Licensing Department, City Of Chelsea, MA

Special Event Request 2025

Mar 21, 2025
submission #306
Application

EVENT INFORMATION

Event/Activity Name Chelsea Chase 5K

CONTACT INFORMATION

Facility (See link to park locations and descriptions above) ---
***Other Description Road Race
Event Date 05/17/2025
Applicants Name ---
Contact Person ---
Cell Phone ---
Email Address ---
Day Phone ---
Address ---
Name of Supervisor/Vendor on Site ---
Supervisor/Vendor Phone Number +16178849435
Name of Second Supervisor on Site ---
Second Supervisor Phone Number +16174611053
Total Estimated Number of Participants 400
Estimated Number of ADULT Participants 350
Estimated Number of YOUTH Participants 50
Organization Type Non Profit - may be asked to provide State Tax # or Federal EIN#
Activity Other (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: Single Date - Time

Date 2025-05-17
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) 11:30am-12:00pm

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? Yes

Type of Event

Select which event type your request is for Parade/Procession/Street Race

Licensing Department and Inspectional Services Department

Are any of the following part of your event? More than 50 people in attendance, Admission fee for participants, Event will generate revenue/ make money (e.g. sponsorships, vendor fees), Music, entertainment, or amplified sound on site, Stages or other temporary structures

Food and Beverage/ Fire Department and Licensing

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: One person will be bringing speaker, microphone, and connect to their Iphone for variety of music, set up on El Potro's property (back patio). In addition, a group of youth dancers from the Boys & Girls Club will perform post-race (around 11am) for about 10 minutes for the race crowd. We may put them on a small elevated (less than 1 foot) stage to that crowd can see dancers.

Department of Public Works

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

Attachments

Please upload any attachments (proposed site plan) ---

Additional Information

Please list any additional Special Requirements ---

Requested Usage from City of Chelsea

Tables ---
Chairs ---
Electricity ---
Stage ---
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? No, no Licensing review needed.
Should Inspectional Services review? No, no IS review needed.
Should Public Works review? No, no PW review.
Should Traffic and Parking review ? No