Application for One-Day Special Liquor License (Page 1) Town of Cummington

To: Cummington Licensing Board Board of Selectmen

P.O. Box 128 Cummington, MA 01026

Name of Person in Charge _____________________________________________

Name of Organization ________________________________________________

Street Address ______________________________________________________

Mailing Address _____________________________________________________ Telephone___________________________

Email _________________________

For-Profit User _______ Not For-Profit User_______

Where will it be held _________________________________________________

Date and Hours of Event ______________________________________________

Type of Event _______________________________________________________

Type of alcohol to be served (check one):

Beer & Wine ___

Wine ___

Beer ___

All Alcohol ____

I hereby certify under the pains and penalties of perjury that the above is true and accurate information, and that I will be responsible for the proper observance of the laws governing the dispensing of such alcoholic beverages. I also acknowledge that I have read and agree to abide with the One-Day Special Liquor License Policy.

Signature: _____________________________________________

Date: ______________

Print Name: ____________________________________________

For Official Use Only

Police Acknowledgement:
Signature: ____________________________________________

Name: _______________________________________________

Security Requests/Concerns:

Board’s Action:

Granted _______________ Date of Approval _____________ Restrictions/Conditions/Remarks:

Dated: __________________ Position: ________________

Rejected ________________

Rev. 3.2023

Town of Cummington
One-Day Special Liquor License Policy (Page 2)

Use of Alcohol and Service of Alcohol by the Lessee on Town Property

1. SERVICE OF ALCOHOL TO ANYONE UNDER THE AGE OF 21 IS EXPRESSLY PROHIBITED BY LAW. “Service” is defined by law as not only serving alcohol to a minor, but also creating a situation in which a minor can reasonably gain access to alcohol (such as leaving an untended bar, keg, et cetera). ANY CONSUMPTION OF ALCOHOL BY MINORS ON THE PREMISES IS EXPRESSLY PROHIBITED. Should the Lessor determine that circumstances exist that may lead to the consumption of alcohol by minors on the Property, this agreement shall terminate immediately, and the Lessee must immediately vacate the property. Any security deposit or other funds held by the Lessor will be forfeited by the Renter or Lessee.
2. Any SALE of alcohol is expressly prohibited.
3. Any alcoholic beverages brought onto the Property for the purpose of dispensing to guests of the Renter or Lessee must be supervised by the Renter or Lessee or their designee at all times during the event, especially if attendees of the event include persons under the age of 21.
4. Alcohol may be dispensed according to local law at events on the Property. The Renter or Lessee is responsible for obtaining and acquiring any necessary permits required to serve alcohol on the Property during any event. A copy of any permits so obtained must be given to the Lessor before the commencement of the event.
5. The Lessor makes no guarantees that appropriate permits for the service of alcohol on the grounds are, or will be made, available by town officials. The failure of the town to issue said permits shall not be grounds for termination of the Agreement.
6. Any dispensing of alcohol without the required permits will result in the immediate termination of the Agreement and will require the Renter or Lessee to vacate the Property immediately. All security deposits and funds paid to the Lessor will be forfeited by the Renter or Lessee should this occur.
7. The Renter or Lessee is solely responsible for any accidents, incidents, or damage incurred by a guest of the Lessee who has been dispensed alcohol at any event held on the Property. The Renter or Lessee hereby agrees to indemnify and hold harmless the Lessor for any such events caused by an intoxicated guest.

Alcohol
Yes, I have read and agree to abide by this policy. ______

Print Name ________________________________________

Signature __________________________________________

Date ____________________________

will be served at the event for which I am applying to use town property.

Rev. 3.2023