Name of Event
Sponsoring Organization (if any)
Applicant's Name
Address
Phone
Email
Date(s) of Event
Type of Event
Starting Time
Estimated attendance per day
List Streets to be blocked/closed: Please include cross-street names and times of closure.
Do you intend to use a Village-owned parking lot? Yes No
Is a County or State-owned street or road affected by your event? Yes No
Will Food be served and/or prepared at your event? Yes No **If so, proof/copy of food handlers license, caterer license, or permit from the Tompkins County Health Department must accompany this application.
Will Alcoholic beverages be available at your event? Yes No **If so, proof of liquor license/permit allowing sale off premises of your establishment must accompany application or permit.
Will there be any live entertainment or music at your event? Yes No If so, what times will the performances take place each day?
Applicant is responsible for obtaining all additional permits, licenses, and insurance certificates required upon the issuance of the Temporary Event Permit. Please fulfill all of the obligations listed on the following page before submitting this application. Once all of these obligations are complete you must place your initials in all of the designated areas marked with a ( ) and then sign and date at the bottom
( ) CLEAN UP: Applicant agrees to promptly clean up all paper or debris caused by applicant’s use of the area and understands that if such clean up is not promptly undertaken the Village reserves the right to do the cleaning itself and to charge the applicant for the actual time and expense incurred.
( ) INSURANCE: Applicant agrees to provide a policy of liability insurance. This insurance shall provide coverage for not less than $1,000,000 for personal injury to each person, $1,000,000, $1,000,000 for each occurrence involving property damage; or a single limit policy of not less than $2,000,000 covering all claims per occurrence. The limits of the insurance shall be subject to statutory changes as to maximum limits of liability imposed on municipalities of the State of New York. This insurance shall be without prejudice to coverage otherwise existing and shall name as additional insured The Village of Trumansburg and its officers, agents, and employees. The sponsor agrees to maintain continuous
( )CONDUCT/NUISANCES: Applicant understands that if the outdoor activity is conducted in such a way as to create a nuisance for any business or resident of the area, future permits may be denied for that reason alone. Applicant will be notified as soon as practical that the activity engaged in created a nuisance and may ask for review of such determination.
( ) VILLAGE CODES/PERMITS: Applicant agrees to obtain all Village permits and licenses that may be required, and shall comply with all other Village laws and other conditions that the Village and its agents determine necessary. The Village of Trumansburg Police Department will determine if a noise variance is necessary after reviewing this application.
By submitting this form, I hereby swear and attest that this submission is accurate and complete to the best of my knowledge.
