Robinson, DanielleL FOR INTERNAL USE ONLY
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FReceivedob y: Joseph P. Paoloni I
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Date Received:
Serial 9:
2021-05-13 JPP
-,,,Town of Wappinp
Application for Hawkers
& Peddler's License
Qpcelve
M, d '1,4Rff5;Wk1
In of \NaPP
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The undersigned does hereby apply to the Town of W�aVNPr Town Clerk fnrq
RENEWAL TENTORARY
(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:
AGE.
CURRENT ADDRESS:
(St 4) (Street) (City) (State) (ZIP)
PHONE4
PERMANENT ADDRESS (if different):
(St 9) (Street) (City) (State) (ZIP)
If Applicant is an Agent or Employer:
Applicant's Employer OpKvnom C 'A
Address of Employer
(St. 4) (Styeet) (city) (State) (ZIP)
Proof of Employment (qqqch
2) Nature of Business:
Tape ,- X 2"
color photo (less
than 60 days Old)
L^ Motor Vehicle (circle one): ar I" truck van
F On Foot Wor with vehicle drawn by hand or animal
Vehicle Info: Vehicle Make H . Vehicle Model 6v'Ll
License Plate 9 2 ! St
ate�,of Registration
,\ "I �f
Operator's License Number , 'I '�) ` ,
Weights & Measures Certificate Certificaie-4—
U Dutchess County Health Dept Permit Permit 4
s
t
3) Veteran Status
2021-05-13JPP
F1 Veteran Applicant - Exempt from license fee (attach certificate from Dutchess County)
Names of all other municipalities in which the applicant has been a vendor in the preceding 6
months:
I
4) Compliance
That the applicant, if the License requested hereby is granted, consents and agrees to conduct the
aforesaid business or activity pursuant to all of the terms and regulations of the Local Law above
specified, and all other rules, regulations and Laws governing ones activities in the Town of
Wappinger as a Peddler or Hawker. F
Dated: U&WA fit* :a , 202'5
Wappingers Falls, N.Y.
Sworn to before me this
2L y of , 20
Notary Public
Lee A. Freno
Notary Public, State of New York
No. 01 FR637731 a
Qualified in Dutchess County
Carnmission Expires 716!
'V&VA6U l 11 seh/
Signature of Applicant
* Application must be accompanied by a fee of Two Hundred Dollars ($200.00) plus $50 for
each addition to the original license per year, payable to the Town of Wappinger. This is a
non-refundable fee,
x Applicants possessing a valid Dutchess County Veterans Vendors License are exempt from
the $200.00 fee, provided that a copy of said license is attached to the application.
1� " CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDDIYYIlYj
1z1z2rzo22
TH16 CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. TH19 CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed.
if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain pollcles may require an endorsement. A statement on
this certI leate does not confer rights to the certificate holder In lieu of such endoreemen# s .
PRODUCER
Edgewood Partners Insurance Center
One State Street Plaza, 9th Floor
New York NY 10004
CT
CNS Certificate Unit
PHONE 404-781-1700Arc Nn
a L : certificate(Ma icbrokers.com
INSURER(S) AFFORDING COVERAGE NAIC 0
11112023
INSURER A.- XL Insurance America Inc. 24554
EACH OCCURRENCE $1,000,000
INSURED ALTICE-01
Altice USA, Inc. & as per attached named insured schedule
One Court Square West
Long Island City NY 11101
INSURERS: Greenwich Insurance Company 22322
INSURERC:
INsuRERX}:
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY ❑ 1PER& D LOC
OTHER:
GENERALAGGREGATE $2,000,000
-
INSURER E:
INSURERF`
INSURERF,
B
^e%%1Cb An CC t-CDTICIr-ATC NI IRMOC:D. RMMRWAA RFVIRICIN NUMBER -
_.. _ _.....
E LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS .
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS 3UEIJF-OT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMIT$ SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INOR
LTR
TYPEOF INSURANCE
POLCYNUMBER
PMIDDN FF
PMYE
LIMITS
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS-MAQEFXI OCCUR
X 31R$1.00O.000
U5000858361123A
11112023
' 9/1/2024
EACH OCCURRENCE $1,000,000
TO RENTED
PRA MISES aarcu $600,000
MEDEXP jAy one anon) $
PERSONAL &ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY ❑ 1PER& D LOC
OTHER:
GENERALAGGREGATE $2,000,000
PROOUCTS�COMPIOPAGG $2,000,000
$
B
AUTOMOBILELIAERITY
X ANYAUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON-OWNEDPROPERTY
AUTOS ONLY AUTOS ONLY
RADI)437830-06
1/1/2023
1/1/2024
1 $ 3,000,000
aacxen34E
BODILY INJURY (Per person) $
BODILY INJURY (Per eaddent) $
DAMAGE q
r accident
$
A
X
UMtiRELLALWr3
EXCESS MAO
X
OCCUR
CLAIMS -MADE
US00066636L123A
11112023
1/1/2024
EACHpCCURRENCE $5000,000
AGGREGATE $ 5,000,000
D 1 X RETENTION
$
A
WORKERSCOMPENSATIDNRWD30D1337OB
AND EMPLOY9RV LIABILnY YIN
ANYPROPF iETOR/PARTNERiEXECUTNE ❑
OPFICERlM EMBER EXCLUDED1
(Mandatory In NH)
ITyas describe Under
DESCRIPTION OF OPERATIONS tomo
NIA
1/1/2023
111/2024
X STATUTE ERH
E.L. EACH ACCIDENT $1,000,000
E.L DISEASE- EA EMPLOYEE $1,000,000
EL DISEASE -POLICY LIMIT $1,000,006
DESCRIPTION OF OPERATIONS/ LOCATIONS I VEHICLSS (ACORD 101,Addlttonal Remarks Schedule, maybe attached it mors space Is required) -
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Evidence of Insurance AuTHORI,zEDREPRESENTATIVE
0 1988 2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD