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Application For Alcoholic Beverage Control Retail License (On Premises) Instructions Form. This is a New York form and can be use in Division Of Alcoholic Beverage Control Statewide.
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INSTRUCTIONS FOR ON-PREMISES LIQUOR RETAIL APPLICATION
Mail the application to:
New York State Liquor Authority
Church Street Station
P.O. Box 3817
New York, NY 10008-3817
PLEASE READ THE INSTRUCTIONS CAREFULLY BEFORE COMPLETING THE APPLICATION.
APPLICATIONS MAY NOT BE HANDWRITTEN - THE APPLICATION CAN BE COMPLETED ON OUR
WEBSITE AND THEN DOWNLOADED FOR SUBMISSION TO THE AUTHORITY.
The following material has been prepared to assist you, the applicant, in developing and filing a completed application
which will result in the approval and issuance of the type of license you desire. It is important to understand that it is
your responsibility to present a clear explanation of what you intend to do and how you will accomplish this.
Incomplete applications may be disapproved. Please make sure you read the instructions carefully, answer every
question and submit any documentation required to support your application.
IMPORTANT: Statutory Disqualification:
The following are Statutory Disqualifications to
holding an alcoholic beverage retail license under
the A.B.C. Law:
1. Under the age of 21;
2. Not U.S. citizens or aliens admitted to the
U.S. for permanent lawful residence;
3. Convicted of any felony, promoting or
permitting prostitution, sale of liquor
without an alcoholic beverage license;
4. Police officers/police officials;
5. A person whose liquor license was
revoked;
or
6. A person who has a wholesale license.
If any apply to you, identify and explain in sections
marked Statutory Disqualification under lines 9 or
10.
APPLICATION
Line 1
APPLICANT NAME
• Enter sole proprietor’s full name.
• If a partnership, enter full name of each partner.
• If a corporation, enter the corporate name.
• If a limited liability company or limited
partnership, enter the company name.
• IMPORTANT: Enter telephone number of
premises or a telephone number where we can
contact you, the applicant, not your
attorney or representative.
TRADE NAME
• Enter your DBA – “Doing Business As” name.
You MUST enter a trade name if you are to
be known by any other name other than what
is listed in APPLICANT NAME. This is the name
that your business is known by – the name that
appears on your building.
PREMISES STREET
• Enter the full address and county of the
premises you are seeking to license (911 street
address where applicable).
• Premises mailing address, if different than above.
• E-mail address, if available.
Line 2
ATTORNEY/REPRESENTATIVE CONTACT NAME
• Enter the name, address and telephone number of
the attorney, representative or contact person for the
completion, filing and handling of this application
(and email address, if available).
BE ADVISED THAT NOTICES OF
INCOMPLETE APPLICATIONS WILL BE
MAILED TO THE APPLICANT AS WELL AS
THE ATTORNEY OR REPRESENTATIVE, IF
APPLICABLE. YOU, THE APPLICANT, ARE
ULTIMATELY RESPONSIBLE FOR THE
INFORMATION PROVIDED IN THE
APPLICATION.
Line 3
FOR SEASONAL LICENSES ONLY
• Provide the months that the sought for license
will begin and end, in that order.
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•
See fee schedule for beginning and ending months
allowed for summer and winter seasonal licenses.
not being transferred, a statement, signed by the
seller, must be submitted.
Line 4
ALCOHOLIC BEVERAGE LICENSE TYPE
• Refer to the Schedule of Retail License Fees for the
license class and code number and enter these in the
spaces on line 4.
Line 7
• If applying as a sole proprietor, enter your Social
Security Number. Others list Federal Identification
Number. This is obtained from the Internal Revenue
Service. If applied for and pending, so indicate.
Line 5
ADDITIONAL BARS
• Enter the number of additional bars, if any.
• A stand up bar is any bar, counter or contrivance
(whether there is seating or not) over which a
member of the public can order, pay for and receive
an alcoholic beverage. Each stand up bar requires
its own license. A service bar is for waiter/waitress
service only, for people seated at tables.
Line 7a
• All applicants are required to obtain a Certificate of
Authority to Collect Sales Tax from the NYS
Department of Taxation & Finance. The permit
number that appears on your certificate is to be
reflected in the box provided.
Line 6
TOTAL PAYMENT DUE
• Refer to the Schedule of Retail License Fees for the
specific license fee and complete the following fee
payment work sheet.
