Wappinger Elks (2)r
TOWN CLERK
Christine Fulton
20 MIDDLEBUSH ROAD
WAPPINGERS FALLS, NY 12590
W W W.TOWNOFWAPPINGER.US
(845) 297-4158 -Main
(845) 297-5771 -Direct
(845) 298-1478 -Fax
TOWN OF WAPPINGER
Office of the Town Clerk
August 17, 2012
New York State Racing and Wagering Board
1 Broadway Center, Suite 600
Schenectady, New York 12305-2553
Subject: Wappinger Elks Lodge 2609
SUPERVISOR
Barbara A. Gutzler
TOWN BOARD
William H. Beale
Vincent Bettina
Ismay Czarniecki
Michael Kuzmicz
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 2012.
Christine Fulton
Town Clerk
Town of Wappinger
enc.
1
GC-2 APPLICATION FOR:
PLEASE CHECK ~ ,~ ~- ~,, ,
NYS RACING & WAGERING BOARD GAMES OF CHANCE ~( ~`"~ - ~ " '- ° '°~j '
1 Broadway Center, Suite 600 (Casino Nights, Ba~ats, Carnivals) ~" '' ;~ +
Schenectady, NY 12305-2353 .~-
Telephone (518) 395-5400 Fax (518) 347-1469 BELL JAR ^ - , ; ,,~-~ P,
wwu.racing_state.ny.us
(~FraFftlL~'w! over 530,000 net Pac O in calendar year)
FOR OFFICE 1 2 O~~m $ 100.00 0 8 ~ 1 7~ 1 2
USE ONLY Municipal License Number Fees Received Date
INSTRUCTIONS: PLEASE FILE THREE SIGNED COPIES WITH MUNICIPALITY
Gc-~-mil - 02- o i
N.Y.S. Identification Number
IT IS A MISDEMEANOR TO MAKE ANY FALSE STATEMENTS IN THIS APPLICATION
To cv iv o f w A~ ~° 1 ~y G A R ~D u T C HESS
Name of Municipality County
PART A. G~NF,RAi.
1. Name of Oraaniz
2. Address ~ ~ ! S ~ O U / E ~ 7 (~ . ly A ~~/~/G E!~ FA ~ ~ ..f' /V Y ~ Z s9o
3. Has applicant ever been denied a games of chance license? ^ Yes ~ No If "yes", why? (Attach extra sheet if necessary)
4. Check type of organization and, if applicable, give the State and date of incorporation.
Corporation ^ ~ m
Incorporated Association ~ State incorporated /Y E w ~0 i` Date 0 6
Unincorporated Association ^ State incorporated
Individual ^
a.m~m~m
5. Did your corporate status change since your identification number was assigned? ^ Yes ~ No
6. Are you doing business under a trade name? ^ Yes ~,No If "yes", what is the trade name?
PART B. LOCATION OF GAMES 1 /
7. Address where games, bell jar, or raffle drawing(s) are to be conducted. ~ / S ~ 0 U 1 F 37 6 W14 1 N 6/t ~ ' " ~l~ N y
8. Name and address of authorized games of
chance lessor renting to applicant.
9. Does the applicant own the premises? Yes
~/~
^ No If "yes", how long? Z 7 ~G ~ l~ f
10. Capacity for public assembly of premises presently owned or occupied.
28~
1 l . Have premises been regularly used? I~Yes ^ No If "yes", how long? 2 u yE I`t ~J
Are games of chance being played now on these premises or has it ever been?(Yes ^ No ff "yes", give full details.
LF}f7 [.icENfE ~EcErrrQlyrt 22 ~ 20 //
12. Are the premises or any part thereof If "yes", state the type of license and number.
where games of chance are to be played ~ Yes ^ No C ~ _ 2 b ~ SO
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
Bd-GC-2 (Rev. 3106) Page 1 of 2 ~ ~ ~ I ~ I ~ ((~ J
1
PART C. PURPOSES OF GAMES
14. State the specific purposes for which the
net proceeds are to be devoted and in what
i/3
I swear (or affirm):
1. That ALL the attached Schedules are a material part hereof and are incorporated herein as if set out in full in the application. All the answers
contained in this application are a material part hereof.
2. That the entire net procceds of all games of chance shall be devoted exclusively to one or more of the "lawful purposes" as defined in the Games of
Chance Licensing Law and the Rules and Regulations of the Board.
3. That for each license period for which a license is sought, one or more of the active members under whose supervision the games are to beheld,
operated and conducted, who is familiar with the Games of Chance Licensing Law, the Rules and Regulations of the N.Y.S. Racing & Wagering
Board and local licensing ordinances or laws, will be present at all times, in charge and primarily responsible for the conduct of games.
4. That the undersigned will be responsible for the holding, operation and conduct of all games of chance in accordance with the terms of the license,
the provisions of the Games of Chance Licensing Law, the Rules and Regulations of the N.Y.S. Racing & Wagering Board and with the provisions
of local licensing ordinances or laws.
5. That the undersigned has read and is familiar with the provisions of the Games of Chance Licensing Law as amended, the Rules and Regulations
of the N.Y.S. Racing & Wagering Board, and the local licensing ordinances or laws.
6. That no commission, salary, compensation, reward or recompense will be paid to any person for holding or assisting in the operating or
conducting of the games, except to bookkeepers or accountants for professional services in an amount not exceeding that fixed by the Board.
0 8 i - ,3 l~ 2 - A ~~x ~° CZAre~-E~,~~
~ ~ ~
Date Signature o ead of Or ization Print Name
STATE OF NEW YORK
COUNTY OF •~~TC ~~s SS
CITY~r~i,~II.,LAGE pF~/1~Pr~i r~G E FZ
~I f tx / • ~2 A /~ ~ ~ ~ C ~ / being duly sworn deposes and says that (s}he is the person above named,
that (s)he has read the foregoing statement and the answer therein noted, and that such answers are true and that (s)he has personally
affixed his (her} signature to this affidavit.
Sworn to fore me this day of ~~~5"/ , 20171 Sign
otary Public Commissioner of Deeds
My Commission expires f_7 ~ ~ ~/~-- 20
MARK LI~~~RMANN
Notary Public - Stat® of New YodC
No. 01 LI6199007
~ualltied in Dutchess County
My Commission Expires October 12, 2013
L sa-GC-2 (Rev. 3/06) Page 2 of 2 ~ ~ ~ ((~ I I ~ u
.~ 7 S
. GC-2A APPLICATION FOR GAMES OF CHANCE LICENSE
NYS Rp-QNG & WAGERING BOARD
l Watervliet Ave. Ext., Suitt 2 ,.
Albany, NY 22206-1668
Telephone (318) 453-8460 Fax (518) 453-8492
wwvv.racing.state.ny.us -
WAPP I NGE R E•L KS LODGE 2fi 09
' Name oit orgaiuzation
C- 1 3- 2 1 9- 6 0 2- 0 2 0 1 3 ~~~ J ~.~-9.1
G•~CL-DCLD
NY5 Identification Number Date
3CSEDULE 1: ~ OFFICERS AND DIRECTORS -
ast names, addresses and dates of birth of all officers.
f organization is a corporation, or an incorporated or unincorporated association, list officers and directors.
. ZTIT~E NAME DATE OF BIRTH STREET ADDRESS I CITY I
I ~~ A~r~,rN~o I l l I i i
I ~ / I I I
. I I/ / I I ~
_ I I / __._/ I I 1
I I ~ ~ I I
~ I ~ ~ I I - I
. I I// 1 I 1
I ~ / I __ I
~_ ( I ~ ~ I- _ ~ i
I ~ I 1 / I _
Attach additional sheet if necessary.
MEMBERS IN CHARGE OF GAMES
SCHEDULE 2:
(MUST LIST AT LEAS'!' FOUR MEMBERS OF APPLICANT ORC,gNiZATiON) .
DATE YEARS OF ~
NAME OF BIRTH MEMBERSHIP STREET ADDRESS CITY I
( / / I I (LaGrange I ' 12540
J au der I 9/ 20 / 1965 I 14 I 134 Anderews Rd
V Simon Kaufman II S 1 16 ~ 1830 I 7 I 8 S Yew L~ _ I Hopewell Jet I 12533
I 7/~/~ I - I 11 lo~ninnq/C G'.illc I '17~Ofl
Lewis Hakim a 1
a/Greg S8fi10 1 7 / Ol / 19361 ?8 ( 1a n^n^ PI^r~o I --~rs~596
/ ~~ I 1 1 _ I
I / ' I I-
~ ~ ~ ~ 1
I ~ ~ I -I"
SCHEDULE 3: A~,'ILIA.RY/AFP'ILLA.TE ORGANIZATIONS ASSISTING AT GAMES •
• (MAX;.NlU1~9 OF 2 AUXII.IARlf:S/AFFILIATES. EACH AUXILIAI'.YlAFFII..IATELIBTED MUST HAVE Ii'S OWN ID NUMBER.)
