§ 110. Information to be requested in applications for licenses or\npermits. 1. The following shall be the information required on an\napplication for a license or permit:\n (a) A statement of identity as follows:\n (i) If the applicant is an individual, his name, date and place of\nbirth, citizenship, permanent home address, telephone number and social\nsecurity number, as well as any other names by which he has conducted a\nbusiness at any time.\n (ii) If the applicant is a corporation, the corporate name of the\napplicant, its place of incorporation, its main business address (and if\nsuch main business address is not within the state, the address of its\nmain place of business within the state), other names by which it has\nbeen known or has conducted business at any time, its telephone number,\nits federal employer identification number, and the names, ages,\ncitizenship, and permanent home addresses of its directors, officers and\nits shareholders (except that if there be more than ten shareholders\nthen those shareholders holding ten percent or more of any class of its\nshares).\n (iii) If the applicant is a partnership, its name, its main business\naddress (and if such main business address is not within the state, the\naddress of its main place of business within the state), other names by\nwhich it has been known or has conducted business at any time, its\ntelephone number, its federal employer identification number, and the\nnames, ages, citizenship, and permanent home addresses of each of its\npartners.\n (b) A statement identifying the street and number of the premises to\nbe licensed, if the premises have a street and number, and otherwise\nsuch description as will reasonably indicate the locality thereof;\nphotographs, drawings or other items related to the appearance of the\ninterior or exterior of such premises, and a floor plan of the interior,\nshall be required. The applicant shall also state the nature of his\ninterest in the premises; and the name of any other person interested as\na partner, joint venturer, investor or lender with the applicant either\nin the premises or in the business to be licensed.\n (c) A description of any other alcohol beverage license or permit\nunder this chapter or any other alcoholic beverage control law which,\nwithin the past ten years, the applicant (including any officers,\ndirectors, shareholders or partners listed in the statement of identity\nunder paragraph (a) of this subdivision or the spouse of any such\nperson) or the applicant's spouse held or applied for.\n (d) A statement that such applicant or the applicant's spouse has not\nbeen convicted of a crime addressed by the provisions of section one\nhundred twenty-six of this article which would forbid the applicant\n(including any officers, directors, shareholders or partners listed in\nthe statement of identity under paragraph (a) of this subdivision or the\nspouse of such person) or the applicant's spouse to traffic in alcoholic\nbeverages, a statement whether or not the applicant (including any\nofficers, directors, shareholders or partners listed in the statement of\nidentity under paragraph (a) of this subdivision or the spouse of any\nsuch person) or the applicant's spouse is an official described in\nsection one hundred twenty-eight of this article, and a description of\nany crime that the applicant (including any officers, directors,\nshareholders or partners listed under paragraph (a) of this subdivision\nor the spouse of any such person) or the applicant's spouse has been\nconvicted of and whether such person has received a pardon, certificate\nof good conduct or certificate of relief from disabilities; provided,\nhowever, that no person shall be denied any license solely on the\ngrounds that such person is the spouse of a person otherwise\ndisqualified from holding a license under this chapter.\n (e) A statement that the location and layout of the premises to be\nlicensed does not violate any requ
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