Fillable Permit Application City of Bridgeport DEPARTMENT OF PUBLIC (City of Bridgeport)

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Permit Application City of Bridgeport DEPARTMENT OF PUBLIC (City of Bridgeport)

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City of Bridgeport Parks and Recreation – Permit Application
City of Bridgeport
DEPARTMENT OF PUBLIC FACILITIES
Department of Parks & Recreation
7 Quarry Rd, Trumbull, CT 06611
203-576-7233 (Phone)
203-576-7235 (Fax)
bridgeportct.gov/parksandrec
Permit Application
(NOT FOR ATHLETIC FIELD USE)
Please read the following and complete the application:
• All permit requests must be submitted 30 days prior to date of event.
• This application form is not a permit. The request will be reviewed by the Parks Department. The
Parks Department will make every attempt to accommodate your request.
• Please provide ALL the information for your event. Incomplete applications will not be processed.
• Due to COVID-19 Permits will not be issued to events that exceed 100 people at this time.
• Events with more than 50 people, will require Board of Park Commissioners approval.
• Due to COVID-19 Inflatable Devices are NOT allowed at this time.
• The City does NOT provide Porta-Johns.
• COVID-19 Form must be completed prior to any permit being issued.
• Completed applications MUST be submitted by email to: parkevents@bridgeportct.gov
Today’s Date: ____________________________________________________________________
Organization (if applicable): _________________________________________________________
Contact Name: ___________________________________________________________________
Address: ________________________________________________________________________
City: ___________________________________ State: ____________________ Zip: __________
Home Phone: ___________________ Work: ___________________ Cell: ___________________
Fax: __________________ Email: ____________________________________________________
Name of Park: _______________________ Specific Location: _____________________________
Estimated People in Attendance: _ 0 – 25 _ 25 – 50 _ 50 – 75 _ 75 - 100
Type of Event/Activity Planned:
_ BBQ _ Community Outreach _ Concert _ Fair/Market
_ Parade _ Rally _ Run/Walk _ Wedding Ceremony/Photos
_ Other (specify): ___________________________________________________________
Date(s) of Event: ____________________ Start Time(s): ___________ End Time(s): ___________
Day(s) of the Week: ________________________________________________________________
Time(s) for Setup: __________________________ Clean up: _______________________________
Person On-site Day of Event: __________________________ Cell: __________________________
Provide valid Email Address: _______________________________________
Craig A Nadrizny
Acting Director of Public Facilities
Jose C. Tiago
Deputy Director of Public Facilities
Lui
s Burgos
Manager of Parks/Roadway Division
Luann Conine
Recreation Superintendent
Joseph P. Ganim
Mayor
Select Location
City of Bridgeport Parks and Recreation – Permit Application
**************************************************************************************************
ADDITIONAL PARK EVENT PERMIT INFORMATION
Small Park Event permits do not guarantee a designated area of a park. Please be advised that Bridgeport parks
are open to the public on a first-come and first serve basis, and visitors are encouraged to arrive to set up their
area early and be courteous.
Larger Events are subject to approval by the Board of Park Commissioners during a scheduled meeting to be
held on the 2nd Tuesday of every month. If required, you shall be notified by parkevents@bridgeportct.gov that
your event will be placed on the agenda for review, date, time and Parks Board meeting location.
In the event the Board of Park Commissioners and/or the Department of Public Facilities, Parks and Recreation
permits the sale or use of alcoholic beverages, the permittee shall take appropriate measures to obtain any other
required permits that may be necessary and shall ensure that the dispensing of such beverages is adequately
supervised in accordance with all applicable State law. The permittee accepts full responsibility for the dispensing
of any permitted alcoholic beverages.
All fees are due and payable 2 weeks prior to the event.
Payment will be made by Credit Card or via Certified Check or Money
Order made payable to the CITY OF
BRIDGEPORT.
Additional fees may apply pending approval once submitted and reviewed by the City of Bridgeport, Parks and
Recreation Dept. and/or the Board of Park Commissioners depending on your event.