NAME OF AUDI-IARY/!~FFII.IATE GANGS OF CI-IANCE ID NUMBER
u~muiuoumiiwn ~
BJ-cc•2n (Rav.4/03) Pape 1 of 2
SCHEDULE 4: ASSISTANTS TO MEMBERS IN CHARGE OF GAMES
List all members of applicant organization and members of authorized affiliates and auxiliary who will assist with games. Each person listed must be a
member of applicant organization or affiliate for at least 1 year.
YEARS OF
MEMBER NAME CITY ZIP
EMBERSHII' STREET ADDRESS
TH M
DA
OF B
I I
~
~ I
A-TTacN E ~ / /
~sc ~ ~ 'pu AEI l I i
y // I I I 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
_ ._ l
-_ _
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 l
Attach additional sheet if necessary. InIII~II~i~~~III~'~H~I
L Bs-cc-in (xev. 31ot7 Page 2 of 2
Schedule 1-Officers and Directors
Office Held First Name Last Name DOB Address
Exalted Ruler Alex Czarniecki 10/16/1941 31 Helen Drive Wappingers Falls
Leading Knight Mark D'Angelo 8/3/1949 17 Forrest Way Poughkeepsie
Loyal Knight Anthony Manzo 3 Dorett Drive Wappingers Falls
~J Lecturing Knight Gabriel Adiletta 2/4/1966 5 Gabriella Road Wappingers Falls
Secretary Robert Acquanita 5/25/1942 10 Vorndran Drive Wappingers Falls
/~Treasurer Pamela Kultsar 2/1/1950 58 Hillis Terrace Poughkeepsie
'~ Trustee -One Year Rocco Valente 6/6/1941 61 Fishkill Hook Road Hopewell Jct.
Trustee -Two Year James Golding 8/25/1966 256 Lakeshore Drive Pleasant Valley
Trustee -Three Year
J Max Dao 12/31/1963 2 Dwyer Lane Wappingers Falls
/
Y Tiler Susan Dorler 3/29/1939 21 Valley Road Wappingers Falls
Esquire Harris Jones 4/24/1944 102 Brothers Road Stormville
Chaplain Catherine Rohling 4/22/1940 54 Brothers Road Wappingers Falls
Inner Guard Margaret Harten 1/2/1937. 20 Valley Road Wappingers Falls
NY 12590-1705
NY 12603-3840
NY 12590-2204
NY 12590-
NY 12590-4517
NY 12603-5812
NY 12533-6416
NY 12569-5605
NY 12590-4806
NY 12590-2105
NY 12582-
NY 12590-3414
NY 12590-2106
Schedule 4. Assistants to Members in Charge of Games
First MI
~~ Frank
Philip A.
Robert
Ralph J.
'~ enry J.
Harold A.
rancis J.
Roger
Robert
Mark H.
J,Harris C.
~/ Robert J.
J William K.
Rosemarie
/ regory F.
~ enneth J.
Robert N.
Last Name
Abato
Abbate
Acquanita
Anzivina
Boldrin
Crawford Sr.
DeGano
DeJordy
Fischetti
Fox
Jones
Juliano
Minkowski
Perretta
Sarno
Tucker
Wallner
Address
39 Kensington Drive
6 Hackensack Hghts Rd
10 Vorndran Drive
12 Thorns Lane
28 Gold Road
318 Sunset Hill East
27 Brandy Lane
83 Kent Road
91 Ardmore Drive
28 Tiger Road
217 Brothers Road
2776 West Matn Street
427 McGrath Bivd..
35 Cathy Road
13 Dana Place
34 Pawling Lake
7 Kinry Road
Town
Hopewell Jct
Wappingers Fails
Wappingers Falls
Highland
Wappinger Falls
Fishkill .
Wappingers Fails
Wappingers Fails
Wappingers Fails
Hopewell Jct..
