SPECIAL EVENTS PERMIT APPLICATION - Atlantic City …userfiles/pdfs/AC-2013-FilmPermit.pdf · SPECIAL EVENTS PERMIT APPLICATION ... Before you submit your special event application,

2013

SPECIAL EVENTS

PERMIT APPLICATION

DEPARTMENT OF HEALTH & HUMAN SERVICES

OFFICE OF SPECIAL EVENTS 1301 Bacharach Blvd. • Room 502 Atlantic City • New Jersey • 08401

http://cityofatlanticcity.org

Phone: 609.347.5643

City of Atlantic City

Mayor Lorenzo T. Langford

http://cityofatlanticcity.org/

2

2013 APPLICATION CHECK LIST

Before you submit your special event application, please make sure that the following steps have been completed:

GENERAL APPLICATION (Must be completed in full & submitted 30 calendar days prior to the date of your event)

HAVE YOU…

Completed all the necessary general information?

Signed and dated your application?

Attached a site plan?

Attached insurance?

Set up meeting or met with the Special Events office?

For Athletic events, have you contacted the Office of Emergency Management?

For parades (this includes festivals), have you registered with the Engineer's Office and met with the Police?

FOOD APPLICATIONS (Must be completed in full & submitted 20 calendar days prior to the date of your event)

HAS THE VENDOR…

Contacted the Health Department)? If not call (609) 347-5671. Completely filled out their applications (including menu items/ingredients, sources of purchase, list of equipment &

cooking times & temperatures)?

Attached a copy of the restaurants most recent Health Department inspection (must be within 6 months). If new

inspection is needed, call the number above.

Registered with the Mercantile Office?

Attached copies of your business registration?

Has the application been signed by the owner/officer?

MERCHANT APPLICATION (Must be completed in full & submitted 20 calendar days prior to the date of your event)

HAVE YOU…

Listed the vendor information or attached a spreadsheet with information?

Entered a count of the total number of vendors?

Registered with the Mercantile Office?

Has the application been signed by the owner/officer?

LIQUOR APPLICATION

HAS THE VENDOR…

Completely filled out the necessary applications?

Attached a copy of your insurance?

Attached a detailed security plan?

Arranged a meeting with the ABC Division?

Signed by owner/officer - original signature?

SUBMIT YOUR COMPLETED SPECIAL EVENT PERMIT APPLICATION TO THE OFFICE OF SPECIAL EVENTS, 1301 BACHARACH BLVD., CITY HALL, ROOM 502.

3

CITY OF ATLANTIC CITY

SPECIAL EVENT PERMIT APPLICATION THIS FORM MUST BE COMPLETED IN FULL & SUBMITTED 30 CALENDAR DAYS PRIOR TO THE EVENT

INSTRUCTIONS FOR COMPLETING THE SPECIAL EVENT PERMIT APPLICATION

Careful completion of the form will help to avoid delays in processing. It is important that you follow the instructions and

provide clear and accurate information. Submit all necessary documents with the application. Please consult the Special Event

Resource Guide for more detailed information.

When you fill out this form:

• do not use white-out on application or attachments

• type or use a pen with BLACK INK and print clearly

• do not write in the shaded areas

The following sections MUST be completed by the event coordinator for ALL events:

• General Event Information

• Security Plan

• Site Plan

• IF THIS IS AN ATHLETIC EVENT: You must provide a clear route map and written description of the route and

a copy of your athletic application that was submitted to the Atlantic City Police Department.

Other than those sections mentioned above which must be completed for ALL events, only complete those sections that

pertain to your individual event.

After submitting all forms, your application will be reviewed by the department’s staff. The application will be sent to all

departments that will be involved in providing services or permits for the event. You will be notified if the event has been

approved. Do not assume that all aspects of the event will be approved; you may be asked to make some changes to your plan

based on the availability of services and scheduling of other events. Therefore, you are encouraged NOT TO MAKE ANY OTHER

ARRANGEMENTS FOR YOUR EVENT UNTIL APPROVAL FROM THE CITY HAS BEEN RECEIVED.

