Application to vary a premises licence under the Licensing Act 2003

PLEASE READ THE FOLLOWING INSTRUCTIONS FIRST

Before completing this form please read the guidance notes at the end of the form.  If you are completing this form by hand please write legibly in block capitals.  In all cases ensure that your answers are inside the boxes and written in black ink.  Use additional sheets if necessary. 

You may wish to keep a copy of the completed form for your records.

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I/We	     	
        (Insert name(s) of applicant) 
being the premises licence holder, apply to vary a premises licence under section 34 of the Licensing Act 2003 for the premises described in Part 1 below

Premises licence number 
     	

Part 1 – Premises Details

Postal address of premises or, if none, ordnance survey map reference or description
     	
Post town	     	Postcode	     	

Telephone number at premises (if any)	       	
Non-domestic rateable value of premises	£     	

Part 2 – Applicant details

Daytime contact 
telephone number	     	
E-mail address (optional)	     	
Current postal address if different from premises address	     	
Post town	     	Postcode	     	

Part 3 - Variation

Please tick as appropriate	
Do you want the proposed variation to have effect as soon as possible?         Yes        	 No	

If not, from what date do you want the variation to take effect?	DD	
MM	
YYYY	

 	
 	
 	
 	
 	
 	
 	
 	

Do you want the proposed variation to have effect in relation to the introduction of the late night levy? (Please see guidance note 1)     Yes	           No
 
Please describe briefly the nature of the proposed variation (Please see guidance note 
2)
     	

If your proposed variation would mean that 5,000 or more people are expected to attend the premises at any one time, please state the number expected to attend:	     	

Part 4 Operating Schedule		

Please complete those parts of the Operating Schedule below which would be subject to change if this application to vary is successful.

Provision of regulated entertainment (Please see guidance note 3)	Please tick all that apply	
a)	plays (if ticking yes, fill in box A)		
b)	films (if ticking yes, fill in box B)		
c)	indoor sporting events (if ticking yes, fill in box C)		
d)	boxing or wrestling entertainment (if ticking yes, fill in box D)		
e)	live music (if ticking yes, fill in box E)		
f)	recorded music (if ticking yes, fill in box F)		
g)	performances of dance (if ticking yes, fill in box G)		
h)	anything of a similar description to that falling within (e), (f) or (g) 
(if ticking yes, fill in box H)		

			
			
Provision of late night refreshment (if ticking yes, fill in box I) 		
Supply of alcohol (if ticking yes, fill in box J)		
In all cases complete boxes K, L and M

A

Plays 
Standard days and timings (please read guidance note 8)	Will the performance of a play take place indoors or outdoors or both – please tick (please read guidance note 4)  
	Indoors		
		Outdoors		
Day	Start	Finish		Both		
Mon	     	     	Please give further details here (please read guidance note 5)
     	
	     	     		
Tue	     	     		
	     	     		
Wed	     	     	State any seasonal variations for performing plays (please read guidance note 6)
     	
	     	     		
Thur	     	     		
	     	     		
Fri	     	     	Non standard timings.  Where you intend to use the premises for the performance of plays at different times to those listed in the column on the left, please list (please read guidance note 7)
     	
	     	     		
Sat	     	     		
	     	     		
Sun	     	     		
	     	     		

B

Films 
Standard days and timings (please read guidance note 8)	Will the exhibition of films take place indoors or outdoors or both – please tick (please read guidance note 4) 
	Indoors		
		Outdoors		
Day	Start	Finish		Both		
Mon	     	     	Please give further details here (please read guidance note 5)
     	
	     	     		
Tue	     	     		
	     	     		
Wed	     	     	State any seasonal variations for the exhibition of films (please read guidance note 6)
     	
	     	     		
Thur	     	     		
	     	     		
Fri	     	     	Non standard timings.  Where you intend to use the premises for the exhibition of films at different times to those listed in the column on the left, please list (please read guidance note 7)
     	
	     	     		
Sat	     	     		
	     	     		
Sun	     	     		
	     	     		

C

Indoor sporting events 
Standard days and timings (please read guidance note 8)	Please give further details (please read guidance note 5)
     	
		
Day	Start	Finish		
Mon	     	     		
	     	     		
Tue	     	     	State any seasonal variations for indoor sporting events (please read guidance note 6)
     	
	     	     		
Wed	     	     		
	     	     		
Thur	     	     	Non standard timings.  Where you intend to use the premises for indoor sporting events at different times to those listed in the column on the left, please list (please read guidance note 7)
     	
	     	     		
Fri	     	     		
	     	     		
Sat	     	     		
	     	     		
Sun	     	     		
	     	     		

D

Boxing or wrestling entertainments 
Standard days and timings (please read guidance note 8)	Will the boxing or wrestling entertainment take place indoors or outdoors or both – please tick (please read guidance note 4)  
	Indoors		
		Outdoors		
Day	Start	Finish		Both		
Mon	     	     	Please give further details here (please read guidance note 5)
     	
