Licensing Department, City Of Chelsea, MA

Special Event Request 2023

May 09, 2023
submission #125
Application

CONTACT INFORMATION

Event/Activity Name ---
Facility (See link to park locations and descriptions above) ---
***Other Description Local vendor market for foods and ingredients
Event Date November 4 & 18 from 9am - 2pm
Applicants Name ---
Contact Person ---
Email Address ---
Cell Phone ---
Day Phone ---
Address ---

EVENT INFORMATION

Name of Supervisor/Vendor on Site ---
Supervisor/Vendor Phone Number +16173967929
Name of Second Supervisor on Site ---
Second Supervisor Phone Number +14436245496
Total Estimated Number of Participants 200
Estimated Number of ADULT Participants 120
Estimated Number of YOUTH Participants 80
Organization Type City or School Use
Activity Community Use (please specify below)
Brief Description of Event ---

First Preference For Event Date

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

First preference: Two or More Dates - Times

Dates (i.e. Every Sunday starting June 1 until September 1, from 10am-12pm) ---

Second Choice Interest: Two or More Dates

If your first choice dates are 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, Food and beverages , 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 ---
Food Trucks No/No

Items for Sale - Detail

Please describe the items that will be available for sale at the event Each vendor will be required to get a vendor license and temporary food permit (when applicable) according to city processes. Vendors will be selling fruit, vegetables, and prepared foods such as tacos, arepas, juices, fruit cocktails, and coffee.
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: Entertainment will be provided on the first Saturday of the month - October 7 and November 4. Entertainment will vary and may include live music, dance, or theater performances, or dj table. A separate entertainment license will be completed for each day of market entertainment.

Machinery Detail

Please describe the machinery that will be used on site, including power source (gas, diesel, electricity) vendors will use trucks to transport produce in and out of market;

Department of Public Works

Will you require electricity? (Please call 617-466-4200 during business hours, and 617-470-2747 after hours).) ---

Attachments

Please upload any attachments (proposed site plan) ---

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 GL_ACORD_CityofChelsea_04_20_2023_P100018122-962902036556-1.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? Yes, Licensing should review.
Should Inspectional Services review? Yes, Inspectional Services review.
Should Public Works review? Yes, Public Works review needed.
Should Traffic and Parking review ? Yes