THE CITYMAN HAT59 East 4th Street - NewPhone: (212) 533-5300 -

www.cb3 manhattan.org

York, NY 10003Fax: (212) S33-3659- info@cb3manhattan.org

oTA

F NEW YORKN COMMUNITY BOARD NO. 3

Dominic Pisciotta, Board Chair Susan Stetzer, District Manager

Communitv Board 3 Liquor License Application Questionnaire

Please complete and return (with requested diagram) to the Community Board office by fax or email. Inaddition, bring 6 conies (double sided) plus supportinq material requested to the merfigg. Failure to completeand return this form on time will result in ybur item being placed at the end of the agenda. Anplication mustbe comDlete to be heard. includins netitions and all items on check list below. Use N/A for answer ifappropriate.

Conspicuously display the enclosed posters on the outside of your establishment for 7 days prior to the meeting.Bring a photo with a newspaper showing date as proof of the posting.

./Check which you are applying for: Vn"* liquor license D upgrade of an existing liquor license

fl alteration of an existing liquor license E transfer of an existing liquor license

If applyingbusiness.

for transfer, you must bring letter from current owner confirming that you are buying

Type of license: Is location currently licensed? tr YesANoIf alteration, describe nature of alteration:

Previous or current use of,the location:

Corporation and trade name of current/previous license:

APPLICANT:

Name of applicant and all principals:

N

Trade name (DBA):

Premises address:

Between what gtreets: 'cl€:

PREMISBS:

Type of building and number of floors:

0oo2

/{

r S+ tt/€14",{(

k t 0 NT t *u* Cp nna.ct t7- ntxet, u* !A*BsPrior use of premises: CglnmL fC I *z_.

Revised: June 2011

Any outside area or sidewalk cafe used for the sale or consumption of alcoholic beverage s? (includes roof &yard) Q yes XNo If Yes, describe and show on diagram:

Does premises have a valid Certificate of Occupancy and all appropriate permits? E Yes #xo L t{ODo you plan to apply for Public Assembly permit? E Yes FNo/\Z,oningo:":W;aximumnumberofpersonsthatcanlegallyoccupythe premise r{: ,:bf

$;l(@-Ti;tr Qve^ lou yo.q;;;g" s, ,ro cdf-o /"7ure/ Tffi-G--D[y t,)el*tnf c1 Zeffer of po '"Q1<tb,, .BARS:

How many *stand-up bars/ bar sqats

How many service bars?

Describe all bars (length, shape and location

Any food counters? $y.r tr No [f yes,

PROPOSED METHOD OF OPERATION:

what fype of establishment will this be? (i.e.: restaurant, tavern, sports bar, etc.)

i z_uo Spqfsare located on the premises (and how many seats)? I

o (//u {d

lb,4e

ibe: Fnollt/t/ar qgoua(41\gisrer;,

,l -

* A stand up bar is any bar or counter (whether seating or not) over which urnirnb", of the public can order,pay for and receive an alcoholic beverage.

KITCHEN:

Does premises have u[fuff kitchen or E food preparation area? (If any, show on cliagram)

lsrfood available for.sale?XYes E No If yesr de_scribe type of foo4and submit a rnenu_ rfr ̂1"g,*;lrfu S""fr:;;:;""1"8:;";;))""",;L; j{;4iipslwiesiAes:pkJ

Re srArrx,*

Q^{^tu,,zeoal A: -/a.F/^

WiII

How

will

X\"' tr No

many employees?

there be security personnel? E Yes (lf Yes, how many?)

Do you D have or E plan to install E French doors, E accordion do,of, or E windows? [on" ofthese

Willthere be TV's? E Yes Pfu"

(tf yes, how man5,?) /tffi

I

i,)

Revised: June 2011

Willpremises have music? p=yes tr No

If Yes, what type of music? Explain in detail:

Type of musicTentertainment: E Live musician tr Live DJ E Juke box I Tapes/CDs

, Volume level: FGackground (quiet)D Entertainment level

{t',urror E plan to install sound-proofing? Please describe your sound ,yrte , S O/O5 T

Will you hos! U promoted events, fl scheduled performances or E any event at which a cover fee is charged? /V O

Do you have plans to manage or address vehicular traffic and crowd control on the sidewalk caused by yourlf ooYes" please affach plans.

