scaffolding and hoarding application form

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Appendix E
Application to Place Scaffolding or hoarding on the
Public Highway (inc. skips)
ALL FIELDS MUST BE COMPLETED
1. APPLICANTS DETAILS
Organisation Name
Organisation Address
Telephone no.
Fax no.
Emergency contact name & no. (24hr)
Your internal job reference no.
2. DETAILS OF PERSON(S) RESPONSIBLE ON
THE SITE WHERE THE SCAFFOLD / HOARDING IS
TO BE USED
(Customer requesting the use of the item)
Name
Address
Telephone no:
Fax no:
Emergency contract name & no: (24 hr)
3. LOCATION DETAILS
Outside/Opposite:
Full address:
Position of item on the Highway (please indicate)
Length of scaffold / hoarding (m, along the highway):
Height of scaffold / hoarding (m, above the highway):
Width of scaffold / hoarding (m, across the highway):
4. NATURE OF REQUIREMENT
Nature of work / activity for which the scaffold/hoarding
is required
Carriageway
Footway
Verge
Previous Permit No.
Is this an extension to an existing permit?
Proposed dates of use:
In place for 24hrs a day?
From
To
If no, proposed hrs:
From
To
The applicant MUST be a registered organisation - contact the Network Management Unit for a registration
form if not completed previously
This application MUST be signed by an authorised representative of the organisation applying. The signature of
this representative is taken as confirmation that all standard conditions have been read, understood and will be
adhered to. By signing, this representative confirms that the Network Management Unit Licensing and Permissions
Policy and Guidance Document and all associated legislation and guidance is understood.
Signature of Applicant:
Printed Name of Applicant:
Date:
Completed forms should be sent to the Network Management Unit E-mail: nmu@staffordshire.gov.uk
Or Fax: 01785 854037
Page 1 of 8
Appendix E
Guidance Notes and Examples
This is the Staffordshire Highways standard pro-forma for applying to place a non-permanent
item on the public highway. Any queries, please contact the Network Management Unit on
01785 276784
Box 1.
Name of the organisation which owns and is responsible for the Scaffold/hoarding.
Number of direct contact - this number should be a direct line or mobile and will not be
shared
publicly but for internal purposes only.
Permit will be sent to this fax number.
Emergency contact for highways staff should an issue arise on site both in hours and out of
hours.
Your internal reference number / job number (which will appear on invoices)
Box 2.
Name of the Customer who has requested the scaffold/hoarding.
Address of the customer. This can be different to the location of the item in some cases but if
not, please enter 'as location'.
Customer contact number. This is required should an issue arise relating to the work or
activity as opposed to the scaffold/hoarding itself.
Emergency contact for highways staff should an issue arise on site both in hours and out of
hours.
Box 3.
Location of where the scaffold/hoarding is required for e.g. Outside 54.
Length in metres that the scaffold / hoarding will occupy along the highway (i.e. length
adjacent the property, parallel to the kerb/carriageway).
Height in metres (can be approximate) of the scaffold / hoarding above the highway (i.e.
vertical height from ground level).
Width in metres that the scaffold / hoarding will occupy across the highway (for e.g. from
kerb to property)
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Appendix E
Box 4.
Brief detail of the works or activity for which the scaffold / hoarding is required for e.g. roof
replacement.
Is this an extension to an existing permit? If so, please quote original permit no.
Proposed dates of use. Please note that permitted dates may be different to those you
propose
Will the item remain on the highway for 24 hours a day? Yes or No.
If not in place for 24hrs a day, please state times of proposed use. Please note that
permitted times may be different to those you propose if the road is traffic sensitive.
Page 3 of 8
Appendix E
CONDITIONS APPLICABLE TO ASSEMBELE OR RETAIN ON OR OVER A HIGHWAYS,
ANY SCAFFOLDING/HOARDING OR OTHER STRUCTURE IN ACCORDANCE WITH
THE HIGHWAYS ACT 1980 SECTIONS 169, 172 AND 173
GENERAL
1. Scaffolding/hoarding shall not be placed on the highway without the prior written approval
of the Highway Network Manager or their representative. The erection of
scaffolding/hoarding without written permission is an offence under The Highways Act
1980 and may result in prosecution.
2. The applicant is responsible for ensuring that the scaffolding/hoarding is positioned on
the highway in such a way that it does not cause an obstruction to other road users. The
item owner is responsible for ensuring that all appropriate legislation is adhered to.
