Green, Beverly S ale Permit
Garage Application
Return to: Town Clerk
Town of Wappinger
20 Middlebush Rd.
Wappingers Falls,NY 12590
's
Name: y
ast '(First)
Address:
treet A ress)
Wa in ers Falls NY 12590
(City) (ST) (zip)
Phone: (IZ4�-L 4 '/'3
Address of Sale:
(1f different from above) (Street Address)
Waiminers Falls NY 12590
(City) (s'r) (zip)
Date of Saler From: ,` g (am/pm)until( / ).
tte t
a e e m
From: (am/pm) until (am/pm}
(Day Two) tme Begin) ime End)
From: (am/pm) until (am/pm)
ay ree) � Gme eget) ime ❑
4' f
Sig Date:
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni F
Grace Robinson
Date Received:
flD rt--/��ri==��
OCT 0 92015
TOWN OF WAPPINGP_
1"naAIIAg 'r-R fir.