Application for Premises Licence / Provisional Premises Licence
Orkney Islands Area Licensing Board
Licensing (Scotland) Act 2005, section 20
Question 1: Name, address and postcode of premises to be licensed
Question 2: Particulars of applicant
2(a)
Where applicant is an individual, please provide full name, date and place of birth and home address including postcode.
2(b)
Where applicant is a partnership, please provide full name and postal address of partnership.
2(c)
Where applicant is a company, please provide name, registered office and company registration number.
2(d)
Where the applicant is a club or other body, please provide full name and postal address of club or other body.
2(e)
Where applicant is a partnership, company, club or other body, please provide the names, dates and places of birth, and home addresses of connected persons (provide on separate sheets as necessary).
Connected person is defined in section 147(3) of the Licensing (Scotland) Act 2005 and in the Guidance issued by this Board.
Question 3: Previous applications
Has the applicant been refused a premises licence under section 23 of the Licensing (Scotland) Act 2005 in respect of the same premises?
If YES – provide full details below:
- YES
- NO
Question 4: Previous convictions
Has the applicant or any connected person ever been convicted of a relevant or foreign offence?
If YES – provide full details below (provide on separate sheets as necessary).
- YES
- NO
For the purposes of this Act, a conviction for a relevant offence or foreign offence is to be disregarded if it is spent for the purposes of the Rehabilitation of Offenders Act 1974.
In addition to any convictions held by the applicant at the time of application, applicants should also familiarise themselves with the contents of section 24(1) of the Licensing (Scotland) Act 2005 in respect of any convictions for relevant or foreign convictions which they may receive during the period beginning with the making of the premises licence application and ending with determination of the application.
| Name and position (if applicable) | Date of conviction or sentence | Court | Offence | Penalty |
|---|---|---|---|---|
Question 5: Description of Premises
Description of premises (continue on separate sheet(s) if necessary and where application is submitted by a members’ club please also complete question 6).
Question 6
To be completed by members’ clubs only.
Do the club’s constitution and rules conform to the requirements of regulation 2 of the Licensing (Clubs) (Scotland) Regulations 2007?
- Yes
- No
Declaration by Applicant / Agent on behalf of Applicant
If signing on behalf of the applicant please state in what capacity.
The contents of this application are true to the best of my knowledge and belief.
| Signature (see note below*): | |
| Date: | |
| Capacity – Applicant / Agent: | |
| Telephone number of signatory: | |
| Email address of signatory: |
Checklist
I have enclosed the relevant documents with this application (please select Yes or No as appropriate):
| Document | Yes | No |
|---|---|---|
| Disabled Access and Facilities Statement. | Yes | No |
| Operating plan. | Yes | No |
| Layout plan. | Yes | No |
| Planning certificate. | Yes | No |
| Building standards certificate. | Yes | No |
| Food hygiene certificate. | Yes | No |
| Application fee. | Yes | No |
Data Protection
*The information on this form may be held on an electronic public register which may be available to members of the public on request. For more information about how your data will be used, refer to the Board’s Guidance published at https://www.orkney.gov.uk/our-services/law-and-licensing/licence-applications/alcohol-licensing/
Paper copies are available on request.
Version: 2018-05-30.