Licensing Department, City Of Chelsea, MA

Special Event Request 2024

Jul 16, 2024
submission #266
Application

EVENT INFORMATION

Event/Activity Name Raise the Roof
Is this a 400th Event? No
Is this event approved by the 400th committee? No

CONTACT INFORMATION

Facility (See link to park locations and descriptions above) ---
***Other Description tent- 99 Marginal St.
Event Date 09/12/2024
Applicants Name ---
Contact Person ---
Cell Phone ---
Email Address ---
Day Phone ---
Address ---
Name of Supervisor/Vendor on Site ---
Supervisor/Vendor Phone Number +12036762507
Name of Second Supervisor on Site ---
Second Supervisor Phone Number +18024983530
Total Estimated Number of Participants 175
Estimated Number of ADULT Participants 165
Estimated Number of YOUTH Participants 10
Organization Type Non Profit - may be asked to provide State Tax # or Federal EIN#
Activity Private Party (please specify below)
Brief Description of Event ---

First Preference For Event Date

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

First preference: Single Date - Time

Date 2024-09-12
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) 9:00 PM-10:00 PM

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? 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 , Admission fee for participants, Event will generate revenue/ make money (e.g. sponsorships, vendor fees), Music, entertainment, or amplified sound on site, Tents larger than 10x10, Stages or other temporary structures

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

Tents: Detail

Please describe the number and size of tents to be used: two tents provided by Eastern Salt.

Department of Public Works

Will you require electricity? (Please call 617-466-4211 (during business hours) and 617-697-3913 (after hours).) ---
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 TND - CITY OF CHELSEA COI_10.31.24 (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? No, no PW review.
Should Traffic and Parking review ? No