3. The Applicant must have the minimum public liability insurance cover (£5 million), proof
of which shall be required. The insurance must cover the full period that the
scaffolding/hoarding is situated on the highway. The Highway Authority must be notified
immediately of any changes to or termination of a policy that may affect this insurance
requirement. The Highway Authority is entitled to amend a permission is such instances
and request the immediate removal of the scaffolding/hoarding
4. The applicant shall be liable for and shall indemnify the Staffordshire County Council as
the Highways Authority against any expense, liability, loss, claim or proceedings
whatsoever made against the Staffordshire County Council in respect of loss, injury
(including death) or damage occurring to any property or sustained by any person and
arising in any way whatever out of the erection and dismantling of the
scaffolding/hoarding or other structure, and the indemnity shall also continue in force
without any amendment during the period of this permission. The policy of insurance
cover for Public Liability shall be sufficient to cover all risks attendant upon the placing of
the scaffolding/hoarding on the highway and the indemnity limit shall be a minimum of £5
million, and this must be produced for inspection by the Highway Officer.
5. The Applicant shall allow at least ten working days from receipt of an application for a
licence to place an item on the highway and the date on which the licence is intended to
commence.
6. The Applicant shall only erect/dismantle scaffolding/hoarding on the public highway
between the hours of 07.30 and 20.30 hours on all days unless specifically notified to the
contrary within the additional special conditions applied to the permission. In some
cases, work in town centres and other particular locations may be conditioned to be
carried out only outside normal working hours.
7. Permission to place scaffolding/hoarding does not extend to other activities such as
placing an items (for e.g. a skip) and a further permission would be required. Contact the
Network Management Unit if unsure whether additional permits are required.
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Appendix E
SCAFFOLDING AND HOARDING
8. The scaffolding shall satisfy the recommendations contained in BS 5973:1993.
9. The applicant shall notify the local police of the dates when he intends to unload, prior to
the commencement of the work, and load the scaffolding components.
10. The application must provide, erect, maintain and subsequently remove all warning signs,
lamps etc. with due regard to the standards recommended in Chapter 8 of the
Department of Transport Traffic Signs Manual 1991. This relates to the provision and
location of warning signs, road danger lamps etc. When in doubt about requirements
please consult the Highway Network Management Office.
11. The application must provide and maintain adequate provisions for all traffic, and
particularly pedestrians, as required under the Health and Safety at Work Act 1974,
disabled Persons Act 1981 amended by the Construction [Metrication] during the
erection, use, and removal of the scaffolding or other structure.
12. The applicant must either:(i)
Provide a convenient covered platform and handrail to serve as a footway for
pedestrians in the carriageway outside the scaffolding or other structure. OR
(ii)
Provide a convenient footway for pedestrians under the scaffolding or structure.
There should be minimum headroom of 2.13 metres beneath the scaffolding and
no less than 1.25 metres width of footway in lightly trafficked areas and 1.50
metres width of footway in busier areas.
Pedestrian barriers should be attached to the scaffolding/hoarding and should be of a
reasonably solid construction to guide visually impaired people. They should have a
robust tapping rail (a red and white retro reflective barrier plank may be used) fixed to a
height of approximately 150mm above ground level, measured to the underside of the rail
and a robust handrail which shall be painted in alternating read and white bands
approximately 300mm wide, at a height of between 1.00 metre and 1.20 metres
measured to the top of the rail.
In both cases the rail should be at least 150mm
deep.
The thickness and/or width will depend on the material and construction and will need to
be such as to ensure sufficient strength.
13. Poles/supports must not cross the highway (diagonally) in such a way as to cause an
obstruction to highway users passing beneath the scaffold. If the structure requires
diagonal supports, a suitable pedestrian walkway outside of the scaffolding must be
provided (see 12(i)).
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Appendix E
14. All vertical scaffolding within 2 metres of the ground must be wrapped in protective
cushioning and covered with red and white hi-visibility marker tape. Particular attention
must be given to nuts, bolts, projections etc.,
15. Where erected within 460mm of, or upon the carriageway, a black and white striped
board shall be fixed to the outside standard of the scaffolding facing oncoming traffic. A
white painted balk of timber shall be laid in the road channel abutting the kerb face and
topped with cones.
