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LondonBorough
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Applicationfor a premiseslicenceto be grar$
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a
undertheLicensinsAct2003
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INSTRUCTIOdd
READTHEFOLLOWING
PLEASE
i-Fii\\#tHtr
Beforecompletingthis form pleasereadthe guidancenotesat the end of ihe form.
lf you are completingthisform by handpleasewritelegiblyin blockcapitals.In all cases
ensurethatyouranswersare insidethe boxesand writtenin blackink. Use additionalsheetsif
necessary.
You may wish to keep a copy of the completedform for your records.
l/We 16e COA(UK)t-td
(lnsertname(s)of applicant)
apply for a premiseslicence under section 17 of the LicensingAct 2003for the premises
described in Part 1 below (the premises)and l/we are making this applicationto you as
the relevantlicensingauthority in accordancewith section 12 of the LicensingAct 2003
Part 1 - PremisesDetails
Nameand postal addressof premisesor, if none, ordnancesurvey map referenceor
description
Cranford Community College
High Street
Cranford
Middlesex
Telephonenumberat premises(if any)
02088972001
valueof premises f 415,000
rateable
Non-domestic
Part2 - ApplicantDetails
Pleasestatewhetheryou are applyingfor a premiseslicenceas
Pleasetick yes
a)
"
an individualor individuals
b)
*
a personotherthan an individual
n
pleasecompletesection(A)
i.
as a limitedcompany
E
pleasecompletesection(B)
ii.
as a partnership
n
pleasecompletesection(B)
or
association
iii. as an unincorporated
pleasecompletesection(B)
iv
T
corporation)
l
other(forexamplea statuiory
pleasecompletesection(B)
APPLICANT{if applicable)
SECONDINDIVIDUAL
Mr tr
Mrs I
Miss X
Surname
I am 18 years old or over
Ms tl
OtherTitle{for
Rev)
example,
Firstnames
n
Pleasetickyes
Currentpostaladdress
if differentfrom
premisesaddress
PostTown
Postcode
DaytimecontacttelePhonenumber
E-mailaddress
(optional)
(B) OTHERAPPLICANTS
please providename and registeredaddressof applicantin full. Where appropriateplease
give any registerednumber. In the case of a partnershipor otherjoint venture(otherthan a
6oOycorporate),pleasegive the name and addressof each party concerned.
Name The GOA (UK) Ltd
Address
76 Middleton Avenue
Greenford
Middlesex
UBlO 8BS
1626437
Description of applicant (for example, partnership' company, unincorporateq
etc.)
Company
Telephonenumber (if anY)
0'2rl 97231322
ffi
Pad 3 OperatingSchedule
When do you want the premiseslicenceto start?
lf you wish the licenceto be val'idonliyforia lrimitedperiod,when do
!ou,w&htit to end?
Day Month Year
m
of the prernises(pleaser:eadguidiance
note'l)
.flEg"r givea generaldescription
The AnnrualFestivalis organisedon the open playingfields/groundsof CranfondComnnunity
College
which is an enclosed location securelyfenced off from the main roads and traffic.
Clear entranceand exit routesare displayedand vislble,for both vehiclesand pedestrians,which
have been previouslyused and proven to be efficientvia this systematicapprobch.
The.groundsare clearlymarkedfor sta'llholderis,
marqueesand the stage,and a detailedhyout plan is
produced.
Washroomfacilitiesare easilyaccessibleand provisionfor disabledgueststoo.
The Bar Area wil! be cordoned off, wiih securitv in attendance
lf 5"000or morepeopleareexpected
to attendthepremises
a,tany
9onetime;plieasestatethe numberexpectedto attend.
What licensableaetivitiesdo you intendto carryon from the premises?
(Pleasesee sections1 and14 of the Licensing
Act 2003and Schedules1 and 2 to the
LicensingAct 2003)
Provislonof reoulatedentertalnment
Pleasetickyes
E
a)
plays(if tickingyes, fill in box A)
b)
films (lf tieking yes, fill in box B)
c)
indoorsportingevents(if tickingyes, fill in box C)
n
d)
boxingonwrestlingenteftainment(if tickingyes,fill in box D)
e)'
live rnusic(if tilckingyes, fill,in box E)
n
0
recordedmusic(lf ticklng,yes, fill in box F)
g)
performancesof dance(if tickiingyes, fill in box G)
g
h\
"t
anythingof a sim,ilardescriptionto that fallingwirthin(e), (0 or (g)
(if tickingyes,fill in box H)
13
E
LJ
I
J
tvl
i-/q .
