Road Construction Consent
March 2017
Road Lighting Installation Certificate: DC3
IMAGE: The Orkney Islands Council crest and logo, with the words “ORKNEY ISLANDS COUNCIL.”
This form should be completed by the installer and submitted to the Local Roads Authority as part of the Application for Adoption using Form CC6. Multiple forms may be submitted for larger projects with more than one road lighting scheme.
| Project: | |
| Description of Road: | |
| Location Details: |
Drawing Reference(s)
Details of Installation
| Column Manufacturer/ Cat. No. | |
| Column Mounting Height | |
| Lantern Manufacturer/ Cat. No. | |
| Lantern Wattage | |
| Control Gear Manufacturer/ Cat. No. | |
| Control Gear Wattage | |
| Cut Out Manufacturer/ Cat. No. | |
| HRC/ MCB Rating | |
| Lamp Manufacturer/ Cat. No. | |
| Ducting Manufacturer/ Cat. No. | |
| Cable Type/ Diameter | |
| Switchbox Manufacturer/ Cat. No. | |
| Distribution Board Manufacturer/ Cat. No. |
March 2017
Details of Installation
| Contactor/ Relay Manufacturer/ Cat. No. | |
| Construction Consent Forms | |
| Details of Installation (continued) | |
| Contactor/ Relay Rating | |
| PEC Manufacturer/ Cat. No. | |
| Lux on and Ratio on/off |
I, being the person responsible (as indicated by my signature below) for the construction of the Lighting Electrical Installation, certify that the said work for which I have been responsible is to the best of my knowledge and belief in accordance with the current Code of Practice for Street Lighting BS 5489, the Local Roads Authority specification for the installation of street lighting, and the Regulations for Electrical Installation 16th Edition as published by the Institute of Electrical Engineers except for departures, if any, stated in this certificate.
The extent of liability of the signatory is limited to the work described above as subject to this certificate.
| Name of Installer: | Position: |
| Company: | |
| Address: | |
| On behalf of (client): | |
| Signed: | Date: |
For office use only
| Inspection Date: | |
| Inspecting Engineer: | |
| Certified for Adoption: |
March 2017