Plcb Special Permit Application Form PDF Details

Are you looking to apply for a Special Permit through the Pennsylvania Liquor Control Board (PLCB)? Then this blog post is for you – we will provide an overview of the PLCB Special Permit Application Form, including important elements such as who should complete the application and what documents are needed to submit it. From there, we'll walk you through each step carefully so that you know exactly how to complete your own form correctly and efficiently. So, if you're ready to learn more about how to successfully file a special permit with the PLCB, let's dive in!

QuestionAnswer
Form NamePlcb Special Permit Application Form
Form Length6 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 30 sec
Other namespa liquor special occasion permit, what is a special occation liquir license in pa, pa plcb, plcb special occasion permit

Form Preview Example

PLCB-1229 7/12

COMMONWEALTH OF PENNSYLVANIA

PENNSYLVANIA

LIQUOR CONTROL BOARD

APPLICATION FOR

SPECIAL OCCASION PERMIT

BUREAU OF LICENSING

(SEE INSTRUCTIONS PAGE 2 OF 2)

PAGE 1 OF 5

The undersigned hereby applies for a SPECIAL OCCASION PERMIT for:

1.a. Nonconsecutive dates of:

Mo./Date/Year

Mo./Date/Year

Mo./Date/Year

Mo./Date/Year

Mo./Date/Year

Mo./Date/Year

____ / ____ / ____

____ / ____ / ____

____ / ____ / ____

____ / ____ / ____

____ / ____ / ____

____ / ____ / ____

 

 

 

 

 

 

b. Consecutive dates from:

to

 

 

 

2.

EVENT

CHAIRMAN/CONTACT PERSON

DAYTIME PHONE NO.

3. TYPE OF ENTITY

(SEE ATTACHED FOR QUALIFYING ELIGIBLE ENTITIES)

(INSERT TYPE FROM LIST)

4. NAME OF APPLICANT GROUP

 

PRIMARY

 

AUXILIARY

 

AFFILIATED LODGE OR SUBDIVISION

 

 

 

 

 

 

 

PHONE NO.

ADDRESS(STREET, RURAL ROUTE, P.O. BOX NO.)(POST OFFICE)(STATE)(ZIP)

 

 

 

 

 

 

 

 

 

 

 

PA

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF MUNICIPALITY

TYPE OF MUNICIPALITY

 

 

 

 

INC.

COUNTY

 

 

 

CITY

 

 

 

 

 

 

 

 

 

 

 

BORO

 

TWP.

 

 

TOWN

 

5.NAME AND ADDRESS TO WHICH PERMIT SHOULD BE MAILED, IF DIFFERENT FROM ABOVE APPLICANT

6.NAME AND ADDRESS OF PRIMARY ORGANIZATION, IF ANY

7.LIST LOCATION OF PREMISES OR AREA TO BE LICENSED

STREET, RURAL ROUTE, P.O. BOX NO.

CITY, BOROUGH, TOWNSHIP, INC. TOWN

COUNTY

LIST DESCRIPTION OF PREMISES OR AREA TO BE LICENSED

INSIDE AREA

WIDTH

LENGTH

OUTSIDE AREA

8.

ARE PUBLIC STREETS, ROADS OR THOROUGHFARES BEING CLOSED FOR THIS EVENT?

 

YES

 

NO

 

If ‘yes,’ attach written approval from municipal authority.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9.

HAS A SPECIAL OCCASION PERMIT EVER BEEN GRANTED TO THIS ORGANIZATION?

 

 

YES

 

NO

 

If ‘yes,’ give License Identiication Number LID -

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If ‘yes,’ give date (Months/Year)

Give NUMBER OF PERMITS this calendar year

DO NOT WRITE BELOW THIS LINE

CO/MNCP _ _ - _ _ _ ZIP _ _ _ _ _ - _ _ _ _

EVENT CO/MUNCP _ _ - _ _ _

PAGE 2 OF 5

10.HOW LONG HAS THE APPLICANT GROUP BEEN IN EXISTENCE?

(Sportsmen’s Club and Non-proit Agricultural Association must have ten years of existence.)

11. ARE LICENSED PREMISES TO BE LEASED?

 

YES

 

NO

 

 

If ‘yes,’ property owner’s/lessor’s NAME

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12.DO YOU HAVE ANY KNOWLEDGE AS TO WHETHER THE PROPOSED PREMISES TO BE LICENSED IS OR WILL BE UTILIZED BY

ANY OTHER PARTIES FOR ALCOHOLIC BEVERAGE SALES ON THE SAME DATE(S)?

