Lane, Timothy
TOWN OF WAPPINGER
P.O. Box 324 - 20 MIDDLEBUSH ROAD
W APPINGERS FALLS, NY 1 2590
Town Clerk
Office: 845.297.5771 ^' Fax: 845.297.4558
www.townofwappinger.us
Application For Hawkers &. Peddlers License
The undersigned does hereby apply to the Town Board of Wappinger, Dutchess County, N.Y. for a
(new) (renewal) (temporary) 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:
Name I~~o+ll L~^~ Age tfe:,
Current Address S-SD?{ f='~ I \ I ^..J 'oAl v /,L-J\) r r
Cr<.~..5Io() iu'
Phone:
2/ ~(/7 L/~2v,
Business (3"':'v v 0 _ 7-./' L
Home ( )
Permanent Address, if Different
If applicant is an Agent or Employee:
Applicant's Employer
Address
Proof of Employment or Agent
l ; ,-
""-:',q
,,' ~""1
)j~' ,
( .~ ,~1;
'I"':",,;,", '(--,'
2. Nature of Business:
S~\ ,
~i.A...r,J,\,^,.z ,
D Motor Vehicle d-tor Truck 1 Motor Van
D ON FOOT and/or WITH VEHICLE DRAWN BY HAND OR ANIMAL
Description of Vehicle "F,-^,r.--J.-+-,z lr'4C,./k
License Plate Number (- p ,-- '11 ~ Y
''\.\ L
State of Registration 1'-1
Operators License Number ~-3-53 0 '2- 0 N ~
Weights & Measures Certificate Number (within 6 mos.)
Proof of Dutchess County Health Department Permit to handle food:
Permit Number
"TOW047.TC-AHPL (4-03 Rev) 1 of2
Names of all other Municipalities in which applicant has been a Vendor in the preceding 6
months: (;' r-e.eIJ-s be ru rv. c.... , ~ 0 ~ cu") ~ v../\ *- 't rJ l....
o url4J .-(.) /'..J ;J ,C .
Attach a copy of any license or permit required in conjunction with applicant's business from
any other Governmental Agency.
3. 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.
Sworn to before me this
1 day of f!Llif:' 2001 ,
~/~/2~ Z(~<i17
t ry Public
d;:::aljt
Dated: ) /7
Wappingers Falls, N.Y.
, 20-.! 7
BARBARA L. ROBERTI
Notary Public, State of New York
Reg. No. 01 R06130344
Dutchess County
My Commission Expires July 18, 2009
* This application must be accompanied by a fee of Two Hundred Dollars ($200.00) payable to the
Town of Wappinger, and is non-refundable.
Applicants possessing a valid Dutchess County Veterans Vendors License are exempt from the
$200.00 fee, provided a copy of said license is attached to the application.
Local Law #10 of '92
Adopted 10/26/92
TOW047.TC-AHPL (4-03 Rev) 2 of2
..----------~
This License Must Be Posted - pena1WWi'lI.'fle ~p:plied For 'l!a:t1ure 1'0 Post iN.f),.
OWNSR$HIP'NOT'~NSF,Efl*Bt;E
For the Period From On' OF BUttIJl'NfGI'ON [.[(CJENSE "'''''1 .ll
b~ r.r-l\l~rdl Date 031 1 9:)/ III 7
'Weeml!e Type .$
I tZ1 1 / 06 TO 06 / 30/ 121 7 T U 11 r-r.tij:: I T 1"rivi~g~ 'I'~ '10:::' t:::.17l
1"enaliy '$
MACK r. NZ I E TIRUC+< LNG -FU~IN I T UR'E 1:) I V I SON 'fOTAJL '$ 1 ~I C::171
R OR OPERATOR
5511lil~ FALL I iNS B~S lJ~ lta;\l~.;pai.atlte;pnv.i1Etg~ '['ax regtlired9.YOl:din;mceof tlte City
This is to certiJiy that of$.uilli:ngtlilli\,1\I1iC,LiGense is hereby issued to engage in the
business. or :pmoollle'of
MACK I N Z I E T RUCK r. NG -F URN I TURt: D PEt)il:LER BY' I,jf;E'H I CLE
33&-5a7-452~.1il
5508 FALL I N6 B ROOKS DR
GREE NSl\ORO NC 2 741l1J 7 -.fZtJllI2li0 for tlteyearslnownat the up:per left.
76 m:::ij/II\llr JFF~ f!l 1\ifP't.J Asst, Tax Collector
.4i
Ma'OKsnzie Truok,ing - Furniture lD:iv;isio!l1l
550'8 F a11'tingB:ro'oksDrive
Greensboro, iNl.C. 214'01
PH 336..S81-4S2"9
R\OWAN 'CtOUNTY
LICENSE
TimofhJ Lane
Owner,f Busiiness rI1~
le;n iYoore
Rowa:rn (C:oun!~, fiax lDdlQ(ectoit
Li(cemse:eXjp;ire$ , , ;~~jtp ..-- ~7
R006-07
t
:BNAf.AlM iA~"l!n( 'If.;Mi' ,I'\t);J:L:~1;)
~. '~WU~nt1fll ';l~:\J~\J:t:'vn
4fltrmm:11I M'Af.lI.!mm
SA~, ~lC._<<
---",..
LICENSE NO. 5386
STATE OF NEW YORK
LICENSE
Personal to the L!censee. Any
transfer or attem pt to transfer
this license is a misdemeanor.
COUNTY OF WESTCHESTER
f
Who resides at
having first presented his Cert!fii.9-te as a~ honorably discharge I/.
from the U .). ~1.. ~<the United States, and signed a statement as required by the
General Business Law.
I HEREBY CERTIFY, That he,isUcensed to Hawk, Peddle, Vend and Sell Goods, Wares or
_v .. .'~..I'r""
Merchandise, or Solicit Trade upon the streets and highways within the County of
Westchester, as provided by Law.
IN WITNE~SWHEREOF, I have set ~and and official seal
this day 0 .. ,19P
k of Westchester County, N. Y.
" '~..'
~,
COPY OF STATEMENT
Name
Residence at the time 0
Residence during last six months
Nature of goods to be sold
If applicant is working on commission or percentage for any company, the
name and business address of such company:
Jlj!
of the United States.
&'J-
,19~L,
"'..
Applicant.
In presence of
~
>
.
~.
~ ~t. 1IJ .
~..........L.J rUK
,~'L'" ,'rl\..ATlOI>i PURPOSES
,,-) -'
THIS IS AN 1?11PORTA,.~T HECORD
SAFEGUARD IT
.p~
l ) , ANY ALTERATIONS IN SHt.DED
_/ ( AREAS RENDER FORM VOID
CERTlFIC;......: bF RElEASE OR DISCHARGE
FROM ACTIVE DUTY
'-{.,
/-~--)
'",J
DD
214
FORM
1 JUl 79
PREViO _ITIONS OF THIS
FORM ARE OBSOLETE.
I NAME (Last, first, middle)
2. DEPA~T:.\ENT, COMPONENT AND oRANG'
AIR FORCE--REG AF
5. DATE OF BIRTH 6. PLACE OF ENTRY INTO ACTIVE JUTY
1060 JUL 06
CHARLOTTE HC
B. STATION WHERE SEPARATED
SEyr,lOUR JOHNSOn AFB HC
10. SGlI COVERAGE
AMOUNT S 35
F
11. PRIMARY SPECIALTY NUMBER, TITlE AND YEARS AND
MONTHS IN SPECIALTY (Addilional specialty numbers and tilles
involving periods of one or more years)
12 RECORD OF SERVICE
YEAR (s)
1979
1983
04
00
00
03
00
1981
1985
a. Dole Entered AD This Period
43151 - AIRCRAFT l1AINTEJ:.1ANCE SPECIALIST
03 YRS, 07 MONTHS
b. Separation Dale This Period
C. Nel Active Service This Period
d. 10tol Prior Active Service
e. lotal Prior Inactive Service
r. Foreign Service
g. Seo Service
h, Effective Date of Pay Grade
3924
(; G t,~' 1\ I;) )
MON (s)
l1AR
tvJAR
00
00
00
00
00
NOV
HAlt
000
o NONE
DAY,(S)
21
20
00
00
00
00
00
01
20
~-- ~
i Reserve Oblig. Term. Date
13. DECORATIONS, MEDALS, BADGES. CITATIONS AND C,AMPAIGN RIBBONS AWARDED OR AUTHORIZED (All periods of sero~e)
AIR FORCE TRAINING RIBBON, EXPERT NARKSHANSHIPRIBBON, OVERSEAS LONG TOUR . luBBON .
GOOD CONDUCT RIBBON.
14. MILITARY EDUCATION (Course Title, number weeks, and month and year completed)
AIRCRAFT ~~INTENANCE SPECIALIST COURSE (TACTICAL), 5 WEEKS, JUN 1979.
AIRCRAFT HAINTENANCE SPECIALIST COURSE (AIRLIFT BOHBARDMEUT), 5 WEEr.s, JUN 1979.
AIRCRAFT HAINTENANCE SPECIALIST COURSE (ENTRY LEVEL), 4 l'IEEKS, AUG 1979.
USAF NCO ORIENTATION COURSE, 1 WEEK, HAR 1982.
