• PEDDLER'S, VENDOR'S, OR SOLICITOR'S APPLICATION FOR PERMIT PURSUANT TO TOWN CODE 167 OF THE TOWN OF IRONDEQUOIT

  • 1. NAME OF APPLICANT: Fill in the exact legal name and address of the person or entity to which the permit is proposed to be issued (the "Applicant").


    (a) If the Applicant is a corporation, list exact full name as it appears on the Certificate of Incorporation, together with the state of incorporation.


    (b) If the Applicant is a partnership, joint venture or D.B.A. with more than one (1) member, list exact full name and address as it appears on the Partnership Agreement, or D.B.A. Certificate, together with the full name of each general partner.


    (c) If the Applicant is an individual, sole proprietorship or individual D.B.A., list the exact name and address of the Applicant and any individual owner.

  • 2. For each entity and/or individual listed in answer to Question No. 1, above, set forth the complete legal address and phone number. For a corporation or partnership, such address will be the principal office of the business, for an individual, such address will be the person's current, permanent home. Please set forth the street address by number, street, city and zip code. 
    POST OFFICE BOX NUMBERS ARE NOT ACCEPTABLE.

  • Is a Certificate from the Sealer of Weights and Measures necessary?*
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  • Is a Professional License necessary?*
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  • Is a bond necessary?*
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  • Is the Applicant a Veteran or other fraternal organization?*
  • Is the Applicant a not-for-profit organization qualified under §501(c)(3)?*
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  • Is Applicant a church, synagogue, or other religious organization or sect?*

  • Set forth a detailed description of the type, name, and brand of all goods, wares, commodities or services to be offered for sale, together with showing the amount, quality, and value of all items to be marketed. Note that your permit is only good for such items as you fully describe on this application form.

  • Details of prior convictions

  • Set forth all felonies and misdemeanors with which Applicant and/or owner, officer, partner or director of Applicant have been convicted within the last ten (10) years, including a description of the original charges, the date charged, and the name and address of the court where such charge was brought and the disposition of each charge.

  • Prior convictions related to the business of soliciting?*

  • NOTE: A POLICE BACKGROUND CHECK OF EACH PERSON TO BE SOLICITING WITHIN THE TOWN IS REQUIRED. THE POLICE CHECK MUST BE MADE AT THE APPLICANT'S EXPENSE AND MUST BE OBTAINED FROM THE TOWN OR CITY
    WHERE EACH SOLICITOR RESIDES AND BE PERSONALLY PROVIDED TO THE TOWN CLERK'S OFFICE AT THE TIME OF APPLICATION AND PRIOR TO ISSUANCE OF LICENSES.

  • Description of proposed plan for solicitation

  • (a) Set forth a detailed description of your specific proposed plan of operations to be used in merchandising the products or services. If door-to-door solicitation is proposed, set forth the days and hours of each week that such solicitation may
    occur.

    NOTE: that you may not sell or vend within 250 ft. of any school property between the hours of 8:00 AM and 4:00 PM on school days, nor enter upon private property for the purpose of peddling or soliciting before the hour of 10:00 AM of any
    day or after one- half hour before sunset of any day, except upon the prior invitation of the householder or occupant.
    There are other restrictions for which you are responsible as well.

    Please review Town Code Section 167-12 for a listing of such restrictions.

  • **YOU MAY NOT DEVIATE FROM THE ABOVE-STATED PROPOSED PLAN OF OPERATION WITHOUT SUBMISSION AND APPROVAL OF A NEW APPLICATION.***

    (b) If a form of contract or order form to be signed by customers is to be used, a copy of such form, complying with the provisions of New York Personal Property Law Article 10-A, if applicable, must be attached to this application.

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  • 11. NOTE If the application has more than one (1) employee, agent, independent contractor, or other authorized representatives, who will work in the Town of Irondequoit, the same information must be supplied as to each such
    person, who must complete and swear to a separate application form and pay for an individual permit fee. List all such persons and their addresses here. They will be asked to provide either an Employee/Agent/Independent Contractor ID or letter from "Applicant" stating they are representing their organization. 

  • Format: (000) 000-0000.

  • NO ENDORSEMENT The grant of a permit or certificate of permit by the Town of Irondequoit does not constitute anendorsement or official approval of your products or services. It is unlawful to make any representation to the contrary.

  • COMPLETED APPLICATION AND $500.00 NON-REFUNDABLE APPLICATION FEE SHALL BE GIVEN TO THE TOWN CLERK AT LEAST TWO (2) WEEKS IN ADVANCE OF THE FIRST DAY OF SOLICITATION. AS NOTED, BACKGROUND CHECK MUST BE SUBMITTED PRIOR TO SOLICITORS RECEIVING LICENSE.

  • 13. CERTIFICATION AND OATH
    (a) The undersigned has received, read and understands Chapter 167 of the Town Code of the Town of Irondequoit, entitled "PEDDLING AND SOLICITING" and agrees to abide by all restrictions and conditions set forth in such law.
    (b) The undersigned applicant has read this completed application and knows the contents thereof and swears that the same is true to deponent's knowledge.

  • Dated*
     - -
    2 digit month, 2 digit day, 4 digit year

  • SOLICITOR LICENSE APPLICATION TO BE COMPLETED BY EMPLOYEE/INDEPENDENT CONTRACTOR OF SOLICITOR

    Solicitor is a person doing business through the acts of selling or offering for sale, soliciting orders, demonstrating or making estimates on goods, services or merchandise directly to the public in the public streets and public places or by going from house to house whether by appointment, referral, uninvited solicitation, route salesman or party plan within the Town of Irondequoit.

  • ***PRIOR TO SUBMITTING AN APPLICATION FOR A SOLICITOR'S LICENSE, EACH APPLICANT MUST OBTAIN A POLICE BACKGROUND CHECK, AT THEIR EXPENSE, FROM THE TOWN OR CITY WHERE THEY RESIDE. THIS MUST BE PRESENTED PERSONALLY TO THE TOWN CLERK'S OFFICE.***

  • Date of Application*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Citizen of U.S.?*
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
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  • Will a vehicle(s) be used in soliciting?*

  • Vehicle Information

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  • Should be Empty: