CITY OF LEBANON N.H.Applications & Permits
Lebanon City Manager’s Office:
Physical address: 20 West Park Street
Lebanon, NH 03766
Mailing address: 51 North Park Street
Lebanon, NH 03766
Email: manager@lebanonnh.gov
Phone: 603-448-4220
Lebanon City Hall offices are closed to the public until further notice. All City Department staff will be available to
answer questions via phone or email.
The City of Lebanon continues to accept applications and permits via email, through the mail or dropped into the
green mailbox outside of the entrance to 20 West Park Street. Application and permit information can be found
on our website here:
https://lebanonnh.gov/203/Applications-Permits
All permits issued for the 2020 calendar year will remain in effect at this time, but with the rapidly evolving
circumstances regarding COVID-19, these may be rescinded. You will be notified at the earliest possible time for
you to plan accordingly.
The City of Lebanon is actively engaged with the New Hampshire Department of Health and Human Services
(DHHS) and our local and regional partners with regards to State and local response to the COVID-19 virus.
We encourage all to visit our website for the latest updates and information:
https://lebanonnh.gov/1350/COVID-19
USE OF CITY PROPERTY CHECKLIST
Use of City Property applications will be reviewed, along with the below checklist, to ensure all City
requirements are met. Please be aware that Colburn Park must remain open and accessible to the
general public.
1. Masks must be worn by all people entering the event, and by those monitoring the entry point.
If participants or people associated with the event are less than six feet apart, masks must be
worn.
2. Hand sanitizer needs to be accessible for all entering the event.
3. Bathroom facilities need to be provided and sanitized after each use.
4. How many vendors will be part of the event? (Please note that vendors are required to be at
least ten feet apart from each other, face a directional walking path, and be able to segregate
from other park activities)
5. Only one entrance and one exit for the event is permitted.
6. Layout Plan required. Please use the attached layout of Colburn Park to show proposed
entrance, exit, vendor locations (indicating distances between), and the directional flow of
participants when they enter.
7. How many event organizers will be in attendance to ensure proper hygiene, bathroom
sanitization, and social distancing?
Pursuant to State of New Hampshire Emergency Orders, I hereby attest to the fact that my business is
deemed an essential service and is in compliance with all New Hampshire issued emergency orders
currently in effect.
________________________________________
Signature
________________________________________
Printed Name
________________________________________
Title
________________________________________
Date
USE OF CITY PROPERTY CHECKLIST
Last Revised 07-18-18 City of Lebanon—Application for Permit
Use of Colburn Park & Parade/Race/Walk
Page 1 of 3
Colburn Park Described as the enƟre area bordered by North Park Street on the north, West
Park Street on the west, South Park Street on the south and East Park Street on the east,
excluding the sidewalks along those streets.
1. If a tent lar ger than 15’ x 15’ is to be used, this permit is condional upon review,
inspecon and approval by the Lebanon Fire Department.Please contact a Fire
Inspectorat4488810tosetupameforinspecononcethetentisinplace.
2. If 50 or more people are expected at an event, a Place of Assembly Permit may be
required from the Lebanon Fire Department.This permit is condional upon review
andapprovalbytheLebanonFireDepartment.PleasecontactaFireInspectorat448
8810.
3. Trashistobedisposedofattheconclusionoftheevent.
4. Any fundraising acvies must be held well within the connes of Colburn Park; no
solicitaonsofanytypearetooccurnearthevariousentrancestothePark.
5. If a public address system or amplicaon is to be used a Sound Permit must be
obtained from the Lebanon Police Department.No amplicaon equipment may be
usedonSundaysexceptbetweenthehoursof1:00pmand5:00pmunlesspermissionis
grantedbytheCityCouncil.
6. Unless a waiver is granted, a CerƟcate of Insurance must be provided to the City
Manager’sOcepriortotheevent.
7. Vehicles are allowed in Colburn Park only for unloading/loading purposes.Please
restricttravelintheParktothepavedwalkwaysonly.Anydamagedonetothegrass
orotherareasoftheparkistheresponsibilityoftheapplicant.
