Off-Site Caterers Approval License Application Download Free Print-Only PDF OR Purchase Interactive PDF Version of this Form
Off-Site Caterers Approval License Application Form. This is a New Hampshire form and can be use in Liquor Commission Statewide.
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Tags: Off-Site Caterers Approval License Application, New Hampshire Statewide, Liquor Commission
State of New Hampshire
LIQUOR COMMISSION
Off-Site Caterers License Application
Application for Site Approval for Off-Site Caterers as pursuant to RSA 178:20,V(e)
***This application must be submitted at least ten business days prior to the event***
DATE OF EVENT:
TIME FROM:
TO:
APPLICANT DATA
APPLICANT:
TRADE NAME:
BUSINESS ADDRESS:
PHONE#:
LIQUOR LICENSE NUMBER:
CLIENT DATA
NAME:
PHONE #
TYPE OF EVENT:
ADDRESS:
SITE DATA
BUILDING NAME:
ADDRESS:
BUILDING OWNER’S NAME AND ADDRESS:
[ ] Prev viewed/Permanent
Authorized Capacity:
# attending:
Entertainment requires city/town approval. Describe any entertainment to be held in conjunction with the event:
[ ] Temporary site
LICENSE SPECIALISTS CERTIFICATION
I certify the premise meets the requirements as a “public building” for Licensure.
License Specialist signature:_____________________________________________________________ Date: _____________________
DOCUMENTATION:
Provide copies of the following documentation for the premise.
1.
2.
3.
4.
Proof of applicant’s ownership, lease or rental of the premise.
Permit of Assembly issued by local or state fire authorities; or [ ] I certify that the state or local authorities do not require permits of assembly.
Health Certificate/license issued by local or state health department; or [ ] I certify that the state or local health departments do not require a
certificate/license.
Written authorization by the city/town for any entertainment to be held; or [ ] I certify that the city/town does not object to the entertainment
described above.
APPLICANT’S CERTIFICATION:
I hereby certify under the penalties of RSA 641:3 that all information is true and correct and all required documentation is attached.
_________________________________________________
Owner/Partner/Officer/Member/Manager
___________________
Date
Dml rev 1/5/01
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