Form 115(W) - Application For Permit To Conduct Wine Tasting Function printable pdf download

Form 115(W) - Application For Permit To Conduct Wine Tasting Function

PERMIT

-30

APPLICATION FOR PERMIT TO

CONDUCT WINE TASTING FUNCTION

Form 115 (W) Miscellaneous (09/02)

(WINERY, FARM WINERY OR WHOLESALE)

STATE OF NEW YORK

AUTHORIZED TO SELL WINE)

LIQUOR AUTHORITY

(MISCELLANEOUS)

Section 99-b, subdivision 1 (k) of the A.B.C. Law provides that a permit may be issued to purchase, receive or sell alcoholic beverages, certificates, contracts

or other documents pertaining to alcoholic beverages, in cases not otherwise expressly provided for by this chapter, when in the judgment of the Liquor

Authority such would be appropriate and consistent with the purpose of this chapter.

Pursuant to that Section, this application is submitted by a Winery, Farm Winery or a Wholesaler authorized to sell wine for a permit to conduct wine tasting

functions.

A wine tasting is a presentation of samples of one or more wines for the purpose of acquainting the tasters with the characteristics of the wine or wines tasted.

This application must be properly executed by the applicant and filed with the Office of the State Liquor Authority at the appropriate zone office and must be

accompanied by a certified check, bank officer’s check or draft, personal check or money order for the required fee payable to the order of the State Liquor

Authority.

SCHEDULE OF FEES (Check one)

Annual

Single Function

Wholesale Liquor ____ $ 256+ $ 20 filing fee

____ $ 26 + $ 10 filing fee

Wholesale Wine

____

256 + 20 filing fee

____ 26 + 10 filing fee

Winery

____

256 + 20 filing fee

____ 26 + 10 filing fee

Farm Winery

____

51 + 20 filing fee

____ 26 + 10 filing fee

ALL ANSWERS BELOW MUST BE TYPEWRITTEN OR PRINTED IN DARK INK.

(IF MORE SPACE IS NEEDED, ATTACH RIDER)

ANY FALSE ANSWER OR STATEMENT MADE BY THE APPLICANT/LICENSEE MAY SUBJECT

THE LICENSEE TO DISCIPLINARY PROCEEDINGS

SECTION A

Give full name of Applicant/Licensee

Type of License (Check one)

Serial #

_____ Winery

________________________

_____ Farm Winery

License Certificate #

_____ Liquor Wholesaler

_____ Wine Wholesaler

Street address of licensed premises

City, Town or Village – Zip Code

County

Telephone Number

APPLICANTS SEEKING A WINE TASTING PERMIT FOR A SINGLE FUNCTION ONLY MUST COMPLETE THE QUESTIONS IN SECTION B

BELOW. ANNUAL PERMIT APPLICANTS SHOULD DISREGARD THIS SECTION.

SECTION B

1. State date, day of the week and time of the day when wine tasting

function will be held:

Date ___________

Day of Week _____________________

Time ____________________

2. State the estimated number persons attending such function:

Number of Persons______________________

State address of premises where function is to be held:

Street address________________________________________________________________________________

Form 115(W) - Application For Permit To Conduct Wine Tasting Function

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