8. Ifelectricityisrequiredforyourevent:
a. Please contact the Lebanon Recreaon Department at4485121 at least 48 hours
priortotheeventtoretrievethekeytotheelectricalbox.Ifyoureventfallsona
SaturdayorSunday,besureto contactRecreaonby theWednesdaypriorto the
event.
b. This permit is condional upon an electrical safety check to be conducted by the
City’selectricalinspector.PleasecontacttheCodes Departmentat least48 hours
priortotheeventat4481524toscheduleasafetywalkthroughpriortotheevent.
If you event falls on a Saturday or Sunday, be sure to contact the Codes
Department by the Wednesday prior to the event and speak with the City’s
ElectricalInspectortogoovertheelectricalsafetyissues.
9. Ifwaterisrequiredforyourevent,pleasecontactUliesMaintenanceat2985190at
least48hourspriortotheevent.Ifyoureventfallsona SaturdayorSunday,besure
tocontactUliesMaintenancebytheWednesdaypriortotheevent.
CITYOFLEBANONN.H.—ApplicationforPermit
COLBURN PARK USE & PARADE/RACE/WALK
Last Revised 07-18-18 City of Lebanon—Application for Permit
Use of Colburn Park & Parade/Race/Walk
Page 2 of 3
10.Alcoholuse,saleorconsumponisprohibitedunlessanAlcohol ExempƟonisgranted.
ANewHampshireliquorlicensemustbeprovidedifthereistobeanysaleofalcohol.
Licenseemusthave acopyoftheNH Liquor License intheirpossessionontheday of
theevent.
11.The Licensee will serve alcohol pursuant to state and federal laws regulang the
distribuonandconsumponofalcohol.
Parade / Race / WalkaThon
1. Coordinate planned route with the Lebanon Police Department to assure the Parade
Routeisadequatelysupervisedbypolicepersonnel.
2. Insurance Requirements Form accompanied by a Cercate of Insurance, if needed,
mustbeprovidedtotheCityManager’sOcepriortotheevent.
3. Detailedsketchormapofparaderoute.
Insurance Requirements
ACercateofInsurancemustbeprovidedforeventswhich are ancipatedtoaract25 or
moreparcipants.Iflessthan25parcipantsareexpected,theCityManagermaywaivethe
requirementattherequestoftheapplicant(seeaachedInsuranceRequirementsForm).
TheCercateofInsurancemustlisttheCityofLebanonasaddionalinsured,andmustbein
anamountnotlessthan$500,000perpersonand$1,000,000peroccurrence.
Checklist:
 CompletedApplicaon
 InsuranceRequirementsForm
 CercateofInsurance
 SoundPermit(ifneeded)
 PlaceofAssemblyPermit(ifneeded)
 AlcoholExemponApplicaon(ifneeded)
 DetailedSketch/MapRoute
 RoutecoordinatedwithLebanonPoliceDepartment
Last Revised 07-18-18 City of Lebanon—Application for Permit
Use of Colburn Park & Parade/Race/Walk
Page 3 of 3
CITYOFLEBANONN.H.—ApplicationforPermit
COLBURN PARK USE & PARADE/RACE/WALK
BUSINESSNAME:
CONTACTPERSON:
StreetAddressCityStateZip
PHONE: EMAIL:
Purpose:
Date(s)EventtobeHeld:
StartTime:EndTime: ParadeRaceWalk‐a‐Thon
RouteofParade/Race/Walk:
 PleaseCompleteAttachedInsuranceRequirements Form.UnlessaWaiverisGranted,PleasePro-
videaCertiicateofLiabilityInsurance
 Ifalcoholicbeveragesaretobeserved,anAlcoholExemptionmustbeissued(CityCode§14)
ReviewRequirementsforConsumptionand/orSaleofAlcoholandcom pletetheAlcoholExemp-
tionForm
ApplicantagreesbytheirsignaturebelowthattheyhavereadandagreetothetermsandconditionsoftheUse
ofCityPropertyandParade/Walk/Race.
