PET ANIMALS ACT 1951 (As Amended)

APPLICATION FOR

PET SHOP

LICENCE

PET ANIMALS ACT 1951 (as amended)

I/We / ......

as (proposed) occupier(s) of the premises mentioned below HEREBY APPLY for a LICENCE TO KEEP A PET SHOP under the provisions of Section 1 of the Pet Animals Act 1951 (as amended) at the premises which particulars are given below.

I/We ENCLOSE HEREWITH the sum of £135.00 being the fee payable in respect of this application.

PARTICULARS

1 / Full Name and Address of applicant(s):
Telephone Number
Email / ......
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2 / Postal Address of Premises (including postcode)
Telephone Number of Premises / ......
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3 / Age of applicant/s (if under 18) / ......
4 / Number, construction and size of rooms in which business will be carried out. (Please provide a sketch plan). / ......
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5 / Types of animals which are intended to be kept or sold. (Please complete the attached schedule). Do you intend to stock animals included in the schedule to the Dangerous Wild Animals Act 1976. (A copy of the schedule is attached). / ......
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6 / Heating Arrangements / ......
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7 / Method of Ventilation of premises / ......
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8 / Lighting Arrangements – Natural
- Artificial / ......
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9 / Water Supply / ......
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10 / Arrangements for food storage / ......
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11 / Arrangements for the disposal of excreta / ......
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12 / Normal times of attendance at the premises when premises are open / ......
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Are you disqualified from:

(a) / keeping a dog breeding establishment? / YES/NO
(b) / keeping a pet shop? / YES/NO
(c) / keeping a dog? / YES/NO
(d) / keeping custody of animals? / YES/NO
(e) / keeping an animal boarding establishment? / YES/NO

Opening times of premises...... am ...... pm

Please give the name and address of your usual Veterinary Surgeon: / ......
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Please state any times in the next 4 weeks when the premises will not be available for inspection

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Data Protection Act 1998

This information is required for the processing of applications under the Pet Animals Act 1951 (as amended). Information provided on the form will be shared with the relevant consultees, including Cornwall Councillors and Members of the Council's Licensing Committee and other organisations as the law allows (these other organisations include government departments and local authorities, for the purposes of preventing or detecting crime or to protect public funds). Information will be held both manually and electronically and will not be kept for longer than is necessary.

I/we agree to permit an Officer, Veterinary Surgeon or Veterinary Practicitioner authorised by the Council to inspect the premises which are the subject of this application before any Licence is granted.

I/WE DO HEREBY DECLARE that to the best of my/our knowledge and belief, the above particulars are true.

Dated this ...... day of …...... 2016 Signed: ......

FOR OFFICE USE ONLY

Premises inspected by Date

Accompanying Vet (if any)

Please return this form to:

Licensing, Cornwall Council

2nd Floor, East Wing

Dolcoath Avenue

Camborne , TR14 8SX

Tel: 01209 615055

Email:

PET ANIMALS ACT 1951

Postal Address of Premises ……......

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MAXIMUM NUMBERS AND TYPES OF ANIMALS PROPOSED TO BE KEPT ON THE PREMISES

Type of Animals / Proposed Numbers / Details of Accommodation / Age at which Proposed to be Sold / Inspector’s Comments
Parrots
Pigeons
Other Large Birds
Budgerigars, Finches and other small birds
Dogs
Cats
Rabbits and Cavies
Hamsters
Rats, Mice and Gerbils
Tortoises
Snakes and Lizards
Fish / Tropical
Marine
Cold Water
Any other species
(please specify)

Any other animals – please specify overleaf