Application Checklist: Supporting documents you need to provide with your application: o Application fee
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1 Applicatin fr Special Licence Sectin 138, Sale and Supply f Alchl Act 2012 General infrmatin: Office Use Only An applicatin fr a special licence MUST be ldged at least 20 wrking days befre the event(s) is t be held. Fr large events, we expect applicatins t be ldged at least 30 wrking days befre the event(s). Please read the ntes ver the page carefully and ensure all parts f the applicatin are cmpleted. Applicatin Checklist: Supprting dcuments yu need t prvide with yur applicatin: Applicatin fee This is an applicatin fee and is nn-refundable after the applicatin is received by the Hamiltn City Cuncil. (See the last page f this applicatin frm fr details n fees). A written statement frm the wner f the building/prperty giving cnsent t the applicant fr alchl t be sld r supplied n the premises (Nte that the written cnsent must be fr the same party as detailed in the applicant sectin f this frm). Detailed A4 scale (with measurements) site plan f the premises/site shwing: i. Thse areas that are t be used fr the sale r supply f alchl. ii. Thse areas (if any) that are t be designated as restricted r supervised areas. iii. The principal entrance. iv. Lcatin f all fd utlets and ther relevant activities. A cmplete list f fd and nn/lw alchlic beverages prvided (menu). Cpies f each manager's certificate fr thse managing the event (if applicable). Prf establishing the event(s) as genuine, special r particular ccasin(s). Such as a prgram f activities / cpy f ticket fr public events / invitatin fr private events / prmtinal material etc. If this is a large event (400 r mre peple): An alchl management plan. If yu are applying fr the special licence n behalf f smene else, yu must als prvide: A cpy f the authrity t act as an agent f the applicant, signed by the applicant Applicatins can be delivered t the Custmer Service Centre in Garden Place r psted t Hamiltn City Cuncil, Private Bag 3010, Hamiltn Yu can als apply nline n ur website: FEE DUE: Office Use Only: Accepted by: Receipt number: Receipt date: Class 1: T Class 2: T Class 3: T
2 Special Licence infrmatin What is a special licence? A special licence allws the sale r supply f alchl n a given premises r cnveyance fr the duratin f a specific ccasin r event. A special licence can als be issued t an n- r club licensee fr an event nt cvered by their licence. A special licence can cver ne event r a series f events, fr up t 12 mnths after it is issued. When is a special licence required? If alchl is sld at an event r supplied t the public at an event, the persn respnsible needs t get a special licence. They als need a special licence if alchl will be available and they charge an entry/ticket fee, r ask fr a dnatin r kha. Even if an event is t take place n already-licensed premises, as a licensee yu will need t check whether a special licence may be needed in relatin t the event, as it may nt be cvered by yur existing n- r club licence. Yu d nt need a special licence if yu are supplying alchl t guests in yur wn private residence r yu are hlding a private event where alchl is nt being sld. Applicatin timeframes An applicatin fr a special licence MUST be ldged at least 20 wrking days befre the event(s) is/are t be held. Applicatins received within 20 wrking days f the event will nt be accepted. Fr large events, we expect applicatins t be ldged at least 30 wrking days befre the event(s). A 'wrking day' des nt include weekends, statutry hlidays r any day frm 20 December and 15 January (inclusive). Applicatin fee See the last page f this applicatin frm fr details n special licence applicatin fees Special licence types: n and ff site An n-site special licence allws the sale r supply f alchl that will be cnsumed at the event(s). An ffsite special licence allws the sale r supply f alchl that will be taken away and cnsumed at anther place. This als allws free samples t be supplied. An ff-site special licensee can nly sell their alchl (fr example, a winery can sell the wine they prduce). Large events The District Licensing Cmmittee may require that an applicant prvide any r all f the fllwing fr a large scale event: An alchl management plan describing hw the applicant prpses t deal with matters such as security, mnitring, interactin with lcal residents and public health cncerns. The applicant may be required t attend a meeting with a licensing inspectr. The applicant will be cntacted after the applicatin has been received t arrange an appintment. Special licences fr mre than ne day r ne event If this applicatin is fr mre than ne day, then the days and events must be related in similarity (number and types f peple, lcatin, type f event) - such as; The same event ver a number f days - i.e. 3 day hme shw, race meetings, series f weekday fundraiser cmpetitin. Small clubs r similar rganisatins that d nt hld a permanent licence. There needs t be many similarities - i.e. One club night a mnth fr the same peple and hurs event with different themes. Functin centre fr different private functins where the numbers, venue and hurs are similar. Otherwise a separate applicatin and fee is required. Public ntice If required t d s by the secretary f the District Licensing Cmmittee, the applicant must within 10 wrking days after filing this applicatin with the cmmittee ensure that ntice f this applicatin in frm 8 is attached in a cnspicuus place n r adjacent t the site t which this applicatin relates.