IMPORTANT CONTACT INFORMATION

Department Phone Number Mercantile 609.347.5315

Police Department (Chief’s Office) 609.347.5824

ABC Division (Alcohol) 609.347.5432

Health Department (Environmental Health) 609.347.5671

Risk Management 609.347.5531

Solicitors Office 609.347.5540

Engineering 609.347.5360

Construction 609.347.5660

Public Works 609.347.5700

4

CITY OF ATLANTIC CITY


APPLICATION GUIDELINES

Careful completion of the form will help to avoid delays in processing. It is important that you follow the instructions and

provide clear and accurate information. Submit all necessary documents with the application. Please consult the Special Event

Resource Guide for more detailed information. If you have any questions, call (609) 343-6326.

1. This application must be filled out no less than THIRTY (30) working days prior to the date of the event.

2. INSURANCE – All applicants must supply a Liability Insurance Certificate in the minimum amount of $1,000,000.00 as a

precondition for obtaining permits. This certificate must be approved as to limits and coverage by the City's Risk

Management Office and Solicitors Office. Insurance Certificate must be submitted with this application or it will be

rejected. No application will be processed, reviewed or routed without the insurance certificate. A hold harmless

agreement may also be requested. Insurance will not be waived. Applicant may be required to secure a performance

bond.

3. Applicants will be required to utilize appropriate public safety coverage deemed necessary by the Public Safety

Department Chiefs. Applicants shall be responsible for compensation of said public safety officers, as per the current

public safety contract.

4. If the permit is granted, the applicant shall remain subjected to all regulations, ordinances and laws of the city, state

and federal departments insofar as they may apply. Failure to comply will result in punishment and fines as per said

legislation as well as potential legal action.

5. The permit, if granted, is not transferrable and is authorized solely as to the applicant and the event said application

concerns. Failure to properly represent any aspect of a proposed event will result in instant termination of the event at

any juncture as well as potential legal action.

6. No vehicles are permitted on the boardwalk without a permit. Please call the City's Engineer's Office at (609) 347-5360

to obtain a vehicle permit. Vehicle permits must accompany this application. Convenience of access will not be just

cause for the use of vehicles on the boardwalk area.

7. All persons who are granted a special events permit must provide their own supervision and cleanup. Failure to do so

will result in denial of future permits. Applicants must leave their permit area clean otherwise; the applicant will be

billed for any/all cleanup fees and personnel hours incurred by the City of Atlantic City as deemed by the Department

of Public Works director.

8. If items are to be sold at the event, a City of Atlantic City mercantile license is required and must be submitted with the

special events application. To apply for a mercantile license, please call (609) 347-5315.

9. If alcohol is to be consumed or sold at the event, an ABC permit must be obtained. Please contact the Atlantic City

Police Department at (609) 347-5432 to apply for the necessary permit regarding alcoholic beverages at least 45 days

prior to official special events application.

10. A meeting in which the applicant must be present, may be required with the City prior to the issuance of a special

events permit.

11. No event shall be advertised prior to permit approval.

5

Recv'd by: FOR OFFICE USE ONLY

Scanned by: 13 -

ATLANTIC CITY D E P A R T M E N T O F H E A L T H & H U M A N S E R V I C E S


INSTRUCTIONS: PLEASE TYPE OR PRINT CLEARLY. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED.

GENERAL EVENT INFORMATION Name of Event First time event? Yes No

Exact Street Address of Event - NO GROVES OR INTERSECTIONS

Date(s) of Event Hours of Event

to

Step-off time (For athletic events only)

Phone number/website for publication Estimated attendance Last years actual attendance

Describe the events community and/or cultural benefit

Name of Company/Organization Contact person from Company/Organization

Company/Organization Address City Zip

Type of Organization (ex: Casino, Religious, Non-Profit, Tech, Community, etc.)

