Shadowbrook
~A~>;
JSt
'In'l:_
STATE OF NEW YORK
EXECUTIVE DEPARTMENT
DIVISION OF ALCOHOLIC BEVERAGE CONTROL
STATE LIQUOR AUTHORITY
SIondardized NOTICE FORM for Providing a
3O-Dav Advance Notice 10 a Local MuniciDlllitv or CommllDitv Board
In connecIiofI with the Sflbmission 10 the S/aJe LiqtlOr Authority of a (check one)
New Application 0 Renewal Application.
Alteration Applicationo Corporate Chanl!e 0
for an On-Premises Alcoholic: Beverlll!.e l.irf!n....
3.
Type(s) of alcohol sold or to be sold under the license
("X"~:
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 Iel!lll minimum food availability requirements)
Ucensed
outdoor area:
D Hotel D ~:sic
D
~ None D Rooftop
D Disk
Jockey
D~
D Patron Dancing D Cabaret, Night Club, Discotheque
(Small Scale) (Large Scale Dance Club)
D Capacity for 600
or more patrons
5.
Type of
establishment:
("X" all
that apply)
Club (e.g. Golf / D Bed & KJI Catering
Fraternal Org.) Breakfast ~ Facility
DFreestanding
Covered Structure
D Karaoke 0 Stage 0 Topless 0 Recreational Facility
Bar Shows Entertainment (Sports Facility/Vessel)
6.
D Patio
or Deck
D Garden /
Grounds
D Sidewalk
Cafe
D Other
(Specify):
Revised 10/12/11
7. Will the license holder or a manager be physically present within the establishment during aU hours of operation? ("X"~:
8. License serial number:
10.
11.
12.
13. City, Town, or Village:
14. The establishment is located on the following f1oor(s) of the building at the above address:
15.
16. Business telephone number of applicant/licensee:
17. Business fax number of applicant/licensee:
18. Business e-mail address of applicant/licensee:
Does the applicant or license holder
19. own the building in which the
establishment is located? { "X" 2!l!:l
20.
21.
22.
23.
24.
DEe 01 2011
TOWN OF WAPPINGER
TO\A/I\I rl J=O v
11/ aq I' ,
I
b k \<::0J0 6\ ~P?II\Cf-<l ~ ~\~(K
\'()i\\ S~~~~1rDc
'!J?:J Q.,n~~A \loirl. \b~ 16Y
Qk\S~ .(\)'1 -
_ l~S\~
~ WA\. d byjk S\0..~o\ (\}.wl{or~ hl6-Ao~
Au\t\cX\ ,1 D..vn ~ll\X) G(Ocl t'hL) RJkK
\0 k\ \\~ ~AY\1~\f\{q If\)
Q0\ ~~\ \c)( ~r Ilqu~hl~.
\ MNv" LpJ to- C{OJ( tVYl e... ·
Rl\ ~yLO~H "P~~~J
~~te~~~~\Q)
DE.e 01 7.0';\
TOWN Of WAPPINKGER
,.OWN CLER
I . ~ . I... ........~_i'-J"" ,
TOWN CLERK
TOWN OF WAPPINGER
".
20 MIDDLEBUSH ROAD
W APPINGERS FALLS, NY 12590
WWW.TOWNOFWAPPINGER.US
(845) 297-4158 - Main
(845) 297-5771 - Direct
(845) 298-1478 - Fax
SUPERVISOR
Barbara A. Gutzler
TOWN BOARD
William H. Beale
Vincent Bettina
Ismay Czarniecki
Joseph P. Paoloni
Office of the Town Clerk
December 1,2012
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
Chelsea Sportsman Assoc, license holder Shadowbook Inc, located at 33 Chelsea Road,
Chelsea, 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,
~~
Christine Fulton
Town Clerk
fcf