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circumstances regarding COVID-19, these may be rescinded.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
City of Lebanon Licensing Board—Application for License
Street Fairs / Theatrical Presentations / Shows
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   -
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
           
                   


     -
  - 



                  

-
 

-
 
           


 
               


    must           




Checklist:





-

STREET FAIR / THEATRICAL PRESENTATIONS / SHOWS
City of Lebanon Licensing Board—Application for License
Street Fairs / Theatrical Presentations / Shows
Page 2 of 2
-

STREET FAIR / THEATRICAL PRESENTATIONS / SHOWS



 
Street Fair Theatrical Presentations / Shows
 



FOR OFFICE USE ONLY
 





Waiver(s) Requested:

FINAL APPROVAL:
MAYOR 
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.
click to sign
signature
click to edit
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
click to sign
signature
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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
LEBANON POLICE DEPARTMENT
36 Poverty Lane
Lebanon, New Hampshire 03766
603/448-8800
APPLICATION FOR SOUND PERMIT
Code of the City of Lebanon, Chapter 110
The following must be completed and submitted to the Lebanon Police Department at least two weeks prior to
the date the permit will be used if approval needed by City Council.
Date of Application: _________________________
Applicant's Name: _______________________________________Phone #: ______________________
Applicant's Address: ___________________________________________________________________
Business Requesting Permit: _____________________________________________________________
Address of Business: ___________________________________________________________________
Type of Sound Equipment: _________________________ Number of Units: ______________________
Proposed Date(s) of Operation: __________ to __________ **Hours of Operation: ______ to ______
Location of Permit Use: ________________________________________________________________
Purpose: ____________________________________________________________________________
If a Sound Truck is Being Used:
Registration #: ______________________________ Year/Make/Type of Vehicle: _________________
Name & Address of Vehicle Operator & Sound Amplifying Equipment Operator:
____________________________________________________________________________________
Proposed Route of Truck:________________________________________________________________
_____________________________________________________________________________________
Approximate maximum distance the sound will be audible from the point of orientation (the vehicle):
_____________________
**According to City Code, Chapter 110, unless approved by City Council,
hours of operation limited to 8:00 am to 8:00 pm Monday-Saturday and
1:00 pm to 5:00 pm Sunday.
CITY COUNCIL APPROVED: ________________ (date)
REVIEWED and APPROVED / DENIED by the Chief of Police or his designee: ______________ (initials)
If Approved, a P.A. Permit will be issued.