Signature:__________________________________________________________________Date:_______________________________
FOROFFICEUSEONLY
DATERECEIVED: LICENSE#
CertiicateofLiabilityInsuranceProvided
InsuranceRequirementsFormProvided
NHLiquorLicenseProvided
PoliceDepartmentApprovalReceived
ALCOHOLTOBESERVED?YesNo
AlcoholExemptionFormProvided
NHLiquorLicenseProvided(SaleofAlcohol)
CITYMANAGER: Date:
APPROVAL:
Waiver(s)Requested:CertiicateofLiabilityInsuranceWorker’sCompBondforDamage
MAYOR: Date:
AgreementandSignature
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signature
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City of Lebanon
Insurance Requirements
Page 1 of 3
CITY OF LEBANON N.H.
-
                

                

INSURANCE REQUIREMENTS
I, (please print legibly) , hereinaer referred to as the
LICENSEE, have requested the use of public facilies, hereinaer referred to as LICENSED PREMISES,
owned and operated by the City of Lebanon, hereinaer referred to as the CITY. The LICENSEE
understands that this aachment constutes a part of that permied use.
1. RELEASE FROM PERSONAL LIABILITY
The LICENSEE hereby releases and forever discharges the City, its heirs, agents, and assigns from any
an all liability for any and all damage to property the LICENSEE brings to the LICENSED PREMISES or any
and all bodily injury the LICENSEE, its employees, invitees, agents, or assigns may suer while at the
LICENSED PREMISES. The LICENSEE has aached hereto a cercate evidencing worker’s
compensaon insurance overage for any and all of its employees.
LICENSEE Signature Date
1.1 Opon to Waive Requirement for Worker’s Compensaon Insurance: The
requirement for worker’s compensaon insurance coverage may be waived by the CITY
if the LICENSEE ceres that they will not have any employees working at the LICENSED
PREMISES. It is understood and agreed by the LICENSEE that waiver of the requirement
for worker’s compensaon insurance coverage does NOT, however, relieve the
LICENSEE from providing the CITY with a Cercate of Insurance, or liability for claims of
property damage, or personal injury to volunteers or non-employees that my assist at
the LICENSED PREMISES.
I, , hereby cerfy that no employees will
be present at the event, and therefore am requesng a Waiver of Worker’s
Compensaon Insurance by the CITY.
Request for Waiver of Worker’s Compensaon Insurance: [ ] Approved [ ] Denied
City Manager Signature Date
2. RELEASE FROM INDEMNIFICATION FROM THIRD PARTY LIABILITY
The LICENSEE hereby releases the CITY from liability for any property damage or personal injury that
any parcipants may suer while at or on the LICENSED PREMISES. The LICENSEE further indemnies
and holds the CITY harmless from and against all claims for such property damage or personal injury
from third persons on the LICENSED PREMISES at the permission of the LICENSEE, including reasonable
aorney’s fees, whether or not such claims result in ligaon.
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City of Lebanon
Insurance Requirements
Page 2 of 3
2.1 Cercate of Insurance: The LICENSEE understands that it is required to have valid
liability insurance in force to guarantee its promise to pay damages to parcipants
outlined in Secon 2 above.
Aached to this release is a valid Cercate of Insurance (required to be in the
amount not less than $500,000 per person and $1,000,000 per occurrence and must list
the City of Lebanon as addional insured) evidencing the LICENSEE’S ability to indemnify
any individual who claims or might claim that acons of the LICENSEE caused him or her
damage to property or bodily injury.
Tenants Users Liability Insurance Policy (TULIP) is available to individuals or clubs
who need coverage for private events. Low cost coverage is obtainable for single-day
events like weddings, pares, reunions, concerts or charity benets. TULIP insurance
will need to be provided prior to any event held on City property by a private group.
(TULIP informaon sheet aached)
LICENSEE Signature Date
2.2 Waiver of requirement for Cercate of Insurance: The requirement for
Cercate of Insurance may be waived by the CITY if the LICENSEE expects to aract
only 25 parcipants or less. It is understood and agreed to by the LICENSEE that waiver
of the requirement for a Cercate of Insurance does NOT waive the requirement for
acceptance of liability outlined in Secons 1 and 2.
I, , am hereby requesng a waiver
from the requirement to provide a Cercate of Insurance as I do not expect to
aract more than 25 parcipants at any given me during the event.
