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Work Permit Application

Please fill out the form below to apply for a work permit.

Contractor

Contractor’s Legal Name*

Contractor’s Email Address*

Contractor’s Phone Number*

Authorisation

Landlord or Tenant Name*

Landlord or Tenant Email*

Landlord or Tenant Phone Number*

Location

Address*

Work Type

Work Type*

Electrical

Plumbing

IT related

Fit-out

Strip out/dilapidations

General maintenance

Hot works

Other

Other*

Hidden

Please detail the specifics of any required actions*

Please detail the specifics of electrical work*

Please detail the specifics of plumbing work*

Please detail the specifics of IT related work*

Please detail the specifics of fit-out work*

Please detail the specifics of strip out/dilapidations work*

Please detail the specifics of general maintenance work*

Please detail the specifics of hot works*

Please detail the specifics of other work*

Required Access

Required Access*

BT frame room

Riser access

Roof access

Plant room

Mechanical

Lift related

Boiler room

Switch room

Car Park (bay to be cordoned off in advance)

Fire Panel

Residential – refer to Managing Agent (Metrus)

Showcase access

Other

Other*

Please detail the specifics for BT frame room access*

Please detail the specifics for riser access*

Please detail the specifics for roof access*

Please detail the specifics for plant room access*

Please detail the specifics for mechanical access*

Please detail the specifics for lift related access*

Please detail the specifics for boiler room access*

Please detail the specifics for switch room access*

Please detail the specifics for car park access*

Please detail the specifics for fire panel access*

Please detail the specifics for residential access*

Please detail the specifics for showcase access*

Please detail the specifics for other access*

Date & Time

Start Date and Time

If the Start Date and Time is less than 48 hours from now, please submit this application and call the Estate Management Office on 020 7225 9150.

End Date and Time

Risk Assessment and Method Statement (RAMS)

RAMS*

Drop files here or

Max. file size: 8 MB.

Insurance Documents

Public Liability Insurance*

Yes

No

£GBP Coverage Amount*

Minimum £10,000,000 for Hot Works, or £5,000,000 for other works

Expiry Date and Time*

Professional Indemnity Insurance*

Yes

No

£GBP Coverage Amount*

Minimum £5,000,000

Expiry Date and Time*

Insurance Document(s)*

Drop files here or

Max. file size: 8 MB.

Statement

Statement*

I have read and understood the Chelsea Harbour Contractor’s Guidelines and Safety Notice.

Hidden

Application ID

Δ

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