Documents › Board Of Trustees, 2025-10-29

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—_ a OFFICE USE ONLY ©) Original © Amended Date Standardized NOTICE FORM for Providing 30-D ay Advance Notice to a Local Municipality or Community Board i 2. Select the type of Application that will be filed with the Authority for an On-Premises Alcoholic Beverage License: For premises outside the City of New York: . © New Application re) Removal oO Class Change For premises in the City of New York: © New Application © New Application and Temporary Retail Permit © Temporary Retail Permit © Removal © class Change © Method of Operation O Corporate Change ©OnRenewal © Alteration For New and Temporary Retail Permit applicants, answer each question below using all information known to date For Renewal applicants, answer ail questions For Alteration applicants, attach a complete written description and diagrams depicting the proposed aiteration(s) For Corporate Change applicants, attach a list of the current and proposed corporate principals For Removal applicants, attach a statement of your current and proposed addresses with the reason(s) for the relocation For Class Change applicants, attach a statement detatling your current license type and your proposed license type For Method of Operation Change applicants, although not required, if you choose to submit, attach an explanation detalling those changes Please include all documents as noted above. Failure to do so may result In disapproval of the application. This 30-Day Advance Notice is Being Provided to the Clerk of the Following Local Municipality or Community Board: 3. Name of Municipality or Community Board: Croton-on-Hudson Applicant/Licensee information: 4, Licensee Serial Number {if applicable): [Fis aie ees Hata Expiration Date {if applicable): fies =" =] 7, Street Address of Establishment: 149 N RIVERSIDE AVENUE 8. City, Town or Village] Croton-on-Hudson »NY ZpCode: [10520 9. Business Telephone Number of applicant/ Licensee: sis “ee ee Se tea ee | 10. Business E-mail of Applicant/Licensee: fos | 11. Type(s} of alcohol sold orto be sotd: © Geer & cider © Wine, Beer & Cider © liquor, Wine, Beer & Cider 12. Extent of Food Service: © Full Food menu; full kitchen run by a chef/cook © Menu meets iegal minimum food requirements; food prep area required 13.Type of Establishment: [Restaurant (full kitchen and full menu required 0 Seasonal Establishment Juke Box Coisc Jockey [el] Recorded Music oO Karaoke 14, Method of Operation: . CiPatron Dancing §=] Employee Dancing [} Exotic Dancing (3 Topless Entertainment Cl Video/ArcadeGames [_] Third PartyPromoters [[] Security Personnel Dlotrerispecy: [~=*d 15. Licensed Outdoor Area: [7] None PatioorDeck [J Rooftop C Garden/Grounds (1 Freestanding Covered Structure (check all that apply) [[] sidewalk Cafe {_] other (specify): MPREIIVGY iow 1aeuea ti OFFICE USE ONLY © Original © Amended Date 16. List the floor(s) of the building that the establishment is located on: [FIRST 17. List the room number(s) the establishment !s located In within the building, If appropriate: St 2 18. Is the premises located within 500 feet of three or more on-premises liquor establishments? O ves @ No 19. Will the license holder or a manager be physically present within the establishment during ail hours of operation? @® Yes © No 20. If this is a transfer application {an existing licensed business is being purchased) provide the name and serial number of the licensee: CROTON CRAB INC 1297656 Name Serial Number 21, Does the applicant or licensee own the bullding in which the establishment is located? © Yes (if YES, SKIP 23-26) ©)No Owner of the Building in Which the Licensed Establishment is Located 22. Bullding Owner's FullName: /TGL REALTY CO INC 23. Building Owner's Street Address: 179 LINDEN AVENUE Representative or Attorney Representing the Applicant in Connection with the Application for a License to Traffic in Alcohol at the Establishment Identified in this Notice 26. Representative/Attorney's FullName: | JOHN P. VARACHI 27. Representative/Attomey's Street Address: 1445 HAMILTON AVENUE t arn the applicant or licensee holder or a principal of the legat entity that holds or is appiying 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. | understand that representations made in this form will also be relied upon, and that false representations may resuit in disapproval of the application or revocation of the license. By my signature, | affirm - under Penalty of Perjury - that the representations made in this form are true. 31. Printed Principai Name: | PHANINTRA THEUYOO Title: | MANAGING MEMBER lit Ka Principal Signature: