Application
CONTACT INFORMATION
| Event/Activity Name |
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| Facility (See link to park locations and descriptions above) |
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| ***Other Description |
PORT Park
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| Event Date |
September 15, 2022
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| Applicants Name |
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| Contact Person |
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| Email Address |
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| Cell Phone |
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| Day Phone |
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| Billing Address |
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EVENT INFORMATION
| Name of Supervisor / Vendor on Site |
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| Supervisor / Vendor Phone Number |
+12036762507
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| Name of Second Supervisor on Site |
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| Second Supervisor Phone Number |
+18024983530
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| Total Estimated Number of Participants |
200
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| Estimated Number of ADULT Participants |
200
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| Estimated Number of YOUTH Participants |
0
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| Organization Type |
Non Profit - may be asked to provide State Tax # or Federal EIN#
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| Activity |
Private Party (please specify below)
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| Brief Description of Event |
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| Special Requirements |
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First Preference For Event Date
| Is this event happening on one date or multiple dates? |
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First preference: Single Date - Time
| Total Time (ex. 2:00pm-6:00pm) |
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| Set-up Time (ex. 2:00pm-3:00pm) |
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| Total Event Time (ex. 3:00pm-5:30pm) |
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| Breakdown Time (ex. 5:30pm-6:00pm) |
9:00 PM-11:00 PM
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Second Choice - Single Date
| If your first choice date is not available, do you have a second choice? |
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Second Preference: One Date
| Date |
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| Total Time (ex. 2:00pm-6:00pm |
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| Set-up Time (ex. 2:00pm-3:00pm) |
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| Total Event Time (ex. 3:00pm-5:30pm) |
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| Breakdown Time (5:30pm-6:00pm) |
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| Facility (please see link above for park locations and descriptions) |
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Specialized Event
| Does your event fall under one of these categories? |
No
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Licensing Department and Inspectional Services Department
| Are any of the following part of your event? |
More than 50 people in attendance, Food and beverages , Admission fee for participants, Event will generate revenue/ make money (e.g. sponsorships, vendor fees), Music, entertainment, or amplified sound on site, Tents larger than 10x10, Stages or other temporary structures, Generator
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Food and Beverage/ Fire Department and Licensing
| Will food and beverages be: |
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| Please specify all food and beverages that will be provided |
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Music and Entertainment: One Day Entertainment License Requirement
| Please describe the type of music or entertainment to be provided: |
Live band and dancers
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Tents: Detail
| Please describe the number and size of tents to be used: |
There are 2 tents. Both are 40 feet wide by 120 feet long. Side by side so 80ft wide by 120 feet long. There is also a smaller tent next to them which is 8feet by 20 ft. All tents will have the French window sidewall panels on them as well as globe lights on all tents.
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Department of Public Works
| Will you require lighting? (Please call 617-466-4200 during business hours, and 617-828-7327 after hours).) |
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| Will you require use of restrooms, if available? |
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Additional Information
| Please list any additional Special Requirements |
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Indemnification / hold harmless / cleanup
Indemnification/Hold harmless/cleanup
| The signatory shall be responsible for and shall indemnify and hold harmless the City of Chelsea from and against all damages, claims or demands that may, during the term of this license, arise by negligent or intentional acts of signatory or signatory's employees. |
I am responsible for any and all indemnity and hold harmless the City of Chelsea
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| If a permit is issued, I agree that my organization will leave the permitted area clean and orderly, and that all trash will be placed in trash receptacles. |
I agree to pick up and clean any trash caused by this event
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| I understand that I am completing a binding electronic signature when I submit this form constitutes a legal signature. |
Yes
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| Up Load Insurance policy/agreement |
TND - Rock Chapel Marine, LLC - COI (2).pdf
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First Review by Special Events Coordinator
Decide which Departments should review this application:
| Should Fire Department review? |
No RD review necessary.
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| Should Police Department review? |
Yes, Police Department should review.
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| Should Licensing review? |
Yes, Licensing should review.
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| Should Inspectional Services review? |
Yes, Inspectional Services review.
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| Should Public Works review? |
Yes, Public Works review needed.
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| Should Traffic and Parking review ? |
No
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