TOWNSHIP OF IRVINGTON
Department of Revenue & Finance
Division of License
Municipal Building - Civic Square
Irvington, New Jersey 07111
973-399-6620

MOTION PICTURE THEATRE - BUSINESS LICENSE APPLICATION

DATE: ______________ LICENSE FEE: ______________
APPLICATION IS HEREBY MADE FOR A LICENSE TO OPERATE "NEW" OR "RE-NEW" A MOTION PICTURE THEATRE IN CONFORMITY WITH THE REQUIREMENTS OF CHAPTER 62 ARTICLE V SECTION 43 THRU 55 OF THE TOWNSHIP OF IRVINGTON CODE.

NAME OF APPLICANT__________________________________________________________

HOME ADDRESS_______________________________________________________________

IF APPLICATION IS FOR A CORPORATION, PLEASE COMPLETE THE FOLLOWING:

INCORPORATED UNDER THE LAWS OF THE STATE OF ___ ____________________________

DATE OF INCORPORATION _______________ ______________________________________

NAME AND ADDRESS OF ALL OFFICERS:

PRESIDENT __________________________________________________________________

VICE PRESIDENT ______________________________________________________________

SECRETARY __________________________________________________________________

TREASURER ____________ ______________________________________________________

REGISTERED AGENT OF THE CORPORATION ________________________________________

TRADE NAME OF THE THEATRE __________________________________________________

STREET ADDRESS OF THE THEATRE _______________________________________________

TOTAL NUMBER OF SEATS IN THE THEATRE ________________________________________

___________________________
APPLICANT'S SIGNATURE


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NJ DRIVER'S LICENSE NUMBER

THIS ________ DAY OF _______________, 20____ SUBSCRIBED AND SWORN TO BEFORE ME


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NOTARY PUBLIC OF NEW JERSEY
I HAVE EXAMINED THIS BUILDING, AND THE PLANS AND SPECIFICATIONS AS SPECIFIED IN CHAPTER 62-45 OF THE TOWNSHIP CODE HAVE BEEN FILED IN MY OFFICE AND THE BUILDING CONFORMS TO THE PROVISIONS OF THIS ARTICLE.

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AUTHORIZED SIGNATURE DEPARTMENT OF PUBLIC WORKS-BUILDING CONSTRUCTION

I HAVE EXAMINED THIS BUILDING AND FIND THE SAME SUITABLE AND PROPERLY EQUIPPED WITH FIRE APPARATUS, AND SO CONSTRUCTED AS NOT TO BE DANGEROUS FROM FIRE OR OTHER CAUSES.

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SIGNATURE OF THE IRVINGTON FIRE DEPARTMENT AND TITLE OF PERSON SIGNING
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