	     	     		
Tue	     	     		
	     	     		
Wed	     	     	State any seasonal variations for boxing or wrestling entertainment (please read guidance note 6)
     	
	     	     		
Thur	     	     		
	     	     		
Fri	     	     	Non standard timings.  Where you intend to use the premises for boxing or wrestling entertainment at different times to those listed in the column on the left, please list (please read guidance note 7)
     	
	     	     		
Sat	     	     		
	     	     		
Sun	     	     		
	     	     		

E

Live music 
Standard days and timings (please read guidance note 8)	Will the performance of live music take place indoors or outdoors or both – please tick (please read guidance note 4)  
	Indoors		
		Outdoors		
Day	Start	Finish		Both		
Mon	     	     	Please give further details here (please read guidance note 5)
     	
	     	     		
Tue	     	     		
	     	     		
Wed	     	     	State any seasonal variations for the performance of live music (please read guidance note 6)
     	
	     	     		
Thur	     	     		
	     	     		
Fri	     	     	Non standard timings.  Where you intend to use the premises for the performance of live music at different times to those listed in the column on the left, please list (please read guidance note 7)
     	
	     	     		
Sat	     	     		
	     	     		
Sun	     	     		
	     	     		

F

Recorded music 
Standard days and timings (please read guidance note 8)	Will the playing of recorded music take place indoors or outdoors or both – please tick (please read guidance note 4)  
	Indoors		
		Outdoors		
Day	Start	Finish		Both		
Mon	     	     	Please give further details here (please read guidance note 5)
     	
	     	     		
Tue	     	     		
	     	     		
Wed	     	     	State any seasonal variations for the playing of recorded music (please read guidance note 6)
     	
	     	     		
Thur	     	     		
	     	     		
Fri	     	     	Non standard timings.  Where you intend to use the premises for the playing of recorded music at different times to those listed in the column on the left, please list (please read guidance note 7)
     	
	     	     		
Sat	     	     		
	     	     		
Sun	     	     		
	     	     		

G

Performances of dance
Standard days and timings (please read guidance note 8)	Will the performance of dance take place indoors or outdoors or both – please tick (please read guidance note 4)  
	Indoors		
		Outdoors		
Day	Start	Finish		Both		
Mon	     	     	Please give further details here (please read guidance note 5)
     	
	     	     		
Tue	     	     		
	     	     		
Wed	     	     	State any seasonal variations for the performance of dance (please read guidance note 6)
     	
	     	     		
Thur	     	     		
	     	     		
Fri	     	     	Non standard timings.  Where you intend to use the premises for the performance of dance at different times to those listed in the column on the left, please list (please read guidance note 7)
     	
	     	     		
Sat	     	     		
	     	     		
Sun	     	     		
	     	     		

H

Anything of a similar description to that falling within (e), (f) or (g)
Standard days and timings (please read guidance note 8)	Please give a description of the type of entertainment you will be providing
     	
Day	Start	Finish	Will this entertainment take place indoors or outdoors or both – please tick (please read guidance note 4) 	Indoors		
Mon	     	     		Outdoors		
	     	     		Both		
Tue	     	     	Please give further details here (please read guidance note 5)
     	
	     	     		
Wed	     	     		
	     	     		
Thur	     	     	State any seasonal variations for entertainment of a similar description to that falling within (e), (f) or (g)  (please read guidance note 6)
     	
	     	     		
Fri	     	     		
	     	     		
Sat	     	     	Non standard timings.  Where you intend to use the premises for the entertainment of a similar description to that falling within (e), (f) or (g) at different times to those listed in the column on the left, please list (please read guidance note 7)
     	
	     	     		
Sun	     	     		
	     	     		

 I

Late night refreshment
Standard days and timings (please read guidance note 8)	Will the provision of late night refreshment take place indoors or outdoors or both – please tick (please read guidance note 4)  
	Indoors		
		Outdoors		
Day	Start	Finish		Both		
Mon	     	     	Please give further details here (please read guidance note 5)
     	
	     	     		
Tue	     	     		
	     	     		
Wed	     	     	State any seasonal variations for the provision of late night refreshment (please read guidance note 6)
     	
	     	     		
Thur	     	     		
	     	     		
Fri	     	     	Non standard timings.  Where you intend to use the premises for the provision of late night refreshment at different times, to those listed in the column on the left, please list (please read guidance note 7)
     	