Provisionof entertainmentfacilities:
i)
makingmusic (if tickingyes, fill in box l)
f,
j)
dancing(if tickingyes, fill in box J)
x
k)'
pf a gimil?Idescription
to thatfallingwithin(i)or (1)
enter:tainment
yes,TlllInooxK)
(rrtrcKtng
T
Provisionof late nightrefreshment(if tickingyes, fill in box L)
Suoolvof alcohol(if tickingyes,fill in box M)
In allcases completeboxesN, O and P
f
J
MI
E
LivernusicStandard
daysandtimings
(p{easeread
guidancenote6)
Willthe oerfcrmance
of livemusictakeolace
indoorsor oufdloo,rs
or both- oleasetick (please Indoors
readguidancenote2)
Oudoors
Day
Both
qlve
Please
f,urther
detailshere(pleasereadguridance
note3)
Start
Finish
Mon
x
d
n
AmateurGoanCommunity Live Bands
AmplifiedMusiccontrolledby a ProfessionalFirm
Speakersare pointedawayfrom residentialhomes(seeattached
plan)
Stateanvseasonalvariationsfor the oedonnanceof liver.nusic
(pleasereadguidanrce
note4)
Tue
Wed
Thu'r
Fri
Non standardtiminos. Where vou intendto use tlhepremisesfor the
oerformanceof live musicat differenttimesto those lislediin the
coliumnon the left. oleaselist (pleaseread,guidancenote 5)
Sat
Last Sundayin July
Sun
10
2.00
20.00
F
Recordedmusic
Standarddaysand
ilmrngs (prease
read guidance
note 6)
Will the olaving of recorded music take olace
indoors or outdoors or both - please tick
Iplease reas guroance nore z,
lndoors
il
Outdoors
d
Both
T
Finish
Please qive further details here (please read guidance note 3)
Amateur Goan Community Recorded Music
Tue
State anv seasonal variatio
(please read guidance note 4)
Wed
iC
Thur
Non standard timings. Where vou intend to use the qremises
Fri
t^-4L^
-l^..:--
^r
-^^^--l^-l
Last Sunday in July
1 4
t l
a+
ali4fa:an*
limac
fa
fhaea
listed in the column on the left. olease list (please read
guidance note 5)
Sat
Sun
n..aia
t2.00
20.00
G
Perform:ancesOf
dance
timings(pleaseread
guidanr
:e note6)
Day
I Start
Will the oerformanceof dance tiakeolace
indoorsor outdoorsqr both - p$easetick
ipleasereadEuidancenote2)
Finish
Mon I
lndoors
T
Outdoors
IVJ
Both
T
Pleasesive further dehils here (please read guidance note 3)
Arnateur GoanrGommurnity Dances
Tue
Wed
State any seasonal variations for the nerfonmance of dance
(please read guidance note 4)
Thur
Non standard timlnqs. Where vou intend to use the oremises
for the pedorrnance, of dance at different times to those listed in
FN
the colurmnon the left.sleaselist tpleasereadguidancenote5)
Sat
LastSundayin July
Sun
tz
12.00
20.00
G
Performances
of
dance
a{anrlarrl
.14t,^
-A.l
(pleaseread
tinnings
guidanr
:e note6
Day
I Stant
Will the pedormanceof dance take olace
indoorsor outdoorsof both - nlieasetick
(pleasereadguridanee
note2)
Finish
Mon
lndoors
n
Outdoors
d
Eoth
TI
Please oive fudtrerdebils here (please read guidance note 3)
Arnateur Goan Comrnunity Dances
Tue
Wed
State anv seasonal variations for the nerformance of dance
(please read Ellidhnce note 4)
Thur
Fri
Non standard timinos. bYherevou intend to use tbe oremises
for the perforrnance af dance at different times to those listed in
the colLrmnon the left, qlease list (please read guidance note 5)
Sat
Last Sunday in July
Sun
12
r.2.00 10.00
M
Surpply
of alcohol
Standard
daysand
rl]aq
(prease
irnnrngs
guidancenote6)
befo'rconsumotion
of alcoho,l
Willthesruooly
{Fleasetickbox)(pleasereadguidancenote7}
Day sta* Finish
i
Mon II ____l
T
Eoth
forthesupolvof alcohol(pleaseread
variations
Stateanvseasornal
guidancenote4)
On the
premises
{
Off the
premrses
!