(ves trNo

El Yes F$"If yes, please indi name of establishment:

Address:

Dates:

lf you answered o'Yes" to the above question, please provide a letter from the community board indicatinghistory of complaints or other comments.

Using the diagram below as an example, attach a separate similar diagram that indicates the location (name andaddress) and total number of establishments selling/serving beer, wine (B/W) or liquor (OP) for 2 blocks ineach direction. Please indicate whether establishments have On-Premises (OP) licenses by circling the letter ondiagram. Please label streets and avenues and identif, your location near the middle of the diagram andindicate it with a [*]. Use the letters to indicate !ar, Restaurant, etc. The diagram must be submitted with thequestionnaire to the Community Board before the meeting.

Bar (B)or)/emExample:

establishment? El Yes

Is this establishment wheel chair accessible.?

Has this corporation or any principal been licensed

How many licensed establishments are within 1 block?

How many licensed establishments are within 500 feet?

How many within 500 feet are On-Premises (Op) liquor licenses?

BRSGBBBRB

B*RSGR[B)BB

Restaurant (R)

onflferw-lfSidewalk Cafe (S)

oe{nrw3'

JXN"

previously?

HotelHLO

BGBS(RIGBRB

BRGSBBBRB

Revised: June 2011

QI!@eFr9/w

If there are block associations or tenant associations in the immediate vicinity of your location, you mustcontact them. Please attach proof (copies of letters and poster) that you have advised these groups of yourapplication. Petitions should clearly state the name, address, license for which you are applying, and thehours and method of operation of your establishment at the top of each page. (,\ttach additional sheets ofpaper as necessary). You may contact the Community Board at info@cb3manhattan.org for any contactinformation that is on file.

INFORMATION REGARDING NEARBY LOCATIONS:

Premises is within a 500 foot radius of three or more establishments with OP license. X\", tr No

Premises is within 200 feet of any school or place of worship? E Yes Ffo"If there is a school place of worship within 200 feet of your premises on the same block, submit a block plotdiagram or area map showing its location in proximity to your applicant premises (8 ll2" x I 1") and indicate thedistance and name and address.

CONTACT INF'ORMATION

Applicant's telephone number: 4t kvin AqnufufVtoa,fl/qContact Name:

Please provide contact information for residents/Community Board and confirm that if complaints are made,you will act immediately to resolve any prciblems.

Contact person , k rin Sotl /h;."1;Address:

,-*uu, Kev in (d ctfto Fo LNotl, rt/,

I hereby certify that the information provided above is truthful and accurate based upon my personalbelief.

Name: CV o1+Signature:

Date: O

rI

hs

Revised: June 2011

t..,':,,,. -f-!t

:i i#t

*1Fr 't- r:j:i:r.j,ti ',:"'',r:.:,,.+ ili,i::+ :.,

=ili;i:+ i;tri:iir,::it:ili:+ lr, ..: ;: ;... 1,11.:.i:1+,. ., : :

I,i!:i.i:ls r.:i:i.:rr:: i.i::::1a / :ii :: -: :":i:ti:i.

:j ii:i:jt:.at,t'.r,::.::,:::i:

*l

ffi,',:14.,

n a.

+s

dd.d.d)co d) d)

(J(JL)YYYJJJ

===uJ uJ uJooooa@(.r)

tdddd.corodl coco cod)d) co lodl ro

U(J(J(JL)\zY\IYVJJJJJ

E====r.u tll uJ ul uJoooooaaaoa

d&.codl.o(J(J:zYJJ

==I,JJ tIJooa(nI.-FFFFFFFFFzzzzzzzz22dddd.ddd.cid.df,ffl=ff==.hFHETEFFFFoaaoataoaav)u.t uJ ut l.ll uJ LU uJ uJ uJ [it d dd dd d. d d d d d. dd.d.d.d.d. d. d. d.d. e.t&d&d.ddd.d.d.d.oooooooooos5 s ssS ssssssssss ss s sstu ul lu uI uJ tu u.I trj trj uJ

