Wappingers ElksTOWN CLERK
Chris Masterson
20 MIDDLEBUSH ROAD
WAPPINGERS FALLS, NY 12590
VV VJ W. TO W N O F W AP P IN GER. U S
(845) 297-4158 -Main
(845) 297-5771 -Direct
(845) 298-1478 -Fax
Office of the Town Clerk
TOWN OF WAPPINGER
July 7, 2011
New York State Racing and Wagering Board
1 Broadway Center, Suite 600
Schenectady, New York 12305-2553
Subject: Wappinger Elks Lodge 2609
TOWN SUPERVISOR
Christopher J. Colsey
TOWN BOARD
William H. Beale
Vincent Bettina
Ismay Czarniecki
Joseph P. Paoloni
Please find enclosed the GC-2, GC-2A, GC-2B, GC-4, and GC-5 for the Wappinger
Elks Lodge 2609 for the year of 2011.
J n C. Masterson
Town Clerk
Town of Wappinger
JCM/cf
enc.
1
GC-5
NYS PACING K WAGERING BOARD
1 Broadway Center. Suite 60U
Schenectady, NY 1230-2553
Telephone (5l8) 395-i40U Fax (518) 347-1469
www.racingstate.ny. us
LICENSE TO CONDUCT
GAMES OF CHANCE
PLEASE CHECK
GAMES OF CHANCE
BELL JAR ^
RAFFLE ^
C7C- 1 3 - 2 1 9- 6 0 2
N.Y.S. Identification Number
7:OOpm - 12:00 AM
i i n ~__ $
Municipal License Number Amount o Fee Paid Lessor's License Number
The following organization:
W a i
Address: 1195 Rte 376, C~~'~Wappingers Falls Zip Code: 12590
Entire net proceeds to be devoted to the following specific lawful purpose(s):
Names of Members in Charge
Paul Bader
Simon Kaufman
Lewis Hakim
('r g. Sarno
LICENSE PERIOD
DATE DAY OF WEEK HOURS TYPE(S) OF GAMES
10/07/11
11/04/11
12/02/11
RAFFLE DRAWING
DATE
~..A
kS ~ J .
,~„.
This License Must Be
Conspicuously Displayed
During Conduct of Games
DRAWING TIME DRAWING LOCATION AMOUNT OF RAFFLE PRIZES (Cash or Merchandise Prizes
at Fair Market Value)
THE MAXIMUM AMOUNT OF PRIZES TO BE AWARDED
~ FOR EACH TYPE OF GAME OF CHANCE
NUMBER OF GAMES EACH GAME (5tartmg Bank)
THE TOTAL AMOUNT OF PRIZES FOR EACH BELL JAR
DEAL SHALL NOT EXCEED $3,000 AND NO SINGLE PRIZE
'SHALL EXCEED $500.
Issued by Wappin~er
(Name of Municipality)
07/07/11
(Date)
BJ-GC-S (Rey. 3JU6)
THE MAXIMUM AMOUNT OF PRIZES TO BE AWARDED
FOR EACH MERCHANDISE WHEEL ~
NUMBER OF WHEELS EACH WHEEL
GAMES SHALL BE PLAYED IN ACCORDANCE WITH
STATE LAWS AND RULES AND LOCAL ORDINANCES OR
LAWS.
(Title of uthorized Officer]
~ (Signature of Authori``zed Officerr)
IIIIIIIIII(IIIIIIIIIIIiIIIIIi
1
GC-4 FINDINGS AND ''
NYS RACING & WAGERING BOARD DETERMINATION _
] Watervliet Ave. Ext., suite 2 FOR GAMES OF CHANCE t
Albany, NY 12206-1668
Telephone (538) 453-8460 Fax (S18) 453-8492 LICENSE
www.racing.state.ny.us "~
GC- 1 3- 2 1 9 - 6 0 2- 2 1 I 1 1 1 0 _
N.Y.S. Identification Number Municipal License Number
Town o~ Wannineer Di,rrheac -
Name of Municipality Count -
W A P P I N G E R E L K
Name of Applicant Organization
QTY 1 959n
1195 Rte 376 Wa~2i ng~rG Fal 1 c
~
Address
r.
