Special Event Request 2023

CONTACT INFORMATION

Event/Activity Name	---
Facility (See link to park locations and descriptions above)	---
Event Date	12/5/2023
Applicants Name	---
Contact Person	---
Email Address	---
Cell Phone	---
Day Phone	---
Address	---

EVENT INFORMATION

Name of Supervisor/Vendor on Site	---
Supervisor/Vendor Phone Number	+16174664150
Name of Second Supervisor on Site	---
Second Supervisor Phone Number	+16174664150
Total Estimated Number of Participants	50
Estimated Number of ADULT Participants	50
Estimated Number of YOUTH Participants	50
Organization Type	City or School Use
Brief Description of Event	---

First Preference For Event Date

Is this event happening on one date or multiple dates?

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First preference: Single Date - Time

Date	2023-12-05
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)	1-5

Second Choice - Single Date

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

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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?

Music, entertainment, or amplified sound on site, None of these will be part of my event.

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:

dj

Department of Public Works

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

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Additional Information

Please list any additional Special Requirements

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