[Village of Tarrytown] 2023 Recreation Parking Permit Application

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Village of Tarrytown, One Depot Plaza, Tarrytown NY 10591

(914) 631-7873 Phone / 914) 631-8770 Fax

2023 Recreation Parking Permit Application

Pursuant to the provisions of the Village Code regulating parking, the undersigned, who resides within the corporate limits of the Village of Tarrytown, hereby makes application for the issuance of a permit to park the motor vehicle hereinafter described in parking areas designated and at times specified in the Village Code when space therein is available.

Recreation Parking Permits are only available to Tarrytown residents and there is NO CHARGE for them. Completed application & copy of valid registration must be submitted to be processed or all will be returned. If registration does not have Tarrytown address, alternate proof of residency is required. Copy of window registration sticker is NOT acceptable.

Name of Applicant

Street Address:

City

State

Zip

Home Phone #

Business/Cell Phone #

Email Address

A separate application must be submitted for each vehicle for which a Recreation Parking Permit is requested.

Vehicle Information:

Vehicle Plate & State

Plate #

State

Car Make & Year

Make

Year

Upload File(s): Vehicle Registration

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The undersigned agrees that the Village of Tarrytown will not be liable for any loss or damage to the above-described motor vehicle or its equipment while such motor vehicle is parked in any parking area in the Village. This permit does not guarantee that a space will be available in designated parking areas. Permit is to be affixed to the left rear bumper of the vehicle. If this permit is placed on a vehicle which is not the vehicle to which the permit was assigned, the permit shall be deemed void and all Recreation Permits issued to that resident or residents family members shall be deemed void. The undersigned swears or affirms under penalty of perjury that they are a bona fide resident of the Village of Tarrytown, that they are the owner of the above-described motor vehicle, and that the foregoing statements are true.

First Name

Last Name

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I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

FOR OFFICE USE: Permit Expires___________ Permit No._____________ Fee Received__________________

Permit Issued By____________ Date_______________Cash__________

Check #___________________Credit Card_______________