Supporting Documentation · Jan 8, 2025
Exhibit A 2 Filing Application Amendment ECCC 101024
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law CHIESA SHAHINIAN & GIANTOMASI PC 105 Eisenhower Parkway, Roseland, NJ 07068 csglaw.com LISA R. BARATA Ibarata@csglaw.com © 973.530.2343 F 973.325.1501 October 10, 2024 Via FedEx Karen Carnevale Township of West Orange Municipal Clerk 66 Main Street West Orange, New Jersey 07052 Re: _ Essex County Country Club - Application Amendment Plenary Retail Consumption License 0722-33-015-001 Dear Ms. Carnevale: I enclose three original copies of a license application amendment to reflect changes/updates to the following: 1 Page 3, Question 3.5- notation indicates “Golf Course” and “See attached sketch” or clarification. 2: Page 3- Reflect pre-existing patio bar and pool bar areas, with satellite image/photo. 3. Question 10.10 - Amended Authorized registered agent for - Joseph P. Kelly. 4. Update/add office phone number for Page 10A officers, managers, and Board of Governors. Please feel free to contact me with any questions or concerns regarding same. Very truly yours, Lisa R. Carata Lisa R. Barata LRB Enclosures NEW JERSEY NEW YORK 4873-5214-4110.v1
TR#: STATE OF NEW JERSEY DEPARTMENT OF LAW AND PUBLIC SAFETY |g et FEE: DIVISION OF ALCOHOLIC BEVERAGE CONTROL A DATE RETAIL LIQUOR LICENSE APPLICATION STATE ASSIGNED LICENSE NUMBER DATE APPLICATION FILED 0722 «(33 015 001 10, 10 2024 [For DIVISION use only ] CODE TYPE OF LICENSE (CHECK ONE) CLASS C LICENSES [R.S. 33:1-12] THIS APPLICATION IS FOR: [ ] D Action ID Code ] Ww [ U ] 31 Club A New License 32 Plenary Retail Consumption Person-to-Person Transfer w/Broad Package Privilege (Including Partnership change, x except Limited Partnership) KC Plenary Retail Consumption Place-to-Place Transfer 36 Plenaly Retail Consumption (Including expansion of premises) —— “Hotel/Motel Exception) Change of Corporate Structure 37 Plenary Retail Consumption (Theatre Exception) Extension of License be! Executor, Receiver, Administrator, etc.) 35 Seasonal Retail Consumption (November 15 through April 30) Renewal of License 34 Seasonal Retail Consumption X __ Amendment of Application on File —— “(May 1 through November 14) Other 44 Plenary Retail Distribution 43 Limited Retail Distribution OTHER 14 Annual State Permit (R.S. 33:1-42, NJAC 13:2-52) 40 Special Permit for a Golf Facility (NJAC 13:2-5.3) This Area is Reserved for Municipal Use Municipal Fee $. Effective Date / / (As Stated in Resolution. Date of resolution unless otherwise established.) State Fee $. Date Denied A / (As Stated in Resolution) Refund Amount $. Special Conditions Attached: Yes No Type or Print Name (Last Name, First Name, Middle Initial) of Municipal Clerk or ABC Secretary Signature of Municipal Clerk or ABC Secretary
Page 2 PLEASE TYPE OR PRINT ALL INFORMATION 001 STATE ASSIGNED LICENSE NUMBER 0722 _ 33 - O15 - Application is made on behalf of 5 1 = An Individual 2 = Business Corporation 7 = Limited Liability Company 3 =A Partnership 4 = Unincorporated Club 5 = Incorporated Club 6 = Limited Partnership 21 NAME(S) AS IT DOES OR WILL APPEAR ON THE LICENSE CERTIFICATE (NOT “TRADE” NAME) License may be held by Individual (Last Name, First Name, Middle Initial), Partnership or Corporation. Essex County Country Club (Last Name, First Name, Middle Initial or Corporate Name) 2.2 ACTUAL ADDRESS WHERE THE LICENSE IS TO BE USED (SITED PREMISES) Street Address 350 Mt. Pleasant Ave. Number Street Name West Orange : 07052 Municipality Zip - 4 il: Telephone number of business (__973_) 731 . 1400 email Area Exchange Number Jkelly@essexcountycc.com 2.3 ifno licensed premises exists or if a mailing address is different than the “actual address” given above, provide the mailing addres (insert N/A if not applicable): n/a Street Address Number Street Name P.O. Box # Municipality State Zip - Telephone ( ) - 2.4 New Jersey Sales Tax Certificate of Authority No. pe ee2! 