w" ),1f Ef r: tqqq LLq

lnsetT name and addrcssof relevantlicensingauthorry and ils referencenumber(optional).1
Applicrtion for a premiseslicenceto be granted
urder the Lic€nsine Act 2003
PLEASf, READ THE FOLLOWING INSTRUCTIONS FIRST
B€forecompletingtbis form pl€asereadthe guidancenotesat th€ endofthe form. Ifyou arecompleting
this form by handpleasewrite legibly in block capitals.In all casesensurelhat your answersareinsideihe
boxesandwritten in black ink. Use additionalsheetsifnepessary.
You may wish to k€ep a copy of ihe completed folm for your rccords.
w" ),1f
Efr: tqqqLLq
(Insen nane(s) of applicant)
apply for a premiseslicenceunder section17 ofthe LicensingAct 2003 for the premisesdescribedin
Part 1 below (the premises)and l/we are making this application to you as the relevant licensing
ruthority in accordancewith section12 ofthe Li€ensingAct 2003
Part 1- PremisesDetails
Postal ad&ess ot' premisesor, ifnone, ordnancesurvey map referenceor description
MERNIS FOOD,
UNIT 2 HANWORTH TRADING ESTATE,
HAMPTON ROAD WEST,
FELTHAM,
MIDDLESEX,
TW136DH
Posttown
FELTIIAM
Postcode
T\d136DH
Telephonenumber at premises(if any)
Non-domestic rateablevalue of premises
f54,OOO
BAND C
Part 2 -ApplicaniDetails
Pleasestatewhetheryou are appling lor a premiseslicenceas
Pleasetick as approp.iate
a)
an individual or individuals *
b)
a personother than an individual *
n
pleasecomplete section (A)
i.
as a limited company
X
pleasecompletesection(B)
ii.
as a partnership
n
pleasecompletesection(B)
iii.
asan unincorporaled
association
or
n
pleasecornplelesection(B)
iv.
other (for examplea stalutory corporation)
n
pleasecomplete section (B.i
c)
a recognisedclub
n
pleasecomplete section (B)
d)
a charity
n
pleasecompletesection(B)
e)
the proprietor of an educatioml establishnent
!
pleasecomplete section (B)
0
a health service body
n
pleasecomplete section (B)
C)
a personwho is register€dunder Palt 2 ofthe Care
tl
Act 2000 (c14)in resp€clofan independert
Standards
hospitalin wales
pleasecomPleiesection (B)
ga)
a personwho is registeredunder Chapter 2 ofPat 1
ofthe Healthand SocialCareAct 2008(within the
meaning of that Part) in an independenthospiial il1
England
n
pleasecomplete section (B)
h)
the chiefofficer ofpolice ofa policelorce in England
andWales
!
pleasecompletesection(B)
* Ifyou are applyirg as a penon describedin (a) or (b) pleaseconfirm:
Pleasetick yes
I am carying on or ploposhg to carry on a businesswhich involves the use ofihe prenises for
licensableactivities;or
I am making lhe application punuant lo a
X
statutory funcion or
a tunction dischargedby viftue ofHer Majesry's prerogative
(A) INDMDUAL
u. n
!
APPLICANTS (fill in as applicable)
u." n
Missn
Surname
Iam 18yearsold or over
ra" n
Odler Title (for
example,Rev)
First names
n
Please
tickyes
Currmt poslaladdressif
differentfrom premises
address
Posttown
DaYtimecontact teleDhonenumber
E-mail address
(optional)
Postcode
SECOND INDMDUAL
iv|. !
APPLICANT (if applicable)
Mr, n
viss !
Surnam€
I am I8 yearsold or over
M, fl
OtherTitle (for
example,Rev)
First names
!
Please
rickyes
Cunent postal addressil
differcnt fiom prel ses
Postcode
Da).timecontact telephonenomber
E-mail addr€ss
(optional)
(B) OTIIIR APPLICANTS
Pleas€provide nameand registeredrddressofapplicant in full. \Vhere appropriate pleasegive any
register€dnumber. In the caseof a partn€rship or other joint v€nture (other than a body
corporate),pl€asegive the nameand addr€ssof eachpsrty concem€d.
