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TOWN OF BOSTON APPLICATION FOR USE OF TOWN MEETING FACILITY Town of Boston/Erie County Clerks Office 10 1 6 26 Name/Organization ____________________________________________________ Date ___/___/_____ Jason Keding Name of person responsible for facilities _______________________________________________________ Town Supervisor Title ________________________________________________________________ 8500 Boston State Road, Boston, NY 14025 Applicant Address _________________________________________________________________________ (716)941-6518 50 Applicant Daytime Phone # ____________________________________ # Of Attendees ____________ October 30, 2026 9am-4pm Mobile DMV Date(s) Requested* ____________________ Time ______________Type of Event ____________________ I, UNDERSIGNED, REQUEST PERMISSION TO USE THE FOLLOWING: (CHECK ALL THAT APPLY) Town Hall Community Room w/o Kitchen Planning Board Room ✔ Court Room I agree that all facilities used will be properly cleaned to the best of my ability upon completion of the event and that I will be responsible for any damages caused to any of the facilities or grounds. SIGNATURE OF APPLICANT __________________________ ____________________________________ Upon Completion, please submit to Town Clerk **************************************************************************************************************** 10/8/2026 APPROVED/DENIED: _______________ (DATE) INSPECTION: _______________ (DATE)