 

YES

 

NO

 

 

If 'yes' list the name(s) and addresses of the other parties, if known

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13.IF APPLYING FOR A FAMILY-ORIENTED CELEBRATION AS PART OF WELCOME AMERICAN, IS PROPERTY LEASED FROM THE CITY?

 

 

 

 

YES

 

 

NO Lease Effective Date

 

 

 

Expiration Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14.

HAS CHARTER BEEN GRANTED BY NATIONAL VETERANS’ ORGANIZATION?

 

 

YES

 

NO

 

 

 

If ‘yes,’ date granted

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15.

IS THE PROPERTY OWNER OR LESSOR A LICENSEE OF THIS BOARD?

 

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If ‘yes,’ give LICENSE NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

16.

IF APPLYING AS AN ARTS COUNCIL, IS THE APPLICANT:

 

 

 

 

 

 

 

 

 

 

Tax Exempt?

 

 

 

 

 

 

 

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Promoting Visual and/or Performing Arts?

 

 

 

YES

 

 

NO

 

 

 

 

 

 

 

 

 

 

 

Receiving Funds Under the Local Arts Services Program Administered

 

 

YES

 

 

 

NO

 

 

 

by the Pennsylvania Council on the Arts?

 

 

 

 

 

 

17.IF APPLYING AS A VOLUNTEER FIRE COMPANY, VOLUNTEER AMBULANCE COMPANY, OR VOLUNTEER RESCUE SQUAD, DOES

 

 

THE APPLICANT HOLD A PLCB LICENSE?

 

 

 

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

If ‘yes,’ give LICENSE IDENTIFICATION NUMBER

 

 

 

 

 

 

 

 

 

 

 

If ‘yes,’ is the facility owned by the licensee?

 

 

 

 

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If ‘yes,’ is the special occasion permit to be used in conjunction with the areas

 

YES

 

 

NO

 

 

 

 

 

 

 

 

presently licensed by the organization?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18.

 

 

 

 

 

 

 

 

 

 

 

 

RESOLUTION (CORPORATIONS AND CLUBS ONLY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

At a regular or special meeting held on ______________________________________________ , 20 ___________ by the applicant

 

corporation/club, it was resolved that said application

be filed with the Pennsylvania Liquor Control Board, and

 

that ______________________________________________

and/or ____________________________________________ i s / a r e

 

 

(NAME OF OFFICER/TITLE)

 

 

 

 

(NAME OF OFFICER/TITLE)

hereby authorized to execute said application, and any other papers required by the Board.

I swear or afirm, subject to the penalties provided by 18 Pa. C.S. §4904 and 47 P.S. §4-403(h) that the foregoing answers and statements provided herein are true and complete to the best of my knowledge and belief.

SIGNATURE

TITLE

SIGNATURE

TITLE

 

 

 

 

PRINT NAME OF PERSON SIGNING

 

PRINT NAME OF PERSON SIGNING

 

 

 

 

 

HOME ADDRESS

PHONE

HOME ADDRESS

PHONE

 

 

 

 

E-MAIL ADDRESS

 

 

 

 

 

 

 

PLCB-1229 7/12

COMMONWEALTH OF PENNSYLVANIA

PENNSYLVANIA

LIQUOR CONTROL BOARD

APPLICATION FOR

SPECIAL OCCASION PERMIT

BUREAU OF LICENSING

PAGE 3 OF5

INSTRUCTIONS

This form is to be used to apply for a Special Occasion Permit for use at a special event including, but not limited to bazaars, picnics and clam bakes. The event must be one which is used by the applicant as means of raising funds for itself.

1.A fee of $30.00 per day MUST accompany this form. If the applicant is a bona ide sportsmen’s club, non-proit agricultural association or museum or performing arts facility and this is the FIRST Special Occasion Permit application iled with the Board, the fee is $85.00 for the irst day and $30.00 for each subsequent day.

2.This form and fee MUST be iled at least 30 days prior to the date of the event.

3.All questions must be answered, even if the answer is “NONE” or “NOT APPLICABLE.” This form MUST have an original signature.

4.Applications from an auxiliary group must be signed by an oficer from the primary organization. If the application is from a church or synagogue AND is signed by the minister, priest, or rabbi, question 17 (Resolution) does not have to be completed.

5.Applications from afiliated lodges or subdivisions of nationally chartered veterans' organizations MUST submit copy of documentation proving afiliation with national veterans.

6.Applications from fraternal beneit societies MUST submit proof that society is licensed to do business in Pennsylvania.

7.Applications from a non-proit organization conducting a regatta or a family-oriented celebration MUST submit proof that the applicant is a non-proit organization as deined under Section 501(C)(3) of the Internal Revenue Code of 1986 [Public Law 99-514, 26 U.S.C. §501(C)(3)].

8.Applications from a non-proit organization whose purpose is to protect the architectural heritage of boroughs MUST submit proof that the applicant is a non-proit organization as deined under Section 501(C)(3) of the Internal Revenue Code of 1986 [Public Law 99-514, 26 U.S.C. §501(C)(3)], AND MUST submit a copy of the borough's municipal resolution recognizing the applicant as such an organization.

PERMITS ARE NOT TRANSFERABLE AND CANNOT BE RENEWED. NO ALTERNATE RAIN DATES MAY BE CONSIDERED. IF YOU REqUIRE ASSISTANCE IN COMPLETINg THE APPLICATION, CALL THE LICENSINg INFORMATION CENTER AT (717) 783-8250.

SEND THE APPLICATION PACkET TO: PENNSYLvANIA LIqUOR CONTROL BOARD

BUREAU OF LICENSINg

P.O. BOx 8940

HARRISBURg, PA 17105-8940

PAGE 4 OF 5

ELIgIBLE ENTITIES LIST

Special Occasion Permits may be issued:

A.For not more than six (6) consecutive or non-consecutive days during the calendar year. One permit may be issued per calendar year to the following applicants:

1)Hospital

2)Church or Synagogue

3)City of the 3rd class.

4)Library

5)Volunteer ire company or ambulance company or rescue squad.

6)Non-proit agricultural association in existence for at least 10 years.

7)Bona ide sportsman’s club in existence for at least 10 years.

8)Nationally chartered veterans' organization and any afiliated lodge or subdivision of such organization.

9)Fraternal beneit society licensed to do business in Pennsylvania and any afiliated lodge or subdivision of such Fraternal Beneit Society.

10)Unit of a nationally chartered club, which has a club liquor license.

11)Non-proit organization as deined by Section 501(c)(3) of the Internal Revenue Code of 1986 whose purpose is to protect the architectural heritage of boroughs or a township of the 2nd class and which has been recognized as such by a municipal resolution.

12)A non-proit corporation that operates an arts facility or museum.

13)A nationally accredited PA non-proit Zoological Institution licensed by U.S. Department of Agriculture.

14)Non-proit organization as deined under Section 501(c)(3) of the Internal Revenue Code of 1986 conducting:

a.a regatta on State park grounds located in a city of the 2nd class, or

b.a family-oriented celebration as part of Welcome America in a 1st class city on property leased from that city for a period of more than 50 years.

NOTE:

Organizations conducting a regatta may install a security fence or similar enclosure around the boundary of the State

 

park or a portion thereof and charge an admission fee not to exceed $5.00 per day.

15)Club licensee that as of 12/31/02 has been in existence for at least 100 years.

16)A non-proit organization as deined under Section 501(c)(3) of the Internal Revenue Code of 1986 whose purpose is to raise funds for the research and treatment of cystic ibrosis.

17)A non-proit organization as deined under Section 501(c)(3) of the Internal Revenue Code of 1986 whose purpose is to educate the public on issues dealing with watershed conservation.

18)A non-proit organization as deined under Section 501(c)(3) of the Internal Revenue Code of 1986 whose purpose is to provide equine assisted activities for children and adults with special needs.

19)A non-proit economic development agency in a city of the 2nd class with the primary function to serve as an economic generator for the greater southwestern Pennsylvania region by attracting and supporting ilm, television, and related media industry projects and coordinating government and business ofices in support of a production.

20)A county tourist promotion agency as deined in Section 3(1) of the act of April 28, 1961, known as the "Tourist Promotion Law"

(information continued on reverse)

PAGE 5 OF 5

21)A junior league that is a non-proit organization as deined under Section 501(c)(3) of the Internal Revenue Code of 1986 that

is comprised of women whose purpose is exclusively educational and charitable in promoting the volunteerism of women and developing and participating in community projects and that has been in existence for over seventy years.

22)A non-proit organization as deined under Section 501(c)(6) of the Internal Revenue Code of 1986 whose purpose is to support business and industry.

23)A club recognized by Rotary International whose purpose is to provide service to others, to promote high ethical standards and to advance world understanding, goodwill and peace through its fellowship of business, professional and community leaders.

24)A non-proit organization as deined under Section 501(c)(3) of the Internal Revenue Code of 1986 whose purpose is to promote mushrooms while supporting local and region charities.

25)A non-proit organization as deined under Section 501(c)(3) of the Internal Revenue Code of 1986 whose purpose is the education and promotion of American history.

26)A brewery which has been issued a license to manufacture malt or brewed beverages and has been in existence for at least 100 years.

27)A museum operated by a not-for-proit corporation in a city of the 2nd class A.

28)A non-proit organization as deined under Section 501(c)(3) of the Internal Revenue Code of 1986 which is located in a city of the 2nd class A and has as its purpose economic and community development.

29)A non-proit organization as deined under Section 501(c)(3) or (6) of the Internal Revenue Code of 1986 that is located in a city of the 3rd class in a county of the 5th class.

30)A non-proit social service organization as deined under Section 501(c)(3) of the Internal Revenue Code of 1986 located in a county of the 3rd class whose purpose is to serve individuals and families in that county of the 3rd class.

31)A non-proit organization as deined under Section 501(c)(3) of the Internal Revenue Code of 1986 whose main purpose is to temporarily foster stray and unwanted animals and match them to suitable permanent homes.

32)A non-proit organization as deined under Section 501(c)(3) of the Internal Revenue Code of 1986 who operates either a

Main Street Program or Elm Street Program recognized by the Commonwealth, the National Trust for Historic Preservation or both.

33)A non-proit radio station that is a member of the National Public Radio Network.

34)A non-proit public television station that is a member of the Pennsylvania Public Television Network.

35)A non-proit organization as deined under Section 501(c)(3) of the Internal Revenue Code of 1986 whose purpose is to promote awareness, education and research and to provide a support system for patients with neutropenia and their families through a national resource network.

36)One auxiliary of any of the foregoing.

B.For not more than six (6) non-consecutive permits per calendar year, each permit being valid for only one day OR for not more than ten (10) consecutive days per calendar year. Permits may be issued to the following applicants:

1)Museum operated by a non-proit corporation.

2)Non-proit corporation engaged in the Performing Arts.

3)An Arts Council, which is a tax-exempt organization promoting visual arts and/or performing arts that receives funds under the local Arts Program Administered by the PA Council on the Arts.

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Writing part 1 in special occasion permit pa cost

2. Your next step would be to fill out these blanks: STREET RURAL ROUTE PO BOX NO, CITY BOROUGH TOWNSHIP INC TOWN, COUNTY, LIST DESCRIPTION OF PREMISES OR, INSIDE AREA, OUTSIDE AREA, WIDTH, LENGTH, ARE PUBLIC STREETS ROADS OR, YES, HAS A SPECIAL OCCASION PERMIT EVER, YES, If yes give License Identiication, If yes give date MonthsYear, and Give NUMBER OF PERMITS this.

ARE PUBLIC STREETS ROADS OR, If yes give date MonthsYear, and INSIDE AREA in special occasion permit pa cost

3. This 3rd section is normally quite simple, HOW LONG HAS THE APPLICANT GROUP, ARE LICENSED PREMISES TO BE LEASED, YES, If yes property ownerslessors NAME, PAGE OF, DO YOU HAVE ANY KNOWLEDGE AS TO, ANY OTHER PARTIES FOR ALCOHOLIC, YES, IF APPLYING FOR A FAMILYORIENTED, YES, Lease Effective Date Expiration, HAS CHARTER BEEN GRANTED BY, YES, If yes date granted, and IS THE PROPERTY OWNER OR LESSOR A - all of these form fields needs to be completed here.

The right way to fill in special occasion permit pa cost step 3

4. Filling out IF APPLYING AS AN ARTS COUNCIL IS, Tax Exempt, Promoting Visual andor Performing, Receiving Funds Under the Local, YES, YES, YES, IF APPLYING AS A VOLUNTEER FIRE, YES, If yes give LICENSE IDENTIFICATION, If yes is the facility owned by, If yes is the special occasion, YES, YES, and RESOLUTION CORPORATIONS AND CLUBS is paramount in the fourth part - be sure to don't rush and be attentive with every blank area!

Step no. 4 for submitting special occasion permit pa cost

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