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Page 1 of 12 LIQUOR LICENCE APPLICATION PACKAGE FOR TRANSFER OF LICENCES The following is a checklist of the documents and information required to make application and submit to the Yukon Liquor Board for their consideration: Completed and sworn (by applicant or by president or director of company) copy of FORM 1, Application for Liquor Licence. Completed and sworn Personal History Report and RCMP Consent for Disclosure record check results for: each director of the company; each partner in a partnership; or for an applicant in a sole proprietorship and for the manager of the premises. A detailed plan of the building(s) or detailed plans for renovations indicating proposed licensed area and liquor storage area(s), including dimensions, and showing doorways, exits, and other major features (Refer to Section 6 of FORM 1 – Application for Liquor Licence). Copy of title or lease agreement (this agreement must be valid for one year or more) or a copy of the option to purchase or lease. Copy of your Business Name registration. Copy of purchase agreement (if leasing the building(s) from one party and have purchased the business from another party). Copy of food menu/list Copy of liquor menu Transfer fee which equals 10 per cent of the applicable annual fee based on seating capacity as determined and advised by local Fire, Building and Environmental/Health department codes, as well as any other appropriate regulatory agencies. Copy of the business licence (which must include liquor service). Application/documents required for specific class of licence, e.g. Club, Recreation Facility, RV Park etc. refer to section 6 of the application. (Other relevant documentation may be required) Approval of the premises by Environmental Health for food service, washroom, and sanitation requirements, etc. Approval of the premises for occupancy by: the City of Whitehorse Building Inspection Branch or YTG-Building Inspection Branch; and/or a copy of the fire inspection report from the City of Whitehorse Fire Department or the YTG-Fire Marshall’s Office. Notification from the current licensee of their intentions to sell or lease their premises along with a letter stating that they have no objection to the transfer of their liquor licences. YG(5503EQ)F12 Rev.01/2016

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Page 1: LIQUOR LICENCE APPLICATION PACKAGE FOR TRANSFER … · liquor licence application package for transfer of licences ... liquor licence application package for transfer of licences

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LIQUOR LICENCE APPLICATION PACKAGEFOR TRANSFER OF LICENCES

The following is a checklist of the documents and information required to make application and submit to the Yukon Liquor Board for their consideration:

Completed and sworn (by applicant or by president or director of company) copy of FORM 1, Application for Liquor Licence.

Completed and sworn Personal History Report and RCMP Consent for Disclosure record check results for: each director of the company; each partner in a partnership; or for an applicant in a sole proprietorship and for the manager of the premises.

A detailed plan of the building(s) or detailed plans for renovations indicating proposed licensed area and liquor storage area(s), including dimensions, and showing doorways, exits, and other major features (Refer to Section 6 of FORM 1 – Application for Liquor Licence).

Copy of title or lease agreement (this agreement must be valid for one year or more) or a copy of the option to purchase or lease.

Copy of your Business Name registration.

Copy of purchase agreement (if leasing the building(s) from one party and have purchased the business from another party).

Copy of food menu/list

Copy of liquor menu

Transfer fee which equals 10 per cent of the applicable annual fee based on seating capacity as determined and advised by local Fire, Building and Environmental/Health department codes, as well as any other appropriate regulatory agencies.

Copy of the business licence (which must include liquor service).

Application/documents required for specific class of licence, e.g. Club, Recreation Facility, RV Park etc. refer to section 6 of the application. (Other relevant documentation may be required)

Approval of the premises by Environmental Health for food service, washroom, and sanitation requirements, etc.

Approval of the premises for occupancy by: the City of Whitehorse Building Inspection Branch or YTG-Building Inspection Branch; and/or a copy of the fire inspection report from the City of Whitehorse Fire Department or the YTG-Fire Marshall’s Office.

Notification from the current licensee of their intentions to sell or lease their premises along with a letter stating that they have no objection to the transfer of their liquor licences.

YG(5503EQ)F12 Rev.01/2016

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LIQUOR LICENCE APPLICATION PACKAGEFOR TRANSFER OF LICENCES

ADDITIONAL INFORMATION

The documents listed in the application package and the transfer fee must be received by our office 30 days prior to the proposed transfer date so that an inspection of the premises can be completed, the transfer application can be considered and if approved, the licences can be issued in advance of your opening date.

A Food Primary - beer/wine licence, allows you to serve beer, wine, ciders and coolers. A Food Primary – all liquor licence, allows you to serve beer, wine and spirits.

New licensees will receive an information package along with a copy of the Yukon Liquor Act & Regulations, and the Yukon Liquor Board Policy Manual from the Licensing and Inspections branch.

To assist you in preparing your transfer application package, please find enclosed:

• Checklist;

• Specific relevant excerpts from the Yukon Liquor Act & Regulations;

• Specific relevant excerpts from the Yukon Liquor Board Policy;

• Application form;

• Personal History Report; and

• RCMP Consent for Disclosure of Criminal Record Information form.

*Note: The RCMP Consent for Disclosure of Criminal Record Information form must be completed and submitted in person to the nearest RCMP detachment with two pieces of ID, one of which must be a valid government issued photo ID.

Please note that the enclosed application form is required when applying for all types of liquor licences outlined in section 1 of FORM 1. If you require any clarification or if you have any questions or concerns, please contact the Licensing and Inspections Branch at 667-5245 or toll free 1-800-661-0408, local 5245.

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FORM 1APPLICATION FOR LIQUOR LICENCE

Application for New Licence Application to Transfer Licence

1. CLASSES OF LIQUOR LICENCE REQUESTED (Liquor Act Section 23)

Liquor Primary Licence

Food Primary Licence

Off Premises Licence

Special Licence

Club Liquor Licence

RV Park Licence

Train, Ship or Aircraft Licence

Recreation Facility Licence

Sports Stadium Licence

Liquor Manufacturers Retail Licence

Liquor Manufacturers Licence

2. CONDITIONS OF LIQUOR LICENCE REQUESTED

Club - all liquor Liquor Primary - all liquor

Club - beer/wine Liquor Primary - beer canteen

Food Primary - all liquor Liquor Primary - mess

Food Primary - beer/wine Off premises liquor

Liquor Manufacturer’s - brewery Off premises liquor - beer/wine

Liquor Manufacturer’s - distillery Recreation Facility

Liquor Manufacturer’s - winery Room Service

Liquor Manufacturer’s Retail - brewery Liquor Manufacturer’s Retail - distillery

Liquor Manufacturer’s Retail - winery

3. APPLICATION INFORMATION

Name of Applicant:

Contact Information:

Name:

Address:

Telephone: Fax: Email:

Website:

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4. BUSINESS INFORMATION

Sole Proprietorship Partnership Corporation Non-profit organization

Name:

Contact Information:

Name:

Address:

Telephone: Fax: Email:

Website:

5. DESCRIPTION OF PROPOSED OPERATION

(If this is an application for dual licensing complete one copy of Part 5 for each type of license being requested for the same premises.)

a. General description

b. Name of premises

c. Start date

d. Person in charge Applicant

Manager (name)

e. Type of food available Full meals (main course & appetizers)

Light meals (appetizers, sandwiches, wraps etc.)

Other (describe):

f. Type of liquor Beer - bottles/cans, ciders and coolers

Beer - draft

Wine

Spirits & liqueurs

g. Type and hours of entertainment and games offered on the premises

Live music/DJ

Karaoke

Comedy/other live act (describe):

TV

Pool table

Table games such as foosball

Darts

Other (describe):

h. Public Notice of application been completed (LA s.26)

Yes No

Provide details:

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i. Hours & days of business operation

DAY M T W T F S S

From

To

If seasonal:

Opening date:

Closing date:

j. Proposed hours of liquor service DAY M T W T F S S

From

To

If seasonal:

Opening date:

Closing date:

