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 preevent 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 1-10 people 11-30 people 31-49 people Over 50 people $150/day $250/day $500/day $750/day Commercial Still Photography 1-10 people 11-30 people Over 30 people $50/day $150/day $250/day
Cost Recovery Fees Application Processing Fee Administrative (Ranger) Cost $150 $50 per hour
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GENERAL APPLICATION FORM
Date _____________
I. General Information
1. 2. 3. 4. 5. 6. 7. 8. Company Name ___________________________________________________________________________ Address __________________________________________________________________________________ City/State/Zip Code_________________________________________________________________________ Phone Number __________________________________ Fax __________________________________________ Producer ________________________________ Company Name for shoot______________________________________________ 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 Stills/editorial Stills, other indicate Feature Film TV Series Documentary/Travelogue Music Video Infomercial Other EXPLAIN X Stills, advertising Stock video/photo TV Movies TV Pilot Commercial Public Service Announcement Industrial
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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 1. 2. 3. Dates Times
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. 3. 4. 5. 6. 7. 8.
Children ___ None ____Yes If Yes to # 2, Number of Children ______ Age Range ________ Animals ___Yes ___No If yes to 4, purpose _________________________________________________________________________ How many animals ______________________________ List animals ______________________________________________________________________________ Trainers name _____________________________________________________________________________ 7
9.
Phone #__________________________________________________________________________________
IX. Special Effects
1. 2. Special effects ____ yes ____no If yes explain __________________________________________________ Special effects (pyrotechnics) ____yes ____ no If yes explain_______________________________________
____________________________________________________________________________________________ ____________________________________________________________________________________________
3. 4. 5. 6.
Effects Technician name: ____________________________________________________________________ Phone Number ___________________________ 5. License Number _________________________________ Address __________________________________________________________________________________ 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_________________________ 8
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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 9
Office Use Only
1. 2. 3. 4. 5. 6. 7. 8. 9. _____ Approved ______ Denied Reasons if Not approved, indicate _____________________________________________________________ Type of Permit ________________________ Administrative Costs $50 per hour Estimated Management Costs $ _______________ Donation $ _______________________________________________________________________________ Park Ranger ____ yes ____no If yes, how many ________ hours of work _________ hourly rate _________ Total ____________ 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 1. 2. 3. 16. Other division called for assistance ___yes ___ no Times
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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