Maupin, DillonFOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni I I
Grace Robinson Li
Date Received:
Serial #: 04-
2010-01-15 JCM
Town of Wappinger
Application for Hawkers
& Peddler's Lisense
q("O
Yp-un, 11 1
_tersigned does hereby apply to the Town of Wappingcr Town Clerk f T1(5,44i,� k `k
NEW RENEWAL TEMPOkAk�
--l-11" (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:
NAMEJ 11100, AGE: '4;-'-'-5;'
CURRENT ADDRESS:
(St #) (Street) 7U�� Looe, (C-Ity) - (State) (ZIP)
PHONE
PERMANENT ADDRESS (if different):
(St #) (Street) (City) (State) (ZIP)
If Applicant is an Agent or Emplo
Ozer: Tape a YX 2"
Applicant's Employer r Home Remodeling G,roup
color photo (less
Address of Employer 60 Commerce , , I D , rTr , u mbull :,CTO6611 than 60 days Old)
Fst. 4. (Street) {&Ity) (State) (ZIP)
Proof of Employment Oattach to aDDlication
2) Nature of Business:
SrIJ221 i
W
X Motor Vehicle (circle one) -r) truck van
[J On Foot &/or with vehicle drawn by hl(� �cor animal
Vehicle Info: Vehicle Mak Vehicle Model
License Plate # JP� _P2, i -J6 State of Registration .. .............. . .......... . . ... ...
Operator's License Number- '
E Weights & Measures Certificate Certificate# nIq
D Dutchess County Health Dept Permit Permit 4 nis
2010-01-15 .ICM
3) Veteran Status
11 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, goveming ones activities in the Town of
Wappinger as a Peddler or Hawker.
Dated:
Wappingers Falls, N.Y.
Sworn to before me this
day of ...:'r
20'
/0
Notary Public
120,Zq
Signatur f i pplicant
ur V��pi�
LISA EINSIDLER
Notary Public - State of New York
No. OIE16423776
Qualified in Suffolk County
My Commission Expires Oct 18, 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.
New York State Department of Taxation and Finance
Certificate of Authority
IdentificaFlo —nn umber
23-3030708
(Uge this number on a# returns and correspondence} � t
POWER HOME REMODELING GROUP, LLC
25x1 SEAPORT DR STE 8110
CHESTER PA 19013-2249
VALIDATED
3/2612014
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 certificate must be prominently displayed at your plaos of business,
Fraudulent or other Improper use of this ear0cate Y411 cause it to be revoked.
The redifloste may not be photocopied or reproduced.
Phulogmpha • aoWthl of NYB Empim State Owelopment
4020109100098 1DB8- aee0sa5 P0000236-01 DTl<-17,A(9110)