FEE PAYMENT WORKSHEET
1. License Fee
$________________
(columns 4-7)
2. Filing Fee
(column 8)
3. Additional Bars (if any)
(stand up bars only)
________ x __________
# of bars
license fee
4. Additional Bar Filing Fee
$20 x # of bars
+________________
+________________
+________________
TOTAL PAYMENT DUE
=________________
(sum of lines 1-4 above)
(Enter this number on application LINE 6)
•
•
•
Attach a personal check, certified check or money
order payable to the New York State Liquor
Authority for the total payment due.
TEMPORARY RETAIL PERMIT FEE ($640)
MUST BE A SEPARATE CHECK. If you are
located in the City of New York, you may only
apply for this permit if purchasing an existing
establishment from a current licensee.
LIQUIDATOR’S PERMIT FEE ($36) MUST BE
A SEPARATE CHECK. A Liquidator’s Permit is
required if there is a transfer of alcoholic beverages
from seller to purchaser. If alcoholic beverages are
Line 8
• If the proposed premises are outside of the city of
New York, are there any restrictions on the sale of
alcoholic beverages?
• Check with your city, town or village clerk to
determine if there are any restrictions that may apply
to the sale of alcoholic beverages and list same.
Line 9
SOLE PROPRIETOR, PARTNERSHIP AND
LIMITED LIABILITY PARTNERSHIP (LLP)
• Enter the name, residence address, social security
number and date of birth of the applicant(s).
• If 10 or less partners, list all. If more than 10
partners, see instructions for “more than 10” in line
10 below.
• List all partners and provide proof of citizenship or
alien status, personal questionnaires, copy of photo
identification, an original color photo (passport size)
and fingerprints on all.
Line 9a
• Enter the name, residence address, social security
number and date of birth of the manager of your
business, if applicable.
Line 10
CORPORATIONS AND LIMITED LIABILITY
COMPANIES (LLC)
• Enter names, residence address, social security
number and date of birth of stockholders, officers,
directors, (If LLC, members and managing
members), if any, as follows:
- If 10 or less shareholders, list all stockholders,
officers, directors, members and managers, if
any, and provide personal questionnaires, proof
of citizenship or alien status, copy of photo
identification, original color photo (passport
size) and fingerprints for all.
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-
•
If more than 10 shareholders, list all
shareholders owning 10% or more of any class
of its shares, and provide personal
questionnaires, proof of citizenship or alien
status, copy of photo identification, original
color photo (passport size) and fingerprints for
those individual. List all officers, directors,
members and managers, if any, (and provide
personal questionnaires, proof of citizenship or
alien status, copy of photo identification,
original color photo (passport size) and
fingerprints for all active in management of
business. Provide listing including name,
address, citizenship and any statutory
disqualification for all others having any
interest.
For Publicly Traded Corporations, provide copy
of annual report listing all officers, directors and
financial statement.
Line 10a
•
Enter the name, residence address, social security
number and date of birth of the manager of your
business, if applicable.
RIGHT TO PREMISES
• Check the appropriate box disclosing how you are in
possession of the premises (own, lease, etc).
• If you own the premises you must supply the deed.
If you have purchased the real property within the
past year, you are required to provide documentation
showing the source of the funds used for the
purchase.
• If you are leasing the premises you must submit a
signed copy of the lease or a letter of intent. The
letter of intent must list the intended term and rent
amount. The lease MUST run for the FULL term of
the license or be renewable for at the least the full
term.
• Answer all questions here regarding the lease
arrangements. NOTE: The lease must state the
EXACT location of the premises in the
building.
INTERESTED PARTIES
• Check YES if there is a license already in effect for
the premises in which the applicant is seeking a
license and state the name of the licensee and license
serial number.
• IT IS STRONGLY SUGGESTED THAT YOU
CONTACT THE STATE LIQUOR
AUTHORITY BEFORE YOU FILE AN
APPLICATION TO DETERMINE IF THERE
ARE ANY DISCIPLINARY ACTIONS
PENDING THAT MAY EITHER DELAY OR
PREVENT THE ISSUANCE OF A LICENSE
AT THE PROPOSED PREMISES. . PLEASE
BE AWARE THAT WE MAY NOT DISCLOSE
A PENDING INVESTIGATION AT A
LOCATION.
• List any person or entity that will share in a
percentage of profits or losses of the business.
• List any interest you, the applicant, have in a
premises or business where any alcoholic
beverages are manufactured or sold at wholesale
or retail.
