Licensing Department, City Of Chelsea, MA

Special Event Request 2024

Aug 12, 2024
submission #268
Application

EVENT INFORMATION

Event/Activity Name City Hall Employee BBQ
Is this a 400th Event? Yes/Si
Is this event approved by the 400th committee? Yes/Si

CONTACT INFORMATION

Facility (See link to park locations and descriptions above) ---
Event Date August 22, 2024
Applicants Name ---
Contact Person ---
Cell Phone ---
Email Address ---
Day Phone ---
Address ---
Name of Supervisor/Vendor on Site ---
Supervisor/Vendor Phone Number +16178991278
Name of Second Supervisor on Site ---
Second Supervisor Phone Number +16174664020
Total Estimated Number of Participants 150
Estimated Number of ADULT Participants 150
Estimated Number of YOUTH Participants 0
Organization Type City or School Use
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

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) 2 to 3

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 , 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: just a speaker and iphone

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 do not agree/no estoy de acuerdo
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 do not agree
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 cha-cha-cha.pps
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? No, no PD review needed.
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 ? No