After investigation, and a hearing if required under Sec. 19 'of'the General M tpal ,the following ftndings and
have been made:
1. All the members-in-charge designated in the pli ~ ,'to con ct s an a of good moral
determinations
/
®Yes ^ No
character and have never been convicted o a c '
Signature of Person Conducting Investigati n~ Title t
2. Applicant is a qualified authorized organization as defined in the Games of Chance Licensing Law. ®Yes ^ No
3. All the members designated in the application to conduct games are bona fide active members of the applicant ®Yes ^ No
organization.
4. The premises presently owned or occupied by the applicant are in every respect adequate and suitable for
~I Yes ^ No
conducting games of chance.
S. The games of chance are to be conducted in accordance with the provisions of the Games of Chance Licensing
Law, the Rules and Regulations of the N.Y.S. Racing and Wagering Board, and local ordinances. ®Yes ^ No
6. The enure net proceeds are to he devoted exclusively to one ore more of the "lawful purposes" as defined in the
Games of Chance Licensing Law and the Rules and Regulations of the N.Y.S. Racing and Wagering Board. ~ Yes ^ No
7. There is satisfactory proof that no commission, salary, compensation, reward or recompense will be paid or
given to any person for conducting the games or assisting therein, except to the extent authorized by the Games
of Chance Licensing Law and the Rules and Regulations of the N.Y.S. Racing and Wagering Board.
8. There is satisfactory proof that the type and value of prizes offered and given will be in accordance with the
provisions of the Games of Chance Licensing Law.
9, If applicable, the rent to be paid to an authorized games of chance lessor is reasonable. E~] Yes ^ No
®Yes ^ No
~ Yes ^ No
10. Other findings: (Specify) ^Yes ^ No
TO BE COMPLETED BY MUNICIPAL CLERK:
As a result of the findings and determinations stated above, license is GRANTED :license is DENIED ^
Signature of ~/~
Filing date of Application .TnnP X8.201 1 Authorized Officer
(Muntcipal Licensing Authority)
Date Title Tn~,r, ('1 Prk ---
ONE COPY OF THIS FORM TOGETHER WTTH ONE COPY OF FORM GC-2, 2A, 2B MUST BE RECEIVED BY THE
N.Y.S. RACING AND WAGERING BOARD FIVE DAYS PRIOR TO THE FIRST AUTHORIZED LICENSE PERIOD. I
L BJ-GC-4 (Rev. 4/03) II~ ~~ III' I I~ II~'I~I II I ~I IIII J
.C-2
APPLICATION FOR:
PLEASE CHECK
GAMES OF CHANCE
BELL JAR ~
y:
_ _..~
CLR-.YY- .
YS RACING & WAGERING BOARD
Watervliet Ave. Ext., Suite 2
Ibany, NY 12206-1668
~lephone (518) 453-8460 Fax (518) 453-8492
.vw.racing.s[ate. ny. us
~~ pv
FOR OFFICE $
USE ONLY lvt,in;r;nat License Number Fees Received
[NSTRUCTIONS: PLEASE FILE THREE SIGNED COPIES WITHUIVICIPALITY
Q.Y.S. I entification umber TEMENTS IN THIS APPLICATION
IT IS A MISDEMEANOR TO MAKE ANY FALSE STA ~ ~~G~~ ~
Vame of Municipality ~ County
PART A. GENERAL
1. Name of Or nnization / ~ ,~
W ~ ~ ~ ~ ,~ C_ ~ O b G ~ 5 ~
t 1 ~5 (~~ ~ 37~ ~~~P' F~-~l5 ~1~ ~z~~
2. Address
3. Has applicant ever been denied a games of chance license? O Yes f ~o if "yes", why'? (Attach extra sheet if necessary)
4. Check type of organization and, if applicable, give the State and date of incorporation.
Corporation ~ ~ g o; \) ~~k Date ~ / ~ /
State incorporated tYS~=--=
Incotporated Association m ,/ m /
Unincorporated Association ^ State incorporated Date
Individual ~
5. Did your corporate status change since your identification Rat~ber was assigned? O Yes [~No
6. Are you duing business under a trade name? O Yes l~No If "yes", what is the trade name'?
PART B. LOCATION OF GAMES Q '~ / , I
7. Address where games, bell jar, or raffle drawing(s) are to be conducted. ~ ~ 7 S ~ I~ -3 ~ ~ ~ .~/- ~° ~~' ~` ~ ~" ~ Z''~`~ l~
8. Name and address of authorized games of _ /
chance lessor renting to applicant. /V ^~ ?~
9. Does the applicant own the premises? Yes ^ No If "yes", how long`? `~
1 U. Capacity for public assembly of premises presently owned or occupied.
~ es ^ No If " es", how long? ~ ~ ~ ~~
11. Have premises been regulazly used. (~' Y
Are games of chance being played now on these pren»ses or has it ever been? j~Yes D No If "yes", give full details.
12. Are the premises or any part thereof ~ If "yes", state the type of license and number. C / 2
where games of chance are to be played ~es s~'C'o ~, L G~ C7Q ~ C~ ~ 7 /
licensed by the State Liquor Authority?
13. Has such license ever been If "yes", why? (Explain on a separate sheet, if necessary, and attach.)
revoked or suspended? ~ Yes ~No
I a,I•cc-2 txev. 4iu31 Page 1 of 2 IIII III III IIII II III II II IIII II
1...
RAFFLE ~
m / m / m
Date
~•
~~
I':1R"1' t_', l'l'K1'Otih:S (_11'' 1;,1!1'11:5
I~! ~tlur the. sl)eritir purposes fur whit:h Ihe. e.ntirt; net pruce.eds ate w be devoted tutu it what manner.
I swear tu, aillt'nu'
1. I but AI.L..he alulchctt J~ itcdulus :Ire a ntateriul pan he.rt;uf wul aic incorporated hcrcic as if set out iu full in the aklpliaulun, All the answers
::,rttaincd ill this application are a nruuri<tl ptu~l herein.
_ l but li,c cntiic net lnucceds of all g,umCS of chtulcC Shull ba elevated rxclusivcly to one or more. ul the "lawlul purposes" us defined in the Gantcs v!
Chnrtc L.II'CllXlllx Law and 1110 Rlllcs and Kagulutions ol'tht; 13oarcl.
s. 1 hat for rarh licc.usr Lxriod for which a lice.nsc. is sought, onr or nutty. of the active «1CIlIbCI'S tlltdCl WhosC Slll)CCVISIUII ItIC ~'a1lIC5 arC tU hC hCid,
~~peratcd a«d w«du. cJ, who is tuntiliur with thu Coates of Chance Licensing Law, the Chiles and kegulations of the N,Y.S. Racing & Wagcnng
iiuurd :~,Id lucai licensing ul~liu:snv.us ur laws, kill he present al all times, Itl Cll4I~C allll pll«lillll)' rCSpU11SIt)1G Cur UlC GUt1dU%l Ut galtlCS.
4, flint tnr undarsigncd well be rrspunsihle ti,r the balding, upuratiiiu rued conduct of all gauzes ul ch,utcc iu accurdaucc with the tcnns al the licensr.,
the Nn;~ isiuns u!' thr (_i:l~ttc ut Chunk Licensing Law, the Rules and Ilugulutiuns ui the N.Y.S. Racing :X Wagering board and wife the pruvlsn)ns
of l~)~:t, Itcensicg urdinnn~cs ur laws.
