Canterbury Earthquake Heritage Buildings Fund
Application for Funding
page 1 of 9
NOTE: This application form should be read in conjunction with the Canterbury Earthquake
Heritage Buildings Fund Policy and the Operational Guidelines.
Purpose of the Fund
The purpose of the Canterbury Earthquake Heritage Buildings Fund is to provide assistance
to owners of listed heritage buildings and character buildings to repair damage caused by the
series of earthquakes in the Canterbury region since September 2010.
The Fund will be used to achieve the maximum public benefit with priority given to places of
greatest heritage significance. Funding will be targeted at the gap between insurance cover
and the total cost of works. Full covenants will be registered against Certificates of Title
where funding exceeds $150,000.00. The Trustees on behalf of the Fund have the absolute
discretion to determine the grant dollar amount depending on the factors set out in the
Operational Guidelines, in particular the Criteria for Assessing Grant Applications. Refer to
section 2.5 of the Operational Guidelines and section 6.2 of the Policy.
Eligibility
Funding will be available for listed heritage buildings and character buildings within
Canterbury, being:
 historic buildings listed in a District Plan or in New Zealand Historic Places Trust’s
(NZHPT) Register of historic places, historic areas, wahi tapu or wahi tapu areas;
 buildings and groups of buildings that make a significant contribution to the historic
identity and visual character of communities; and
 marae buildings and other buildings of significance to Māori.
Applicants should ensure that they meet the eligibility requirements relating to (i) ownership
and (ii) the scope of proposed works (see Operational Guidelines sections 3.0 and 4.0).
Important
Each section of this form must be completed in full. Applicants may include additional
information to support their application. Please attach additional pages to this application.
Further information may be requested if this is needed to substantiate or assess the case for
funding.
CANTERBURY EARTHQUAKE HERITAGE BUILDINGS FUND 1
APPLICATION FORM 2012
Please submit your application form to:
The Chairperson
The Canterbury Earthquake Heritage Buildings Fund
c/- Strategy and Planning Group, Christchurch City Council
PO Box 73012, Christchurch 8154
Please identify the Canterbury local authority district within which your building is located.
1.0 Applicant’s Details
Applicant’s Name:
Individual/Representative:
If representative, name of group, agency, organisation:
If representative, summary of legal status, purpose and activities of group, agency or
organisation:
Postal Address:
Phone:
Email:
2.0 Property Details
Name of property:
Owner of property (if different from applicant):
Address of property:
Certificate of Title details (please attach a copy of the Certificate of Title)
CANTERBURY EARTHQUAKE HERITAGE BUILDINGS FUND 2
APPLICATION FORM 2012
3.0 Registration/Listing Details of Property
Is the property registered by the New Zealand Historic Places Trust under the Historic Places
Act 1993?
Y/N
If yes, what is the category? ( e.g., historic place, category 1 or 2)
Is the property listed in a city/district plan?
Y/N/Don’t Know
4.0 Heritage value
If not a Registered or Listed Building, provide a summary and description of the heritage values
of the building.
Also provide a summary of the contribution that the proposed works will make to heritage
values and the visual character of the community.
CANTERBURY EARTHQUAKE HERITAGE BUILDINGS FUND 3
APPLICATION FORM 2012
5.0 Description of Damage Sustained
Please attach a damage report from your architect, assessor, builder or engineers. Before &
after photos would be helpful if available. Give a brief summary below
6.0 Description of Restoration Works
Is it intended to: (Tick box)
1. Fully restore the building
2. Partially restore the building
3. Retain the façade only
Describe in more detail the scope and nature of the works to be undertaken. Include a report
from your architect, assessor, builder or engineer, providing evidence of the feasibility and
durability of the proposed works.
7.0 Project Timing and Management
Provide details of proposed time frames for the projects.
Who will manage the contract?
CANTERBURY EARTHQUAKE HERITAGE BUILDINGS FUND 4
APPLICATION FORM 2012
8.0 Project Management
Please name the following if being utilised
Architect:
Contact details
Assessor:
Contact details
Builder:
Contact details
Engineer:
Contact details
9.0 Document Check List
Provide a list of the documents attached to your application
Before & after photographs of the building, including damage sustained and where possible the
building before the damage occurred.
