Loading...
Ross, JoshuaFOI.I.R""""",,.,I,"NTERN.AL USE ONLY, Received by: Joseph P. Paoloni Lynn, O'Dell IJ A Cooper Leatherwood Date Received: WiN I") Serial #,.- C�2 G;Ll� 2021,-05-13 Jff e i v e Town of Wappinger Applicatlion for Hawkers & Peddler's License, The undersigned does hereby apply to the Town of Wappinger Towii, Clerk for a 04MA TEl''TrIf Ky (I weekend, only) License for HawkIng and Peddling Pursuant to Town of Wapp inger Local Law No. 1, 0 of 1992, I .. . n I r SIM application, does state the following: 1) Applicant: NAME-',', 1a AGE: CURRENT ADDRE S: (St #) (Street) (City) tate) (Z I P') H ' ONE 9 PERMANENT ADDRESS (if different): (St fl, (Street) (City) If Applicant is an Agent or Employer - Applicant's Employer Address of Employer (State) (ZIP) (St. (Street) (City) (State) (ZIP) Proof of Employment (attach to ap,p,1,i,c,qtiop,) 2,) Nature of Business: 0 Tape a 2"X 211 color photo (less than 60 days Old) /itoltor Vehicle (circle one): car truck van On Foot &/or with vehicle drawn by hand or animal Vehicle Info: Vehicle Make, Vehicle Model J, License Plate # C7, State o "r Regi stration Number Operator's Liceilse '2112 Weights & Measures Certificate Certqiffie'ate # 7 ............. - Dutchess, County Health Dept Permit Permit # 20,21-05-13 JPP 3) Veteran, Status Veteran Applicant - Exempt from license fee (attach certificate from w County) Names of all other municipalities inwhiich the applicant has been a vendor in the preceding 6 months. - 4) Compliance That the applicant, ifthe License requested hereby is granted, consents. and agrees to conduct the aforesaid business or activity pursuant to all, of the terms and regulat�ions 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. -z1� Dated,. " 120Z,"b Wa I ingers Falls, N.Y. pp* Sworn to bshore me this ay od' 20'Z 6, ry ' Public Lee A. Freno Nmota ry Public, State,, of New, York No. 0IFR632'7313 Qualified in Dutchess Co Commission, Expires 7161 �§i6ature of Applicant Application must be accompanied by a fee of Two'Hundred Dollars ($2010.00) plus $50 for each addition to the original license per year, payable to the Town of Wappinger. This is, a non-refundable fee. Applicants possessi ina valid Dutchers County Veterans Vendors License are exempt from the $200.00 fee, provided that a copy of said license is attached to the application,. i t y SOLAR NY Putnam County Home Improvement Contract�+ r # PC6987 NY Putnam County Electrical License # R23713 NY Westchester County Home Improvement Contractor #WC-27944-HI5 NY Westchester County Electrical License # 599 NY Rockland County Home Improvement Contractor #H-1231340 NY Rockland County Electrical License # 402 NY Orange County Electrical License # 198 NY'Sullivan County Electrical License # 442 NY Greene County Electrical License # 5,02 NY, Jurisdictions, license or registration information furnished upon request. For, other jurisdictions, please visit. http-://www.trinity-solar.com/about-,us/locations-and�i-Ilcenses January 1,2,, 2026 ,Josh.ua Ross is a Trinity Sales employee seeking approval to solici�t in the Town of Wappinger. We alre a local solar company specializingin residential financing options, and they are a part of the division that generates leads by golng door-to-door., The most prominent i procl�uict: we offeir is a power purchase agreement for homeowners to supplement thell r current Please contact me if you should have any questions Sincerely, M- ow6w N U4114/ Miaria: Nuzzi Lice n ng Ad m 1 nistrator 0 0 732-780-3779 E: Lice,nsin,g@trinity-sola�r.com Hudson Valley Office 62 Leone Lane Chester, New York 10918 I -877-SUNI-SAVES Ph, 8,45-572-0060 Fax, 8,45-576-0068; moM %tt-k! 11 �I&AIMVIIML- M150M -n W=9 Request for Taxpayer Fain, i Give Form to the (Rev. October 2018) Identification Number and Certification requester. Do not ,Department of the Treasury send to the IRS. Internal Revenue Service 0* Go to www. /rS.gov1ForrnW9 for instructions andthe latest information. =Z 1 Name (as, shown on your income taxreturn), Name I's required on this, finie; do not leave this line blank, 1 'ri n ity Soll ar, LLC i ine ss namiV isregaraed entity name, it teVerent from above 3 Cheick appropriate box for federal tax classification of the person whose narne Is entered on fine!l. Check only one of the following seven boxes. 