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Small Business Social Distancing Exterior Premises Use Application

  1. Businesses must be properly licensed in the City of Buffalo in order to obtain permission via this application. Licenses should be available upon request.

  2. Have you submitted a New York State Safety Reopening Plan? *

  3. The City MUST have a copy of the New York State Safety Reopening Plan before your application can be approved.

  4. Indicate on the drawing if the business plans to use on-street parking that is currently available, and if so, how many spots. Also show the existing curb line location and any existing trees, hydrants, bike racks, sign posts, trash receptacles, etc.

  5. Please indicate which days of the week you wish use the exterior premises*

  6. Exterior premises will not be permitted to operate later than 11:00 p.m.

  7. Exterior premises will not be permitted to operate later than 11:00 p.m.

  8. Exterior premises will not be permitted to operate later than 11:00 p.m.

  9. Exterior premises will not be permitted to operate later than 11:00 p.m.

  10. City of Buffalo Hold Harmless Agreement and Copy of Insurance

  11. This will be required after approval for applications requesting use of property owned by the City of Buffalo, but before the exterior premises can be used.

  12. All businesses must obtain liability insurance policy in the amount of not less than one million dollars ($1,000,000.00), or a larger amount in the discretion of the City, with the City of Buffalo named as an additional insured. This insurance policy must specifically include the external premises

  13. This application grants permission for the use of exterior areas only on property owned by the applicant or the City of Buffalo. The applicant is responsible for securing permissions required by other governmental authorities or entities (e.g., State Liquor Authority, Erie County Department of Health)

  14. City of Buffalo reserves the right to request additional information from the applicant. Failure to comply with the details of the plan submitted and approved; requisite rules and regulations or the City of Buffalo and other authorities; and more specifically, failure to meet social distancing requirements, will result in the revocation of the privilege granted to use the exterior premises.

  15. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

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  17. This field is not part of the form submission.