Crestmont ZBA Application Package 72224

Borough of Rseland 3/04/24 11:12 Invoice Poynent Custoner; SCHKO00S Wane: SEHKOLHICK, RICHARD LLE Tnvoices 82400287 BLOCK 174 LOT £.01 Tea 1 10.00 LIST OF PROPERTY OUNERS (C33) ChkB: 28999814995 batch Td: NOH Ref Yun; 17425 Seq: 17 to 1? Cash Aeaunt; 4,00 Check Aeaunts Credit Apaunt: Total:

Must also.Cantact Boroiigh of Raseland 140 Eagle Ree Avenue Roseland, td OFO5S" PSEZG Company Migr. Corp. Prap. &D Park Place T-SB Newark, M87202 Verizon 540 Broad Street Newari, MJ G7102 Hos fin micme ann fei ta ae a os ~~ Cameast Cablevision” inner epee: einem onan a eatin Fone Rance nian 8D0 Rahway Avenue Union, NY 07083 Shade Treé Commission 140. Eagle Rotk Avenue Roseland, NJ O7068 |

TOWNSHIP OF LIVINGSTON CERTIFIED LIST OF PROPERTY OWNERS WITHIN 200 FEET 4 . Block: |” Lot(s): iol 750 Eagle Rock Avenue June 27,2024 The below public utilities and all names on the attached Adjacent Property Listing must be notified ten (10) days in advance of the scheduled hearing date by handing a copy of such notice to each of said owners and acquiring said owner’s signature, OR by certified registered mail (return receipt not necessary). All original signatures and certified mail receipts must. be-returned to the Planning Department along | with the Affidavit of Service of Notice form ten (10) days prior to the scheduled hearing date. : UTILITY COMPANIES TO BE NOTIFIED: - « Township Clerk — 357 S Livingston Avenue, Livingston, NI 07039 » NJ American Water Company ~ 167 JFK Parkway, Sliurt Hills, NJ 07078 » PSE&G Company — Mer, Corp. Properties, 80 Park Plaza, T6B, Newark, NJ 07102 » Jersey Central— PO Box 16001, Reading, PA 19612-6001 « Comeast Cablevision — 800 Rahway Avenue, Union, NJ 07083 » Verizon — 9 Gates Ave, #2, Montclair, NJ 07042 If your property fronts on a County Road and/or a-State highway, notices must be provided to the County and/or State accordingly. if your property borders another municipality, a 200 ft list must be requested Srom that municipality and notices must be provided accordingly.

174 1.01 Subject Property: Block? lots: " Qual: Address(es): 750 Eagle Rock Avenue, West Orange, NJ Date Prepared: June 27, 2024 The data provided has been extracted from the Assessor's current database and is based ‘on the list and map provided. Comments: Subject property in West Orange, NJ. -- 200° List includes Livingston properties only. {Map supplied by Livingston Engineering Department. < 200' list cover page

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| | | nts etamnendts| 2.2 US, sitizen of offer U.S. person { som W=Q (Rev. October 2a1e) Dépadment of the Treasury Informal Revenue Service Request for Taxpayer Identification Number and Certification > Go to www.irs.gov/FormW9 for Instructions and the latest information. Give Form to the requester. Do not gend to the IRS, Crestmont Country Club, Inc. ‘1 Name {as shown on your thcome tax retum), Name is required on this ine; do not leave this line Blank. 2 Business namo/disregarded enilty name, i diferent from above Crestmont Country Club following seven boxes. D1 Inctviduatisote proprietor or CComoration (1) Scorperation singie-member LLG (7 Other (sea instructions) > (CO) United tablity company, Enter the tax classticatlon (C=C corporation, S=$ corporation, P=Partnership) Note: Check the appropriate box n the tine above for he fax classification ofthe single-membor owner. Domnot check | Exemption from FATCA reporting LLG te LLC classed 25a single-ombor LLC hats laragared rom the owner nless the aura of tbe ULC | oer anyh another LLC that Is not disregarded from tha aumer for U.S, federal tax purposes, Otherwise, a single-member LLC tha "7 1s disregarded from the owner should check the appropriate box for the tax classification ofits owner. '& Check appropriate box for federal tax classification of the parson whose name is entered on fine 1. Check only ona of the | 4 Exemptions {codes apply only to certain entities, not incividuais: see Instructions an page 3): 1 Parinerstip =) Trusvestare Exempt payee code {if any) optes i accounss muna outsce me U8) & Address (number, street, and apt. or suite no.) Sce instructions. P.O. Box 358 / 780 Eagte Rock Avenue- Print or type. See Specific Instructions on page 3. Rieguester's nama and address (optional 6 City, state, and ZiP coda West Orange, NJ 07052 7 Uist acceum aumber(e) hara (optional Taxpayer Identification Number (TIN} Enter your TIN in the appropriate box, The TIN provided must match the name given online 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). Howaver, fora resident alien, sole proprietor, or disregarded entity, see the Instructions for Part |, later, For other -| 7 entities, il Is your employer identification number (Eth). If you do not have a number, see How fo geta TIN, later. Note: [f the accountis in more than

