N.Y. Comp. Codes R. & Regs. tit. 9, § 104.1 – Publication notice by applicants for on-premises licenses.

(a) Every person applying for a license issued pursuant to section 51, subdivision 4, section 55, 64, 64-a, 64-c, 81 or 81-a shall publish a notice stating where the premises are located.
(b) Where the prospective licensed premises are located in any county other than New York, Kings, Queens or Bronx, notice shall be published once a week for two successive weeks in a daily or weekly newspaper to be designated by the county clerk, published in the city, town or village in which the prospective licensed premises are located, and if there be none, in the county where the proposed premises are to be located in a daily or weekly once a week for two successive weeks.
(c) Where the prospective licensed premises are located in the counties of New York, Kings, Queens or Bronx, such notice shall be published once a week for two successive weeks in one daily and one weekly newspaper, to be designated by the county clerk, published in the county in which the prospective licensed premises are located.
(d) The notice to be so published shall be printed in English, in substantially the following form:
1. (1) Form of notice for on-premises license. Notice is hereby given that license (fill in beer, liquor or wine as the case may be, and license number) has been applied for by the undersigned to sell (beer, liquor or wine, as the case may be) at retail in a (hotel, club, restaurant, vessel, car, or other type of establishment, as the case may be) under the alcoholic beverage control law at (fill in street address, city, town or village and county in which the prospective licensed premises are located) for on-premises consumption.
  [Name of Licensee]
  [Address of Licensee]
(e) The provisions of this section shall apply only to the application issued to the licensee for the premises.
(f) Except for good cause shown, the first publication of said notice shall be made within 10 days after the date of submission of the application and two original copies of proof of such publication, in the form hereinafter set forth shall be obtained by the applicant. One original copy shall be submitted to the authority within 15 days of receipt and the others shall be retained by the applicant. Except for good cause shown, the authority shall not issue the license sought by the applicant, unless such proof is submitted within such 15-day period. The form of proof of such publication shall be as follows:
STATE OF NEW YORK }
} SS:
COUNTY OF................. }
_____ of _____ being duly sworn, says that he is ___ of the publishers of the _____, a (daily) or (weekly) newspaper (printed and) published in the (city, town, or village and county) _____, and that the notice of which the annexed is a true copy, has been published in said newspaper for two successive weeks commencing on the ___ day of ___
__________
Sworn to before me this day
Of _____,

STATE OF NEW YORK	}
	}	SS:
COUNTY OF.................	}