The LICENSEE further promises that it will return the LICENSED PREMISES to the CITY in a
condion equal to or beer than its condion prior to its use. This includes removal of
any and all equipment which the LICENSEE brings to the LICENSED PREMISES as well as
lier, and also to repair all facilies damaged during the term of the permit.
Request for Waiver of Liability Insurance: [ ] Approved [ ] Denied
City Manager Signature Date
3. LIABILITY FOR DAMAGE TO CITY FACILITIES
Bond for Damage: The LICENSEE posts a bond (or leer of credit or cash deposit received by the CITY
this date) in the amount of $ payable to the CITY to be used by the CITY to
guarantee the promise in Secon 3 above. The bond (leer of credit or cash deposit) shall be in an
amount determined by the City Manager taking into account the intensity of use that the LICENSEE
ancipates for the LICENSED PREMISES. The LICENSEE understands that the CITY may take this bond
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City of Lebanon
Insurance Requirements
Page 3 of 3
(leer of credit or cash deposit) and repair any and all damage, replace any and all equipment
removed, remove any and all lier, or in any other manner expend it in order to return the LICENSED
PREMISES to a condion equal to what it was before the premises permied use.
3.2 Waiver of requirement of bond for damage: The CITY may waive the requirement
for a bond (leer of credit or cash deposit). Waiver of the requirement for a bond
(leer of credit or cash deposit) does not waive the liability of the LICENSEE for damage
to CITY property outlined in Secon 3.
I, , am hereby requesng a waiver
from the requirement to provide a Bond for Damage based on the informaon
provided in this applicaon and the low intensity of use expected at this event.
Request for Waiver of Bond for Damage: [ ] Approved [ ] Denied
City Manager Signature Date
TULIP Coverage A Guide for Users
Tenants Users Liability Insurance Policy (TULIP)
The TULIP PROGRAM provides low cost General Liability insurance to “third party” users of
various venues and facilities. It is used by institutions that permit “third parties” to use their
facilities for specific events. It protects both the facility user and the facility itself against claims
by “third parties” who may be injured or lose property as a result of participating in the event.
Events may range from very low risk activities, such as seminars, receptions or weddings, to
higher risk events including camps, sports events and concerts. The premium is based upon the
risk associated with the event or activity, the number of days needed, the number of participants
and if there are any special requirements, including alcohol liability, food service, etc.
Here’s what you need to do:
Go to link: https://tulip.onebeaconentertainment.com/e/tulip/apply.aspx
Enter the City of Lebanon’s venue ID Code OB54-402 (this will pre-fill the City of
Lebanon’s address).
Enter your event information.
If you have any difficulty with this process, please call NH Primex at 1-800-698-2364 x136.
City of Lebanon
Application for Sound Permit
Page 1 of 2
CityCodeChapter110.NoiseFromSoundAmpliicationSystems
§1104Permitrequired.
It shall be unlawful for any person to use or operate or cause to use or operate any sound-
amplifying equipment for commercial or noncommercial purposes on the street, in front
of or outside of any building, place or premises, or in any vehicle operated, standing or
being in or on any public street, highway, park or place or from any stand platform or
other structure or anywhere on or in the public streets highways, parks or places within
the corporate limits of the City of Lebanon unless he/she shall ϐirst obtain a permit from
the City of Lebanon.
§1106Termsforissuanceofpermits.
A. The issuing authority shall be the Chief of Police, and a permit shall not be denied for
any speciϐic time, location or use to any applicant who complies with the provisions of
this article, except as hereinafter excepted:
(1) Improper and incorrect application.
(2) Overlapping in the granting of permits for the same purpose or for more than one
purpose within a maximum of 100 yards of each.
(3) In any location within 100 yards of a school, courthouse, church, hospital or similar
institution.
(4) In any location between the hours of 8:00pm and 8:00am.
(5) In or on any vehicle standing or in motion between the hours of 8:00pm and
8:00am.
(6) In any location where the volume of sound emitted from the sound-amplifying
equipment will be audible for a distance in excess of 100 yards from the place or
places where such sound-amplifying equipment or apparatus will be located.