16. A road sign depicting a white arrow on a blue background (diagram 610 of the Traffic
Signs Regulations and General Directions (2002)) and appropriate road narrows board
directing traffic away from the kerb must be provided and sited on the upstream side of
the balks.
17. The application must sufficiently light the scaffolding or other structure and any platform
and handrail and cause the work to be properly guarded and lighted at all times between
half an hour before sunset to half an hour after sunrise or in fog
Road danger lamps must be placed on scaffolding/hoarding and may show either steady
or intermittent amber light. The height of the centre of each lens of a road danger lamp
shall not exceed 150mm where the speed limit of the road is 40mph or less and not less
than 120mm where the speed limit on the road is more than 40mph
Where a road danger lamp which shows an intermittent light is placed within 50 metres of
a street lamp lit by electricity on a road subject to a speed limit of 40mph or less, the rate
of flashing shall be not less than 30 no more than 150 flashes per minute. On other
roads the rate of flashing shall not be less than 900 flashes per minute. They should be
placed at regular intervals along the line of the obstruction. Lamps should comply at all
times with BS3143: Part 2 1990 “Low intensity battery operated lamps” or an equivalent
specification of a European Economic Area State, and must comply with Regulation 40.
Care should be taken to ensure that the intervals at which bulbs and batteries are
changed and the type of replacements used are in accordance with the manufactures.
recommendations
18. Where necessary the applicant must place suitable steel plates where necessary
between the vertical scaffolding poles and the highway to prevent damage to highway
surface.
If it should be necessary to repair the footway or carriageway a permanent reinstatement
to a standard required by the Highway Authority will be required at the applicants’
expense.
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Appendix E
19. The applicant must ensure that the scaffolding/hoarding or other structure is boarded and
screened in such a manner as to prevent the falling of any tool or object onto the highway
and that as little inconvenience as possible is caused to the general public. No door
forming part of any hoarding shall be hung, so as to open outwards across any part of the
highway.
20. The scaffolding/hoarding or other structure must be satisfactory earthed (BS 6651 –
1992). One suitable method is to run a metal (not aluminium) strip 20mm x 2.5mm in
size underneath and in contact with the base plates carrying the vertical members. The
strip should be suitably earthed at intervals not exceeding 20 metres.
21. The application must accede to any reasonable request by a statutory licensed
undertaker or Highway Authority to do anything necessary for the purpose of giving
access to or protection of their apparatus.
22. The applicant shall provide sufficient and satisfactory protection to prevent water used for
washing buildings from falling upon any part of the protected highway.
23. For walk-through scaffoldings the first lift shall be protected as its perimeter by a 1.83
metre high chain link or mesh fence or substantial sheeting to prevent unauthorised
access.
24. The scaffolding shall be fences to a height of 1.83 metres.
25. Loose scaffolding components shall not be stored on any part of the highway unless
secured within a fenced off area not accessible to the public.
26. Every hoist or pulley wheel shall be adequately fenced. No load shall be raised or
lowered over the highway unless there is adequate protection for the public.
27. All lower ladders shall be removed when the scaffolding is not in use to prevent any
unauthorised access.
28. The applicant shall continue to maintain the scaffolding/hoarding or other structure in
such a way as not to cause a hazard to the highway user.
29. On completion of the works the applicant will remove the scaffolding/hoarding or other
structure and any associated works when required and will undertake to make good any
damage to the highway caused as a result of the proposed works. In the event of a
failure to do so the applicant will be required to reimburse the Staffordshire County
Council as the Highway Authority the cost of making good any such damage.
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Appendix E
ADDITIONAL CONDITIONS
1. The applicant will comply with the conditions listed in the Health & Safety at Work etc.
Act 1974 guide issued in July 2000 on the safe erection and dismantling of
scaffolding.
2. Any other condition as may be required by unusual site conditions may be added and
any of the above not applicable may be deleted from the consent form.
3. All the above to be carried out to the satisfaction of the Highway Authority.
4. Traffic includes pedestrians and animals.
Where the highway authority grants permission to place scaffolding, hoarding or
other structure on the highway it should be noted that this permission only relates to
the signing and guarding measures and other traffic management measures required
to ensure the safety to the travelling public. It is not an acceptance or endorsement
by the highway authority as to the safety, design or stability of the
scaffolding/hoarding or other structure. This remains the responsibility of the
applicant who, if in any doubt, should contact the building regulation section of the
appropriate district council for advice.
Page 8 of 8
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