Great Yarmouth Mandatory HMO Licensing

Application Form - HMO Mandatory Licence
PLEASE READ

From 1 November 2018 all Houses in Multiple Occupation (HMO) mandatory licence applications will be processed on behalf of Great Yarmouth Borough Council (GYBC) by The Home Safe Scheme Limited, the Council’s mandatory HMO application service partner. Payment will be required in two stages as follows; payment of £855.00 (or £849.00 for renewals) for an HMO with standard units of accommodation for 5 persons forming two or more households (plus £40.00 for each additional unit of accommodation, £40.00 for renewals) will be required in full before we can confirm your application is complete. Once we have checked your application for the correct licence fee we will send you an invoice which will include payment details. If everything is satisfactory with your application, once we have received the correct payment, Home Safe will forward your payment to GYBC with the recommendation to conduct their pre-licensing inspection of the property. Following the pre-licensing inspection any issues raised will need to be addressed before GYBC will issue your draft licence so any representations can be made. When any representations have been considered GYBC will contact you for the remainder of the payment, £390.00 (making £1245.00, or £1239.00 for renewals, in total for an HMO with standard units of accommodation for 5 persons forming two or more households, plus £40.00 for each additional unit of accommodation or £40.00 if its a renewal). When the remainder of the full fee is paid GYBC will issue your licence. All fees and guidance are advertised on the Council’s website at www.great-yarmouth.gov.uk/hmo and on our website at www.thehomesafescheme.org.uk/licence-schemes

The Housing Act 2004 introduced the mandatory licensing of HMOs from 6th April 2006. The Act was amended on 1st October 2018 whereby any property comprising of 5 or more persons who form two or more households, who share (or lack) an amenity such as a bathroom, kitchen or toilet, must be licensed. Buildings consisting solely of self-contained flats or purpose-built flats are normally exempt from licensing. Before making an application for a mandatory HMO licence, please ensure that you have read the guidance notes at www.great-yarmouth.gov.uk/hmo

Please complete your application as thoroughly and honestly as possible, should any follow-up action be necessary the Council may charge for this at the current rate advertised on their website at www.great-yarmouth.gov.uk/hmo. We need to ensure we have all the correct information before putting your details forward for a mandatory HMO licence. We strongly recommend you read the Council's licence conditions before, or as, you are completing this form as some of the questions are further explained by the conditions.

Please note it may take up to 45 minutes to complete this form depending on the number of properties you are registering. You will need copies of the relevant certificates to hand (such as for Gas Safety, EPC, EICR and Fire Detection).

TIP: Only use the back and next buttons at the bottom of each page as the back button on your browser will not move you between pages on this form.

You must complete this application in one visit as you cannot save and return later.

Once you have submitted your application you will receive an acknowledgement email from us confirming your application has been received.
Your Details
If there is more than one owner of the properties being registered please complete this form using the details of the lead Landlord and then provide additional details of the other owner(s) at the bottom of this page.
Are you a member of any other Home Safe scheme?

YesNo
Full Name*

First NameLast Name
Email*
Contact Number*
(mobile, home or work)
Alternative Contact Number
(mobile, home or work)
Your Personal Home Address*

Street Address

Address Line 2

Town/CityCounty

Post Code
Date of Birth*
DD/MM/YYYY
Place of Birth*
Emergency Contact Name
Emergency Contact Number
Additional Landlord Details
Please provide names, email addresses and contact numbers of each additional Landlord. Please note that each application for membership requires that the property ownership reflects the exact details of the membership. Therefore one membership is required for every ownership configuration. e.g if a person has a property registered in their sole name and a second property registered jointly in both their name and the name of a partner, then a second membership would be required for the second property.
Are you applying on behalf of a business?*

YesNo

This page is only applicable if you are applying as a business, if not applicable please click next at the bottom of this page.
Business Name
Business Status
Is your business registered outside the UK?
Company number if Ltd and Registered in the UK
VAT number if applicable
Business Address

Street Address

Address Line 2

Town/CityCounty

Post Code
Your position in the business

Rental Property Details
Number of properties being registered*
Property 1
Type of application*

New LicenceRenewal of existing HMO Licence
Property 1 Address*

Street Address

Address Line 2

Town/CityCounty

Post Code
Please provide all names of owners registered at Land Registry for this property*
Does anyone else have an interest in the property or its management, other than the owner? If so please provide the full name, address, contact number and email address where possible of each party.*
(e.g Mortgage company, freeholder, leaseholder, managing agent etc)
Are you a resident Landlord at this property?*
(please select yes if you live in the same property as the rooms you let out)
What year was the property built?*
(estimate if exact not known)
How many storeys?*
Include the ground floor, basements, attics and mezzanines.
Property type?*

Detached houseSemi-detached houseTerrace houseEnd terrace houseBack-to-back houseResidential blockMixed-use block (e.g. flat(s) above commercial premises)Grouped structure (e.g. dwelling which shares a party wall in a cluster or around a courtyard)Other
Is the property to be licensed:*

