Newtown Boro special events application

Permit Fee:
$250.00 per day

NEWTOWN BOROUGH
BUCKS COUNTY, PENNSYLVANIA
SPECIAL EVENT PERMIT APPLICATION

1. Applicant Information:
Name: ____________________________________________________________
Address: ____________________________________________________
Telephone ________________ (daytime) _______________ (emergency)
Email Address ______________________________________________________
2. Contact Person Information (if different from above):
Name: ____________________________________________________________
Address: ____________________________________________________
Telephone ________________ (daytime) _______________ (emergency)
Email Address ______________________________________________________
3. Property Owner Information (if different from above):
Name: ____________________________________________________________
Address: ____________________________________________________
Telephone ________________ (daytime) _______________ (emergency)
Email Address ______________________________________________________
4. Name / Type of Special Event:
__________________________________________________________________
__________________________________________________________________
5. Date(s) and Time(s) of Special Event:
__________________________________________________________________
__________________________________________________________________
6. Exact Location of Property to be Used for Special Event:
__________________________________________________________________
__________________________________________________________________
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7. Estimated Attendance:
Minimum: _____________ Probable: _____________ Maximum: ____________
8. Estimated Parking Requirement
Number of Vehicles expected:

___________

Number of On-Site Parking Spaces: __________
9. Will alcohol be sold or served at this Event? [ ] Yes

[ ] No

(If alcohol is to be served or sold, copy of PLCB Permit Required)
10. Describe Provision for Monitors or Private Security:
__________________________________________________________________
__________________________________________________________________
11. Describe Sound Amplification to be used at Event:
__________________________________________________________________
__________________________________________________________________
12. Describe Structures or Special Equipment:
__________________________________________________________________
__________________________________________________________________
13. Describe Water Aid or First Aid Stations:
__________________________________________________________________
__________________________________________________________________
14. Describe any Special Services requested by the Applicant (police services, traffic control,
crowd control, special parking/no parking signs or provisions, closure of streets or public
ways for parades, etc.):
__________________________________________________________________
__________________________________________________________________
***IF EVENT IS A PARADE, ATTACH A MAP OF THE ROUTE***
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15. Is the Applicant requesting a waiver of the Permit Fee or payment for Special Services?
[ ] Yes

[ ] No

If Yes, please state the basis for the waiver request (see Section 127.5(f) of the Ordinance)
__________________________________________________________________
__________________________________________________________________

BOROUGH USE ONLY
Completed Application Received on: __________________
Copy of Application Provided to: [ ]
[ ]

Chief of Police

Date: __________

Newtown Fire Association

Date: __________

Review Completed by
Chief of Police:

____________________________________

Date: __________

(Signature of Chief of Police)
Good Faith Estimate: __________________________________
PLCB Permit Provide on:

__________________

Proof of Insurance Provided on:

__________________

Application Fee paid on:

__________________

Permit Scheduled for
Consideration by Council on:

__________________

Permit Denied on:

__________________

Permit Approved on:

__________________

Conditions of Approval:
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

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RESPONSIBILITIES OF PERMITTEES, SPONSORS AND HOSTS
(a)
Any person permitted to conduct a special event shall comply in full with all
ordinances of the Borough and statutes of the Commonwealth of Pennsylvania; take all
necessary action required to prevent the use of loud or noisy devices or activities or the
occurrence of any disorderly conduct by patrons, attendees or employees of the permittee,
sponsor or host. Any person permitted to conduct a special event shall ensure, as a condition to
retention of the permit, that the special event closes no later than the time set forth in the permit.
(b) Any person permitted to conduct a special event shall not engage in any illegal
activities or engage in any conduct which violates any ordinance, statute, law or enactment of
Newtown Borough or the Commonwealth of Pennsylvania.
(c) Participants in any special event shall not engage in any loud, boisterous conduct or
allow loud noise, talk or music to a degree that causes annoyance to the residents of the Borough
as set forth in the Borough's ordinance regulating noise.
(d) Any and all temporary lighting for such special event shall be directed away from
the abutting streets and properties using shielding devices to prevent unreasonable glow beyond
property lines.
(e) Any permittee, sponsor or host of a special event shall be obligated to comply with
the Emergency Medical Services Act, Act of 1985, July 3, P.L. 164, as amended (35 P.S. §6921,
et. seq.) and the regulations of the Pennsylvania Department of Health, 28 Pa. Code § 1013.1 et
seq. as they are now or may hereafter be amended.
(f) The individual or organization sponsoring or conducting the special event shall be
responsible to the Borough for damage caused to Borough property by the participants, attendees
and employees of the event.
(g) Failure of any permittee, sponsor or host to comply with the requirements of this
section shall be grounds for immediate revocation of the permit previously issued.

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AGREEMENT FOR PAYMENT OF SPECIAL SERVICES
I/We, the undersigned, hereby agree to reimburse the Borough of Newtown for any expense
directly incurred by the Borough of Newtown as a result of the Special Event described on the
attached form, including expenses for Special Services provided by the Borough of Newtown.
Special Services, which the Borough of Newtown may either provide, or be directly billed for,
may include, but are not limited to:
traffic control, crowd control, special parking or no parking signs or provisions,
closure of streets for parades or other activities on public rights of way, police
services, ambulance or other emergency medical services, fire protection, sanitary
facilities, clean up, waste disposal, illumination, food, water, camping or trailer
facilities, communication, noise control and abatement, and any other special
service, other than listed above, which a particular special event might need

Applicant or Authorized Agent: _________________________________ Date:__________
Signature

Subscribed and sworn to before me this
____day of_____________, 20______,

_________________________________
Notary Public
My Commission Expires: ____________

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