Photo/Film Shoot
Special Park Use
Jamaica Bay Unit
Breezy Point District
Permit Application for Photo/Film Shoot
Gateway National Recreation Area
Building #1, Fort Tilden, NY 11695
Phone Number – 718-318-4300
Fax Number - 718-318-4310
You, the permit holder, are advised to read thoroughly the requirements for the photo/film shoot. All staff
participating in the photo/film shoot are encouraged to read the park rules and regulations. Any one of the
guidelines violated below are subject to ONE or ALL of the following:
Having the photo/filming shoot cancelled on the spot
Pay for damages of Federal Government property
Pay for the overtime of park staff assisting in the photo/film shoot.
Disciplinary actions from the United States Park Police.
These guidelines are recommended for the areas in Fort Tilden and Riis Park or location where the shoot
is taking place within the Breezy Point District. Please print clearly and use an ink pen when filling out the
application form. Submit only the application and keep the park rules and regulations on file for copying
and distribution to participants involved in film shoot. All parts of the application must be properly filled out.
If there is a section that does not pertain to your film shoot indicate in the blank space “Not Applicable”.
Areas that are not filled out may cause a delay in the permit processing and/or denial of the permit request.
1. The United States Department of the Interior, National Park Service will in no way be held responsible
in the event of any personal injury and/or loss or damage to personal property during or occurring from
the use of this area.
2. Under 18 U.S.C. 1 1 , any person who knowingly and willfully falsifies, conceals or covers up any trick,
scheme, device or material fact or makes any false statement or representations; in respect of any
matter within the jurisdiction of any department or agency of the United States, is liable to a fine in the
amount of $10,000.00 and imprisonment for no more than five years, or both.
3. The National Park Service at the discretion of the Superintendent or his/her authorized representative,
reserves the right to immediately revoke or cancel this permit should it become necessary in the
interest of public safety, public health or general welfare.
4. The National Park Service reserves the right to enter the permit area at any time for inspections.
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5. Absolutely no swimming, sunbathing, etc., on Fort Tilden beaches. Swimming is permitted at Riis Park
from Memorial Day through Labor Day.
6. Glass containers and helium balloons are prohibited in the park.
7. Mechanical amusement rides, games, and tents of chance will not be permitted without proper
insurance and proper authorization from park officials for any of the surrounding areas.
8. The Permittee shall ensure that the group participating in the film shoot will comply with any
instructions from the designated official representing this office, and/or similar instructions from the
United States Park Police.
9. Discovery of any illegal or criminal act shall be reported immediately to the United States Park Police.
10. The Permittee shall insure that all persons using the area, or participating in the activities, are informed
of and comply with park rules and regulations, and all applicable state and federal laws. It is
recommended that copies of the agreement be distributed or posted on a temporary bulletin board so
all participating in film shoot.
11. The Permittee will take no action, which would be detrimental to historical or natural resources of the
park or have any adverse impact on the environment. i.e. sand dune use, shots in or on historic
structures, etc.
12. Disorderly Conduct - a person is guilty of disorderly conduct if his/her actions cause public
inconvenience, annoyance, alarm or recklessly creates a risk to other(s). This is subject to action by
the United States Park Police.
13. The Permittee shall ensure that those persons conducting and participating in the film/photo shall
maintain proper decorum.
14. Permittee is responsible for making photocopies of the parking permits for participants involved in the
shoot. Participants in the activity that do not have a copy of the parking permit are subject to
summonses from the United States Park Police.
15. This permit is issued only for the use of the area designated and does not include permission for
activities at other sites or areas outside the park area.
16. All vehicles will park in parking areas designated by the Site Manager or other park representatives
only. All overflow traffic for event and any function held on the Drill Grounds are to park in the T-4 lot.
All other areas are prohibited and subject to summonses by the United States Park Police.
17. No Porta-Johns are provided by Breezy Point Site for the film shoot unless approved by a park official
and furnished by Permittee.
18. Informational signs may be erected only with prior approval of the Site Manager or designated park
official. And must be taken down at the conclusion of the activity by the permittee.
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19. Alcoholic beverages and/or drugs - possession and consumption of alcoholic beverages by persons
under 21 years of age are prohibited. The possession, consumption or other use of dangerous,
intoxicating or illegal drugs is strictly prohibited.