Purpose built with its present design?Converted from a previous residential dwelling?Converted from a non-residential structure?A Standard residential property that has undergone no alterations?
Has the property been granted planning permission as a HMO?*
How long has the property been used as a licensable HMO?*
Are any parts of the building used for non-residential purposes?*
Non residential such as commercial use
What is your proposed maximum number of households for this property?*
A household consists of family members or a cohabiting couple (e.g. a group of 4 friends counts as 4 separate households). If you have a double room and would like to let that to a couple then any such couple would be classed as one household
What is your proposed maximum number of occupiers for this property?*
Include any children, and the landlord and family, if applicable.
Is the property furnished, part furnished, or unfurnished?*

FurnishedPart FurnishedUnfurnished
If furnished or part furnished is all furniture compliant with the fire and furnishings act?*
What catering arrangements are offered to occupants of the property?*

B&BFull boardHalf boardSelf-cateringNone
Number of separate letting units in the property*
These are rooms or units let on separate tenancy agreements in which the occupiers have exclusive use. For example if you have 4 rooms at your property and they are all let to 4 individual people on seperate agreements then you have 4 seperate letting units.
Of the separate letting units in the property how many are self-contained? (flats or bedsits)*
Occupants have exclusive use of kitchen, bath/shower and toilet facilities.
Of the separate letting units in the property how many are not self-contained? (flats or bedsits)*
Occupants have their own bedroom but share use of kitchen, bath/shower and/or toilet facilities.
Of the separate letting units in the property how many are dormitories?*
Occupants share use of facilities including sleeping space.

Do all baths, showers, sinks and wash hand basins supply cold and constant hot water?*
Please advise which of the following the kitchen at this property is equipped with (please note that all these items will be required as part of the licence conditions:*

A sink with draining boardA means of cooking foodElectrical socketsWorktops for food preparationStorage cupboardsRefrigerator and freezer (or freezer compartment)Refuse storage facilities
Is the property Vacant or Let*
Please select let if one or more units is let
Do you take deposits?*
If you do take deposits, are they protected with one of the three recognised Tenancy Deposit Schemes?*
Are occupants given a tenancy agreement or licence?*
Please note: This is mandatory and The Home Safe Scheme and/or the Local Authority may request to see these.
Number of households in the property at time of application*
A household consists of family members or a cohabiting couple (e.g. a group of 4 friends counts as 4 separate households).
Number of occupants in the property at time of application*
Include any children, and the landlord and family, if applicable.
Number of adult tenants living at the property*
Number of children living at the property*
under 18 years old
Please identify any energy efficiency measures already installed at the property*

Double or Triple GlazingCombination boiler gas central heatingSolid wall insulation (externally fitted)Cavity wall insulationLoft InsulationSolarLED LightingBiomass BoilerGround & Air Heat SourceHot water tanks lagged
What type of heating does the property have?*

Gas central heatingElectric central heating/night storage heatersFixed gas heaters/firesFixed electrical heaters/firesSolid fuel firesSolar heatingBiomass heatingOther
Do all rooms in the property have a source of heat (e.g. radiator or fire)?*
Do all bathrooms and kitchens have a means of natural or mechanical ventilation?*
Are portable electrical appliances provided for use by occupants (e.g. kettle, refrigerator, vacuum cleaner)?*
If portable electrical appliances are provided for use by occupants (e.g. kettle, refrigerator, vacuum cleaner) are you carrying out an annual PAT?*
Are the occupiers of the house given clear advice, by means of a visible sign, on the action to be taken in the event of an emergency including the contact details for such emergency?*
Have you conducted your own fire risk assessment of the property to be licensed or commissioned one for a competent person?*
Please advise what fire safety measures are in place at the property to be licensed:*

Nothing in placeNothing in place but I will resolve this within the next 14 daysBattery operated smoke/heat detectorsHard wired smoke/heat detectorsHard wired interlinked smoke/heat detectorsHard wired interlinked smoke/heat detectors with call pointsEmergency lightingStand alone fire alarm system including a fire panel
Please advise location of any smoke or heat detectors:*

Shared kitchen(s)Shared living room(s)HallwaysLandingsBedrooms / bedsitsOther (please specify)
If other please specify:
Please upload your last fire alarm service certificate (please note these are required to be carried out every 6 months by law)*

Browse Files

Cancelof
Does the property have a fire blanket in each shared kitchen and in any unit of accommodation equipped with cooking facilities?*

Nothing in place or not in all unitsNothing in place or not in all units but I will resolve this within the next 14 daysYes
Does the property have a 2kg dry powder fire extinguisher in each shared kitchen and in any unit of accommodation equipped with cooking facilities?*

Nothing in place or not in all unitsNothing in place or not in all units but I will resolve this within the next 14 daysYes
Does the property have fire extinguisher(s) in the communal areas?*

Nothing in place or not in all areasNothing in place or not in all areas but I will resolve this within the next 14 daysYes
Does the property have fire door(s) to all risk rooms?*

Nothing in place or not in all areasNothing in place or not in all areas but I will resolve this within the next 14 daysYes
Does the property have fire escape signage in place?*