(7) In any location where, upon investigations by the issuing authority, it shall be
determined that the conditions of vehicular and/or pedestrian trafϐic are such that
the use of sound-amplifying equipment or apparatus will constitute a threat to the
safety of pedestrians or vehicle operators.
§1107Sundaysandlegalholidays.
Except between the hours of 1:00pm and 5:00pm, on Sundays and legal holidays, and only
by special permission of the City Council for good cause shown, permission to use and
operate sound-amplifying equipment shall not be granted. This is so ordered to ensure
against interference with religious services or civic observances and the general
tranquility of the community.
§11010Permitfees.
No permit fees shall be imposed upon any applicant for permit under the terms of this
article.
CITY OF LEBANON NH—POLICE DEPARTMENT
APPLICATION FOR SOUND PERMIT
City of Lebanon
Application for Sound Permit
Page 2 of 2
CITY OF LEBANON NH—POLICE DEPARTMENT
(INACCORDANCEWITHCITYCODE§110)
PleasesubmittotheLebanonPoliceDepartmentatleasttwoweekspriortotheevent.
APPLICATION FOR SOUND PERMIT
Applicant Name:
Business/Organization:
Street Address City State Zip
Phone: Email:
EVENTINFORMATION
Location of Event:
Event Purpose:
Event Date:_______________________________________ *Start Time:_______________End Time:_______________
*HoursarelimitedtoMondaySaturday,8am—8pmandSunday1pm—5pm,unlessapprovalbyCityCouncil.
Type of Sound Equipment: Number of Units:
ApplicantagreesbytheirsignaturebelowthattheyhavereadandagreetothetermsandconditionsoftheCity
CodeChapter110—ApplicationforSoundPermit.
Signature: __________________________________________________________________ Date: _______________________________
FOROFFICEUSEONLY
Date Received: PERMIT #
AgreementandSignature
SOUNDTRUCKINFORMATION(ifapplicable)
Vehicle Registration #:
Name & Address of Vehicle Operator & Sound Amplifying Equipment Operator:
Proposed Route of Truck:
Approximate Distance the sound will be audible from the vehicle:
Year/Make/Type of Vehicle:
APPROVAL
Police Chief Approval: Date:
City Council Approval (ifneeded): Date:
City of Lebanon
Exemption to Allow Alcohol on City Property
Page 1 of 2
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-
---
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               
           
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           
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            
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
EXEMPTION TO ALLOW ALCOHOL ON CITY PROPERTY
City of Lebanon
Exemption to Allow Alcohol on City Property
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CITY OF LEBANON N.H.
(IN ACCORDANCE WITH CITY CODE §14-5)
The purpose of this article is to regulate and control the consumption and possession of alcoholic
beverages in certain places. The authority for this article is RSA 47:1 and RSA 47:17.
EXEMPTION TO ALLOW ALCOHOL ON CITY PROPERTY
NAME:
ORGANIZATION:
ADDRESS:
PHONE: EMAIL:
EVENT INFORMATION
DATE: START TIME: END TIME:
LOCATION:
PURPOSE:
TYPE OF EXEMPTION REQUESTED
Consumption of Alcohol Sale of Alcohol* Both Consumption/Sale
*For the sale of alcohol, please attach a copy of your New Hampshire Liquor License.
Please provide the name and phone number of the person (over the age of 21) designated to remain
substance-free and to monitor the event for appropriate alcohol consumption by attendees.
Name: Phone/Cell #:
Please provide the names and phone numbers of two (2) designated drivers who will not consume alcohol,
and will be available until the end of the event.
Name: Phone/Cell #:
Name: Phone/Cell #:
CONDITIONS OF USE:
The exemption time period shall not exceed 12 hours.
Alcohol will be served only pursuant to State and Federal Laws regulating the distribution and
consumption of alcohol.
Please have a copy of the NH Liquor License in your possession the day of your event.
FOR OFFICE USE ONLY
DATE RECEIVED: PERMIT #
Monitors Name Provided
Designated Drivers Names Provided
NH Liquor License Provided
Police Chief Approval:
Date Received:
FINAL APPROVAL:
CITY MANAGER: Date: