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ORKNEY ISLANDS AREA LICENSING BOARD

APPLICATION FOR TEMPORARY PREMISES LICENCE

Licensing (Scotland) Act 2005, section 47

APPLICANT INFORMATION

Question 1

Name, address and postcode of premises to be licensed.

Question 2

Particulars of applicant

2(a)

Where applicant is an individual, 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.*

* Connected person is defined in section 147(3) of the Licensing (Scotland) Act 2005 and in the Guidance Notes 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?

YES/NO*

*If YES – provide full details

IMAGE: The page provides a large blank box for details of any previous application refused, followed by Question 4 and a blank response area for the YES/NO answer.

Question 4

Previous convictions

Has the applicant or any connected person ever been convicted of a relevant or foreign offence(a)

YES/NO*

*If YES – provide full details

For the purpose of this Act, a conviction for a relevant offence or foreign offence is to be disregarded if it is spent for the purpose of the Rehabilitation of Offenders Act 1974.

Name & position (if applicable)Date of conviction or sentenceCourtOffencePenalty

(a) 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.

IMAGE: The page shows a blank table for recording convictions, with columns for name and position, date of conviction or sentence, court, offence and penalty.

DESCRIPTION OF PREMISES

Question 5

Description of premises (where application is submitted by a members’ club please also complete question 6)

IMAGE: The page provides a large blank box for the description of the premises.

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*

* Delete as appropriate

IMAGE: The page presents Question 6 in a two-column response table, with the question in the left column and YES/NO in the right column, followed by the note “ Delete as appropriate”.

DECLARATION BY APPLICANT/OR 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 (delete as appropriate)

Telephone number and email address of signatory …..……………………………………….

………………………………………………………………………………………………………..

See Checklist over –

IMAGE: The page provides blank lines for the signature, date, capacity, telephone number and email address of the signatory, and includes the instruction “See Checklist over –”.

DOCUMENT CHECKLIST

I have enclosed the relevant documents with this application – please tick the relevant boxes

  • Operating plan
  • Layout plan (5 copies)

* Data Protection Act 1998

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 use by the Licensing Board only

Application checklist

Date received
Fee amount
Consideration date
Date granted/refused (delete as appropriate)

Documents required

Operating plan
Layout plan

IMAGE: The page shows a checklist table for enclosed documents, with rows for “Operating plan” and “Layout plan (5 copies)” and blank boxes for ticking. It also shows a Licensing Board-only application checklist with blank fields for date received, fee amount, consideration date, date granted/refused, operating plan and layout plan.