Block Party Application Page 1 of 2
Date Application Received: ___
WAYNE H. WINK, JR., TOWN CLERK _____________________DATE:________________________
APPLICATION FOR THE PURPOSE OF CONDUCTING A BLOCK PARTY
Print this form and complete it in writing. Answer all questions. Application must be filed 20 days prior to the date of event.
ORGANIZATION NAME (If applicable): Phone #
E-mail: __________________
ORGANIZATION OFFICERS
Name:
Address:
Name:
Address:
Name:
Address:
Person
in Charge:
Address:
Title:
Telephone:
Title:
Telephone:
Title:
Telephone:
Email: __________________________________
Telephone:
Location of block party (street): between
and . Community
Day and Date: Rain Day and Date:
Hours: From To _____________
Please Note: Chapter 38 of the town Code prohibits unreasonably loud noises after 10 PM
Name of your local Fire Department:
If barriers are required, arrangements must be made with the Highway Department Sign Shop, 285 Denton Avenue,
New Hyde Park, call Telephone #739-6731. Barriers must be picked up before 2 p.m. on the Thursday or Friday
before the event and returned the next working day after the event between 8 a.m. & 3 p.m., in good condition or
there will be a charge.
AT NO TIME CAN ANY VEHICLE BLOCK ACCESS TO THE STREET. SAFETY-SCENE TAPE,
CONSTRUCTION CONES OR REMOVABLE BARRICADES MAY ONLY BE USED TO BLOCK END OF
THE STREETS. (SAFETY-SCENE TAPE IS AV ILABLE AT STAPLES OR HOME DEPOT) THE
ROADWAY MUST HAVE A LANE FREE OF OBSTRUCTION, TO ALLOW EMERGENCY VEHICLES
ACCESS TO THE ENTIRE BLOCK. THE PERSON IN CHARGE LISTED ON THIS APPLICATION IS
RESPONSIBLE FOR INSURING THAT THE ABOVE CONDITIONS ARE MET.
Will you be erecting any type of tent?
If
yes, you must contact the Nassau County Fire Marshall's Office and the Town of North
Hempstead Building Department. (Enclose proof of approval)
Town Code Section 44-4 Consumption of alcohol in a public place permission
requested? (Yes / No)
If “Yes,” please contact the New York State Liquor Authority, 80 South Swan Street
Albany, NY 12210 (518) 474-3114 to determine if you need a 24-hour SPECIAL EVENTS
PERMIT. If so, please allow at least 15 days prior to the event for mailing of permit.
For Clerk use only
Application-
Approved / Disapproved
Clerk: _
PO Box 3000, 200 Plandome Road
Manhasset, NY 11030
516-869-7646
A FALSE STATEMENT WILL RESULT IN THE DENIAL OF THIS OR
ANY FUTURE PERMIT APPLICATIONS
