Supporting Documentation · Dec 4, 2024
Filing Letter to Board in Response to M Bennett Email with Exhibits 12 02 2024
8d6c31704941a25307d37c2154a0f8bc3a4cd3522ed1b8e13d7965a5bb610530Indexed text
ge Number ) Number ol shares Stockholder Partner Treasurer Director Vice-Presidenl Secretary Receive. Agent Executor/Administrator Manager - 7o of business owoed or conlrolled Check position that applies; E - President Trustee Bene,iciary- . - Sole owner Olher (specily) - - - - -
Page'10.\ PLEASE TYPE OR PFIINT ALL INFOFIMATION STATE ASSIGNED LICENSE NUMBEF 2020 33.027._!Er. ALL APPLICANTS ANSWER THE FOLLOWING IADD PAGES AS NECESSARY] SOLE OWNEFS AND PARTNEHSHIPS: Complete the page in full. LIMITED PARTNEHSHIP: AII inlormation about a geneial partner or parlners ol a limiteq partnership must be reported, whether the general parlner is an individual or a corporalion. A list ol the names and addresses ol all limited partners must be submilted as an atlachment lo this applicalion with an idenlitication of the percentage of each llmited partner as it relates lo total ownership ol the business entity to be licensed. CORPORATIONS: All corporatlon applicants or licensees and any corporation that has an ownership inleresl in the corporation under license or to bs licensed must have been reporled on page 10. lntormation on this page, '10A, willidentify all otflcers, dlrectors, and stockholders holding one percent or more of the shares of the respective company. Club licenses must list names ol officers and directors and attach a currenl membership llst. ** * *lr*** *** * * ** * * ************ **** ** **** ** **** *************** ***********:t NAME OF CORPORATION OR CLUB COVEBED BY THIS PAGE (COMPLETE ONLY IF APPLICANT OR STOCKHOLDER IS A CORPORATION OR PARTNERSHIP). Echo La TO AIJI) Name ol ifrdividual (lasl name first), stockholder, pSrtner:, gfficer or director: Molowa David Middle loilial Last Name Home Street Address Number P.O. Box 7i^ # State M unicipality Date ol Social Security number - 6irth Home lelephone number Area Exchange Number Exchange Number Olfice telephone number Number of shares o/o of business owned or conirolled Partner Stockholder Ireasurer Direclor Secretary - Sole owner Check position Ihat applies: President Vice-President Truslee Agent IL Manager (specily) Beneficiary Other - Name ol indiviCual (lasl narne firsl): Executor/Administrator - Receiver TO ADD David Lt-e berman Middle lnitlai Last Nam6 Home SIreet Address Number P.O. Box # ,,^ _ Municipality State Date of birth Social Security n umber (_) Home telephone number Exchange Number Exchange Number Ollice lelephone number Number of shargs o/o of business own€d or controlled Check position lfrat
e of birth Social Security n umber (_) Home telephone number Exchange Number Exchange Number Ollice lelephone number Number of shargs o/o of business own€d or controlled Check position lfrat applies: Stockholder Partner Director Secretary Treasu.er Vice-President Receiver Agent Executor/Administralor Manager - Presidenl Ia - Trustee - Bene,iciary -. - Sole owner Olher (specify) - - - - -
Page 10A LEASE rypE oR pBrNT ALL INFoBMATIoN srArE ASSTGNED LlcENsE NUMBEFT 202Q 33 - 027_i0l. ALL APPLICANTS ANSWER THE FOLLOWING IADD PAGES AS NECESSAFIY] SOLE OWNERS AND PARTNEHSHIPS: Complete the page in lull. LIMITED PARTNERSHIP: All iolormalion aboul a geneial parlner or partners ol a limited pa.tnership must be reported, whether the general parlner is an individual or a corporalion. A list ol the names and addresses o, all limiied parlners must be submjtted as an altachment to this applicalion wilh an identi,icalion of the percenlage ot each limited partner as il relates to total ownership of the business entity to be licensed. COFIPOBATIONS: All corporation applicanls or licensees and any corporation that has an ownership interesl in the corporation under license or to be licensed musl have been reported on page 10. lntormation on this page, 10A. willidentily all oflicers, directors, and siockholde.s holding one percent or more of the shares ol the respective company. Club licenses must list names of officers and directors and attach a current membership lisl. **i*********************************************************tt********** NAME OF COBPORATION OR CLUB COVEFiED BY THIS PAGE {COMPLETE ONLY IF APPLICANT OR STOCKHOLDEF IS A CORPOBATION OR PARTNERSHIP). Echo Lake Countrv Club TO TDD Name of individual (last name first), stockholder, partler, o-ttiCe. or director E. Davld