Tesco Stores Ltd Staines Road Feltham

Application for a premises licence to be granted
under the Licensing Act 2003
PLEASE R.EAD THE FOLLOWING INSTRUCTIONS FIRST
Before completing this form pleaseread the guidancenotesat the end of the form. If you are completing
this form by hand pleasewrite legibly in block capitals. ln all casesensurethat your answersare inside the
boxes and written in black ink. Use additional sheetsifnecessary.
You may wish to keep a copy of the completed form for your records.
Ywe Tg_s_cp
_q!_olg_s_
I-!q
(Insert name(s)of applicant)
apply for a prernises licence under section 17 of the Licensing Act 2003 for the premises described in
Part I below (the premises) and Vwe are making this application to you as the releyant licensing
authority in accordance with section 12 of the Licensing Act 2003
Part 1- PremisesDetails
Postal addressofpremises or, ifnone, ordnancesurvey map referenceor description
Tesco Stores Ltd
507-511StainesRoad
Feltham
Post town
Postcode
Feltham
TW148BN
Telephonenumber at premises(if any)
Non-domestic rateablevalue of oremrses
Not Yet Assessed,f315.00 chequeenclosed,
Part 2 - Applicant Details
Pleasestatewhether you are applfng for a prerniseslicence as
Pleasetick as appropriate
a)
an individual or individuals *
b)
a person other than an individual *
i.
asa limited company
ii.
as a parrrership
iii.
as an unincorporatedassociationor
iv.
other (for example a statutory corporation)
c)
a recognisedclub
d)
a charity
e)
the proprietor of an educationalestablishment
n
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n
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pleasecomplete section (A)
pleasecompletesection(B)
pleasecompletesection(B)
pleasecompletesection(B)
pleasecompletesection(B)
pleasecompletesection(B)
pleasecompletesection(B)
pleasecomplete section (B)
pleasecomplete section (B)
f)
a health servicebody
g)
a person who is registeredunder Part 2 ofthe Care
!
StandardsAct 2000 (cl4) in respectofan independent
hospital in Wales
pleasecomplete section @)
ga)
a person who is registeredunder Chrfter 2 ofPart 1
of the Health and Social CareAct 2008 (within the
meaning of that Part) in an independenthospital in
England
tr
pleasecomplete section (B)
h)
the chief ofEcerofpolice ofa police force in England
and Wales
!
pleasecompletesection@)
Ll
* If you are applying as a person describedin (a) or (b) pleaseconfirm:
Pleasetick yes
I am carrying on or proposing to carry on a businesswhich involves the use of the premisesfor
licensableactivities;or
I am making the application pursuant to a
n
n
statutory function or
a function dischargedby virtue ofHer Majesty's prerogative
(A) INDMDUAL
APPLICAi\TS (fill in as applicable)
MrnMIsflMissnMsn
Surname
I am 18yearsold or over
OtherTitle (for
example,Rev)
First names
n
Please
tick yes
Currentpostaladdressif
differentfrom premises
address
Posttown
Daltime contacttelephone
number
E-mailaddress
(optional)
Postcode
SECOI\'DINDMDUAL APPLICAIIT (if applicable)
Other Title (for
example,Rev)
MtnMrsnMissIMrn
Surname
First names
I am 18 years old or over
n
Please
tick yes
Current postal addressif
different from premises
address
Posttown
Postcode
Daltime contact telephone number
E-mail address
(optional)
(B) OTHER APPLICA]\[TS
Pleaseprovide nameand registeredaddressof applicantin full. Where appropriatepleasegive any
registerednumber. In the caseof a partnership or other joint venture (other than a body
pleasegivethe nameand addressof eachparty concerned.
corporate)n
Name Tesco StoresLtd
Address
TescoHouse
DelamareRoad
Cheshunt
Waltham Cross
Herts
ENS gSL
Registerednumber (where applicable)
ComoanvNumber 00519500
Description of applicant (for example,partnership,company,unincorporatedassociationetc.)
Limited ComDanv
Telephonenumber(it any) 01707634831
E-mail address(optional)licensing.team@uk.tesco.com
Part 3 Operating Schedule
When do you want the premiseslicence to start?
As soonasoossible
If you wish the licence to be valid only for a limited period, when do you
want it to end?
(pleasereadguidancenote 1)
Pleasegive a generaldescriptionofthe pre.rnises
sellinga rangeof goodsand services.This includesthe saleof alcohol
Retailpremises(supermarket)
off the premisesare madefrom
for consumption
off the premises.Salesof alcoholfor consumption
the suoermarket
salesflooras shownon the enclosedolan
If 5,000 or more people are expectedto attend the.premisesat any one time,
pleasestatethe number expectedto attend.
What licensable activities do you intend to carry on from the prernises?
(Pleaseseesections 1 and 14 of the Licensing Act 2003 and SchedulesI and 2 to the Licensing Act 2003)
Provision of regulatedentertaiffn€nt
Pleasetick any that
aPPlv
a)
play,s(if ticking yes, fill in box A)
n
b)
films (ifticking yes,fill in box B)
!
c)
indoor sporting events(if ticking yes, fill in box C)
!
d)
boxing or wrestling enteriaiffnent (ifticking yes, fill in box D)
!
e)
live music (if ticking yes, fill in box E)
n
f)
recordedmusic (ifticking yes, fill in box F)
tr
C)
performancesof dance(if ticking yes, fill in box G)
!
h)
anything ofa similar description to that falling within (e), (f) or (g)
(ifticking yes,fill in box H)
!
J
Supply of alcohol
Standarddays and timings
(pleaseread guidancenote
6)
Day
Start
Finish
Mon
0600
2300
Tue
0600
2300
Wed
0600
2300
Thur
0600
2300
Will tlte suoply of alcohol be for consumotion olease tick (pleaseread guidancenote 7)
On the
premrses
!
