SOUTH LAKELAND DISTRICT COUNCIL Public Health & Licensing Group, South Lakeland House, Lowther Street, Kendal, Cumbria LA9 4UD Tel: 0845 050 4434 Fax: (01539) 740300 www.southlakeland.gov.uk e-mail: [email protected] Application for a premises licence to be granted 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. I/We Ashleigh_ Mayvers__ on behalf of Southern_District_Young Farmers --------------------------------- (Insert name(s) ofapplicant) apply for a premises licence under section 17 of the Licensing Act 2003 for the premises described in Part 1 below (the premises) and I/we are making this application to you as the relevant licensing authority in accordance with section 12 of the Licensing Act 2003 Part 1 - Premises Details Postal address of premises or, if none, ordnance survey map reference or description Hawkswell Farm Ulverston Cumbria Post town I Ulverston I Postcode I LA12 7pp Telephone number at premises (if any) Non-domestic rateable value of premises £2000 Part 2 -Applicant Details Please state whether you are applying for a premises licence as Please tick as appropriate a) an individual or individuals * □ please complete section (A) b) a person other than an individual * i. as a limited company □ please complete section (B) ii. as a partnership □ please complete section (B) iii. as an unincorporated association or □ please complete section (B) October 2012 iv. other (for example a statutory corporation) □ please complete section (B) c) a recognised club □ please complete section (B) d) a charity X please complete section (B) e) the proprietor of an educational establishment □ please complete section (B) f) a health service body □ please complete section (B) g) a person who is registered under Part 2 of the □ please complete section (B) Care Standards Act 2000 (c14) in respect of an independent hospital in Wales ga) a person who is registered under Chapter 2 of □ please complete section (B) Part 1 of the Health and Social Care Act 2008 (within the meaning of that Part) in an independent hospital in England h) the chief officer of police of a police force in □ please complete section (B) England and Wales * If you are applying as a person described in (a) or (b) please confirm: Please tick yes I am carrying on or proposing to carry on a business which involves the use of the D premises for licensable activities; or I am making the application pursuant to a statutory function or X a function discharged by virtue of Her Majesty's prerogative □ (A) INDIVIDUAL APPLICANTS (fill in as applicable) Other Title (for Miss Ms Mr □ Mrs □ □ □ example, Rev) Surname First names I am 18 years old or over □ Please tick yes N/A Current postal address if different from premises address Post town I I Postcode I Daytime contact telephone number I E-mail address (optional) October 2012 SECOND INDIVIDUAL APPLICANT (if applicable) Other Title (for Mr Mrs Miss Ms □ □ □ □ example, Rev) Surname First names I am 18 years old or over □ Please tick yes N/A Current postal address if different from premises address Post town I I Postcode I Daytime contact telephone number I E-mail address (optional) (B) OTHER APPLICANTS Please provide name and registered address of applicant in full. Where appropriate please give any registered number. In the case of a partnership or other joint venture (other than a body corporate), please give the name and address of each party concerned. Name Southern District Young Farmers Clubs Address Ashleigh Mayvers Young Farmers County Office Newton Rigg Penrith Cumbria Registered number (where applicable) Description of applicant (for example, partnership, company, unincorporated association etc.) Charity company national Telephone number (if any) 01768 866550 County Office Ashleigh Mayvers E-mail address (optional) [email protected] October 2012 Part 3 Operating Schedule DD MM YYYY When do you want the premises licence to start? 17/05/2014 I n1 jtg $1 .zj al nl §l- If you wish the licence to be valid only for a limited period, when do DD MM YYYY you want it to end? 18/05/2014 Inl Bil ol ~ ~ g ,1 'i+ Please give a general description of the premises (please read guidance note 1) Farm buildings in an isolated rural location. If 5,000 or more people are expected to attend the premises at any IN/A one time, please state the number expected to attend. What licensable activities do you intend to carry on from the premises? (Please see sections 1 and 14 of the Licensing Act 2003 and Schedules 1 and 2 to the Licensing Act 2003) Please tick any that Provision of regulated entertainment 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) X f) recorded music (if ticking yes, fill in box F) X g) performances of dance (if ticking yes, fill in box G) □ anything of a similar description to that falling within (e), (f) or (g) h) (if ticking yes, fill in box H) □ X Provision of late night refreshment (if ticking yes, fill in box I) Supply of alcohol (if ticking yes, fill in box J) X In all cases complete boxes K, L and M October 2012 E Live music Will the 11erformance of live music take 11lace Indoors X Standard days and indoors or outdoors or both - 11lease tick timings (please read (please read guidance note 2) guidance note 6) Outdoors □ Day Start Finish Both □ Mon Please give further details here (please read guidance note 3) Amplified live music as a one off event not annually at this venue Tue Wed State anl,'. seasonal variations for the 11erformance of live music (please read guidance note 4) Thur Fri Non standard timings. Where Ji'.OU intend to use the 11remises for the 11erformance of live music at different times to those listed in the column on the left, 111ease list (please read guidance note 5) Sat 19 00 Sun 01 30 October 2012 F Recorded music Will the [!lal£ing of recorded music take [!lace Indoors X Standard days and indoors or outdoors or both - [!lease tick timings (please read (please read guidance note 2) guidance note 6) Outdoors □ Day Start Finish Both □ Mon Please give further details here (please read guidance note 3) Tue Wed State anl£ seasonal variations for the [!lal£ing of recorded music (please read guidance note 4) Thur Fri Non standard timings. Where l£OU intend to use the [!remises for the [!lal£ing of recorded music at different times to those listed in the column on the left, [!lease list (please read guidance note 5) Sat 19 00 Sun 01 30 October 2012 Late night refreshment Will the provision of late night refreshment Standard days and take place indoors or outdoors or both - Indoors D timings (please read please tick (please read guidance note 2) guidance note 6) Outdoors X Day Start Finish Both D Mon Please give further details here (please read guidance note 3) Burger van. Tue Wed State anl£ seasonal variations for the [!rovision of late night refreshment (please read guidance note 4) Thur Fri Non standard timings. Where l£OU intend to use the [!remises for the [!rovision of late night refreshment at different times, to those listed in the column on the left, [!lease list (please read Sat guidance note 5) -- 23 00 Sun 01 30 ------------ October 2012 J Supply of alcohol Will the sueelJt: of alcohol be for consumetion On the Standard days and - elease tick (please read guidance note 7) premises □ timings (please read guidance note 6) Off the premises □ Day Start Finish Both X Mon State anJt: seasonal variations for the sueelJt: of alcohol (please read guidance note 4) Tue Wed Thur Non standard timings. Where Jt:OU intend to use the eremises for the sueelJt: of alcohol at different times to those listed in the column on the left, elease list (please read guidance note 5) Fri Sat 19 00 Sun 01 30 State the name and details of the individual whom you wish to specify on the licence as designated premises supervisor: Name Stephen Proctor Postcode I Personal licence number (if known) PA 1048 Issuing licensing authority (if known) SLDC October 2012 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 8). N/A L Hours premises are State any seasonal variations (please read guidance note 4) open to the public Standard days and timings (please read guidance note 6) Day Start Finish Mon Tue Wed Non standard timings. Where you intend the eremises to be oeen to the eublic at different times from those listed in the Thur column on the left, elease list (please read guidance note 5) Fri Sat 19 00 Sun 01 30 ----------- October 2012 M Describe the steps you intend to take to promote the four licensing objectives: al General - all four licensina obiectives lb, c, d and e) (please read guidance note 9) 9xMale, 1xFemale Registerd Doorstaff, Risk assessments, Fire Safety Officers, No under 18 yrs old b) The prevention of crime and disorder Registered door staff plus designated Advisory Members in attendance.