Application For Salvage Dealer's License
2010-01-15 JCM
Received by:
Christine Fulton 0
Jessica Fulton 0
Town of Wappinger
Application for Salvage
Dealer's License
FOR INTERNAL USE ONLY
Date Received:
I
I
Serial #:
Application for Salvage Dealer's License
N.Y.
The undersigned hereby applies to the Town Board of Wappinger, Dutchess County, N.Y. for a (new) (renewal)
(temporary) license to engage in the salvage business pursuant to Town Code Chapter 153 entitled "Salvage Yard
Ordinance: An Ordinance Licensing and Regulating the Activities and Businesses of Dealers in Second Hand
Materials, Junk and Used parts," adopted by the Town Board on the 11th day of July, 1977, and Amended June 8,
1984, and in connection with such application does state as follows:
1. That the applicant, if an individual or member of an association or partnership, or the person signing
this application, if the application is made by a corporation, is over 21 years of age and a citizen of
the United States.
2. That the residence or principal office of the applicant is
3. That the premises where the business is to be or is presently located and carried on is at
, and that attached hereto is a map or plan of said
real property indicating the location and nature of all requirements specified in Section 4 of said
Ordinance or their proposed location and nature.
4. That the exact nature ofthe business to be conducted on said premises is
and the nature of the materials to be handled is
5. That applicant is the owner of said premises, or, if not the owner, applicant's right of occupancy is
derived from the owner (Owners name and address:
) as follows:
6. If applicant is a corporation, its principal officers with their respective place of residence and the title
of their respective offices are:
7. If applicant is a partnership, association or firm or conducts business under an assumed name, name
of the partnership, association or firm, or such assumed name is
and the names of all persons possessing a proprietary interest therein and their respective place of
residence are
8.
That applicant expects to engage
employees.
2010-01-15 JCM
9. That the applicant, if the license requested hereby be granted, consents and agrees to conduct the
aforesaid business or activity pursuant to all of the terms and regulation of the Ordinance above
specified.
All of which is respectfully submitted this
day of
,20_.
Applicant
By
Title
("Owner", or capacity in which acting if applicant is
other then individual).
* This application must be accompanied by a fee of Two Hundred dollars ($200.00), payable to the "Town of
Wappinger" (Section 5), and the map described in the Ordinance (Section 4). See the Ordinance for terms, time
allowed for compliance for renewal, etc.