City of Bridgeport Parks and Recreation – Permit Application
*PLEASE READ THE FOLLOWING CAREFULLY & SIGN*
The applicant agrees to be bound by the rules and regulations of the Parks Department governing its use and by
the Ordinances of the City of Bridgeport and Regulations of the Bridgeport Board of Park Commissioners. The
applicant will pay the fees provided by the Parks Department in certain instances that have been identified on
this application and the information sheet. The applicant will be required to pay the fees including applicable
cleanup bond associated with this event prior to the actual park permit being issued. Certified checks or Money
Orders and Credit Cards must be made payable to the CITY OF BRIDGEPORT.
On (date’s), the undersigned applicant has inspected the site where the event will occur and
is satisfied with and accepts the site in its existing condition and hereby agrees to indemnify, defend and hold
harmless the City of Bridgeport, its elected officials, department heads, Board of Park Commissioners, and their
employees, officers and agents from and against any and all claims, losses, suits, actions, demands, fines, fees,
judgments, damages and cost arising out of or in any way connected with the use of the undersigned of the City of
Bridgeport facility known as ____________________________________, on the date(s) of the permitted
event.
Upon reviewing all information on this application, the Public Facilities Director and/or Police Chief may require
Park’s staff and/or Police to be present at this event. The undersigned permit holder agrees to pay for all city
services directly associated with the event.
Please note that all components of the event are subject to Parks Department approval and may require approval
by and/or permits from other city agencies. Parks Department approval does not constitute permission from
other agencies. It is the responsibility of the applicant to secure all necessary city permits.
Evidence of insurance may be required before final permit approval. Please provide an insurance certificate,
which shows a minimum of $2 million dollars in commercial liability insurance and a policy endorsement which
indemnifies and holds harmless the City of Bridgeport and the Bridgeport Board of Park Commissioners. Some
events may require a higher limit of insurance. The permittee must also list the parties as additional insured on
their certificate of insurance. Each event is evaluated on its risk exposure. The City of Bridgeport is not responsible
for any accidents or damages to persons or property resulting from the issuance of this permit.
** In applying for this park permit, the applicant shall agree that no intoxicating liquors shall be sold, distributed
free or otherwise made available in connection with the use of such permit. Any special concerns and/or
considerations about the event must be made by contacting the Department of Parks and Recreation
parkevents@bridgeportct.gov or at (203) 576- 7233.
Everything I have stated on this application is correct to the best of my knowledge. I have read, understand and
agree to abide by these policies, rules and regulations on this form as they pertain to the requested usage. The
permit, if granted, is not transferable and is revocable at any time at the discretion of the Parks Department
and/or the Board of Park Commissioners.
By: __________________________________________ _______________________________________
Name Signature Date
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City of Bridgeport Parks and Recreation – Permit Application
Standard Event Checklist
Please indicate whether the following items pertain to your event. If none applies, please check ‘No’.
YES/NO
_ _ Food Served. Source: __ Food Truck(s) or Caterer(s)/Vendor(s) Name:______________________
Caterer(s)/Vendor(s) Name:______________________
Caterer(s)/Vendor(s) Name:______________________
If yes, please contact Health Department 203-576-7474 (City of Bridgeport Public Health License is required)
Are you having Vendor/Sponsor Booth(s), Exhibit Display(s), Table(s)? _ _ Specific number of: _______
• Please attach list of Vendors/Sponsors and contact information to this Application. Application is
incomplete without list of Vendors/Sponsors attached.
__
__ Are you using Canopy(ies), Tent(s) and/or Enclosures? If yes, dimensions: _____________________
__ __ Do you need Trash Receptacles? Specific nu
mber of: _________________
__ __ Entertainment, please describe: PROVIDE DETAILS BELOW
__ __ Are there any tickets, admission or other charges? Amount: __________________________________
__ __ Will this event be advertised if approved? * Park Events cannot be advertised until all applicable
approvals are processed and the final event permit is issued.
•
Please attached statement of how this event will be advertised with all details and attach a copy of the
advertisement, promotion to this application form.