====,========F==F===;fi=B=H*fi Bf f fi fi***= fi*=H=m!:hhF F FFF F FFFF F FFFFF F.F F Fl,u Lll LlJ llJ lu Lu tu uJ LlJ Lu IJJ LlJ uJ llJ rJJ iJ u i! ilJ iu irl i.lJ iJJuJ u.J u.l tlJ UJ tlf UJ. l! l! l! 14 l! t! ]U lu uJ t! tU llJ uJ trJ rU t!44ll * d&d d dlll 4 d.d.d.d.e. de a a.hLLE L ht:L h LI:LL !:' FFFFF trtr tr traaoa a |o |./l (/) @ aaa@ a (/)toto(,LD tDirD @ i,IIEI E IIE I -III I IIIEI II I Ihhl: h h hlrh L htLh h FFFFF trtr tr tr$tt$ \,- rJ-<'\t Co (nrr)cf)cf) (o No.lNNN NN N ;ild;i H Hilil il ilTilT d iHilHd ili il Hhthh !: !:h!: !: h'Ll-:l-: h FhhFF FF l- FoUlthAA o(r1 aAUlUl aUl aAAAV, o(/) oLO(/}(r1(,r)!D ,^LDLD ,^Ln ,"Ln9?<<<< '4< ql<<< a< a<<<< '1)< ut<<.<<< ,1,<< 6< ,i <9rJJuJtUur EUJ 0.'uruJlrJ EUJ EutuJuJuJ Etu ou.iu.iu.juiui EuillJ Eur gur

EdOtC)N 'l3t !OCON OOr !(oNNc{ !\O ELr)LOO)Ord !fqi !il E}NElJ){-Cn$ ON !n.rf)$ E$ !ti'fY)(Y) EO O++sf stL !ilrt- Or c+<rnc"tcnm <t <Lor.orn <r"1 <$tt$ <trt <coc"rrnrqrn <sri {Ln <dtU

ogo<7ug.itrEooru

oo=>E<os>i,ctrnoo(u3!lU :0)o 6-!0o -o0t =o LnLELv llls VO rO P.c 9b-c 9trrE!:uCZN O(Jr{ (Er.rJrlZZrlZ>

N rf)o-N o-N(go

==;:o :jo.9b ,9b#6 I^ot o:t)E Utr0f, ofJZ JZ

otro

t

o:>h<o!ALEco tl,

PPooF{ rlEtroruo0,3 i;v >Po .-=! 0,o 4506 * ^={i,g H=Eng 8'u

Ees=EHZZvE!S9;SHE5SgE8

oJ?o

rI?l\EGo,o

vorloE! E

:fr8il= iuv<r0ztr: -e?v3,>-EL96cfiP?o6z

EdFHT(olFdGtZmOlr{

E(,)

siEors(oo>3!Oir>LLOuOO'-Oie3P&Po=oo uxi oP r^HF Yo Yza oO O 4unt O (,

<.t 26aa! dgA 9i.utG -|Jor-o-(L<d)-OtEoE E9evl >t Ek(ouFloJ<<r.uGloru

Zd.rtZZ6=Y'{ZEor c)dN(f) $

o. oHiili o-*C,O(t,E=Eccco Eo Eob .9b .9b^I^!^7 6E r!=c urc Ultrf 0f o:lZ JZ JZ

oEo^ir0

59F,!19nE<EiEO:G!L

orunvvluUtuiD>E<ECrudcrc,(rFf,turu

o *d !{l< !, ruE ?*Hgr0 *o9JP-gE rne9flE QE

9,E2t42,=2tE=<Ftr,.E=il+(o<T.d<<'o}z{.;1 ZYO<YnZ<d

dN(r)$ ra)

o. o-(I,oE=CC::o t:o ';

.9b .9b .99^I^YG= tEF lEl",E ()tr Iof of 0JZ JZ J

lJ)(ol'.@Or OnOdilHH ONN(o(o==

EO EO.9b .9bP6 IAGF G7(JE (Jtro:l of,JZ JZ

(o.N @o.(o

=coEb.9^!7Gtr(J=oZJ

4dddd&.d.d.dd.Io drcodl d) dlco dr d] d). co di di ro

(J(J(JU(J(-)(J(JOL)Y Y Y. Y Y \z \l Y Y YJJJJJJJ]Jf

==========r.lJ llt ru uJ tu UJ lu tu lu iuoooooooooo=uta@6a@ooau.,

|rFFFFFFFFFzzzzzzzzzzdddddddd.d.d.

