Licensing Department, City Of Chelsea, MA

Special Event Request 2022

Feb 03, 2023
submission #91
Application

CONTACT INFORMATION

Event/Activity Name ---
Facility (See link to park locations and descriptions above) ---
***Other Description We would like to have the Flag raising and the speeches in the Square and then have vendors on 2nd street between the two parks - bordered by Broadway and Hawthorne.
Event Date June 3rd
Applicants Name ---
Contact Person ---
Email Address ---
Cell Phone ---
Day Phone ---
Billing Address ---

EVENT INFORMATION

Name of Supervisor/Vendor on Site ---
Supervisor / Vendor Phone Number +19176989734
Name of Second Supervisor on Site ---
Second Supervisor Phone Number +18003435978
Total Estimated Number of Participants 50
Estimated Number of ADULT Participants 40
Estimated Number of YOUTH Participants 10
Organization Type Chelsea Adult Organization - must have 80% Chelsea Residents
Activity Community Use (please specify below)
Brief Description of Event ---
Special Requirements ---

First Preference For Event Date

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

First preference: Single Date - Time

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) 7pm - 8pm

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? Yes

Type of Event

Select which event type your request is for Street Performer/Micro Activity

Licensing Department and Inspectional Services Department

Are any of the following part of your event? More than 50 people in attendance, Food and beverages , Event will generate revenue/ make money (e.g. sponsorships, vendor fees), Items will be for sale at event, Music, entertainment, or amplified sound on site

Food and Beverage/ Fire Department and Licensing

Will food and beverages be: ---
Please specify all food and beverages that will be provided ---

Items for Sale - Detail

Please describe the items that will be available for sale at the event We are inviting vendors - artists and others to have tables at the event to sell their product. The Chelsea Pride Committee is not selling any product. We are also not asking vendors to pay to appear at the event as this is the first year we are inviting vendors.
How will the items be offered for sale? (check all that apply) Vendors will be selling items

Music and Entertainment: One Day Entertainment License Requirement

Please describe the type of music or entertainment to be provided: DJ only.

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 ---

Requested Usage from City of Chelsea

Tables ---
Chairs ---
Electricity ---
Stage ---
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