Tue
Wed
Non standard tim,iinqs.Where vou i:ntendto uisethe oremises
fnr fhe sunnlv of alcoho,lat different times to those listed in the
column on the lefL olease list(please read guidance note 5|
Th:ur
Fri
Last Sunday in July
Sat
Sun
t2.00
t9.30
Statethe name and detaitsof the individualwhorr you wish to specifyon the licenceas
premisessupervisor
Name PauliDe-Mendonca
Address
" The Firs"
17 Firs Drive
Granford
Middlesex
Postcode i TW59TA
Personal Licence number (if known) 01104
lssuinglicensingauthority(if known)Hounslow
18
N
otherentertainment
or matters
or services,
activities,
Pleasehighlight
anyadultentertainment
ancillaryto the use of the premisesthat may give rise to concernin respectof children
(pleasereadguidancenote8)
o
Hourspremisesi1re
opento the publi
Standarddaysarrd
timings(pleaser,--ad
guidancenote6)
State anv seasonalvariations(pleaseread guidancenote4)
Finish
Mon
Tue
Wed
Non standard timinqs. Where vou intend the oremises to be
ooen to the oublic at different times from those listed in the
column on the left. olease list (please read guidance note 5)
Thur
Last Sunday in July 2014
Fri
Sat
Sun
19
)9.00
!2.00
P Describe
thestepsyourintendto ta,keto prornote
thefourlicensing
objectives:
a) General*allfourlicensing
(b,c,d,e)
objectives
noteg)
{pleasereadlguidance
see The EventManagement
Planattachedin all cases
b) Thepr'evention
of crimeanddisorder
T P M Security {SlA} Firnnwill be in attendance (See detailed breakdqnn of personnel}
Pedestrians tsags are ahecked by security staf{
V€hlcles are checked by security sliaff
Young adults witl be checked for age verification (lD)
Alll Bar staff will be briefed of their responsibilities on the day
See attached Event Safety Plan
Publicsafety
Alitdrinkswill be servedin PlasticGlasses
Alllbarswill be cordonedoff with a securitysta,ffmanningthe entrance
A fully equippedFirstAid facilitywill be in attendance
SpeedLimit enforcedat 5 mph within the Sch,oolperimeter
RiskAssessmentcarriedout and form attached
Food Hygienecoursesare offeredto all FoodCaterersand is mandatory-Level2
d) Theprevention
of publlcnuisance
Leafletsare distributed to local residentsadvising them of the Festivaland
welcomingthem to attend the festival
TFM Security Firm will be in afiendance
Trafficwill be controlledby Stewards
e)
The protectionof childrenfrom harm
I childrenare accompaniedby Adults on entranceto the site
in organiser'sare C R B checked,
separatemarqueeirsprovidedfor lost childrenand attendedby CRBchecked
lenge21125policyfor the Sal,eof Alcohol,approvedl.D.Passport,PhotoDriving
icence
20
r
'
r
Pleasetick yes/
Nt
I have made or enclosedpaymentof the fee
=
M
I have enclosedthe plan of the premises
and
authorities
and the planto responsible
I havesentcopiesof thisapplication
otherswhereapplicable
I have enclosedthe consentform completedby the individualI wish to be premises
if applicable
supervisor,
J
H_l
that I mustnow advertisemy application
I understand
will
my application
that if I do not complywiththe aboverequirements
I understand
E
o
.
r
m
m
be rejecied
TO A FINEUP TO LEVEL5 ON THE
IT IS AN OFFENCE,LIABLE ON CONVICTTON
TO MAKE A
THE LICENSINGACT 2OO3
158
OF
SECTION
UNDER
STANDARDSCALE,
WITHTHISAPPLICATION
FALSESTATEMENTIN OR IN CONNECTION
Part 4 - Signatures (pleasereadguidancenote 10)
(SeeSignatureof applicantor applicant'ssolicitor or other duly authorisedagent
capacity'
what
in
please
state
applicant
of
the
behatf
on
tuiO"n"" note t i;. lf signing
rq*
other
For joint applicationssignatureof 2ndapplicantor 2ndapplicant'ssolicitor or
applicant
the
of
behalf
on
lf
signing
12)'
guidance
note
read
authorisedagent. lpleaJe
please state in what caPacitY'
Cor,ta"tname(wherenot previouslygiven)and postaladdressfor correspondence
note13)
readguidance
witirttrisapplication(please
associated
number(if anY)
Telephone
lf y"" to.rld pt"f"**
21
t. ""t*tp
d with you by e-mait your e-mail address (optional)
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