20. Site Inspections are conducted before and after the film shoot and determined if conditions of property
are in sound, clean, and orderly manner. A designated park official will complete an inspection form
and an agreement signature from the permittee is required prior to the event, as well as the end of the
event. Any damaged or stolen material will be charged to the Permittee and/or bond withheld.
21. The condition of government property used during the film shoot is to be clean, and grounds to its pre-
event condition. All generated garbage from the event is to be properly disposed of, and removed from
park property.
22. Loudspeakers for P.A. systems cannot be audible to disturb other park functions.
23. Film shoot activities will be terminated by 10:00 p.m. or time agreed upon between Site Manager and
permittee and the building and grounds vacated at that time.
24. Park may assign park rangers or United States Park Police to monitor the film shoot. The cost will be
incurred by the Permittee for that day(s). Permittee will pay for the cost of overtime for any staff
needed to monitor the activity as well.
25. Failure to comply with the above conditions will cause for termination of the permit and/or additional
fees to be paid.
26. The management team of the Jamaica Bay Unit, Breezy Point District may require a copy of the
storyboard or script for the motion picture or descriptive summary of the still photo shoot.
27. A copy of the final shoot product may be requested for park archives.
28. Credits indicated at the completion of the motion picture shoot or on the still film shoot advertisement
should be noted as follows:
National Park Service
Gateway National Recreation Area
Jamaica Bay Unit – Breezy Point District
29. Designated areas for filming
Club Fed, Bay 16 and 17 beach front.
Jacob Riis Park - except from Labor day through Memorial Day
30. Insurance and Indemnity
The Permittee shall save, hold harmless, defend and indemnify the United States of America, its
agents and employees on account of fire or other peril, bodily injury, death or property damage, or
claims for bodily injury, death of any nature whatsoever, and by whomever made, arising from the
activities of the Permittee, his employee, sub-contractors or agents under the permit. Permittee
may be required to provide a Certificate of Insurance for minimum liability $ 1,000,000 bodily
injury/per occurrence with the United States Government, National Park Service, Breezy Point
Site, named co-insured.
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Location Fee Schedule
National Park Service
Effective June 28, 2006
*The park is now required to charge a location fee for all commercial filming and still
photography. The location fee is in addition to the cost recovery fees that the park is
currently charging. The total Cost Recovery Fee as well as the Performance Bond will be
determined after final review of the application. Cost recovery amounts are based on the
actual cost incurred by the park in processing the request, monitoring the activity and
rehabilitating or restoring the permitted area. We are unable to process credit cards.
Checks/money orders are payable to the National Park Service. These fees may not be
waived.
Motion Pictures/Videos Commercial Still Photography
1-10 people $150/day 1-10 people $50/day
11-30 people $250/day 11-30 people $150/day
31-49 people $500/day Over 30 people $250/day
Over 50 people $750/day
Cost Recovery Fees
Application Processing Fee $150
Administrative (Ranger) Cost $50 per hour
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GENERAL APPLICATION FORM
Date _____________
I. General Information
1. Company Name ___________________________________________________________________________
2. Address __________________________________________________________________________________
3. City/State/Zip Code_________________________________________________________________________
4. Phone Number __________________________________
5. Fax __________________________________________
6. Producer ________________________________
7. Company Name for shoot______________________________________________
8. Applicant Name ___________________________ 9. Agents Name ________________________________
10. Address __________________________________________________________________________________
11. City/State/Zip Code_________________________________________________________________________
12. Phone Number ___________________________ 13. Pager/Cell Phone _______________________________
14. Photographers Name ____________________________ 15. Directors Name____________________________
16. Name of Project/Client_______________________________________________________________________
17. Federal Tax ID and/or Social Security Number ____________________________________________________
II. Type of Project
X X
Stills/editorial Stills, advertising
Stills, other indicate Stock video/photo
Feature Film TV Movies
TV Series TV Pilot
Documentary/Travelogue Commercial
Music Video Public Service Announcement
Infomercial Industrial
Other EXPLAIN
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IV. Summary of Scene(s)
V. Site Information
1.
Sun. Mon. Tues. Wed. Thurs. Fri. Sat.
2. Dates needed ________________ to __________________
3. Total Days ______________
VI. Sites requesting
1. Include buildings.
Site Dates Times
1.
2.
3.
