Ny Block Party Permit Form – Fill Out and Use This PDF

APPLICATION #:_____________

APPLICATION #:_____________

PRECINCT # ________________

T H E C I T Y O F N E W Y O R K

O F F I C E O F T H E M A Y O R

STREET ACTIVITY PERMIT OFFICE

100 GOLD STREET- 2ND FLOOR, NEW YORK, NY 10038

PHONE: 212-788-7437 ~ FAX: 212-788-7887

STREET FESTIVAL / BLOCK PARTY

PERMIT APPLICATION

A STREET ACTIVITY PERMIT IS NOT VALID BEFORE 8AM OR AFTER 11:30PM

APPLICATION MUST BE SUBMITTED TO THE STREET ACTIVITY PERMIT OFFICE AT LEAST 60DAYS PRIOR TO

THE EVENT WITH A $15 NON-REFUNDABLE MONEY ORDER OR CERTIFIED CHECK

(MADE PAYABLE TO THE CITY OF NEW YORK – DEPARTMENT OF FINANCE)

APPLICATIONS FOR MULTI-DAY AND MULTI-BLOCK EVENTS MUST BE FILED DIRECTLY WITH SAPO BY THE

FILING DEADLINE OF DECEMBER 31ST OF THE PRECEDING YEAR.

APPLICANT INFORMATION

______________________________________________	(_____)________-___________	(_____)________-_________________
APPLICANT NAME	TELEPHONE NUMBER	CELL NUMBER

______________________________________________________________________________________________________________________

ADDRESS	ZIP CODE	E-MAIL ADDRESS
______________________________________________	(_____)________-___________	(_____)________-_________________
SPONSOR NAME/COMPANY NAME	TELEPHONE NUMBER	FAX NUMBER
(ON BEHALF OF)

______________________________________________________________________________________________________________________

ADDRESS	ZIP CODE
______________________________________________	(_____)________-___________	(_____)________-_________________
PRODUCER NAME IF APPLICABLE	TELEPHONE NUMBER	FAX NUMBER

______________________________________________________________________________________________________________________

ADDRESSZIP CODEE-MAIL ADDRESS

EVENT INFORMATION

Type of Event: Block Party	Street Festival Clean Up	Mobile Unit Religious Ceremony	Farmers Market
Other __________________________________________

Event Name: ______________________________________________________________________________________________

Event Description: _________________________________________________________________________________

________________________________________________________________________________________________

Requesting permission to conduct street activity on:

____________________________________________________________________________________Street/Avenue (Circle One)

Between Locations:

____________________________________________and_____________________________________________

Activity to take place on (Check ALL that Apply):

Sidewalk	Curb Lane	Partial Street Use	Full Street Closure	Other__________________________
Date(s) of Event: ___________		Rain Date (Block Party’s ONLY): __________			Number of Days: ____________
Borough: __________________		Actual Time of the Event: __________			Estimated # of People: _______
Number of Blocks: __________		Set-Up Time: ____________________			Break-Down Time: __________

Street Activity Permit Office Street Festival/ Block Party Application

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			APPLICATION #:_____________
			APPLICATION #:_____________
			PRECINCT # ________________
		T H E C I T Y O F N E W Y O R K
		O F F I C E O F T H E M A Y O R
Street Activity Permit Office		Street Festival/Block Party Permit Application – Page 3

APPLICANT/SPONSOR RULES AND RESPONSIBILITIES

IT IS THE APPLICANT’S/SPONSOR’S RESPONSIBILITY TO:

MAINTAIN ONE LANE ON EVERY STREET FOR EMERGENCY VEHICLES.

KEEP ALL FIRE HYDRANTS AND ALARM BOXES FREE OF OBSTRUCTION.

SUBMIT EVIDENCE OF INSURANCE (EXCLUDING BLOCK PARTIES WITHOUT RIDES) PRIOR TO FINAL PERMIT APPROVAL. PLEASE PROVIDE A CERTIFICATE OF INSURANCE WHICH NAMES THE CITY OF NEW YORK AS AN ADDITIONAL INSURED AND SHOWS A MINIMUM OF $1MILLION IN COMMERCIAL GENERAL LIABILITY INSURANCE AND A POLICY ENDORSEMENT WHICH INDEMNIFIES AND HOLDS HARMLESS THE CITY OF NEW YORK.

PLEASE NOTIFY THE COMMUNITY OF THE EVENT BY POSTING “INFORMATIONAL” SIGNS 48 HOURS PRIOR TO CLOSURE OF THE STREET OR USE OF PARKING (THESE SIGNS WILL BE ISSUED WITH YOUR PERMIT). AND CONFIRM WITH THE NYPD THE POSTING OF “NO PARKING SIGNS” FOR ENFORCEMENT AND TOWING.

AFFIDAVIT OF APPLICANT/SPONSOR

WHEN APPROVED, THIS APPLICATION OR A STREET ACTIVITY PERMIT SHOULD AUTHORIZE THE SPONSOR TO CONDUCT A STREET ACTIVITY AS DESCRIBED. IT IS SUBJECT TO REVOCATION IF THE SPONSOR DOES NOT COMPLY WITH ALL PERTINENT LAWS, RULES AND REGULATIONS INCLUDING ANY CONDITIONS OR RESTRICTIONS IMPOSED BY THE STREET ACTIVITY PERMIT OFFICE.

THE SPONSER AGREES TO INDEMNIFY AND HOLD HARMLESS THE CITY OF NEW YORK FROM ANY AND ALL CLAIMS AND JUDGEMENT FOR PERSONAL INJURY OR DAMAGE TO PROPERTY RESULTING, DIRECTLY OR INDIRECTLY, FROM THE ACTIVITIES IN CONNECTION WITH WHICH THIS IS ISSUED, AND FROM ANY COSTS AND EXPENSES TO WHICH THE CITY MAY BE SUBJECTED OR WHICH IT MAY SUFFER OR INCUR BY REASON THEREOF. THE APPLICANT FURTHER AGREES TO COMPLY WITH THE PERTINENT PROVISIONS OF NEW YORK LAWS, RULES AND REGULATIONS. THE APPLICANT HAS READ THE LIST OF SPONSOR RESPONSIBILITIES AND HAS AGREED TO ALL TERMS AND CONDITIONS OF THIS APPLICATION.

Applicant Name (Print)SignatureDate

Community Board#_________Address_______________________________________Telephone#__________

Community Board Recommendation: Approval Denial _____________________________	_________
(CB Authorized Signature)	(Date)

FOR OFFICE USE ONLY

Date of Application_____________				Application No._______________ Precinct_________________							CB___________
Support Permits/Approval Required (Check all that Apply):
NYPD Sound Permit		DOB Permit_______________ DOT_______________							Other________________
Notification:
NYPD	DOT		FDNY		Sanitation		Transit/MTA		DCA	DOHMH
				Cultural Affairs		CB		Office		
StreetParks Activity PermitDOBOffice									SpecialNYC &EventCo.	PermitSportsApplicationCommission– Page4

Street Activity Permit Office Street Festival/ Block Party Application

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APPLICATION #:_____________

Precinct #___________________

	T H E C I T Y O F N E W Y O R K
	O F F I C E O F T H E M A Y O R
Street Activity Permit Office	Street Festival/Block Party Permit Application – Page 4

SUPPORT PERMIT REQUIREMENTS

PLEASE NOTE THAT ALL COMPONENTS OF THE EVENT ARE SUBJECT TO APPROVAL BY THE STREET ACTIVITY PERMIT OFFICE AND MAY REQUIRE APPROVAL BY AND/OR PERMITS FROM OTHER CITY AGENCIES. THE STREET ACTIVITY PERMIT OFFICE APPROVAL DOES NOT CONSTITUTE PERMISSION FROM OTHER AGENCIES. IT IS THE RESPONSIBILITY OF THE APPLICANT/SPONSOR TO SECURE ALL NECESSARY CITY OF NEW YORK PERMITS AND PROVIDE DOCUMENTATION TO THE STREET ACTIVITY PERMIT OFFICE PRIOR TO PERMIT ISSUANCE.

Department of Buildings:

DOB Structure Permit: Stages, Platforms, Press Risers, Truck-mounted structures, Props, Scaffolding, Tents, Canopies

DOB Temporary Place of Assembly Permit: attendance of 200+ seated
DOB Contacts: Bronx	718-579-2943	Queens	718-286-0622
Brooklyn	718-802-3677	Queens (Alt.)	718-286-0603
Manhattan	212-566-3300	Staten Island	718-816-2178/2314

New York City Police Department (Local Precinct):

NYPD Sound Permit: Amplified sound

Contact Local Precincts: (www.nyc.gov/nypd)

Department of Transportation:

DOT Electrical Permit Cabling/Wiring Approval: Overhead/On-Ground cabling or electrical wiring

DOT Oversized Truck Permit: Oversized Truck (Width – 96 inches, Height – 13 ½ feet, Length – 55 feet)

DOT Electrical Permit: Pole Tap for Electricity

DOT Removal of Street Furniture Removal Approval: Streetlights, Bollards, Traffic Lights, Streets Signs, Bus Stop Shelters or any other furnishing on the street and/or sidewalk

DOT Street Pole Banner Permit: Approval for any Street Pole Banners

DOT Horse-Drawn Carriage Variance: Horse-Drawn Carriages Being Used Outside of Central Park and its perimeter

DOT Contact: DOT Special Events Unit 40 Worth Street, Rm. 1215 New York, NY 10013 Phone: (212) 442-1700 http://www.nyc.gov/html/dot/html/permits/permits.shtml

New York City Fire Department:

FDNY Fuel Permit: Liquid/Gaseous Fuels

FDNY Generator Permit: Portable, Truck-mounted or an other kind of generator

FDNY Pyrotechnics Permit: Open Flames or Pyrotechnics

FDNY Contact: (718) 999-0320 or (718) 999-1007

Department of Consumer Affairs:

DCA Thirty-Day Street Fair Vending Permit: General Vendors at Events

DCA Portable Amusement Device Permit/DCA Temporary Amusement Device Permit: Truck-Mounted Rides/Other Type of Rides

DCA also accepts applications for the Department of Health and Mental Hygiene for the Temporary Mobile Food Vendor Permits at events (Temporary Mobile Food Unit Permit, Biennial Citywide Mobile Food Unit Permit, Biennial Borough Specific Mobile Food Unit Permit, Biennial Citywide Veterans Mobile Food Unit Permit, and Restricted Area Mobile Food Unit Permit).

DCA Contact : DCA Licensing Center is located at: 42 Broadway, 5th Floor

New York, NY 10004 Phone: 311

DCA 30-Day Street Fair Vendor Permit.

http://www.nyc.gov/html/dca/html/licenses/111.shtml

DCA Portable Amusement Device Permit application

http://www.nyc.gov/html/dca/html/licenses/018.shtml

DCA Temporary Amusement Device Permit application

http://www.nyc.gov/html/dca/html/licenses/090.shtml

Street Activity Permit Office Street Festival/ Block Party Application

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APPLICATION #:_____________

Precinct #___________________

	T H E C I T Y O F N E W Y O R K
	O F F I C E O F T H E M A Y O R
Street Activity Permit Office	Street Festival/Block Party Permit Application – Page 5

Department of Health and Mental Hygiene:

DOH Temporary Food Service Establishment Permit: Non-Processing/Processing Food Unit

Animal Exhibit Permit: Non-Domesticated Animals Present

DOH Contact: DOHMH Temporary Food Service Establishment Permit (via DCA) The DCA Licensing Center is located at:

42 Broadway, 5th Floor New York, NY 10004 Phone: 311

http://WWW.nyc.gov/html/doh/html/inspect/ispecial.shtml

DOHMH Animal Permit

Tel: 212-676-2112

Human Resources Administration/Dept. of Social Services:

HRA Permit to Solicit Funds: Permit to Solicit Funds at an Event

HRA Contact: 180 Water Street

New York NY 10038

Tel: 212-331-5166

New York State Liquor Authority

SLA Temporary Beer & Wine Permit: Alcoholic Beverages will be consumed. (Only applicable for vendors currently have a liquor license)

New York City Regional SLA Office Contact: 317 Lenox Ave., 4th Floor New York, NY 10027 Phone: (212) 961-8284 http://www.abc.state.ny.us/

Department of Sanitation

Clean Up

Sanitation Contact: Special Events Office

New York City Department of Sanitation 125 Worth Street – Room 807

New York, NY 10013

(646) 885-4867 or 4868

Street Activity Permit Office Street Festival/ Block Party Application

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