Francis, DavidFOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni l i
Grace Robinson F-1
Lor -i
Date Received:
Serial
006 to] HIMSwul
Town of Wappinger
Application for Hawkers
& Peddler's Lisense
The undersigned does hereby apply to the Town of Wappinger Town Clerk
RENEWAL
TEMPORAR"I
(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: iamm
1) Applicant:
NAME: i> -d Zs AGE:
CURRENT ADDRESS:
(St #) (Street) (City) (State) 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 Home Remodeling Group color photo (less
Address of Employer 60 Commerce Dr Trumbull CT 06611 than 60 days Old)
(St. (Street) (City) (State) (ZIP)
Proof of Employment %Xattach to aimlicationj
2) Nature of Business:
153rd EV i Coo 6:66,uli ' I -,--J o,er3
N Motor Vehicle (circle one): (car truck van
0 On Foot &/or with vehicle drawn by hand or animal
Vehicle Info: Vehicle Make Vehicle Model
License Plate # ��jy 6 State of Registration.
Operator's License Number
L Weights& Measures Certificate Certificate
U Dutc,hess County Health Dept Permit Permit # nha
2010-01-15 JCM
3) Veteran Status
El 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.
Dated:
Wappingers Falls, N.Y.
Sworn to before me this
day of
Notary Public
Sign'fure of
pp
Alicant
' a
If/
— _pft46a ft db
LISA EWSIDLER
N,oLary Public - State of New York
NO, 01EI6423776
QuMified in Suffolk County
My C
My, Commislion Expires Oct 18, 2075
I
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.
Now York State Department of Taxation and Finance
Certificate of Authority
' r
Identification number
23-3030708
I� E
,
(Use this number on sAreturns and correspondence)
POWER HOME REMODELING GROUP, LILAC
2601 SEAPORT OR STE 8190
CHESTER PA 19013.2240
VALIDATED
i
312612014
Dept of Tax
and Finance
is authorized to collect sales and use taxes under Articles 26 and 29 of the New York State Tax Law.
Nontransferable
This certificate must be prominently displayed at your place of business,
Fraudulent or other unproper use Wills certificate Y411 cause It to be revoked.
The certificate may not be photocopied or reproduced.
Pho"rephs • aapyright of NY8 Emp4re Slate 0*bv1Wmenr
40201091OU098 ID88-0860636 P0000236-01 DTF47A.(9/10)