Special Event Request 2025

EVENT INFORMATION

Event/Activity Name

Celebration of Land, Art and Community

CONTACT INFORMATION

Facility (See link to park locations and descriptions above)	---
***Other Description	41-43 Orange Street
Event Date	July 24, 2025
Applicants Name	---
Contact Person	---
Cell Phone	---
Email Address	---
Day Phone	---
Address	---
Name of Supervisor/Vendor on Site	---
Supervisor/Vendor Phone Number	+18572583485
Name of Second Supervisor on Site	---
Second Supervisor Phone Number	+18573337587
Total Estimated Number of Participants	50
Estimated Number of ADULT Participants	35
Estimated Number of YOUTH Participants	15
Organization Type	Non Profit - may be asked to provide State Tax # or Federal EIN#
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?

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First preference: Single Date - Time

Date	2025-07-24
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)	6:00pm-7:00pm

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

Community Event

Licensing Department and Inspectional Services Department

Are any of the following part of your event?

Food and beverages , Generator, Machinery powered by gasoline, diesel, or electricity

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

Machinery Detail

Please describe the machinery that will be used on site, including power source (gas, diesel, electricity)

Popcorn machine with a small generator.

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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Attachments

Please upload any attachments (proposed site plan)

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Additional Information

Please list any additional Special Requirements

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Requested Usage from City of Chelsea

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

Equipment

How many tables are needed?	13
How many chairs are needed?	50