Applicatin fr Renewal f Off-Licence Sectin 127, Sale and Supply f Alchl Act 2012 General infrmatin: An applicatin fr renewal f club licence must be filed at least 20 wrking days befre the licence is due t expire. Office Use Only Applicatin Checklist: Supprting dcuments yu need t prvide with yur applicatin: Applicatin fee + public ntice fee This is an applicatin fee and is nn-refundable after the applicatin is received by the Hamiltn City Cuncil. (Please see infrmatin sheet n the last tw pages f this applicatin r cntact us fr assistance). Detailed A4 scale map f the interir f the premises shwing: i. the areas used fr sale f alchl ii. areas that are t be restricted r supervised iii. the principal entrance iv. the layut f the interir f the premises v. CCTV placement and security lighting (if applicable) vi. Fr supermarkets and grcery stres nly: the single area where alchl will be displayed must be clearly shwn. A Hst Respnsibility Plicy. Cpies f each current manager s certificate fr thse nminated t manage the premises. Evidence f staff training in hst respnsibility practices. Fr grcery stres nly: A statement f 12 mnths sales figures (verified by an accuntant) establishing the range f gd sld (as required by regulatins 12/13 f the sale and Supply f Alchl Regulatins 2013) Cpies f any prpsed advertising r prmtins (if applicable). If yu are applying fr the renewal f ff-licence n behalf f smene else: 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 3240. FEE DUE: Office Use Only: Accepted by: Receipt number: Receipt date: App Fee $453.00 App Fee $694.50 App Fee $901.50 App Fee $1108.50 App Fee $1292.50 T310 350.75 T310 575.00 T310 764.75 T310 937.25 T310 1035.00 T311 17.25 T311 34.50 T311 51.75 T311 86.25 T311 172.50 T414 85.00 T414 85.00 T414 85.00 T414 85.00 T414 85.00
Applicatin fr Renewal f Off-Licence Sectin 127, Sale and Supply f Alchl Act 2012 T the Secretary District Licensing Cmmittee, Hamiltn City Cuncil Applicatin fr renewal f ff-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... 5. Pstal address (fr service f dcuments): 6. Hme phne: Wrk phne: Pstcde: Mbile phne: 7. E-mail address:
8. Daytime cntact details (if different frm abve) Name: Phne number: Mbile number: E-mail 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 Further details where applicant is a cmpany 10. Date and place f incrpratin: 11. State the full details f each directr: Name Address Date f birth Place f birth Designatin
12. If applicant is a private cmpany, state the full details f each persn wh hlds any shares issued by the cmpany: Name Sharehlder 1 Sharehlder 2 Sharehlder 3 Sharehlder 4 Address Date f birth Place f birth Designatin Number f shares 13. If applicant is a public cmpany, state the full details f each persn wh hlds 20% r mre f the shares, r f any class f shares, issued by the cmpany: Name Sharehlder 1 Sharehlder 2 Sharehlder 3 Sharehlder 4 Address Date f birth Place f birth Designatin Number f shares Further details where applicant is a partnership 14. State the full details f each partner: Name Partner 1 Partner 2 Partner 3 Partner 4 Address Date f birth Place f birth
15. Regarding the abve cmpany/partnership details, have there been any changes since the issue f the licence r last renewal? If s, what are thse changes? Premises details 16. Address f licensed premises: 17. Trading name: 18. 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? Business details 19. What is the general nature f the business cnducted by the applicant under the licence? (e.g. htel, tavern, supermarket, grcery stre, whlesaler, alchl retailer, ther) 20. Is the sale f alchl the principal purpse f the business? Yes N If NO, what is the principal purpse f the business?
21. On which days and during what hurs is alchl sld under the licence? 22. Is any endrsement sught, r sught t be renewed? Auctineer (Sectin 39) Yes N Remte sales (Sectin 40) Yes N Duty managers details 23. State the full details f each manager r prpsed manager: Name Date f birth Certificate number Expiry date Cnditins 24. What part (if any) f the premises is intended t be designated as (select at least ne): A restricted area (n ne under 18 allwed n site)? A supervised area (minrs allwed nly with parent r legal guardian)? Undesignated (any age allwed)?
25. T what extent, and where, is drinking water freely available t patrns fr tastings? 26. What steps are taken t ensure that the requirements f the Act in relatin t the sale and supply f alchl t prhibited persns are bserved? 27. What steps are in place aimed at prmting the respnsible cnsumptin f alchl with the aim f minimising the harm caused by the excessive r inapprpriate cnsumptin f alchl? 28. State the prximity f all sensitive sites (e.g. childcare centres, schls and churches) within a 500m radius f the premises (a site plan wuld assist): 29. State the number f residential neighburs within a 50m radius f the premises: 30. What security systems are in place (e.g. lighting, indr/utdr CCTV) and where? 31. Can the entire premises be seen frm the service cunter? Yes N If NO, where there are blind spts, are mirrrs r CCTV installed? Is the internal lighting inside the premises suitable and is there gd visibility t the utdr areas?
32. Des the lighting utside the premises discurage litering? Des the lighting allw staff t check IDs etc? 33. Will security staff be emplyed? Yes N If YES, When are the security staff be used? What frmal registratin r qualificatin (such as Certificate f Apprval) d security staff have? 34. Are yu invlved in any mystery shpper/pseud cntrlled purchase peratin prgrammes? Yes N IF YES, please state details: 35. Is there a till prmpt system regarding age checks? Yes N 36. What staff training will be prvided regarding cmpliance with the Act and hst respnsibility practices? Explain the cntent, duratin and hw ften (include any systems relevant t assisting with cmpliance): 37. Explain fully yur intentins regarding advertising and prmtins. This shuld include infrmatin such as the number f prmtins, where, size, relative t what prducts and the prpsed % discunts. Shp windws r n the building: Street and r ftpath signage: Scial media:
Newspapers and magazines: Other: 38. What is the plicy regarding pricing and prmtins f alchl? 39. Will there be any single sales f any alchlic prducts in cntainers less than 750mls? Yes N If YES, prvide details: 40. Have yu had any cmplaints frm the neighburs (including cnfirmed nise cmplaints) that yu are aware f? 41. Has yur business been subject t plice cntrlled purchase peratins and if s, what were the results? 42. Have yu r any related businesses appeared befre the Alchl Regulatry and Licensing Authrity fr any reasn? Yes N If YES, please prvide details: Licence details Licence details 43. Are there any changes sught t the present cnditins f the licence? Yes N If YES what are the changes?
44. Licence number: 45. Expiry date: 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) 838 6633 E-mail: licensing@hcc.gvt.nz Website: www.hamiltn.gvt.nz/alchl Lcatin: Service Centre - Grund Flr, Garden Place, Hamiltn
EVACUATION OF PREMISES DECLARATION Sectins 100 and 127, Sale and Supply f Alchl Act 2012 I, NOTE: This declaratin is t be cmpleted, signed and returned with yur applicatin, even if an evacuatin scheme is nt required. [full name] licence hlder (r secretary) f the premises knwn as [trade name] situated at [premises address] and which perates under a des nt apply] n / ff / club licence state that: [select ne] [select ne] the wner f the building in which the premises are situated prvides and maintains an evacuatin scheme as required by sectin 21B f the Fire Service Act 1975; r because f the building's current use, its wner is nt required t prvide and maintain such a scheme; r because f the nature f the building, its wner is exempt frm the requirement t prvide and maintain such a scheme [Signature] [Date] [Name and designatin/psitin] Nte: A registered evacuatin scheme is required when: The building can hld mre than 100 peple; There are mre than 10 emplyees in the entire building; r Overnight accmmdatin is prvided fr mre than 5 peple Please cntact the NZ Fire Service fr mre infrmatin abut evacuatin schemes and fire safety requirements.
