Hudson Rib & Fish
-..
Ii j'"
[Pa ~CC~DW~[f5)
~~~~'~: I
t'." ,1
'.~ . ,~::;/ J
MAR 1 5 2011
TOWN OF WAPPINGER
TOWN CLERK
STATE OF NEW YORK
EXECUTIVE DEPARTMENT
DIVISION OF ALCOHOLIC BEVERAGE CONTROL
ST ATE LIQUOR AUTHORITY
Standardized NOTICE FORM for Providing a
30-Dav Advance Notice to a Local MuniciDalitv or Communltv Board
in connection with the submission to the Slate Liquor Authority oJ a (check one)
New Application 0 Renewal Application'S(
Alteration Application 0
I, Date the original copy of this Notice was mailed to the Local Municipality or Community Board:
THIS 30-DAY ADVANCE NOTICE IS BEING PROVIDED TO THE CLERK OF THE FOLLOWING LOCAL MUNICIPALITY. OR COMMUNITY BOARD
2, Name of the Local Municipality or Community Board: r ~ If} C4c Itr 7Oc...J N . ~ ~ #0 p~ ttOau!# ill ~ ~A~~
FOR HBW APPLICANTS, PROVJDBDBSC~lOHB~~'lIVullmG;ALL lKFORM;\TlQl'(KKOWKTO.DATB
FOR ALTBRATlOH APPLICAKT8, ATTACH COMPLftBDBSCRlPTlOH.AKl) DlAGRAM'OFPROPOSBDALTBRATlOH(SI
FOR CURRBKT LlCBHSBBS, Sft FO~'APPROVB:DJOr1'HODOF OPBRATlOHOKLY
DO NOT USB THlS FORlllTO CHANGBYOUR.MBTHODOF OPBRATlON
3,
Type(s) of alcohol sold or to be sold under the license
(-X"~:
D Beer Only
D Wine and Beer Only
~ Liquor, Wine, and Beer
4,
Extent of
food service:
("X"~
~
Restaurant (Sale of food primarily; Full food menu;
Kitchen run by chef)
D 'Tavern / Cocktail Lounge / Adult Venue / Bar (Alcohol sales primarily-
meets legal minimum food availability requirements)
5,
Type of
establishment:
0 Hotel D Live, D Disk D Juke D Patron Dancing D Cabaret, Night Club, Discotheque D Capacity for 600
MUSIC Jockey Box (Small Scale) (Large Scale Dance Club) or more patrons
D Club (e,g, Golf / D Bed & D Catering o =oke o Stage D Topless D Recreational Facility
Fraternal Org,) Breakfast Facility Shows Entertainment (Sports Facility/Vessel)
e:?
("X" sl1
that apply) ~
6,
Licensed
outdoor area:
D None 0 Rooftop
D Patio
or Deck
O Freestanding ,
Covered Structure
D Garden /
Grounds
D Sidewalk
Cafe
D Other
(Specify):
8,
License serial number:
Expiration Date:
7, Will the license holder or a manager be physically present within the establishment during all hours of operation?
10,
11.
12,
13, City, Town, or Village:
14, The establishment is located on the following fioor(s) of the building at the above address:
17,
Business fax number of applicant/licensee:
~9
~9 7
01.... CoM
/C~.
S-D 0 ~
D~~7
IS,
Within the building at the above address, the establishment is located within the room(s) numbered as follows:
16,
Business telephone number of applicant/licensee:
18,
Business e-mail address of applicant/licensee:
19,
Does the applicant or license holder
own the building in which the
establishment is located? ( "X" ~
Yes D
If "YES", SKIP items No, 20-23.
Complete the 3 entries
at Item No, 24,
No~
If "NO", ANSWER items No, 20-23,
and complete the 3 entries
at Item No, 24,
OWNER OF THE BUILDING IN WHICH THE LICENSED ESTABUSHMENT IS LOCATED
20,
Building owner's full name is:
l-fe/l. ~ /260'
'i"'"o w~#"pc:.
oCJ~N"< 4Q.pS "e
'l'LD p4f4lt.,-r~e .:s
70 MJ A t.J,E. ·
21.
Building owner's street address:
22,
City, Town, or Village:
23,
Business telephone number of building owner:
I am the applicant or hold the license or am a principal of the legal entity that holds or is applying for the license, Representations in this form are in conformity with
representations made in submitted documents relied upon by the Authority when granting the license. I understand that representations made in this form will also be
relied upon, and that false representations may result in disapproval of the application or revocation of the license,
By my signature. I amrm - der PelUiIty of Perjmy - that the repr..sentations made in this fo
"I
24,
s~ IZ- ~e~"
,,-
,.
TOWN CLERK
Chris Masterson
TOWN OF WAPPINGER
20 MlDDLEBUSH ROAD
WAPPINGERS FALLS, NY ]2590
WWW.TOWNOFWAPPINGER.US
(845) 297-4]58 - Main
(845) 297-577] - Direct
(845) 298-]478 - Fax
TOWN SUPERVISOR
Christopher 1. Colsey
TOWN BOARD
William H. Beale
Vincent Bettina
lsmay Czarniecki
Joseph P. Paoloni
Office of the Town Clerk
March 31, 2011
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
Hudson's Ribs and Fish, located at 1099 Route 9, Fishkill, 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,
fi{~
J C. Masterson
Town Clerk
JCM/cf