~. that tltc undersigned C«ts road an~1 is iatuiliar with Ihe. provisions i)1'the (lan)es ul Chance C..icuusiug Law GIs tuncnded, the Rules and Regu!titiuns
vt tllJ ti.l .:i. Racing ~Y: 'ti1 ag,erin~; t3uurd, and the local licensing ordinunws ur laws.
G. I"hat nu ~uuunissiun, salary', a)utpcnsutitin, reward or recompense will be paid to any persu« for holding ur assisting, in the operating i)r
"~utiuvting of the gurus, except to buukkC;rpers or aur.ountants lur prolessiona! sen'ices is an autuuut out exazding that fixed by the Board.
---------I - ..,...--- - - - --~ '
Uate Signaliire of 1ic,.u1 ,tf C)ro:tnicluiun Print Name
~~C:1~1'I{ (il~ NE{W 1'l)RK
Ct.)t!N'i'Y t)F ~l7[~~~~~~~ SS
C'1 !'1`!'I'OW'N; A'll_.l.,~t_ll..: OF ~.~Gy_~,~,,.,..___~r__._
{ ~
~~q~ (~~_ _ ~ l'.1~.Q being fluty sworn deposes and says that (s)he is the person above canted,
tl,;u ,, lw ties :cud tl,r lurug~)ing .,tutentunt un~l tlic ausw'er tllorein noted, cud that stxh answers are true untl that (s)he has personally
ulu.\o:.i hts 1,heri strr,ature. to this alllilavtt.
~~ 1
Jw,trn lu ! .t:,t~: nt ~ (his y ttt ?U Signed ~ .--
~ 1 _.G-._
` ~ ,~.u y4',hlic " ~ ~ ,, / Gonimission~:r of Deeds
11y l~uuut:isstun expires __. ~ _...___.___ 2U / ~,i
DEBRA E. CLARK
Notary Public, Stag of New York
ID No. 01 Cd.6071733
Qualified in Dutchess County
N9y Commission Expires AAarch 25,
L.,,.,.... , . - ~IIIIININIINIINilllll J
Y _
GC-2A aPPLICATIOI~ I'OR GAMES OF CHANCE LICENSE ~/$
NYS RACING & WAGERING I3~ARD
] Watervliet Ave. Ext., Suite 2 t
Albany, M' 12206-1668
Telephone (518) 453-8460 Fax (518) 453-849.
www.racingstate,ny.us
WAPP I NGE R EL KS L ODGE 26 09
Name o Organization
GC- 1 3- 2 1 9- 602 - 0 2 0 1 3 ®~/~~/ ,
~~
NYS Identification Number Date
SCHEDULE 1: OFFICERS AND DIRECTOP.S
ast names, addresses and data. of birth of all officers.
t organization is a corporation, or an incorporated or unincorporated association, list officers and directors.
~~ NAME DATE OF BIRTH STREET ADDRESS;,, CITY ZIP
L N~dk tt I ~L r~t~~1 I r~ / ~/ - ~ 3yA,.~a~s ~ ~~<'~~~ ~'>/ ~ I l2. ~
`~ ~ ~r 2 i /"~~~"~ ~fiX ~ I ~1~11`%S~~ I:z~-//cr~,~ I~,~~.>~>~l/ 3~1 I ~L 53~~
`5 ~ l+ Iti ~
n .tJ' :.~ L r3/ >~ /'.Vc s L L; I~ l ''2 L" l ~~l ~f ~ I S t ~C~7f11/t ~~ ~~r*/~n /_~q //s I 1 L ~~~ J
`-~A, ,• / c) 5 / Z 5~/ ~ ~ LI /ii / n mar/ ~ (~J-~~ :;~ l;i/lS ~ / 2 S"`' u
/ /6 4/ul:ac:c~~ I - f% T/ t
:~ ~c~ , ,~ ,-' l ~ ~ ,g v ~/ o .7 ~~ I ~s-~,~-r~i~ ,E'er-I F~ _~~,;~y ~I I2 ~'c~,;
I r. ~ t.lt l / I u +a rI TA I I ~ ~
i i. ,r._ I n•4V1f G ~ 5 }~t-~(1 5.~.2I / ~~ /' ~ jy~J//,'~(•l-rte ~ , 5~ •-' 1 ZC~ c-
~ ~Q`~~~G I ~+~'Lt'1.'S ~_Ji_ ~~i1/~ I ~ ~ /7~'Y l1 j~ 1~~~ ~,Lla~c%.r'JS L` ,, r
Attach additional sheet if necessary.