Suggested time maximums of liquor service:Food Primary: 10:00am - 2:00am - 16 hours maximum Off Premises: 10:00am - 12:00amLiquor Primary:12:00pm - 2:00am - 14 hours maximum

k. Estimated ratio of food sales to liquor sales

Food % Liquor %

l. Clubs # of resident members

# of non-resident members

# of honorary members

Annual dues ($)

Bylaws

m. Recreation facility - type of recreation to be provided

(provide details):

n. Dual licensing - how minors will be excluded from the liquor primary premises

(provide details):

6. OWNERSHIP

If Partnership:

Name of each owner: % of Ownership

If Corporation:

Date of incorporation Public Private

Territorial, provincial or federal charter (specify):

Shares authorized Common Preferred

Shares issued Common Preferred

Par value of shares Common Preferred

Bonds issued and o/s Number Preferred

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Applicants position with Corporation:

Location of Corporation:

Address of Corporation:

If Corporation or Non-Profit Organization

Officers & Directors Name (attach list, including # shares held (common & preferred) if Corporation)

President

Vice-President

Secretary

Treasurer

Director

Director

Previous licences operated (Have you been granted a liquor licence previously by a Liquor Board or Commission; if so, provide details)

Relationship with liquor manufacturers:

Do you have any agreement to sell specific liquor products?

Yes No

If yes, describe:

Do you have any connection, financial or otherwise, direct or indirect, with any liquor manufacturing interests?

Yes No

If yes, describe:

7. DESCRIPTION OF PREMISES

a. Location Legal description Lot Block Plan

Street address

b. Ownership of premises Same as above

Leased (minimum 12 months as per YLA. s. 61(b)

Other (provide details)

c. Type of structure # stories

Conventional framing

Concrete

Other (provide details)

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d. Are there plans for renovating premises

No

Yes (provide details)

e. Location of where liquor is to be served

Area in square feet (approx.)

Desired capacity (approx.)

f. Kitchen equipment on the premises

Full kitchen

Other (ie: food preparation equipment)

g. General furnishing Number of tables & chairs

Number of bar stools

Number of sofas and armchairs

h. Describe lighting in the premises

Bright

Dim

i. Washrooms (Department of Environmental Health Office 867-667-8391 will confirm capacity based on the number of washrooms)

Numbers Men Women

Toilets

Urinals n/a

Washbasins

j. Liquor storage location (describe area for liquor storage

k. For off-sales, RV park & manufacturer’s retail:

i. Location from which liquor will be sold (provide details)

ii. By whom (position)

iii. Liquor storage location

l. Sketch attached Yes No

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ATTACHMENTS – The following items listed are required by Legislation for your application to appear before the Yukon Liquor Board. Please indicate by checking the applicable boxes below which documents are attached and which ones are to follow.

Check the boxes below

Affidavit

Application fee: 10% of the cost of the licenses provided

Business Name Registration

Business Licence

Certificate of Title or Property Lease

Club: Constitution and bylaws, club rules and regulations, minutes of last annual meeting, list of members

Corporation: complete list of shareholders showing # of shares held, certificate of incorporation

Detailed plan (to scale of at least 1/8”to 1’) of the entire premises where the licensed areas would be located. The plan must clearly show exits, entrances, toilets, washbasins, bars, games, tables and chairs, liquor storage (for on-and off-premises sale), and where the premises are situated withinthe building.

Liquor manufacturing: details of manufacturing operation

Menu - food

Menu - liquor and/or off sales menu

Officers & Directors

Personal History Reports for licensee(s) and manager(s)

Purchase Agreement

Recreation Facility: an outline of the system of membership, including a) the maintenance of a register of membersb) the times and places where memberships will be sold c) the cost of membershipd) the eligibility requirementse) the issuance of membership cardsf ) the maintenance of a register of guests g) the benefits provided to membersh) the term of which memberships are effective

Registered partnership: copy of registration

RV Park: overnight guest registration system

Sketch plan (location on block)

Train/ship/aircraft: attach separate page describing # of units, routes and frequency(including duration and time of each scheduled run in or over the Yukon)

