3. Name of Organisation or Company FORMTEXT      Address of Organisation or Company FORMTEXT      Postcode FORMTEXT      Landlord Registration Number of Organisation or Company FORMTEXT        If more than three, please use separate sheet at Section 14 NOTE: The first named individual below will be considered as the nominated person for the organisation or company. Any change to the nominated person will require a Variation to the Licence and the appropriate fee. TitleSurnameFirst Name FORMTEXT       FORMTEXT       FORMTEXT      Middle Name(s)Maiden Name (if applicable)Date of Birth FORMTEXT       FORMTEXT       FORMTEXT      Place of Birth FORMTEXT      Male  FORMCHECKBOX  Female  FORMCHECKBOX Home Address FORMTEXT      Postcode FORMTEXT      Home Telephone NumberMobile Telephone NumberWork Telephone Number FORMTEXT       FORMTEXT       FORMTEXT      Email Address FORMTEXT      Landlord Registration Number  FORMTEXT       TitleSurnameFirst Name FORMTEXT       FORMTEXT       FORMTEXT      Middle Name(s)Maiden Name (if applicable)Date of Birth FORMTEXT       FORMTEXT       FORMTEXT      Place of Birth FORMTEXT      Male  FORMCHECKBOX  Female  FORMCHECKBOX Home Address FORMTEXT      Postcode FORMTEXT      Home Telephone NumberMobile Telephone NumberWork Telephone Number FORMTEXT       FORMTEXT       FORMTEXT      Email Address FORMTEXT      Landlord Registration Number  FORMTEXT       TitleSurnameFirst Name FORMTEXT       FORMTEXT       FORMTEXT      Middle Name(s)Maiden Name (if applicable)Date of Birth FORMTEXT       FORMTEXT       FORMTEXT      Place of Birth FORMTEXT      Male  FORMCHECKBOX  Female  FORMCHECKBOX Home Address FORMTEXT      Postcode FORMTEXT      Home Telephone NumberMobile Telephone NumberWork Telephone Number FORMTEXT       FORMTEXT       FORMTEXT      Email Address FORMTEXT      Landlord Registration Number  FORMTEXT        YES  FORMCHECKBOX  NO  FORMCHECKBOX  If the answer to the above question is YES, please provide the name of the applicant below. (The named individual below must appear in Section 4 or Section 5). If the answer is NO, please go to 6.4. TitleSurnameFirst Name FORMTEXT       FORMTEXT       FORMTEXT      Middle Name(s)Maiden Name (if applicable)Date of Birth FORMTEXT       FORMTEXT       FORMTEXT      Place of Birth FORMTEXT      Male  FORMCHECKBOX  Female  FORMCHECKBOX Home Address FORMTEXT      Postcode FORMTEXT      Home Telephone NumberMobile Telephone NumberWork Telephone Number FORMTEXT       FORMTEXT       FORMTEXT      Email Address FORMTEXT      Landlord Registration Number  FORMTEXT        TitleSurnameFirst Name FORMTEXT       FORMTEXT       FORMTEXT      Middle Name(s)Maiden Name (if applicable)Date of Birth FORMTEXT       FORMTEXT       FORMTEXT      Place of Birth FORMTEXT      Male  FORMCHECKBOX  Female  FORMCHECKBOX Home Address FORMTEXT      Postcode FORMTEXT      Home Telephone NumberMobile Telephone NumberWork Telephone Number FORMTEXT       FORMTEXT       FORMTEXT      Email Address FORMTEXT      Landlord Registration Number (if applicable) FORMTEXT        An Agent is an individual, organisation or company appointed to submit and process an application on behalf of the owners of the property but who will not be acting as day to day managers once a licence has been granted. This section need not be completed if the applicant(s) or appointed day to day manager are submitting the application. Name of Organisation or Company (if applicable) FORMTEXT      Name of responsible person or agent FORMTEXT      Address FORMTEXT      Postcode FORMTEXT      Telephone number FORMTEXT      Mobile number FORMTEXT      E-mail address FORMTEXT        The contact details below can be the applicant, day to day manager or agent as required.  Name of Contact Person FORMTEXT      Address FORMTEXT      Postcode FORMTEXT      Telephone number FORMTEXT      Mobile number FORMTEXT      E-mail address FORMTEXT        Applicant or Day to Day Manager s representative Name of Contact Person FORMTEXT      Address FORMTEXT      Postcode FORMTEXT      Telephone number FORMTEXT      Mobile number FORMTEXT      E-mail address FORMTEXT         Has any person listed in Sections 4, 5, 6 or 8 been convicted of any offences or been issued with any fixed penalty notices?YES  FORMCHECKBOX  NO  FORMCHECKBOX  If the answer to the question above is YES, please provide the details below NOTE: Details of ALL convictions and FIXED PENALTIES (CRIMINAL and ROAD TRAFFIC) including spent convictions must be given below, even if they have been previously disclosed on a prior application form. NameDateCourtCrime/OffencePenalty FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT        An application will only be deemed competent where all necessary information is submitted together with the relevant fee. NEW APPLICATION CHECKLIST DocumentGuidance Note(GN) Approved Standards (AS)CommentEnclosed (Three sets of paper plansGN- Section1.4 FORMTEXT       FORMCHECKBOX Copy of Tenancy/Occupancy AgreementAS-Appendix 2 FORMTEXT       FORMCHECKBOX Copy of Property InsuranceGN- Section 1.4.4 FORMTEXT       FORMCHECKBOX Copy of Landlords Public Liability InsuranceGN- Section 1.4.4 FORMTEXT       FORMCHECKBOX Current NICEIC or SELECT Electrical Installation Condition ReportAS -Section 9 FORMTEXT       FORMCHECKBOX Current Portable Appliance Test (PAT) CertificateAS- Section 9 FORMTEXT       FORMCHECKBOX Gas Safety Certificate (if applicable)AS- Section 12/Appendix 1 FORMTEXT       FORMCHECKBOX Fire Risk AssessmentAS- Section 13 FORMTEXT       FORMCHECKBOX Application FeeGN -Section 1.5 FORMTEXT       FORMCHECKBOX Public Notice displayedGN -Section1.4 FORMTEXT       FORMCHECKBOX The Guidance Note referred to above and below form part of 鶹Ѱ & Butes Councils Guidance Notes and Approved Standards for Houses in Multiple Occupation which is available from the downloadable from the website at: http://www. argyll-bute.gov.uk/licences/house-multiple-occupancy-licence RENEWAL APPLICATION CHECKLIST DocumentGuidance Note(GN) Approved Standards (AS)CommentEnclosed (Copy of Tenancy/Occupancy AgreementAS-Appendix 2 FORMTEXT  u9 p q r ƽ}rf^Ofjh CJUaJh CJaJjh CJUaJh ph.wCJaJh ph.w56h ph.wCJaJhh^Jh h2^J h^J hp^J hw^J h.w^Jh.wh.w^Jh.wCJaJh+CJaJhBCJaJjhjUmHnHu&jhjCJUaJmHnHtH u    Tuq r $$Ifa$gd6i $Ifgde & F$Ifgd & FL$If^`Lgdz@  xxoc $$Ifa$gd6i $Ifgd6i $Ifgde}kd$$Ifl4F^")` t)6    44 lapyt6i    2 4 H J L V X Z \ ` v x ⹪⹛̐}qbqjh6iCJUaJjh6iCJUaJh ph6iCJaJh6iCJaJh ph6iCJaJj h CJUaJjph CJUaJh CJaJh ph.wCJaJh phCJaJh ph.wCJaJjh CJUaJ"jh CJUaJmHnHu    2 Z TKKB6 $$Ifa$gd6i $Ifgd6i $IfgdekdM$$Ifl4\^#")  $   t)644 lap(yt6iZ \ ^ ` v TKKB6 $$Ifa$gd6i $Ifgd6i $Ifgdekd$$Ifl4\^#")  $   t)644 lap(yt6i TKKB6 $$Ifa$gd6i $Ifgd6i $Ifgdekd$$Ifl4\^#")  $   t)644 lap(yt6i    " $ & ( , N P R f h j t v x z ~ Ĺyn_ĹPjq h CJUaJjh6iCJUaJh ph6iCJaJh phCJaJ"jh CJUaJmHnHuj=h CJUaJh CJaJjh CJUaJh ph.wCJaJh ph.wCJaJh ph6iCJaJh6iCJaJjh6iCJUaJ"jh6iCJUaJmHnHu & TKKB6 $$Ifa$gd6i $Ifgd6i $Ifgdekd$$Ifl4\^#")  $   t)644 lap(yt6i& ( * , P x TKKB6 $$Ifa$gd6i $Ifgd6i $Ifgdekd$$Ifl4\^#")  $   t)644 lap(yt6ix z | ~ TKKB6 $$Ifa$gd6i $Ifgd6i $IfgdekdN $$Ifl4\^#")  $   t)644 lap(yt6i  5 F R [ ~peYJ?h9Hh6iCJaJjh9Hh6iCJUaJh6ih6i5CJaJhNhz@CJaJ jxh:hhz@CJaJh,CJaJh:hhz@5CJaJh:hhz@CJaJhz@CJaJh.wCJaJ&jhz@CJUaJmHnHtH uhJjh.wCJ aJ h phCJaJh ph.wCJaJjh CJUaJ"jh CJUaJmHnHu TOMMMME$a$gd6}gd.wkd $$Ifl4\^#")  $   t)644 lap(yt6i  * + 9 R d e f  $$Ifa$gd6i $IfgdcFf $$Ifa$gd9H $Ifgd:h    ' ( ) * 8 9 A I R S a b c d e f z Ǿӣǚǚӈ}ynfnZRh CJaJjh CJUaJhiCJaJh9HhcCJaJh:hh9Hh6iCJaJ#j h9Hh6iCJUaJhN5CJaJ#j~ h9Hh6iCJUaJh [5CJaJhB 5CJaJh6ih6i5CJaJh9Hh6iCJaJjh9Hh6iCJUaJ#j h9Hh6iCJUaJ   .0FǼtcUcFjh9HhcCJUaJh~5B*CJaJph h9Hhc5B*CJaJphhNhcCJaJhcCJaJ jxhchcCJaJhcCJaJhchc5CJaJhchcCJaJhz@CJaJh9HhCJaJh9HhcCJaJ"jh CJUaJmHnHujh CJUaJjh CJUaJ(ljjjaU $$Ifa$gd9H $Ifgdnkdq$$Ifl0")$j  t 044 lapyt6i"$&(*bdfh .0246ɾɜ}ncQ#jh9HhcCJUaJh9Hh6iCJaJj}hY`CJUaJhY`CJaJjhY`CJUaJh9Hh6iCJaJh6iCJaJ#jSh9HhM CJUaJhNCJaJh9HhcCJaJh9HhCJaJjh9HhcCJUaJ#j)h9HhcCJUaJh9HhcCJaJ(*fmdX $$Ifa$gd9H $Ifgd~kd$$Ifl0%(d&  t 0644 lapyt!mdX $$Ifa$gd9H $Ifgdckd$$Ifl0%(d&  t 0644 lapyt!4mdX $$Ifa$gd9H $Ifgd~kd$$Ifl0%(d&  t 0644 lapyt!46 md $Ifgdckd$$Ifl0%(d&  t 0644 lapyt!6  "$&02468LNPZ\^`bf ۴sh`LDhYCJaJ&jhYCJUaJmHnHtH uh#jCJaJh9HhCJaJ(jh9HhCJUaJmHnHu#jqh9HhCJUaJh9HhCJaJjh9HhCJUaJ(jh9HhcCJUaJmHnHu#jqh9HhcCJUaJjh9HhcCJUaJh9HhcCJaJh9HhcCJaJ  4| $Ifgdcykd$$Ifl(4)  t 0644 lap yt!46^ $Ifgdcpkd$$Ifl(4) t0644 lap yt9H^`bhjln Lt $Ifgdi(pkd$$Ifl(4) t0644 lap yt9H LNbdfprtv*ۢېsa#j3hhCJUaJ#jhhCJUaJhh9HCJaJ#jhhCJUaJ#jghhCJUaJ(jhhCJUaJmHnHu#jqhhCJUaJhhCJaJjhhCJUaJhhlJ%CJaJ&tvkbb $Ifgdi(kd$$Ifl0\ ")   t 0644 lapytY`e\\ $Ifgdi(kd$$Ifl0.")  t0644 lapytY`tkk $Ifgdi(kdO$$Ifl0.") t0644 lapytY`e\\ $Ifgdi(kd$$Ifl0 ")v  t0644 lapytY`.0DFHRT(*,68ŶŤŶ}ŶkcŶQ#j"hh^HCJUaJh~CJaJ#j?"hh^HCJUaJ#j hh^HCJUaJ(jhh^HCJUaJmHnHu#jP hh^HCJUaJjhh^HCJUaJhh^HCJaJhhlJ%CJaJ(jhhCJUaJmHnHujhhCJUaJ.Vtkkkk $Ifgd^Hkd$$Ifl0 ")v t0644 lapytY`:/&&& $Ifgd^Hkd>> $Ifgdn Ekd6$$IflF| e")    t06    44 lapyt!JL`bdnprt޾޾޾kYk#j:h!hCJUaJ(jh!hCJUaJmHnHu#j:h!hCJUaJjh!hCJUaJh!hCJaJ#j7h!hn ECJUaJh!hn ECJaJ(jh!hn ECJUaJmHnHujh!hn ECJUaJ#j|7h!hn ECJUaJ,H\SSS $Ifgdkdh8$$IflF| e")   t06    44 lapyt!HJrG>>> $Ifgdkd)9$$IflF| e")    t06    44 lapyt!468VXtvx|޾޾޾ncTcjh!hnCJUaJh!hnCJaJ#j!=h!hCJUaJ#j<h!hCJUaJh!hCJaJjh!hCJUaJ#j7<h!hCJUaJh!hCJaJ(jh!hCJUaJmHnHujh!hCJUaJ#j;h!hCJUaJ z\SSG $$Ifa$gd! 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jxhUhWCJaJh(:\CJaJh(:\h(:\CJaJhh\RCJaJh\RCJaJhhWCJaJhWCJaJhWhW5CJaJhu5CJaJhF@hWCJaJhUCJaJhFhFCJ^JaJhFh2CJaJ܇45>Phpy{ $$Ifa$gdy  $Ifgdy  X]X^gd%l {|) $Ifgdy kd[$$Ifl\%N)*<8  t(0644 lap(ytF@      FORMCHECKBOX Copy of Property InsuranceGN -Section 1.4.4Current certificate and previous two years certification required. FORMCHECKBOX Copy of Landlords Public Liability InsuranceGN- Section 1.4.4Current certificate and previous two years certification required. FORMCHECKBOX Current NICEIC or SELECT Electrical Installation Condition ReportAS-Section 9Certification to be current