FflFFFflflflf,Ea@aaoavtoaaur l,lJ ru uJ IIJ ur tu tu uJ tud d. ddd d d.dd d.d d d.d dd.dd.d.d. d.d.d.d.d.d.d.d.Ed.ddil.dd.oooooooooof f-, I l- :) I - f f :) fs ssss sss sss s q ssssLIJ uJ uJ trr rrJ uJ tII uJ uJ uIzzzzzzzzzz

H

===3======E f; E<rB B=<E< E E=F== fr===ecl d) ctctco co coco.o coco co roro cococo co.rididd

FF FF F FF Ful lu uJ uJ llJ tu uI ultu ul u.J Ul UJ uJ ru rIJdd. dd d d.d. dFI.. FI- F FF F,6A tna tD aa toE urII TE T -I EU,I o 3FF FF F FF IX = ZdH dd O Oc) Ol-: q UJlUtUultU [ltUuJ[U

u u*3 a?9 sP a3? aQE s sR shhhhh nhhhhI ELuuJ EuruJ Ellr guuJ EUJ* I E- oa;Jii 0rlrrr! !OO !l'. l\ EN Elr}rn !No) E od Ei-0Oid@ OVO@<-A !On !$$ q$ 1q\OOr !Nff) q Q(f) Eilc)ddOr EclrclrcocOr

o:oe$ou

f3a3+l*!P??tE=OEE

Iiilsiif;f;HIEEElEEEfEEtEeEEi$I:o(Oi,o(toEEEruooruruoruEtrtr>3t>>:roo'oi,ggt,6gggHREECtrtrEEEoooooooa66

E fr;rr f .f; i.E iHE iE E eEE ; H; + ; HE ! q; ; e bH H 6f;f; 68# =H

E,H 8tH E ;E ox =E iH.3.c, P c 9l{ r.c I i <-c I *-c P I ?.c 9H E-c I < 9>< 19 E XH L < 9 i u = ?HE y.EZE5Ekg68668556E>X.tE fi EZtE3d\=ff;EftpS=rtz rtz <a dz

= rz d zu dzZ-. jtzl9 fi iz iz> eZy to

= (J t JZ z tr O Ld

$to '{)N @ oo iN ff) $t/)\oN@ oroiNo. o_N N o.N N o.N oN O o-O O o. o-0 oro (o co co cf, o(f) $ s $(E(oC,(,(I,(I](,(g(!(o

=(n = E = = = =(n = = =-(9 - -(9i5E ;5 ;5 ;5 ;5 ;5 eEEiS ;5 ;5.9bh .9b .9b .90 .9b .9b .9b6.9b .eb .ebf,:= f,€ f€ f: f,: f;: E€if,: H€ H:L,tr^ (Jtr 9c (rtr (,tr (,tr (Jc_lJtr (,tr Otro:1(J o:, o:l of of 0f of,(Jo5 of, o:lJZZ JZ JZ JZ JZ JZ JZZJZ JZ JZ

d.d.ddd.d.cocoto cod)dl dld)roto dr d) co@d) @d)rod! dico(J(JU(JL)t'YYYY:(YJJJJJf

======lU tU IIJ IIJ I,U IJooooooa (n a aa @ a

dco

(JYJ

=TIJoa@

FzdDFatud

dddddd.d.oooooood(r O- a?(L O- O- O- O- (L ayo- (L (L tat t-J (L O- O- O- dO- O- O_ -6_

=d d =db'bbbd Sbbb 5 = b--5 I555 55LlJ UJ llt llt r! uJ ulzzzzzzz==B====E===B H EaE= B HdI co rodr co dt dldl d]co d) dr

LlJ LU llJ IU tU rU

o F F F F F o UJ LlJ tlJ lU lU tlJ o tlJ llJ LlJ o lIJ m lJJ tlJ llJ L,lJ llJ ra Llj LU tU,^ lu

!d(f)@sl'\o Eor(r)i@No !\oo\t !(o !(oF.oroN !r.r)vor Esl-1f,f\\O\O\O\O Eililil.iHil rOOOrOr OO !N\O\ON\O !NNH aoC)<Hntilil <C.lNNC{NN {Nr* <d {rrililil <NNN <N

FFFFFFzzzzzzdddddd

flFflflflF@oaovtotlt lrJ ru uJ ul ItJdddddd. d il dd, dd d dd. d.d.d d.d. d.