Name of Applicant Position/Title

Address City Zip

Applicant Phone Number Email

FAX Number Cell Number Alternate Contact:

Describe, in detail, your special event (MUST BE COMPLETED):

ciancion

Typewritten Text

6

ATLANTIC CITY DEPARTMENT OF HEALTH & HUMAN SERVICES, SPECIAL EVENTS EVENT PERMIT APPLICATION continued


THIS FORM MUST BE COMPLETED IN FULL & SUBMITTED 30 CALENDAR DAYS PRIOR TO THE EVENT

Are you serving food at your Event? NO YES If yes, how many vendors?

If yes, you must submit the Temporary Food License Application twenty (20)

working days prior to your event. You must obtain a temporary Food Vendor

License for each food vendor.

Are you serving beer and wine at your Event? NO YES If yes, how many vendors?

If yes, you must submit the Special Event Liquor License Application twenty (45)

working days prior to your event. You must obtain a liquor license for each

booth that will be serving liquor. Contact ABC Division 609.348.5432

Are you selling retail merchandise at your Event?: NO YES If yes, how many vendors?

If yes, you must submit the Merchant Application twenty (20) working days

prior to your event. You must obtain an Itinerant Merchant License for each

vendor. Contact Mercantile Division 609.347.5315

Are you erecting a tent over 400 sq. ft.? NO YES If yes, you must submit Tent & Canopy Application to the Department of

Construction - Room 101

Are you closing the street for your festival? NO YES (Type III barricades and detour signs are required for all Event Street Closure)

Will there be an athletic event along with your festival? NO YES

Will the street closure be on a NJTA bus route?

NO

YES If yes, include a map/plan for the routing of buses.

Have you determined how area residents and

businesses will be notified of street

closures, parking restrictions?

NO YES If yes, include a description of community outreach plan.

Has the event already been publicized? NO YES If yes, include a copy of flyer/mailing or description of efforts.

Will the event require electric? NO YES

Will the event require water? NO YES

Will the event require staging? NO YES (There will be a charge)

7




SECURITY/SAFETY PLAN

Name of Event Date of Event

Name and Date of your event in previous year

Name of Private Security Company (If applicable)

Address City Zip Code

Phone Number Number of Private Security Personnel hired per shift and total number

If a private security company is to be used, then the company MUST supply proof that they’re licensed, bonded and insured

Describe procedure for carding minors (if applicable)

Describe procedure for preventing over-consumption of alcohol (if applicable)

Please describe a Disaster Plan that addresses emergencies specific to your event (must include a plan for weather related emergencies and cancellations)

Ambulance Provider

Contact Name Contact Number

Comments or Special Instructions

Number of estimated spectators:______________________________________________________

Will there be a wanding station/magnetomers?

(Check One)

If yes, describe the following:

NO YES

How many? _____________________________________________________________________________________________

Who will operate them? ___________________________________________________________________________________

What is/are the location (s) ________________________________________________________________________________

8

Will there be a VIP Entrance? (Check One)

If yes, describe the following (see on next page):

NO YES

Who will control it?_______________________________________________________________________________________

What is/are the location(s)? _______________________________________________________________________________

Will there be VIP parking? (Check One)

If yes, answer the following:

NO YES

What is the location? _____________________________________________________________________________________

List of VIP's_______________________________________________________________________________

If yes, did you supply the following?

List of VIP's (Check One): YES NO

Photocopy all VIP/Credentials to be used (Check One ): YES NO

Will you need the Police Department to supply

Jersey Barriers? (Check One)


NO YES

How many? _____________________________________________________________________________________________

What is/are the location (s)? ________________________________________________________________________________

What is/are the layout(s)? ________________________________________________________________________________

Will entry be allowed at gates? NO YES

Will a parking area be needed? (Check One)

NO YES

Will you employ flaggers/lot people? (Check One) Y E S N O

Will there be an admission/parking fee? (Check One) YES NO

Will there be a ticket purchase area?


