Fireworks Display Permit Application

Please use this application for the request to perform an aerial fireworks display.

Applicant is?*

Property Owner's Name (where aerial display will occur)*

First NameLast Name

Property Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Applicant's Phone#*

Area CodePhone Number

Applicant's email*

Name of Business Entity or Pyrotechnician performing display event *

Business or Pyrotechnician Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Business or Pyrotechnician Phone #*

Area CodePhone Number

Business or Pyrotechnician's email*

Fireworks Display Event Date:*

Date

Fireworks Display Event Rain Date:*

Date

Display Start Time*

:HourMinutesAM/PM Option

Display Completion Time*

:HourMinutesAM/PM Option

The following information is required to be submitted with application:

1. Plot Plan depicting property lines, fallout area location and size, location of mortar and ground displays, anticipated audience location, storage location

2. Copy of valid ATF License of operator and assistants

3. Copy of valid Registration with the Attorney General's Office

4. Complete list detailing the quantity, size, type, ignition type, and number & size of chain-fused racks, of all fireworks to be discharged

5. Copy of valid bond in the amount of $50,000.00

ONCE YOU HAVE BEEN NOTIFIED VIA EMAIL OR PHONE THAT YOUR PERMIT HAS BEEN ISSUED AND YOU ARE READY TO SIGN AND SUBMIT THE ASSOCIATED FEES, YOU MAY DO SO BY EITHER SIGNING ELECTRONICALLY AND RECEIVING IT BY MAIL AFTER PAYMENT IS RECEIVED, OR BY COMING TO THE TOWNSHIP CODE DEPARTMENT MONDAY - FRIDAY BETWEEN 8 am - NOON TO SIGN, PAY FOR AND PICK UP. APPLICANTS CHOOSING TO RECEIVE IT BY MAIL WILL RECEIVE A SNAPSHOT OF THE PERMIT IN AN EMAIL PRIOR TO PAYING.

I, the applicant, hereby agree to electronically sign my permit and agree to install the improvements only in accordance with the permit and will conform to the requirements of the existing Ordinances of the Township of Amity and Laws of the Commonwealth of Pennsylvania. I understand there are required inspections listed on the back of the permit that I must get approved prior to occupying the improvement. The permit will not relieve me from complying with other governmental regulations, deed restrictions or covenants outside the jurisdiction of Amity Township.*

I agree and I choose to receive my permit by first class mailI do not wish to sign electronically, and I will make arrangements for either myself or someone I have authorized to come in to the Code Department M-F, between 8 am -Noon to sign and pay for the permit

Attach any files you may have

Upload a File

Once the application and required documents are received, permit processing generally takes 7-10 business days once we receive all required documents. Please check your email during this process as we may contact you for additional information that may be required. A Permit fee of $200.00, per Resolution, will be due upon issuance of the permit.

If you cannot attach the required documents, please fax to (610) 689-9870 or mail to 2004 Weavertown Rd, Douglassville, Pa 19518

I hereby certify the code administrator and code inspectors shall have the authority to enter areas covered by such permit application at any reasonable hour to inspect existing conditions applicable to such permit application*

I agreeI disagree