Nothing in place or not in all areasNothing in place or not in all areas but I will resolve this within the next 14 daysYes
Have details of fire exit routes and other fire safety training been provided to the occupiers?*
Please upload copies of your property documentation below or request an order.
If you have a copy of your Energy Performance Certificate (EPC) then please upload it here

Upload a File

Cancelof
Action*

SubmittedWill provide within 14 days
If you have a copy of your Electrical Installation Condition Report (EICR) then please upload it here

Upload a File

Cancelof
Action*

SubmittedWill provide within 14 days
If you have a copy of your Gas Safety Test Certificate then please upload it here

Upload a File
(only applicable if gas is provided on the premises, please note that if your certificate does not show that your gas appliances have been serviced then you will not be in compliance with gas regulations unless you can provide further documentation proving that appliances have been serviced annually.) Cancelof
Action*

SubmittedWill provide within 14 daysNot applicable as no gas is supplied to the property
Do you have adequate Smoke Alarms installed at the property?*

Already InstalledWill install within the next 14 days
Do you have adequate Carbon Monoxide Detectors installed at the property?*

Already InstalledWill install within the next 14 days
Are you nominating a Manager or Agent? (please note Agents must be members of an Ombudsman Scheme and have Client Money Protection in place, evidence will be required)*

YesNo
Name of Manager or Agent*
(if agent please give the business name and contact person)
Relation to the Owner*
(e.g relation, business associate, friend or agent etc)
Email address of Manager or Agent*
Phone Number of Manager or Agent*
Property 2
Type of application*

New LicenceRenewal of existing HMO Licence
Property 2 Address*

Street Address

Address Line 2

Town/CityCounty

Post Code
Please provide all names of owners registered at Land Registry for this property*
Does anyone else have an interest in the property or its management, other than the owner? If so please provide the full name, address, contact number and email address where possible of each party.*
(e.g Mortgage company, freeholder, leaseholder, managing agent etc)
Are you a resident Landlord at this property?*
(please select yes if you live in the same property as the rooms you let out)
What year was the property built?*
(estimate)
How many storeys?*
Include the ground floor, basements, attics and mezzanines.
Property type?*

Detached houseSemi-detached houseTerrace houseEnd terrace houseBack-to-back houseResidential blockMixed-use block (e.g. flat(s) above commercial premises)Grouped structure (e.g. dwelling which shares a party wall in a cluster or around a courtyard)Other
Is the property to be licensed:*

Purpose built with its present design?Converted from a previous residential dwelling?Converted from a non-residential structure?Standard residential property that has undergone no alterations
Has the property been granted planning permission as a HMO?*
How long has the property been used as a licensable HMO?*
Are any parts of the building used for non-residential purposes?*
Non residential such as commercial use
What is your proposed maximum number of households for this property?*
A household consists of family members or a cohabiting couple (e.g. a group of 4 friends counts as 4 separate households). If you have a double room and would like to let that to a couple then any such couple would be classed as one household
What is your proposed maximum number of occupiers for this property?*
Include any children, and the landlord and family, if applicable.
Is the property furnished, part furnished, or unfurnished?*

FurnishedPart FurnishedUnfurnished
If furnished or part furnished is all furniture compliant with the fire and furnishings act?*
What catering arrangements are offered to occupants of the property?*

B&BFull boardHalf boardSelf-cateringNone
Number of separate letting units in the property*
These are rooms or units let on separate tenancy agreements in which the occupiers have exclusive use. For example if you have 4 rooms at your property and they are all let to 4 individual people on seperate agreements then you have 4 seperate letting units.
Of the separate letting units in the property how many are self-contained? (flats or bedsits)*
Occupants have exclusive use of kitchen, bath/shower and toilet facilities.
Of the separate letting units in the property how many are not self-contained? (flats or bedsits)*
Occupants have their own bedroom but share use of kitchen, bath/shower and/or toilet facilities.
Of the separate letting units in the property how many are dormitories?*
Occupants share use of facilities including sleeping space.

Do all baths, showers, sinks and wash hand basins supply cold and constant hot water?*
Please advise which of the following the kitchen at this property is equipped with (please note that all these items will be required as part of the licence conditions:*

A sink with draining boardA means of cooking foodElectrical socketsWorktops for food preparationStorage cupboardsRefrigerator and freezer (or freezer compartment)Refuse storage facilities
Is the property Vacant or Let*
Please select let if one or more units is let
Do you take deposits?*
If you do take deposits, are they protected with one of the three recognised Tenancy Deposit Schemes?*
Are occupants given a tenancy agreement or licence?*
Please note: This is mandatory and The Home Safe Scheme and/or the Local Authority may request to see these.
Number of households in the property at time of application*
A household consists of family members or a cohabiting couple (e.g. a group of 4 friends counts as 4 separate households).
Number of occupants in the property at time of application*
Include any children, and the landlord and family, if applicable.
Number of adult tenants living at the property*
Number of children living at the property*
under 18 years old
Please identify any energy efficiency measures already installed at the property*