SCHEDULE 2: MEMBERS IN CHARGE OF GAMES
(MUST LLST AT LEAST FOUR MBMBERS OF APPLICANT ORGANIZATION)
DATE YfiARS OF
NAME OF BIRTH MEMBERSHIP STREET ADDRESS CITY I ZIP
( / / I I. I
au I 9/ 20 / 1965 I 14 ~ 134 Anderews Rd I LaGrange I 12540
'inttut Katdman - - ti ~ 18 / 1930 I ~; 9 S View Ln _ {Hopewell Jd ~ 12533
j ~~;,~auc _. t..~,o.
/ I
LeW18~IkRTt 7 r ...~ ~. ___~___-
~:;re ~ ~ / 01 / 19361 __-~___. ,~.~.,s - i ~--=
{
i / / ~ R 1
I / / ~
I / / ~ _I --
SCHEDULE 3: AIT~'ILIAR~'/A + +ILIATE ORGANIZATIONS ASSISTING AT GAMES
(MAX.^.vIUM OP 2 AUXII,IARff:S/AFFD.IP.TBS. EACH AUXII.IAItY/AFFIl-IATE LISTED MUST HAVE n'S OWN lU NtlMBER.)
NAME OF AU~IL.IARY/AFF]LIA1'E GAMES OF CHANCE ID NUMBER
B1-cc-ze (ltev. 4/03) Pale 1 of 2
9~IW~~IIVA~6 J
SCHEDULE 4: ASSISTANTS TO MEMBERS IN CHARGE OF GAMES
List sU membea of applicant otganizadoa and manbtxs of suthoriaed affiliates and auxiliary who will assist with games. Each person listed must be s
member of apDlicaut organization or affiliate for at least 1 year.
YEARS OF
MEMBER NAME 'DATE OF B TH MEMBERSHIP STREET ADDRESS I CITY I ZIP
/ 1
/ I I I I
/ / I I I l
1// I I I I
I// I I I I
I / /
I / / i
I / / I I.
I// I I i i
I// I I I i
I// i I I 1
/ / I I I I
I// I I 1 I
I / /
I / /
i / / I I 1
I// I I l I
I// I I I I
I// I I I I
I / /
I / / I I I
/ /
I// I I~ I I
I / ~ / i
I / / I I
I / /
I// I I I I
I / / I I I. I
I / / I { I I
/ / I l I i
/ / I I I I
I / / I i
I: / / I I I
I / /
Attach additional sheet if necessary. IIII (I~U~I I III'I I) ~~I I nIl'I
s,.ccz,+ ~, nos) Page 2 of 2 ` II
Schedule 4. Assistants to Members in Charge of Games
First MI Last Name DOB Address Town Yrs an Elk
Frank Abato 04/24/1940 39 Kensington Drive Hopewell Jct 8
Philip A. Abbate 05/16/1937 6 Hackensack Hghts Rd Wappingers Falls 15
Ralph J. Anzivina 12/21/1935 12 Thorns Lane Highland 18
Henry J. Boldrin 01/11/1936 28 Gold Road Wappinger Falls 12
Harold A. Crawford Sr. 02/23/1936 318 Sunset Hill East Fishkill 15
Francis J DeGano 07/18/1946 27 Brandy Lane Wappingers Falls 15
Roger DeJordy 09/19/1944 83 Kent Road Wappingers Falls 15
Richard 0. Desruisseau 11/05/1936 183 Red Cardinal Court Poughkeepsie 18
Richard D. Dobbins 05/30/1949 6 Schuele Drive Wappingers Falls 19
