8 Till Late Ltd 57 Kingsley Road

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Applicationfor a premiseslicenceto be granted
underthe LicensingAct 2003
THE FOLLOWINGINSTRUCTIONS
FIRST
pleasereadtheguidance
notesat theendof theform.
lf you are completingthis form by hand pleasewritelegiblyin blockcapitals.In all cases
ensurethat youranswersare insidethe boxesand writtenin blackink. Use additionalsheetsif
necessary"
You may wish to keep a copy of the completedform for your records.
lM|e 8 Till Late Ltd
(lnsertname(s)of applicant)
applyfor a premiseslicenceundersection17of the LicensingAct 2003for the premises
describedin Part1 below(thepremises)and l/weare makingthis applicationto you as
the relevantlicensingauthorityin accordancewith section12ofthe LicensingAct 2003
Part'l - PremisesDetails
Postaladdressof premisesor, if none,ordnancesurveymap referenceor description
57 Kingsley
Road
Post town
Hounslow
Post code
TW31QB
(if any)
Telephone
numberat premises
Non-domestic
rateablevalueof oremises f15,750BandB
Part2 - ApplicantDetails
Pleasestatewhetheryouareapplyingfor a premiseslicenceas
Pleasetickves
a)
*
an individual
or individuals
b)
*
a personotherthanan individual
n
pleasecomplete
section(A)
i.
as a limitedcompany
X
pleasecomplete
section(B)
ii.
as a partnership
!
pleasecomplete
section(B)
!
pleasecomplete
section(B)
iv. other(forexamplea statutorycorporation) n
iii. as an unincorporated
association
or
c)
a recognised
club
n
section(B)
. pleasecomplete
pleasecomplete
section(B)
d)
a charity
!
pleasecomplete
section(B)
e)
f)
S)
the proprietor
of an educational
establishment L_l
a healthservicebody
n
pleasecompletesection(B)
a personwho is registered
underPart2 ofthe
CareStandards
Act 2000(c14)in respectof an
independent
hospital
in Wales
!
pleasecompletesection(B)
U
pleasecomplete
section(B)
n
pleasecompletesection(B)
underChapter2 of
Sa) a personwho is registered
Part1 of the HealthandSocialCareAct 2008
(withinthemeaning
of thatPart)in an
independent
hospital
in England
the chiefofficerof policeof a policeforcein
England
andWales
h)
* lf you areapplyingas a persondescribedin (a)
pleasecomplete
section(B)
or (b) pleaseconfirm:
Pleasetick yes
I am carrying
on or proposing
to carryon a business
whichinvolves
theuseof
Lr
the premises
for licensable
activities;
or
o I am makingtheapplication
pursuant
to a
o statutoryfunctionor
n
o a functiondischarged
by virtueof HerMajesty'sprerogative
n
.
(A) INDIVIDUAL
(fillin as appticabte)
APPLICANTS
Mrn
MrsI
Missn
Surname
Ms!
OtherTitle(for
example,
Rev)
First names
I am 18 yearsold or over
n
Please
tickyes
Currentpostal
addressif different
from premises
address
Post Town
Postcode
Daytimecontacttelephonenumber
E-mailaddress
(optional)
SECONDINDIVIDUAL
(if applicable)
APPLICANT
Mrn
Mrsn
Missn
Msn
OthbrTitle(for
example,
Rev)
I am 18yearsold or over
n
Pleasetickyes
Currentpostal
addressif different
from premises
address
Post Town
Postcode
Daytimecontacttelephonenumber
E-mailaddress
(optional)
(B)OTHERAPPLTCANTS
Pleaseprovidenameand registeredaddressof applicantin full. Whereappropriate
pleasegiveany registerednumber.ln the caseof a partnershipor otherjoint venture
(otherthan a body corporate),pleasegive the nameand addressof eachparty
concerned.
Name
8 Till Late Ltd
Address
3d Floor
VymanHouse
104CollegeRoad
Harrow
HA.l1BQ
Registered
number(whereapplicable)
04759388
(forexample,
Description
partnership,
of applicant
company,
unincorporated
association
etc.)
PrivateLimitedCompany
Telephone
number(ifany)
E-mailaddress(optional)
Part3 OperatingSchedule
Whendo youwantthe premiseslicenceto start?
lf youwishthelicenceto bevalidonlyfor a limitedperiod,whendo
youwantit to end?
Pleasegivea generaldescription
of the premises(pleasereadguidancenotel)
A smallretailconvenience
storeset in a busymixedresidential
andcommercial
areacloseby
to HounslowEastStation.Theofferwill bethatof a triedandtestedformatofferinggroceries
goodsandalcoholtogetherwithNationalLotteryandOystercard
household
lf 5,000or morepeopleareexpectedto attendthe premisesat any
onetime,pleasestatethe numberexpectedto attend.
Whatlicensable
activitiesdo you intendto carryon fromthe premises?
(Pleaseseesections
1 and14ofthe Licensing
Act2003andSchedules
1 and2 to the
Licensing
Act2003)
Provisionof requlatedentertainment
Pleasetick yes
a)
plays(iftickingyes,fillin boxA)
b)
films(iftickingyes,fill in boxB)
n
n
c)
indoorsporting
events(iftickingyes,fillin boxC)
D
d)
(iftickingyes,fillin boxD)
boxingor wrestling
entertainment
e)
livemusic(iftickingy.es,fillin boxE)
f)
recordedmusic(if tickingyes,fill in boxF)
S)
performances
of dance(iftickingyes,fillin boxG)
h\
anything
of a similardescription
to thatfallingwithin(e),(fl or (g)
(iftickingyes,fillin boxH)
n
n
n
n
n
Provisionof entertainment
facilities:
i)
makingmusic(iftickingyes,fillin boxl)
n
j)
dancing(iftickingyes,fill in boxJ)
!
r.\
'''
entertainment
of a similardescription
to thatfallingwithin(i)or o
(iftickingyes,fillin boxK)
Provisionof lateniqhtrefreshment
(iftickingyes,fillin boxL)
n
n
Supolvof alcohol(iftickingyes,fillin boxM)
X
M
Supply of alcohol
Standarddaysand
timings(pleaseread
guidancenote6)
Day
Start
Mon
08.00
Finish
23.00
Tue
Will the supplvof alcoholbe for
consumption(Pleasetick box) (pleaseread
guidance
note7)
08.00
On the
premises
n
Off the
premrses
X
Both
!
State anv seasonalvariationsfor the supplv of alcohol (please
readguidancenote4)
ChristmasEve 08.00- 00.00
New Year'sEve 08.00- 00.00
23.00
Wed
08.00
23.00
Thur
Nonstandardtiminqs. Wherevou intendto usethe premises
for the supplvof alcoholat differel!timesto thoselistedin the
08.00
23.00 column on the left. please list (pleasereadguidancenote5)
Fri
08.00
23.00
Sat
08.00
23.00
Sun
08.00
23.00
Statethe nameand detailsof the individualwhom you wish to specifyon the licenceas
premisessupervisor
Name
Babu Karavadra
Address
2 Bullstrode
Gardens
Hounslow
Teleohone:02085775239
Postcode I TW33AJ
PersonalLicencenumber (if known)
H00258
lssuing licensing authority (if known)
L B Hounslow
18
N
Pleasehighlight any adult entertainmentor services,activities,other entertainmentor
matters ancillary to the use of the premisesthat may give rise to concern in respect of
children (pleasereadguidancenote8)
None
o
Hourspremisesare
opento the public
daysand
Standard
timings(pleaseread
guidance
note6)
Day
Start
Mon
08.00
Stateanv seasonalvariations(pleasereadguidance
note4)
Christmas
Eve08.00- 00.00
NewYear'sEve08.00- 00.00
Finish
23.00
Tue
08.00
23.00
Wed
08.00
23.00 Non standard timings. Where you intend the premisesto be
Thur
open to the public at differenttimes from those listed in the
08.00
columnon the left.pleaselist (pleasereadguidance
note5)
23.00
Fri
08.00
23.00
5aI
08.00
23.00
Sun
08.00
23.00
19
P Describethe stepsyou intendto taketo promotethe fourlicensingobjectives:
a) General- all four licensingobjectives(b,c,d,e)(pleasereadguidance
noteg)
See below
b) Thepreventionof crimeand disorder
1 . Thepremises
shallinstallandmaintain
a comprehensive
CCTVsystemas perthe
minimum
requirements
of theHouslow
PoliceandCouncilLicensing
Team.Allentryand
exit pointswill be coveredenablingfrontalidentification
of everypersonenteringIn any
lightcondition.
TheCCTVsystemshallcontinually
recordwhilstthepremises
is openfor
licensable
activities
andduringalltimeswhencustomers
remainonthepremises.
All
pe od of 31 dayswithdateandtimestamping.
recordings
shallbe storedfor a minimum
Viewingof recordings
shallbe madeavailable
immediately
upontherequestof Policeor
authorisedofficerthroughout
the preceding31 dayperiod.
Allsalesof alcoholfor consumption
offthe premises
shallbe in sealedcontainers
only,
andshallnotbeconsumed
on thepremises.
No cansof super-strength
beer,lagers,cidersor spiritmixturesof 6.0%ABV (alcoholby
volume)or aboveshallbesoldat the oremises
4. A Challenge
25 proofof ageschemeshallbeoperated
at the premises
wheretheonly
photographic
acceptable
formsof identification
are recognised
identification
cards,such
passport
as a drivinglicence,
or proofof agecardwiththe PASSHologram.
A recordshallbekeptdetailing
all refusedsalesof alcohol.