0 2.5 TRADE NAME(S) UNDER WHICH BUSINESS IS TO BE CONDUCTED. ALL TRADE NAMES MUST BE LISTED AND REGISTERED WITH THE N.J. SECRETARY OF STATE [if a corporation] OR COUNTY CLERK [if a partnership or sole proprietor]: Essex County Country Club 26 THE FOLLOWING QUESTIONS ARE TO BE ANSWERED BY ALL APPLICANTS OTHER THAN APPLICANTS FOR A NEW LICENSE: A. 1S THE LICENSE ACTIVELY USED AT AN OPERATING PLACE OF BUSINESS? Yes No B. IF NO, GIVE THE DATE THE BUSINESS STOPPED OPERATING (OR THE DATE THE LICENSE WAS ORIGINALLY ISSUED IF NEVER SITED AT AN OPERATING BUSINESS): J / C. IF THE LICENSE IS INACTIVE AND THE APPLICATION IS FOR A TRANSFER, WILL THE LICENSE BE USED AT AN OPERATING PLACE OF BUSINESS AFTER APPROVAL? Yes No 27 THE FOLLOWING QUESTIONS ARE TO BE ANSWERED BY AN APPLICANT FOR A NEW LICENSE: n/a A. WILL THE LICENSE BE USED AT AN OPERATING PLACE OF BUSINESS IMMEDIATELY UPON ISSUANCE? Yes No B. IF NO, PROVIDE ANTICIPATED DATE OF LICENSE ACTIVATION: / i
Page 3 PLEASE TYPE OR PRINT ALL INFORMATION 33 015 001 STATE ASSIGNED LICENSE NUMBER _9722_ e 2 The following questions identify information about the licensed premises. This describes the area or place which is to be licensed for the sale, service, consumption, delivery, receipt or storage of alcoholic beverages. If the license is inactive and NOT SITED AT A PLACE OF BUSINESS, answer question 3.1 only, entering N/A for “not applicable.” [If you use N/A as a response to question 3.1, question 2.2 on Page 2 should also be answered N/A.] 3. 3. 3 | 2 3 34 3. 3. 3. 3. 3. a 6 v4 o © HOW MANY SEPARATE BUILDINGS ARE TO BE INCLUDED UNDER THIS LICENSE? If more than one building is to be included under this license, a separate Page 3 is to be submitted covering each building An up-to-date sketch of the entire licensed premises should be submitted for inclusion in the State ABC license file. BUILDING NO. 1 OF 2 TO BE LICENSED. Clubhouse IS THE ENTIRE BUILDING TO BE LICENSED? Yes x No and patio bar If the answer to question 3.3 is “No,” specify which floors are to be under license and which ones are not by answering the following questions: Basement _X_ Yes ___No Allofit Yes X No 1° floor _X Yes ____No Allofit__X Yes ____No 2" floor _ Xves___No Auofit __XyYes ____No 3" floor ___ Yes No Allofit__—s Yes ___No Specify each additional floor number to be included under this license: If only part of any floor is to be licensed, attach a more detailed explanation with sketches to clearly delineate licensed areas from unlicensed areas. ARE ANY GROUNDS ADJACENT TO THE BUILDING UNDER LICENSE TO BE INCLUDED AS PART OF THE LICENSED PRENISES? Yes No Golf Course. See attached sketch IS THERE ANY UNLICENSED AREA LOCATED BETWEEN BUILDINGS UNDER THIS LICENSE OR BETWEEN LICENSED ADJACENT GROUNDS? Yes X_ No IF THE ANSWER IS “YES,” ATTACH A SKETCH OF THE LICENSED AND UNLICENSED AREAS SHOWING DIMENSIONS IN FEET. DOES THE APPLICANT OWN THE BUILDING? X_Yes No IF “YES,” IS THERE A MORTGAGE ON THE BUILDING? X Yes No DOES THE APPLICANT LEASE THE BUILDING? Yes No if there is a mortgage on the property, answer question 3.8. If the licensed premise is leased, answer question 3.9. MORTGAGEE (HOLDER OF MORTGAGE): TD Bank Name, Fi la Middle Initial or Corporate Name) Street Address 4B BieRaa Wales iray Number Street Name P.O. Box # Municipality __ West Orange
swer question 3.9. MORTGAGEE (HOLDER OF MORTGAGE): TD Bank Name, Fi la Middle Initial or Corporate Name) Street Address 4B BieRaa Wales iray Number Street Name P.O. Box # Municipality __ West Orange state___NJ Zip__ 07052 - LANDLORD (HOLDER OF LEASE) n/a (Last Name, First Name, Middle Initial or Corporate Name) Street Address Number Street Name P.O. Box # Municipality State 4 |