Stephen F. Drobnak 02/02/1957 53 Moccasin View Rd. Fishkill 6
Robert Fischetti 06/07/1926 91 Ardmore Drive Wappingers Falls 25
Mark H. Fox 09/15/1957 28 Tiger Road Hopewell Jct. 11
Harris C. Jones 04/24/1944 217 Brothers Road Stormville 15
Robert J. Ju~ano 10/05/1953 2776 West Mlain Street Wappingers Falls 10
Joseph Jurina 02/28/1963 173 Hillside Lake Rd. Wappinger Falls 7
William K. Minkowski PSVP 03/20/1942 427 McGrath Blvd. ~ Fishkill 25
Eugene P. Pampalone 09/03/1936 53 Helen Drive Wappingers Falls 17
Rosemarie Perretta 09/07/1943 35 Cathy Road Poughkeepsie 5
Gregory F. Sarno 07/01/1936 13 Dana Place Wappingers Falls 25
Kenneth J. Tucker 03/19/2029 34 Pawling Lake Pawling 6
Robert N Wallner 01/17/1933 7 Kinry Road Poughkeepsie 16
G C-2B
NYS kACING 8: WA(~tiRIN(; }3OARI)
114atervliCt A+'r. Ex[., Suite 2
Alh~+uy, Nti" 1?20frIt5b8
'1'rlcptuln~ (~ 15) 453-84b0 }~ua tS l ts) x}53 -~4+)2
W W W JSLL:I111~~. SldlC.lly.Uti
AYPLICATIUN FUR GAMES OF
CHANCE LICENSE
,~
ti
w~~ ~ ~~,L ~ L ~~GE
Nun~e ~l (7rganization
1\Y'S tdentitication Number Dale
SCIiEllULE 5 llATES, HUUKS AND RENT OF ALL LICENSE PERIODS 'rU BE HEI,ll
1~'~'OT APPLICABLE FOR BELL JAR GAMES)
~DATF_, HOURS RENT
/~~-~ ~ am / pm - am l pm ~ ~ _
-._J • 1. 4
/ / am /prn - am / pn}
.~ ~ / ._-_L.~ / ..~_~, ~ ~.~ ~ ~~ am / m - . ~ . 02--: (' am pm ~
_ _.--.__-, / ~-__._~ / ._~.~._. ~--_y__~ • ._ am /prn - am / pm ~
/ / ~ ~ • am /prn - am /pier
~
'
~__~ / / __ am /prn - am 1 pnr ! $ .
J / / ~
J am / pm ~ am / pm
/ /
' am / pn} - am /prn
!t A t~ I' I.I?S
UA'I'L'
TIME PRIZES (Cash (~r Fair Market
Valcre of Merchandise)
-_ / / ~ ..._ .___ am / pm - um / pm ~
_~ ~. / / i aiu / pm - am 1 pnr ~
~ ~ • ~ ~ J
/ ~ / ~ ._____.~ ~ um /prn - am / pm !
/ / am / pm - am / pm
.. ~ .~
/ am / pm am / pm
/ ~ - ~~
_._____,
5CH>F;l)ULE 6 Ii;XI'ENSES
List itetns of expense; t(r be incurred, and the names a})d addresses of persons tta he paid.
t'I'1~M C)1~~ E'il'F:NSE VENllUK NAME STREET ADDRESS CI'T'Y S•CATE L1P
,L % t~. L [ G r~iN5~ j . C~ `L (o Ss-v-9-~--•- ~=-~J lsy ~ 1~ ~ 1 ~~~~ U
~ _ L r3~~-~ _ Il 9s 6Z~ 3 ? ~_ C~ ~ t,Z Sf ~ ~
rt.3-t.,c-~la txrr. iro~t
V1111119111~11 J
SCI~iDiJLE 7 TYPES OF GAMES
List all of the single types of games to be conducted at all license periods enumerated in Schedule 5.
