Licensing Department, City Of Chelsea, MA

Special Event Request 2023

Oct 26, 2023
submission #182
Application

CONTACT INFORMATION

Event/Activity Name ---
Facility (See link to park locations and descriptions above) ---
***Other Description Santa on a Fire Truck
Event Date 12/2/2023
Applicants Name ---
Contact Person ---
Email Address ---
Cell Phone ---
Day Phone ---
Address ---

EVENT INFORMATION

Name of Supervisor/Vendor on Site ---
Supervisor/Vendor Phone Number +16178844877
Name of Second Supervisor on Site ---
Second Supervisor Phone Number +16178844877
Total Estimated Number of Participants 200
Estimated Number of ADULT Participants 100
Estimated Number of YOUTH Participants 100
Organization Type Non Profit - may be asked to provide State Tax # or Federal EIN#
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: 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? ---

Second Preference: Multiple Dates

Dates (i.e. Every Sunday starting June 1 until September 1, from 10am-12pm) ---
Facility (See link to park locations and descriptions above) ---

Specialized Event

Does your event fall under one of these categories? Yes

Type of Event

Select which event type your request is for Community Event

Licensing Department and Inspectional Services Department

Are any of the following part of your event? More than 50 people in attendance, 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 ---
Food Trucks No/No

Items for Sale - Detail

Please describe the items that will be available for sale at the event Pre-packaged Pastries and baked goods.
How will the items be offered for sale? (check all that apply) Organization hosting event will have items for sale, Vendors will be selling items

Music and Entertainment: One Day Entertainment License Requirement

Please describe the type of music or entertainment to be provided: School Department choir, school music department, one individual performer.

Department of Public Works

Will you require electricity? (Please call 617-466-4211 (during business hours) and 617-697-3913 (after hours).) ---

Additional Information

Please list any additional Special Requirements ---

Requested Usage from City of Chelsea

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

Equipment

How many tables are needed? 15
How many chairs are needed? 40
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
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