Special Event Request 2025

EVENT INFORMATION

Event/Activity Name

Iglesia Pentecostal Unida Hispana Inc.

CONTACT INFORMATION

Facility (See link to park locations and descriptions above)	---
Event Date	9/6/2025
Applicants Name	---
Contact Person	---
Cell Phone	---
Email Address	---
Day Phone	---
Address	---
Name of Supervisor/Vendor on Site	---
Supervisor/Vendor Phone Number	+18328704135
Name of Second Supervisor on Site	---
Second Supervisor Phone Number	+18572587113
Total Estimated Number of Participants	25
Estimated Number of ADULT Participants	15
Estimated Number of YOUTH Participants	10
Organization Type	Non Profit - may be asked to provide State Tax # or Federal EIN#
Activity	Other (please specify below)
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	2025-09-06
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)	5pm

Second Choice - Single Date

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

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Second Preference: One Date

Date	---
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 (5:30pm-6:00pm)	---
Facility (please see link above for park locations and descriptions)	---

Specialized Event

Does your event fall under one of these categories?

Yes

Type of Event

Select which event type your request is for

Religious Event

Licensing Department and Inspectional Services Department

Are any of the following part of your event?

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:

Guitar, 2 amps, microphones, voice, music. Church music/Christian music.

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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Requested Usage from City of Chelsea

Tables	---
Chairs	---
Electricity	---
Stage	---