FORM 7 PUBLIC NOTICE Sectin 127(3), Sale and Supply f Alchl Act 2012 Public ntice f applicatin fr renewal f ff-licence PLEASE NOTE WE NOW HAVE A NEW PROCESS FOR PUBLIC NOTICES. This ntice is t be displayed in a cnspicuus place n r adjacent t the site t which the applicatin relates within 10 wrking days AFTER filing yur applicatin. Please ensure the applicant name matches that stated n the applicatin frm Yu DO NOT need t publish this ntice in the newspaper. This ntice will be published n the Hamiltn City Cuncil website: www.hamiltn.gvt.nz/publicntices There is a $85.00 administratin fee fr this service, payable at the time f applicatin. Sectin 127(3), Sale and Supply f Alchl Act 2012 [Full name, address, and ccupatin f applicant] has made applicatin t the District Licensing Cmmittee at Hamiltn City Cuncil fr the renewal f an ff-licence in respect f the premises situated at [address] knwn as [trade name] The general nature t be cnducted under the licence is [type f business - fr example, htel, tavern, restaurant, entertainment/night club]. The days n which and the hurs during which alchl is sld under the licence are [specify days and hurs] The applicant seeks the fllwing variatin t the licence cnditins: [prpsed changes t licence cnditins (if any)] The applicatin may be inspected during rdinary ffice hurs at the ffice f the Hamiltn District Licensing Cmmittee at Hamiltn City Cuncil Municipal Building, Garden Place, Hamiltn. Any persn wh is entitled t bject and wh wishes t bject t the issue f the licence may, nt later than 15 wrking days after the date f the publicatin f this ntice, file a ntice in writing f the bjectin with the Secretary f the District Licensing Cmmittee at Hamiltn City Cuncil, Private Bag 3010, Hamiltn. N bjectin t the renewal f a licence may be made in relatin t a matter ther than a matter specified in sectin 131 f the Sale and Supply f Alchl Act 2012.
Alchl Licensing Fees ff-licence The Sale and Supply f Alchl Act 2012 has intrduced natinal risk based fees fr all alchl licences. The new fee system, set by the Ministry f Justice, mre fairly reflects the cst f alchl licensing. The licence fee categry is determined using the belw criteria. Yu can use the tables belw t estimate the fee yu need t pay when ldging yur applicatin Type f Premises Weighting Supermarket, grcery stre, bttle stre 15 Htel, tavern 10 Club, remte sale premises, ther 5 Winery cellar drs 2 + Latest trading hur allwed by licence Weighting 10:00pm r earlier 0 Any time after 10:00pm 3 Remte sales premises 0 + Number f enfrcement hldings in last 18 mnths Weighting Nne 0 1 10 2 r mre 20 = Yur weighting: Definitins Enfrcement has the same meaning as a Hlding under sectin 288 f the Act, r a previus ffence fr which a hlding may have been issued if the ffence had ccurred befre 18 December 2013.
Applicatin Fee The licensing system has five fee categries, which reflect the range f cst/risk ratings. A premises' fee categry determines the applicatin fee that the licensee has t pay. Ttal weighting Fee categry 0-2 Very Lw 3-5 Lw 6-15 Medium 16-25 High 26+ Very High In additin t the applicatin fee, applicants are required t pay an $85.00 administratin fee t cver public ntificatin f the applicatin. Applicants were previusly required t place the public ntice in the newspaper at their wn cst. In many cases, this is up t 75 per cent less than yu wuld therwise pay thrugh the newspaper. All fees belw are GST inclusive. Annual Fee Fee categry Ttal applicatin fee Very Lw $453.00 Lw $694.50 Medium $901.50 High $1108.50 Very High $1292.50 The new Act als intrduces an annual fee fr all licences. The annual fee is due befre the licence is issued (fr new licences) and then every year n the licence anniversary date. The amunt f the annual fee yu pay will be determined n the fee categry and risk rating at the day the annual fee is due. Yu will receive a reminder that yur annual fee is due in the mail prir t the due date. All fees belw are GST inclusive. Fee Categry Annual Fee Very Lw $161.00 Lw $391.00 Medium $632.50 High $1,035.00 Very High $1,437.50 Please nte that it is Hamiltn City Cuncil that determines the final applicatin and annual fees s yu may be charged further fees befre yur licence is granted. All fees are set by the Ministry f Justice. Fr mre infrmatin, see www.justice.gvt.nz. If yu need assistance calculating yur fees, please cntact us n the details belw. Cntact us: Phne: (07) 838 6633 E-mail: licensing@hcc.gvt.nz Website: www.hamiltn.gvt.nz/alchl Lcatin: Service Centre - Grund Flr, Garden Place, Hamiltn