Note for Vegas Nights and Bazaars only: The total amount of prizes during any one license period shall not
aggregate more than $400 for each single type of game of chance when five types of games of chance are to be
conducted during any one license period. The total amount of prizes during any one license period shall not
aggregate more than $S00 for each single type of games of chance when less than five single types of games of
chance are to be conducted during any one license period.
LIST NAME OF EACH TYPE OF
GAME OF CHANCE
(Limit: 5 Games)
L g (~~ at
/~~= at
w ~
J at
at
at
LIST THE MA~GMUM AMOUNT OF PRIZES
TO BE AWARDED FOR EACH TYPE OF
GAME OF CHANCE (GAME BANK)
$ ~~~ - ~C~
$
For Merchandise Wheels, Bell Jars and Raffles, please complete the appropriate spaces below.
MERCHANDISE WHEELS:
THE TOTAL AMOUNT OF PRIZES FOR
INDICATE NUMBER OF EACH MERCHANDISE WHEEL SHALL
MERCHANDISE WHEELS NOT EXCEED $10,000 AND NO SINGLE
(NO LIMIT) 1~RIZE SHALL EXCEED $250
BELL JAR:
INDICATE IF THIS APPLICATION
IS FOR A BELL JAR
LICENSE
YES ^ NO J~1
THE TOTAL AMOUNT OF PAYOUTS
FOR EACH BELL JAR DEAL SHALL NOT
EXCEED $3,000 AND NO SINGLE PRIZE
SHALL EXCEED $500
RAFFLES:
INDICATE IF TIiIS APPLICATION
IS FORA R'FLE
LICENSE
YES ~ NO ~
IF YES, LIST RAFFLE DATES, TIlvIE(S)
OF DRAWII3G(S) AND PRIZES IN
SCHEDULE 5
L BJ-GC 2B (Rev.. 3106)
THE TOTAL AMOUNT OF I?~~S FQR
ALL ~~~col*~;~l;~x-
ING TICS ~ C~AI.~AIDAR 'E~A.R
N+DT EXCEED ~ $10D000. NO ~,' „ `E
PRIZE SHALL EXCEED $SQ000
EXCEPT THAT A SINGLE PRIZE O,I;
$100,000 MAY BE AWARDED IF SO
INDICATED IN SCHEDULE 5
~•~~_ ~IIIII~IIII J
,~
,,
., _ 9
TOWN CLERK
Chris Masterson
20 MIDDLEBUSH ROAD
WAPPINGERS FALLS, NY ]2590
W W W.TOWNOFWAPPINGER.US
(845) 297-4158 -Main
(845) 297-5771 -Direct
(845) 298-1478 -Fax
Office of the Town Clerk
June 28, 2011
Adrian Anderson, Sheriff
150 North Hamilton Street
Poughkeepsie, NY 12601
Dear Sheriff Anderson:
TOWN SUPERVISOR
Christopher J. Colley
TOWN BOARD
William H. Beale
Vincent Bettina
Ismay Czarniecki
Joseph P. Paoloni
Enclosed, please find a copy of the members of the Wappinger Elks #2609,
Route 376, Town of Wappinger, who will be conducting Games of Chance
on October 7, 201 1, November 4, 2011 and December 2, 2011.
I would appreciate your review of the "Members in Charge" listed on the application.
Please complete the "Findings and Determination" form attached and return the form
to our office.
Thank you for your attention to this request and your prompt reply.
Yours truly,
Jo C. Masterson
Town Clerk
TOWN OF WAPPINGER
JCM/cf
Enc.