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Prahach, RyanFOR INTERNAL USE ONLY Received by: Joseph P. Paoloni [-.1 Lynn O'Dell Lj I �, 2021-05-13 JPP of Wappinger, Application for Ra kers ec6oe6 & Peddler's License 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: Applicant: A -ilk a, NAME: 9 A V/ " �'�l AGE:Z2-�. CURRENT ADDRESS- p(xk-4Ukg!ac (St (Street) (t?ity) (State) (ZIP) PHONE 4 Y PERMANENT ADDRESS (if different): (St #) (Street) (City) (State) (ZIP) If Applicant is an Agent or Employer: Applicant's Employer Address of Employer 70 S�,,tA Proof of Employment (St. 4) (Street) (City) (State) (ZIP) _. (attach to application) 2) Nature of Business: Tape a 2"X 2" color photo (less than 60 days Old) Motor Vehicle (circle one): 1 -car -tx truck van Fi On Foot &/or with vehicle drawn by hand or animal Vehicle Info: Vehicle Make "( Vehicle Model License Plate 9 Les '�3tj-7( — State of Registration PJ Operator's License Number ac z -,;c cnc,,,ic+ , E Weights & Measures Certificate Certificate 4 Lj Dutchess County Health Dept Permit Permit 4 2021-05-13 JPP 3) Veteran Status Veteran .Applicant - Exempt from license fee (attach certificate from Daatchess County) Names of all other municipalities in which the applicant has been a vendor in the preceding 6 months: 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. Dated: �N�)b A :,, 2025,E Wappingers palls, N.Y. ESworn to before me this # 1�d y of d0 L aaj— NotPublic Lee A. Freno Notary Public, State of New York No. 01 FR6327313 taualified in Cutchess County Commission Expires 716t , M " - Si�nature 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. Applicants possessing a valid Dutchess County Veterans Vendors License are exempt from; the $200.00 fee, provided that a copy of said license is attached to the application. Rp® CERTIFICATE OF LIABILITY INSURANCE MIDONYM DATE(M12!22212022/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Edgewood Partners Insurance Center One State Street Plaza, 9th Floor New York NY 10004 NWNTEACT CertlfIG8te Unit PHONE 404-7$t-17013 A� No AMss: certificate a Icbrokera.com INSURERS AFFORDING COVERAGE NAIC# INSURERA: XL Insurance America Inc. 24554 INSURED ALTICE-01 Altice USA, Inc. & as per attached named insured Gehadula One Court Square West Long Island City NY 11101 INSURERS: Greenwich Insurance Com an 22322 INsuRERc: INSURERD: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER_ 80582OA4 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 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 18 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR � LTR TYPE OF INSURANCE LSUSR POLICY NUMBER POLICYEFF O POLICYEXP O LIrIRTS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X SIR$1,000,000 U800086636LI23A 9/112023 1/1/2024 EACH OCCURRE=NCE $1,000,000 SMI Es TO aoonurence $600,000 MEDEXP An one rson $ PERSONAL 8,ADVINJURY $1,000,000 GEN'LAGGREGATEIJMrrAPPLIESPi-R: X POLICY 0 JECT 0 Lac OTHER: GENERALAGGREGATE $2,000,000 PRODUCTS -COMPIOPAGO $2,000,000 $ B AUTOMOHILELIABILITYRADM78SO-06 X ANYAUTO OWNM SCHEDULED AUTOS ONLY AUTOS ARED ONLY AUTOS ONLYO 11112©23 1/1/2024 BINED 141BINED iN LE LI kT $3,000,000 Ea acddeMl BODILYINJURY (Per person) $ BODILY INJURY (Per accitlent) $ firer ac.RTY DAMAGE er accala $ A X UMBRELLA LWI3 X MES8LAB OCCUR CLAIMS -MADE US000856361-i23A 1/1/2023 1/1/2024 EACH OCCURRENCE $5,000,000 AGGRE"TE $5,000,000 DEEP I X I RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETORIPARTNERIEXBCiJTNE YINN1A OPi'IOERIM eMBEREXGLU[f Eq7 (Mandatory In NH) U yes, deson"be under DESCRIPTION OF OPERATIONS below RWD3001337-00 1/112023 11112074 X STATUTE - E.L. EACH ACCIDENT $10O4,AOU E.L. DISEASE -EA EMPLOYEE $1,000000 E.L. ❑ $EASE- POLICY LIMIT $1,000,006 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICL59 (ACoM 161, Additional Remarks Schedule, may be arawhed N more space Is raqulrod) 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 AUTHORIZED, REPRESENTATIVE 1988-2015 ACORD CORPORATION, All rights reserved. ACORD 25 (20713103) The ACORD name and logo are registered marks of ACORD