Petroleum Spirit Licence

APPLICATION FORM PETROLEUM-SPIRIT LICENCE

Grant/Renewal/Transfer (*) of a Petroleum-Spirit Licence
Petroleum (Consolidation) Act (Northern Ireland) 1929

Your name

Premises to be Licensed

Postcode:

Tel:

Fax:

Mobile:

Email:

 
Licence Type:
Cost (£):
 
Name and Address of Applicant(s)

Postcode:

Tel:

Fax:

Mobile:

Email:

 

I/We hereby apply to Derry City Council for a licence under the Petroleum (Consolidation) Act (Northern Ireland) 1929 to store litres of Petroleum-Spirit at my/our premises as detailed below.

   
Storage Details (1) Tanks

litres
  (2) Can Store

litres
  (3) Filling Shed

litres


I/We Undertake-
  1. to abide by the terms of the licence, if granted, and to
  2. deliver up the licence for cancellation within one month of any sale or other disposal of the premises or of thepremised ceasing to be used for the purpose for which the licence was granted.

I/We Understand- that the licence will not be granted if the premises do not comply with the requirements of the Act and any Regulations made thereunder, with the appropriate Model Code of Principals of Construction and the Licensing Conditions issued by the Home Office under the Petroleum (Consolidation) Act 1928 and with the requirements of the Northern Ireland Fire and Rescue Service and that the licence may at any time be cancelled if the premises cease to comply.


Notes: if the applicant is-

  • (a) an individual or partnership the full names and addresses of all partners;
  • (b) a Limited Company, the full name and address of the registered office in Northern Ireland of the company and the full name of the secretary or other authorised officer of the company must be given.

If the applicant is-

  • (c) an individual or partnership, to be singed by all partners;
  • (d) a Limited Company, to be signed by the secretary or other authorised officer. In the case of a new application or where any alterations have been carried out to the layout of the storage, a plan of the premises in duplicate on a scale of not less 1/12500 must be submitted with the application form.