$tormvilie
Wappingers. Falls
Fishkill
Poughkeepsie
Wappingers Fails
Pawling
Poughkeepsie
Years
Elk
11
18
22
22
15
18
18
18
28
14
18
13
28
6
28
9
19
DOB
04/24/1940
05/16/1937
05!2511942
12/21/193.5
01/11/1936
02/Z3/1936
07/18/1946
09/19!1944
06/07/1926
09!1511957
04/24/1944
10/05/1953
03/20/1942
09/07/1943
07/01/1936
01 /17/1933 ..
.... ~.
~~; ,
,: .
~~,
... .
1
GC-2B
NYS RACING & WAGERING BOARD
1 Broadway Center, Suite 600
Schenectady, NY 12305-2553
Telephone (518) 395-5400 Fax (518) 347-1469
www.racing.state.ny.us
APPLICATION FOR GAMES OF
CHANCE LICENSE
a ~ ~ ~ ;
. .., , ~.,.:c. ".
WA~° P ! NGER ~LKJ LOaG~ 2609
Name of Organization
Gc- /3 - 21 - ~d2- 020/ 3 0~l OZl /~
NYS Identification Number Date
SCHEDULE 5 DATES, HOURS AND RENT OF ALL LICENSE PERIODS TO BE HELD
(NOT APPLICABLE FOR BELL JAR GAMES'}
DATE HOURS RENT
l ~ l . I Z ~ 7.: 0 Oam/ m - ~ ~ •~am/®~~
I ~ l ~ ~ 2- ~ ,~,~~ :. . v .~ Jam- ~ : v . 1 .~ pm
/ ~ am / pm -
. . am / pm
. .
/~ / .
am / pm - ,
~ / Pm ~
/ / ~ am / pm - am / Pm ~
/ / ~ am / pm - am J pm ~
/ / ~ am / pm - am / pm ~
/ / ~ am / pm - am / pm ~
/ / ~ am / pm - am / pm ~
/ / ~ am / pm - am / pm ~
FFLES
TE
TIlV1E pRIZE r air Market
/ /
! / m - Value of Merchandise)
am / pm ~ $
L / / , ~ - am / pm ~
.
/ / ~ am / pm - am ~~
_
~ am / pm - am / pm ~
/ ~ am / pm - am / pm ~
SCHEDULE 6 EXPENSES
List items of expense to be incurred, and the names and addresses of persons to be paid.
ITEM OF EXPENSE VENDOR NAME STREET ADDRESS CITY STATE ZIP
L B.T-cC-2s (Rev. aro61 Page 1 of 2 I~ ~` ~ I ~ I ~~ ~ ~) I ~ ,~
SCHEDULE 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 $500 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)
TO /~ ~ /~ r° 0 /~. E 2
~3rG six wH~E~-
LIST THE MA~GMUM AMOUNT OF PRIZES
TO BE AWARDED FOR EACH TYPE OF
GAME OF CHANCE (GAME BANK)
at $ SO Q , d~
at $ ~6~. ICJ
at $ ~Q O, 0 0
at $
at $
~ For Merchandise Wheels, Bell Jars and Raffles, please complete the appropriate spaces below.