	     	     		
Sat	     	     		
	     	     		
Sun	     	     		
	     	     		

J

Supply of alcohol
Standard days and timings (please read guidance note 8)	Will the supply of alcohol be for consumption – please tick  (please read guidance note 9)  
	On the premises		
		Off the premises		
Day	Start	Finish		Both		
Mon	     	     	State any seasonal variations for the supply of alcohol (please read guidance note 6)
     	
	     	     		
Tue	     	     		
	     	     		
Wed	     	     		
	     	     		
Thur	     	     	Non-standard timings.  Where you intend to use the premises for the supply of alcohol at different times to those listed in the column on the left, please list (please read guidance note 7)
     	
	     	     		
Fri	     	     		
	     	     		
Sat	     	     		
	     	     		
Sun	     	     		
	     	     		

K

Please highlight any adult entertainment or services, activities, other entertainment or matters ancillary to the use of the premises that may give rise to concern in respect of children (please read guidance note 10).
     	

L

Hours premises are open to the public
Standard days and timings (please read guidance note 8)	State any seasonal variations (please read guidance note 6)
     	
		
Day	Start	Finish		
Mon	     	     		
	     	     		
Tue	     	     		
	     	     		
Wed	     	     		
	     	     	Non standard timings.  Where you intend the premises to be open to the public at different times from those listed in the column on the left, please list (please read guidance note 7)
     	
Thur	     	     		
	     	     		
Fri	     	     		
	     	     		
Sat	     	     		
	     	     		
Sun	     	     		
	     	     		

Please identify those conditions currently imposed on the licence which you believe could be removed as a consequence of the proposed variation you are seeking.
     	

Please tick as appropriate	
	I have enclosed the premises licence		
	I have enclosed the relevant part of the premises licence		

If you have not ticked one of these boxes, please fill in reasons for not including the licence or part of it below

Reasons why I have not enclosed the premises licence or relevant part of premises licence.
     	

M Describe any additional steps you intend to take to promote the four licensing objectives as a result of the proposed variation:

a) General – all four licensing objectives (b, c, d and e) (please read guidance note 11)
     	

b) The prevention of crime and disorder
     	

c) Public safety
     	

d) The prevention of public nuisance
     	

e) The protection of children from harm
     	

Checklist:
Please tick to indicate agreement	

	I have made or enclosed payment of the fee; or 
I have not made or enclosed payment of the fee because this application has been made in relation to the introduction of the late night levy.	

	I have sent copies of this application and the plan to responsible authorities and others where applicable.		
	I understand that I must now advertise my application.		
	I have enclosed the premises licence or relevant part of it or explanation.		
	I understand that if I do not comply with the above requirements my application will be rejected. 		

IT IS AN OFFENCE, UNDER SECTION 158 OF THE LICENSING ACT 2003, TO MAKE A FALSE STATEMENT IN OR IN CONNECTION WITH THIS APPLICATION. THOSE WHO MAKE A FALSE STATEMENT MAY BE LIABLE ON SUMMARY CONVICTION TO A FINE OF ANY AMOUNT.  

Part 5 – Signatures   (please read guidance note 12)

Signature of applicant (the current premises licence holder) or applicant’s solicitor or other duly authorised agent (please read guidance note 13).  If signing on behalf of the applicant, please state in what capacity.

Signature		
Date	     	
Capacity	     	

Where the premises licence is jointly held, signature of 2nd applicant (the current premises licence holder) or 2nd applicant’s solicitor or other authorised agent (please read guidance note 14).  If signing on behalf of the applicant, please state in what capacity. 

Signature		
Date	     	
Capacity	     	

Contact name (where not previously given) and address for correspondence associated with this application (please read guidance note 15)
     	
Post town	     	Post code	     	
Telephone number (if any)	     	
If you would prefer us to correspond with you by e-mail, your e-mail address (optional)
     	

Notes for Guidance

This application cannot be used to vary the licence so as to extend the period for which the licence has effect or to vary substantially the premises to which it relates. If you wish to make that type of change to the premises licence, you should make a new premises licence application under section 17 of the Licensing Act 2003.

