GRANT SCHEME FOR THE RESTORATION, CONSERVATION AND MAINTENANCE OF PRIVATELY OWNED RESIDENTIAL BUILDINGS WITHIN URBAN CONSERVATION

AREAS AND GRADE 1 AND GRADE 2 SCHEDULED BUILDINGS

2012

APPLICATION FORM EXPRESSION OF INTEREST

REFERENCE NO.:
DATE:

APPLICATION FORM - EXPRESSION OF INTEREST

HOW TO COMPLETE THIS FORM
o

All questions within the application form must be correctly filled. Reference should be made to the accompanying guidance notes and the Government Notice regulating this scheme when filling in this form. All supporting/requested documents should be included with the application on submission. The application cannot be processed until all the information and documents have been submitted. Incomplete applications forms will be returned. Applications for work that have already been carried out will not be accepted, unless the work is covered by a valid planning application and supported by a Restoration Method Statement (RMS). Such works must also have been subject to periodical monitoring and supported by original fiscal receipts. The scheme is intended to fund works of a restoration nature and no applications involving one or more qualities as listed in section 4(iii) of the Government Notice regulating this scheme will be considered (refer also to guidance notes). Application forms can be submitted between the 17 February 2012 and 30 June 2012. These are to be submitted at MEPA, St. Francis Ravelin Floriana. The scheme will be terminated once all 1,000 grants have been awarded.
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APPLICANT
Q1 APPLICANTS DETAILS (OWNER) Title: Name/Surname: I.D. number: Address: Locality: Telephone/Mobile: E-Mail: Postcode: (supply a copy of ID)

Q2

CONTACT DETAILS OF THE PERSON IN CHARGE OF THE PROJECT (IF APPLICABLE IN CASES WHERE THE OWNER IS NOT THE PRIME CONTACT) Title: Name & Surname: Address: Locality: Telephone/Mobile: E-Mail: Postcode:

PROPERTY
Q3 DETAILS OF THE PROPERTY FOR WHICH YOU ARE APPLYING Name: No.: Street: Locality: Postcode:

A SITE PLAN CLEARLY INDICATING THE PROPERTY, IS TO BE

SUBMITTED WITH THE APPLICATION
Q4 IS THE PROPERTY SCHEDULED OR WITHIN AN UCA? (THIS CAN BE CHECKED FROM: HTTP://WWW.MEPA.ORG.MT/SCHEDSCHEDULINGSEARCH ) YES If yes, state which grade and Government Notice number Grade 1 Grade 2 UCA Q5 STATUS OF PLANNING APPLICATION Approved Pending Not yet submitted but screening letter has been issued Screening not yet submitted Provide PA number Provide PA number Provide screening number Government Notice number NO

Q6

HAS THE WORK BEEN UNDERTAKEN AND COMPLETED? YES Date when work commenced NO Date works completed

Q7

IS THE WORK STILL IN PROGRESS? YES NO

Q8

IF WORKS HAVE ALREADY BEEN UNDERTAKEN OR STILL IN PROGRESS, ARE THEY COVERED BY A PLANNING PERMIT? IF YES, PROVIDE DETAILS YES List Planning applications: NO

Q9

IS THERE A PREVIOUS OR PENDING ENFORCEMENT NOTICE? YES List enforcement notices: NO

Q10

ARE THERE ANY PREVIOUS/PENDING PLANNING APPLICATIONS (GRANTED OR REFUSED) ON SITE? IF YES, PROVIDE DETAILS. YES NO

THE PROJECT
Q11 PROVIDE DETAILS OF THE PROJECT FOR WHICH YOU ARE SEEKING A GRANT

Q12

PROVIDE DETAILS OF THE ARCHITECT RESPONSIBLE FOR THE PROJECT Name & Surname: Warrant No.: Address: Locality: Email: Mobile No.: Postcode:

Q13

PROVIDE DETAILS OF CONTRACTOR ENTRUSTED WITH THE PROJECT (IF ALREADY CONTRACTED) Name & Surname: Company name: License No. Address: Locality Postcode:

Q14

DOES THE WORKS FOR WHICH YOU ARE APPLYING NEED TO BE CARRIED OUT URGENTLY (EG. WITHIN THE NEXT 12 - 24 MONTHS) OWING TO DANGER OR TO PREVENT LOSS OR DAMAGE TO THE HISTORIC FABRIC? YES If Yes, provide details NO

Q15

REGULAR MAINTENANCE IS IMPORTANT, HOW DO YOU INTEND TO CARRY OUT REGULAR

MAINTENANCE IN ORDER TO ENSURE THAT THE BENEFITS OF YOUR PROJECT ARE MAINTAINED

PROJECT COSTS AND FUNDING

Q16 PROVIDE AN ESTIMATED BREAKDOWN OF THE PROJECT COSTS MATERIAL (MASONRY, WROUGHT IRON, WOODEN FIXTURES, ETC.) AND LABOUR Item Cost (incl. VAT)

Subtotal Q17 PROVIDE AN ESTIMATED BREAKDOWN OF THE PROJECT COSTS HIRE OF EQUIPMENT Item Cost (incl. VAT)

Subtotal

Q18

PROVIDE AN ESTIMATED BREAKDOWN OF THE PROJECT COSTS PROFESSIONAL SERVICES (EG. ARCHITECT, CONSERVATOR, QUANTITY SURVEYOR, ETC.). Item Cost (incl. VAT)

Subtotal Q19 HAVE YOU EVER BENEFITED OR APPLIED FOR ANY GRANT OR VAT REFUND? (EG. GOOD CAUSES FUND, EU PROJECTS/FUNDING) YES If Yes, provide details NO

Q20

HOW DO YOU PROPOSE TO FUND YOUR SHARE FOR THE PROJECT? (THE INCENTIVES WILL NOT COVER ALL THE COSTS, THEREFORE YOU ARE EXPECTED TO CONTRIBUTE TO THE TOTAL COSTS).

DECLARATION
The completed application form must be signed by the applicant in Q1. If any misleading, incorrect or outdated information is found to have been submitted, the application is automatically deemed null. If such is only realized after a fiscal incentive has been awarded, then the amount must be reimbursed. I/WE CONFIRM THAT I/WE HAVE READ AND ACCEPT ALL THE RELEVANT INFORMATION (THE GUIDANCE NOTES, GOVERNMENT NOTICE) AND THAT THE INFORMATION IN THIS APPLICATION FORM, TOGETHER WITH THE SUPPORTING INFORMATION ENCLOSED WITH IT, IS ACCURATE, COMPLETE AND UP TO DATE.

Signature of applicant:

Name of applicant: Date: ARCHITECTS DECLARATION I, the undersigned architect, hereby declare that to the best of my knowledge all the technical content contained in this application is correct and that I shall undertake the direction and responsibility for the works referred in this application according to Article 97 (o) of the Code of Police Laws (Chapter 10).

Signed OWNERSHIP

Architects Official Stamp

Date

I certify that nobody except the applicant is the owner of any part of the building to which the applicant relates.

Signed

Name/surname & ID no.

Date

FOR OFFICE USE ONLY

MEPA Certificate of completion
REFERENCE NUMBER: DATE OF SUBMISSION:

APPLICATION VALIDATED AND ASSESSED ON AND LETTER OF CONDITIONAL APPROVAL ISSUED ON:

PLANNING APPLICATION NUMBER DATE OF PERMIT:

COMPLETION OF WORKS TO THE SATISFACTION OF MEPA:

FISCAL RECEIPTS SUBMITTED ON: CHECKED:

RECOMMENDED FOR PAYMENT OF GRANT

STATE REASONS IF NO

YES

NO

NAME

DATE

POSITION

RUBBER STAMP

10

VAT Department
DATE RECEIVED:

APPLICATION RECEIVED AND CHECKED ON/BY:

ORIGINAL FISCAL RECEIPTS ASSESSED ON/BY:

I HEREBY DECLARE THAT THE ORIGINAL FISCAL

RECEIPTS SUBMITTED WITH THIS APPLICATION WERE VERIFIED AND FOUND TO CONFORM WITH THE PROVISIONS IN THE THIRTEENTH SCHEDULE TO THE VALUE ADDED TAX ACT (CAP. 406)

RECOMMENDED FOR PAYMENT OF GRANT COMMENTS:

YES

NO

GRANT DUE (AMOUNT IN )

NAME

DATE

POSITION

STAMP

11