and cover the preceding period of licence. FORMCHECKBOX Current Portable Appliance Test (PAT) CertificateAS-Section 9Current certificate and previous two years certification required. FORMCHECKBOX Gas Safety Certificate (if applicable)AS-Section 12 Appendix 1Current certificate and previous two years certification required. FORMCHECKBOX Fire Risk Assessment and service records (current and previous 2 years).AS- Section 13Service records for Fire Extinguishers, Emergency Lighting and Alarm System FORMCHECKBOX Application FeeGN- Section 1.5 FORMTEXT       FORMCHECKBOX Public Notice displayedGN -Section1.4 FORMTEXT       FORMCHECKBOX   Variation CHECKLIST DocumentGuidance Note(GN) Approved Standards (AS Change of ownership prior to Licensing Committee (New Application only)Change of day to day managerChange of OccupancyPhysical change to propertyEnclosed (Three sets of paper plansGN Section 1.4RequiredRequired FORMCHECKBOX Copy of Tenancy/Occupancy AgreementAS Appendix 2RequiredRequired FORMCHECKBOX Copy of Property InsuranceGN Section 1.4.4Required FORMCHECKBOX Copy of Landlords Public Liability InsuranceGN Section 1.4.4Required FORMCHECKBOX Planning Change of Use Consent (if applicable)GN Section 1.3RequiredRequired FORMCHECKBOX Building Standards Warrant and Completion Certificate (if applicable)GN Section 1.3Required FORMCHECKBOX Fire Risk AssessmentAS Section 13RequiredRequiredRequiredRequired FORMCHECKBOX Application FeeGN Section1.5RequiredRequiredRequiredRequired FORMCHECKBOX   Where declaration (A) is made a Certificate of Compliance with paragraph 2(5) of Schedule4 to the Housing (Scotland) Act 2006 must be produced in due course (see notes). (A)I  FORMCHECKBOX  / we  FORMCHECKBOX  declare that I  FORMCHECKBOX  / we  FORMCHECKBOX  shall, for a period of 21 days commencing with the date hereof, display at or near the premises so that it can conveniently be read by the public, a note complying with the requirements of Paragraph 2(1), (2) and (3) of Schedule 4 of the Housing (Scotland) Act2006 (see note 2).OR(B)I  FORMCHECKBOX  / we  FORMCHECKBOX  declare that I am  FORMCHECKBOX  / we are  FORMCHECKBOX  unable to display a notice of this application at or near the premises because I  FORMCHECKBOX  / we  FORMCHECKBOX  have no rights of access or other rights enabling me to do so, but that I FORMCHECKBOX  / we  FORMCHECKBOX  have taken the following steps to acquire the necessary rights, namely: (specify steps taken here). but have been unable to acquire those rights.OR(C)I am  FORMCHECKBOX  / we are  FORMCHECKBOX  not required to display a notice as the application is in respect of premises used as a Womens refuge.  Data Protection Act 1988  Your Personal Data Argyll and Bute Council respects your personal information and undertakes to comply with the Data Protection Act 1998. The personal data you have provided will be used to process your application. Your data may be disclosed to Police-Scotland, Fire-Scotland and other Council Departments involved in the processing of the application and Elected Members when considering representations made regarding the application. The data (with the exception of details of any convictions) will also be kept in Argyll and Bute Council s HMO  Public Register which is open to public inspection. By completing and submitting