Qo = one 5c No changes on as er OFFICE OF THE CITY CLERK ‘City Hall - Room 202 AD 434-5090 CABARET APPLICATION FINAL DETERMINATION FORM Te (Chief Krokoft— Police Department 1 Pat Jordan- Law Dept a 1D Rich Nicholson ~ Planning 1D Cato Fatomeni~Division of Buiting nd Regulatory Compliance Do Deputy Chief Toomey- Fite Department 1D. Common Council Member: shard Cont From: Nala R Woodard City Clerk Cabaret L.A.X. Restaurant and Lounge Cabaret Address: 203-207 Central Ave Please return this form to the City Clerk in The Ofce ofthe City Clerk ASAP. Copies of these 2015 CABARET APPLICATIONS are in our ofice, Please le ws know if you need a copy for {your records. Ifyou have any questions regarding ths application please contact me or the Applicant diectiy. If there are oustanding issues, which may delay your review, and you cannot proces this aplication within 30 days, please contact me FINAL DETERMINATION: [issuance [E]_ssvance wrriconprions pease explain & provide documentation) [L]_ DENIAL (otease explain & provide documes Explantation& Determinations: Signature Date PLEASE PROVIDE ALL DOCUMENTATION IN ACCORDANCE WITH § 111-69 (C) (2) and (D) (2)CITY OF ALBANY CABARET LICENSE APPLICATION INSTRUCTIONS: This application must be completed in ful, either typed or printed ‘leary, and submitted tothe City Clerk, City Hall, Room 202, by the owner or tenant oF the rope for whic he cabaret lomse is being reqsied. Make all chests payableto tht Cy Albany. ‘This form must be accompanied with copy of the maximum certifnt of occupancy, a ‘copy of the liquor license (if applicable) and documentation stating your Not-For-Profit Status (applicable). Al es for the Iiense are to be collected with the aplication an arenon-refundable, All licenses expire on December 31" of cach calendar year. Iyouave any questions please contact the Offic of City Clerk at (518) 44-5080, APPLICANT: ‘Name of Applicant wine Plans Name ofBsabishment_LAt Restart Zi unbe Telephone Number: (BIV)IRS-SPAT ata Pele @ Horace Address: AOS LARK ST. AUB ALT jzeds om ro) ica) rnp Offices (eet from bss abe. ‘Avion’ Intreat in opr (Check One): Owner (OY Tenant C]- er weay Please lst a agent that is authorize to act on your behalf PROPERTY ‘Name of the Owner: ite Pitan Céntee StvaRE | WC ‘Additional Owmner"s Name(s) Phone #:_(S13) SF5-£53- ‘Additional Owner's Name): Phone Address(es): _S Vex Pointe _Oa-— Location of entertainment indoor/outdoor) iwQoor ‘Total interior square footage (W x1): 20 £36 ‘Expected number of attendees per event(s) (please check one): Eup m1s0 1 1st0300 1 301 v9 500 0 sovormore Number of events: C1 C2 — oeerongpemit —" Etcemed not fonprofit apis 10 events NovFor Profi, please ithe en ates of efor his xlendar year ‘temporary licens, please list th one orto dates of we: Will alcohol be served?” GJ Yee =] No ‘What type of entertainment willbe provided (live band, ise jockey, kainoke, et) i ny? Live Gand , OBC Joctey, Vbetore. iE ote, Hao, What are the proposed hour and days of operation? 7 sh Mon Shit ved 098 hs 0 Bet Mag ab es! Wed 064" ts, 8 et Y ‘Son, ‘What s the proposed numberof employees designated for security, during the hours and days of operntion? Mon_\' te! wot 2 mint 2 wi 3s, 3 se Does the establishment (listed above) have soundproofing? [] Yes DW No eyes, pete dre ‘Does the establishment havé adional eoms tha areused independently? Yes [No tyes, please tthe location of each room: [the undersigned, hereby atest othe accuracy of the information submited herein, and inthe eveat that this application is spproved, I agree to abide by any and all conditions ofthe license and fully snc my ps parang Caps fie Cty City of Albany. ets gersMAXIMUM SUCUPANCY 4U PERSONS iv’ iT) OF ALBAN} * OF BUILDINGS ANE DRY COMPLIANGE |iy of Albany Room 202, Cy Hall ‘Albany, NY 12207 (18) 434-5000 RECEIPT #000070 sarrarota Phan, Wil 205 Lark St. ‘Albany, NY’ 12210 Drivers License Number: Date of Birt NIA Received $ 150.00 for Cabaret License, on 12/12/2014. Thank you for stopping by the City Clerk's office, ‘As always, itis our pleasure to serve you. Nala R, Woodard City Clerk