FIREWORKS PERMIT APPLICATION
This application for a Fireworks Permit is being issued under authority of Chapter 40, Town of Newbury Ordinances. The Fireworks Permit, when issued is not an authorization to violate any State law or other chapter or provision of the Town of Newbury Ordinances. The authorizing official holds no liability in the issuance of this permit. It is the responsibility of the permittee to refer to all applicable State laws and Town of Newbury Town ordinances, and to operate within their provisions. Applicants must be at 18 years of age.
This application must be made to the Newbury Fire Department 48 hours in advance of the day and time of the display. The application must be approved and a permit issued by the Fire Chief or his designee before the display can be held.
Permit Applicant:
Name: ___________________________________________________________________
Address: _______________________________________________________________
DOB: ___________ Phone (s): ____________________
Location of Display: (If different from above) ___________________________________
Class / Type / Description of Fireworks:
BELOW TO BE COMPLETED BY AUTHORIZED OFFICIAL FOR THE NEWBURY FIRE DEPARTMENT
Application Received by: ____________________ Date ________________ Time ________
Date of Display: Authorized Times: until
Specific Restrictions Regulating display:
________________________________________________ ______________
Authorized Signature: Fire Chief or Designee Date
| 
