Special Event Permit Application

New York State Liquor Authority

Landlord Authorization Form

Date(s) of event:

______________________________________________________

B & L RESTAURANT GROUP LLC

Name of Applicant:

______________________________________________________

Venue Name:

______________________________________________________

Venue Street Address:

________________________________________________ _ _____

Venue City and zip code:

______________________________________________________

I, the landlord/owner of the applied for premises, hereby grant permission for

the sale or services of alcoholic beverages by the applicant for consumption

on said property.

____________________________________________

Print Authorized Landlord Name

____________________________________________

Print Landlord Title

____________________________________________

Landlord Signature & Date

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Parent category: Legal

Special Event Permit Application - New York State Liquor Authority