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

MAINTAIN ONE LANE ON EVERY STREET FOR EMERGENCY VEHICLES.

KEEP ALL FIRE HYDRANTS 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 TOWN OF ULSTER 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 TOWN OF ULSTER.

PLEASE NOTIFY THE COMMUNITY OF THE EVENT BY POSTING “INFORMATIONAL” SIGNS 48 HOURS PRIOR TO CLOSURE OF THE STREET.

REMIT A $25 APPLICATION FEE TO THE TOWN CLERKS OFFICE PRIOR TO THIS APPLICATION BEING PROCESSED. MUST BE A CHECK OR MONEY ORDER ONLY MADE PAYABLE TO TOWN OF ULSTER HIGHWAY DEPARTMENT.

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 SUPERINTENDENT OF HIGHWAYS.

THE SPONSER AGREES TO INDEMNIFY AND HOLD HARMLESS THE TOWN OF ULSTER 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 TOWN OF ULSTER 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.

Check #_______________

Date Received ____/____/____

Received by:__________________________

Event: Approved ____ Denied____

Approved/Denied By: _________________________________

Date: ____/____/____

Permit: #___________

Date of Application____/____/____