Erie County Health Department Form

Erie County Department of Health Division of Environmental Health Services

Application for a Permit to Operate a Temporary Food Service Establishment

Operation of a food service establishment without a permit is a misdemeanor under part 14 of the New York State Sanitary Code.

Submit this application at least 5 days before the first day of operation.



1. Event

a. Name of event or festival

b. Number and street where event is being held.

c. City, Town or Village event is located in.

d. Indicate beginning and ending dates of the event.

2. Food Stand

a. Name on food stand for this event.

b. Indicate location of stand at the event.

c. Indicate the foods that will be served at this stand.

3. Owner/Operator

a. Name of owner of business or corporation and home phone number.

b & c. Permanent address of business.

d. Name of Responsible Person - name and title of individual responsible for the operation who may be contacted in the event of an emergency, etc. If available, fax number where permit could be sent.

4. Fee Required

Check the boxes that apply and enter the fee total.

5. Signature

a. Signature of the owner or operator.

b. Title of the person signing this application and the date it was signed.


Click here to Download the Application

Instructions on digitally submitting the form

  1. Download the application above
  2. Open the application with Adobe Reader
  3. Complete the application
  4. Use the "fill & sign" tool in Adobe reader to digitally sign the document
  5. Save a copy of the application
  6. Upload the saved copy below and submit.


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