MERCHANDISE WHEELS:
TE NUMBER OF
ISE WHEELS
(NO L )
THE TOTAL AMOUNT OF
EACH MERCHANDISE W
NOT EXCEED $10,000 AN]
PRIZE SHALL EXCEED~l
SHALL
SINGLE
BELL JAR:
T TOTAL AMOUNT OF PAYOUTS
INDICATE IF THIS APPLICATION REACH BELL JAR DEAL SHALL NOT
IS FOR A BELL JAR XCEED $3,000 AND NO SINGLE PRIZE
LICENSE L EXCEED $500
YES ^ NO ^
RAFFLES:
INDICATE IF THIS APP ATION THE TOTAL AMO F PRIZES FOR
IS FORA LE ALL THE RAFFLES CO TED DUR-
LIC E ING THIS CALENDAR YE SHALL
^ NO ^ NOT EXCEED $100,000. NO GLE
PRIZE SHALL EXCEED $50,
IF YES, T RAFFLE DATES, TIlvIE(S) EXCEPT THAT A SINGLE PRIZE OF
O RAWING(S) AND PRIZES IN $100,000 MAY BE AWARDED IF SO
SCHEDULE 5 INDICATED IN SCHEDULE 5
L-~eM-~ .~==a. ~IIIII,III1 J
08/05/2012 15:19 8452977214 COMPTROLLER PAGE 02/06
I •
-
~'INDIN S A.ND
Gc-4
NYS RACING AGERING SGARD DETERM~N~jT'IQN
l Watervliet Aver xt_~ Suite 2 TpR GAMES 0~' C~iA-NCE
Albany. NY 1 zed l 668 Z,j • NSA •
Telephone (518) :i-8aH0 Fax (51 B) 453-Sa z
www.racing.state , y.us
CYC - - t.1~L l .l~l - 6 z ~ o
N.Y.S. Ida ification Number ~ Municipal License Number
Dut:chess
Town o~ Wa in er ~ Count
Noma of nicipality
= R 1 lcl L o d g a 2 G 0~
W a p ~- n g
Name of licani Organization
376 Wa ~n eY Fa7.ls iVY 12590 ' •
Address
if ufred under Sec.19Z f the 1 Municipal Law, the following find9ngs and datccuu~~saons
After imrestiga n, and a heanng ray ~
have been mad Yes D No
1. A11 theme hers-in-charge destgnat iu U•-e ap i o uat g es of chance are of good moral
character a d have never been convi~ted of a ri a
i ~
9ignamrc of P on Conducting Invcs[igAtien -
I I
2. Applicant 9 a qualified authorized o}ganization as flefined in t~e Qataes of Chance Licensing Law. ~7 Yes D No
3. All the me bets designated in the a~plieation to conduct games are bona fide active members of the applicant ~] Yes D No
organizati
q, The preen s prt:ee~~Uy owned or o upiad by the applicant srelin every respt:ct adequate and suitable far ~l Yes ^ No
conducdn~ es of chance.
5_ The gnmes~ f chance are to be coed in accordance with th'e provisions of die Games of Chaoee Licensing ~I Yes D No
Law, the lea and Regulations of tl~e N.Y.S. Racing and WagCring Board, and local ordinances.
6. The entire et proceeds are to he de~oted exclusively m one or~ more of the "lawful purpot+es" as de5ned in the ®Yes ^ No
Games of hence Ltcensing Lxw an~IIl ttie Itnlcs and Ragulatioai of the N.Y_S. I2ncing and Wagering Board.
7. There is sfactory proof that no cdmraisslon, salary, compensation, inward or recompense will be paid or ®Yes D No
given rn n~ person for conducting the games or assisting therein, except to the extent atrthvrized b3' the Games
of Chance 'causing Law and the Riles and Regulations of tbe;N.Y.S. xaeing one wagering Bolero.
S. There is s~ sfactory proof that the t~pe and value of prizes off~red and given wi11 be in accardanee with the ~ Yes D No
provfsiom f ll~ dames of Cbanoo ~II.ioensing Law- i
9, If applie ,the rent to be paid to ah authorized games of chance lessor is reasonable. ~ Yes D No
I U, Umor final gs: (Specify) ~ ~ Yes ^ No
I
I
i'
TO BE CO E1~D 13Y MUIVICIP CLERK:
As a result of t .findings and dotermina~ons stated above, license is GRANTER D: license is DTLIITJ(ED ^
~ 5ignatttre of
Filing •d8te of placation 08 ~ 0~'0 ~~_ ; Authorized Officer
(Municipal Ucensing Authority)
~' l ~-•- ~ I Title C ristine F
Date
ONE CO OF THLS FORM TO~ETI~R WTI'H ONE COPY OF FORM GC-Z, zA, zs MUST s1E'E~cEtvEp 8~ T~
N.Y.S. CING AND yyAGE'lzllaG BOARD FIVE DAYS~P1(uOR TO THE FIRST AUTAORI7~mmD LImmCENSri PERI~OID.
J $s-cc-a ~.aroa) ~ III~IIIIII~~I~~I~I~
L
LICENSE TO CONDUCT
GC-5
NYS PACING & WAGERING BOARD GAMES OF CHANCE
I Droadway Center. Suite 60p PLEASE CHECK
Schenectady, NY 123U5-2553 GAMES OF CHANCE
Telephone (5l8) 395-400 Fax (~18) 347-1469 BELL JAR ^
www.racing.state.ny.us
RAFFLE ^
GC_~- 2 1 9- 6 0 2- 0 2 0 1 3
N.Y.S. ldentif cation Number
1 2 0 4 $ 100`00
Municipal License Number Amount of Fee Paid Lessor's License Number
The following organization:
tom.
