Application for a premises licence from Mansfield District Council

Step 2 of 4 Submit the application

Email address

Please provide your email address, so the licensing authority can let you know if your application has been successful or not.

Email address Confirm email address

Application form

Please attach the completed application form below.

Application form

Supporting documents

All documents are required, unless stated otherwise. Photos of documents are acceptable, as long as all the relevant information is clear. We'll only share these documents with the licensing authority.

Maximum size allowed per file is 10 MB.

We only allow the following file types : doc, docx, gif, jpeg, jpg, pdf, png, ppt, pptx, rtf, txt, xls, xlsx

What if I can't submit the documents digitally?

If you can't submit the documents digitally you can send copies by post instead. We'll give you the address and reference number to quote once you've paid the licence fee.

OK, I'll submit all the documents by post instead

Premises Plan
Regulations made under the Licensing Act 2003 state that the plan must show:— a) the extent of the boundary of the building, if relevant, and any external and internal walls of the building and, if different, the perimeter of the premises; b) the location of points of access to and egress from the premises; c) if different from sub-paragraph (3)(b), the location of escape routes from the premises; d) in a case where the premises is to be used for more than one licensable activity, the area within the premises used for each activity; e) fixed structures (including furniture) or similar objects temporarily in a fixed location (but not furniture) which may impact on the ability of individuals on the premises to use exits or escape routes without impediment; f) in a case where the premises includes a stage or raised area, the location and height of each stage or area relative to the floor; g) in a case where the premises includes any steps, stairs, elevators or lifts, the location of the steps, stairs, elevators or lifts; h) in the case where the premises includes any room or rooms containing public conveniences, the location of the room or rooms; i) the location and type of any fire safety and any other safety equipment including, if applicable, marine safety equipment; and j) the location of a kitchen, if any, on the premises. The plan may include a key through which the matters mentioned or referred to above are sufficiently illustrated by the use of symbols on the plan. Whilst not a requirement of the legislation we ask that for ease of handling, plans are provided no larger than A3. The following information may be added to your plans. This is not a mandatory requirement but will assist your application by making it easier for us and the responsible authorities to understand your application and how the premises are to be operated. a. Plans to be dated and bear the name and location of the premises b. To be endorsed with a location plan showing the site of the premises c. The scale used to be endorsed on the plan d. The total extent of the proposed licensed area to be defined by a continuous red line e. Emergency exit routes not intended to be used for the consumption of alcohol to be uncoloured f. Where areas of the premises are to be used for specific purposes to which the licence will apply for example, children only allowed into one area, adult entertainment and showing of films, those areas should be outlined and defined in a key accompanying the plan

DPS consent form
Required to determine on the application as to who will be responsible for alcohol sales. Not required if the application is for late night refreshment only

Proof of your right to work in the UK
If applying as an individual, you must supply your proof of right to work in the UK. Please check the following website for further information about the acceptable documents: https://www.gov.uk/government/publications/right-to-work-checklist

Declaration

I understand it is an offence, liable on summary conviction to a fine not exceeding level 5 on the standard scale, under section 158 of the Licensing Act 2003, to make a false statement in or in connection with this application.
I understand that I must now advertise my application in a local newspaper and by displaying a notice on the premises.
I understand that if I do not comply with the requirements my application will be rejected.
[Applicable to individual applicants only, including those in a partnership which is not a limited liability partnership] I understand I am not entitled to be issued with a licence if I do not have the entitlement to live and work in the UK (or if I am subject to a condition preventing me from doing work relating to the carrying on of a licensable activity) and that my licence will become invalid if I cease to be entitled to live and work in the UK (please read guidance note 15).
The DPS named in this application form is entitled to work in the UK (and is not subject to conditions preventing him or her from doing work relating to a licensable activity) and I have seen a copy of his or her proof of entitlement to work, if appropriate (please see note 15).

Ticking this box indicates you have read and understood the above declaration

By continuing, you're giving the Cabinet Office permission to pass the information you're supplying to the relevant authority.

For more details on how your information is used please refer to the Government Digital Service privacy notice (opens in new tab) and Mansfield District Council.