LANDLORD IDENTIFICATION
• All applicants are required to have the owner of
the property (landlord) where the proposed
premises is to be located complete this Section.
(If YOU own the property YOU must complete
this section as landlord.) All questions must be
answered accurately and completely. All
individuals or principals of the landlord
corporation must be listed on this form.
• If you own the property under a name other than
the name you are applying for license under, you
are required to submit a lease between both
entities.
LIST OF EXPENSES
• List the amount of money spent (or intended to
be spent) for each item listed on this page.
• If the real property has been purchased by the
principals of the LLC or Corporation under a
different entity name, a separate List of
Expenses should be completed by that entity.
• Identify ALL sources of funds. This includes
cash and deferred funds as follows: savings,
checking, stock, business accounts, property,
gifts or loans, etc.
• Provide bank statement(s) that show you have
sufficient funds for this venture. If any finances
have already been expended, provide statements
to reflect you had the funds at that time.
• For personal bank accounts provide an
explanation for any deposits over $10,000.
• Personal questionnaires are required on all
lenders, donors, giftors and all persons listed on
bank accounts that the funds will be withdrawn
from. The applicant must account for and
document the source of all funds invested in the
proposed business or premises.
• Loan agreements are required (even if the loan is
between family members) for every loan
showing the terms of the loan and default
clauses. If the money is gifted from anyone other
than a spouse, a letter stating the finances are a
gift must be provided.
• You are not limited to the above. Submit any
and all records, documents and/or affidavits that
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may assist you in explaining your financing,
background and operation of the applied business.
Attach additional sheets and explanations, if
necessary. More information may be required if
deemed necessary to process the application.
STATEMENT OF AREA PLAN
• When completing this section, please be aware that
whether or not the premises is within 200’ of a
school, church or place of worship, you MUST also
identify the name and distance of the CLOSEST
school, church or place of worship within 300’ of
the proposed premises.
• If you ARE within 200’ of a school, church or
place of worship, you must answer the question
“YES” regardless of whether or not you believe
it is being used exclusively as a school, church
or place of worship. The Authority will make
this determination and advise you accordingly.
• The measurement from the school, church or place
of worship are to be taken in a straight line from the
center of the nearest entrance to the school, church
or place of worship to the center of the nearest
entrance of the premises to be licensed. If the
school, church or place of worship is set back from a
public thoroughfare, the walkway or stairs leading to
any such door shall be deemed an entrance and the
measurement must be taken from the center of the
walkway or stairs where it meets the building line or
public thoroughfare. Entrances are considered any
door used to give ingress to students of the school,
the general public attending the place of worship
and to patrons or guests of the proposed premises to
be licensed. Doors with no exterior hardware are not
considered an entrance.
incomplete answer may delay or prevent the
processing of the application.
• In this section you must describe the premises to
be licensed.
• Indicate if an outdoor area is to be used for the
sale or consumption of alcoholic beverages and
submit appropriate permits, if required. This
includes patios, roofs, yards and decks. Show
how the area will be contained and submit a
statement detailing how the area will be
supervised.
• Submit a copy of a valid certificate of
occupancy (or a letter from the municipality
stating one is not needed). The Certificate of
Occupancy must list the appropriate use.
Indicate whether all other appropriate
permits have been applied for and received.
• You must indicate what floor(s) the licensed
premises will be located on and answer all
questions pertaining to the interior of the
premises to be licensed including what each
room in the premises to be licensed will be used
for; access between floors; number of persons
legally allowed in the licensed premises; the
number of and description of all stand up bars or
service bars (see the instructions under “Line 5”
on the 2nd page of the instructions for definition
of stand up and service bars); whether there is a
kitchen or food preparation area. You must
submit a menu with your application.
• If there is interior access from the floor(s) you
are licensing to any other floor(s) of the building
(whether or not you are licensing those floor(s)),
you MUST describe the means of access (ie.
stairs, elevator) and state what occupies the
other floor(s) (ie. apartments, offices). If you are
using the basement or another floor(s) of the
building to store alcoholic beverages, that area
must be included as part of the licensed
premises. If there is no interior access to the
storage area from the floor(s) you propose to
license, you must file for a Warehouse Permit
(this application is available on our website).
Please make sure to answer this question
accurately on the Establishment Questionnaire to
avoid any confusion or delays in processing your
application.
HELPFUL HINT: You may find it easier to
prepare your diagram of the premises prior
to completing this section….seeing the layout
of the premises may help you in answering
the questions.
