Licensing Department, City Of Chelsea, MA

Special Event Request 2025

Jul 30, 2025
submission #346
Application

EVENT INFORMATION

Event/Activity Name NATIONAL NIGHT OUT

CONTACT INFORMATION

Facility (See link to park locations and descriptions above) ---
***Other Description Williams School Courtyard and Walnut St.
Event Date August 5, 2025
Applicants Name ---
Contact Person ---
Cell Phone ---
Email Address ---
Day Phone ---
Address ---
Name of Supervisor/Vendor on Site ---
Supervisor/Vendor Phone Number +16176428144
Name of Second Supervisor on Site ---
Second Supervisor Phone Number +16178948441
Total Estimated Number of Participants 300
Estimated Number of ADULT Participants 150
Estimated Number of YOUTH Participants 150
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 2025-08-05
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) 7:30pm-8pm

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

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: N/A, under CPS

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 ---
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