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Lent, CodyFOR INTERNAL USE ONLY Received by: Joseph P. Paolom 0 Grace Robison 0 Lori McConologue [I Date Received: Towti Serial #: To 2021-05-13 JPP Town of Wappinger kers ,�pplication far Haw eceive,(, & Peddler's License of Wappinge wn Clerk The undersigned does hereby apply to the Town of Wappinger Town Clerk for a NEW RENEWAL TEMPORARY (I weekend only) License for Hawking and Peddling pursuant to Town of Wappinger Local Law No. 10 of 1992, regulating Hawkers and Peddlers in the Town of Wappinger, and in connection with such application, does state the following: 1) Applicant: NAME: k. ' I C, 0+ AGE: CURRENT ADDRESS: 3S o-Icie-1- 10r, /0 C) (St #) (Street) ((Yty) (State) (ZIP) PHONE# (614 ) 0 PERMANENT ADDRESS (if different): (St #) (Street) (city) (State) (ZIP) If Applicant is an Agent or Employer: Applicant's EmployerF-Wejlo(,� 1", AAJC,-,ron Address of Employer a K' .&� K V11 t cl 611-( 1 owt, (St. #) (Street) (City) (Stafe) (ZIP) Proof of Employment (attach to application) Tape a 2"X 2" color photo (less than 60 days Old) 2) Nature of Business: t+ Lk n Ck n Oc, F-1 Motor Vehicle (circle one): car truck va 0 On Foot &/or with vehicle drawn by hand or animal Vehicle Info: Vehicle Make Vehicle Model License Plate State of Registration Operator's License Number E Weights & Measures Certificate Certificate # 11 Dutchess County Health Dept Permit Permit # a a a At - co Q C� �' �j' ,� IP;� 'f-� •,3 ,,kyr. - Cl 0 Fd Ul pd ' cl n0 r C ' � "�' � � P. Qrlot.; , . � E -i � ,�. • to tj :Nd y> tJ m cv"c31 �9 j Q . co fid... •,©� N. Ln i NC) vn N N C7 }s N CD t Lo N^ At - co v C� �' �j' ,� IP;� 'f-� •,3 ,,kyr. �- �' A.oq 0 Fd -2:0 pd ' cl n0 r C ' � "�' � � , . � E -i � ,�. • to tj :Nd y> tJ m cv"c31 �9 j Q . co fid... •,©� N. Ln i NC) vn N N C7 }s N v to •„b gm O cn 2 mm X -ten . w Dov Mm:i 9i R f-" ten'' � ZE 5L C1 Gl 2: ffi � br C �s p o ro v i N s na m o ° p� Q � ea Ci m LPCD x C6 a o 6i CJ a w m i t 22V o 0 m 0 M � Q � �> Z . C g - I i N CL El 2L m z ID ORO— O i �m 7d C 4 IMN rn ' .. h. #,ia•' �-�• �+�'[ a w,A � �4 .� Ill G C7 �v wG) 9 m N� g m a _ a, :t N Ciro f. E R � wo a _ � � Q N m n 300 54 MO rFl Gl a act, ���i Cpm« m ttea g ro a c�c77 p �,-n> UT ;U m p G) r O ***RECEIPT*** Date: 01/10/24 Recent#: 115854 Quantity Transactions Reference Subtotal 2 Peddlers Permit 24-01 24-02 $100.00 Notes Payment Type Amount CK #83612 $100.00 Name: Renewal by Anderson 110 Rotterdam Industrial Park Schnectady, NY 12306 Paid By Renewal by Anderson Total Paid: $100.00 Clerk ID: LM Internal ID: 24-0124-02