Double or Triple GlazingCombination boiler gas central heatingSolid wall insulation (externally fitted)Cavity wall insulationLoft InsulationSolarLED LightingBiomass BoilerGround & Air Heat SourceHot water tanks lagged
What type of heating does the property have?*

Gas central heatingElectric central heating/night storage heatersFixed gas heaters/firesFixed electrical heaters/firesSolid fuel firesSolar heatingBiomass heatingOther
Do all rooms in the property have a source of heat (e.g. radiator or fire)?*
Do all bathrooms and kitchens have a means of natural or mechanical ventilation?*
Are portable electrical appliances provided for use by occupants (e.g. kettle, refrigerator, vacuum cleaner)?*
If portable electrical appliances are provided for use by occupants (e.g. kettle, refrigerator, vacuum cleaner) are you carrying out an annual PAT?*
Are the occupiers of the house given clear advice, by means of a visible sign, on the action to be taken in the event of an emergency including the contact details for such emergency?*
Have you conducted your own fire risk assessment of the property to be licensed or commissioned one for a competent person?*
Please advise what fire safety measures are in place at the property to be licensed:*

Nothing in placeNothing in place but I will resolve this within the next 14 daysBattery operated smoke/heat detectorsHard wired smoke/heat detectorsHard wired interlinked smoke/heat detectorsHard wired interlinked smoke/heat detectors with call pointsEmergency lightingStand alone fire alarm system including a fire panel
Please advise location of any smoke or heat detectors:*

Shared kitchen(s)Shared living room(s)HallwaysLandingsBedrooms / bedsitsOther (please specify)
If other please specify:
Please upload your last fire alarm service certificate (please note these are required to be carried very 6 months by law)*

Browse Files

Cancelof
Does the property have a fire blanket in each shared kitchen and in any unit of accommodation equipped with cooking facilities?*

Nothing in place or not in all unitsNothing in place or not in all units but I will resolve this within the next 14 daysYes
Does the property have a 2kg dry powder fire extinguisher in each shared kitchen and in any unit of accommodation equipped with cooking facilities?*

Nothing in place or not in all unitsNothing in place or not in all units but I will resolve this within the next 14 daysYes
Does the property have fire extinguisher(s) in the communal areas?*

Nothing in place or not in all areasNothing in place or not in all areas but I will resolve this within the next 14 daysYes
Does the property have fire door(s) to all risk rooms?*

Nothing in place or not in all areasNothing in place or not in all areas but I will resolve this within the next 14 daysYes
Does the property have fire escape signage in place?*

Nothing in place or not in all areasNothing in place or not in all areas but I will resolve this within the next 14 daysYes
Have details of fire exit routes and other fire safety training been provided to the occupiers?*
Please upload copies of your property documentation below or request an order.
If you have a copy of your Energy Performance Certificate (EPC) then please upload it here)

Upload a File

Cancelof
Action*

SubmittedWill provide within 14 days
If you have a copy of your Gas Safety Test Certificate then please upload it here

Upload a File
(only applicable if gas is provided on the premises, please note that if your certificate does not show that your gas appliances have been serviced then you will not be in compliance with gas regulations unless you can provide further documentation proving that appliances have been serviced annually.) Cancelof
Action*

SubmittedWill provide within 14 daysNot applicable as no gas is supplied to the property
If you have a copy of your Electrical Installation Condition Report (EICR) then please upload it here

Upload a File
5 year report Cancelof
Action*

SubmittedWill provide within 14 days
Do you have adequate Smoke Alarms installed at the property?*

Already InstalledWill install within the next 14 days
Do you have adequate Carbon Monoxide Detectors installed at the property?*

Already InstalledWill install within the next 14 days
Are you nominating a Manager or Agent? (please note Agents must be members of an Ombudsman Scheme and have Client Money Protection in place, evidence will be required)*

YesNo
Name of Manager or Agent*
(if agent please give the business name and contact person)
Relation to the Owner*
(e.g relation, business associate, friend or agent etc)
Email address of Manager or Agent*
Phone Number of Manager or Agent*
Property 3
Type of application*

New LicenceRenewal of existing HMO Licence
Property 3 Address*

Street Address

Address Line 2

Town/CityCounty

Post Code
Please provide all names of owners registered at Land Registry for this property*
Does anyone else have an interest in the property or its management, other than the owner? If so please provide the full name, address, contact number and email address where possible of each party.*
(e.g Mortgage company, freeholder, leaseholder, managing agent etc)
Are you a resident Landlord at this property?*
(please select yes if you live in the same property as the rooms you let out)
What year was the property built?*
(estimate)
How many storeys?*
Include the ground floor, basements, attics and mezzanines.
Property type?*

Detached houseSemi-detached houseTerrace houseEnd terrace houseBack-to-back houseResidential blockMixed-use block (e.g. flat(s) above commercial premises)Grouped structure (e.g. dwelling which shares a party wall in a cluster or around a courtyard)Other
Is the property to be licensed:*

