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faba’: ee ge oa Nochangs fom at yen OFFICE OF THE CITY CLERK City Hall - Room 202 ashe 434-5090 CABARET APPLICATION FINAL DETERMINATION FORM ee — Carlo Fihioment- Division of Building and Regulatory Compliance o ooo Deputy Chief Toomey- Fire Department 1 Common Council Member: Richard Centi From: Nala R Woodard —City Clerk Cabaret Name: OH Bar Cabaret Address: 304 Lark Street Pleas tum this form tothe City Clerk in The Office ofthe City Cetk ASAP. Copies of these 2015 CABARET APPLICATIONs ae in our office, Please let us know if you need copy for Yyour records. I you have any questions regarding this application please contact me or the Applicant drei. If there are outstanding issues, which may delay your review, and you can not proces his application within 30 days, please contact me, FINAL DETERMINATION: [1 ssvance [D]_SsuANcE WrrH CONDITIONS (please explain & provide dacementation) [DENIAL (lense explain & provide docomentation) Explantation& Determinations: Signature Date, PLEASE PROVIDE ALL DOCUMENTATION IN ACCORDANCE WITH § 111-69 (C) (2) and (D) (2) ‘Annual Fee Upto 80 penons $150.00 131300 eons = 20000 3011 30 pens = $300.00 50 mae pesens = $500.00 No Aol $50.00 INSTRUCTIONS: ‘his pplication must be completed in fll, either typed or printed clearly, and submitted tothe City Clerk, City Hall, Room 202, by the owner ot tenast of the property for which the cabaret license is being requested. Make all checks payable to the City of Albany. ‘This form must be accompanied with copy of the maximum certificate of eccupancy, a copy ofthe liquor license (if applicable) and documentation stating your Not-For-Profit ‘Status (if applicable). All ess for the license are to be collected withthe application and ‘are non-refundable, All licenses expire on December 31" of each calendar year. Ifyou have any questions, please contact the Office of City Clenk at (518) 434-5090, APPLICANT: Name ot Appian _ALALED J. firmrang Fe Name of Bstabtishment: C/A SV. ‘Telephone Number: WUS- G00 ___paman_ajtamiane @ Het. ccm Address: ZY Cinch Sr Wi Ban yy N/ (2210 Ge ‘Gop cae) Prineipal Offices i different from busines adress: Applicant's Interest in Property (Check One): Owner £2] Tenant [] Other ay ‘Please list a agent thet i authorize to act on your behalf PROPERTY Nameotite Owner ALFRED TS, Fitracnn, We Peet 336-3765 Additional Owner’s Name(s) Phone Atdrestes: YOQ. Sinfe $7 Mibmy Wi 12203 ‘Total interior square footage (Wxiy_30 KX VGC YE ‘Expected numberof stendees per ovei() (please check one): Avpw1s0 0 istwo300 1 3010500 1D s01cemore Number of events: D1 D2 — B1yestongpemit 1D ticensed not-for-profit —up t0'10 events 1ENot-For Profit, please list the ten dates of use for this calendar year: SS ‘ftemporary Hicenoe, please list he one or two dates of use Willalcoholbeseved?

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