Nowicki Middle hilial Lasl Name Home Street Address Number P.O. Box # State M unicipality zip Date ol birlh Social Securily number Home lelephone number Number Exchange Oflice telephone number o/o Area Erchanqe Number Number of shares ot business owned or controlled Pa(lner Stockholder Treasurer Director Secrelary - Sole owner Check posilion that applies: Vice-President -X- President Agent 4L Trustee - Manager (speci,y) Beneliciary Other - Executor/Administralor - Receiver - - TO ADD Name ol individual {lasl name tirsl) Last Name - Middle hilial Firsl Home Streel Address SIreel Name Number P.O. Box # State M unicipality Zip Dale of birth Social Security num ber - Home telephone number --- Exchange Oftice telephone num ber ) Exchange Number Number of shares ot business owned or controlled Stockholder Partner Sole owner Check position lhat
ity num ber - Home telephone number --- Exchange Oftice telephone num ber ) Exchange Number Number of shares ot business owned or controlled Stockholder Partner Sole owner Check position lhat applies: Treasurer Direclor Secretary Presidenl Vice-President Receiver Executor/Administralor Agent IL - T.ustee - Manager Beneliciary OIher (specify) - o/o - -
Page 10A . 2Pd{r6sE STATE ASSIGNED LICENSE NUI\,4BER lPj: oR Pt!}ALL rUbTMAroN ALL APPLICANTS ANSWER THE FOLLOWING [ADD PAGES AS NECESSARY] SOLE OWNERS AND PARTNERSHIPS: Complete this page in full LIMITED PARTNERSHIPS: All information about a general partner or partners of a limited partnership must be reported, whether the general partner is an individual or a corporation. A list of the names and addresses of all limited parlners must be submitted as an attachment to this application with an identification ofthe percentage ofeach limited partneras it relates to total o!,vnership ofthe business entity to be licensed. CORPORATIONS: All corporation applicants or licensees and any corporation that has an ownership interest in the corporation under license or to be licensed musl have been reported on Page '10. lnformation on this Page, 10A, will identiry all officers, directors and stockholders holding one percentormore ofthe shares ofthe respective company. Club licenses must lisl namesofofficers and directors and attach a current membeFship list. TO ADD t*+***++****!t**+******++*****************************************t*t****************************+++t+***********t NAME OF CORPORATION OR CLUB COVERED BY THIS PAGE (COMPLETE ONLY IF APPLICANT OR STOCKHOLDER IS A CORPORATION oR PARTNFRSHIP), l0 ADD Name of individual (last name tirst), stockholder, partner, officer or direclor Meus Richard Last Name Middle lnitial Home Streel Address Number P.O.Box#_ Street Name Municipality State E-Mail Address zip Date of Birt Social Security Numbe Home telephone number - office telephone nu.u", Area 7o of business owned or controlled _ _ President _ _;91_Trustee _ _ Beneficiary _ Check position that applies: Number 0' Sole owner Vice-President Manager Number of shares _ _ _ 0 Partner Stockholder Secretary Treasurer Darector Agent Executor/Adminislrator Receiver Other (speciry) Name of individual (last name first) , stockholder, partner, officer or director: Walsh Michae I Middle lnitial Last Name Home Street Address Street Name Number P.O. Box # Stat Municipality E-MailAddress zip Social Security Num6g Date of Birt Home telephone number Area Offlce telephone number ( _ ) Area Exchange Number Exchange Number Check position that applies. _ Number of shares 0 0 70 of business owned or controlled Sole
t Home telephone number Area Offlce telephone number ( _ ) Area Exchange Number Exchange Number Check position that applies. _ Number of shares 0 0 70 of business owned or controlled Sole owner Vice-Presidenl President _ _ xx Trustee _ Manager Beneficiary _-:-__ Other (specify) _ _ _ _ Partner Secretary Agent _ _ Stockholder Treasurer Director Executor/Administrator Receiver