1.	You do not have to pay a fee if the only purpose of the variation for which you are applying is to avoid becoming liable for the late night levy
2.	Describe the premises. For example, the type of premises, its general situation and layout and any other information which could be relevant to the licensing objectives. Where your application includes off-supplies of alcohol and you intend to provide a place of consumption of these off-supplies of alcohol, you must include a description of where the place will be and its proximity to the premises.
3.	In terms of specific regulated entertainments please note that: 
•	Plays: no licence is required for performances between 08.00 and 23.00 on any day, provided that the audience does not exceed 500.
•	Films: no licence is required for ‘not-for-profit’ film exhibition held in community premises  between 08.00 and 23.00 on any day provided that the audience does not exceed 500 and the organiser (a) gets consent to the screening from a person who is responsible for the premises; and (b) ensures that each such screening abides by age classification ratings.
•	Indoor sporting events: no licence is required for performances between 08.00 and 23.00 on any day, provided that the audience does not exceed 1000.    
•	Boxing or Wrestling Entertainment:  no licence is required for a contest, exhibition or display of Greco-Roman wrestling, or freestyle wrestling between 08.00 and 23.00 on any day, provided that the audience does not exceed 1000. Combined fighting sports – defined as a contest, exhibition or display which combines boxing or wrestling with one or more martial arts – are licensable as a boxing or wrestling entertainment rather than an indoor sporting event.
•	Live music: no licence permission is required for:
o	a performance of unamplified live music between 08.00 and 23.00 on any day, on any premises.
o	a performance of amplified live music between 08.00 and 23.00 on any day on premises authorised to sell alcohol for consumption on those premises, provided that the audience does not exceed 500.
o	a performance of amplified live music between 08.00 and 23.00 on any day, in a workplace that is not licensed to sell alcohol on those premises, provided that the audience does not exceed 500. 
o	a performance of amplified live music between 08.00 and 23.00 on any day, in a church hall, village hall, community hall, or other similar community premises, that is not licensed by a premises licence to sell alcohol, provided that (a) the audience does not exceed 500, and (b) the organiser gets consent for the performance from a person who is responsible for the premises.
o	a performance of amplified live music between 08.00 and 23.00 on any day, at the non-residential premises of (i) a local authority, or (ii) a school, or (iii) a hospital, provided that (a) the audience does not exceed 500, and (b) the organiser gets consent for the performance on the relevant premises from: (i) the local authority concerned, or (ii) the school or (iii) the health care provider for the hospital.
•	Recorded Music: no licence permission is required for:
o	any playing of recorded music between 08.00 and 23.00 on any day on premises authorised to sell alcohol for consumption on those premises, provided that the audience does not exceed 500.
o	any playing of recorded music between 08.00 and 23.00 on any day, in a church hall, village hall, community hall, or other similar community premises, that is not licensed by a premises licence to sell alcohol, provided that (a) the audience does not exceed 500, and (b) the organiser gets consent for the performance from a person who is responsible for the premises.
o	any playing of recorded music between 08.00 and 23.00 on any day, at the non-residential premises of (i) a local authority, or (ii) a school, or (iii) a hospital, provided that (a) the audience does not exceed 500, and (b) the organiser gets consent for the performance on the relevant premises from: (i) the local authority concerned, or (ii) the school proprietor or (iii) the health care provider for the hospital.

•	Dance: no licence is required for performances between 08.00 and 23.00 on any day, provided that the audience does not exceed 500. However, a performance which amounts to adult entertainment remains licensable.
•	Cross activity exemptions: no licence is required between 08.00 and 23.00 on any day, with no limit on audience size for:   
o	any entertainment taking place on the premises of the local authority where the entertainment is provided by or on behalf of the local authority; 
o	any entertainment taking place on the hospital premises of the health care provider where the entertainment is provided by or on behalf of the health care provider; 
o	any entertainment taking place on the premises of the school where the entertainment is provided by or on behalf of the school proprietor; and
o	any entertainment (excluding films and a boxing or wrestling entertainment) taking place at a travelling circus, provided that (a) it takes place within a moveable structure that accommodates the audience, and (b) that the travelling circus has not been located on the same site for more than 28 consecutive days.
4.	Where taking place in a building or other structure please tick as appropriate (indoors may include a tent).

5.	For example state type of activity to be authorised, if not already stated, and give relevant further details, for example (but not exclusively) whether or not music will be amplified or unamplified.
6.	For example (but not exclusively), where the activity will occur on additional days during the summer months.
7.	For example (but not exclusively), where you wish the activity to go on longer on a particular day e.g. Christmas Eve.
8.	Please give timings in 24 hour clock (e.g. 16.00) and only give details for the days of the week when you intend the premises to be used for the activity.
9.	If you wish people to be able to consume alcohol on the premises, please tick ‘on the premises’. If you wish people to be able to purchase alcohol to consume away from the premises, please tick ‘off the premises’. If you wish people to be able to do both, please tick ‘both’.
10.	Please give information about anything intended to occur at the premises or ancillary to the use of the premises which may give rise to concern in respect of children regardless of whether you intend children to have access to the premises, for example (but not exclusively) nudity or semi-nudity, films for restricted age groups or the presence of gaming machines.
11.	Please list here steps you will take to promote all four licensing objectives together.
12.	The application form must be signed.
13.	An applicant’s agent (for example solicitor) may sign the form on their behalf provided that they have actual authority to do so.
14.	Where there is more than one applicant, each of the applicants or their respective agents must sign the application form.
15.	This is the address which we shall use to correspond with you about this application.