SECOND-HAND GOODS / PAWN SHOPS LICENCE APPLICATION FORM Note: Application fees are not pro-rated. Withdrawn or unapproved applications are subject to a 50% processing fee. This Licence Application is not a Municipal Licence. Approval from various municipal and government authorities must be received prior to the issuance of a Licence. This licence category expires on March 31st Our offices are located at: 2141 Major Mackenzie Drive, Clerk's Department - Licencing Division. Our business hours are: Monday to Friday 8:30am to 4:30pm. For General inquiries, please contact our offices at (905) 832-8585 or visit our website at http://www.city.vaughan.on.ca Business Registration submitted: �Corporation �Partnership �Sole Proprietorship Note : A Master Business Licence is also required if any of the above business registrations do not indicate the business location within the City of Vaughan jurisdiction. Assistance is available for business registration at the Vaughan Business Enterprise Centre - Located at 9995 Keele Street. Telephone:905 832-8526 Website:www.vaughan.ca/VBEC Address of Business: Unit City: Postal Code Registered Business Name Operating Name Bus. Tel. # Fax # Mobile Tel # Email Home Tel. # Mailing Address (If Different than above) Unit Postal Code City: Prov/State Anticipated Date of Occupancy In addition to the requirements set out in section 4.3 of Bylaw 315-2005, every application for a Second Hand Goods / Pawn shop Licence or renewal of such licence, shall be accompanied by the following: •Where the applicant is a natural individual, two (2) passport size photographs, taken within thirty (30) days; •Where the applicant is a partnership, such photographs shall be taken of one of the partners; •Where the applicant is a corporation, such photographs shall be taken of an officer of the corporation; •Deed of Property / Lease Statutory Declaration - to be completed by a Sole Proprietor, Partners and any officers of the business Surname: Given: Signature Position within company: Address: Apt/Unit/Suite# City: Prov: Police Clearance Letter attached □ (Please see next page /back for additional requirements): Postal Code: Statutory Declaration – Continued (to be completed by a Sole Proprietor, Partners and any officers of the business) Surname: Given: Signature Position within company: Address: Apt/Unit/Suite# City: Prov: Postal Code: Police Clearance Letter attached □ Surname: Given: Signature Position within company: Address: Apt/Unit/Suite# City: Prov: Postal Code: Police Clearance Letter attached □ Surname: Given: Signature Position within company: Address: Apt/Unit/Suite# City: Prov: Postal Code: Police Clearance Letter attached □ (Please attach any additional Officers with required information, documents and signature) BUSINESS TRANSACTIONS PER MONTH How many transactions (buys, pawns, and trades) come into the store on a monthly basis? □ 1 – 100 □ 101 – 250 □ 251 – 500 □ 501 and over Please check ALL types of second-hand goods carried by the store: □ □ □ □ □ □ □ □ □ Bicycles Collector Cards Coins Compact Discs Computers Computer Accessories Computer Games & Software Computer Hardware Electronic Equipment □ Jewellery □ Jewellery, Coins, Medals, and/or other precious metals for the purposes of smelting □ Leather Jackets □ Musical Instruments □ Photographic Equipment □ Pre-Recorded Audio Tapes and/or Discs □ Pre-Recorded Video Tapes and/or Discs □ □ □ □ □ □ □ □ □ Radios Sports Equipment Stereos Telephones Televisions Tools Video Games Video Game Terminals Watches □ Other:_____________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ MUNICIPAL LICENCE APPLICATION LAND AND BUILDING USE DECLARATION Description of Main Use or Activity: List of other uses or activities: Has there been any construction, alterations or renovations at the subject premises since the previous Licence issuance? Yes □ No □ 1) Please answer all of the following questions: a) Will food be sold to the public for immediate Yes □ No □ consumption on the property? (eating establishment) b) Is there an outdoor patio associated with Yes □ No □ an eating establishment? Yes □ No □ c) Will food be sold for take-out? (eating establishment) d) Are any of the following activities being Yes □ No □ proposed at the subject location? □ wood working □ spray painting □ welding □ commercial cooking □ use of compressed flammable gases e) Total number of staff: Male f) Will the use include the repair or servicing Yes □ No □ of equipment/appliances? g) Will the use include the repair or servicing Yes □ No □ of motor vehicles? h) Will there be any outdoor storage of Yes □ No □ vehicles, goods or materials? i) Will there be any outdoor display of Yes □ No □ vehicles, goods or materials? j) Will the use include retail sales? Percentage (%) of Floor Area devoted to retail sales % If you answered yes to the above, will all of the commodities you retail be products of the main use or activity? Yes □ No □ Yes □ No □ k) Will the use include wholesale sales? Yes □ No □ Female For information regarding Land Use – please contact Building Standards Department at 905 832-8510 2) Identification of Hazardous/Dangerous Materials Please identify by Trade Name and substance, all hazardous/dangerous materials that are used/stored on the premises. If additional space is required please attach a separate list to this form. □ check here if no hazardous/dangerous materials are used/stored on the premises. Trade Name Substance (Please see next page /back – Signature Required): 3) Declaration I, (Print name in full) Position with Company: certify that: 1) The information contained in this application, attached schedules, attached plans and specifications, and other attached documentation is true to the best of my knowledge. 2)I have authority to bind the corporation or partnership (if applicable). 3) I acknowledge that the application may contain “personal information” as defined under the Municipal Freedom of Information and Protection of Privacy Act. This information is required pursuant to the provisions of the Municipal Act. It will be used by the City of Vaughan to process this application, for administration of this Licence and to ensure compliance with all applicable statutes, regulations and by-laws. Questions about this collection should be directed to the Licensing Office, City of Vaughan. 2141 Major Mackenzie Drive Vaughan, Ontario L6A1T1 (905) 832-8585. 4) The applicant further agrees that any false information may result in a revocation of any Licence that may be issued.. Do not mail or email this application (Date) (Signature of applicant) OFFICE USE ONLY □Fire Department □ Health Department □ B.S.D. Application No. □ No Objection Comments Inspector’s Name M.L. □ Objections