Lawrence, JasonFOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni
Grace Robinson
LO rIN C– ('0 0 0 1 O�
Date Received:
Serial #:
2010-01-15 JCM
Town of Wappinger
Application for Hawkers
& Peddler's Lisense
I
The undersigned does hereby apply to the Town of Wappinger Town Clerk for a (sq's", "�
L4
NEW 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: AGE:
CURRENT ADDRESS:
WbA Re)
(F_
�te)
(St #) (Street) (City) (ZIP)
PHONE#
PERMANENT ADDRESS (if different):
(St #) (Street) (City) (State) (ZIP)
If Applicant is an Agent or Employer: Tape a 2"X 2"
Applicant's Employer ower Home Rerrfodeling Group color photo (less
Address of Employer 60 Commerce Dr TrumbuU CT 06611 than 60 days Old)
(St. ##) (Street) (City) (State) (ZIP)
Proof of Employment (attach to application)
2) Nature of Business:
M Motor Vehicle (circle one): car truck van
Ej On Foot &/or with vehicle drawn by hand or animal
Vehicle Info.- Vehicle Make �6�C4 Vehicle Model
License Plate # ' k4A�_�_ —" State of Registration __A�y
Operator's License Number q- I --
El Weights& Measures Certificate Certificate # n
F1 Dutchess County Health Dept Permit Permit 4 niq
2010-01-15.1CM
3) Veteran Status
❑ 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 5
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: �� , 20 Z14
Wappingers Falls, N.Y.
Sworn to before me this
day of 2 i 20aC
Notary Public
LISA EINSIRLER
Notary PoInk - State of New York
NO, 01EI6423776
Qu llfled in Suffoik County
My CtsMMI191on Expires Oct la, 2025
Application must be accompanied by a fee of Two Hundred Dollars ($200.00), 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.
...»,y w,
' &44Rin%
New York State Department of Taxation and Finance
Certificate of Authofity
Iderrliflcation number
23-3030708
(Use this number on a# returns and correspondence)
POWER HOME REMODELING GROUP, LLC
2501 SEAPORT OR STE 8110
CHESTER PA 19013.2249
Dept of Tax
and Finance
is authorized to collect sales and use taxes under Articles 28 and 29 of the New York State Tax Law.
Nontransferable
This Gediflcate must be prominently displayed at your place of business.
Fraudulent or other improper use of this oortiflcate will cause it to be revoked.
The certificate may not be photocopied or reproduced.
Phaboraphs - copyright of NY& Empire State DmWopmeat
40201091 0098 1DBB-0850635 1;0000236-01 DTF-17.A(9110)