Street Closing Application (fillable)

Supporting Documents

Street Closing Application (pdf) (14 KB)

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Name: *

Address (Line 1): *

Address (Line 2): *

If use is proposed to be conducted for, or behalf of, or by an Organization, list the Name, Address, and Telephone of the headquarters of the Organization and the authorized and responsible heads of such Organization:

Organization Name:

Org. Address (Line 1)

Org. Address (Line 2)

Org. Telephone No:

Name, Address, Telephone, and Email Address of the person who will be the chairperson of the event and who will be responsible for conduct:

Name: *

Address (Line 1) *

Address (Line 2)

Telephone No: *

Email Address: *

Date and time when the permit is to be used:

Date:

edit-submitted-date-month

edit-submitted-date-day

edit-submitted-date-year

Time starting: *

edit-submitted-time-hour

edit-submitted-time-minute

Time ending: *

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edit-submitted-time-ending-minute

Rain Date:

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edit-submitted-rain-date-day

edit-submitted-rain-date-year

If original date needs to be canceled, please contact the Yorktown Police Department (914-962-4141) and leave a message with the Town Clerk's Office (914-962-5722, ext. 209)

Name and Area of Street for Closure *

A list of properties affected with a map* showing all properties that would have access limited by the permit: *

*The map of the properties may scanned and submitted by email to [email protected] and brought to the Town Clerk's office - 363 Underhill Avenue, Yorktown, NY.

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Street Closing Application (fillable)

Supporting Documents

Contact Information