~ ~_~ . '.
u~.
~:~ ~:
,:
. :', ,c
This License Must Be
Conspicuously Displayed
During Conduct of Games
Address: City': Wappinf~ers Falls Zip Code: 12590
1 1 DS T2n,~ta '~7Fi
Entire net proceeds to be devoted to the following specific lawful purpose(s):
1/2 Charitable 2/3 0 erations
Names of Members in Charge
Paul Bader
Simon Kaufman
Lewis Hakim
LICENSE PERIOD DAY OF WEEK
DATE
HOURS
TYPE(S) OF GAMES
10/n5,f ~f11
11/02/2012
12/o~/zn»
RAFFLE DRAWING
DATE
THE MAXIMUM AMOUNT OF PRIZES TO BE AWARDED THE MAXIMUM AMOUNT OF PRIZES TO BE AWARDED
FOR EACH TYPE OF GAME OF CHANCE FOR EACH MERCHANDISE WHEEL
3 $ 500.00 $
NUMBER OF GAMES EACH GAME (Starting Bank) NUMBER OF WHEELS EACH WHEEL
THE TOTAL AMOUNT OF PRIZES FOR £ACH BELL JAR GAMES SHALL BE PLAYED IN ACCORDANCE WITH
DEAL SHALL NOT EXCEED $3,000 AND NO SINGLE PRIZE STATE LAWS AND RULES AND LOCAL ORDINANCES OR
SHALL EXCEED $500. LAWS.
lssued by
( ame of Municipality)
(Date)
L BJ-GC-S (Rev. 3/U6)
Friday 7:OOpm- 11:59pm
DRAWING TIME DRAWING LOCATION AMOUNT OF RAFFLE PRIZES (Cash or Merchandise Prizes
at Fair Market Value)
_ C'hri GYine ~' ~ *nn Tncm ('1 Prk
(Title of orized Officer)
(Signa of Authorized Officer)
lllllllllllllllllllllllllllll J
TOWN CLERK
Christine Fulton
20 MIDDLEBUSH ROAD
WAPPINGERS FALLS, NY 12590
WWW.TOWNOFWAPPINGER.US
(845) 297-4158 -Main
(845) 297-5771 -Direct
(845) 298-1478 -Fax
TOWN OF WAPPINGER
Office of the Town Clerk
August 3, 2012
Adrian Anderson, Sheriff
150 North Hamilton Street
Poughkeepsie, NY 12601
-Dear Sheriff Anderson:
SUPERVISOR
Barbara A. Gutzler
TOWN BOARD
William H. Beale
Vincent Bettina
Ismay Czarniecki
Michael Kuzmicz
Enclosed, please find a copy of the members of the Wappinger Elks #2609,_
Route- 376, Town of Wappingers wha wi~l be Eonducting Games Of Chance
- on September 7, 2012, October 5, 2012, November 2, 2012 and December 7; 2012.
- I would appreciate your review of the "Members in Charge" listed on the application.
'lease complete the Findings and~etermiriation' form a~.tac~ed~and return t11e
form to our office.
Thank you for your attention to this request and your prompt reply.
Yours truly,
Christine Fulton
Town Clerk
CF
Enc.
TOWN CLERK
Christine Fulton
20 MIDDLEBUSH ROAD
WAPPINGERS FALLS, NY 12590
W W W.TOWNOFWAPPINGER.US
(845) 297-4158 -Main
(845) 297-5771 -Direct
(845) 298-1478 -Fax
Office of the Town Clerk
SUPERVISOR
Barbara A. Gutzler
TOWN BOARD
William H. Beale
Vincent Bettina
Ismay Czarniecki
Michael Kuzmicz
The Following Fax Message Consists of Pages
Including Cover Sheet
FAX TELEPHONE NUMBER (845) 298-1478
DATE ~ ~~i ~`c~
TO
FROM
REFERENCE ~ ~- (_ _
IF YOU DO NOT RECEIVE ALL THE PAGES, PLEASE CONTACT
SENDER IMMEDIATELY.
TOWN OF WAPPINGER
Sender=