Fireworks – Discharge Permit Application

Discharge of Fireworks Permit General Terms and Conditions

Fireworks shall not be set off or discharged:

any day between 11p.m. and 10 a.m. the following day (exception for New Year’s – may be set off between 11 p.m. one day and 1 a.m. the next day);
within 50 meters of a nursing home or group home;
within 50 meters of a place where explosives, gasoline or other highly flammable substances are commercially manufactured, stored or sold;
when a burning ban is in effect within the Township; and
by a person under the age of 18 years of age.

Immediately after the conclusion of the Firework’s event:

all debris must be removed

Download printable PDF form.

Applicant/Firework Supervisor Name *

First

Last

Email Address *

Phone Number *

Owner is different than applicant

The owner is different than the applicant

If an application is signed by an individual other than the owner, the owner’s written authorization shall be completed below.

Display Details

Address/Display Location *

Address Line 1

Address Line 2

City

Province

Postal Code

Date and Time of Display *

Date

Time

Alternate Date of Display

Date

Time

Firework’s Certificate Number *

Expiry Date *

Insurance Upload *

Click or drag a file to this area to upload.

Please upload a copy of your Commercial General Liability Insurance.

The applicant acknowledges having read Fireworks By-law No. 039/14 and has completed the application accurately and truthfully. By signing this application the applicant agrees to adhere to the requirements of the By-law and to the terms and conditions of the permit.

Applicant Signature *

Clear Signature

Discharge of High Hazard Fireworks Permit

Price: $116.00

Convenience Fee + 1.75%

Price: $2.03

Total

$0.00

Stripe Credit Card *

Card

Name on Card

Personal information on this form is collected under the authority of the Municipal Act and the Fire Protection and Prevention Act and will be used to determine the eligibility of a permit. The information is used for the purpose of processing this application and administering the Permit Program and is maintained in accordance with the Municipal Freedom of Information and Protection of Privacy Act. Questions regarding the collection of this information may be directed to the Township Clerk’s office.

The Township of Puslinch is committed to providing accessible formats and communication supports for people with a disability. If another format would work better for you, please contact the Township Clerk’s office for assistance.

Name

Discharge of Fireworks Permit General Terms and Conditions

Fireworks shall not be set off or discharged:

Immediately after the conclusion of the Firework’s event:

Display Details

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