Name
MERNIS FOOD LTD
Address
204,226 IMPERIALDRWE,
HARROW,
MIDDLESEX,
ENGLAND,
IIA2 7HH
Registerednumber (where applicable)
09144780
Description of applicanr (for example,partnership, company, unincorporatedassociationetc.)
PRIVATE LM1TED COMPANY
Telephonenumber(if any)
E-mail address(optional)
Part 3 Operating Schedule
Wh€n do you want the Femises licence to start?
ff you wish the licence to be valid only for a limited period, when do you
want it to end?
DD
MM
1
DD
MM
Pleasegive a generaldescdptionofthe premis€s(pleasereadguidancenote1)
A WHOLESALE(CASH& CARRY) COMPANYMPORTING FOODAND OTHERPRODUCTS
FROMROMANI,AFOR SAIE BY WHOLESAIE TO EAST EUROPEANRETAIL OUTLETSAND
BY RETAIL TO MEMBERSOF THE PUBLIC.
THE PREMISESIS A LARGEPURPOSEBUILT WAREHOUSELOCATEDON A TRADING
ESTATEwlTH AN OUTSIDELOADING AREA AND CAR PARK. THEREARE OFFICES,STAFF
TOILETS& A KITCHENAREA TO THE SIDEAND OFFICESABOVE TO THE REARON THE
FIRSTFLOOR.
If 5,000 or morc people are expectedto attend the premisesat any one time,
Dleasestate the number exDectedto attmd,
wllat licensableactivities do you intend to carry on iom the piemises?
(Pleases€esecrons 1 and i4 of&e Licensing Act 2003 and Schedules1 and 2 to the Licensing Act 2003)
Provisionof regulatedentertainment
a)
plays(if ticking yes,fi11in box A)
b)
films (ifticking yes,filt in box B)
c)
indoorsportingevents(if ticking yes,fill in box C)
d)
boxingor wrestlingente$ainnent(if ticking yes,filI in box D)
e)
live music(if ticking yes,fill in box E)
f)
recordedmusic(if ticking yes,filI in box F)
c)
pedormances
of dance(if ticking yes,fill in box G)
h)
an)'thingof a similardescriptionto thatfalling within (e),(0 or (g)
(if ticking yes,fill in box H)
Pleasetick any ihat
apply
!
n
n
n
n
n
n
n
Provision of late niqht relreshment (if ticking yes, 6ll in box l)
Supolv of rlcohol (ifticking yes,fill in box J)
X
In all casescomplete boxes It L and M
A
Plays
Standarddaysandtimings
(pleasereadgnidancenote
Will the performanc€ of a bliy trk€ place indoors
or ouldoors or bodr - oleasetick (pleaseread
suidancenote 2)
Indoors
Outdoon
Day
Mon
Start
Finish
Both
n
n
n
Pleasesive further detrils here (pleasercadguidancenote3)
Tue
State any seasonalvariations for performine plavs (pleaseread guidance
note4)
Ttur
Fri
Non statrdardtimines. Wlere you intend lo usathe premisesfor the
o€rformanceof plavs at dilTerenttim€sto thoselisted in the cotrmn on
the lefl. pleaselist (pleasereadgridancenore5)
Sat
Sun
J
Supply ofalcohol
Standarddaysandtimings
(pleasereadguidancenote
Duv
Start
Mon
08.00
Finish
18.00
Tu€
Will th€ supplv of alcohol be for coasumption plselglqg! (pleaseread sridarce note 7)
On the
!
Off the
prcmises
X
Both
!
