Notification of new construction project (NI10)

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Notification of construction project (NI10) The Data Protection Act 1998 requires the Health and Safety Executive for Northern Ireland (HSENI) to inform you that this form may include information about you (this is called ‘personal data’ in the Act) and that we are a ‘data controller’ for the purposes of this Act. HSENI will process these data for health, safety and environmental purposes. HSENI may disclose these data to any person or organisation for the purposes for which it was collected or where the Act allows disclosure. As data subject, you have the right to ask for a copy of the data and to ask for any inaccurate data to be corrected. This form is to be used for new notifications only. If you are wishing to update a previously submitted notification, this should be done by email quoting the case reference number and indicating the amendments required. Emails must be sent to: [email protected]

Transcript of Notification of new construction project (NI10)

Notification of construction project (NI10) The Data Protection Act 1998 requires the Health and Safety Executive for Northern Ireland (HSENI) to inform you that this form may include information about you (this is called ‘personal data’ in the Act) and that we are a ‘data controller’ for the purposes of this Act. HSENI will process these data for health, safety and environmental purposes. HSENI may disclose these data to any person or organisation for the purposes for which it was collected or where the Act allows disclosure. As data subject, you have the right to ask for a copy of the data and to ask for any inaccurate data to be corrected. This form is to be used for new notifications only. If you are wishing to update a previously

submitted notification, this should be done by email quoting the case reference number and

indicating the amendments required. Emails must be sent to: [email protected]

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About you
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Title:
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First Name:
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Surname:
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Job Title:
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Telephone:
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E-mail:
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Site Address - if multiple, enter primary site details below and further addresses in the Description field.
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Date of notification:
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Property:
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Postcode:
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County:
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Town:
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Locality:
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Street:
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Description of the project and the construction work it includes:
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Client Contact Details
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Name:
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Locality:
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Postcode:
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E-mail:
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HSENI Form: NI10
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(Please use format: dd/mm/yyyy)

12. Declaration of client

Signed by or on behalf of the organisation

Print name Date

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Principal Designer Details
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E-mail:
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Principal Contractor Details
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E-mail:
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(If more than one designer, please attach details on a separate sheet)
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Project
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What is the time allowed by the client to the principal contractor referred to in regulation 4(1) for the construction work?
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Please give your estimates for the following? Planned commencement date:
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Duration: (weeks - insert number only)
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Max no. of people carrying out construction work on site at any one time:
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The number of contractors expected to work on site:
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Provide names, addresses and contact details of any designers or contractors already appointed:
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I hereby declare that I am aware of my duties under the Construction (Design and Management) Regulations (Northern Ireland) 2016 No. 146.
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Name:
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Street:
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Town:
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Postcode:
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Property:
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Locality:
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Telephone:
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Name:
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Street:
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Town:
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Property:
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Telephone:
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(Please use format: dd/mm/yyyy)
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