HomeMy WebLinkAboutApplication for Special Entertainment 2024TOWNOFYARMOUTH tsoARI) ( tt
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LIC[SN INC
,\DI\I IN ISTRATOR
rrrlotn B I'nr,:
I146 ROUTE 28, South Yarmouth, Massachusetts 02664
Telcphone (508) 398-2231. cxt. l:68. Fax (508) 398-2365
APPLICATION FOR SPECIAL ENTERTAINMENT
The undersigred hereby applies for a licerse in accordance with thc provisions of MA General Laws: Chapter l40 Seciixrl83A amended, Chapter 351 Section 85 ofAcs of 1981, Chapter 140 Section l8l. & Chapter 136 Section 4.
Applicent ,r-ame:
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/7/o,n S/-7;Applicant Address:
p1;yars (D ol'uersCq?eCcal , Cc t,-t
Applicent Email:
.-5o5
Applicant Telephone:
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Event Locetion:
Event Drtes:
2 2
Event Hours:
)7L.
ls utdoors?
t €(i {-
lndoors:
Doe3 the Event hrye Alcohol Scrvice? lf v€s-
plecse Iill out e Speciel Alcohol License Applicrtion
Ouldoor!: _
Event lndoo
7Number of Guests at Event:
Does Event Locatio n heve a fire Protection Svstem?
By Entenahers _ No Daocing /
Band _{ Numbcrof MusiciansS Amplifrcation Sy.,". _/ Ot
Ple ase Check All Thet Apply:l. Dencing: By patrons /2, Mwic: Recordcd _ Live No Music
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will an ined to a on the remlses tn an
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. Sprlnlder Syltcm: y''
. Flre Alrrm System: .z/
Low Lighting _ Music Above Nomal Sound Levels _ Nlghtrime Operation _ Clearly Dcfined AislesDance Floor_ Limited Food Sewice _
3. Shows: TheatE_ Movics_ Floor Show_ Lighr Show_ public Sho*_NoShow_
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to public view any portion ofthepubic area, anus. or genitals. orany simulation
will be permined lo appear on the premises in any manner or anire as to expos
below thc top of the arcola, or any simulation lhcrcof? (Chapter 694)o yes _oNo
thereof. or lvhether any fcmalc pcrson
e to public view a portion of the breast
This liccnsc issucd bythis applicaion is valid for the caleldu year _ through
-
provided lhe tyPe ofentertainment
spccified abovc docs not ctr.iigc. lnthc cvent ofa changg in type ofctrlcnainnrnt different than indicarcd above. a new
application will be requir€d, and a new license issued.
By signing this application, the applicarl certifies that they have read Chapter 272 Section 29-31 of the Massachusetts
General Lar
*)log laaaqolo
Documentr Required:o Detailed Floor Plan ofEvent (Showing egress. ables seating. dance floor. food setuP, whcre entertainment will
be set up, emergency lightin& etc.)
. Certificate of ltrsurance naming the Town of Yarmouth as the additional insured.
Fees:
Heering Required
Lcgrl Ad Required (posted t 0 days prior to hcaring)
Abutter Notices (scnt l0 d!ys prbr to hearing)
Signature of Applicant Date
. Hearing Fee: 365o Licensc Fee: $55o Legal Ad Fee: To be dctermined once legal ad is placed.
. Abuncr Notice Mailing is paid by the applicant.
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TOWNOFYARMOUTH tlo:\ RD of
SELECTITIEN
Ltc!s\ l\( i
ADMINISTRATOR
Dalotr B. Pruc.
I1.16 ROUTE 18, South Yarmouth, Massachusens 01664
Tclcphonc (508) 198-2231. cxr. 1268. fax (508) 398-?365
APPLICATION FOR SPECIAL ENTERTAINMENT
The undersigned bereby applies for a license in accordance with the provisioos ofMA General Laws: Chapter 140 Sectbn
l83A amcnded, Chapter 351 Section 85 of Acts of 1981, Chaptcr 140 Section l8l, & Chapter 136 Section 4.