Stateanv seasotrslvadations for the supplv ofalcohol (pleasercad
gl]idancenote4)
NONE
08.00
18.00
08.00
18.00
Thur
Fri
Notr slandard timings. r,Vhererou inlend to usethe premisesfor the
suoolv ofalcohol al different times to thoselicted in the column on the
08.00
08.00
1 8 . 0 0 lqlt de$q!!q! (pleasercadguidancenote5)
NONE
18.00
Sat
08.00
17.00
Sun
09.00
i1.00
Statethe name and detailsof the individual whom you wish to specifyon the licenceas designated
premisessupervisori
Name
MS ALEXANDRA-LIDIA
ANGHELINA
Addrcss
113GREATSOUTHWESTROAD,
HOUNSLOW,
I\,1IDDL
ESEX,
TW47NR
TW4 7NR
Personal
lic€ncenumber(ifknown)
TBA
Postcode
Issuinglicensingaurhority(if known)
LONDON BOROUGHOF HOUNSLOW
K
Pl€asehighlight any adult ent€rtainmentor serr,,ices,
activities,other entertainmentor matters
rncillary to th€ useof the premisesthat may give rise to concemin respectof children (pleaseread
guidance
note8).
NONE
L
Hourspremises
arc open
to th€ public
Standarddaysandtimings
(pleasereadguidancenote
Dav
Start
Mon
08.00
State anv seasonalvariations (pleaseread glridancenote 4)
NONE
Finish
18.00
Tue
08.00
r8.00
08.00
1 8 . 0 0 Non rtandard timinqs. Wbere rou intend the premisesro be open lo lhe
Thur
08.00
18.00
Fri
08.00
18.00
Sat
08.00
17.00
Sun
09.00
14.00
p!Cg!q!!qt(pleasereadguidancenote5)
NONE
K
Pleas€ highlight any adult enterttinment or servi€es,activities, other entertainment or matten
ancillary to the use of th€ pr€mises that may giv€ rise to concertr in rcspect oI children (pleaseread
guidancenote 8).
NONE
L
Hourspremfues
are open
to the public
Standarddaysandtimings
(pl€asereadguidancenote
Dav
Start
Mon
08.00
Stat€ any seasonalvariations (pl€asercad guidarce note 4)
NONE
Finish
18.00
Tue
08.00
18.00
08.00
18.00 Non standard timings, !\tere lou inlend the premise\ lo be open to the
Thur
08.00
18.00
Fri
08.00
18.00
Sat
08.00
17.00
Sun
09.00
14.00
public tt different timesfrom thoselisted ia the column on the l€ft
p!e!!gl!!! (pleasercadguidancenote5)
NONE
M Describe ttre stepsyou intend to take to promote the four licensing objectives:
a) Generul- all four
ectiveslb. c. d and et fDlease
read
ANDACTIVELY
PROI\,4OTE
WEWILLOPEMTEOURBUSINESS
INA RESPONSIBLE
I\4ANNER
THELICENSING
OBJECTIVES
AT ALLTII\4ES.
b) The Drev€ntion of crime and disorder
1)A) THE PREI\/IISES
LICENCEHOLDERSHALLENSURETHATA CCTVSYSTEI\4
IS INSTALLED
POLICE.THE
IN THEPREI\4ISES
OF A STANDARD
ACCEPTABLE
TO THE IUEIROPOLITAN
SHALLBE II,IAINTAINED
IN GOODWORKINGORDER& FULLYOPEMTIONAL
SYSTEI\4
HAVEACCESS
COVERING
ALLINTERNAL
AREASOFTHEPREMISES
TOWHICHTHEPUBLIC
& ALSOTHEAREAIM[.4EDIATELY
OUTSIDE
THEPREMISES,
ALLENTRY& EXITPOINTS
SHALLBECOVERED
ENABLING
FRONTAL
IDENTIFICATION
{FULLHEAD& SHOULDERS
I[.4AGES),
OF EVERYPERSONENTERING
THEPREMISESIN ANY LIGHTCONDITION
TO AN
EVIDENTIAL
STANDARD.
A CAMERASHALLBE INSTALLED
IN THE SERVERY/ TILLAREANO HIGHERTHENA I\4ETRE
THE FLOORANGLEDUPWARDSSO AS TO TAKEA FACIALSHOTOF ALL PERSONSIN
FROI\,,I
ITSAREAOF COVER,
B) MANAGEMENT
& PERMANENT
MEMBERS
OF STAFFWILLBETRAINED
INTHEOPERATION
OF THE SYSTEMWITHAT LEASTONEMEI\4BER
OF THISCCTVCOI/PETENTSTAFFON DUTY
EVERYDAYTHEPREMISES
ISOPENFORBUSINESS,
C) THE CCTVSYSTEI\4
WILLHAVETHE CAPABILITY
TO EITHERDOWNLOAD
FOOTAGEONTO
DISKOR I\4EMORY
STICK,THE FOOTAGEOF THE CCTVSYSTEMWILLBE RETAINEDFORA
MINIMUM
PERIOD
OF 31 DAYSBEFORE
RE-WRITING
ITSELF
WITHCORRECT
DATE& TIME
THE FOOTAGESHALLBE MADEAVAILABLE
TO POLICEOR LOCALAUTHORITY
SHOWING.