NO YES

Will call (Check One): Y E S N O

Who will secure it? ___________________________________________________________________________________

Have you ran a similar event in the past? (Check

One)


NO YES

Name and Date of event: _____________________________________________________________________

9

Is the event a parade? (Check One)

If yes, answer the following:

NO YES

Have you registered with the Engineer's Office? (Check One): YES NO

What is the total number of units/floats in the procession? _____________________________________________________________

What is the travel route? __________________________________________________________________________________________

What is the Gross Vehicle Weight of each unit/float in the procession? ___________________________________________________

Have all participants signed waiver/hold harmless agreement? (Check One): YES NO

Has registration and insurance been produced for each participant vehicle in the procession? (Check One): YES NO

Note: Registration & insurance subject to review by Risk Management

What is the total number of units/floats in the procession? ____________________________________________________________

10




SITE PLAN

Please use this Site Plan to illustrate the layout of your event. If you need additional space, please attach a separate sheet.

If applicable the following must be included: Location of food vendors (FV)

Location of beverage vendors both non-alcoholic (NAB) and alcoholic beverages (AB) along with number of serving stations at each location

Location of toilets (T)

Location of hand washing sinks (HWS)

Location of retail merchants (RM)

Location of First Aid (+)

Location of garbage receptacles (G) and recycling receptacles (R)

Show walk, run and bike routes if athletic event

Location and number of Type III Barricades (III)

Location of fire lane (FL)

Location of fire extinguishers (FE)

Public entrances and exits

Location of sound stages and amplified sound

Location of residential streets surrounding event

Location of “FREE ADMISSION - DONATIONS ACCEPTED” sign

11




TERMS AND CONDITIONS

The applicant must promptly reimburse the City for (and make good to it) any and all damage of any kind to any property of the City which may result from the use by the applicant of the City’s premises under the permission granted herein, and the applicant further agrees that it will not hold liable the City for or in account of any loss or damage to property owned by it or controlled by the applicant, or for or on account of any loss or damage sustained by the applicant as a result of injuries to employees or agents of the applicant. Applicant may be required to secure a performance bond.

By checking this box, I agree that the information in this application is true and correct to the best of my knowledge.

I agree to inform the City of Atlantic City's Office of Special Events and the Atlantic City Police Department of any changes in

this application at least 20 days prior to the date of the event.

I agree to the terms and conditions listed above.

Signature of Organizer/Applicant Date

12




SPECIAL EVENT FOOD LICENSE M E R C A N T I L E APPLICATION

FEE: $ 100.00 PER VENDOR. MAKE CHECKS PAYABLE TO THE CITY OF ATLANTIC CITY.

THIS FORM MUST BE SUBMITTED 20 DAYS PRIOR TO THE EVENT TO THE MERCANTILE OFFICE, ROOM 120

Please type or print clearly. Application will be returned if not completed in it’s entirety.

Name of Event

Address of Event


Name of Sponsoring Event/Coordinator Phone Number

Name of Food Vendor Contact

Department of Business Affairs & Consumer Protection Account Number Phone Number

If you do not have copies of that information, please phone (*to be included*)

Address City Zip Code

Print Name: Title:

SIGNATURE (*Must be signed by an owner or officer) Date:

13




The following section applies to special events that intend to include food vendors. The forms on

page 14-15 are to be returned to the Environmental Health Office, Room 403 in City Hall. Please call

(609) 347-5670 if you have any questions.

GUIDELINES FOR TEMPORARY FOOD ESTABLISHMENTS

1. All employees must be aware of the guidelines for the operation of a temporary food service establishment.

2. A metal stem thermometer shall be available to check internal food temperatures. A thermocouple (thin probe

thermometer must be available to monitor internal temperatures of thin products).

3. Alcohol wipes shall be available to sanitize thermometers stems before and after taking a food temperature

4. Adequate hand washing facilities shall be provided. Portable hand washing stands are available for rental and

shall be properly maintained and used.