Permit to Operate from Environmental Health Office

Approval from Fire Authorities

Approval from YG Building Safety Branch and/or Municipal Building Inspection Department

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8. SIGNATURE OF APPLICANT

(print name) (title)

(signature) (date yyyy/mm/dd)

SIGNATURE OF APPLICANT

(print name) (title)

(signature) (date yyyy/mm/dd))

Application Received by Yukon Liquor Corporation:

Date (yyyy/mm/dd) Name & Title

Date Reviewed with Client:

Date (yyyy/mm/dd) Name & Title

Some of the information on this form may be your personal information. We are collecting it in order to process your application for a liquor licence or to transfer a liquor licence. Processing your application will require providing the information collected here to the Yukon Liquor Board. Our legal authority for this collection is the Liquor Act, R.S.Y. 2002, c.140 and the Liquor Regulations, OIC 1977/37. If you have any questions about why we need this information please contact the Director of Licensing & Inspections at (867) 667-5245 or Toll Free within Yukon 1-800-661-0408 or at 9031 Quartz Road, Whitehorse, Yukon Y1A 4P9.

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AFFIDAVITOATH OF APPLICANT

I/We, _________________________________________ and __________________________________________

of the _______________________________________________________________________________________

of_______________________________________________________________________________ in Yukon

MAKE OATH AND SAY THAT:

1. I/we have read the Application;

2. I/we have knowledge of the matters therein;

3. All the facts stated and information furnished therein and pursuant thereto are true and correct;

4. I/we am/are the full age of nineteen years; and

5. I/we am/are the authorized representative of the applicant.

____________________________________________ Signature

SWORN BEFORE ME AT THE )

___________________ of __________________ )

in Yukon, this ______ day of _________________ )

20 ____. )

________________________________________ )A Notary Public in and for Yukon

FORM 2AFFIDAVIT FOR

APPLICATION FOR LIQUOR LICENCE

(name) (name)

(name of sole proprietorship, partnership, corporation, organization)

(community/location)

YG(5503Q)F1 03/2015

____________________________________________ Signature

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PERSONAL HISTORY REPORT

1. Legal Name: Last Name First Name Middle Name(s)

Name most commonly used: Last Name First Name

Street Address City Province/Territory

Date of Birth:

2. Name of premises:

3. Proposed role(s): Licensee Manager (responsible for day-to-day control)

4. Employment History:

Date from: Date to: Occupation Name & Address of Employer

present

5. Have you ever held a liquor licence/managed a licensed premise before? If so, provide details if not included in employment history above.

6. Have you ever been convicted of a Criminal Code of Canada offence for which you have not received a pardon? If so, provide details.

7. Are there unsatisfied legal judgments or outstanding warrants against you? If so, provide details.

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8. Have you, as an individual or in your association with any group, proprietorship, partnership, or corporation, ever been the subject of bankruptcy proceedings? If so, provide details.

9. Have you any interest, direct or indirect, in any business where alcoholic beverages are manufactured or sold? No Yes: provide details below:

10. State other business interests, if any:

11. Have you taken the Be A Responsible Server (BARS) training course, or equivalent? What year? Yes No Equivalent (specify):

12. Name five responsible non-related persons who may be contacted as character references:

Name Address Occupation Telephone #

STATUTORY DECLARATION

I, , do solemnly declare that the particulars furnished by me herein before set out are true and correct statements of fact and I make this solemn declaration conscientiously believing it to be true and knowing that it is of the same force and effect as if made under oath and by virtue of the Canada Evidence Act.

SWORN before me at )

Of in the Yukon Territory)

this day of )

A.D. . )

A Justice of the Peace, a Commissioner of Oaths or a Notary Public

Signature

This information is being collected under the authority of sections 61 & 62(2) of the Yukon Liquor Act; section 46(1) Yukon Liquor Regulations for the purpose of liquor licensing and administration.For further information direct inquiries to the Director, Licensing & Inspections at (867) 667-5245.