C
orr
Applicant Name:
LI
')
4Applicant Address:o
Applicsnt Emeil:
O t)'fL o
Puo..rcxs.Applicant TelGphone:G2(q
1
Event Locgtion: a'\
(t e ci'Lu.;se,la,./ ttlz)l*ozqEvent Drtes:
)au)L,
EYent Hours:
t'11 )2
Does the Eyent have Alcohol Service? !f yes-
please llll out a Sp€cirl Alcohol License Applicrtion
utdoo rs?s
r Scr d<Outdoors:
Indoors:
Yent
Numb€r of Guests .t Event: --
Does Event Locetion hrve ape ProtectioD Svstem?. SDrlnkler Srrt m: , -. Flre alermirst "-l-; /
By EotcnartrJrr _ No [hncing_
Band /Numbcrof Uusriansf emptftarion Sysrem
Low Lightrng
-
Music Abovc Normalsound Lcvels
-
Nighnme operation _ clearty Dcfined Aislcs _Dance Fhor Limited Food Senice
Sbows: Thcatrc_ Movies _ Floor Show _ Light Show _ public Show No Show
t)J No Music
3
l. Dencing: By Patpos2. Music: Recorded Live
Please Check All Thrt Apply:
DGtrlled Dcscription of Entert.lnment:
l;v't_ Brr,rr( L-
e_u kr{aintu&ar t- cdy, (F/r)
Lt';cQ cvr feJular
(^*dusdr,)
//cl,'aoy,',
art of the cntertainmenAs will an erson be tied to a ear on thc remses m an SCmanner or anire as to cx
fi1
I
lo public view any porrion ofthe pubic area, anrc, orgenitals. or any simulation thcreof, or whether any fcmale person
will be permittcd to apFar on the premises in any manner or anir€ as lo cxpose to public view a ponion of the brcast
below the top of the arcola, or any simulation thereof? (Chaptcr 594). yes _rNo
This liccnsc issued by this applicaion is valid for the calendu year _ through _ provided the type of entenainment
specified abovc does not change. Il the eveot ofa changp in type ofentcrtainrnent different than indicated abovc, a new
application will be requircd. and a new license issued.
By signing this application. the applicant certifiesthat they havc read Chapter 272 Section 29 -l I of the Massachusetts
General Law.
\ntg,l.ide6oil C.ootyO ta I ogl;l.c
Documents Rcquired:o Dcrailed Floor Plan of Ev€nt (Showing cgess, tables. seaing dance floor. food sctup, where entertainment will
be set up, emergency lighting, etc.)o Ceflificate of Insurance naming the Town of Yarmouth as the additional insured.
Fees:
Hearing Fee: $65
Liccnsc Fee: 555
Legal Ad Fcc: To bc delermined once legal ad is placed
Abutter Notice Mailing is paid by the applicant.
Herring R€quired
Legrl Ad Required (posred l0 days pnor lo heanng)
Abuttcr Noticcs (senl l0 days prior to hcaring)
Signature of Applicant Date
.l
1146 ROUTE 28 South Yarmouth Massachusetts 02664
Telephone (508) 398-2231, ext. 1268 - Fax (508) 398-2365
Business Name:Oliver's & Planck's Tavern
LICENSI:\..C
ADMINISTRATOR
Amber Thomas
IN REGARD TO
Business Address: 960 Main Street, Route 6A, Yarmouth Port, MA 02675
Date of Select Board meeting: 1111212024 (Tentatively)
Fire Department Comments:
Steps required to be taken prior to insurance of license:
Bnp> lo Le Se{'f cL{ fl"? yrt dekr*"^tet
Loc*{;,^t +. +k An? l:{rert ,zY/u"' }" L'
;l.t . t- "ff ; + F'-rr *laaz Act"'"*k J '
Date:,/0'a 0.2"/
Use & Occupancy Permit Required?
YES NO
Certifi cate of Inspection Required?
YES NO
Total Occupancy of Premises?
Signature:L+
NE COMPLETED FORM ASAP - Before: 101241202d
T O WN O F Y A RM O U T H sELEcTBoARD
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