5. Sanitary food handling techniques must be used at all times. Food handlers shall use suitable utensils to

minimize handling. Plastic disposable gloves shall be utilized. BARE HAND CONTACT OF READY TO EAT FOOD

IS PROHIBITED.

6. Wiping cloths: Disposable single use wipes shall be used for wiping cloths. Cotton cloths shall not be permitted.

NSF approved pre-packaged sanitizing wipes may also be used for any counter wiping.

7. Service must be restricted solely to single service articles (e.g. plastic knives, forks, spoons, disposable plates,

etc.).

8. Dishwashing Facilities: Equipment and utensils must be washed in three compartment sinks. The process

includes washing the equipment/utensils in hot soapy water, rinsing in hot water, sanitizing, and air drying. If

possible, an adequate quantity of utensils should be in the booth for the day's operation and returned to the

establishment's kitchen for proper washing and sanitizing.

9. Sponsors of large events must provide a conveniently located, properly plumbed three compartment sink with

adequate hot and cold running water. This facility can be utilized by several food booths.

10. All food production MUST be done in an approved kitchen facility (e.g. the kitchen is permitted and inspected

by the Health Department).

11. No food preparation shall be permitted in food booths.

12. ALL COOKING OF FOOD MUST BE DONE TOWARD THE BACK OF THE BOOTH OUTSIDE THE VERTICAL PLANE

OF THE TENT. Regulations by Atlantic City Fire Department must be followed.

13. Appropriate fire extinguishers shall be easily located and available in booths that are cooking.

14. SMOKING, EATING, OR DRINKING in booths while working is not allowed.

15. All non-working unauthorized persons are to be kept out of the booth.

16. Crock pots, steam tables, or other hot holding devices are not to be used as a means of heating up foods; they are only to be used for hot holding purposes. We recommend that foods be heated on the grill or propane stove to bring the food temperature to at least 165° F within 30 minutes. Crock pots, steam tables or other hot holding devices are slow cooking; food heated with this equipment may take longer than 30 minutes which may activate the multiplication of bacteria if present.

14

DEPARTMENT OF HEALTH & HUMAN SERVICES - TEMPORARY FOOD ESTABLISHMENT GUIDELINES - continued

17. Leftovers may not be used in the booth. NO LEFTOVERS are to be served or sold in the booth. Hot held foods

which have not been used by the end of the day must be discarded.

18. No person who is infected with a communicable disease, including the flu, fever, diarrhea, vomiting, or who

has open sores or infected cuts on his/her hands shall work in any temporary food establishment.

19. Chemicals such as liquid bleach, detergents and so forth must be stored in a separate area away from food set

up and display areas.

20. A broom and a dust pan should be available for sweeping the floor.

21. A refuse container with a tight-fitting lid should be available for garbage.

22. Liquid waste shall not be dumped into streets, storm drains, or onto the ground.

23. Storage of prepackaged food in contact with water or undrained ice is prohibited. Wrapped foods (e.g.

sandwiches) shall not,be stored in direct contact with ice.

24. Foods on display must be covered and the public shall NOT be allowed to help themselves to open containers.

Condiments such as ketchup, mustard, coffee creamer, sugar, and so forth, should be served preferably in

individual packets or from squeeze containers.

25. Foods must be stored at least 6 inches above the ground.

26. Any other requirement deemed necessary by the Department or Health Authority to protect the public health

in view of the particular nature of the food service operation shall be met .

27. A refrigerated truck may be required to hold cold food product depending on size of the event .

REQUIRED FOOD TEMPERATURES:

Cold Food: -41°F or below

Hot Food: 135°F or above

Proper Cooking temperatures of food product per NJ State Sanitary Code shall be followed per NJ State Sanitary Code

Food in transit must be protected from contamination during transportation and must meet the above

temperature requirements.

15




Forms are to be sent to the Environmental Health Office, Room 403 in City Hall. Please call (609) 347-5670 if you have any questions.

Please type or print clearly. Application will be returned if not completed in it’s entirety.

Name of Event

Address of Event


Name of Sponsoring Event/Coordinator Phone Number

Name of Food Vendor Contact Name

Email Account Phone Number

SIGNATURE (*Must be signed by an owner or officer) Date:

Type of overhead protection (to be approved by Health & AC Fire Prevention): _____________________________________________________________

Floor Surface (ex: rubber mats): _______________________________________________________________________

Sneeze guard protection devices: ______________________________________________________________________

Location of cooking equipment: ________________________________________________________________________

Note: No cooking equipment at the front of the venting space is allowed or on the sides if you are directly next to another vendor; cooking

permitted at the rear of the space.

Physical barriers preventing public access to prep areas: _______________________________________________________________________________

List the name and address of the licensed kitchen or food establishment to be used for the initial food preparation and storage of equipment (where

food is to be actually prepared and equipment is sanitized and stored). Food or equipment may not be stored in the home (Attached signed

Affidavit)

Describe the method of transporting food and the temperature it will be held at the event site (i.e. refrigerated cold storage containers, refrigerated

vehicle capable of maintaining temperatures of 40° F or below, hot foods 140° F or above)

Describe the method of storage at the event site (i.e. refrigerated cold storage containers, refrigerated truck capable of maintaining temperatures of

40° F or below) Hot foods must be maintained at a temperature of 140° F or above. List the temperatures food items will be cooked to.

Indicate the location of restroom facilities within proximity to the food vending booth on the attached site plan.

Describe hand washing facilities at the food vending booth. Portable hand sinks are required. A permit will not be issued without hand washing facilities.

16

CITY OF ATLANTIC CITY DEPARTMENT OFHEALTH & HUMAN SERVICES SPECIAL EVENT FOOD LICENSE APPLICATION continued


THIS FORM MUST BE SUBMITTED 20 CALENDAR DAYS PRIOR TO THE EVENT

SPECIAL EVENTS MENU APPROVAL REQUEST

Must Be Filled Out (Provide detailed information for each question). Requirements may be imposed to protect the public's health or to prohibit the

sale of some or all potentially hazardous foods such as raw foods, sushi or oysters. Advanced cooking is prohibited. When no health hazard exists, some

requirements may be waived.

List the proposed foods and ingredients to be served at the event. You may list up to 4 items on one sheet (use back of sheet if necessary)

Food Item 1

Food Item 2

Food Item 3

Food Item 4

List source where items will be purchased (Name, Address, Phone Number . . . retain all receipts for inspection)

Food Item 1

Food Item 2

Food Item 3

Food Item 4

List any equipment that may be used at the event in the preparation of food or beverages (i.e. mixers, blenders, etc. include drawings & specifications

Food Item 1

Food Item 2

Food Item 3

Food Item 4

Describe the method of cooking at the event: Raw animal products must be cooked to the following internal temperature for at least 15 seconds: Poultry and stuffed foods - 165° F, Pork; ground, diced or shredded meats and fish; eggs cooked in advanced - 155° F, whole cut meats and fish, eggs 145° F. List the temperatures food items will be cooked to.

Food Item 1

Food Item 2

Food Item 3

Food Item 4

All vendors must have a passing inspection dated not more than six months before the event. Non-Atlantic City establishments must submit their latest sanitation report from their local Health Department jurisdiction dated no more than six months before the event. A copy of the following must be attached to each application: Site Plan, Summer Festival Food Vendor sanitation certificates(s), signed affidavit, if you received permission to use a licensed kitchen. A copy of your current health inspection must be attached to each application.

Documents

SPECIAL EVENTS PERMIT APPLICATION - Atlantic City …userfiles/pdfs/AC-2013-FilmPermit.pdf · SPECIAL EVENTS PERMIT APPLICATION ... Before you submit your special event application,