ESTABLISHMENT QUESTIONNAIRE
• Answer ALL questions completely. Please do not
answer “see attached” to any question. Any
METHOD OF OPERATION
• Answer ALL questions completely. The
information provided in this section will be the
500’ RULE
• This section MUST be completed by all
applicants for an On-Premises Liquor License. If
you answered YES to the question asking if there
are three or more premises with on-premises
liquor licenses within 500’ of the proposed
premises, YOU MUST EXPLAIN IN WRITING,
IN DETAIL, WHY GRANTING OF THE
LICENSE APPLIED FOR WOULD BE IN THE
PUBLIC INTERES, NOT HOW IT WOUOLD BE
IN THE APPLICANT’S INTEREST. IF
APPLICABLE, YOU MUST ALSO PROVIDE
THE NAMES AND ADDRESSES OF THE
BUSINESSES WITH ON-PREMISES LIQUOR
LICENSES LOCATED WITHIN 500’ OF THE
PROPOSED PREMISES.
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•
•
•
•
•
•
•
method of operation you are approved for and will
be binding. Should you wish to deviate from this
method of operation in any way, you must first
apply for and receive permission by the Athority.
Any change in method of operation must be
approved by the State Liquor Authority prior to
initiating the change.
If you intend to operate as a restaurant, you are
required to be open regularly for the serving of
meals to guests for compensation, have suitable
kitchen facilities in the licensed premises that are in
charge of a chef and necessary help at all times.
Meals must be the usual assortment of foods
commonly ordered at various hours of the day. The
service of only sandwiches and salads does not meet
the food requirements needed to operate as a
restaurant. Alcoholic beverages are to be incidental
to the service of food.
PLEASE NOTE THAT FOOD MUST BE
AVAILABLE FOR SALE DURING ALL
HOURS OF OPERATION. This does not include
allowing your patrons to order from other
restaurants and having the food delivered to your
premises. The food must available at YOUR
place of business.
In the City of New York you are required to obtain a
cabaret permit if you will allow dancing at your
establishment.
If you are employing a manager, they must provide
a Personal Questionnaire, photo identification and
an original color photo no smaller than 2”x2”
If you are employing security personnel you should
contact the NYS Department of State and find out if
they are required to be registered in accordance with
NYS Security Guard Registration.
If you are applying as a sole proprietor with more
than one employee, whether or not they are family
members, or if applying as a partnership, Limited
Liability Partnership (LLP), Limited Liability
Company LLC) or as a corporation, provide
Workers’ Compensation/Disability Benefits Carrier
Name and Policy Number. If applied for and
pending, so indicate.
YOU MAY NOT EMPLOY ANYONE
CONVICTED OF A FELONY UNLESS YOU
HAVE THE PERMISSION OF THE
AUTHORITY OR THE PERSON HAS
RECEIVED A CERTIFICATE OF RELIEF
FROM DISABILITIES FROM THE COURT.
NOTIFICATION OF PUBLICATION
• Please read this section carefully. The first notice
of publication must be published within 10 days of
the filing of this application. The original
publication notice must be submitted to the
Authority within 15 days of receipt.
PROOF OF CITIZENSHIP
• This section must be completed by an attorney
duly admitted to practice law in New York
State. This section is not required for natural
born citizens.
APPLICANT’S STATEMENT
• Please read this section carefully. This section is
an affirmation that you understand that you are
bound by the answers and information you
provide in the application.
• Applicant signatures required for: sole
proprietors, each partner in a partnership and at
least one authorized official of a corporation.
APPLICATION FOR LIQUIDATOR’S
PERMIT
• This section must be completed and filed by the
LICENSEE who is selling or liquidating their
business and will be disposing of their stock
of alcoholic beverages in connection with such
sale. A list of the inventory being liquidated
must be submitted prior to the issuance of
this permit.
PERSONAL QUESTIONNAIRE – THIS FORM
MUST BE COMPLETED IN FULL BY THE
FOLLOWING PERSONS:
• All sole proprietors.
• Each partner in a partnership.
• For Corporations or Limited Liability
Companies (LLC), see instructions for Line 10
of the application.
• Managers.
• Individual lenders and donors and giftors (state
your relationship to the applicant).
• Co-signers of loans.
• Spouses who assist in management of premises;
will be employed at the premises or who hold
joint bank accounts with applicant.
• Anyone holding a joint account with an
individual who will be providing funds for this
venture, whether the applicant, a lender or
donor.
