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2. Entity Name*
3. DBA*
5. First Name*
6. Last Name*
8. Primary Contact Email Address*
9. Has any of your contact information changed since last year?*
   -- Select One --YesNoI didn't have outdoor dining last year
11. Business Address*
13. Owner*
14. Manager*
16. 24-Hour Contact Number*
18. Do you have a liquor license?*
    -- Select One --YesNo
20. Ideal Start Date*
    Ideal Start Date

    NOTE: Jersey barriers and planters will be installed on Tuesday, April 14th. 

21. Do you intend to make any alterations to the setup from last year?*
    -- Select One --YesNoSlight Modification
23. What are you looking to alter?*
    -- Select One --Days/Hours of OperationAwning/Tents/Umbrellas?Description of PremisesOther
24. Proposed Days & Hours of Operation*
26. Awnings, Tents or Umbrellas?*

    If you plan to erect a tent, you are required to get written permission from your abutting neighbors. You must also contact the Building Department. 

    1. Awning(s)
    2. Tent(s)
    3. Umbrella(s)
    4. None
27. Permission from Abutting Neighbors Supporting the Tent
29. Detailed description of expansion*

    Please summarize, in detail with square footage and capacity, the alterations you wish to make. 

30. Detailed Floor Plan*

    Please upload a detailed plan that includes dimensions and layout of tables and chairs

32. Extension of premises must be EITHER:*

    1. Contiguous to the licensee’s premise with either a clear view of the area from inside the premises.
    2. The licensee may commit to providing management personnel dedicated to the area.
33. Barriers/Delineation of Area*

    1. Jersey barriers provided by the city
    2. Stanchions with rope, chain, etc.
    3. Fencing
    4. Other
34. If other, please explain:
36. In what public space will your expansion encroach upon?*

    1. Public Parking Lot
    2. Sidewalk Furnishings Zone (red brick pavers)
    3. Public Park
    4. City-Owned Alley
    5. Street
    6. Other
37. If other, please explain:
39. Will the expansion cause potential noise concerns/complaints from neighbors?*

    1. Yes
    2. No
40. If yes, please explain:
42. ADA Accessibility

    The outdoor dining areas and barriers must be accessible and meet ADA and Massachusetts Architectural Access Board's regulations

46. Certification of Safety Standards and Guidelines

    By signing below, I, being the owner or manager of the above-referenced establishment located at the address indicated above, acknowledge, accept, and will comply with the responsibilities of maintaining a safe outdoor dining experience for guests and staff in the outdoor dining area through the diligent adherence to my submitted plans. Additionally, I commit to abiding by the Policy on the Prohibition of Smoking in Workplaces and Public Places, and keeping my designated area clean and aesthetically pleasing to enhance the overall dining environment.

48. Signature*
49. Date*
    Date
51. FOR LIQUOR LICENSE HOLDERS ONLY: Certification of Compliance with ABCC Guidelines For Extension of Premises to Patio & Outdoor Areas

    By signing below, I, being the owner or manager of the above referenced establishment located at the address indicated above, acknowledge, accept, and will comply with the guidelines for extension of premises to patio and outdoor areas.

53. Signature
54. Date
    Date
Leave This Blank:


55. 1. Receive an email copy of this form.
56. Email address

    This field is not part of the form submission.

57. Submit

* indicates a required field