OFFICERS
UPONREOUEST.
D) IFTHECCTVSYSTEMIS BROKEN
THEPREMISES
LICENCE
HOLDER
SHALLNOTIFY
THE
AS SOON
LICENSING
AUTHORITY
AS SOONAS POSSIBLE
ANDGETTHEFAULTRECTIFIED
AS PRACTICABLE.
F) THEPREMISES
LICENCE
HOLDER
THATA LOGIS KEPTWITHTHE
SHALLENSURE
DETAILSOF THE DATESOF ALLWORK/ REPAIRSCARRIEDOUTONTHE CCTVSYSTEIVI
INCLUDING
THENAME& PHONENUMBER
OFTHEENGINEER.
2) THERESHALLBE NOSUPPLYOFALCOHOL
FORCONSUMPTION
OFFTHEPREI\4ISES
EXCEPT
IN SEALED
CONTAINERS.
3) AN INCIDENTBOOKSHALLBE KEPTAT THE PREI\4ISES
ANDIVADEAVAILABLE
TO THE
POLICE
ORAUTHORISED
COUNCIL
OFFICERS
WHICHWILLRECORD
THEFOLLOWING:
A) ALL CRII\,1ES
REPORTED.
B LOSTPROPERTY,
c ALL EJECTIONSOF CUSTOI\,4ERS.
D ANYCOI\,4PLAINTS
RECEIVED.
E ANYINCIDENTS
OF DISORDER,
F ANY FAULTSIN THE CCTV.
G ANYREFUSAL
INTHESALEOFALCOHOL.
ANYVISITBY A RELEVANT
AUTHORITY
OR EI\,lERGENCY
SERVICE.
THECHALLENGE
25 PROOFOFAGEPOLICY
WILLBEOPERATED
AS THEPROOFOFAGE
(SEEBOXE FORFURTHER
SCHEI\,1E.
DETAILS).
5) ALLSTAFFSHALLBETRAINED
FORTHEIRROLEANDINTHEPROVISIONS
OFTHE
LICENSING
ACTINCLUDING
CHALLENGE
25 ON INDUCTION
ANDGIVENREFRESHER
(SEEBOXE FORFURTHER
INTERVALS.
TRAININGAT A I\4INII\,1UM
OF SIX I\,,IONTHLY
DETAILS).
COVEREDBY CCTVAT ALLTI|\,'IES.
BE SPECIFICALLY
6) ALL DISPLAYS
OF ALCOHOLI\,4UST
OF BEER,LAGERORCIDERSHALLBE SOLD
7) A MINII\4UI\4
OF FOUR(4)CANSOR BOTTLES
INANYRETAIL
SALETO THEPUBLIC.
8) NO BEER,LAGEROR CIDERABOVE6% ABV I\,IAYBE SOLDBY RETAILSALETO THE
PUBLIC.
9) THE PREI\4ISES
WILLACTIVELYENGAGEWITHANDWORKWITHIHE LOCALPOLICE
TEAMS,
TEAI\,,I
ANDPOLICE& COUNCILLICENSING
EXITDOORANDPOINTOF
DISPLAYED
BYTHEENTRY/
1O)NOIICESWILLBE PROMINENTLY
ADVISINGCUSTON4ERS:
SALE(ASAPPROPRIATE)
25 ARE IN OPERATION;
THATCCIV & CHALLENGE
-[HE
ACT REGARDING
OF
LICENSING
ADVISINGCUSTOI\4ERS
OF THEPROVISIONS
UNDFRAGE
& PROXYSALES;
TIMESOF THE
& IHE OPENING
OFTHEPERMITTED
HOURSFORTHESALEOFALCOHOL
PRE[,4ISES;
TO LEAVEQUIE]LYANDNOTTO LOITEROUTSIDE;
TO DISPOSEOF LITTERLEGALLY;
NOTTO DRINKALCOHOL
OUTSIDE
OR INTHESTREET;
(ORCOPIES)
WILLBE KEPTAT
ANDTOBACCO
PRODUCTS
11)INVOICES
FORALLALCOHOL
TO POLICEOFFICERS,
AUTHORISED
AVAILABLE
THE PREMISESFORA YEARANDBE I\,,IADE
ON REOUEST.
