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Peltz, JacobLOR INTERNAL USE ONLY Received by: Joseph P. Paoloni I I Grace Robinson F-1 i k -OV-' Date Received: Serial 2010-01-15 JCM Town of Wappinger Application for Hawkers & Peddler's Lisense A w 0j C\e� undersigned does hereby apply to the Town`bMapM*� �own Clerk for a NE 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: -I NAME: ........ .... . ... .... . ...... .. AGE:- '3— CURRENT ADDRESS: -� (St (Street) (City) (State) (ZIP) PHONE# �41 �jq qz PERMANENT ADDRESS (if different): (St #) (Street) (City) (State) (ZIP) If Applicant is an Agent or Employer: Applicant's Employer .0"wer Home Remodeling Group Address of Employer ' 60 Co�Street_r..._...,....merce Dr Trumbull CT 06611 (State) (St. #) ) Proof of Employment Vfattach to aDDlication) 2) Nature of Business: Tape a 2"X 2" color photo (less than 60 days Old) M Motor Vehicle (circle one): car truck van 11 Clan Foot &/or with vehicle drawn by hand or animal Vehicle Info: Vehicle Make -Su ,rL,, Vehicle Model License Plate # LCU - 9 State of Registration Operator's Licen'se—N' u--m—bei !,I "P'2 Ll Weights & Measures Certificate Certificate # nz-q. 7 Dutchess County Health Dept Permit Permit 4 n1c, 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: I/ 1—H 20N Wappingers Falls, N.Y. Sworn to before me this day of O.;,<?, 20 of ry Public Signature of Applicant SC 'OT -1- MCKIM,�E'Y §, J Cl ub I � C, S'Wf, of Conneclicut ExpiraS 03/31/2028 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. w STATE OF CONNECTICUT ml -603 DEPARTMENT OF REVENUE SERVICES Rev.OSY21 Tax Permit s CT Tax Registration No.: 048915557-001 Letter ID: L0006704230 Date Issued: January 30, 2024 POWER HOME REMODELING GROUP LLC Y POWER HOME REMODELING GROUT' INC 2501 SEAPORT DR STE B110 CHESTER PA 19013-2249 ml -603 Dear Taxpayer, Attached is your Sales & Use tax permit. Please display it conspicuously for your customers to see. Any permit previously issued by the Connecticut Department of Revenue Services (DRS) for the specific location noted on this permit is now void and should be destroyed. Any change in ownership or form of organization requires a new permit. If your business is sold, transferred, or discontinued, return this permit at once to: Department of Revenue Services 450 Columbus Blvd. Suite 1 Hartford, CT 06103 Enter the last day of business and the name of the successor, if applicable, on the back of the permit. Sign the permit as indicated. Business and individual taxpayers can use myconneCT to file a variety of tax returns, update account information, and make payments online. This Tax Permit is valid for two years. You may not assign or transfer this permit. Display this permit conspicuously for your customers to see. Department of Revenue Services State of Connecticut Sales & Use 450 Columbus Blvd. Tax Permit Suite 1 Hartford, CT 06103 aur Syssaxti raaxsmtrr The .person named below is licensed under the Sales &Use Tax Act. Use only at this location: This permit is good only for the named permittee and at the location shown. POWER HOME REMODELING GROUP LLC If there is any change in ownership, the permit is null and void. POWER HOME REMODELING GROUP INC bate Issued Expiration [late Business Start Connecticut Tax 60 COMMERCE DR Date Registration Number # 150 01/30/2024 03/31/2026 04/01/2010 048915557-001 TRUMBULL CT 06611-5403 POWER HOME REMODELING GROUP LLC POWER HOME REMODELING GROUP INC 2501 SEAPORT DR STE B110 CHESTER PA 19013.2249 This license may not be transferred or assigned. Mark D. Boughton Commissioner of Revenue Services A� Rf® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIODIYYYY} 3/21/2024 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND 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: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lacher & Associates Insurance Agency Lacher Insurance Group 632 Past Broad Street CONTACT - NAME: PHONE FAX c No Ex • 215-723-4378 AIc No:215-723-5757 E-MAIL cortificato@lacherinsurance.com INSURERS AFFORDING COVERAGE NAIC# Souderton PA 18964 INSURERA: Harleysville Insurance Co of New York 10674 IIGPP1081300 INSURED POWERCL-01 Power Home Remodeling Group, LLC 2501 Seaport Drive, 4th Floor INSURER B: Markel American Ins Co 28932 INSURER C: Arch Insurance Company 11150 INSURER D: Arch Indemnity Insurance Company 30830 Chester PA 19013 INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 1005957011 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE 1NSURFD NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR VVVQ POLICY NUMBER POLICY EFFPOLICY MMIDDIYYYY EXP MMIDDIYYYY LIMITS C X COMMERCIAL GENERAL LIABILITY IIGPP1081300 1/1/2024 111/2025 EACH OCCURRENCE $2,000,000 CLAIMS -MADE rx-1 OCCUR PREM SESCEa accE ence $2,000,000 MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $ 2,000,000 GEN'LAUG REGATELIMIT APPLIHSPER: GENERAL AGGREGATE $4,000,000 POLICY � jEOT E] LCC PRODUCTS - COMP/OP AGG $ 4,000,000 Policy Gen Aggregate $10,000,000 OTHER: C C AUTOMOBILE X LIABILITY ANY AUTO 11 CAB1081300 11 CAB1081400 MA ONLY 111/2024 1/1/2024 1/1/2025 1/1/2025 COMBINED SINGLE LIMIT $ 2,000,000 Ea accident BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident HIRED NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAR X OCCUR CRAD000027 111/2024 111/2025 EACH OCCURRENCE $ 3,000,000 AGGREGATE $9,000,000 EXCESS LIAB CLATMS-MADE DEC I X RETENTION $ GL&Products Aggregate $ 3,000,000 C D WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTIVE Y IIWCIIDS1300 FLONLY 14WC11081400 111/2024 1/1/2024 111/2025 1/1/2025 X I STATUTR ORTH- E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatary in NH) If yes, describe under DESCRIPTION OF OPERATIONS below H.L. DISHASE - POLICY LIMIT $ 1,000,000 S EXCESS LIABILITY MKLM7EUE101220 4/1/2024 1/1/2025 FACH OCCURRENCE 5,000,000 AGGREGATE 5,000,000 Excess of 3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Town of Wappinger 20 Middlebush Road Wappingers Falls NY 12590 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE �� O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD