Licensing Department, City Of Chelsea, MA

Special Event Request 2022

May 25, 2022
submission #24
Application

CONTACT INFORMATION

Event/Activity Name ---
Facility (See link to park locations and descriptions above) ---
***Other Description the procession for Corpus Christi start at St. Rose of Lima Church and continue to Broadway / Crescent Ave.
Event Date Sunday 6/19/2022
Applicants Name ---
Contact Person ---
Email Address ---
Cell Phone ---
Day Phone ---
Billing Address ---

EVENT INFORMATION

Name of Supervisor / Vendor on Site ---
Supervisor / Vendor Phone Number +17742238042
Name of Second Supervisor on Site ---
Second Supervisor Phone Number +16176370671
Total Estimated Number of Participants 100
Estimated Number of ADULT Participants 80
Estimated Number of YOUTH Participants 20
Organization Type Non Profit - may be asked to provide State Tax # or Federal EIN#
Activity Other (please specify below)
Brief Description of Event ---

First Preference For Event Date

Is this event happening on one date or multiple dates? ---

First preference: Single Date - Time

Date 2022-06-19
Total Time (ex. 2:00pm-6:00pm) ---
Set-up Time (ex. 2:00pm-3:00pm) ---
Total Event Time (ex. 3:00pm-5:30pm) ---
Breakdown Time (ex. 5:30pm-6:00pm) 0

Second Choice - Single Date

If your first choice date is not available, do you have a second choice? ---

Specialized Event

Does your event fall under one of these categories? No

Licensing Department and Inspectional Services Department

Are any of the following part of your event? More than 50 people in attendance

Department of Public Works

Will you require lighting? (Please call 617-466-4200 during business hours, and 617-828-7327 after hours).) ---
Will you require use of restrooms, if available? ---

Additional Information

Please list any additional Special Requirements ---
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
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
I understand that I am completing a binding electronic signature when I submit this form constitutes a legal signature. Yes
Up Load Insurance policy/agreement 080_1_Participant Confirmation_Workers Compensation_Saint Rose of Lima Parish_FEB-28-2022-6-48-46 (1).pdf
First Review by Special Events Coordinator

Decide which Departments should review this application:

Should Fire Department review? No RD review necessary.
Should Police Department review? Yes, Police Department should review.
Should Licensing review? No, no Licensing review needed.
Should Inspectional Services review? No, no IS review needed.
Should Public Works review? Yes, Public Works review needed.
Should Traffic and Parking review ? Yes