OFFICERS
OR HI\,4RC
/ UKBAOFFICERS
COUNCIL
cl Public aaf€tv
ANDREGULARLY
PLANWILLBE PREPARED
A FIRERISKASSESSI\4ENT
& EMERGENCY
FIRESAFETYTRAINING.
REVIEWED.
STAFFWILLBEGIVENAPPROPRIATE
d) The preventionofpublic nuisance
DISPLAYED
BYTHEENTRY/EXITDOORANDPOINTOF
1) NOTICES
WILLBEPROI\4INENTLY
1OFORFULLDETAILS.
SEESECTION
B CONDITION
SALEAS APPROPRIATE_
PERSONSFROMLOITERING
DISCOURAGE
2) I\4ANAGEI\4ENT
ANDSTAFFWILLPROACTIVELY
THEWAREHOUSE.
OR DRINKING
OUTSIDE
3) THEAREATOTHE FRONTWILLBE KEPTTIDYAT ALLTIIVES.
GLASSWARE
WILLBE RECEIVED
OR REMOVALOF RUBBISHESPECIALLY
4) NO DELIVERIES
AND07.OO
DAILY,
TAKEPLACEBETWEEN2,I.OO
e) The protectionofch;ldrenfiorn harm
BEOPERATED
ANDONLYA
25 PROOFOFAGEPOLICYWILL
1)THECHALLENGE
HI/ FORCESPHOTOGMPHIC
DRIVINGLICENCE,
A VALIDPASSPORT,
PHOTOGRAPHIC
& THE
OR PROOFOF AGECARDWITHTHEBEARER'SPHOTOGRAPH
IDENTITYDOCU|\rlENT
AS PROOFOFAGE,
ON ITWILLBEACCEPTED
PASSLOGO/HOLOGRAM
RECORDWILLBE KEPTAS PARTOF THE INCIDENTBOOKAND
2) A WRITTENREFUSALS
TO POLICEOR COUNCILOFFiCERSON REQUEST,
I\4ADE
AVAILABLE
DISPLAYED
BY THE ENTRY/EXITDOORANDPOINTOF
3) NOTICESWILLBE PROI\4INENTLY
B CONDITION
1OFORFULLDETAILS.
SEESECTION
SALEASAPPROPRIATE_
ANDAT REGULAR
4) ALLSTAFFWILLBETRAINED
FORTHEIRROLEON INDUCTION
IDENTIFYING
PERSONS
THEREAFTER.
TRAINING
WILLINCLUDE
INTERVALS
OF SIXMONTHS
ANDRECORDING
ACCEPTABLE
PROOFOFAGE,MAKING
UNDER25.I\4AKING
A CHALLENGE,
ALCOHOL
RETAILING.
A REFUSAL.
PROXYSALES.AVOIDING
CONFLICT
ANDRESPONSIBLE
ANDI\4ADE
WILLBE KEPTFORALLSTAFFI\,lEIVBERS
5) WRITTENTRAININGRECORDS
AVAILABLE
TO POLICE
ORCOUNCIL
OFFICERS
ON REQUEST.
AGECHECKFUNCTION
6) UNLESS
AN EPOSTILLIS IN USEWITHAN INTERGRAL
WILLBEDISPLAYED
BYTHETILLTO
INCORPORATED
IN IT , A MANUAL
TILLPROIVPT
REI\4IND
S'AFF TO APPLYCHALLENGE
25 & CHECKPROOFOFAGEWHEREAPPROPRIATE.
