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2. Date and Time of Function
   Date and Time of Function Start Date

   Date and Time of Function Start Time

   —

   Date and Time of Function End Date

   Date and Time of Function End Time
4. Road(s) to be blocked
6. Estimated Number attending
7. Age Group
9. Are you requesting a Police Officer?

   1. Yes

   1. No
11. Please provide 2 residents to contact:
13. Contact 1 Name
14. Contact 1 Email Address
16. Contact 1 Full Address
17. Contact 1 Phone Number
19. Contact 2 Name
20. Contact 2 Email Address
22. Contact 2 Full Address
23. Contact 2 Phone Number
25. Name of person making request
26. Requestor Email Address
28. Requestor Full Address
29. Requestor Phone Number
31. Please check required compliance*

    1. I have read the Block Party Policy and fully understand it. I will comply with this policy, if the application is approved
33. BLOCK PARTY POLICY
    
    1. Applications for permission to hold a block party must be obtained at the office of the Board of Selectmen. The application form must be completed, signed and returned to the Board of Selectmen for clearance by the Department of Public Works, Fire Department and Police Department.
    
    2. The applicant should supply, if appropriate, the Board of Selectmen with an adequate detour plan prior to the granting of permission to close off a roadway.
    
    3. The Traffic/Safety Division will determine if a police officer is needed and advise the Selectmen before a permit is issued.
    
    4. The permit may be revoked and the party terminated by the Police Department in the event of any rowdiness, excessive noise or any other disturbance.
    
    5. After a permit is issued, the permit holder must arrange with the Department of Public Works (781-741-1430) for barricades, signs, etc. Any damage to this equipment will be the responsibility of the permit holder. A $50.00 refundable deposit, payable to the Department of Public Works, is required and will be returned to the permit holder upon return of the equipment in good condition.
    
    6. It is the responsibility of the permit holder to see that the area is left clean and orderly following the function and to return to the Department of Public Works any signs, barricades, etc. loaned by the Town.
    
    7. The By-laws of the Town of Hingham prohibit drinking alcoholic beverages on Town property.
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35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

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