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PREMIUM WINE GROUP, LLC

Company Details

Name: PREMIUM WINE GROUP, LLC
Jurisdiction: New York
Legal type: DOMESTIC LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 25 Feb 2000 (25 years ago)
Entity Number: 2478278
ZIP code: 11952
County: Suffolk
Place of Formation: New York
Address: PO BOX 1424, 13015 MAIN ST, MATTITUCK, NY, United States, 11952

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PREMIUM WINE GROUP LLC 401(K) PROFIT SHARING PLAN AND TRUST 2019 113542232 2020-07-16 PREMIUM WINE GROUP LLC 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-06-01
Business code 312130
Sponsor’s telephone number 6317341100
Plan sponsor’s address 13050 OREGON ROAD, PO BOX 907, CUTUCHOGUE, NY, 11952

Signature of

Role Plan administrator
Date 2020-07-16
Name of individual signing TED GAVIN
PREMIUM WINE GROUP LLC 401(K) PROFIT SHARING PLAN AND TRUST 2018 113542232 2019-07-29 PREMIUM WINE GROUP LLC 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-06-01
Business code 312130
Sponsor’s telephone number 6317341100
Plan sponsor’s address 13050 OREGON ROAD, PO BOX 907, CUTUCHOGUE, NY, 11952

Signature of

Role Plan administrator
Date 2019-07-29
Name of individual signing TED GAVIN
PREMIUM WINE GROUP LLC 401(K) PROFIT SHARING PLAN AND TRUST 2017 113542232 2018-08-21 PREMIUM WINE GROUP LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-06-01
Business code 312130
Sponsor’s telephone number 6317341100
Plan sponsor’s address 13050 OREGON ROAD, PO BOX 907, CUTUCHOGUE, NY, 11952

Signature of

Role Plan administrator
Date 2018-08-21
Name of individual signing RICHARD BAILEY
PREMIUM WINE GROUP, LLC 401(K) P/S PLAN 2015 113542232 2017-08-24 PREMIUM WINE GROUP, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-04-01
Business code 111300
Sponsor’s telephone number 6312981900
Plan sponsor’s address 35 COX NECK RD, MATTITUCK, NY, 119521458

Signature of

Role Plan administrator
Date 2017-08-24
Name of individual signing RICHARD BAILEY
PREMIUM WINE GROUP, LLC 401(K) P/S PLAN 2014 113542232 2015-10-13 PREMIUM WINE GROUP, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-04-01
Business code 111300
Sponsor’s telephone number 6312981900
Plan sponsor’s address 35 COX NECK RD, MATTITUCK, NY, 11952

Plan administrator’s name and address

Administrator’s EIN 113542232
Plan administrator’s name PREMIUM WINE GROUP, LLC
Plan administrator’s address 35 COX NECK RD, MATTITUCK, NY, 11952
Administrator’s telephone number 6312981900

Signature of

Role Plan administrator
Date 2015-10-13
Name of individual signing DAVID SANATORE
PREMIUM WINE GROUP, LLC 401(K) P/S PLAN 2013 113542232 2014-08-27 PREMIUM WINE GROUP, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-04-01
Business code 111300
Sponsor’s telephone number 6312981900
Plan sponsor’s address 35 COX NECK RD, MATTITUCK, NY, 11952

Plan administrator’s name and address

Administrator’s EIN 113542232
Plan administrator’s name PREMIUM WINE GROUP, LLC
Plan administrator’s address 35 COX NECK RD, MATTITUCK, NY, 11952
Administrator’s telephone number 6312981900

Signature of

Role Plan administrator
Date 2014-08-27
Name of individual signing RUSSELL HEARN
PREMIUM WINE GROUP, LLC 401(K) P/S PLAN 2012 113542232 2013-10-08 PREMIUM WINE GROUP, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-04-01
Business code 111300
Sponsor’s telephone number 6312981900
Plan sponsor’s address 35 COX NECK RD, MATTITUCK, NY, 11952

Plan administrator’s name and address

Administrator’s EIN 113542232
Plan administrator’s name PREMIUM WINE GROUP, LLC
Plan administrator’s address 35 COX NECK RD, MATTITUCK, NY, 11952
Administrator’s telephone number 6312981900

Signature of

Role Plan administrator
Date 2013-10-08
Name of individual signing RUSSELL HEARN
PREMIUM WINE GROUP, LLC 401(K) P/S PLAN 2011 113542232 2012-06-27 PREMIUM WINE GROUP, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-04-01
Business code 111300
Sponsor’s telephone number 6312981900
Plan sponsor’s address 35 COX NECK RD, MATTITUCK, NY, 11952

Plan administrator’s name and address

Administrator’s EIN 113542232
Plan administrator’s name PREMIUM WINE GROUP, LLC
Plan administrator’s address 35 COX NECK RD, MATTITUCK, NY, 11952
Administrator’s telephone number 6312981900

Signature of

Role Plan administrator
Date 2012-06-27
Name of individual signing RUSSELL HEARN
PREMIUM WINE GROUP, LLC 401(K) P/S PLAN 2010 113542232 2011-06-29 PREMIUM WINE GROUP, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-04-01
Business code 111300
Sponsor’s telephone number 6312981900
Plan sponsor’s address 35 COX NECK RD, MATTITUCK, NY, 11952

Plan administrator’s name and address

Administrator’s EIN 113542232
Plan administrator’s name PREMIUM WINE GROUP, LLC
Plan administrator’s address 35 COX NECK RD, MATTITUCK, NY, 11952
Administrator’s telephone number 6312981900

Signature of

Role Plan administrator
Date 2011-06-29
Name of individual signing RUSSELL HEARN
PREMIUM WINE GROUP, LLC 401(K) P/S PLAN 2009 113542232 2010-09-29 PREMIUM WINE GROUP, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-04-01
Business code 111300
Sponsor’s telephone number 6312981900
Plan sponsor’s address 35 COX NECK RD, MATTITUCK, NY, 11952

Plan administrator’s name and address

Administrator’s EIN 113542232
Plan administrator’s name PREMIUM WINE GROUP, LLC
Plan administrator’s address 35 COX NECK RD, MATTITUCK, NY, 11952
Administrator’s telephone number 6312981900

Signature of

Role Plan administrator
Date 2010-09-29
Name of individual signing RUSSELL HEARN

DOS Process Agent

Name Role Address
WICKHAM BRESSLER GORDON & GEASA PC DOS Process Agent PO BOX 1424, 13015 MAIN ST, MATTITUCK, NY, United States, 11952

History

Start date End date Type Value
2000-02-25 2004-05-27 Address C/O WICKHAM, WICKHAM ETAL, PO BOX 1424, 10315 MAIN ROAD, MATTITUCK, NY, 11952, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
180702007536 2018-07-02 BIENNIAL STATEMENT 2018-02-01
160201006740 2016-02-01 BIENNIAL STATEMENT 2016-02-01
140507006634 2014-05-07 BIENNIAL STATEMENT 2014-02-01
120410002011 2012-04-10 BIENNIAL STATEMENT 2012-02-01
100412003038 2010-04-12 BIENNIAL STATEMENT 2010-02-01
080410002556 2008-04-10 BIENNIAL STATEMENT 2008-02-01
040527002191 2004-05-27 BIENNIAL STATEMENT 2004-02-01
020205002235 2002-02-05 BIENNIAL STATEMENT 2002-02-01
000516000874 2000-05-16 AFFIDAVIT OF PUBLICATION 2000-05-16
000516000873 2000-05-16 AFFIDAVIT OF PUBLICATION 2000-05-16

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
341245884 0214700 2016-02-11 35 COX NECK ROAD, MATTITUCK, NY, 11952
Inspection Type Complaint
Scope Partial
Safety/Health Safety
Close Conference 2016-02-11
Emphasis L: FORKLIFT, N: AMPUTATE
Case Closed 2016-05-16