Purpose built with its present design?Converted from a previous residential dwelling?Converted from a non-residential structure?Standard residential property that has undergone no alterations
Has the property been granted planning permission as a HMO?*
How long has the property been used as a licensable HMO?*
Are any parts of the building used for non-residential purposes?*
Non residential such as commercial use
What is your proposed maximum number of households for this property?*
A household consists of family members or a cohabiting couple (e.g. a group of 4 friends counts as 4 separate households). If you have a double room and would like to let that to a couple then any such couple would be classed as one household
What is your proposed maximum number of occupiers for this property?*
Include any children, and the landlord and family, if applicable.
Is the property furnished, part furnished, or unfurnished?*

FurnishedPart FurnishedUnfurnished
If furnished or part furnished is all furniture compliant with the fire and furnishings act?*
What catering arrangements are offered to occupants of the property?*

B&BFull boardHalf boardSelf-cateringNone
Number of separate letting units in the property*
These are rooms or units let on separate tenancy agreements in which the occupiers have exclusive use. For example if you have 4 rooms at your property and they are all let to 4 individual people on seperate agreements then you have 4 seperate letting units.
Of the separate letting units in the property how many are self-contained? (flats or bedsits)*
Occupants have exclusive use of kitchen, bath/shower and toilet facilities.
Of the separate letting units in the property how many are not self-contained? (flats or bedsits)*
Occupants have their own bedroom but share use of kitchen, bath/shower and/or toilet facilities.
Of the separate letting units in the property how many are dormitories?*
Occupants share use of facilities including sleeping space.

Do all baths, showers, sinks and wash hand basins supply cold and constant hot water?*
Please advise which of the following the kitchen at this property is equipped with (please note that all these items will be required as part of the licence conditions:*

A sink with draining boardA means of cooking foodElectrical socketsWorktops for food preparationStorage cupboardsRefrigerator and freezer (or freezer compartment)Refuse storage facilities
Is the property Vacant or Let*
Please select let if one or more units is let
Do you take deposits?*
If you do take deposits, are they protected with one of the three recognised Tenancy Deposit Schemes?*
Are occupants given a tenancy agreement or licence?*
Please note: This is mandatory and The Home Safe Scheme and/or the Local Authority may request to see these.
Number of households in the property at time of application*
A household consists of family members or a cohabiting couple (e.g. a group of 4 friends counts as 4 separate households).
Number of occupants in the property at time of application*
Include any children, and the landlord and family, if applicable.
Number of adult tenants living at the property*
Number of children living at the property*
under 18 years old
Please identify any energy efficiency measures already installed at the property*

Double or Triple GlazingCombination boiler gas central heatingSolid wall insulation (externally fitted)Cavity wall insulationLoft InsulationSolarLED LightingBiomass BoilerGround & Air Heat SourceHot water tanks lagged
What type of heating does the property have?*

Gas central heatingElectric central heating/night storage heatersFixed gas heaters/firesFixed electrical heaters/firesSolid fuel firesSolar heatingBiomass heatingOther
Do all rooms in the property have a source of heat (e.g. radiator or fire)?*
Do all bathrooms and kitchens have a means of natural or mechanical ventilation?*
Are portable electrical appliances provided for use by occupants (e.g. kettle, refrigerator, vacuum cleaner)?*
If portable electrical appliances are provided for use by occupants (e.g. kettle, refrigerator, vacuum cleaner) are you carrying out an annual PAT?*
Are the occupiers of the house given clear advice, by means of a visible sign, on the action to be taken in the event of an emergency including the contact details for such emergency?*
Have you conducted your own fire risk assessment of the property to be licensed or commissioned one for a competent person?*
Please advise what fire safety measures are in place at the property to be licensed:*

Nothing in placeNothing in place but I will resolve this within the next 14 daysBattery operated smoke/heat detectorsHard wired smoke/heat detectorsHard wired interlinked smoke/heat detectorsHard wired interlinked smoke/heat detectors with call pointsEmergency lightingStand alone fire alarm system including a fire panel
Please advise location of any smoke or heat detectors:*

Shared kitchen(s)Shared living room(s)HallwaysLandingsBedrooms / bedsitsOther (please specify)
If other please specify:
Please upload your last fire alarm service certificate (please note these are required to be carried very 6 months by law)*

Browse Files

Cancelof
Does the property have a fire blanket in each shared kitchen and in any unit of accommodation equipped with cooking facilities?*

Nothing in place or not in all unitsNothing in place or not in all units but I will resolve this within the next 14 daysYes
Does the property have a 2kg dry powder fire extinguisher in each shared kitchen and in any unit of accommodation equipped with cooking facilities?*

Nothing in place or not in all unitsNothing in place or not in all units but I will resolve this within the next 14 daysYes
Does the property have fire extinguisher(s) in the communal areas?*

Nothing in place or not in all areasNothing in place or not in all areas but I will resolve this within the next 14 daysYes
Does the property have fire door(s) to all risk rooms?*

Nothing in place or not in all areasNothing in place or not in all areas but I will resolve this within the next 14 daysYes
Does the property have fire escape signage in place?*

