Department of Planning and
Economic Development
433 River Street, Suite 5001
Troy, N.Y. 12180
(518)279-7412
www.troyny.gov
This application pertains to businesses with valid food service establishment licenses and that would like to provide outdoor dining
opportunities on the publicly owned sidewalk or right-of-way. This form should be updated with configuration or business
ownership changes, as needed.
Legal Entity / DBA:
EIN #:
Business Address:
Owner / Manager:
Address:
City:
State:
Zip Code:
Email:
Telephone:
Name
Address
City:
State:
Zip Code:
Telephone:
Email:
Fax:
Fax:
If yes, please follow guidelines set by the Rensselaer County Health Department and NYS
Liquor Authority permits for outdoor dining.
Copy of SLA permit.
Hand drawn plans to scale are acceptable.
.
and will be compliant with the guidelines set forth in the Americans with Disability Act (ADA).
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