,'~. MEMBER CONTRIBUTED TO POST-VIETNAM ERA 16. HIGH SCHOOL GRADUATE OR EOUIV ALENT
VETERANS' EDUCATIONAL ASSISTANCE PROGRAM 0 nil n?I 0
YES ~ NO L.:j YES NO
I B. REMARKS
17. DAYS ACCRUED
LEAVE PAID 5.5
--NOT APPLICABLE-
19. MAILING ADDRESS AFTER SEPARATION
5508 FALLING BROOKS DR. GREENSBORO, NC 27407
SENT TO
20. MEMBER REOUESTS COPY 6 BE
NC
" "G ':'"'~IM'" "ON
'//Tnn. 111
22. TYPED NAME. GRADE, TII E
AUTHORIZED TO SIGN
t"'h~...f: (\...,~~...
23. TYPE OF SEPARATION
RELEASE
SPECIAL ADDITIONAL INFORMATION (For use b)' authorized agencies only)
24. CHARACTER OF S~RVICE (Includes upgrades)
HONORABLe;
25. SEPARATION AUTHORITY
AFR 39-10
26. SEPARATION CODE
MBK
27. REENLISTMENT CODE
1J
.:>B NARRATIVE REASON FOR SEPARATION
EXPIRATION TERM OF ACTIVE OBLIGATED SERVICE
CD".f-~"""""
S r, OJ02.LF-OCiO.2140
(
INITIALS
29. DATES OF TIME LOST DURING THIS PERIOD
NONE
SERVICE - 2
THE REPLY TO THE INQUIRY WIL E FOUND IN THE CHECKED ITEM(S). IF YOU WRITE TO US AGAIN ON THIS SUBJECT,!
PLEASE RETURN YOUR ORIGINAL REQ~.FST, THIS FORM. AND ANY OTHER FORM YOU COMPLETE.
~ Copies of requested military ~ p:fstn~1 0 medical records are attached. We suggest you make an extra copy and guard against
losv>r demage. We regret if any photocopies may be of poor quality, but they are the best copies obtainable.
~ The attached separation document may include the following information: ,authority for separation, reason for separation, Reenlistment
Eligibility Code, and Separation (SPN/SPD) Code. If you require a copy of the separation document that does not contain the above information,
you may request a deleted copy from this Center.
o The Privacy Act of 1974 does not permit the release ofa social security number or other personal information to the public without the
authorization of the veteran concerned; therefore, we have deleted personal identifying data relating to other persons,
o The Reenlistment Eligibility (RE) Code issued upon release from active duty on
o The reason and authority for separation from active duty/disch~rgeon
is
is
'~
;.
~i .~,
,0 ,The record ofse~ice inthe ",' indic,a~esbeing i~a POW Iltatus, from to
~ilitary persdnnel, upon discharge from the A~m~~" Forces,'fsre issued disCh'~rg~ certificates. These certificates are prepared in the ~;i~inal O~~y; M
therefore, copies cannot be furnished. The law' does provide that upon ,presentation ofsatisf~ctory :prqof of ,loss (such as ,a .signed statement),
an honorably discharged veteran or the survivingspo,use maybe givenll"!.certificate in lieu of lost or destroyed discharge:' We are unable to
issue a certific:ate in lieu to anyone other than as provided by law.
o The doc~ment you have requested, DO Form 214, Report of Separation, was not used until Jan. 1, 1 950. However, a similar form was
used at the time the person named above was separated. A copy of it is attached.
o When the person named above was separated, it was not the practice to issue a docurpent which served as a report of separation.
o The original Report of Separation was issued at the time of separation. Another original cannot be issued. The attached copy, however,
will serve the same purpose as the original.
o No Report of Separation was issued since the person named above had no active service, or less than 90 days of active duty for training.
The seniicerecord of the person named, above does not contain a copy of a Report of Separation, or its equivalent. Therefore, we are
,.Instead furnishing the attached NA Form 13038, Certification of Military Service. This will serve as verification of military service and may be
used for any official purpose.
o That portion of your request seeking medals/awards has been referred to the office checked below. That office has jurisdiction over the
issuance of medals/awards. Any further correspondence on this subject should be addressed to that office.
o ARPERCEN, Attn: DARP-PAS-EAW 0 Navy Liaison Office, Room 3475, N-314 9700 Page Blvd., St Louis, MO 63132
o The medical records you request 0 The documents you request pertaining to discharge have been lent to the Veterans
Administration and may be obtained from the VA office shown b!llow.
o According to the provisions of 000 Directive 5400.11, we cannot release a portfn of the medical records you have requested. They contain
information that can be interpreted and explained properly only bya physician. If you wish us to send copies to a designated physician, please
furnish us with the name and address of that physician. . The request MUST INCLUDE the service person'swritten consent (signature). authorizing
the release of the records to the designated physician.
o
~dL Kud ~~
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~N'V
jtJ7/}?
.
NCPM Fe. S'
Iv ~~=.....
NATIONAL PERSONNEL RECORDS CENTER
(Military Personnel Records)
9700 Page Boulevard
St Louis, Missouri 63132-5100
NATIONAL ARCHIVES AND RECORDS ADMINISTRATION
NA FORM 13044 (REV. 4-88)