Special Event Permit Application

Privately Supplied Equipment

Please complete all sections that apply.

Amplified Sound (click here to open this section)
Amplified Sound

Any amplified sound is subject to the City of Albany Noise Ordinance. Electronic amplification may only be used after 10 a.m. and before 6 p.m. Electronic amplification inside the Washington Park Lake House must cease by 11 p.m
Will amplified sound be used?

YesNo
Amplified Sound Start Time:

Hour Minutes
AM/PM Option
Amplified Sound End Time:

Hour Minutes
AM/PM Option
Name of vendor/contractor providing service
Phone number of vendor/contractor providing service
Please enter a valid phone number.

Tents (click here to open this section)
Tents

No stakes can be used to secure tents. Only weights can be used to secure tents.
Will a tent be used?

YesNo
Description, Quantity, Size, and Location of Tent(s):*
Name of vendor/contractor providing service*
Phone Number of vendor/contractor providing service*
Please enter a valid phone number.

Stages (click here to open this section)
Stages

Please note: the City of Albany does not have any stages available for use/rent at Special Events. Applicants must make accommodations for their own stage.
Will a stage be used?*

YesNo
Who is providing the stage? Provide contact information for the company responsible for the stage. *
Please provide a description of the stage that includes dimensions, capacity, if it is mobile or built on site, where in the event footprint the stage will be set up and who will be providing the barrier to secure the stage and backstage areas:*
When will the stage arrive at the event space?*
When will the stage be removed from the event space?*
Name of vendor/contractor providing service*
Phone Number of vendor/contractor providing service*
Please enter a valid phone number.

Inflatable Devices (click here to open this section)
Inflatabale Devices

Inflatable devices are only allowed on City property with a Certificate of General Liability Insurance in the Amount of $2,000,000 naming the City of Albany as "additional insured" on a primary and non-contributing basis. The Albany Fire Department and Albany Police Department reserve the right to direct the removal of the inflatable device for public safety precautions at any time.
Will an inflatable device be used?

YesNo
Description, Quantity, Size, and Location of Inflatable Device(s):
Name of vendor/contractor providing service
Phone Number of vendor/contractor providing service
Please enter a valid phone number.

Read, Complete & Sign
Applicant is solely responsible for costs incurred for City services rendered for each event. The event sponsor upon submission of this application agrees to follow the rules of New York State, Albany County, and the City of Albany, and acknowledge that any violations will result in the revocation of the special event permit and could negatively impact the issuance of future permits. The sponsor/organization also acknowledges that event organizers can be held responsible for violations of the Governor Cuomo’s executive orders, up to and including civil and criminal penalties No alcohol is permitted without the approval of an Open Container Permit.

A copy of the permit must remain on-site for inspector's review. Applicants must apply with the City of Albany, Albany County and/or the State of New York for alcohol, merchandise vending, food vending, and other sampling. The City is unable to provide amenities such as port-a-johns/portable washrooms, tables, chairs, or medical services (other than EMS). The applicant is required to secure port-a-johns/portable washrooms, chairs, trash boxes, and any medical needs for the event at the applicant's expense. The applicant is also required to provide recycling to attendees for events where trash is generated. Failure to adequately provide such amenities could result in the event applicant(s) or coordinator(s) inability to hold future events in the City of Albany. Special Events cancellations or cancellation of requested services must be made in writing ten days prior to the event. Failure to provide written verification may result in the sponsor(s) being required to reimburse the City of Albany for the agreed upon services.

A certificate of insurance must be delivered to City of Albany, City Clerk’s Office, 24 Eagle Street, Room 202, Albany NY 12207 or via cityclerk@albanyny.gov. The certificate must evidence General Liability Insurance, with a $1,000,000.00 limit of liability, (liability, or $2,000,000 limit of liability if an inflatable device/bounce house is present) naming the City of Albany, its officers, agents, and employees as additional insured on a primary and non-contributing basis, while specifically referencing the scheduled event. Each vendor or contractor must provide proof of insurance.
Verify you have read and understand the above requirements.*
By signing and submitting this Special Events Application, the sponsoring organization agrees to indemnify, defend and hold harmless the City of Albany and it's officers, employees, and agents from and against any and all loses, costs (including but not limited to, litigation costs and attorney fees) clams, suits, actions damages, liability and expenses occasioned wholly or in part by Event sponsor's act or omission or negligence or fault or the act or omission or negligence or fault of Event sponsor’s agents subcontractors suppliers, employees or servants in connection with the Permit.

By signing this Electronic Signature Acknowledgment Form, I agree that my electronic signature is the legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature, it has the same validity and meaning as my handwritten signature. I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding.
By checking this box, I understand that my Special Events Permit Application will not be considered complete until I have submitted the requisite application fee to the City Clerk's Office, City Hall, Room 202, Albany, NY 12207*
Signature*

Clear
Legal Name of Organization (if applicable):*

Estimated Fees
Location of Event*
If Other, please identify location of event
Application Fee
Non-refundable, unable to be waived
Usage Fee
4 hour permit ($25 per hour over4 hours)
Total Fee Due
Fees are not final and are subject to change
Washington Park Additional Surcharge Fee (50%)

Applications for demonstartions, marches, parades or protests may be grantes an application fee waiver pursuant to Section 251-26 of the City Code if requested.

Additional Services Fees

Police and Public Safety Fees	If Albany Police Dept. services are needed, a fee will be calculated and provided to the applicant prior to the event.
Fire & Emergency Services Fees	If Albany Fire Dept. services are needed, a fee will be calculated and provided to the applicant prior to the event.
DGS & City Equipment Services Fees	If Albany DGS Dept. services and/or equipment are needed, a fee will be calculated and provided to the applicant prior to the event.

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