0 Inds viduaVsole proprietor or EJ C Corporation S Corporation E] Partnership Trust/estate single -member LLC P Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership)i Note: hethe appropriate box In the lineabove for the tax classification of the single -member owner. Do not check LLC if the LLC Is, classified as a sin1 Z gle-member LLC that is di regarded from the owner unless the owner of the LLC is anNY ther LL,C that Is not d[sregarded from the owner, for US, federal tax, purposes, OtherwIse, a single -member LLC that is disregarded from the owner should check the appropriate box for the tax classification of Its owner, 110 ther (see instructions) lo P__0 5; Address (number, street, and apt. or suite no.) See instructions. t2l 1, Allenwood Road 6 City, state, and ZIP code Wall, NJ 07719 7' List account numbers) here (optional) 4 Exemptions (codes apply only to certain entities, not inclividuals; see Instructions on page 3). Exempt payee code (ifany) Exemption from FA'TCA reporting code (if any) (Applies�tea accounrs mainsained outside M& US) Requester's name and address (optionat) Z ocial security number i i I "I ink TAMimIGIMISTS ILMAMEM-UN 0 MINIM INT1,91dormigiff "s I WIWI vitwr�141'!il=Lwl a Pertification 1 Signature of Here U.S. person M W Z 1ate 0- 08/01,/2023 # W 0 Cat. No. 10231X F'orm, W-9 (Rev. 10-2018) N! EW Workers YORK LL,swi Com,p ensation, CERTIFICATE OF INSURANCE COVERAGE Board NYS DISABILITY AND PAID FAMILY LEAVE BENEFITS LAI PART 1. To be completed by NYS disability and Paid Family Leave benefits carrier or licensed insurance agent of that carrier 1 a. Legal Name & Address of Insured (use street address only) 1 b. Business Telephone Number of Insured Trinity Solar LLC 62 Leone, Lan 3733765 Chester, NY 10918 1 c. Federal, Employer Identification Number of Insured or Social Security Number Work Location of Insured (Only required if coverage is specifically limited to certain, locations in New'Yrk State, i.e., Wrap -"gyp Policy) 22-3292324 2. Name and. Address of Entity Requesting Proof of Coverage 3a. Name of Insurance: Carrier (Entity Being Listed as the Certificate Holder) Standard Security Life Insurance Company of New York Town of Wappinger 20 Middlebush Road 3b. Policy Number of Entity Listed in Box, la Wappingers Falls,, NY 12590 R71757-002 USA 3c. Policy Effective Period 8/1/2017 to 62026 4. Policy provides the following benefits: A. Roth disability and Paid Family Leave benefits. B. Disability benefits only. C. Paid Family Leave benefits only. 5. Policy covers: Fg] A. All of the employer's employees eligible under the NYS Disability and Paid Family Leave Benefits Law. E] B. nly the following class or classes of employer's employees: Under penalty of pedury, I certify that I am an authorized representative or licensed agent of the insurance carrier referenced above and that, the named insured has NYS disability and/or Paid Family Leave benefits insurance coverage as, des,cr" d above. Data Signed 6/2/2025 By 4j*�ut . . . ..... .... (Signature of insurance carrier's, authorded represent 'ative or, NYS licensed insurance agent of that ins,urance carrier) Telephone, Number (212) 355-4141 Name and Title S E VI S ' - UP ICY SERVICES I MPTANT: If'Boxes 4A and 5A are hecked, and thlis form is signed by the insurance carrier's authorized representative or NYS Licensed Insurance Agent