this form you consent to the use of your personal data including, where appropriate, sensitive personal data. You have a right to apply for a copy of the information we hold about you, and to have any inaccuracies corrected. The set fee of 10 will be charged. Should you wish to exercise this right, your request must be made in writing to the Data Protection Officer, Argyll & Bute Council, Kilmory, Lochgilphead, PA31  I DECLARE THAT THE PARTICULARS GIVEN BY ME ON THIS FORM ARE CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF AND THAT I HAVE READ THE GUIDANCE NOTES. I FURTHER ACKNOWLEDGE THAT I UNDERSTAND IT IS A CRIMINAL OFFENCE TO OPERATE AN HMO PRIOR TO A LICENCE BEING GRANTED. Signature of Applicant or Agent* (*delete as necessary) FORMTEXT       The individual signing this application should be an applicant or alternatively the agent or day to day manager identified in this application. Name (BLOCK CAPITALS) FORMTEXT      Position (if signing on behalf of applicant) FORMTEXT      Address FORMTEXT      Postcode FORMTEXT        This application should be lodged with the HMO & Landlord Registration Team, Regulatory Services, Kilmory, Lochgilphead, PA31 8RT, or submitted to a Customer Contact Point, together with the fee and supporting documents. The fee is non refundable other than where an application is withdrawn before being determined or unsuccesful in which case a partial refund will be made (refer to Guidance Note section 1.5 and Approved Standards for Houses in Multiple Occupation, paragraph 2). An application can only be made in the name of the owner(s) of the property, even if they are being represented by an appointed agent or property management service. An appointed agent (see section7 of the application form) is a person who assists an owner in the application process but who will not be involved in the day to day management of the property. They are not subject to a Police check. In terms of the Housing (Scotland) Act 2006, a Notice in the prescribed form must be prominently displayed at or as near to the property as possible so that it can be conveniently read from the public footpath, for a period of 21 days from the date the application is lodged with the local authority. (Copy Noticeenclosed). The Certificate of Compliance, forming part of this application, must be completed and returned confirming that the steps at (A), (B) or (C) detailed in the Section 11  Public Notice Declaration have beencarriedout.(CopyCertificateenclosed). The certificate should be submitted after the expiry of the 21 day period (see note 2 above). Refer to the attached  Guidance Notes and Standards for Houses in Multiple Occupation for further information. Details of the fee scales are provided in the Guidance Notes. Cheques should be made payable to  Argyll and Bute Council Anyone who can require a Licensing Authority to give reasons for a licensing decision (both objectors and applicants) can appeal to the Sheriff against it by summary application. The appeal must be lodged within 28days. The Sheriff can uphold an appeal only if the authority erred in law, based their decision on an incorrect material fact, acted contrary to natural justice, or exercised their decision in an unreasonable manner.If you are in a position where you are considering an appeal to the Sheriff you should consult a Solicitor or Citizens Advice Bureau for further information. Should you require any further assistance in completing this application, please contact: Argyll & Bute Council s HMO & Landlord Registration Team on 01546 605519, Regulatory Services, Kilmory, Lochgilphead, Argyll & Bute PA31 8RT.  