Licensing Department, City Of Chelsea, MA

Special Event Request 2025

Apr 09, 2025
submission #308
Application

EVENT INFORMATION

Event/Activity Name Memorial Day Ceremony

CONTACT INFORMATION

Facility (See link to park locations and descriptions above) ---
***Other Description Garden Cemetery
Event Date May 26, 2025
Applicants Name ---
Contact Person ---
Cell Phone ---
Email Address ---
Day Phone ---
Address ---
Name of Supervisor/Vendor on Site ---
Supervisor/Vendor Phone Number +17814846402
Name of Second Supervisor on Site ---
Second Supervisor Phone Number +16175439545
Total Estimated Number of Participants 20
Estimated Number of ADULT Participants 15
Estimated Number of YOUTH Participants 5
Organization Type City or School Use
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: Single Date - Time

Date 2025-05-26
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) 20 mins

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? 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

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 ---
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? No, no PD review needed.
Should Licensing review? No, no Licensing review needed.
Should Inspectional Services review? No, no IS review needed.
Should Public Works review? Yes, Public Works review needed.
Should Traffic and Parking review ? No