99D{rtuoocroLLL!yJtooo.EE.EJYUolYtNrl r{ r{lrtr!trtrEooGEEE!.J+rPr{tGlililr{EtrEoQrtu9uOlUE 9I E El0 ri'i { Ol uJ iUIt :> tlJlt Ad .O

i,E:Eaf;:,8s33,xdE!{l?4eurAEr'==6E=is;ii=ffEi*=gpiE;@OrOtN m+Lr} \O

O[n Ln \() \O \o. O\O (o \O O.@o(,o===cccEo Eo Eooh ot o!.!u.-u.-uE€ E€ f,€trc L,tr (Jtr

0f 0:r ofJZ JZ JZ

PooL*,o?uddEtroPalr{co-q g

llIJ ,59 tfr3 -a;q6< fi6=E g o-^-JOrz.=<F(Uf

E=id(JdE:oO{--.r)o<z (JTuJ<ZY

YIoc)ooLLPPoo.cEY ,*tlYlNr,l ilt.ttrEGO??-9!iGldr{ccoF{{,oll0,3 = X ==a, rr' (-) Ei.O urilZco !rOrr P(,pu-Zec, IhS*doat?,LIFi?h=dEioinurlYdigJEHEirEi

@ o.r ().r C{ (f)o$ $ to L [r) tn(o:

ooototco

-oo=E>5^0tZL

9 =U fiE Xg rr<8,5i3$?vE*.dzIr\,1 9yf,3ff1

co$l.n(oNo$ d'\t t $(E

=c::oo!rE79tro:,JZ

Noho=c:jo

.9brE=UtrofJZ

.9brE7(rtrolJZ

;ioo!G;tJEofJZ

+l.n(oorn lJ) LD

o=

ddd,d.d.@co dldld) co d) co cctlo

UU(J(JL.,YY\zV\zJJJJ]

=====IIJ IIJ I.U IU I.U(]0000(,,a@vt(,(na

d.

toloco(JYJ

=IUovlFFFFFFzzzzzzEd.,dddd

FFF<FflF,aatnaalnrJJ UJ rJJ uJ uJ u,ldddddddd. d.d.d d. d. d. d.d. d4d.d.d.d.dgooooof - - I - = f f

=sqq q ? s55 g g gS gs-ioo o :I.,IJ I.IJ IJJ tU IIJ II.llzzzzz

H

======B === = B== B B B BdI d)dtco d) cod)ro dl co co (o

@cocococoro.o rorocodld! u (J

s>'EY99Eg 899999 s s sE sEalo@(o$Norr.r) !\t@@c!o E ! 1f!n !Hlqot@@@@F\N gN(c)\o(c)ro If, ! Eo !N

9YD-P!lu(,oarrtuoEEEEESu9ugDEool,(,)l,li,.Ea,E.crE+,v---Fr{OFti{r{Od!lr{ildrltttEltrEEEEEEooGoooJtrE.c.EtE+l+.1+t--Nr{tt|YlNrlrldi;;i;EtrtrEEEqrotlJoooo!, !, !!o o o o oI i 92 t t i i d.

€ L o E Oy 5 n n 5 ;

csx$eHrsrEsfrfil*-EsEsEsE*sr\QOrC)dN(n sltO\ONd (\ (r)

O.@0tor\r\NN ONNNNN O O. ON O.No(I,ooooE = EU) 2a = =c = e(9 c(9 c -;o ;5 iSErO=u6 ad.9b .9H EIE€EEEE EEEE fi: Ets=EE1EE E€o? dS t5oor(Jof, orJz JZ . JZZJZZJZ JZ