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  5. HILAND PARK COUNTRY CLUB INC.

HILAND PARK COUNTRY CLUB INC.

Company Details

Name: HILAND PARK COUNTRY CLUB INC.
Jurisdiction: New York
Legal type: DOMESTIC BUSINESS CORPORATION
Status: Active
Date of registration: 30 Dec 2002 (22 years ago)
Entity Number: 2850537
ZIP code: 12804
County: Warren
Place of Formation: New York
Address: 195 Haviland Rd., Queensbury, NY, United States, 12804
Principal Address: 195 HAVILAND RD, QUEENSBURY, NY, United States, 12804

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HILAND PARK COUNTRY CLUB 401(K) PLAN 2016 020658178 2017-08-10 HILAND PARK COUNTRY CLUB 103
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 722300
Sponsor’s telephone number 5187932000
Plan sponsor’s address 195 HAVILAND RD, QUEENSBURY, NY, 12804

Signature of
Role Plan administrator
Date 2017-08-10
Name of individual signing IVAN FLORES
HILAND PARK COUNTRY CLUB 401(K) PLAN 2015 020658178 2016-08-22 HILAND PARK COUNTRY CLUB 83
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 722300
Sponsor’s telephone number 5187932000
Plan sponsor’s address 195 HAVILAND RD, QUEENSBURY, NY, 12804

Signature of
Role Plan administrator
Date 2016-08-22
Name of individual signing IVAN FLORES
HILAND PARK COUNTRY CLUB 401(K) PLAN 2014 020658178 2015-09-30 HILAND PARK COUNTRY CLUB 67
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 722300
Sponsor’s telephone number 5187932000
Plan sponsor’s address 195 HAVILAND RD, QUEENSBURY, NY, 12804

Signature of
Role Plan administrator
Date 2015-09-30
Name of individual signing IVAN FLORES

DOS Process Agent

Name Role Address
RAFAEL FLORES DOS Process Agent 195 Haviland Rd., Queensbury, NY, United States, 12804

Chief Executive Officer

Name Role Address
RAFAEL FLORES Chief Executive Officer 195 HAVILAND RD, QUEENSBURY, NY, United States, 12804

Licenses

Number Type Date Last renew date End date Address Description
0186-21-210036 Alcohol sale 2024-05-29 2024-05-29 2027-05-31 195 HAVILAND ROAD, QUEENSBURY, New York, 12804 Outdoor Athletic Fields and Stadiums
0340-23-227299 Alcohol sale 2023-03-29 2023-03-29 2025-03-31 195 HAVILAND ROAD, QUEENSBURY, New York, 12804 Restaurant
0423-23-227083 Alcohol sale 2023-03-29 2023-03-29 2025-03-31 195 HAVILAND ROAD, QUEENSBURY, New York, 12804 Additional Bar
0370-23-227299 Alcohol sale 2023-03-29 2023-03-29 2025-03-31 195 HAVILAND ROAD, QUEENSBURY, New York, 12804 Food & Beverage Business

History

Start date End date Type Value
2024-01-18 2024-01-18 Address 195 HAVILAND RD, QUEENSBURY, NY, 12804, USA (Type of address: Chief Executive Officer)
2024-01-18 2024-10-29 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2021-03-29 2024-01-18 Address 3 PROSPECT STREET, MORRISTOWN, NJ, 07960, USA (Type of address: Service of Process)
2005-03-24 2024-01-18 Address 195 HAVILAND RD, QUEENSBURY, NY, 12804, USA (Type of address: Chief Executive Officer)
2002-12-30 2024-01-18 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2002-12-30 2021-03-29 Address 3 PROSPECT STREET, MORRISTOWN, NJ, 07960, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
240118004540 2024-01-18 BIENNIAL STATEMENT 2024-01-18
210329060100 2021-03-29 BIENNIAL STATEMENT 2020-12-01
181213006648 2018-12-13 BIENNIAL STATEMENT 2018-12-01
170103006784 2017-01-03 BIENNIAL STATEMENT 2016-12-01
150521006056 2015-05-21 BIENNIAL STATEMENT 2014-12-01
110208002540 2011-02-08 BIENNIAL STATEMENT 2010-12-01
081209002612 2008-12-09 BIENNIAL STATEMENT 2008-12-01
061208002823 2006-12-08 BIENNIAL STATEMENT 2006-12-01
050324002659 2005-03-24 BIENNIAL STATEMENT 2004-12-01
021230000755 2002-12-30 CERTIFICATE OF INCORPORATION 2002-12-30