Nothing in place or not in all areasNothing in place or not in all areas but I will resolve this within the next 14 daysYes
Have details of fire exit routes and other fire safety training been provided to the occupiers?*
Please upload copies of your property documentation below or request an order.
If you have a copy of your Energy Performance Certificate (EPC) then please upload it here)

Upload a File

Cancelof
Action*

SubmittedWill provide within 14 days
If you have a copy of your Gas Safety Test Certificate then please upload it here

Upload a File
(only applicable if gas is provided on the premises, please note that if your certificate does not show that your gas appliances have been serviced then you will not be in compliance with gas regulations unless you can provide further documentation proving that appliances have been serviced annually.) Cancelof
Action*

SubmittedWill provide within 14 daysNot applicable as no gas is supplied to the property
If you have a copy of your Electrical Installation Condition Report (EICR) then please upload it here

Upload a File
5 year report Cancelof
Action*

SubmittedWill provide within 14 days
Do you have adequate Smoke Alarms installed at the property?*

Already InstalledWill install within the next 14 days
Do you have adequate Carbon Monoxide Detectors installed at the property?*

Already InstalledWill install within the next 14 days
Are you nominating a Manager or Agent? (please note Agents must be members of an Ombudsman Scheme and have Client Money Protection in place, evidence will be required)*

YesNo
Name of Manager or Agent*
(if agent please give the business name and contact person)
Relation to the Owner*
(e.g relation, business associate, friend or agent etc)
Email address of Manager or Agent*
Phone Number of Manager or Agent*
Property 4
Type of application*

New LicenceRenewal of existing HMO Licence
Property 4 Address*

Street Address

Address Line 2

Town/CityCounty

Post Code
Please provide all names of owners registered at Land Registry for this property*
Does anyone else have an interest in the property or its management, other than the owner? If so please provide the full name, address, contact number and email address where possible of each party.*
(e.g Mortgage company, freeholder, leaseholder, managing agent etc)
Are you a resident Landlord at this property?*
(please select yes if you live in the same property as the rooms you let out)
What year was the property built?*
(estimate)
How many storeys?*
Include the ground floor, basements, attics and mezzanines.
Property type?*

Detached houseSemi-detached houseTerrace houseEnd terrace houseBack-to-back houseResidential blockMixed-use block (e.g. flat(s) above commercial premises)Grouped structure (e.g. dwelling which shares a party wall in a cluster or around a courtyard)Other
Is the property to be licensed:*

Purpose built with its present design?Converted from a previous residential dwelling?Converted from a non-residential structure?Standard residential property that has undergone no alterations
Has the property been granted planning permission as a HMO?*
How long has the property been used as a licensable HMO?*
Are any parts of the building used for non-residential purposes?*
Non residential such as commercial use
What is your proposed maximum number of households for this property?*
A household consists of family members or a cohabiting couple (e.g. a group of 4 friends counts as 4 separate households). If you have a double room and would like to let that to a couple then any such couple would be classed as one household
What is your proposed maximum number of occupiers for this property?*
Include any children, and the landlord and family, if applicable.
Is the property furnished, part furnished, or unfurnished?*

FurnishedPart FurnishedUnfurnished
If furnished or part furnished is all furniture compliant with the fire and furnishings act?*
What catering arrangements are offered to occupants of the property?*

B&BFull boardHalf boardSelf-cateringNone
Number of separate letting units in the property*
These are rooms or units let on separate tenancy agreements in which the occupiers have exclusive use. For example if you have 4 rooms at your property and they are all let to 4 individual people on seperate agreements then you have 4 seperate letting units.
Of the separate letting units in the property how many are self-contained? (flats or bedsits)*
Occupants have exclusive use of kitchen, bath/shower and toilet facilities.
Of the separate letting units in the property how many are not self-contained? (flats or bedsits)*
Occupants have their own bedroom but share use of kitchen, bath/shower and/or toilet facilities.
Of the separate letting units in the property how many are dormitories?*
Occupants share use of facilities including sleeping space.

Do all baths, showers, sinks and wash hand basins supply cold and constant hot water?*
Please advise which of the following the kitchen at this property is equipped with (please note that all these items will be required as part of the licence conditions:*

A sink with draining boardA means of cooking foodElectrical socketsWorktops for food preparationStorage cupboardsRefrigerator and freezer (or freezer compartment)Refuse storage facilities
Is the property Vacant or Let*
Please select let if one or more units is let
Do you take deposits?*
If you do take deposits, are they protected with one of the three recognised Tenancy Deposit Schemes?*
Are occupants given a tenancy agreement or licence?*
Please note: This is mandatory and The Home Safe Scheme and/or the Local Authority may request to see these.
Number of households in the property at time of application*
A household consists of family members or a cohabiting couple (e.g. a group of 4 friends counts as 4 separate households).
Number of occupants in the property at time of application*
Include any children, and the landlord and family, if applicable.
Number of adult tenants living at the property*
Number of children living at the property*
under 18 years old
Please identify any energy efficiency measures already installed at the property*

Double or Triple GlazingCombination boiler gas central heatingSolid wall insulation (externally fitted)Cavity wall insulationLoft InsulationSolarLED LightingBiomass BoilerGround & Air Heat SourceHot water tanks lagged
What type of heating does the property have?*

