Fireworks Permit Application Form

This application must be submitted to the Fredericton Fire Department a minimum of 14 days prior to the event and include all requested documentation.

Event Information

Event Location

Event Date(s) and Time(s)

Event Date(s) and Time(s)
Event Date(s) and Time(s) Event Date(s) and Time(s): Date Event Date(s) and Time(s): Time

Rain Date(s) and Time(s)

Rain Date(s) and Time(s)
Rain Date(s) and Time(s) Rain Date(s) and Time(s): Date Rain Date(s) and Time(s): Time

Description of the event

Sponsoring Organization (if applicable)

Organization Name

Contact Person's Name

Phone

Mailing Address

Street Address, City, Province, Postal Code

Certified Fireworks Operator (Display Supervisor)

Name

Company Name (if applicable)

Email Address

Phone Number

Mailing Address

Street Address, City, Province, Postal Code

Certificate Number

Certificate Class

Expiry Date

Additional Certified Fireworks Operators (if applicable)

Additional Certified Fireworks Operators (if applicable)
Additional Certified Fireworks Operators (if applicable) Name Certificate Number Certificate Class Expiry Date

Upload proof of certification of the applicant as a Fireworks Operator, and any other persons handling and discharging consumer fireworks, display fireworks, or special effect pyrotechnics.

* Each copy of an Operator’s Certificate must include front and back.

Proof of Certification

One file only.
128 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

For additional display assistants, please submit the above-requested information for each person separately.

Proof of Certification for Additional Display Assistants

Maximum 3 files.
128 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Fireworks/Pyrotechnics Information

Upload a list of materials.

This includes a description of the type and kind of consumer fireworks, display fireworks, or special effect pyrotechnics that may be discharged.
Type, size and quantity of each must be listed
The document must be saved in PDF format to upload

List of Materials

One file only.
128 MB limit.
Allowed types: pdf.

Discharge techniques to be used

Hand Fire

Fire Electronically

Site Plan

A description of the discharge site to be used for the discharging of the consumer fireworks, display fireworks, or special effect pyrotechnics (including measurements).

Document must in PDF format

Upload Site Plan

One file only.
128 MB limit.
Allowed types: pdf.

Identify the place and method of fireworks/pyrotechnic storage on site

Name of person(s) who will transport the materials

Identify your fire emergency procedures

Insurance Information

Insuring Agency Name

Policy Number

Insurance Amount

Upload proof of insurance and indemnification, including the requirements below.

The applicant shall provide and maintain Commercial General Liability insurance subject to limits of not less than two million dollars ($2,000,000) inclusive per occurrence for bodily injury, death, and damage to property including loss of use thereof. Such insurance shall be in the name of the applicant and shall name The City of Fredericton as an additional insured thereunder. Such insurance shall include permission to conduct displays of consumer firework, display firework, or special effect pyrotechnics. Such insurance policy shall contain an endorsement to provide The City of Fredericton with thirty (30) days prior written notice of cancellation or of a material change that would diminish coverage, and a Certificate of Insurance evidencing such insurance coverage shall be provided to the Fredericton Fire Department prior to the issuance of a permit.
The applicant shall indemnify and save harmless The City of Fredericton from any and all claims, demands, causes of action, loss, costs, or damages that The City of Fredericton may suffer, incur, or be liable for resulting from the performance of the applicant as set out in the by-law, whether with or without negligence on the part of the applicant, or the applicant’s employees, directors, or agents.

Upload Insurance Information

Maximum 2 files.
128 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.