Therecordshouldinclude
the dateandtimeof the refusedsaleandthe nameof the memberof staffwhorefused
thesale.Therecordshallbe available
for inspection
at the premises
bythe policeor an
authorised
officerof theCouncilat alltimeswhilstthe premises
areopen.
All cashierswill receiverefreshertrainingon the relevantalcohollawsandthe licence
policyon Challenging
holder's
for suchlD. Suchtraining
willtakeplaceat leasttwicea
year. Records
willbe maintained
at thepremises
containing
information
aboutthe
trainingof anypersonwhomaymakea saleof alcoholincluding
thedateof theirtraining
andthenatureof thetrainingundertaken.
Therelevant
documentation
shallbe
producedon requestto a policeofficeror relevantofficerof a responsible
authority.
* Till LateToONLYpurchasestockfroman authorized
wholesaler
and producereceipts
(Anauthorized
uponrequest
for inspection.
wholesaler
meansan established
warehouse
or outletwitha fixedaddressand notfroma vanor streettraderevenif they
claimthattheyare partof or actingon behalfof an authorized
wholesaler).
To NOTtake partin ANYstockswapsor lendor borrowanygoodsfromanyother
sourceunlessthesourceis anothervenueownedandoperated
bythesamecompany
whoareALSOsubjectto buyingtheirstockfroman authorized
wholesaler.
20
c) Public safety
Allfiresafetyequipment
willbe installed
andmaintained
as according
to manufacturers
guidlines
e) Theprotectionof childrenfrom harm
See abovere stafftrainingand challenge25 policy
Pleasetick yes
.
.
.
.
'
.
payment
I havemadeor enclosed
of thefee
I haveenclosedthe b'lanof the oremises
I havesentcopiesof thisapplication
andthe planto responsible
authorities
and
otherswhereapplicable
I haveenclosed
theconsent
formcompleted
bythe individual
I wishto be premises
supervisor,
if applicable
I understand
thatI mustnowadvertise
myapplication
I understand
thatif I do notcomplywiththeaboverequirements
my application
will
be rejected
IT IS AN OFFENCE,
LIABLEON CONVICTION
TO A FINEUPTO LEVEL5 ONTHE
STANDARD
SCALE,UNDERSECTION
158OFTHELICENSING
ACT2OO3
TO MAKEA
FALSESTATEMENT
IN OR IN CONNECTION
WITHTHISAPPLICATION
Part4 - Signatures (pleasereadguidance
note10)
Signatureof applicantor applicant'ssolicitoror otherduly authorisedagent(See
guidance
note11). lf signingon behalfoftheapplicantpleasestatein whatcapacity.
n
n
n
n
n
n
Signature
4esE*
Date
Capacity
?'--..-]:-..--.
e+ lrwry?-ctD-ryt+
Owner
For joint applicationssignature of 2ndapplicantor 2ndapplicant'ssolicitor or other
authorisedagent. (pleasereadguidancenote 12). lf signing on behalfofthe applicant
please state in what capacity.
Signature
Date
Capacity
Contactname(wherenot previouslygiven)and postaladdressfor correspondence
associatedwith this application(pleasereadguidance
note13)
Post town
Postcode
Telephonenumber (if any)
lf you wouldpreferus to correspondwith you by e-mailyour e-mailaddress(optional)
Notesfor Guidance
1. Describe
thepremises.
Forexample
thetypeof premises,
itsgeneralsituation
and
layoutandanyotherinformation
whichcouldbe relevant
to thelicensing
objectives.
Whereyourapplication
includes
off-supplies
of alcoholandyouintendto providea place
for consumption
of theseoff-supplies
youmustincludea description
of wheretheplace
willbeanditsproximity
to thepremises.
2. Wheretakingplacein a building
pleasetickas appropriate.
or otherstructure
Indoors
mayincludea tent.
3. Forexample
thetypeof activity
to be authorised,
if notalreadystated,andgiverelevant
furtherdetails,
(butnotexclusively)
for example
whetheror notmusicwillbe amplified
or
unamolified.
(butnotexclusively),
4. Forexample
wheretheactivity
willoccuron additional
daysdurrng
thesummermonths.
(butnotexclusively),
5. Forexample
whereyouwishtheactivity
to go on longeron a
particular
daye.g.Christmas
Eve.
6. Pleasegivetimingsin 24 hourclock(e.9.16:00)andonlygivedetailsfor thedaysof the
weekwhenyouintendthe premises
to be usedfortheactivity.
7. lf youwishpeopleto beableto consume
pleasetickon,if you
alcoholon thepremises
wishpeopleto beableto purchase
please
alcoholto consume
awayfromthepremises
tickoff.lf youwishpeopleto beableto do bothpleasetickboth.
Shelvingprofiles
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CONTRAST
SHOPFITTERS
LTD
Conrrasr ShoDtiters Lld.
Unlt3 TrumpersWay IndlsrrialEstale,Hanwett,w7 2QA
Iel- (020)84531331 Far - (020)396546S2
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