Shadowbrook Inc
..........--
STATEOFNEWYORK RECEIVE~dardized RENEWAL APPLICATION NOTICE FORM forProvidinga
EXECUTIVE DEPARTMENT 30-Dav Advance Notice to a Local Municioalitv or Community Board
DIVISION OF ALCOHOLIC BEVERAGE cor;ralWlt 1 9 2009 in connection with the submission 10 the Slate Liquor Authority of a
STATE LIQUOR AUTHORITY I'U V Renewal Aoolication for an On-Premises Alcoholic Beveral!e License
10.
Type(s) of Alcohol sold under ;~e License ( "X" !mID:
II.
Extent of
Food Service:
( "X" !mID
01
RestB.urant (Sale of Food
Primarily; Full Food Menu;
Kitc~en run by Chel)
D Tavern-Restaurant (A mixed-use establishment that
has both a sit-down dining area and a "stand-up" bar
where patrons may receive direct deliveries of alcohol)
D
Tavern / Cocktail Lounge / Adult Venue /
Bar (Alcohol sales primarily - meets legal
minimum food availability requirements)
12.
Type of
Establishment:
o Hote;
I Live
Music
II Disk
Jockey
D Bed &
Breakfast
D Juke
Box
I Patron Dancing D Cabaret, Night Club, Discotheque
(Small Scale) (Large Scale Dance Club)
D Capacity for 600
or more patrons
~
( "X" all ~
that a.pply)
II Club-(e.g. Golf /
Fraternal Org.).
I
Catering
Facility
D Stage
Shows
D Topless
Entertainment
D Other
(Specify):
13.
Licensed
Outdoor Area:
I Nori~~ D Rooftop D Patio D Freestanding D Garden / 0 Other
or Deck Covered Structure Grounds (Specify):
Mondav_. Tueadav Wedneadav Thuradav Frldav Saturday Sunday
- AM PM - AM PM -----'-- AM PM - AM PM - AM PM - AM PM - AM PM
TO TO TO TO TO TO TO
- AM PM - AM PM AM PM AM PM AM PM AM PM AM PM
Days and Hours
of Operation
(Complete all;
circle AM or PM)
15_
Will the License Holder or a Manager be physically present within the establishment during All Hours of Operation?
16.
License Serial Number:
18.
The License Holder's Full Name, as it appears
on the Alcoholic Beverage Licc{nse Certificate, is.:
The Full Name of the Establishment (the Trade Name under
which the Licensed Establishment conducts business) is:
The Licensed Establishment isJocated within the
building which has the folloWing street address:
City, Town, or Village:
19.
20.
21.
22.
The Licensed Establishment is located on the following noor(s) of the building at the above address:
23.
24. Business Telephone Number of Current License Holder:
Does the License Holder own the
25. building in which the Licensed
Establishment is located? ( 'X" !mID
27_
28. City, Town, or Village:
lH4.{l1
A~
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TOWN OF WAPPINGER
TOWN CLERK
CHRIS MASTERSON
SUPERVISOR
CHRISTOPHER J. COLSEY
TOWN CLERK'S OFFICE
20 MIDDLEBUSH ROAD
WAPPINGERS FALLS, NY 12590
(845) 297-5771
FAX: (845) 298-1478
TOWN COUNCIL
WILLIAM H. BEALE
VINCENT BETTINA
MAUREEN McCARTHY
JOSEPH P. PAOLONI
November 19,2009
New York State Liquor Authority
80 South Swan Street
Suite 900
Albany, New York 12210
Attn: Renewals
Dear Sirs:
Please be advised that the Town Board of the Town of Wappinger has been notified by
Shadowbrook Inc., 33 Chelsea Rd, New York, of intention to file an application with the
New York State Liquor Authority.
As this location is within the Town of Wappinger, the Town Board has received and
directed that this application be placed on file with no comment.
Sincerely,
hn C. Masterson
own Clerk
JCM/cf