__ __ Electricity: If available, please be advised there are additional costs.
• Please indicate Electricity Start Time: ____________ End Time: ____________
__ __ Amplified Sound/DJ? If yes, please indicate Start Time: ____________ End Time: ____________
Please be advised Amplified Sound/DJs are not allowed in any Bridgeport Park without the review and approval of
the Board of Park Commissioners.
The City of Bridgeport requests that there be no amplified sound on park property before 11:00 AM except for purposes
of sound checking.
Any Special Requests: PROVIDE DETAILS BELOW
**Please attach additional sheets as necessary (including Covid-19 plans, drawings, maps, etc.)
**************************************************************************************************
Yes
No
Yes
No
Yes
No
COVID-19 EVENT PLANNING FORM
In accordance with Governor Lamont’s Executive Order, event size cannot exceed 100 individuals and the
event organizer must ensure guidelines are followed. All organizations are required to complete the following
event management template to assist their efforts to plan a safe event. This document must be kept and
available for inspection by the local health officer or their designee.
Event Details:
Event Type:
Static: events where the attendees primarily enter, watch event and depart.
Interactive: events where attendees create a walking flow and interact with each
other
Participant: events where attendees primarily participate in an activity or production
Community: events with many activities, many groups and likely a random walking
traffic pattern flow
Organizer, Staff, Volunteers, Players, Performers, Attendees, Etc.
Checklist:
❑ Symptom checking station (checklist or
verbal), including temperature checks
when feasible
❑ Face coverings are worn in settings
where other social distancing measures
are difficult to maintain
❑ Ensure that face coverings are available
if participants do not have any
❑ Distance markings are to be used for
social distancing along with walking flow
❑ Implement cleaning schedule
❑ Provide area for high-risk attendees &
staff; minimize face-to-face contact,
assign tasks that allow these individuals
to maintain a 6-foot distance from other
attendees
❑ Comply with all distancing, hygiene, rest
room and food guidelines
❑ Maintain a log of all attendees
❑ Sports activities shall adhere to all
health guidelines
❑
Hand sanitizers at entry/exit and
common areas
* - Included ALL supporting document(s), image(s) or diagram(s) for each COVID-19 Planning sections, in the
four (4) spaces at the bottom.
Tracking Attendance: Must have the ability to track attendance, please describe your plan to track attendance
to support contact tracing.
Social Distancing: A 6-foot distance must be maintained between household groups at all times including while
seated, limiting the number of people in a confined area to enable adequate distancing at all times, and congregating
at any point is not allowed. Please describe your plan to maintain appropriate social distancing throughout the event.
(Include any supporting documents, images or diagrams below in the section boxes)
High-Risk Attendees: Set an established window time for high-risk groups to come in without pressure from
crowds and/or separate entrances and queues, please describe your plan to accommodate high-risk attendees.
Signage: Maintain signage to remind and help individuals stand or sit at least 6 feet apart, please describe your
plan to maintain signage including the number of anticipated signs as well as locations.
Payment Options: Encourage contactless payment; disinfect between transactions and please describe your
plan for payment.
Hygiene & Sanitization
:
Dedicated staff for sanitizing high-touch areas, please describe your plan to provide
hygiene and regular sanitization throughout the event.
C
oncessions and
Food Serving
Checklist:
❑ Serving, seating protocols and Any
concessions/restaurant seating is
compliant consistent with https://
portal.ct.gov/-/media/DECD/
Covid_Business_Recovery-
Phase-2/IndoorDining C3_V1.pdf
❑ Encourage contact-less payment
❑ To the extent reasonable, serve
grab-
and-go food items
❑ Maintain 6-foot distancing for all lines
❑ Eliminate buffet and self-serve stations
❑ Utensils should be rolled or packaged.
Additional Safeguards: Please share any additional planned safeguards or measures being enacted at the
event.
Signature: Please provide the signature of the organizational representative that will be responsible for ensuring
event oversight.
Printed Name Title
Signature Date
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Permit Application City of Bridgeport DEPARTMENT OF PUBLIC (City of Bridgeport)

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Completed 22 January 2021

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