Melara, RobertFOR INT ?,NAL —USE ONLY
Received by. Joseph P. Paoloni E
Grace Robinson
Lori McConologue /Av
Date Received: — /
Serial #;
NEW
2021-05-13 JPP
Town of Wappinger
A plication for Hawkers
I& Peddler's License
/- C � h,.� �°awl+
does hereby apply to the Town of Wappinger Town Clerk for a
FREMMUM
TEMPORARY
(I weekend only)
License for Hawking and Peddling pursuant to Town of Wappinger Lo, -d I nix,'Njn
,,
rTown Hawkers and Peddlers in the own or 11.1 p�ap E,or qvid in Co
application, does state the following:
1) Applicant:
NAME: R,,-)ker AGE:
CURRENT ADDRESS:
C) 16 1-4 3
(St (Street) (city) (State) (ZIP)
PHONE ##
PERMANENT ADDRESS (if different):
10 of IQQ?
(St #) (Street) (City) (State) (ZIP)
If Applicant is an Agent or Employer:
r -
Applicant's Employer
Address of Employer115-o �r ov q, o.
-E "I �ow 17 �", � I ,, I "
(St. #) (Street) (City) (State) (ZIF
Proof of Employment — I
2) Nature of Business:
r -i Motor Vehicle (circle one): artruck van
)
L. On Foot &/or with vehicle drawn by h.an or animal
Vehicle Info: Vehicle Make I'� ?L rLj_�j- Vehicle Model
License Plate 4 State of g11tr tion lillc—\
I -� ') o
Operator's License Number �,/ 0 L, �
L Weights &Measures Certificate Certificate
7- Dutchess County Health Dept Permit Permit #
2021-05-13JPP
3) Veteran Status
LJ 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:
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.
b 20
Dated: —
Wappingers Falls, N,Y. Signature of Applicant
Sworn to before me this
�f y of��., 20Z�
Noc
Lee A. Freno
Notary Public, State of New Yotk
No. 01 FR6327313
Qualified in Dutchess County
Commission Expires MI.. 4�
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. "' ,is a
non-refundable fee.'
Applicants possessing a valid Dutchess County Veterans Vendors Lice`
the $200.00 fee, provided that a copy of said license is attached;.t
. e7
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