NOTE: Additional information may be requested
on any individual submitting a personal
questionnaire if needed to complete the review of
the application. Each questionnaire must be
signed and dated.
THE FOLLOWING DOCUMENTS MUST BE
SUBMITTED WITH THE APPLICATION:
•
ORIGINAL APPLICATION NOTICE FORM
In the City of New York, you are required to
notify the local community board at least 30
days prior to submitting an application to the
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Application for Alcoholic Beverage Control Retail
License.
YOU MUST SUBMIT A COPY OF THE
COMPLETED AND SIGNED ORIGINAL
APPLICATION NOTICE FORM WITH YOUR
APPLICATION ALONG WITH PROOF OF
MAILING OR HAND DELIVERY.
•
State Liquor Authority for a license for onpremises consumption of liquor, wine or beer.
Outside of the City of New York you are
required to notify the clerk of the city, town or
village where this premises is located at least 30
days prior to submitting an application to the
State Liquor Authority for a license for onpremises consumption of liquor.
PHOTOGRAPHS
• Must be at least 5” x 7” and NO POLAROIDS.
• Interior Photographs – showing interior of
premises. Bars must be clearly shown together
with a full view of the room or rooms – this
includes kitchens.
• Exterior Photographs – Showing front of
premises, structure or proposed site.
• PHOTOS ARE REQUIRED AT THE TIME
OF FILING THE APPLICATION.
ADDITIONAL PHOTOS MAY BE
REQUIRED IF RENOVATIONS OR
CONSTRUCTION IS NOT COMPLETED
AT THE TIME OF FILING.
• You may submit your photos electronically.
Please refer to the detailed instructions on our
website.
• All hard copy photographs submitted MUST BE
ENDORSED on the reverse side with the name
and address of the applicant and the date when
the photographs were taken.
A CONTRACT OF SALE MUST BE
SUBMITTED IF PURCHASING AN
EXISTING BUSINESS AND APPLYING
FOR A TEMPORARY RETAIL
PERMIT.
ALL APPLICANTS WILL BE REQUIRED TO
BE FINGERPRINTED ELECTRONICALLY:
ELECTRONIC FINGERPRINTING
PERSONS REQUIRED TO BE FINGERPRINTED:
• All sole proprietors.
• All partners in a Partnership and Limited
Liability Partnership (LLP).
• For Corporations and Limited Liability
Companies (LLC) see instructions for line 10.
•
•
NOTE: Persons CURRENTLY licensed by the
State Liquor Authority do not have to be
fingerprinted.
Each applicant required to be fingerprinted must
contact L-1 Enrollment Services after the successful
submission of your applications.
The fee for electronic fingerprinting is $105.00 and
will be paid directly to L-1 Enrollment Services
when you are fingerprinted.
PENAL BOND (FORM L-9)
• Submit a penal bond, Form L-9, in the sum of
$1,000, issued by any qualified surety company
authorized to execute such bonds in the State of
New York.
• IMPORTANT: The bond MUST have the
premises name and address typed EXACTLY AS
IT APPEARS ON THE APPLICATION.
• Altered or handwritten bonds are not
acceptable (i.e.: whiteouts, typeovers).
• The expiration date on the bond must indicate
only the year of expiration of the license.
• The applicant MUST SIGN THE BOND.
CONTRACTS
• Submit a copy of the contract of sale or purchase of
business/stock, etc. The name of the person/entity
listed as purchaser on the contract of sale must be
the name of the applicant as it appears on the
•
DIAGRAMS
• All diagrams must be submitted on
8 ½” x 11” paper AND MUST BE
CLEARLY MARKED.
• See examples at end of instructions
1. Interior Diagram:
• Diagram or sketch of the interior with
dimensions. Include ALL floors that will be part
of the licensed premises (including the basement
or any other floor being used for the storage of
alcoholic beverages). Label all rooms, including
bathrooms, and the basement or any other floor
if part of the licensed premises (ie. storage room,
office, dining area, kitchen, food preparation
area). Show the measurements and locations of the
bar(s) and number of tables and chairs for patrons in
each room. Show any outside dining/service areas
(e.g. sidewalk café, deck, porch, roof, etc.). If the
premises is in a multi-unit or multi-story building,
diagram must also state and show where it is located
in the building. Give details as to how this area will
be contained and supervised.
Each floor should have its own diagram (including
any floor used for the storage of alcoholic
beverages).
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•
Show all entrances and exits, sanitary facilities,
display windows or other openings, counters,
closets, shelves and storage areas.
2. Block Plot Diagram
• A Block Plot Diagram showing all other buildings,
lots, etc. must be submitted. Make sure that you
label each building (ie. Nail Salon, Church,
Residence)
• IMPORTANT: All submissions, including
photographs and diagrams, must have the name
and address of the applicant’s premises.
FILING RECEIPT OR ASSUMED NAME
CERTIFICATE
• If applying as a Corporation, LLC or LP you must
submit the Filing Receipt issued by the NYS
Department of State showing proof of incorporation.
• If you have a trade name (DBA) you must file an
Assumed Name Certificate issued by the NYS
Department of State.
NOTICE OF APPEARANCE
• Section 166 of the Executive Law requires a
regulatory agency to maintain for public inspection a
record of who appears before it for a fee as a third
party (i.e. an attorney, an agent, a lobbyist or
representative) on behalf of a person or organization
subject to the regulatory jurisdiction of the agency.
• This form must be completed and submitted by
•
•
all represented applicants.
If you were assisted in the preparation and/or
filing of the application, you must have the
person you paid complete and submit the Notice
of Appearance with the application.
NOTICE TO BE POSTED AT PROPOSED
PREMSIES
Section 100(7) of the Alcoholic Beverage Control
Law requires that Notice be posted in a conspicuous
place at the entrance of the premises within 10 days
of filing your application. This Notice Form can be
found on our website under “Notice to be Posted at
Proposed Premises”.
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Filing Checklist
Items that need to be submitted with your application.
This checklist has been created to better assist you with the application process. All items on the checklist must be
complete and
accurate to the best of your ability. If all items on the checklist are not submitted, the application may be disapproved for
Failure
to Comply.
All Applicants MUST submit the following Sections of the Retail License Application upon filing of the application:
_____Application
_____Right to Premise
_____Landlord Identification
_____List of Expenses
_____Establishment Questionnaire
_____Method of Operation
_____Citizenship Affirmation (for each principal not US born)
_____Applicant’s Statement
_____Personal Questionnaire (for each Principal, Manager, Lender, Donor, etc.)
All Applicants MUST submit the following Supporting Documents upon filing of the application:
_____Bond , Form L-9 (signed by the applicant and expiring at the end of the initial licensing term)
_____Community Board/Municipality Notification (using the correct Standardized Form)
_____Detailed Diagrams which include Interior and Block Plot
_____Investment Records showing the source and availability of the funds to be used for the venture
_____Lease/Deed/Contracts (any applicable for this venture)
_____Photo Identification for all applicant Principals and Managers
_____Photos of applicant Principals and Managers
_____Proof of Citizenship for all applicant principals NOT currently licensed with the NYS Liquor Authority(copy of Birth
Certificate, Passport)
_____Photos of the proposed premises (interior including kitchen area and exterior)
_____Notice of Appearance (if represented by someone other than the applicant)
On-Premise (beer, beer & wine, beer, wine & liquor) Applicants MUST ALSO submit the following Sections of the Retail
License
application and the following Supporting Documents upon filing of the application:
_____500’ Rule Statement
_____200’-Statement of Area Plan
_____Letter of request to waive the 2 bathroom rule (if only 1 bathroom)
_____Maximum Occupancy Certificate (if requesting the Bathroom Waiver)
_____Menu
Off-Premise (beer, beer & wine, beer, wine & liquor) Applicants MUST ALSO submit the following Sections of the Retail
License
application and the following Supporting Documents upon filing the application:
_____Grocery Store Stipulation (Grocery Stores Only)
_____Liquor Store Questionnaire (Liquor & Wine Stores Only)
_____Frontal Elevation Diagram (Liquor & Wine Stores Only)
_____Pharmacy License Certificate (Drug Stores Only)
All Applicants MUST submit the following Supporting Documents before a license can be issued:
_____Certificate of Assumed Name (if a DBA is used)
_____Certificate of Authority to Collect Sales Tax
_____Certificate of Occupancy (On-Premise Establishments Only)
_____Coast Guard Certification (Vessels Only)
_____Department of State Filing Receipt
_____Newspaper Affidavit
_____Photos of the premise showing ready to open and operate
_____Worker’s Comp & Disability Insurance policy numbers AND carrier names OR a Certificate of Attestation of Exemption from
coverage.
Revised 11/8/11
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