Page 'l PLEASE TYPE OR PRINT ALL INFORMATION 1 STATE ASSIGNED LICENSE NUMBER 2O2O LICENSE PERIOD APPLIED FOR State - 33 027 FRoM 20L2 OOI AFFIDAVIT 20L3 TO DATE: May 15, 2012 New Jerse of SS: County of TTn i on As provided by law (R.S. 33:1-35), (Check One) 1. The lndividual Applicant 2. Members ofthe Partnership Applicant a. David E. Nowicki Echo Lake Country Club of (PresidentIffi5tstr$I$if (corporation or club Name) consent(s) that the lic€nsed premises and all portions ofthe building constituting the licensed premises, including allrooms, cellars, closets, out-buildings, passageways, vaults, yards, attics and every part of the structure of which the licensed premises are a parl and all buildings used in connectlon therewith which are in his/her/their possession or under his/her/lheir control, may be inspected and searched without wanant at all hours by the Director of the Division of Alcoholic Beverage Control, his or her duly authorized deputies, inspectors or investigators and all other sworn law enforcement offcers, and being duly sworn according to law, upon his,/her/their oath(s), depose(s) and say(s) that he/she is (they are) the person(s) duly authorized to sign the application, that in instance of corporale ownership, the signator is authorized by corporate resolution to sign on behalf of the corporations: and that the contents of this application represent complete disclosure of the fact, and that the contents of this application are true. (Signature of lndividualAgent / Sole Proprietor) (Corporalions Only) Attestation by Corporate Secretary (Partnership Name) (Signature of Parlner) ilcho Lake Country Club Attest Co S"orr^yfu'A^ _ (Signature of Partner) me By (Signature of Corporale President (Signature of Partneo Signatuo/ (Signature of Partner) Jqffix Corporate Seal Sworn lo and subscribed before me this 5rh day of May 20 l2 AFFIDAVIT MUST BE SIGNED HERE -.--.-_--.---> atuie of Officer Administering Oath) BY DULY AUTHORIZED NOTARY PUBLIC OR AN ATTORNEY-AT.LAW OF NEW JERSEY Ke therine Rose (Printed Name of Officer Administering Oath) Uontroller (fitle of Ofiicer Administering Oath) N KATHEBINE BOSE Public, State of New Jersey (Date Commis{glffipt 2
State of New Jersey Department of Law and Public Safety Division of Alcoholic Beverage Control PO Box 087, Trenton, NJ 08625-0087 Amendment Application Summary - Person to Person Transfer - Retail Licenses File Number: 551211 License Number: 1802-33-005-012 Created By: Anna Perna Date Submitted: Apr 08, 2022 Fee Amount: $0.00 Fees Paid: $0.00 Licensee Information Previously Licensee: Mailing Address: Physical Address: Preferred Contact: Corporation Number: Incorporation Date: NJ Tax Auth Number: HGC BASKING RIDGE LLC 13873 PARK CENTER ROAD SUITE #203N HERNADON, VA 20171 USA Establishment Information DH OF BASKING RIDGE LLC 185 MADISONVILLE ROAD BASKING RIDGE, NJ 07920 USA 185 MADISONVILLE ROAD BASKING RIDGE, NJ 07920 USA Previously Establishment Type: DBA / Trade Names: Operator: Contact Name: Business Phone: Home Phone: Mobile Phone: Email: Mailing Address: Physical Address: Consumption BASKING RIDGE COUNTRY CLUB HGC BASKING RIDGE LLC HGC BASKING RIDGE LLC (908) 766-8200 13873 PARK CENTER ROAD SUITE #203N HERNADON, VA 20171 USA 185 MADISONVILLE ROAD BASKING RIDGE, NJ 07920 USA Preferred Contact Method: Mail Plenary Retail Consumption License DELICIOUS HEIGHTS OUTPOST DH OF BASKING RIDGE LLC DH OF BASKING RIDGE LLC (908) 953-9092 185 MADISONVILLE ROAD BASKING RIDGE, NJ 07920 USA
State of New Jersey Amendment Application Summary - Department of Law and Public Safety Person to Person Transfer - Retail Division of Alcoholic Beverage Control . PO Box 087, Trenton, NJ 08625-0087 Licenses File Number: 551211 License Number: 1802-33-005-012 Created By: Anna Perna Date Submitted: Apr 08, 2022 Fee Amount: $0.00 Fees Paid: $0.00 License Information Previously License Type: Plenary Retail Consumption License License Type Code: 33 License Number: 1802-33-005-012 1802-33-005-011 Term: 09/30/2022 - 06/30/2023 07/01/2022 - 06/30/2023 County: 18 - SOMERSET COUNTY Municipality: 02 - BERNARDS TOWNSHIP Expiration Date: 06/30/2023 Effective Date: 09/30/2022 07/01/2022 Issue Date: 10/04/2022 Last Major Application Questions 1: IS THIS LICENSE BEING ACTIVELY USED AT AN ACTUAL PREMISE? [v/Yes [_]No DOES THE APPLICANT OR ANY OTHER PERSON MENTIONED IN THIS APPLICATION, OR ANY PERSON HAVING A BENEFICIAL INTEREST IN THE LICENSED BUSINESS, HOLD OFFICE IN THE UNIT OF GOVERNMENT ISSUING THE LICENSE? (Cyes [¥|No IN THE PAST 12 MONTHS, HAVE YOU ENTERED INTO AN AGREEMENT IN WHICH YOU OFFERED THE LICENSE OR ANY FINANCIAL INTEREST IN THE LICENSE AS COLLATERAL OR SECURITY TO A PERSON OR ENTITY NOT NAMED IN THE APPLICATION. LlYes [vINo IN THE PAST 12 MONTHS, HAS THE LICENSEE BEEN NAMED AS A PARTY TO A LAWSUIT, ARISING FROM CONDUCT IN NEW JERSEY, THAT HAS NOT BEEN DISMISSED AND IN WHICH IT IS ALLEGED THAT THE LICENSEE SERVED AN INTOXICATAED PATRON? LlYes [¥JNo
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- Sep 29, 2026
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