Checklist:
Pleasetick to indicate asreement
I
x
x
.
I have maaleor enclosedpaynent ofthe fee.
.
I have encloseddre plan of the prcnises.
.
I havesentcopiesofthis applicationand th€plan to rcsponsibl€aulhoritiesard otherswherc
applicable.
a'
.
I have enclosedthe consentform completed by the individual l wish to be d€signatedpremises
superv'sor.ilapplicable.
v
.
I undeNtandthat I mustnow advertisemy application.
X
.
I undeNtandthatifl do not complywith the aboverequirem€nts
my applicationwiil be
rejec,ed.
IT IS AN OFFENCE, LIABLE ON SUMMARY CONVICTION TO A FTIIE NOT EXCEEDING
LEVEL 5 ON TIIE STANDARD SCALE, UNDER SECTION 158OF THE LICENSING ACT 2003,
TO MAKE A FAISE STATEMENT IIi OR IN CONNECTION WITH THIS APPLICATION.
Part 4 - Signatures (pleasereadguidancenote 10)
Signatureof applicant or applicant's soli€itor or oth€r duly authoiised agent (seeguidancenote I 1).
If signhg on behalf of the applican! please strte in what capacity,
Signature
Dal--
2 0n n 6
Capacily
{UTHORISTD
T ICF\SINCCONSUT
TA\T
For joint appli€atiotrs,signatureof2"d rpplicstrt or 2'd applicsnt's solicitor or other authorised
agent (pleasereadgxidancenote l2). ff signingon behalfof the applicant,pleasestatein what
capacty.
Signature
Date
Capacily
Contact name (wher€ not previously given) and postal addressfor correspondenceassociatedwith this
application(pleasereadguidancenote l3)
GT LICENSING CONSULTANTS,
55 CODENHAM GREEN,
BASILDON,
ESSEX.
SS165DT
Postrown
BASILDON
Postcode I 5516sDT
07810826?78
Telephonenumber(if an))
If you would prefer us to correspondwith you by e-mail, your e-mail addrcss(optional)
googlerndil.com
grlicensingconsuhdnls@
Notesfor Guidance
Describe the premises,for example dle t]?e ofFemises, its generalsituation and layout and any
other infonnation which could be relevant to the licensing obje€tives.W}lere your application
includes off-supplies ofalcohol and you intend to provide a place for consumptionof theseoffsupplies,you must include a description olwhere the place will be and its Foximity to the
premises.
2. Wlere taking place in a building or oiher stluctule pleasetlck as appropiate (indoors may include
a tent).
3. For example the twe ot'activity to be authodsed,ilnot already stated,and give relevant fu her
details, lor example (but not exclusively) whether or not music will be amplified or unamplified.
4. Fo. example (but not exclusively), where d1eactivity will occur on additional days during the
summermoflths,
5. For exanple Out not exclusively), where you wish the activity to go on longer on a particular day
e.g.Ch.istmasEve.
6. Pleasegive timingsin 24 hourclock (e.g.16:00)and only give detailsfor rhe daysofthe week
when you intend the prernisesto be used for the activity.
7. Ifyou wish peopl€to be ableto consumealcoholon theFemises,pleasetick'on the premises'.If
you wish people to be able to purchasealcohol to consumeaway from the premises,pleasetick
'offthe premises'.lf you wish peopleto be ableto do both,pleasetick 'both'.
8. Pleasegive information about an)'thing intended to occur at the premisesor ancillary to the use of
the prerniseswhich may give dse to concem in respectof children, regardlessof wheth€r you
intend childrcn to have accessto the premises,for example (but not exclusively) nudity or selnlnudity, films for restricted age groups or the presenceof gaming machines.
9. Pleaselist here stepsyou will take to promote all four licensing objeciiv€s together
10. fte applicdion lorn musrbe signed.
11. An applicant'sagent(for examplesolicitor)may sign the folm on thelrbehalfprovidedthatthey
have actual authority to do so.
12. Wlere iherc is morc than one applicant, each ofthe applicant or their respectiveagelt must sign
the application fom.
13. This is dre addresswhich we sha11useto conespond with you about this applicalion.
L
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