A full engineering report relating to the damage sustained and the work proposed is a
requirement.
Have you included: (Tick boxes)
Copy of Certificate of Title (Question 2)
Before & after photographs (Question 5)
Report(s) on damage sustained and works proposed (Questions 5 and 6)
CANTERBURY EARTHQUAKE HERITAGE BUILDINGS FUND 5
APPLICATION FORM 2012
10.0 Consultants/Professional Advisors
Provide details of the consultants/professional advisors relevant to this work. For listed and
registered heritage buildings, work must be carried out by appropriately skilled and (as
appropriate) qualified professionals.
Name:
Address:
Phone:
Email:
Profession:
Name:
Address:
Phone:
Email:
Profession:
Name:
Address:
Phone:
Email:
Profession:
11.0 Building and Resource Consents
Has the applicant discussed the proposed works with council staff in their district? Y/N
Have building or resource consents been applied for at the time of application? Y/N
12.0 Applications concerning/affecting Māori heritage
If the application concerns Māori heritage (wahi tapu, wahi tapu areas or historic places or
areas) and the application is not made by the appropriate whanau, hapu or iwi, indicate if
endorsement by the appropriate whanau, hapu or iwi has been received and attach evidence of
that endorsement.
Names of whanau, hapu or iwi
Endorsement received and attached?
CANTERBURY EARTHQUAKE HERITAGE BUILDINGS FUND 6
APPLICATION FORM 2012
13.0 Applications concerning New Zealand Historic Places Trust-registered buildings
If the application concerns a property registered by the New Zealand Historic
Places Trust, has the proposed work been discussed with the Historic Places Trust?
Y/N
14.0 Project Costs and Funding Sources
Project Costs
Costs must be independently verified preferably by a Quantity Surveyor and/or builder. All costs
are to be inclusive of GST.
What is the total cost of the work proposed?
$
Itemised cost of restoration works eligible for funding:
Refer to the Operational Guidelines for eligible works.
$
Insurance Cover
Please attach a verified estimate of private insurance cover from the applicant’s insurance
company, loss adjuster or broker.
Private insurance cover
Insurance excess
EQC cover
$
$
$
Other sources of Project Funding
Own contributions
$
Government agency
Local authority
Charitable trust
Other (please specify)
$
$
$
$
Summary of Project Costs and Funding
Total costs of proposed work
$
Insurance cover
$
Other funding
$
Shortfall
$
CANTERBURY EARTHQUAKE HERITAGE BUILDINGS FUND 7
APPLICATION FORM 2012
15.0 Previous funding (if known)
Have any previous grants been received for conservation and maintenance of this
building?
If yes, please list the amount and purpose of any previous grants.
16.0 Urgency of Application
Is the decision on this application urgent?
Y/N
If yes, explain why.
CANTERBURY EARTHQUAKE HERITAGE BUILDINGS FUND 8
APPLICATION FORM 2012
Declaration
The applicant hereby declares that all information contained in this application is true and
correct, and that no material information has been deliberately omitted or withheld from this
application. The applicant also agrees that:
1. Compliance with all applicable statutory requirements, including necessary resource
and building consents, is the responsibility of the recipient.
2. The property must be made available for viewing/ inspection for the purposes of
assessing the funding application.
3. Photographs of the property may be used by the Trust for the purposes of promoting
the Fund and reporting to the Minister for Arts, Culture and Heritage. The Trust may
request involvement of the owner in publicity and promotion of the Fund for any
media statements.
4. The Trust may make public the name of the recipient, the name and address of the
property and its heritage significance, the funding allocated, and the scope of work.
5. The Ministry for Culture and Heritage may disclose or publish relevant information
about the applicant, the organisation they represent or the project, where the Ministry
considers it necessary or desirable for the purposes of administering Government
funds or meeting its obligations under the Official Information Act 1982.
6. The applicant agrees for their insurer to be contacted.
7. The Trust is not obliged to fund any project, and the amount and proportion of any
funding provided is at the absolute discretion of the Trust.
Name:
Signature:
Date:
CANTERBURY EARTHQUAKE HERITAGE BUILDINGS FUND 9
APPLICATION FORM 2012