Offthe
premrses
Both
!
State anv seasonalvariations for the suoplv of alcohol (pleaseread
guidancenote 4)
Non standardtimines. Where vou intend to uscllhc Drcuiscstblllhc
sunolv of alcohol at different times to those listed in tJte column on tfie
left. oleaselist (pleaseread guidancenote 5)
Fri
0600
2300
Sat
0600
2300
Sun
0600
2300
State the nam€ and details of the individual whom you wish to specify on the licence as designated
premisessupervisor:
Name
Greg Bartley
Address
39 Of{ley Road
Hitchin
Herts
I SG52BB
Personallicence number (if known) Harlow/pers/0094
Postcode
Issuinglicensingauthority(ifknown) Ha ow District Council
K
Pleasehighlight any adult entertrinment or services,activities,other entertainmentor matters
ancillary to the useof the premisesthat may give rise to concernin respectof children (pleaseread
guidance
note8).
L
Hours premises are open
to the public
Standarddays and timings
(pleaseread guidancenote
6)
Day
Start
Finish
Mon
0600
2300
Tue
0600
2300
Wed
0600
2300
Thur
0600
2300
Fri
0600
2300
Sat
0600
2300
Sun
0600
2300
State any seasonalyariations (pleaseread guidancenote 4)
Non Btandard timinss. Where you intend the preqdle! llqbelDe4llallhc
oublic at different times from those listed in the colunn on tle left.
p!9499!q! (pleaseread guidancenote 5)
M Describethe stepsyou intendto taketo promotethe four licensingobjectives:
a) General - all four
d and e) (Dleasereadzuidancenorc
We are a nationalretailerthatsellsalcoholas partof a broadofferingof goodsand services.We have
heldoff-licences
in our storesfor manyyearsand are an approvedBritishInstituteof Inn-keeping
are in place,
centre.We havewriftentrainingpoliciesandformaltrainingprogrammes
examination
All trainingand
whichensureour peopleareequippedto meetall licensingobjectives.
materialsare reviewedregularly.All storescurrentlycomplywithour 'Think25'
revision/refresher
policy,this is broughtto customer'sattentionthroughpointof salematerialwithinthe store.We take
legalcompliance
veryseriouslyand in additionto localtrainingwe employa centralalcohollicensing
compliance
nranager
andhavea compliance
committee.
b) The prevention of crime and disorder
The premiseswill havedigitalCCTVsystemthatcoversmanyareasof the shopfloor,includingthe
withour applicationoroposedareawhichwill be usedfor beerand wine,shouldwe be successful
request.
lmageswill be retainedfor a minimumof 21 daysand madeavailableon enforcement
premises
the
storeis open.
will
on
the
all
the
time
Ordinarily,
a memberof theManagement
team be
A personwill haveresponsibility
for the premiseswhilstthe premisesare open.
c) Public safety
whilstthe premises
areopen.
for the premises
A personwillhaveresponsibility
including
lookingafterour
willbe trainedto supportthe runningof the premises
Management
relating
rules
regulations
to public
and
staff.
The
store
will
adhere
to
all
and
customers
safety.
d) The preventionofpublic nuisance
We intendto be an activememberof thecommunity.
authoritiesshouldthe needarise.
We welcomethe opportunity
to liaisewith Policeand enforcement
e) The protection ofchildren from harm
All staffwill be trainedand regularlyrefreshedin the corporate'Think25' Policy.Staffwill be trained
and'Think25'whensellingalcohol.
to lookat thecustomer
A tillpromptwillappearon the initialsaleof alcoholthatwillremindthesellerof theirresponsibilities
notto sellalcoholto anyoneundertheageof 18.
including
of our'Think
bothstaffandcustomers
informing
Thestorewilldisplaysignagearoundthepremises
25' policyon alcohol.
Checklist:
Please tick to indicate rgreement
o
I have rnadeor enclosedpayrnent ofthe fee.
x
.
I baveenclosedthe plan ofthe premises.
X
.
I have sent copies ofthis application and the plan to responsibleauthorities and otherswhere
applicable.
X
.
I have enclosedthe consentform completedby the individual I wish to be designatedpronises
supervisor,if applicable.
X
.
I undentand that I must now advertisemy application.
X
.
i understandthat ifl do not comply with the aboverequirernentsmy application will be
rejected.
X
IT IS AN OFFENCE, LIABLE ON SUMMARY CONVICTION TO A FINE NOT EXCEEDING
LEVEL 5 ON THE STAI\DARD SCALE. UNDER SECTION 158 OF THE LICENSING ACT 2003.
TO MAKE A FALSE STATEMENT IN OR IN COI\IIECTION WITH TIIIS APPLICATION.
Part 4 - Signatures (pleaseread guidancenote l0)
Signature of applicant or applicsnt's solicitor or other duly authorised agent (seeguidancenote I 1).
If signing on behalf of the applicant please state in what capacity.
Signature
Date
12fr March 2014
Capacity
Greg Bartley - Licence Manager
For joint applicationsosignature of2od applicant or 2odapplicant's solicitor or other authorised
agent (pleasereadguidancenote l2). If signing on behalfofthe applicant pleasestatein what
capacity,
Signature
Date
Capacity
Contact name (where not previously given) and postal addressfor correspondenceassociatedwith this
application (pleaseread guidancenote 13)
Greg Bartley
Licensing Department,Tesco StoresLtd
Cimrs Building C
Shire Park
Posttown
I WelwW Garden Cify
01707634837
Telephonenumber (if any)
Postcode
I AL7 IZIi
If you would prefer us to correspondwith you by e-mail, your e-mail address(optional)
Licensing.team@uk.tesco.com
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