Gas central heatingElectric central heating/night storage heatersFixed gas heaters/firesFixed electrical heaters/firesSolid fuel firesSolar heatingBiomass heatingOther
Do all rooms in the property have a source of heat (e.g. radiator or fire)?*
Do all bathrooms and kitchens have a means of natural or mechanical ventilation?*
Are portable electrical appliances provided for use by occupants (e.g. kettle, refrigerator, vacuum cleaner)?*
If portable electrical appliances are provided for use by occupants (e.g. kettle, refrigerator, vacuum cleaner) are you carrying out an annual PAT?*
Are the occupiers of the house given clear advice, by means of a visible sign, on the action to be taken in the event of an emergency including the contact details for such emergency?*
Have you conducted your own fire risk assessment of the property to be licensed or commissioned one for a competent person?*
Please advise what fire safety measures are in place at the property to be licensed:*

Nothing in placeNothing in place but I will resolve this within the next 14 daysBattery operated smoke/heat detectorsHard wired smoke/heat detectorsHard wired interlinked smoke/heat detectorsHard wired interlinked smoke/heat detectors with call pointsEmergency lightingStand alone fire alarm system including a fire panel
Please advise location of any smoke or heat detectors:*

Shared kitchen(s)Shared living room(s)HallwaysLandingsBedrooms / bedsitsOther (please specify)
If other please specify:
Please upload your last fire alarm service certificate (please note these are required to be carried very 6 months by law)*

Browse Files

Cancelof
Does the property have a fire blanket in each shared kitchen and in any unit of accommodation equipped with cooking facilities?*

Nothing in place or not in all unitsNothing in place or not in all units but I will resolve this within the next 14 daysYes
Does the property have a 2kg dry powder fire extinguisher in each shared kitchen and in any unit of accommodation equipped with cooking facilities?*

Nothing in place or not in all unitsNothing in place or not in all units but I will resolve this within the next 14 daysYes
Does the property have fire extinguisher(s) in the communal areas?*

Nothing in place or not in all areasNothing in place or not in all areas but I will resolve this within the next 14 daysYes
Does the property have fire door(s) to all risk rooms?*

Nothing in place or not in all areasNothing in place or not in all areas but I will resolve this within the next 14 daysYes
Does the property have fire escape signage in place?*

Nothing in place or not in all areasNothing in place or not in all areas but I will resolve this within the next 14 daysYes
Have details of fire exit routes and other fire safety training been provided to the occupiers?*
Please upload copies of your property documentation below or request an order.
If you have a copy of your Energy Performance Certificate (EPC) then please upload it here)

Upload a File

Cancelof
Action*

SubmittedWill provide within 14 days
If you have a copy of your Gas Safety Test Certificate then please upload it here

Upload a File
(only applicable if gas is provided on the premises, please note that if your certificate does not show that your gas appliances have been serviced then you will not be in compliance with gas regulations unless you can provide further documentation proving that appliances have been serviced annually.) Cancelof
Action*

SubmittedWill provide within 14 daysNot applicable as no gas is supplied to the property
If you have a copy of your Electrical Installation Condition Report (EICR) then please upload it here

Upload a File
5 year report Cancelof
Action*

SubmittedWill provide within 14 days
Do you have adequate Smoke Alarms installed at the property?*

Already InstalledWill install within the next 14 days
Do you have adequate Carbon Monoxide Detectors installed at the property?*

Already InstalledWill install within the next 14 days
Are you nominating a Manager or Agent? (please note Agents must be members of an Ombudsman Scheme and have Client Money Protection in place, evidence will be required)*

YesNo
Name of Manager or Agent*
(if agent please give the business name and contact person)
Relation to the Owner*
(e.g relation, business associate, friend or agent etc)
Email address of Manager or Agent*
Phone Number of Manager or Agent*
Please note, if you are wanting to register and obtain an additional licence for more than 4 properties please contact Home Safe in the first instance.

Payment*

Ticking this box indicates you have submitted the correct fee with your application, £855.00 (or £849.00 for renewals) for a HMO with standard units of accommodation for up to 5 occupiers and an additional £40.00 for each additional unit of accommodation. Please note before your final licence can be issued Great Yarmouth Borough Council will require a further payment of £390.00, making £1245.00 (or £1239.00 for renewals) in total.