Page 3 STATE ASSIGNED LICENSE NUMBER _9722_- 2 g PLEASE TYPE OR PRINT ALL INFORMATION 33 O15 001 The following questions identify information about the licensed premises. This describes the area or place which is to be licensed for the sale, service, consumption, delivery, receipt or storage of alcoholic beverages. If the license is inactive and NOT SITED AT A PLACE OF BUSINESS, answer question 3.1 only, entering N/A for “not applicable.” [if you use N/A as a response to question 3.1, question 2.2 on Page 2 should also be answered N/A.] 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 HOW MANY SEPARATE BUILDINGS ARE TO BE INCLUDED UNDER THIS LICENSE? If more than one building is to be included under this license, a separate Page 3 is to be submitted covering each building. An up-to-date sketch of the entire licensed premises should be submitted for inclusion in the State ABC license file. BUILDING NO 2 OF 2 TO BE LICENSED. IS THE ENTIRE BUILDING TO BE LICENSED? No If the answer to question 3.3 is “No,” specify which floors are to be under license and which ones are not by answering the following questions: Poolhouse Yes and pool bar area Basement = Yes: "No Allofit__._—s Yes ___—sNo 1* floor ____ Yes ____No Allofit____ Yes ___No 2" floor ____ Yes ___No All of it Yes ____No 3" floor Yes No Allofit____ Yes ___No Specify each additional floor number to be included under this license: If only part of any floor is to be licensed, attach a more detailed explanation with sketches to clearly delineate licensed areas from unlicensed areas. ARE ANY GROUNDS ADJACENT TO THE BUILDING UNDER LICENSE TO BE INCLUDED AS PART OF THE LICENSED FREMSESS Golf Course. See attached sketch. Yes IS THERE ANY UNLICENSED AREA LOCATED BETWEEN BUILDINGS UNDER THIS LICENSE OR BETWEEN LICENSED ADJACENT GROUNDS? Yes X_No IF THE ANSWER IS “YES,” ATTACH A SKETCH OF THE LICENSED AND UNLICENSED AREAS SHOWING DIMENSIONS IN FEET, DOES THE APPLICANT OWN THE BUILDING? X Yes No IF “YES,” IS THERE A MORTGAGE ON THE BUILDING? X Yes No DOES THE APPLICANT LEASE THE BUILDING? Yes No If there is a mortgage on the property, answer question 3.8. If the licensed premise is leased, answer question 3.9. MORTGAGEE (HOLDER OF MORTGAGE): TD Bank (Last Name, First Name, Middle Initial or Corporate Name) Street Address 425 Pleasant Valley Way Number Street Name N P.O. Box # Municipality West Orange
3.9. MORTGAGEE (HOLDER OF MORTGAGE): TD Bank (Last Name, First Name, Middle Initial or Corporate Name) Street Address 425 Pleasant Valley Way Number Street Name N P.O. Box # Municipality West Orange state J Zip 07052 - LANDLORD (HOLDER OF LEASE) n/a (Last Name, First Name, Middle Initial or Corporate Name) Street Address Number Street Name P.O. Box # Municipality State Zip 3
Page 10 PLEASE TYPE OR PRINT ALL INFORMATION STATE ASSIGNED LICENSE NUMBER 9722.33 015__—-_(001 QUESTIONS TO BE ANSWERED BY CORPORATIONS AND LIMITED LIABILITY COMPANIES ONLY. ANY CORPORATION OR LIMITED LIABILITY COMPANY THAT IS REPORTED TO HAVE AN INTEREST IN THE BUSINESS TO BE LICENSED, WHETHER THE LICENSEE COMPANY, THE PARENT CORPORATION OF THE LICENSED COMPANY, HOLDING COMPANY OR OTHERWISE AFFILIATED IN THE CORPORATE CHAIN, MUST ANSWER THE FOLLOWING USING A SEPARATE PAGE 10 AND PAGE 10A FOR EACH CORPORATION. ANSWER QUESTIONS ON BOTH PAGE 10 AND PAGE 10A FOR EACH CORPORATION. 