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Luigi's Pizza & Grille .. 1Fd ~ (C[E ~%7[~:rQ) Slandardized NOTICE FORM for Providing a JO-Dav Advuee Notiee to a Local Munidoality or Com.uuity Board in connection with the submission /0 the State Liquor Authority of a. (check one) New Aoolication 0 Renewal Aoolication if Alteration AoolicationD Coroorate Chan2e 0 for an On-Premises Alcoholic Beverll2e License 1\ -- tAY'r:. r~: ">~'J ST.+ffi* lEt y2i1J EXECUTIVE DEPARTMENT ~~OW~~t~~R TOWN CLERK THIS 3O-DAY ADV.\NCE NOTICE IS BtINOi"RQVIOED TO THE CLltRl{. OF TJ-m. ~NQ I.OCALMUtflClPALI1'\' OR COMMUNlTY BOARD I. Date the original copy of this Notice was mailed to the Local Municipality or Community Board: 3. Type(s) of alcohol sold or to be sold under the license D ( T !ill9: Beer Only 52( Restaurant (Sale of food primarily; Full food menu; Kitchen run by chef) D Liquor, Wine, and Beer 2. Name of the Local Municipality or Community Board: 4. Extent of food service: ( T !ill9 o Tavern / Cocktail Lounge / Adult Venue / Bar (Alcohol sales primarily- meets legal minimum food availability requirements) 5. Type of establishment: Hotel D Live. MuSIC D Disk Jockey D Juke Box D Patron Dancing D Cabaret, Night Club, Discotheque (Small Scale) (Large Scale Dance Club) D Capacity for 600 or more patrons (Tall that apply) Club (e.g. Golf / D Bed & D Catering Fraternal Org.) Breakfast Facility D Karaoke 0 Biage 0 Topless 0 Recreational Facility Bar Shows Entertainment (Sports Facility/Vessel) 6. D Rooftop D Patio or Deck D Freestanding Covered Structure D Garden / Grounds D Sidewalk Cafe 7. Will the license holder or a manager be physically present within the establishment during all hours of operation? 8. License serial number: 10. II. 12. 13. City, Town, or Village: 14. 15. 16. Business telephone number of applicant/licensee: 17. Business fax 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? ( T !ill9 YesD If "NO", ANSWER items No. 20-23, and complete the 3 entries at Item No. 24. 20. OWNER OF THE BUlLDING IN W1iICHTJ-m t,ICENSED BS'l'.t\Bl.lSHMENT IS LOCATED Building owner's full name is: L, 21. 22. City, Town, or Village: 23. Business telephone number of building owner: I am the appficant or hold the ~ or 8lJl a. ptinclpa1 or the ~~~tb!tt~~I!J~for the llceruIe' Repn:aentations in this fQm;l ~ In ~ with representations made in lIl1bmi1:ted docuo.,nts.",Ji!;d .uponbytheAu~~~thellcerule.1 ~ that representations made ltl thIa rcmn wiI1ll1!1O be reUed upon, and that faI$e ~tlotl$ may rtiIlUlt~ ~of the lIJlI)IIc:at!on or revocation of the ficense. By my si&nature. I atJJrtn - under .....,. GIt...". - that therept"e8!mtationll made in t.hla form are true. 24. Revised IO/12l11 20 MIDDLEBUSH ROAD W APPINGERS FALLS, NY 12590 WWW.TOWNOFWAPPINGER.US (845) 297-4158 - Main (845) 297-577] - Direct (845) 298-1478 - Fax SUPERVISOR Barbara A. Gutzler 1\ - TOWN CLERK TOWN OF WAPPINGER .. TOWN BOARD William H. Beale Vincent Bettina Ismay Czamiecki Joseph P. Paoloni .....- Office of the Town Clerk November 14,2011 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 Luigis Pizza & Grill, located at 1315 Route 9, Hark Plaza Ste 9, Wappingers Falls, New York, of intention to file a renewal 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, ~ Christine Fulton Deputy Town Clerk Icf