Fit & Proper Person Declaration
A fit and proper person is defined in sections 66 and 89 of the Housing ct 2004 and means a person who does not have any relevant unspent convictions and in particular has not:

- Committed any offences involving fraud or other dishonesty, or violence or drugs or any offence listed in Schedule 3 to the Sexual Offences Act 2003 (i.e. offences attracting notification requirements);

- Committed any unlawful discrimination on grounds of sex (including within the provisions of the, colour, race, ethnic or national origins or disability in, or in connection with, the carrying on of any business;

- Contravened any provision of the law relating to housing or of landlord and tenant law; or

- Acted otherwise than in accordance with any applicable code of practice approved under section 233

And, during the last five years, neither the applicant nor any person associated or formerly associated with him/her have:

- Been in control of any property subject to a control order under section 379 of the Housing Act 1985;

- Been refused a license or had a license removed for any property in relation to HMO, additional or selective licensing under the Housing Act 2004;

- Been found to have breached a condition on a license for any property in relation to HMO, additional or selective licensing under the Housing Act 2004;

- Been found by a local authority to have acted otherwise than in accordance with any Code of Practice approved under section 233 of the Housing Act 2004;

- Been in control of any property that has been the subject of any proceedings by a local authority (such as breaches of the Environmental Protection Act, planning control or compulsory purchase proceedings);

- Been in control of any property on which the local authority has carried out work in default; or

- Been in control of any property which has been the subject of an interim or final management order or a special interim management order under the Housing Act 2004.

We may approach other Authorities such as the Police Authority, Fire and rescue Service, Office of Fair Trading or County Court etc, for information and confirmation regarding your Fit and Proper status.

By signing this declaration you are agreeing that any such investigations or action can be taken and you are also confirming that none of the above prevents you from qualifying to be a member of the Home Safe Scheme.

I declare that to the best of my knowledge and belief, the statements made and the information supplied in support of my application for membership of the Home Safe Scheme and any attachments thereto are complete and correct.
Ticking this box indicates you have read and understood the Fit & Proper Person Declaration
Furnishing Declaration*

If I have let or am letting the property on a furnished or part furnished basis I declare that any furniture and/or furnishings provided by me at the start of or during the tenancy are compliant with both conditions 2 and 10 of the Edlington selective licensing conditions including the Furniture and Furnishings (Fire) (Safety) Regulations 1988 (as amended 1989, 1993 and 2010) and that I will maintain and/or replace any such items, during the tenancy, as far as it is a landlord’s responsibility so to do. I further declare that any electrical appliances that I similarly provide have been, where required, PAT tested, are in a safe and good condition.

Declaration to be provided to the Local Authority
I declare that the information contained in this application is correct to the best of my knowledge. I understand that I commit an offence if I supply any information to a local housing authority in connection with any of their functions under any of Parts 1 to 4 of the Housing Act 2004 that is false or misleading and which I know is false or misleading or am reckless as to whether it is false or misleading.

I declare that I have served notice of this application on the persons or companies identified within this application as having an interest in any of the properties being registered and who are required to be informed that I have made this declaration.

I declare that I am authorised on behalf of all applicants named within this application to make this declaration.

I authorise Home Safe to provide this information to the Local Authority.
Ticking this box indicates you have read and understood the Declaration to be provided to the Local Authority
By ticking this box you are giving your consent for us to contact you in future with updates or information on policies, events, products or services which we feel are of benefit to our membership and which allow us to provide support to our members. Please see our Ts&Cs for further information. You can withdraw your consent at any time though this may affect the level of support that we can provide to you.
Scheme
Should be Empty:

	Total in property	Exclusive to one letting unit	Shared between letting units
Bedrooms (exclude bedsits)
Bedsits (e.g. combined living/bedrooms)
Living/dining rooms (exclude kitchen-dining rooms and bedsits)
Kitchens (include kitchen-dining rooms)
Sinks (exclude wash hand basins)
Shower/bathrooms
Toilets in shower/bathrooms
Separate toilets with wash hand basins (exclude external toilets)
Separate toilets without wash hand basins (exclude external toilets)
Wash hand basins (include all wash hand basins)

	Total in property	Exclusive to one letting unit	Shared between letting units
Bedrooms (exclude bedsits)
Bedsits (e.g. combined living/bedrooms)
Living/dining rooms (exclude kitchen-dining rooms and bedsits)
Kitchens (include kitchen-dining rooms)
Sinks (exclude wash hand basins)
Shower/bathrooms
Toilets in shower/bathrooms
Separate toilets with wash hand basins (exclude external toilets)
Separate toilets without wash hand basins (exclude external toilets)
Wash hand basins (include all wash hand basins)

	Total in property	Exclusive to one letting unit	Shared between letting units
Bedrooms (exclude bedsits)
Bedsits (e.g. combined living/bedrooms)
Living/dining rooms (exclude kitchen-dining rooms and bedsits)
Kitchens (include kitchen-dining rooms)
Sinks (exclude wash hand basins)
Shower/bathrooms
Toilets in shower/bathrooms
Separate toilets with wash hand basins (exclude external toilets)
Separate toilets without wash hand basins (exclude external toilets)
Wash hand basins (include all wash hand basins)

	Total in property	Exclusive to one letting unit	Shared between letting units
Bedrooms (exclude bedsits)
Bedsits (e.g. combined living/bedrooms)
Living/dining rooms (exclude kitchen-dining rooms and bedsits)
Kitchens (include kitchen-dining rooms)
Sinks (exclude wash hand basins)
Shower/bathrooms
Toilets in shower/bathrooms
Separate toilets with wash hand basins (exclude external toilets)
Separate toilets without wash hand basins (exclude external toilets)
Wash hand basins (include all wash hand basins)

Application Form - HMO Mandatory Licence