Inspections

Date Inspection Object Address Grade Type Institution Desctiption
2024-07-01 No data 195 HAVILAND ROAD, QUEENSBURY Critical Violation Food Service Establishment Inspections New York State Department of Health 2C - Cooked or prepared foods are subject to cross-contamination from raw foods.
2023-09-22 No data 195 HAVILAND ROAD, QUEENSBURY Not Critical Violation Food Service Establishment Inspections New York State Department of Health 11D - Non food contact surfaces of equipment not clean
2022-06-15 No data 195 HAVILAND ROAD, QUEENSBURY Critical Violation Food Service Establishment Inspections New York State Department of Health 5A - Potentially hazardous foods are not kept at or below 45°F during cold holding, except smoked fish not kept at or below 38°F during cold holding.
2021-07-23 No data 195 HAVILAND ROAD, QUEENSBURY Not Critical Violation Food Service Establishment Inspections New York State Department of Health 12C - Plumbing and sinks not properly sized, installed, maintained; equipment and floors not properly drained
2020-08-05 No data 195 HAVILAND ROAD, QUEENSBURY Critical Violation Food Service Establishment Inspections New York State Department of Health 4D - Other Violations Deemed a Public Health Hazard by the Permit Issuing Official {14-1.10(a)}
2019-05-30 No data 195 HAVILAND ROAD, QUEENSBURY Not Critical Violation Food Service Establishment Inspections New York State Department of Health 8E - Accurate thermometers not available or used to evaluate refrigerated or heated storage temperatures
2018-08-30 No data 195 HAVILAND ROAD, QUEENSBURY Not Critical Violation Food Service Establishment Inspections New York State Department of Health No data
2018-06-20 No data 195 HAVILAND ROAD, QUEENSBURY Not Critical Violation Food Service Establishment Inspections New York State Department of Health 11D - Non food contact surfaces of equipment not clean
2017-05-11 No data 195 HAVILAND ROAD, QUEENSBURY Critical Violation Food Service Establishment Inspections New York State Department of Health 5B - Potentially hazardous foods are not cooled by an approved method where the food temperature can be reduced from 120oF to 70oF or less within two hours and 70oF to 45oF within four hours.
2016-05-12 No data 195 HAVILAND ROAD, QUEENSBURY Critical Violation Food Service Establishment Inspections New York State Department of Health 1D - Canned foods found in poor conditions (leakers, severe dents, rusty, swollen cans)

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
344255963 0213100 2019-08-23 195 HAVILAND ROAD, QUEENSBURY, NY, 12804
Inspection Type Referral
Scope Partial
Safety/Health Health
Close Conference 2019-08-23
Case Closed 2019-12-13

Related Activity
Type Referral
Activity Nr 1488600
Health Yes
Type Inspection
Activity Nr 1423064
Safety Yes

Violation Items
Citation ID 01001
Citaton Type Other
Standard Cited 19100242 B
Issuance Date 2019-10-24
Current Penalty 0.0
Initial Penalty 4508.0
Final Order 2019-12-13
Nr Instances 1
Nr Exposed 3
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.242(b): Compressed air used for cleaning purposes was not reduced to less than 30 p.s.i.: (a) On or prior to 8/23/2019, in maintenance area, maintenance employee was observed using compressed air to blow off mower with regulated pressure set to as high as 100 psi.
344230644 0213100 2019-08-14 195 HAVILAND ROAD, QUEENSBURY, NY, 12804
Inspection Type Complaint
Scope Partial
Safety/Health Safety
Close Conference 2019-08-14
Case Closed 2021-03-23

Related Activity
Type Complaint
Activity Nr 1487318
Safety Yes
Type Inspection
Activity Nr 1425596
Health Yes

Violation Items
Citation ID 01001
Citaton Type Serious
Standard Cited 5A0001
Issuance Date 2019-09-18
Abatement Due Date 2020-04-20
Current Penalty 5000.0
Initial Penalty 5304.0
Contest Date 2019-10-15
Final Order 2020-03-30
Nr Instances 1
Nr Exposed 2
Related Event Code (REC) Complaint
Gravity 5
FTA Current Penalty 0.0
Citation text line OSH ACT of 1970 Section (5)(a)(1): The employer did not furnish employment and a place of employment which were free from recognized hazards that were causing or likely to cause death or serious physical harm to employees in that employees were exposed to fall hazards while being lifted in the loader bucket of a tractor: (a) At the worksite, during tree pruning: On or prior to 8/14/19, employee was operating a chainsaw from the elevated bucket of a John Deere 4500 tractor.
Citation ID 01002
Citaton Type Serious
Standard Cited 19100132 A
Issuance Date 2019-09-18
Abatement Due Date 2020-04-20
Current Penalty 5000.0
Initial Penalty 6630.0
Contest Date 2019-10-15
Final Order 2020-03-30
Nr Instances 1
Nr Exposed 1
Related Event Code (REC) Complaint
Gravity 5
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.132(a): Protective equipment was not used when necessary whenever hazards capable of causing injury and impairment were encountered: (a) At the worksite, during tree pruning: On or prior to 8/14/19, employee was cutting overhead limbs with a Stihl MS 291 chainsaw with 20" bar; employee did not use of personal protective equipment, including, but not limited to: hardhat, safety glasses, face shield, gloves, and upper body protection.
Citation ID 02001
Citaton Type Other
Standard Cited 19100132 D02
Issuance Date 2019-09-18
Abatement Due Date 2020-04-20
Current Penalty 0.0
Initial Penalty 0.0
Contest Date 2019-10-15
Final Order 2020-03-30
Nr Instances 1
Nr Exposed 8
FTA Current Penalty 0.0
Citation text line 29 CFR 1910.132(d)(2): The employer did not verify, through a written certification, that the required workplace hazard assessment had been performed: (a) At the worksite -- On or prior to 8/15/19, the employer did not have a written certification that a personal protective equipment hazard assessment had been performed for employee job tasks, including but not limited to: course maintenance and related activities, which required the use of personal protective equipment.
343275079 0213100 2018-07-04 195 HAVILAND ROAD, QUEENSBURY, NY, 12804
Inspection Type Fat/Cat
Scope Partial
Safety/Health Safety
Close Conference 2018-07-04
Case Closed 2018-10-25

Related Activity
Type Accident
Activity Nr 1355391
Safety Yes

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
8270718303 2021-01-29 0248 PPS 195 Haviland Rd, Queensbury, NY, 12804-8702
Loan Status Date 2021-09-15
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 110881.87
Loan Approval Amount (current) 110881.87
Undisbursed Amount 0
Franchise Name -
Lender Location ID 101888
Servicing Lender Name Broadview Federal Credit Union
Servicing Lender Address 575 Broadway, ALBANY, NY, 12207-2921
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Queensbury, WARREN, NY, 12804-8702
Project Congressional District NY-21
Number of Employees 50
NAICS code 713910
Borrower Race Unanswered
Borrower Ethnicity Hispanic or Latino
Business Type Corporation
Originating Lender ID 101888
Originating Lender Name Broadview Federal Credit Union
Originating Lender Address ALBANY, NY
Gender Female Owned
Veteran Unanswered
Forgiveness Amount 111436.28
Forgiveness Paid Date 2021-08-04

Related by officers

RAFAEL FLORES

AGUA BLANCA, L.L.C. CHAVELIETE LLC 5801 FOOD CORP. MOHAWK RIVER COUNTRY CLUB CHATEAU, INC. RAFAEL FLORES CORP.

Related by address

No related companies by address

Date of last update: 30 Mar 2025

Sources: New York Secretary of State

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