2. Site closures/Road closures requested __yes ___no If yes explain______________________________________
____________________________________________________________________________________________
3. Times of closure needed __________________ for what dates ________________________________________
4. Night work ____ yes _____ no If yes, explain project _______________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
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5. Electrical needs _____________________________________________________________________________
6. Generators ___Yes __No If yes how many________________________________________________________
7. Set dressing of any of the facilities ______________________________________________________________
VII. Caterer
1. Caterer ___Yes ____No If NO, continue to section VIII
Set up, break down and clean-up is the responsibility of the caterer. Carry-In Carry Out-Policy strictly
enforced.
2. Caterer Name _______________________________________________________________________________
3. Address ___________________________________________________________________________________
4. City/State/Zip Code__________________________________________________________________________
5. Phone Number _________________________________ Fax ________________________________________
VIII. Operational Information
1. Personnel and vehicles:
______Total Cast and Crew
______ No. Personal Cars
______ No. Large Trucks
______ No. Of Caravans/motor homes
______ Other Trucks
______ Vans
______ Camera Car
______ Picture Cars
______ Dressing Rooms
2. Children ___ None ____Yes
3. If Yes to # 2, Number of Children ______ Age Range ________
4. Animals ___Yes ___No
5. If yes to 4, purpose _________________________________________________________________________
6. How many animals ______________________________
7. List animals ______________________________________________________________________________
8. Trainers name _____________________________________________________________________________
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9. Phone #__________________________________________________________________________________
IX. Special Effects
1. Special effects ____ yes ____no If yes explain __________________________________________________
2. Special effects (pyrotechnics) ____yes ____ no If yes explain_______________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
3. Effects Technician name: ____________________________________________________________________
4. Phone Number ___________________________ 5. License Number _________________________________
5. Address __________________________________________________________________________________
6. Stunts _____ yes ____no If yes, explain________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
7. Any other unusual or hazardous activities, explain__________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
X. Coordinators
1. Person on location responsible for company’s adherence to all terms and conditions of the film permit.
Name: ___________________________ Title: _________________ Phone Number_________________________
2. Person on location responsible for coordinating activities with the NPS:
Name: ___________________________ Title:_________________ Phone Number_________________________
3. Person at the company office to contact for follow-up information and billing
Name: ___________________________ Title:_________________ Phone Number_________________________
4. Name of Producer
Name: __________________________________________________ Phone Number________________________
5. Name of Director
Name: __________________________________________________ Phone Number________________________
6. Name of photographer
Name: _________________________________________________ Phone Number_________________________
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7. Name of lead cameraman
Name: _________________________________________________ Phone Number_________________________
I hereby state the above information given is complete and correct, and that no false or misleading information or
false statements have been given. All estimates are reliable to the best of my knowledge and I have the full authority
to represent the applicant/production company and the project described. I understand the rules and regulations
stated above, and understand that production of the shoot may be terminated if any of the violations indicated
herewith are violated.
Signature __________________________________________ Title ______________________________________
Date _______________ Company Name ___________________________________________________________
Revised January 2007
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Office Use Only
1. _____ Approved ______ Denied
2. Reasons if Not approved, indicate _____________________________________________________________
3. Type of Permit ________________________
4. Administrative Costs $50 per hour
5. Estimated Management Costs $ _______________
6. Donation $ _______________________________________________________________________________
7. Park Ranger ____ yes ____no
8. If yes, how many ________ hours of work _________ hourly rate _________ Total ____________
9. United States Park Police ____ yes ____no
10. If yes, how many ________ hours of work _________ hourly rate _________ Total ____________
11. TOTAL COST Administrative Cost $_____________
Application Cost $_____________
Park Ranger Cost $_____________
USPP Cost $_____________
Subtotal $___________
Donation $_____________
Total $_____________
12. Name(s) of Rangers assigned to work a. _________________________ Date _________ Time_____________
b. _________________________ Date _________ Time_____________
c. _________________________ Date _________ Time_____________
d. _________________________ Date _________ Time_____________
13. Bond ____ yes ____ no If yes $_______________
14. Certificate of Insurance ____ yes ____ no If yes $_________________
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15. Sites/dates/times
Site Dates Times
1.
2.
3.
16. Other division called for assistance ___yes ___ no
17. If yes to 9, explain__________________________________________________________________________
18. Number of vehicles permits ____________________
19. Comments ________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
20. Payment Received by _________________________________ date _________________
21. Bill of Collection issued ___ yes ___ no If yes, by who ____________________________________________
22. Bill of Collection received by ___________________________ date__________________
Application reviewed by ________________________ date ____________________________
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