3 Applicatin fr Special Licence Sectin 138, Sale and Supply f Alchl Act 2012 T the Secretary District Licensing Cmmittee, Hamiltn City Cuncil Applicatin fr a special licence is made in accrdance with the details set ut belw. Applicant details 1. Full legal name t appear n licence: (the licensee, i.e. the persn r rganisatin that the prceeds frm alchl sales are ging t): 2. Date f birth (if the applicant is an individual): 3. Occupatin (if the applicant is an individual): 4. Status f applicant: Individual persn Trustee Private cmpany Partnership Club Public cmpany Lcal authrity Licensing trust r cmmunity trust Other - advise what authrity under which incrprated Pstal address (fr service f dcuments): 6. Hme phne: Wrk phne: Pstcde: Mbile phne: 7. address:
4 8. Daytime cntact details (if different frm abve) Name: Phne number: Mbile number: address: 9. Des the applicant (r any cmpany directrs) have any criminal cnvictins? (ther than cnvictins fr ffences against prvisins f the Land Transprt Act 1998 nt cntained in Part 6, and ffences t which the Criminal Recrds (Clean Slate) Act 2004 applies) Yes N If YES, please state the nature f the ffence, date f cnvictin and penalty suffered: Nature f the ffence Date f cnvictin Penalty suffered 10. What relevant experience and training des the applicant have relevant t alchl service and cmpliance? Premises details 11. Address f premises where event(s) is t be held: 12. Trading name f premises r name f building:
5 13. Des the premises already hld a licence? Yes N If YES, state the licence number: 14. Is a licence sught cnditinal upn cnstructin r cmpletin f the premises? Yes N 15. Des the applicant wn the prpsed licensed premises? Yes N If NO - What is the full name and address f the wner? What frm f tenure and term f tenure will the applicant have? If NO, what frm f tenure and term f tenure will the applicant have? 16. What part (if any) f the premises des the applicant intend shuld be designated as (select at least ne): A restricted area (n ne under 18 years f age allwed n site)? A supervised area (minrs allwed nly with parent r legal guardian)? Undesignated (any age allwed)? Event details 17. Will alchl sld at the event(s) be fr cnsumptin n site r ff site? On site Off site Bth 18. State the nature f the event(s) r ccasin(s): NB If the event is a fundraiser please clarify what/whm the funds are ging twards. 19. Will tickets be sld fr this event(s)? Yes N
6 20. On which day(s) and during what hurs is alchl t be sld under the licence? 21. Number f peple attending (estimate, if nt knwn): 22. Prbable age distributin f peple attending: 23. Des the applicant intend t engage in the sale r supply f any gds ther than alchl and fd, r in the prvisin f any services ther than thse directly related t the sale r supply f alchl and fd? Yes N If YES, what is the nature f thse ther gds and services? 24. What types f cntainer will alchl be sld in? e.g. plastic glasses, paper cups, standard bar glasses, cans, bttles etc. 25. What is the range (types) f alchl prducts yu intend t sell and the alchl percentage (%)? e.g. Lin Red stubbies 4%, Wdstck 5%, etc. 26. Fr ff-site applicatins nly If prviding tastings, please specify what prducts, alchl percentage (%), and the size f each tasting (ml).
7 27. Fr large events nly, what security will yu be prviding and evidence f their qualificatins? Managers (r persns respnsible) details The Sale and Supply f Alchl Act 2012 requires the appintment f managers fr special licences unless exempted by the District Licensing Cmmittee (DLC). Therefre, fr large events and many medium events certificated manager(s) are essential. Fr ther events the DLC may cnsider a respnsible persn. 28. Fr each manager r respnsible persn, please state the full legal name, date f birth and residential address. If they are certificated managers, please supply a cpy f their manager s certificate(s). Name Address Date f birth Manager s certificate number (if applicable) Cnditins fr n-site applicatins nly 29. What prvisin will be made fr the sale and supply f: Fd? LOW alchl beverages (2.5% r less) and NON-alchlic beverages?
8 30. What steps will be taken t prvide assistance with r infrmatin abut alternative frms f transprt frm the premises? Cnditins fr n- AND ff-site applicatins 31. T what extent, and where, is drinking water t be freely available t patrns? 32. What steps will be taken t ensure that the requirements f the Act in relatin t the sale and supply f alchl t prhibited persns are bserved? 33. What steps will be taken t prmte the respnsible cnsumptin f alchl? 34. What ther systems (including training systems) and staff will be in place fr cmpliance with the Act?
9 Declaratin The New Zealand plice are required by the Sale and Supply f Alchl Act 2012 t make inquiries int the suitability f the applicant. This will invlve infrming the District Licensing Cmmittee and the Alchl Regulatry and Licensing Authrity f any cnvictins r cncerns invlving the applicant. Shuld there be any cncerns, the applicant will als be infrmed. I cnsent t the release f this infrmatin I hereby state that the abve particulars are true and crrect I understand that my applicatin will nt be ldged with Cuncil until the applicatin fee is paid and all required dcuments are supplied. Incmplete applicatins will be returned. [Signature] [Date] [Name] [Designatin] Cntact us: Phne: (07) licensing@hcc.gvt.nz Website: Lcatin: Service Centre - Grund Flr, Garden Place, Hamiltn
10 Special Licence applicatin fee There are three fee rates fr special licences. The fee depends n the size and number f events cvered by the licence. The new fee system, set by the Ministry f Justice, mre fairly reflects the cst f alchl licensing. Use the chart belw t determine which categry yur special licence fits int. All applicatin fees belw are GST inclusive. Licence Type Applicatin Fee Descriptin Class 3 $ r 2 events cvered by the licence that are f a 'small size' Class 2 $ t 12 events cvered by the licence that are f a 'small size', r 1 t 3 events that are f a 'medium size' Class 1 $ All ther special licences, including licences fr events that are f a 'large size', 13 r mre events that are f small size, r 4 r mre events that are f medium size. A small event is an event that will be attended by less than 100 peple. A medium event is an event that will be attended by between peple. A large event is an event that will be attended by mre than 400 peple. Please nte that it is Hamiltn City Cuncil that determines the final applicatin fee s yu may be charged further fees befre yur licence is granted. Applicatin fees are set by the Ministry f Justice. Fr mre infrmatin, see If yu need assistance calculating yur applicatin fee, please cntact us n the details belw. Cntact us: Phne: (07) licensing@hcc.gvt.nz Website: Lcatin: Service Centre - Grund Flr, Garden Place, Hamiltn
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