Related Activity

Type Complaint
Activity Nr 1057467
Safety Yes

Violation Items

Citation ID 01001
Citaton Type Serious
Standard Cited 19100023 C01
Issuance Date 2016-03-10
Abatement Due Date 2016-03-29
Current Penalty 1500.0
Initial Penalty 2000.0
Final Order 2016-03-23
Nr Instances 1
Nr Exposed 6
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.23(c)(1): Open-sided floors and/or platforms four feet or more above adjacent floor or ground level were not guarded with standard railings (or equivalent) and toeboards:Note: Toeboards are only required when persons can pass, there is moving equipment or there is equipment with which falling materials could create a hazard. a) Workplace, exterior - Employees access the openings of wine tanks by standing on the top. The perimeter of the tanks are not guarded and the employees are exposed to falling up to approximately 15ft; on or about 2/11/16. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.
Citation ID 01002A
Citaton Type Serious
Standard Cited 19100146 C01
Issuance Date 2016-03-10
Abatement Due Date 2016-03-29
Current Penalty 1500.0
Initial Penalty 2000.0
Final Order 2016-03-23
Nr Instances 1
Nr Exposed 6
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.146(c)(1): The employer did not evaluate the workplace to determine if any spaces were permit-required confined spaces: a) Workplace - Employees enter the red wine fermentation tanks to remove the grape pomace; on or about 2/11/16. Note: In addition to abatement certification the employer is required to submit abatement documentation for this item in accordance with 29 CFR 1903.19.
Citation ID 01002B
Citaton Type Serious
Standard Cited 19100146 C05 II C
Issuance Date 2016-03-10
Abatement Due Date 2016-03-29
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2016-03-23
Nr Instances 1
Nr Exposed 6
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.146(c)(5)(ii)(C): Employees entered into permit spaces that met the conditions set forth in 29 CFR 1910.146(c)(5)(i) but before an employee entered the space, the internal atmosphere was not tested with a calibrated direct-reading instrument: a) Workplace - Employees enter the red wine fermentation tanks to remove the grape pomace without testing the internal atmosphere; on or about 2/11/16. Note: In addition to abatement certification the employer is required to submit abatement documentation for this item in accordance with 29 CFR 1903.19.
Citation ID 01002C
Citaton Type Serious
Standard Cited 19100146 G01
Issuance Date 2016-03-10
Abatement Due Date 2016-03-29
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2016-03-23
Nr Instances 1
Nr Exposed 6
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.146(g)(1): The employer did not provide training so that all employees whose work was regulated by 29 CFR 1910.146 (permit required confined spaces) acquired the understanding, knowledge, and skills necessary for the safe performance of the duties assigned under 29 CFR 1910.146: a) Workplace - Employees enter the red wine fermentation tanks to remove the grape pomace, and were not trained to recognize the hazards of entering a permit required confined space; on or about 2/11/16. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.
Citation ID 01003
Citaton Type Serious
Standard Cited 19100147 C01
Issuance Date 2016-03-10
Abatement Due Date 2016-04-26
Current Penalty 1500.0
Initial Penalty 2000.0
Final Order 2016-03-23
Nr Instances 1
Nr Exposed 6
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.147(c)(1): The employer did not establish a program consisting of an energy control procedure, employee training and periodic inspections to ensure that before any employee performed any servicing or maintenance on a machine or equipment where the unexpected energizing, startup or release of stored energy could occur and cause injury, the machine or equipment shall be isolated from the energy source and rendered inoperative: a) Workplace: Employees are required to provide repair and maintenance on equipment such as, but not limited to a GAI 4297, 4000A, and 4608DL Bottling Machine, with numerous sources of energy and were not provided with a Lockout/Tagout program,; on or about 2/11/16. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.
Citation ID 01004
Citaton Type Serious
Standard Cited 19100147 C04 I
Issuance Date 2016-03-10
Abatement Due Date 2016-04-26
Current Penalty 1500.0
Initial Penalty 2000.0
Final Order 2016-03-23
Nr Instances 1
Nr Exposed 6
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.147(c)(4)(i): Procedures were not developed, documented and utilized for the control of potentially hazardous energy when employees were engaged in activities covered by this section: a) Workplace: Employees are required to provide repair and maintenance on equipment such as, but not limited to a GAI 4297, 4000A, and 4608DL Bottling Machine, with numerous sources of energy and were not provided with Lockout/Tagout procedures; on or about 2/11/16. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.
Citation ID 01005
Citaton Type Serious
Standard Cited 19100147 C05 I
Issuance Date 2016-03-10
Abatement Due Date 2016-04-26
Current Penalty 1500.0
Initial Penalty 2000.0
Final Order 2016-03-23
Nr Instances 1
Nr Exposed 6
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.147(c)(5)(i): Locks, tags, chains, wedges, key blocks, adapter pins, self-locking fasteners, or other hardware were not provided by the employer for isolating, securing or blocking of machines or equipment from energy sources: a) Workplace: Employees are required to provide repair and maintenance on equipment such as, but not limited to a GAI 4297, 4000A, and 4608DL Bottling Machine, with numerous sources of energy and were not provided with Lockout/Tagout hardware; on or about 2/11/16. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.
Citation ID 01006
Citaton Type Serious
Standard Cited 19100147 C07 I B
Issuance Date 2016-03-10
Abatement Due Date 2016-04-26
Current Penalty 1500.0
Initial Penalty 2000.0
Final Order 2016-03-23
Nr Instances 1
Nr Exposed 6
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.147(c)(7)(i)(B): Each affected employee shall be instructed in the purpose and use of the energy control procedure. a) Workplace: Employees are required to provide repair and maintenance on equipment such as, but not limited to a GAI 4297, 4000A, and 4608DL Bottling Machine, , with numerous sources of energy and were not provided with Lockout/Tagout training; on or about 2/11/16. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.
Citation ID 01007
Citaton Type Serious
Standard Cited 19100151 C
Issuance Date 2016-03-10
Abatement Due Date 2016-04-05
Current Penalty 1500.0
Initial Penalty 2000.0
Final Order 2016-03-23
Nr Instances 1
Nr Exposed 9
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.151(c): Where employees were exposed to injurious corrosive materials, suitable facilities for quick drenching or flushing of the eyes and body were not provided within the work area for immediate emergency use: a) Workplace - Employees use materials such as, but not limited to sulfur dioxide, which is a corrosive. An eye wash station was not provided for immediate use; on or about 2/11/16. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.
Citation ID 01008
Citaton Type Serious
Standard Cited 19100178 L
Issuance Date 2016-03-10
Abatement Due Date 2016-04-26
Current Penalty 1200.0
Initial Penalty 1600.0
Final Order 2016-03-23
Nr Instances 1
Nr Exposed 6
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.178(l): Operators were not trained in the safe operation of powered industrial trucks: a) Workplace - Employees operating Forklifts did not receive training, on or about, 2/11/16. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.
Citation ID 01009
Citaton Type Serious
Standard Cited 19100212 A01
Issuance Date 2016-03-10
Abatement Due Date 2016-03-22
Current Penalty 1500.0
Initial Penalty 2000.0
Final Order 2016-03-23
Nr Instances 1
Nr Exposed 10
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.212(a)(1): One or more methods of machine guarding was not provided to protect the operator and other employees in the machine area from hazards such as ingoing nip points: a) Workplace - Employees operating Machines such as but not limited to a GAI 4000A bottle filler, were not protected from the moving parts; on or about 2/11/16. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.
Citation ID 02001
Citaton Type Other
Standard Cited 19100134 C02 I
Issuance Date 2016-03-10
Abatement Due Date 2016-03-22
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2016-03-23
Nr Instances 1
Nr Exposed 6
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.134(c)(2)(i): Respirator users were not provided with the information contained in Appendix D to 29 CFR 1910.134 when the employer determined that any voluntary respirator use was permissible: (Construction Reference 1926.103) a) Workplace - Employees were provided with a half faced respirator for voluntary use; on or about, 2/11/16. Note: The employer is required to submit abatement certification for this item in accordance with 29 CFR 1903.19.
Citation ID 02002
Citaton Type Other
Standard Cited 19101200 E01
Issuance Date 2016-03-10
Abatement Due Date 2016-04-26
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2016-03-23
Nr Instances 1
Nr Exposed 9
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.1200(e)(1): The employer did not develop, implement, and/or maintain at the workplace a written hazard communication program which describes how the criteria specified in 29 CFR 1910.1200(f), (g), and (h) will be met (Construction Reference: 1926.59): a) Workplace - Employees use materials such as, but not limited to, Acetic Acid to clean wine tanks. A written hazard communication program was not in place; on, or about, 2/11/16. Note: In addition to abatement certification the employer is required to submit abatement documentation for this item in accordance with 29 CFR 1903.19. ABATEMENT NOTE: The written Hazard Communication Program must include descriptions of how the following program elements, required by this regulation, will be developed, implemented, and conveyed to the employer's employee(s) who are exposed to hazardous materials: a. Labeling and other forms or warning: Labels shall include at least the identity of the hazardous chemical(s), the appropriate hazard warnings, the target organs, and the name and address of the chemical manufacturer, importer or other responsible party; b. A list or inventory of all hazardous materials known to be present in the workplace must be compiled and be maintained as part of the employer's written Hazard Communication Program; c. Material Safety Data Sheets (MSDSs) for all materials used by employee(s) in the workplace must be maintained and readily available all employee(s) on all shifts. d. The employer's Hazardous Materials Information and Training Program must be based upon the employer's written Hazard Communication Program. The training for employee(s) must include at least: Methods and observation that may be used to detect the presence or release of hazardous chemicals in the work area. The physical and health hazards of the chemicals in the work area. The measures employee(s) can take to protect themselves, such as, specific procedures, appropriate work practices, emergency procedures, and personal protective equipment to be used. The details of the employer's Hazard Communication Program including an explanation of the labeling systems used, Material Safety Data Sheets and how employees can obtain and use the appropriate hazard information; e. Methods used to inform employees of the hazards associated with non routine tasks must also be addressed in the employer's written program; and f. The employer's written Hazard Communication Program must be made available upon request. For Multi Employer Work places, the employer's Written Hazard Communication Program must also specifically address how: a. Material Safety Data Sheets for each hazardous material on the job site will be provided to other employers in the event the other employer's employee(s) may be exposed to these materials. b. The methods the employer will use to inform other employer(s) of any precautionary measures that need to be taken to protect employee(s) during normal operating conditions and in foreseeable emergencies. c. The methods the employer will use to inform the other employer(s) of the labeling system used in the workplace.
Citation ID 02003
Citaton Type Other
Standard Cited 19101200 H01
Issuance Date 2016-03-10
Abatement Due Date 2016-04-26
Current Penalty 0.0
Initial Penalty 0.0
Final Order 2016-03-23
Nr Instances 1
Nr Exposed 9
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.1200(h)(1): Employees were not provided effective information and training on hazardous chemicals in their work area at the time of their initial assignment and whenever a new hazard that the employees had not been previously trained about was introduced into their work area: a) Workplace - Employees use materials such as, but not limited to, Acetic Acid to clean wine tanks. A written hazard communication program, including training was not in place; on, or about 2/11/16. Note: In addition to abatement certification the employer is required to submit abatement documentation for this item in accordance with 29 CFR 1903.19. ABATEMENT NOTE: The written Hazard Communication Program must include descriptions of how the following program elements, required by this regulation, will be developed, implemented, and conveyed to the employer's employee(s) who are exposed to hazardous materials: a. Labeling and other forms or warning: Labels shall include at least the identity of the hazardous chemical(s), the appropriate hazard warnings, the target organs, and the name and address of the chemical manufacturer, importer or other responsible party; b. A list or inventory of all hazardous materials known to be present in the workplace must be compiled and be maintained as part of the employer's written Hazard Communication Program; c. Material Safety Data Sheets (MSDSs) for all materials used by employee(s) in the workplace must be maintained and readily available all employee(s) on all shifts. d. The employer's Hazardous Materials Information and Training Program must be based upon the employer's written Hazard Communication Program. The training for employee(s) must include at least: Methods and observation that may be used to detect the presence or release of hazardous chemicals in the work area. The physical and health hazards of the chemicals in the work area. The measures employee(s) can take to protect themselves, such as, specific procedures, appropriate work practices, emergency procedures, and personal protective equipment to be used. The details of the employer's Hazard Communication Program including an explanation of the labeling systems used, Material Safety Data Sheets and how employees can obtain and use the appropriate hazard information; e. Methods used to inform employees of the hazards associated with non routine tasks must also be addressed in the employer's written program; and f. The employer's written Hazard Communication Program must be made available upon request. For Multi Employer Work places, the employer's Written Hazard Communication Program must also specifically address how: a. Material Safety Data Sheets for each hazardous material on the job site will be provided to other employers in the event the other employer's employee(s) may be exposed to these materials. b. The methods the employer will use to inform other employer(s) of any precautionary measures that need to be taken to protect employee(s) during normal operating conditions and in foreseeable emergencies. c. The methods the employer will use to inform the other employer(s) of the labeling system used in the workplace.

Date of last update: 31 Mar 2025

Sources: New York Secretary of State