10.1 10.2 10.4 10.9 10.10 10.11 Namie‘of corporation Essex County Country Club 350 Mt. Pleasant Ave. Number Street Name West Orange Street address of home office Municipality State NJ Zip 07052 - 220-895-770/000 NJ Sales Tax Certificate of Authority Number IF CORPORATION ADDRESS IN NUMBER 10.2 ABOVE IS OUT OF STATE, REPORT BELOW THE ADDRESS OF ANY OFFICE LOCATION IN NEW JERSEY. INSERT N/A IF NONE. Street Address nia Number Street Name Municipality New Jersey Ap aS Seer ee x IS THE CORPORATION NOW AN EXISTING, VALID CORPORATION? Yes No DATE CHARTERED OR INCORPORATED __5__y__29__y_1887__ state NJ CERTIFICATE OF INCORPORATION NUMBER 0100063426 IF NOT INCORPORATED UNDER THE LAWS OF NEW JERSEY, HAS THE CORPORATION RECEIVED AN AUTHORIZATION TO CONDUCT BUSINESS IN NEW JERSEY FROM THE NEW JERSEY OFFICE OF THE SECRETARY OF STATE? ___X Yes No n/a HAS THE CORPORATION CHARTER EVER BEEN REVOKED BY THE OFFICE OF THE SECRETARY OF STATE IN NEW JERSEY? Yes No IF THE ANSWER IS “YES,” INSERT THE DATE OF REVOCATION, OR IF SUSPENDED, THE BEGINNING AND ENDING DATE OF THE SUSPENSION. Date of revocation / / Beginning date / 1 Ending date I / INSERT THE NAME AND ADDRESS OF THE REGISTERED OR AUTHORIZED AGENT IN NEW JERSEY UPON WHOM SERVICE OF PROCESS IN ANY PROCEEDINGS AGAINST THE APPLICANT, PURSUANT TO THE NEW JERSEY ALCOHOLIC BEVERAGE LAW, THE ALCOHOLIC BEVERAGE TAX LAW OR PROCEEDINGS IN A STATE OR U.S. DISTRICT COURT, MAY BE MADE. Kelly, Joseph, P. (Last Name, First Name, Middle Initial or Corporation) 350 Mt. Pleasant Ave. Name Street Address Number Street Name estas West Orange Municipality New Jersey Zip 07052. Telephone Number (__973__)_731 -__ 1400 Area Exchange Number IF THE LICENSED COMPANY IS OWNED BY OTHER CORPORATION(S) OR IS INA CORPORATE CHAIN, ATTACH A DIAGRAM
ge Municipality New Jersey Zip 07052. Telephone Number (__973__)_731 -__ 1400 Area Exchange Number IF THE LICENSED COMPANY IS OWNED BY OTHER CORPORATION(S) OR IS INA CORPORATE CHAIN, ATTACH A DIAGRAM DEPICTING THE CORPORATE RELATIONSHIPS AND THE PERCENTAGE OF STOCK INTEREST IN THE COMPANY TO BE LICENSED, OWNED BY OTHER CORPORATIONS OR OTHER NON-CORPORATE ENTITITES (INDIVIDUALS, PARTNERSHIPS, ASSOCIATIONS).
Page 10A PLEASE TYPE OR PRINT ALL INFORMATION STATE ASSIGNED LICENSE NuMBER _0722._ 33. O15 001 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 partners must be submitted as an attachment to this application with an identification of the percentage of each limited partner as it relates to total ownership of the 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 must have been reported on Page 10. Information on this Page, 10A, will identify all officers, directors and stockholders holding one percent or more of the shares of the respective company. Club licenses must list names of officers and directors and attach a current membership list. FXII see eeeeees nee: eek seek Sopa toe * NAME OF CORPORATION OR CLUB COVERED BY THIS PAGE (COMPLETE ONLY IF APPLICANT OR STOCKHOLDER IS A CORPORATION OR PARTNERSHIP): Essex County Country Club Name of individual (last name first), stockholder, partner, officer or director: Trapasso Anthony LastName 169 Rensselaer Rd. First Name Middle Initial Home Street Address Number Pele! Name P.O. Box # Municipatity __P88ex Fells state__NJ sdeepeeareetirreeaey £.: 1769 2 1975 Social Security Number 139 - 60 - Date of Birth ft 4 / Home telephone number (_973__)__ 479 .__ 7363 Area Exchange Number Office telephone number (_973__)_731 -__ 1400 Area Exchange Number % of business owned or controlled Number of shares Check position that applies: Sole owner Partner Stockholder X President Vice-President Secretary Treasurer Director Trustee Manager Agent Executor/Administrator Receiver Beneficiary Other (specify) Name of individual (last name first) , stockholder, partner, officer or director: ponzilli Jason Last Name First Name Middle Initial Home Street Address__210 Smulll Ave. Number Street Name P.O. Box # Municipality _ North Caldwell state__NJ Zip 07006 - - 1977 Social Security Number _ 144 007 8 18G08 Date of Birth 8 ! / Home telephone number ( 973 ) 418 - 3252 Area Exchange Number Office telephone
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- Sep 29, 2026
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