Special Events Permit Application

TOWN OF BATH

SPECIAL EVENTS PERMIT APPLICATION

1. Name of Event:
2. Location of Event:

(If Private Property, Property owner must sign application)

1. Date and Time of Event:

Starts:

Ends:

1. When will advance set up begin? Describe activities to set up:
   
   
   
   
2. SPONSORING ORGANIZATION OR PERSON(S):
   
   
   
   
   
3. Describe Event, including number of entrants/participants, and number of spectators expected:
   
   
   
   
   
4. Describe tents, booths or other items to be set up for event, including size and number:
   
   
   
   
   
5. Are you requesting any public streets to be closed?  If so, please describe where and how long.
   
   
   
   
   
6. Will any food preparation or sales be done?  (      ) Yes   (     )  No    
   
7. Describe method of garbage collection and clean up after event, including the name, address and cell phone number of responsible person:
   
   
   
   
   
8. Will you be using an amplified sound system?  Describe detail, including name and cell phone number of responsible person:
   
   
   
   
   

APPLICANT CERTIFICATION

The undersigned Applicant, hereby certifies complete understanding and responsibility for:

1. Securing additional permits and certificates as indicated above.
2. Coordinating with Agencies other than the Town of Bath for services required.
3. Notifying the Town of Bath about any changes, additions, deletions or modifications to the event as described above no later than one week prior to the event.
4. Providing handicap access to activities that are open to the public.
5. Having a responsible person on site at the beginning of set up through the duration of the event.
6. Informing vendors about regulations or requirements in the Town of Bath Special events Application, or rules and regulations of other Agencies with jurisdiction over activities at the event.
7. Settling disputes about locations or other matters between vendors.
8. Insuring access for emergency and service vehicles to the event’s venue and activities.
9. Coordinating permission with private property owners if a privately owned location will be used for event activities.
10. Notifying effective parties about the street and/or parking lot closings due to the event.
11. Informing the public about the event if this is a public event.

I also understand that the requirement of liability insurance will be made by the Town of Bath based upon this application and the risks perceived above, and agree to provide such insurance if required.

I also understand that allowing non-permitted or unscheduled activities to occur during the above special event will result in forfeiture of my deposit and may jeopardize receipt of special events permits for the Town of Bath in the future.

Applicant

Property Owner (if different)

Print Name Signature Date

Deposit Paid: Fee:

PERMIT #

TOWN OF BATH

SPECIAL EVENTS PERMIT

A permit is hereby granted to the person/organization listed below for a special event within the Town of Bath:

Name of Permit Holder:

Cell Phone Number:

Date of Event:

Description of Event:

Liability Insurance Required:   (        )  Yes     (        )  No

If Yes, Amount:

This permit is conditioned upon holder complying with all rules and regulations of the Town of Bath and other local and state regulations, and the certification contained in the application.

This is the  day of , 20 .

TOWN OF BATH

BY: