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_T '' Town Administrator
2198 Main Street
—y Brewster,Massachusetts 02631-1898
(508) 896-3701
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APPLICATION FOR
ONE-DAY LIQUOR LICENSE
(must be submitted with application fee two (2) weeks prior to the date of the event)
Applicant's Name: Phone:
Applicant's Address:
Type of Event:
Location and Address where Liquor will be served if different from Applicant's Address:
Date and hours requested for Licensed Authorization to serve Liquor:
Day: Times:
Types of Liquor to be served:
Will food be provided?
Number of attendees anticipated?
Who will serve the liquor?
Name:
Address:
Contact phone number(s) for Server(s):
FEE= $35/day/location
Signature of Applicant:
Date:
Signature indicating for Licensing Authority's Approval:
Date
Please note in the fall of 2012 the Town of Brewsterpassed a bylaw requiring civil fingerprinting for the
state and national criminal history screening of applicants for the following municipal licenses:
Alcoholic Beverages License (Manager)
Hawker & Peddler
Ice Cream Truck Vendor
All holders of the above listed licenses must be fingerprinted. Licensing applicants may appear at the
Brewster Police Department, located at 631 Harwich Road, for fingerprinting collection on the
following days by appointment only; Tuesdayy evenings between 5pm and 7ppm or on Fridays between
Sam and loam. Contact Lt. Bausch at 508-8y6-7011 or by email at dauschwtown.brewster.ma.us to
schedule an appointment. -
Lt. Bausch Date
Payment of Fingerprinting Fees:
Fingerprinting fees include federal, state and local fees. Before being fingerprinted, all licensing
applications must pay the statutory fingerprint fee of thirty dollars ($30.00) with a money order
or bank check payable to the "Commonwealth of Massachusetts". In addition to a signature, the
money order or bank check shall include the name of the applicant hand-printed in block letters.
Licensing applicants may pay the municipal fingerprint fee of seventy dollars ($70.00) by check.
*The Board of Selectmen will not approve any Hawker and Peddler applications until the results of
the state and national criminal history information have been received. This will take a minimum of 2
weeks.
BREWSTER POLICE DEPARTMENT
Chief Iclzard J.Kocli,Jr.
631 Harwich Road
Brewster,Massacllusetts 02631
Pbone508-896-7011 wwwbrewsterpolice.org Fax 508-896-4525
CIVIL FINGERPRINTING CONSENT FORM
I, consent to the collection of my fingerprints as part of the
application process for the following license:
I acknowledge and understand that my fingerprints will be searched against the database maintained by
the Federal Bureau of Investigation.
Signature Date
Name (printed)
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