Fay - Cannizzan, Mary Garagel It Application.
Return to Town Clerk
Town of Wappinger
20 Middlebush Rd.
Wappirigers Falls, NY 12590
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Naive:
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Address: w � �� i�°"
(Street Address)
Wappingers g Falls, NY1 2r)590 AUGG 2020
Phone: Cw 9 2- 7 �! / _. -'"OWN OF WAPPINGF"
Address of Sake: J. r�
(If different from above) (Street:Address)
Vv appiners Falls, NY 1259O
(City) (S'r) (zip)
Date of Sale: From: (am/pm) until 4•_. (arnJpm)
(Day One) (Tire Begin) ("rune End)
l' From: { t"°y _(a /pm) until (a1Ta/prn}
' " ._
(Day 7'wo) (Tire Begin) (Tirne End)
_From: (am/pm) until (am/pm)
(Day Three) (Tire Begin) (Time End)
Sign
FOR INTERNAL USE ONLY
Received by: Joseph P. Paoloni
Grace Robinson
Date Received. l
Serial.#: