Application Form for a Certificate of Compliance (Alcohol Licensing)

Transcription

1 Date Reeived: Appliation Number: Appliation Form for a Certifiate of Compliane (Alohol Liensing) Pursuant to setions 100(f) Sale and Supply of Alohol At 2012 Page 1 of 6

2 Certifiate of Compliane (Alohol Liensing) APPLICATION FOR A CERTIFICATE OF COMPLIANCE CERTIFYING THAT THE PROPOSED USE OF PREMISES MEETS REQUIREMENTS OF THE RESOURCE MANAGEMENT ACT 1991 AND OF THE BUILDING CODE. This appliation will be heked by a Resoure Planner and Building Offier to ensure ompliane with the RMA and Building At. Please indiate the reason for this appliation by tiking the appropriate box(es) below: Brand-new premises (whether built or not) Existing premises either not previously liensed or liensed for different type (i.e.: hange of use) Already liensed (new owner seeking new liene) Variation of ondition of existing liene (i.e.: hours) Redefinition of liensed premises (i.e.: area) Contat Details 1.0 Name of Appliant: Mailing Address: Daytime Contat Person: Telephone/Fax: 2.0 Name of Premises/Establishment: 3.0 (i) Address of Premises in respet of whih a liene appliation is to be made: 3.0 (ii) Legal Desription: 3.0 (iii) Valuation Number: Page 2 of 6

3 4.0 (i) Proposed Lienes Speify type of lienes sought and proposed use of premises Tik only one box per setion ON-LICENCE Setion 14 & 15 Hotel Tavern Entertainment/Funtion Centre Restaurant Nightlub BYO Caterers OFF-LICENCE Setion 17, 18 & 19 Hotel/Tavern Club Manufature or sale Supermarket Groery Store Setion 20 (Autioneers) CLUB LICENCE Setion 21 Type of lub: 4.0 (ii) Existing Liene(s) If there is an existing on-liene please state the authorisations (if any) and urrent usage. If there is an existing off-liene please state type. If there is an existing lub liene please state type of lub. ON-LICENCE Setion 14 Current Usage: Hotel Tavern Entertainment/Funtion Centre Restaurant Nightlub Others Please speify OFF-LICENCE Setion 17, 18 & 19 Hotel/Tavern Club Manufature or sale Supermarket Groery Store Setion 20 (Autioneers) CLUB LICENCE Setion 21 Type of lub: 5.0(i) Hours Please state the existing hours (if appliable) shown on the liene: 5.0(ii) Please state the proposed hours the premises will be open: Page 3 of 6

4 5.0(iii) Please state the proposed hours the sale of liquor will take plae if different: 6.0 Land Use How was the use established (e.g. Permitted ativity in terms of the relevant Distrit Plan or resoure onsent granted)? Supporting evidene & doumentation must be attahed. A Site Plan of the property, in aordane with Chapter 4 of the Distrit Plan, must be provided along with a floor plan, and if it is a new building, opies of the Building Plans are required. Please see the Certifiate of Compliane (Liquor) pamphlet for more details. 7.0 Car Parking If the use requires off-street ar parking, where is this provided (e.g. on-site, existing use rights, leased site nearby, et)? Doumentation and plans showing parking layout et must be provided. 8.0 If a Club (i) Please state the number of members presently in the lub and any proposed membership inrease if appliable: (ii) Please state whether the lub has reiproal visiting arrangements with other lubs: 9.0 Plans This appliation must be aompanied by a plan to a reognised sale (e.g. 1:200) showing those parts of the premises that are to be used for the sale, supply or onsumption of liquor Additional Information Required Please provide below any additional information required: Attahments I Attah (tik as appliable): Payment Evidene and/or doumentation showing how the use was established A site plan in aordane with Chapter 4 of the Distrit Plan A floor plan and (if it is a new building) building plans Doumentation & plans showing parking layout et A plan showing areas to be used for sale, supply or onsumption of alohol Other (list below) Your page number: Page 4 of 6

5 Three opies of the ompleted appliation form and aompanying information must be supplied (inluding 1 full set of plans & 2 sets redued to A4 size). Note: The Certifiate of Compliane (Alohol Liensing) pamphlet lists the information requirements for this appliation. Please use the heklist on the pamphlet to ensure that you provide all the neessary information at the right level of detail. Inomplete appliations may result in requests for further information (under s88(3) & s92 RMA) and therefore delays may be experiened. The Counil website has opies of most Counil booklets, forms and pamphlets Signature I hereby ertify that, to the best of my knowledge, the information given in this appliation is true, omplete and orret. I undertake to pay all atual and reasonable appliation osts inurred by the Far North Distrit Counil. Signed: Dated: Postal Address for Servie of Douments: This appliation form, together with a opy of the present liene (if appliable) and the presribed fee and all supporting doumentation are to be lodged with: The Building Administrator, Far North Distrit Counil, Environmental Management Private Bag 752, KAIKOHE 0440 Telephone: Fax: (09) Please allow 20 working days for the proessing of your ertifiate. To avoid unneessary delays in proessing please ensure that your appliation is aompanied by doumentation to support Question 6 and plans as requested in Questions 6, 7 & 9. For offie use only: Date reeived: Name of CSO: Fees reeipted: Reeipt Number: RC Appliation Number: Other Referene Numbers (e.g. PIM or BC et.) DEFINITIONS Legal desription: This relates to the legal definition of the site on whih the premises being liensed is loated. This an be obtained from your rates notie (loated on the reverse side in the Property Details area). Valuation Number: This is the unique referene number for the site that the premises is loated on and an also be obtained from your rates aount (loated on the reverse side in the Property Details area). Supermarket: This means a supermarket having a floor area of at least 1000 square metres. Groery Store: A groery store is defined as being less than 1000 square metres in area, where the Liensing Authority is satisfied that the prinipal business of the store is the sale of main order household foodstuff requirements. Page 5 of 6

6 Land Use: Question 6 on Land Use requires you to indiate how the premises were first established. The premises ould have been established either as a permitted ativity under the Distrit Plan at the time or by way of applying for a resoure onsent. If a resoure onsent was required please ensure you enlose a opy of this with your appliation. If the use of the premises was established as a permitted ativity please give details of dates et when it was first established. Change of Use: If this ategory is seleted it is likely that a Building Consent approval will be neessary before a Certifiate an be signed. A hange of use is for example a Retail Shop to on liene afé or even an inrease in the liensed area and aepted numbers. Page 6 of 6