*New* Combined License Application

SeamlessDocs

Type of License
Assumed Name
Entity
NYS Incorporated
Operating before 9/7/18
Change in COP
License Suspended/Revoked
Felony/Crime/Violation
Alcohol
Own Property
Cabaret Days
Alcohol (C)
Method of Payment
Your Name HereClick to Sign
Role
Signature HereClick to Sign
07/02/2026Click to Sign
Payment Received
Signature HereJeaneth Guinansaca Will Sign Here
07/02/2026
Debt/Obligation
Signature HereDale Brennan Will Sign Here
07/02/2026
Police Complaints
OPD Calls
Signature HerePolice Department Will Sign Here
07/02/2026
Open Permits
CO
Code Violations
Site Plan
Cabaret Passed
Refreshment Passed
Coin Passed
Signature HereGregory Grose Will Sign Here
07/02/2026
x

Additional Signatures Required