Instructions for Part |, later, For other -| 7 entities, il Is your employer identification number (Eth). If you do not have a number, see How fo geta TIN, later. Note: [f the accountis in more than ane name, see the instructions for line 1, Also see What Nartie and Number To Give the Requester for guidelines on whose number to enter, [Social secunty number or Employer identification nur 2/2) -1 1/5) 4/5 ol2ja (EG Certification Under penalties of perjury, t cerlify that: 1. The number showin on this form is my correct taxpayer identification number (or | am waiting for a number to be Issued to me); ancl 2.1.am not subject 10 backup withholding because: (a) ! am exempt from backup withholding, of (b)] have not been notified by the intema{ Revenue ‘Service (IRS) that | am subject te backup withholding as a result of a failure to report all interest or dividends, or (c) tite IRS has netified me that | am no longer subject to backup withholding; and below); and... 4, The FATCA code(s) enterad on this form (if ar licating that | am exempt from FATCA reporting is correct. Gertification Instructions. You must cross oul item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because You have failed to report all interest and dividends on your tax retum. For real estate tranactions, item 2 does nol apply. For mortgage interest paid, acquisition or abandonment of secured property, cancelalign’ct ‘debi, contributions to an individual retirement arrangement (IRA), and generally, payments (0° other than interest and Cividends, you are not requites: in the ceriification, but you must provide your correct TIN. See the instructions for Part #, later. a Sf Sign |. signature of Here | us. person® Dote® SEY Zo 22 General Instructions Section references are ig the Internal Revenue Code unless otherwise noted, Le Future developments. For the latest information about developments related to Form W:3 and ils instructions, such as legislation enacted after they were published, ga to www.irs.gow/FormW9_ Purpose of Form An Individual or entity (Form W-8 requester} who is required to file an information return with the IRS must obtain your correct taxpayer Identification number (TIN) which may be your social security number (SSN, individual taxpayer Identification number (ITIN), adoption taxpayer identification

the IRS must obtain your correct taxpayer Identification number (TIN) which may be your social security number (SSN, individual taxpayer Identification number (ITIN), adoption taxpayer identification number {ATIN), or employer identification number {EIN), to report on an information return the amount paid to you, or other amount reportable on an information return, Examples of information telus include, but are not fimited to, the folowing. » Form 1099-IN7 (interest earned or paid) + Form 1098-DiV (dividends, including those from stocks or mutual furids) ‘# Form 1039-MISG (various types of income, prizes, awards, or gross proceeds) » Form 1099-8 (stock or mutual fund sales and cartain other transactions by brokers) + Form 1099-8 {proceeds from real estate transactions} * Form 1089-K (merchant card anc third party network transactions) ‘* Form 1098 (rome mortgage interest), 1098-E (student Joan interest), 1098-T (tuition) « Form 1089-C (canceled debt) * Form 1099-A (acquisition or abandonment of eacured property) Use Form W-9 only if you are a U.S. person (Including a resident alien), to provide your correct TIN. Hf you do not return Form W-9 to the requesier with a TIN, you might be subject to backup withholding, See What is backup withholding, Jater, Gat. No, 10231% Form W-9 (Rav. 10-2078]

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RESOLUTION Township of West Orange Planning Board PB 23-06 Crestmont Country Club/750 Eagle Rock Avenue Block: 174 Lot: 1.01; Zone: R-2 Decided on July 5, 2023 Memorialized on July 19, 2023 Minor Site Plan Approval WHEREAS, Crestmont Country Club (Hereinafter the “Applicant”) has made an. application for Minor Site Plan approval to construct three (3) pickleball courts adjacent to its tennis courts located at 750 Eagle Rock Avenue, also known as Block: 174 Lot: 1.01, in the R-2 Zone; and WHEREAS, a properly noticed public hearing was conducted on July 5, 2023; and. WHEREAS, the Applicant was represented by Gary Forsher, Esq.; and Engineering, a licensed Civil Engineer in the State of New Ji etsey whose credentials were accepted by the Board; and WHEREAS, the Applicant provided testimony by Dana Cancellaro, General Manager and COO of the Crestmont Country Club; and WHEREAS, the Applicant submitted the following documents to the Board in the form of the application package: WHEREAS, the Applicant provided testimony by Daniel Fryer P.E., of Van Cleef... [ITEM SIGNED BY [DATE/REVISION J