Please indicate relevant section ( Section 4 FORMCHECKBOX Section 5 FORMCHECKBOX Section 6 FORMCHECKBOX  TitleSurnameFirst Name FORMTEXT       FORMTEXT       FORMTEXT      Middle Name(s)Maiden Name (if applicable)Date of Birth FORMTEXT       FORMTEXT       FORMTEXT      Place of Birth FORMTEXT      Male  FORMCHECKBOX  Female  FORMCHECKBOX Home Address FORMTEXT      Postcode FORMTEXT      Home Telephone NumberMobile Telephone NumberWork Telephone Number FORMTEXT       FORMTEXT       FORMTEXT      Email Address FORMTEXT      Landlord Registration Number  FORMTEXT      Will this applicant be carrying out day to day management of the HMO?YES  FORMCHECKBOX  NO  FORMCHECKBOX  TitleSurnameFirst Name FORMTEXT       FORMTEXT       FORMTEXT      Middle Name(s)Maiden Name (if applicable)Date of Birth FORMTEXT       FORMTEXT       FORMTEXT      Place of Birth FORMTEXT      Male  FORMCHECKBOX  Female  FORMCHECKBOX Home Address FORMTEXT      Postcode FORMTEXT      Home Telephone NumberMobile Telephone NumberWork Telephone Number FORMTEXT       FORMTEXT       FORMTEXT      Email Address FORMTEXT      Landlord Registration Number  FORMTEXT      Will this applicant be carrying out day to day management of the HMO?YES  FORMCHECKBOX  NO  FORMCHECKBOX  Intentionally Blank Notice for Posting-Housing (Scotland) Act 2006  NOTICE IS HEREBY GIVEN that an application has been made on the & & & & to Argyll and Bute Council for a House in Multiple Occupation Licence/Licence Renewal at the following address (Insert full address) Postcode Name and Address of Applicant Postcode  Directors names and addresses NameAddress    Day to Day Manager name and address Person engaged for the purposes of day  day management Postcode Any objections and representations in relation to the application must be addressed to Regulatory Services, Argyll & Bute Council, Kilmory Castle, Lochgilphead, Argyll and Bute, PA318RT within 28 days of the above mentioned date. Objections and representations should be made in accordance with the following provisions namely: 1. Any objection or representation relating to an application for the grant or renewal of the licence shall be entertained but only if the objection or representation: a. is in writing b. specifies the grounds of the objection or , as the case may be , the nature of the representation; c. specifies the name and address of the person making it; d. is signed by him or on his behalf; e. was made to them within 28 days of whichever is the later or as the case may be the latest of the following dates Where public notice of the application was given in a newspaper, the date when it was first given; Where the Argyll and Bute Council has required the applicant to display the Notice again from that specified date. In any other case, the date when the application was made to them. 2. Notwithstanding 1.1.5 it shall be competent for Regulatory Services Manager to entertain an objection or representation received by them before they take a final decision upon the application to which it relates if they are satisfied that there is sufficient reason why it was not made in the time required. 3. An objection or representation shall be made for the purposes of section 1 aforementioned if it is delivered by hand within the time specified to the correct address or posted( by registered or recorded delivery) so that in the normal course of post it might be expected to be delivered to them within that time. 4. Argyll and Bute Council shall send a copy of the objection or representation to the applicant. Intentionally Blank Certificate of Compliance - Housing (Scotland) Act 2006 I ( state name)  being the applicant/agent(delete as appropriate) for a Licence for a House in Multiple Occupation, hereby certify that a NOTICE has been posted at or near the premises at : (insert full address) Postcode From (insert dates)  To  Containing such information as is required by paragraph 2(5) of Schedule 4 of the above Act. *Where said notice was removed, obscured or defaced during the above mentioned period I took all reasonable steps for its protection and replacement as follows(*Delete if not applicable): (Give details and circumstances)  I can confirm I have removed the NOTICE following it being displayed for 21 days Signature  Date  This Certificate must be returned to: HMO & Landlord Registration Team Regulatory Services, Argyll and Bute Council, Kilmory, Kilmory Castle, Lochgilphead, PA318RT only after the 21 day notice period is over. Intentionally Blank     PAGE  HMO/GN/1IssueReview Date10/01/12 PAGE \* MERGEFORMAT 21 Page  PAGE \* MERGEFORMAT 1 HMO/ (December2015) House in Multiple Occupation (HMO) Application for Grant, Renewal or Variation of Licence Section 1  Application Type Section 2  Property Details Section 3  Previous Licence Applications Section 4  Applicant Details (Individual Person) 4.1 Main Applicant (to be completed if an individual person) 4.2 Joint Owners (to be completed if an individual person) Section 5  Applicant Details (Company/Charity/Trust/Partnership) 5.1 Please indicate whether the applicant is a Company, Charity, Trust or Partnership 5.2 Please provide the details of the Company, Charity, Trust or Partnership 5.3 Please provide details of all Director(s), Trustees or Partners. Section 6  Day to Day Management 6.1 Is the day to day Manager an organisation or company? 6.2 Please provide the details of all Directors or Partners where an organisation or company is carrying out the day to day management 6.3 Will any of the applicants for this licence be carrying out the day to day management? 6.4 If the day to day Manager is an individual other than an applicant, named in Section4 or Section 5, please complete the details below Section 7  Appointed Agent Section 8  Contacts 8.1 Contact for access and queries during the application process 8.2 Contact for access and queries during the life of the licence Section 9  Details of Convictions and Fixed Penalty Notices Section 10  Checklist of Required Enclosures and Actions Section 10  Checklist of Required Enclosures Section 11  Public Notice Declaration Section 12  Data Protection Act 1988  Your Personal Data Section 13  Notes Section 14  Additional Applicants     , . 0 4 j       2 4 6 : \ j    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