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One Day Alcoholic Beverage License Application - WINE & MALT BEVERAGES

  1. Special or “one day” licenses for the sale of wine and malt beverages are available to the responsible manager of any indoor or outdoor activity or enterprise (for profit or non-profit) which, in the opinion of the Town of Ipswich Board of Selectmen, complies with all state and local requirements and demonstrates satisfactorily that granting of the license is in the best interests of the Town of Ipswich. This application must be submitted at least two weeks prior to the event. The application fee must be submitted with application.

  2. I hereby make application for a ONE DAY SPECIAL WINE & MALT BEVERAGE LICENSE for the purpose of selling and dispensing all alcoholic beverages permitted by law at a

  3. Is an admission fee to be charged?*

  4. How will alcoholic beverages be dispensed or served?*

    Please check all that apply

  5. Name and phone number of the official, employee, or representative of the Non-Profit Sponsor who will be present at the event and who has been duly authorized by the Non-Profit sponsor to be responsible for supervising the event to ensure that it is properly controlled and that all the State and Town laws and regulations are complied with.

  6. I certify under penalty of perjury that:
    a) I am a citizen of the United States and the duly elected/appointed of the Organization applying;
    b) I shall be responsible for the proper observance of all laws and conditions governing this license;
    c) All information contained in this application is true and correct;
    d) The Establishment/Person has the right or has made arrangements to use the location for which this License is sought on the date and at the time requested(please provide documentation);
    e) The Establishment/ Person has approved the gathering for which the License is sought and the filing by me of this Application;
    f) Food service is required at a one-day function where alcoholic beverages are to be served, per rules and regulations.
    By exercising the privileges of this license in serving persons with alcoholic beverages, the license is potentially exposed to significant liability for injuries and damages to persons served or to others who are injured or damaged by the persons served. Your acceptance and exercise of this license will be deemed to be acknowledgement that you are aware of this potential liability. You are encourages to discuss the risks associated with exercising your privileges of the license and the precautions appropriate to avoid injuries, damage and liability to others with your legal and/or insurance advisors. The Town of Ipswich, and the Board of Selectmen as Local Licensing Authority, shall not be liable to the licensee or others if injury or damage shall result from the exercise of the license.

  7. Leave This Blank:

  8. This field is not part of the form submission.