Fill - Free fillable Special Events Permit Application (Incorporated Village of Sag Harbor) PDF form

Special Events Permit Application

INSTRUCTIONS TO APPLICANT

Special Event: Any occasion or activity occurring on public or private property, having more

than 75 persons in attendance, private, or open to the public, conducted out-

doors, with or without an admission fee or donation and held on a one-time

or occasional basis, including, but not limited to, carnivals, circuses, fairs,

bazaars and outdoor shows, horse shows or exhibitions, concerts, parties of

any type, road rallies and parades. A special events permit will be required

regardless of the number of expected persons where the proposed event is to

walk, run, or bike on any public street or road, or will require a road closure.

1. Written Permit Required. Where the activity does not constitute a special event as defined above, the

Village Administrator may, upon written request, confirm in writing that the event does not require a

special event permit.

2. Early Notice. A letter of intent to apply is encouraged to be submitted at the earliest possible date.

(Include the proposed date(s) of the event, time, address location where the event is to be held and an

estimated number of persons attending the proposed event.

3. Mandatory Notice. Applications must be completed in full, submitted with all required information and

material Thirty (30) days prior to the event requested. Applications must be complete at the time of

submittal.

4. All applications must be submitted with the associated fee as stated in Section 5 of this application and

must be accompanied by a Comprehensive Liability Insurance Policy naming the “Village of Sag

Harbor” as an additional insured in accordance with Section 9 of this application.

5. All applications for permits shall be reviewed by the Village Board, Chief of Police and all necessary

departments or advisory boards. The Village Board may conduct a public hearing or hearings with

respect to any application of a special event permit, the Board shall fix a time and place for such

hearing(s) and provide notice at least Ten (10) days prior to such hearing.

6. Applicants remain subject to all other applicable permits as may be required, including but not limited to

approvals for signs, banners, tents and fireworks.

7. The Village Board may require the applicant to provide a letter of credit, bond or other suitable security

instrument to secure compliance with conditions in Chapter 85 of the Sag Harbor Village Code to ensure

that the Village is reimbursed for its costs to ensure adequate cleanup after the event. If the applicant

fails to honor the permit conditions or to adequately cleanup the property within 24 hours following the

event, the Village may use such portions of the security as is required to remedy the situation.

8. Where concerns exist regarding health, safety and welfare, the Village may require that any temporary

structures or equipment erected in connection therewith, to comply with all applicable minimum zoning

setbacks pursuant to Chapter 300 of the Village Code.

9. The Village may condition the benefit conferred by a special event permit upon such other additional

requirements it deems necessary to ensure compliance with Chapter 85 of the Sag Harbor Village Code

and for the general protection of the health, safety and welfare of persons and property in the Village.

10. If permission to hold a special event is granted, the permit shall set forth the maximum number of

persons permitted to attend the event.

11. The special event permit issued hereunder shall be kept on the property during the special event and

shall be presented for inspection by any enforcement officer or other duly authorized official or

employee of the Village of Sag Harbor upon request.

12. Permit shall be submitted with $25.00 non-refundable Submission Fee.

If a section is not applicable, indicate N/A. NO BLANKS It is the applicant’s responsibility to ensure that the

application is complete, accurate and is submitted with all the required information and material as stated

herein. Incomplete applications will not be processed.

REVIEWED BY ____POLICE DEPT. ____HWY DEPT.____ CODE ENFORCE. ____BUILDING DEPT. FIRE DEPT.

Village of Sag Harbor Special Event Permit Application

If a section is not applicable, indicate N/A. NO BLANKS It is the applicant’s responsibility to ensure that the

application is complete, accurate and is submitted with all the required information and material as stated

herein. Incomplete applications will not be processed.

Applications MUST be submitted at least 30 DAYS prior to event.

Section 1: Applicant Information

Name of Applicant: _________________________________________________________________________

Name of Organization (if applicable): ___________________________________________________________

Mailing Address: ___________________________________________________________________________

Phone # _____________________Cell # ______________________Email\Fax # ________________________

Section 2: Property Information

Date(s) of Event: _________________________________ Hours of Event: ____________________________

Date(s) for Site Set-Up: ____________________________Date(s) for Site Clean-Up:____________________

Please note set-up and clean-up dates (dates are not to exceed a 24 hour period prior to event) should be included in the Insurance

Requirements indicated in Section 9 of this application.

a) Name of event: __________________________________________________________________________________

b) Nature and Purpose of Event (describe in detail):________________________________________________

_________________________________________________________________________________________

c) Is this event a Fundraiser: __________YES _________NO

If yes, state exactly the cause or charity to benefit from this event:________________________________

d) Will there be an Admission Fee or Ticket Price for this event: ______YES _____ NO

If yes, state exactly the cost of admission or ticket price, including general admission and special admissions (i.e. tables, groups,

children, seniors, etc.): ___________________________________________________________________________

Non-charitable organizations shall have 90 days after the date of the event to submit verification, in the form of a cancelled check, to

the Village Administrator which demonstrates that the proceeds have been paid to the charitable organization listed in the

applications.

e) Will the event include sales of any kind: __________YES _________ NO

(Including but not limited to food, drink, crafts, merchandise or goods and services)

Section 3: Event Information

a) Property Address of Event: _________________________________________________________________

Name of Property Owner: ____________________________________________________________________

Mailing Address of Owner:___________________________________________________________________

_________________________________________________________________________________________

Phone # of Property Owner: __________________________________________________________________

Cell # of Property Owner: __________________________________________________________________

Contact Person Name and Phone #: ____________________________________________________________

b) Type of Property: ______Residential Zoned _______Commercially Zoned _______Split Zoned

c) Are there any restrictions on the Use of this Property: ______ YES ______ NO

( i.e. covenants, Planning Board determinations, site plan restrictions) If Yes, please list current restrictions on

this property______________________________________________________________________________

_________________________________________________________________________________________

d) List any proposed or existing structures that are to be used during this event, please include the dimensions of

the structure: ______________________________________________________________________________

_________________________________________________________________________________________

e) Is the aforementioned property in this section LEASED: ______ YES ______ NO

If yes is checked a copy of the lease agreement is required to accompany this application along with a duly acknowledged Consent

from the property owner to use the above property for the proposed event.)

f) Will there be any entertainment for this event: _______ YES _______ NO

If yes, please indicate the type of entertainment ( i.e. Live Band, D.J., Stereo, Performers other)_____

____________________________________________________________________________

All Village Noise Regulations shall be complied with. See Chapter 167 for detailed information.

g) Will Lighting be needed for this event: _______ YES _______ NO

If yes, please indicate all lighting to be used other than the preexisting lighting and the measures to be taken to prevent any

source of exterior lighting from becoming visible across property line.

__________________________________________________________________________________________________________

_

h) Will there be animals involved in this event: _______ YES _______ NO

If yes, please complete the following:

Number of Animals: _________________________________________________________

Types of Animals: __________________________________________________________

Number and Type of Vehicles Used to Transport and/or house the animals:

____________________________________________________________________________

Storage and provisions for disposal of all animal waste: _________________________________

____________________________________________________________________________

i) Will there be temporary signage for this event: _______ YES _______ NO

If yes, please complete the following:

Number of Sign(s): __________________________________________________________

Type of Sign(s): ____________________________________________________________

Size of Sign(s): _____________________________________________________________

Location(s) of Sign(s): _______________________________________________________

____________________________________________________________________________

No sign or banner shall be placed or posted on a Village highway unless applicant has obtained prior approval of such

placement from the Superintendent of Highways. All signs, banners, and posters shall be erected no more than 10 days prior and must

be removed within 24 hours after the proposed special event.

Section 4: Additional Permits Required

a) Will any Roadways or Parking be obstructed by this event: ______YES ______ NO

If yes, an additional application to Encumber Public Property must be submitted in full with any additional fees or

Requirements included.

b) Will a Tent be erected for this event: _______ YES _______ NO

If yes, an additional application for a Tent Permit is required and must be submitted in full with any additional fees or

requirements included. A Tent Permit is required for all tents over 200 sq. feet or 50 persons. No tent is to be erected more

than 48 hours prior to the permitted event and must be removed within 48 hours following the permitted event unless otherwise

approved in writing by the Village.

c) Will there be a Fireworks Display at this event: _______ YES ______ NO

If yes, an additional application for a Fireworks Display Permit is required to be submitted in full with any additional Fees or

requirements included.

Section 5: Submission and License Fees

Submission Fee (Non-Refundable) $25__________

Estimated Attendance _________________________________

0-50 People _____

51-100 People_____

101-150 People_____

151-over People_____

Section 6: Use of Village Facilities and Assistance

a) Will the Use of any Village Property be needed for this event: ________ YES _______ NO

If yes, please list Village Properties that you are requesting for use. (Additional applications may be required):

Windmill Park _____

Marine Park _____

Long Wharf _____

Havens Beach _____

Other____________________________________________

Private Property____________________________________

b) Will the Village Police Department be needed for traffic control: _______ YES _______ NO

If yes, please state how many Police Officers you would like to request and how many hours they would be needed for:

____________________________________________________________________________

c) Will the Village Custodial services be needed for this event: ________ YES ________ NO

If yes, please state for what purpose and how many hours they would be needed for: ______________________

____________________________________________________________________________

d) Will the Public Works Department be needed for this event: _______ YES _______ NO

If yes, please state for what purpose and how many hours they would be needed for: ______________________

____________________________________________________________________________

e) Will any other Village agency be needed for assistance with the event: ____ YES ____ NO

If yes, please state what agency is needed and for what purpose and how many hours they would be needed for:

_________________________________________________________________________________________

Village Personnel may require the applicant to reimburse or secure the reimbursement to the Village for the costs of increased

police protection, public safety oversight and public works facilitation, including any additional equipment as may be deemed

necessary by Village Personnel to adequately and safely control and protect the persons attending the event, the event area and traffic

in and around the event area. Please note any event that requires the assistance of emergency services (i.e. Fire and/or Ambulance) is

the sole responsibility of the applicant to make all the arraignments necessary for assistance.

Section 7: Parking

a) Total number of parking spaces provided on-site: ______________________________

b) Total number of parking spaces provided off-site: ______________________________

c) Maximum number of vehicles expected to be parked at any given time: ________________

(including guests, participants, hired staff, etc. )

d) Will there be a parking attendant service: _______ YES _______ NO

A Parking Plan Must be Attached Showing the Ingress and Egress of All Pedestrian and Vehicular

Traffic and Access Locations

It is understood that the parking of vehicles shall not block any driveways or fire hydrants and that vehicles shall park in the same

directions of the flow of traffic. All Village parking regulations shall be compiled with.

Section 8: Provider Service Information

Alcoholic Beverage Supplier: ________N/A

___________________ _________________ _______________ _____ ______