Applicant Information Applicant Name * Applicant Job Title * Applicant Email * Applicant Phone Number * Date * MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Day12345678910111213141516171819202122232425262728293031 Day Year Proposed Street Seat Location Street Address * Borough * the Bronx Brooklyn Manhattan Queens Staten Island ZIP Code * Cross Street 1 * Cross Street 2 * Community Board (number) * Length of establishment frontage * Is this seating area intended to span more than one establishment? * *If the answer to this question is “yes,” an application must be received from each sponsoring business/organization. Yes No Parking regulations at proposed seating area: * Are there metered parking spaces at the site? * Yes No IFO Business/Organization Information Legal Name of Business/Organization: * “Doing-Business-As” (DBA) Name: * Federal Tax ID# * Type of Business/Org. * Owner/Mgr/Principal Name * I am the owner/mgr/principal of this business/org Yes Owner/Mgr/Principal Phone * Owner/Mgr/Principal Email * Property Owner Information Name of Property Owner or Representative * Name of Property Owner Company * Street Address * City * State * - Select state -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP Code * Signature * Property Owner’s Affirmation —I, the undersigned, do affirm that I am the owner or a duly authorized representative of the corporation owning the above referenced property. I have been made aware of the Applicant’s intent to install a Street Seat in the curb lane in front of the business listed on this application and have no objections. Date * MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Day12345678910111213141516171819202122232425262728293031 Day Year Street Seat Options Street Seat Platform * Are you interested in installing a Street Seat with a platform, or without? (You do not have to finalize your decision at this time.) Custom Design Platform Non-platform DOT Standard Design Platform Not sure at this time Food Establishments Is this a restaurant or food service establishment? * Yes No Food service establishment permit number Expiration date MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Day12345678910111213141516171819202122232425262728293031 Day Year Is this establishment eligible for a sidewalk café from the Department of Consumer Affairs? Yes No If not, for what reason? Sidewalk too narrow Obstruction Restricted on this street Submit