of that carrier, this certificate is COMPLETE. Mail it directly to the certificate holder. If Box 4B, 4C or 5B is checked, this certificate is NOT COMPLETE for purposes of Section 220, Subd. 8 of the NYS Disability and Paid Family Leave Benefits Law. It must be emailed to PAU@wcb.ny.gov or it can be: mailed for completion to the Workers' Compensation Board, Plans Acceptance Unit, PO Box 52 ,00, Binghamton, NY 139,02-5,200. PART 2. To be completed by thie NYS Workers' Compensation Board (Only if B�ox 413, 4C or 5B of Part I has, been checked) State of' New York Workers' Complens,at,ion Board According to information maintained by the NYS Workers' Compensation Board, the above-named employer has complied with the NYS Disability and Paid Family Leave Benefits Law(Article 9 of the Workers" Compensation Law) with respect to all of their employees. Date Signed By (Signature Df Authorized NYS Workers' Compensation Board Employee) Telephone Number Name and Title Please Note: Only insurance Grarrfers licensed to write NYS disability al�d' Paid Fa/77ily Leave benefits insurarice poficies and NYS ficensed ill&lranceagoat, of those insUirancecarriers are authonzedto issue Form D113-120.1. Insurance brokers are NOT authorized to issue this form. B-120.1' (12-21) ,D EW 'Workers" YORK =Compensat'" CERTIFICATE OF yo", \ITV��, E Board ion NYS WORKERS" COMPENSATION INSURANCE COVERAGE 1 a. Legal Name & Address of Insured (use street address only) 1 b. Bou siness'Telephlone Number of Insured Trinity Solar LLC 631-319-7233, 62 Leone Lane Chester, NY 109,18, 1c. NYS Unemployment Insurance Employer Registration Number of' Insured 49-230,977 1 d . Federal Employer Identification Number of Insured or Social Security Woocan o rk Ltiof Insured (Only requireld if coverage is specifically limited Number to certain locations in, New York State, i - e, a Wrap -Up Policy) 22-3292324 2. Name and Address of Enti:tquesting Proof of Coverage 3a. Name ofincur aro ce Carrier (Entity Being Listed as the Certificate Holder) Town of'Wapp�ingder National Union Fire Insurance Company 20 Middlebush Road 3 b. IPolicy, N u rnber ofEntity Listed i n Box 1 a" Wappingers Falls, NY 12590 13188225 USA 3. Policy effective period 6/1/2025 to 6/1/2026 3d. The Proprietor, Partners or Executive Officers are included. (Only, check box I all partnerslofficers included) all excluded or certain partners/officers excluded. This certifies that the insurance carrier indicated above in box"3" insures the! business referenced above in box I a"' for workers' compensation under the New York State Workers'Compensation Law. To use this form, New York (NY) must be listed under Item 3A on the INFORMATION PAGE of the workers' compensation insurance policy). The Insurance Carrier or its licensed agent will send this Certificate, of Insurance to the entity listed above as the certificate holder in box '71". The insurance carrier must notify the above certificate holder and the We rkers'Compensation Board within 10 days IF a policy is canceled due to nonpayment of premiums or within 30 days IF there are reasons other than nonpayment of premiums that cancel the polig y or eliminate the, insured from the coverage indicated on this Cd rtifite. (These notices may be sent by regular mail.) Otherwise, this Certificate is valid for one year after this form is approved by the insurance carrier or its, licensedi agent, or uritilthe policy expiration date listed in box "3c", whichever is earlier. 'This certificate is issued as a, matter of information only and confers no rights upon the, certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policy listed, nor does it confer any rights or responsi bill ities beyond those contained in the referenced policy. This certificate may be used as evidence of a Workers' Compensation contract of insurance only while the underlying policy is in effect. Please Note: Upon cancellation of the workers" compensation policy indicated on this form, if the business continues, to be named on a permit, license or contract issued by a certificate hiolder, the business must provide that certificate holider with, a new Certificate of Workers' Compensation Coverage or other authorized' proof that the business is complying with the, mandatory coverage require sea nts of the New York State'Workers' Compensation Law. Under penalty of perjury, I certify that I am an authorized representative or licensed agent. of the insurance carrier referenced above and that the named insured has the coverage as depicted on this, form. Approved by:, Michael Price (Print name Of alUthorized representative or ficensed agent of insurance carrier) Approved by- .. ........ 6/1/2025 (Signature) (Date) Title: C.E.O. North America Telephone Number of authorized rd pr or licensed agent of insurance carrier - Please Note: Onlyire surance carriers and the licensed agents, are authorized to, issue ForrM 0-105.,2. Insurance brokers are -NOT authorized to, issue it. C- 10 5.2 (9 -1117) www.wcb.ny.gov D) ACC)R,L> CERTIFICATE OF LIB BILITYINSURANCE DATE (MM/DNYYY 5/30/2025 ..... ..... THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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(S), AUTHORIZED REPRESENTATIVE, OR PRODUCER., AND THE CERTIFICATE HOLDER. IMPORTANT: Ifthe certificate holder is an ADDITIONAL INSURED, the poli (i must have ADDITIONAL INSURED provisions or be endors,ed. If SUBROGATION IS WAIVED, subject, to the terms and conditions of the policy, certain polic,ies may require an endorsement. A statement on this - certificate does not confer, rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Alex Wlikin Arthur J, Gallagher Risk Management Services, LLC PHIONE . ................................ FAX / 56-482-9900 . . . . ............ JC, No). 856-482-1888 300 Fellowship Road (A (A Suite 200 E-MAIL ss.Ch....err, D.Ce1rtI)4,@ ADDRIE111- "I . .. .. ... .... . Mmint I :;iirpl Ki.i n,Rn-A;Vii. INSURED Trinity Solar LLC 62 Leone Lane Chester, NY 109,18 COVERAGES INSURE�!(�kffqR_PING COVERAGE NV I+ # . . . . ..... .. .............. ... .......... .... .... . ....... ........... ....... . ......... INSURER A.. National Union Fire Insurance Co,mpan of Pitt, 19445 uw . ....... ......... y 9- TSI NHEA-03 INSURER B . Evans,ton Insurance Com 35378 . ...... .. P ..... . . . ....... . . . ... . ................... . . .................................. . ....... INSURER, C.Nav(,gat.qrs_qp!qciaI! 36056 y Insurance Comp ..... ..... .. py . . . . .......... .. ........ . .......... . INSURER 1) . Endurance American Si . ecans Co P .. . . .... I ......... !"""IY-1Io 171 � . ... . . ................ ...... . ....... INSURER E,Liberty Insurance Underwriters, Inc 19917 CERTIFICATE NUMBER: 1906495449 BREI ILII NLIMRFR- THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABO�VE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANYREQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMEI' TWITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMIT'S SHOWN MAY HAVE BEEN REDUCED BY PAID, CLAIMS, ......... . . .. . . . . . .................... . . ............ ... . . ... . . . . . . ........ .................... FN -SF . . ...... . . .. ..... .. .. ............. . POLICY EFF P &Lf tko �', LTR TYPE OF INSURANCE POLICY NUMBER LIMITS W`VD (MMIDDIYYYY) (MMIDDIYYYY) � B X COMM ERAL GEN ERAL LIABILITY y MKLV7ENV1 06507 6/1 /2025 6/1/2026 EACH OCCURRENCE s 3,0001, 00 CLAIMS- MADE 1-K DAMAGE TO RENTED—` . ........ OCCUR PREMISES (Ea occurrence $300,0100 .... . . ...... . ..... ------ MED EXP (Any one person) $ 25,0D0 . . ........... PERSONAL & ADV INJURY $ 3T000 ? 000 GEN1 AGGREGATE LIMIT APPLIES PER,. ............. -_ GENERAL AGGREGATE $ 3,000,000 PRO- LOC .. . ........ POLICY LK DIET . . ...... .... .. .... ........ . P.R ODUCTS - COMPIOP AGG m_ . ........ ..... . . . .. . ................ $3T0001000 $ OTHER: A AUTOMOBILE LIABILITY 2960145 6/1/21025 6/1/2026 COMBINED SINGLE UMIT (Ea accid!tqi) ... . . ..... .. ....... s 5,000,000 X ANY AUTO BODILY I NJURY (Per person) $ ........... OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED PRO 11 PE I RT I Y DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accideDD . . ...... .. ........... . .. . ....... ........ ......... ... ....... $ C IC UMBRELLA LIAB A OCCUR . . . . . .......... NY25EXCZOLOHKIC NY25EXCZOLOHKIC 6/1/2025 6/1/2026 6/1/2025 6/1/2026 EACH OCCURRENCE ........ . . ........ $ 5,000,000 D E X EXCESS LIAB f . CLAIMS -MADE ...... 11111-111111 ELD300069891 03 6/1/2025 6/1/2026 AGGREGATE $ 5,000,0010 ... . . .................. 1000,231834-09 6/1/2025 6/1/2026 LE[RETENTIONS LIMIT X OF$5,000,000 $ 16,000,000 A WSNI COMPENSATION 13188225 6/1/20125 6/1/2026 X PER OTIC - STATUTE � EORH ........ AND EMPRS LOYE' LIABILITY YIN E,,L. EACH ACCIDENT 1111111--- $5,000,000 ANYPROPRIETORIPARTNER[EXECU I IVE N OFFICER/MEMBER EXCLUDED? NIA ................................ E.L. ISI SEAS,E - EA EI PLOYEE1 $5,000,000 (Mandatory in NH,) ff yes, describe under . ............................ DESCRIPTION OF OPERATIONS, below E.L. DISEASE - POLICY LIMIT $5,000,000 A AUTOMOBILE;; 296014�5 6/112025 6/1 /'2026 ALL OTHER, UNITS $2,50/$500 COMP. I COLLISION DEDUCT. j TRUCK7TRA CTORS,ILII SEMI -TRAILERS $,250/$500, DESCRIPTION, OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks, Schedule, may be attached if more space is required) EXCESS LIABILITY - CONT. Carrier: Columbia Casualty Company Policy #: 70396505,82 Policy Period: 6/1/2025 - 6/1/2026 Limit' $5,000,000 xs, $21,000,,000, The Certificate Holder is named as additional insured with respect to the above General Liability Policy, if required by written contract executed priorto services performed. CERTIFICATE HOLDER CANCELLATION ..... . .. . ........ ............. . . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED, BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Wappinger ACCORDANCE WITH THE POLICY PROVISIONS. 20 Middlebush Road Wappingers Falls NY 1,2590 AUTHORIZED REPRESENTATIVE USA @ 1988-201RD CORPORATION. All rights reserved. ACORD 25 (20,16/03) The ACORD narne and logo are registered marks of ACORD ,y�)< .< \ .:«:,> . y f ` \ \ \ » : » » a . . . . . » �§f $ ~^� �`�` <� d d ^ ^ \� \` :\©���� �� �~^�� >: .� � � � \d § ff # ,< :w :« \< 2»f4` TM, S L A R M TO 0 Wappingers Falls, NY 12590 (845) 297-57172 Provided i n this packet, �please submit it to the town clierk at the address above. A $200 check has been provided to cover the fee. Back, ,grouind Check/Fingerprlinting Required? (Instructions): A background check may be required.There is no mention, of Fingerprinting at the time. If any of this information changes, please inform the Licensing Department immediately. Special Notes About Township/Application Process: The permit process could take up to a month to receive,,, JO% Calesperson is required tio provide the following items: I - Valid Driver's License Company ID 2 Passport Photos All checks and documents provided in this packet, please complete the application fully. . . .. . . . .... ... .... . . .... ........ a lop IMP ............ J dab Best of Luck! Licenslll;,ng@tr*inity-,solar.com rl B ell% 2 9 6 3 8:15 M,&, cl n k TRINITY SA,R,, LLC 2,211 ALLENWOOD ROAD 104/220 WALL, NJ 07719 OIAR 1 /l 3/2,026 PAY TO THE ORDER OF' Iowa-Qf W -C iecs $**200.00` 00 HU, NDREDAI-101, 001 DOLLARS, VOID,AFTER ,1801DAYS, _j Town of Wappinger L 20 lsRoad'ers Falls NY 125,90 MEMO Solicitation Permit -joshua Ross - App. Fee S E (C Ul 11 E nN 2 q 1; 3 8 S iitin 501licitation Permit -Joshua Ros's -App. Fee