Special Event Request 2023

CONTACT INFORMATION

Event/Activity Name	---
Facility (See link to park locations and descriptions above)	---
Event Date	6/7/23
Applicants Name	---
Contact Person	---
Email Address	---
Cell Phone	---
Day Phone	---
Address	---

EVENT INFORMATION

Name of Supervisor/Vendor on Site	---
Supervisor/Vendor Phone Number	+16174612940
Name of Second Supervisor on Site	---
Second Supervisor Phone Number	+16174612940
Total Estimated Number of Participants	5
Estimated Number of ADULT Participants	50
Estimated Number of YOUTH Participants	0
Organization Type	Other Adult Organization
Activity	Private Party (please specify below)
Brief Description of Event	---
Special Requirements	---

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)	---
Set-up Time (ex. 2:00pm-3:00pm)	---
Total Event Time (ex. 3:00pm-5:30pm)	---
Breakdown Time (ex. 5:30pm-6:00pm)	230am 3am

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

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 (5:30pm-6:00pm)	---
Facility (please see link above for park locations and descriptions)	---

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, 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

Music and Entertainment: One Day Entertainment License Requirement

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

Hip hop , Latin , reggae , Bronx whine , dembow and bachata.

Department of Public Works

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

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Requested Usage from City of Chelsea

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