Incorporated Village of Cedarhurst
200 Cedarhurst Ave
Cedarhurst, NY, 11516
516-295-5770
516-295-1077 Fax

Application for Sign/Awning Installer/Contractor License

Fee _________________
Date ________________
Receipt # ____________


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Name of Sign/Awning Installer/Contractors

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Address

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City                                            State                                    Zip

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Telephone Number

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Insurance Carrier

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Policy Number

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Contact Person

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Signature

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Title


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Approved By:                                               Date: