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Cutchogue-New Suffolk Historical Council
4 � - 4 b `ELIZABETH A. NEVILLE,MMC ® �we. Town Hall,53095 Main Road TOWN CLERK P.O.Box 1179 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS Fax(631)765-6145 MARRIAGE OFFICER ®� Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD May 10, 2019 CIe -o? dep Mr. Robert Snowden eA 2870 Fairway Drive @ rr� Cutchogue, NY 11935 Dear Mr. Snowden: The Southold Town Board, at its regular meeting held on May 7, 2019, granted permission to the Cutchogue New Suffolk Historical Society to hold its Antique Show and Sale on June 29, 2079 (rd 6/30/19). A certified copy of this resolution is enclosed along with the Town of Southold Policy for Special Events on town Properties and Roads. Failure to heed the policy may result in the loss of Clean-up deposit. An insurance policy naming the Town of Southold as additionally insured has been filed with this office. Please contact Captain Kruszeski at the Police Department, as soon as possible, to coordinate traffic control. If you have any questions please contact me at the Town Clerk's office at 631-765-1800. Good Luck with your event. Sincerely, Lynda M Rudder Deputy Town Clerk enc Southold Town Board - Letter Board Meeting of May 7, 2019 RESOLUTION 2019-403 Item# 5.6 a� y3p�*Haag ADOPTED DOC ID: 15178 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2019-403 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON MAY 7, 2019: RESOLVED that the Town Board of the Town of Southold hereby grants permission to the Cutchogue-New Suffolk Historical Council to close a portion of Cases Lane to Main Road, Cutchogue, from 9:00 AM to 4:30 PM for its Annual Antiques Show and Sale, on Saturday, June 29, 2019 (rd 6/30/189), provided they adhere to the.Town of Southold Policy for Special Events on Town Properties and Roads. All Town fees for this event, with the exception of the Clean-up Deposit, are waived. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Louisa P. Evans, Justice SECONDER:William P. Ruland, Councilman AYES: Dinizio Jr,Ruland, Doherty, Evans, Russell ABSENT: Robert Ghosio Generated May 8, 2019 Page 24 WFOLei ELIZABETH A.NEVILLE,MMC ®� ®p Town Hall,53095 Main Road TOWN CLERK �� P.O.Box 1179 coo Southold,New York 11971, REGISTRAR OF VITAL STATISTICS Fax(631)765-6145 MARRIAGE OFFICER ,�. ��. Telephone(631)765-1800 'RECORDS MANAGEMENT OFFICER �Ol �`� www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER 4 OFFICE OF THE TOWN.CLERK t RECEIVED TOWN OF SOUTHOLD APR 2 9 2019 APPLICATION FOR A PERMIT'TO HOLD A Southold Town Clerk SPECIAL EYI NT Please provide ALL of the information requested below:Incomplete applications WILL NOT be reviewed. Date of Submission �® Name of Event 6/SrT( r Name of Organization: ^C`_�-6 Is this a Not-For-Profit Event?Yes/No Contact's Name: ,— Mailing Address: 4` �G Contact's Phone Number: C'ontact's Email Address: � 1 Event Location and.Site Diagram:" V 04` `CT (Use-additional ®paper if necessary) Event Date(s): C�✓► �� � �� - (Include set up and,shutdown times and dates) Nature of Event: IY-Fr�l l�C1x (Please attach a detailed description to this application) • Time Period(Hours)of Event: From q& 14YAto Maximum Number of Expected Attendees: Specify any special requirements (i.e. road closure,police presenc : �s � S � S a If a Tent or other temporary structure will be used please contact the Southold Town Building Department at 631-765-1802 Mailing Address to Send.Event Permit to: dar Event Fees: - —\\ $250 for events with less than 1000 expected attendees ' $500 for events with 1000 or more expected attendees Clean-up Fees(Can NOT be waived): $1,500.00 Clean-up for Bicycle and/or Running Special events(ONLY) $250 or more Clean-up deposit all other events CERTIFICATE OF INSURANCE REQUIRED:. Not less than$2,000,000 naming the Town of Southold as an"additional insured. ***NOTE: PLEASE SEE ATTACHED REVISED;ADOPTED TOWN POLICY*** Additional information and requirements may be required as deemed necessary by the Town Board. �GB E� c �ij�J C ' Print name of Authorized Person filling out Signature of Authorized Person filling out application application *Upon the request by applicant,the Town Board may waive in whole or in part any of the application requirements. 2 r If a Tent or other temporary structure will be used=please contact the Southold Town Building Department at 631-765-1802 Mailing Address to Send Event Permit to: 011 Event Fees: $250 for events with less than 1000 expected attendees $500 for events with 1000 or more-expected attendees Clean-up Fees (Can NOT be waived): $1,500.00 Clean-up for Bicycle and/or Running Special events (ONLY) $250 or more Clean-up deposit all other events CERTIFICATE OF INSURANCE REQUIRED:. Not less than$2,000;000,naming the Town of Southold as an additional insured. t, ***NOTE: PLEASE SEE ATTACHED REVISED, ADOPTED TOWN POLIC4 ' Additional information and requirements may be required as deemed necessary by the Town Board. Print name of Authorized Person filling out Signature of Authorized Person filling out application application *Upon the request by applicant,the Town Board may waive in whole or in part any of the application requirements. 2 ao of j / A tv oe t' P V. _�1L 6 6_�S4 FT. 1b O ii i s ¢ •Cl- 'c '{CUTGitJ6U F���fvig2AfiY� �g N r P o{din D �• N 0 8G6ba COO- tn y if OS • � � � n F ,�• Fltlkta ' �, � C' _��,�� 9•� _ S t}_f�T. moi. p S o, N � 1 � ••���3�'s®~W � 1 ' • � W ���Y^. :••--.•r •:•�,ne nar ra.x ten �• 5p- kq. \ E1.ux taaa S- }�- , oa•+.••,d+hiewars�raar�q�rr arotlwtdr� t tt,•r..r1 t VFVWRW.rkrd..ar a a tr.+r:--:+4 seA aMdl me 9r mrek!.ret � � b�cataMlttwaryt .� O•Aeeatewl�l�fixMRda'1na11 •y �j. $a�a! ` k�cMa4�MtMlidttot�� �� ydw a a 7r_'r�r r/. f• •'^9 Mrle6 haiaon.••9 a Gar+>r+r�e�MinetheMtler`S'1 CUTCNEW-01 DNUHFER Aco/zo CERTIFICATE OF LIABILITY INSURANCE [7D.TE(MMIDD/YYYY) 3/20/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: East End Insurance Agency PHONE P.O.Box 1406 (A/C,No,Ext):(631)765-3811 P.O. Ne):(631)765-3846 Southold,NY 11971 ADDRESS: INSURERS AFFORDING COVERAGE NAIC N INSURER A•MARKEL INSURANCE COMPANY INSURED INSURER B: Cutchogue New Suffolk INSURER C: Historical Council P.O.Box 714 INSURER D: Cutchogue,NY 11935 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER /YPOLICY EFF POLICY EXP LIMITS LTR INSD WVD MMIDDYYY MM/DDIYYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1'000'000 CLAIMS-MADE X OCCURX HUP1488-02 511/2019 5/1/2020 DAMAGEPREMISES TOEa RENTEDoccuence $ 100,000 rr MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- E] LOG PRODUCTS-COMP/OP AGO $ 2,000,000 JECT OTHER HIRED NON OWN A $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN ST TER ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA A E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E L DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder is included as additional insured for all events held by the named insured during the policy term CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Southold THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1179 Southold,NY 11971 AUTHORIZED REPRESENTATIVE ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Rudder, Lynda From: Spiro, Melissa Sent: Tuesday, April 30, 2019 9:42 AM To: Rudder, Lynda; Blasko, Regina; Doroski, Melanie; Duffy, Bill; Fisher, Robert; Flatley, Martin; Hagan, Damon; Kruszeski, Frank; Norklun, Stacey; Silleck, Mary Subject: RE:Antiques show This is not Town preserved land. Melissa Spiro -----Original Message----- From: Rudder, Lynda Sent:Tuesday,April 30, 2019 9:18 AM To: Blasko, Regina <rblasko@town.southold.ny.us>; Doroski, Melanie<Melanie.Doroski@town.southold.ny.us>; Duffy, Bill <billd@southoldtownny.gov>; Fisher, Robert<Robert.Fisher@town.southold.ny.us>; Flatley, Martin <mflatley@town.southold.ny.us>; Hagan, Damon <damonh@southoldtownny.gov>; Kruszeski, Frank <fkruszeski@town.southold.ny.us>; Norklun, Stacey<Stacey.Norklun@town.southold.ny.us>;Silleck, Mary <marys@town.southold.ny.us>; Spiro, Melissa <Melissa.Spiro@town.southold.ny.us> Subject: Antiques show Please approve/disapprove and provide cost analysis thanks. 1 Town of Southold Police Department Special Event CostAnalysis Event: Cutchogue- New Suffolk Historical Antique Show Date(s): June 29, 2019 Location: Village Green, Cutchogue Allocation F4 Patrol tbir Event Reg Hours OT-'Hrs [Hrly Wage Total Comments Police rs $p _ '_ ...... Reg Hours _06-Ti A'rsFArlY"Wage _ Total- Comments Bicycle Patrol: Highway Pa#rot, 1,Eaf fl Reg Hours IOTHrsjHrlyWage Total Comment TC Officer#1 91 $17.47 $157.23 TC Officer#2 9 $1747 $157.23 TC Officer TC Officer TC Officer �q�!_p t- osts _P�VAI"Ie vehicles— 'fhhr_ 'Total 1 $10.00 $90.00 $90.00 Command Van -Marine Patrol Boats ,Total Department Cost for Event = $404.46 Prepared by Chief M. Flatley 4/30/2019 Page 1 Rudder, Lynda From: Flatley, Martin Sent: Tuesday,April 30, 2019 9:56 AM To: Rudder, Lynda; Blasko, Regina; Doroski, Melanie; Duffy, Bill; Fisher, Robert; Hagan, Damon; Kruszeski, Frank; Norklun, Stacey; Silleck, Mary; Spiro, Melissa Subject: RE:Antiques show Attachments: Cutch-New Suff Antique Show.xls I have no objections to this event being approved, my cost analysis is attached. Martin Flatley, Chief of Police Southold Town Police Department 41405 State Route 25 Peconic, New York 11958 631-765-3115 -----Original Message----- From: Rudder, Lynda Sent:Tuesday,April 30, 2019 9:18 AM To: Blasko, Regina <rblasko@town.southold.ny.us>; Doroski, Melanie<Melanie.Doroski@town.southold.ny.us>; Duffy, Bill <billd@southoldtownny.gov>; Fisher, Robert<Robert.Fisher@town.southold.ny.us>; Flatley, Martin <mflatley@town.southold.ny.us>; Hagan, Damon <damonh@southoldtownny.gov>; Kruszeski, Frank <fkruszeski @town.southold.ny.us>; Norklun,Stacey<Stacey.Norklun @town.southold.ny.us>;Silleck, Mary <marys@town.southold.ny.us>; Spiro, Melissa <Melissa.Spiro@town.southold.ny.us> Subject:Antiques show Please approve/disapprove and provide cost analysis thanks. 1 Rudder, Lynda _ From: Duffy, Bill Sent: Wednesday, May 1, 2019 11:36 AM To: Rudder, Lynda Subject: RE:Antiques show No objection William M. Duffy, Esq. Town Attorney Town of Southold Southold Town Annex 54375 Route 25 (Main Road) P.O. Box 1179 Southold, New York 11971-0959 Office: 631.765-1939 Fax: 631.765.6639 Email: billd@southoldtownny.gov ATTORNEY-CLIENT COMMUNICATION;ATTORNEY WORK PRODUCT; INTER/INTRA AGENCY COMMUNICATION; NOT SUBJECT TO FREEDOM OF INFORMATION LAW DISCLOSURE; DO NOT FORWARD WITHOUT PERMISSION Note: Service of legal documents is not permitted via electronic mail or fax. The information contained in this electronic message and any attachments to this message are intended for the exclusive use of the addressee(s) and may contain information that is privileged,confidential and exempt from disclosure under applicable law. Unintended transmission shall not constitute a waiver of the attorney/client privilege or any other privilege. If the reader of this message is not the intended recipient,you are hereby notified that any review, retransmission, conversion to hard copy, copying, reproduction, circulation, publication, dissemination or other use of, or taking of any action, or omission to take action, in reliance upon this communication by persons or entities other than the intended recipient is strictly prohibited. If you have received this communication in error, please (i) notify us immediately by telephone at 631.765.1939, (ii) return the original message and all copies to us at the address above via the U.S: Postal Service, and (iii) delete the message and any material attached thereto from any computer, disk drive, diskette, or other storage device or media. -----Original Message----- From: Rudder, Lynda Sent:Tuesday,April 30, 2019 9:18 AM To: Blasko, Regina; Doroski, Melanie; Duffy, Bill; Fisher, Robert; Flatley, Martin; Hagan, Damon; Kruszeski, Frank; Norklun,Stacey; Silleck, Mary; Spiro, Melissa Subject: Antiques show Please approve/disapprove and provide cost analysis thanks. 1 I ELIZABETH A.NEVILLE, MMC �" Town Hall,53095 Main Road TOWN CLERK "" P.O.Box 1179 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS , Fax(631)765-6145 MARRIAGE OFFICER Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER " a" www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK ;`, RECEIVED TOWN OF SOUTHOLD MIT 2 9 2019 APPLICATION FOR A PERMIT TO HOLD A Southold Town Clerk SPECIAL EV#,NT Please provide ALI,of the information re crested below.Incompleteapplications,W11, L NOT be reviewed. _ao �.. ............Date of Submission .._ - Name of Event Name of Organization: "'" Lk v w — 1c o h. IV Is this a Not-For-Profit Event?Yes/No... Contact's Name: '" Mailing Address: .� cc) Contact's Phone Number: � .. '('.� ............... Contact's Email Address: ( el Event Location and Site Diagram: (Use additional paper if necessary) Event Date(s): �� �` (Include_ set up and shutdown times and dates) m Nature of Event: -.. .� ..... (Please attach a detailed description to this application) Time Period (Hours) of Event: From to Maximum Number of Expected Attendees: )' _ _. ......... ............ _..... . Specify any special requirements (i.e. road closure,police present : " _...� If a Tent or other temporary structure will be used please contact the Southold Town Building Department at 631-765-1802 Mailing Address to Send Event Permit to: Event Fees: IT$250 for events with less than 1000 expected attendees $500 for events with 1000 or more expected attendees Clean-up Fees (Can NOT be waived): __/ $1,500.00 Clean-up for Bicycle and/or Running Special events (ONLY) $250 or more Clean-up deposit all other events __CERTIFICATE Ol+'�LNS T�ANCE:IO? UIRE'D: Not less than$2,000,000 naming the Town of Southold as an additional insured. ***NOTE: PLEASE SEE ATTACHED REVISED ADOPTED TOWN POLICY*** Additional information and requirements may be required as deemed necessary by the Town Board. �GB Ci�� c S�-Jv_�Qax Print name of Authorized Person filling out Signature of A'ulhor'iz(-d Person filling out application application *Upon the request by applicant,the Town Board may waive in whole or in part any of the application requirements. 2 11 i "Nr oer Q fi To oe Srer oPF rr -31 - - L6 6 GOO. -. nz ��� a � O• �tip{�le a S 3p ST _ r w ► sowwG. �` � --•,..!rAtt-ems..r«�ela� VO 160- 4q.9 - •�eb nac �- C, 1 � bm• a � rym ebur 5 gelfar kw_ �a T +R.fjl MI nol CUTCNEW-01 DNU!HFER TE,a�oRo � . CERTIFICATE OF LIABILITY INSURANCE DA312012019 MM.DfYYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVEORPRODUCER,AND THE CERTIFICATE HOLDER.mm �. .. .... .... IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy„certain policies may require an endorsement. A statement on this certificate does not confer ri hts to the certificate holder in lieu of such endorsement($).mmm mm CO TACT PRODUCER NA E,.-.-. _--- ......._ .. ..�. ._ East End Insurance Agency FAXExsl (631)765-3811 IArc NeY(6'31)765-3846 P.O.Box 1406E dVlAll Southold,NY 11971 AMISS_. _ INsuRl�Nzlsl A a aeacrinxe CovRACE IIAA ;.t. INSURFRAr MARKEL INSURANCE COMPANY' ....INSURED ........... ..W.., INSURER 81 ... . _...._. -------- ....m...._ ........ Cutchogue New Suffolk INSURER C e Historical Council - — _ P.O.Box 714 INWRERL7 Cutchogue,NY 11935 INSURERL INSURER F: COVERAGES � CwI�RTIFICATE N9JmMBER. REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW FOR THE POLICY PERIOD INDICATED. BHROCONDITION F ANY OOOOWHI CE FICATE MAYISSUED OR PERTAIN, THE INSURANCE Y THEOLIICESDCRIBDHERIN SSUB ECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MY HAVE BEEN REDUCED BY PAID_CLAIMS_. IN .. N ADDL s �' l l t? 1,000,000 A COMMERCIAL GENERAL LIABILITY � F"OIA1 Y E MM DDY�"M'Y '" POUC TYPE OF INSURANCE D WYVO POLICY NUMBER LIMITS LITY EACM IOCC'LJRR1rNC-f...,.,.,...,,. 5 ._.. CLAIMS-MADE X �( TO REIIIE�D 100,000 OCCUR HUP1488-02 5/1/2019 5/1/2020 L,IyIMy EPS E Uczuirexcr� .. DAMAGE NAf I"�_F,yP IAiru Uric�reusUzrb 5,000 4?ER 0m�Iw,�mAOVIN.URY y,...., 1 0008300 GENII.Af.zGREGA rE LIMIT APPLIES P. ER: 2,000,000 C'FN^IF}TA@ AGGREGATE ATI ...._.m. 000,000 X w CLaCr 11 LDC PRODHIRED UD NOhIDOPIDP AG4�hi1 A Is 14£1010 00 .,....,.,. �I JECT . .,, OT iL.FI:. 0 "CChMI61IdLD.�,IIdCi.E LJMVI AUTOMOBILE LIABILITY trLa�'sa_�c:da .....,.,5 ........,. - ANY AUTOIIPDILY IN'.URY LPcx OWNED SCHEDULED AUTOS ONLY AUTOS 63ODILY 9NJu e I. Orry .. _ .,. AUTOS ONLY .�,__. Al PGII:'4,5 IJh�IL''Dt ...Ferr actRl r1l AMR,CF 5.... ...^, ...._. UMBRELLA OCCUR EACH I OL"L,+YJiN�RFIIC,"fw EXCESS LIABAB CLAIMS MADE AUGREl'ATE DED RETENTION$ Pr WORKERS COMPENSATIONTIF4']:U7`E AND EMPLOYERS'LIABILITY Y/N ANY PROP RIETOR/PARTN ER/EXECUTIVE ❑ NIA .„EI EACIi.hl IIphEN1 5 OFFICER/MEMBER EXCLUDED? (Mandatory ) .. . EMP,lOYEEl .. Mandato m NH E R LiISFA��F EA It Wcos,describe under POLICY DESCRJPTION.or OPEP.ATIONS belcw ..._.,. ....... ... _ L DISEASE-'”OLILLIMITS....._..... _........... Certificate hI olderOPERATIONS/incled as additionlall Insured far all events held by the named insured during they policy required) ...... Se i Of CLES (ACORD le,maybe attached Wraore Certificate holder IS included y 9 p cy term CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1179 Southold,NY 11971 .... ....._ AUTHORIZED REPRESENTATIVE – ©1988-2015 ACORD g..._ ACORDD 225 5((2016/03) ...... _.D CORPORATION.N. All rights reserved. The ACORD name and logo are registered marks of ACORD ELIZABETH A.NEVILLE,MMC Town Hall,53095 Main Road TOWN CLERK P.O.Box 1179 CA Southold,New York 11971 REGISTRAR OF VITAL STATISTICS Fax(631)765-6145 MARRIAGE OFFICER " '" ' RECORDS MANAGEMENT OFFICER �+ ► „� Telephone(631) 00 www.s outholdtownny.nny.ggov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK RECEIVED TOWN OF SOUTHOLD R 2 0 2430 APPLICATION FOR A PERMIT TO HOLD A SPECIAL EVENT Southold Town Clerk Please provide ALL of the information requested below. Incomplete applications WILL NOT be reviewed. Date of Submission .......... _ ..................---------- Name of EventAL Name.of Organization: Is this a Not-For-Profit Event? Yes/No Contact's Name: ...._.... � � ...... __.. a Mailing Address: �� � � l",!� ,IIt""" Contact's Phone Number: 77 r' . ��`" Contact's Email Address: ��w. Event Location and Site Diagram: C (Use additional piper if Necessary) Event Date(s)., Include set ua sd Shu cdoNNvn times and dates) ITmm ( p P ) Nature of Event: _ :_.. ._ .. � ..... ". (Please attach a tlet�riled description to this application) C01Time Period (Hours) of Event: From to Maximum Number of Expected Attendees: .,, Specify any special requirements (i.e. road closure, police presence): Revised 8/5/15 If a Tent or other temporary structure will be used please contact the Southold Town Building Department at 631-765-1802 Mailing Address to Send Event Permit to: 9:70 Event Fees: 1 $250 for events with less than 1000 expected attendees m � $500 for events with 1000 or more expected attendees Clean-up Fees (Can NOT be waived): $1,500.00 Clean-up for Bicycle and/or Running Special events (ONLY) $250 or more Clean-up deposit all other events Y CERTIFICATE OF 1NSUI AN'C 1? R.E l�l]lZE : Not less than $2,000,000 naming the Town of Southold as an additional insured. ***NOTE: PLEASE SEE ATTACHED REVISED ADOPTED TOWN POLICY*** Additional information and requirements may be required as deemed necessary by the Town Board. 1� . m__. i Person fillinout Signature 32tithorizecPerson filling o Print name of Author g gout application application *Upon the request by applicant, the Town Board may waive in whole or in part any of the application requirements. .. .... Revised 3/21/16 2 CUTCNEW-01 DN.UHFER " CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)3/20/2019 ED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLD THIS CERTIFICATE IS ISSUED HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on not confer rights to the certificate holder in lieu of such endorsement(s). this certificate does IT...� ,..�....,...._. ..��........ CONTACT PRODUCER ad.AlMIF,,_...� .. ....... . ... _.--- ......... ..r.....-............_ .... ....... East End Insurance Agency P.O.Box 1406 I_AH/c°,No,Ext):(631)765-3811 _ �;(AIX No):(631)765-3846 E MAI Southold,NY 11971 ADD)Z INSURER,(S)AFFORDINGCOVERAGE w NAIC#,,,, m_ INSURERA:MARKEL INSURANCE COMPANY INSURED INSURER B: Cutchogue New Suffolk INsuRER c Historical Council . - P.O.Box 714D INSURER,.., ... „. ......,..._........... .. ._._.—.. __........ ..._..-- Cutchogue,NY 11935 _INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER ..... .._.._._.... .. ....._ REVISION NUMBER. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICED WN MAY HAVE BEEN REDUCED BY PAID CLAIMS A X „ IES.LIMITS COMMERCIAL GENERAL LIABILITY_ LT ADDLSD$UBR POLICY EFF POLJCY EXP INSR TYPE OF INSURANCE POLICY NUMBER MM/DDS LIMITS P OCCURRENCE 000 000 DAMAge rO RENTE 100 000 E — CLAIMS-MADE OCCUR X DAMAL£10 (1UP1488-02 5/1/2019 5/1/2020 _ c 4 �[ p MED EXP(Any one person,/ s 5 000 1,000,000 PERSONAL&ADV INJURY GR41 AGGREGATE LIMIT A PDLICY El PRO& PP POECR: PRODUCTS OOA PG , HIRED NONWN 0001, X OT6if;st ..... 1000, AUTOMOBILE.�.IGOMrrdIP!fED E=tlABILITY - SINGLMtT AUTOS ONLY AUTOSBODILY, N,IURY�PerpersonZ_ ANY AUTO BODILY I OWNED SCHEDULED " ........... AV�170�5'C?I RN (DAMAGE,....dentl S H F 5 NL.rPr WL@.h. }'�FdOPER1" ) gg ��1LLN B AlJ4"`S'ONLY Ptur'ax�Cdrnt $ ...... ..... . UMBRELLA LIAB OCCUR EACH OCCURRENCE,,,,, S E%CESSLIAB ...............,. . .CLAIMS-MADE :AGGREGATE ,.,....._._ WO KERS. --.��.. .. STAT_lJT_E FRH .._ _..... RKERS COMPENSATION �AND EMPLOYERS LIABILITY Y1N� I FA('H..A(:CIOFNT .ANY ROPRIETOR/PARTNERIEXECUTIVE ,„F „,„„„„„„T. ........ ............_ ...-- _ f'FIC RfMF�MBER EXCLUDED? N I'4 aotdmatdry bn NH) E L,fISFASE FA FMPI CYEk S If yes,describe under DESCRIPTION OF OPERATIONS below E.L..DISEASE-POLICY LIMIT mmS I DESCRIPTION OF OPERATIONS 11LOCATIONS I VE141CLES IACORD 101,Additional Remarks Schedule,may he attached tt more space is required) Certificate holder is included as additional insured for all events held by the named insured during the Policy term CERTIFICATE HOLDER mm...�_... .. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1179 Southold,NY 11971 -- AUTHORIZED REPRESENTATIVE V _ ©1988-2015 ACORD CORPORATION.. ..... ACORD 25(2016/03) All rights reserved. The ACORD name and logo are registered marks of ACORD ELIZABETH A.NEVILLE,MMC Town Hall,53095 Main Road TOWN CLERK P.O.Box 1179 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS Fax(631)765-6145 MARRIAGE OFFICER Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER . " + www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK RECEIVED TOWN OF SOUTHOLD 'VAR APPLICATION FOR A PERMIT TO HOLD A SPECIAL EVENT Southold Town Clerk Please provide ALL of the information reguested below. Incomplete a a plications WILL NOT be. reviewed. Date of Submission Name of Event "" ' A L Name.of Organization: _f... Is this allot-For-Profit. Event?Yes/No .... Contact' s NaName: ... . .... Mailing Address: � ,,W 4— ,�� . e Contact's Phone Number: Contact's Email Address; Event Location and Site Diagram .._.. 0 XU (Use additional ptlper if iecessary) Event Date(s): " 67 .. (Include set up a.id shu down times and dates) Nature of Event: (Please attach a detailed description to this application) Time Period Hours of Event: From to 1 ,_.,m Maximum Number of Expected Attendees b� Specify any special requirements (i.e. road closure, police presence). Revised 8/5/15 If a Tent or other temporary structure will be used please contact the Southold Town Building Department at 631-765-1802 � 9 . 7) Mailing Address to Send Event Permit to °....� '.. � ... � " Event Fees: $250 for events with less than 1000 expected attendees $500 for events with 1000 or more expected attendees Clean-up Fees (Can NOT be waived): $1,500.00 Clean-up for Bicycle and/or Running Special events (ONLY) $250 or more Clean-up deposit all other events CERTIFICATE IF�ICA` E OF 1NSURANt" j', ISE 1jgE1:1: Not less than $2,000,000 naming the Town of Southold as an additional insured. ***NOTE: PLEASE SEE ATTACHED REVISED ADOPTED TOWN POLICY*** Additional information and requirements may be required as deemed necessary by the Town Board. r ', _ � _.p , ��01� 6k � ._ .. �.. � .� ,.� Person ..-- Print name of Authorized Person filling out Signature o Zt' al. r:zec filling out application application *Upon the request by applicant, the Town Board may waive in whole or in part any of the application requirements. IIS �� � '"MN ✓'"' K,/' `6� "-"" ..% I� ", .u°' d ✓m+ Revised 3/21/16 2 CUTCNEW-01 - D DNUHEER _ CERTIFICATE OF LIABILITY INSURANCE DA (MMIDD�) 3 �19 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. _ IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on g h endorsement(s). this certificate does not confer rights to the certificate holder in lieu of such ....._... ......� µµµµµmm_ CONTACT PRODUCER NAM ....._ East End Insurance Agency PHO No,Ext);(631 765-3811 FAX 631 765-3846 P.O.Box 1406 "_ Southold,NY 11971 rMID .., „N,,,, RER(S)AFFORDING COVERAGE ,NAIC# _..... ..INsuRERA a MAR,KEL LNS,URANCE COMPANY ..... .. ... ............ '.....INSURED klwRER.RERS ....yy_n.n 1__..__... Cutchogue New Suffolk INSURERC Historical Council ............ _ P.O.Box 714 INAURER.D ..... .__-,_. Cutchogue,NY 11935 INSURER E INSURER F: ❑ ,,,Y„„„„„„ COVERAGES _ CERTIFICATE NUMBER .... ., REV'I'SION N.U.MBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT„ TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CLAIMS INSR EXCLUSIONS,APDOFCONDITIONS RANCE QF SUCH,P001.SUO LIMITS SHOWN OLJYNUMBERHAVE BEEN REDUCED F PPOO.,� EAGHOCCURRENGE LIMITS 1 ooO o00 A X COMMERCIALGE.. CY'EXP NERAL LIABILITY / r JLL OccUR X HUP1488-02 5/1/2019 51112020 DAMAGE TO RENTED 100,000 CLAIMS-MADE X .._PREMR;r .,.(E ,(as�al�rE,.s.) ..$ _, ._..,. MED EXP,.(nny one person]_ $ 5,000 PERSONA.L_&ADV INJURY _ $ 1,000,000 GEN'L A GRE., -- CATC LIMIT APPLIES PER: GENERAL AGGREG-'ATE $ 2,000,000 POLL }E r ❑ Loc PRODUCTS COMP(aP AGr„.$ _2,000,000 000.. X I"R ❑0 IHER HIRED NON OWN A $ 1,000,000 COMA. .....� .....,... ._ ...... ...........�„ __........... ,. AUTOMOBILE LIABILITY �,,,EP R�, s pnt pp------ ANY --- 1..IHN67 �I .,..... ., ANYAUTO P9PII,Y,INJURY Pergemm) $....., OWNED SCHEDULED AUTOS ONLY AUTOS BODII?INJURY(Per,accadent) $ HIRED Ne;I-IQWPIEL7 IDAMA GE _..... uutiti PRI�1�R�'i'' AUTOS ONLY ......_.. A LbSON1.Y IPeraa�,uywra„ _.... _. 5 UMBRELLA LIAB OCCUR -.... _. EACH OCC,URRENCE,,,,,,, EXCESS LIAB CLAIMS-MADE AGGREGATE ,__ Blt, ..... ........ WORKERS.�OMPENSATI YIN ..... ❑ST��E �ORH ._ .....,... DED RETENOTIN N$ ._..,,...... $._ ..-..._ ..,.m....... AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E L PACH AGCIOFNT $NIA A __ _ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E L DISEASE FA EMPLOYEE $ _ If yes,dea,cribe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY DESCRIPTION OPERATIONS ncld as aDdditional Esured for all vents held � .. i ............ ----- -..Omunarq�s Schedule,may be xtttiyched dr snorespam Is required) by the named insured during the policy term CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1179 Southold,NY 11971 ...... °° IT.""' ''..AUTHORIZED REPRESENTATIVE ACORD 25(2016 _.. _ ©1988-2015 ACORD CORPORATION. All rights reserved. served. The ACORD name and logo are registered marks of ACORD 1 ;a �J a 1' /1 j i y « «• - W 'uuM w r w' mmw,w;eoM w mM m9wdr 6 w: Wwwxwlbmwop#,r,M o W�ii. A A'w y ,., nMnr�xa xnixrew.'crmarM9 mmwnmrwaM'-w�Ma rnaP "NI 4 i C6a�c - � iiia HISTORICAL COUNCIL .M BOX 714 CorcHoGU " t 11936 - - � M� !a�nuuuu�mnmr,oWrc�� M r P®iy to m ,du mlwrm�uow,MwtwaW -e nr,Wc�Mnuv Ou M'mmmwrnww��iwx iwv"lmr i M��' u ,W„wuquU ugVuwaMu(� ,y;+M�ww%NYuwwn I w'w the T IN 4 Order Of FMo'wwu aiof�m:�anMuwu �, Mm ii i� , . ,,, •, � « ,, i aw u ry w r`.a gnu«aMaaw�v�nm r av mrmu wM �r xmw ,�,N�,°� ?� m rr � a x7)aww� s '^MWw�MwN w�WUNAWU�wu'� � m M?6fl 4 C 111 Nrw.�mywsawww.;Matl �m re Mm M1 f ,,•� M,w° w+P Me'w W l��l���w w�fnlll ullrof r q� ,aW'i+ Mc +wvmJ.t'mwM'Wuf � J wW�MA!"nNPoNY M!p'WSN,+ @ Of. 9 .� �' wMbl oN1MIlNYB!W,�w'wwu Nw .w. mY 1 00 peoples'c47f'A'y '.a a v W w aMiµu � i owmMM �J m+,w I /,rw �.y,,,,ti miN 4 I frt nBIWi'w�' A�N'aAptl rP,W w M A!M w d mwy n 1 Fr ��, 1 n wuwwu w rvv war WW' AW°" .w>• I"mom m A w'rwwr 1,r w 1 mw rM.r�. g MM h'w M w�Mww.l imry « .w..rmr ure xw,mm. id/XR „qtr, p Y 4 r- }a J" i r Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 04/02/19 Receipt#: 252624 Quantity Transactions Reference Subtotal 1 Event Fee6.15.19 $250.00 Total Paid: $250.00 Notes: Payment Type Amount Paid By CK#3211 $250.00 Cutchogue, -new Suff. Historical Cncl Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Cutchogue, -new Suff. Historical Cncl P.o. Box 714 Cutchogue Village Green Cutchoque, NY 11935 Clerk ID: BONNIED Internal ID:6.15.19 lr 4 hf/ • " i4k CI I � „ P� ro eek sir oaF _a j s s `sa.FrIr ,tr � `moi '{CUfCitO6UE ¢E�ff LiB2ASY� "��• vi t 5 , f na G Ftin{cls - � 0, • - d ��� roe G G V uar i Al •� `� the � 1 em:-�laialM�retMmneM� t boa �IMe/N S. Sa�� ire errw r'"w +nd ,. • F.W., .... r of F04 ELIZABETH A. NEVILLE, MMC ®� ®(oy Town Hall,53095 Main Road TOWN CLERK a P.O.Box 1179 rA Southold,New York 11971 REGISTRAR OF VITAL STATISTICS ® Fax(631)765-6145 MARRIAGE OFFICER ,l, �. Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER �Ol �`�� www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD May 10, 2019 Robert Snowden l 2870 Fairway11 CSU Cutchogue,NY 11935 C Dear Mr. Snowden: The Southold Town Board, at its regular meeting held on May 7, 2019, granted permission to the Cutchogue-New Suffolk Historical Society to hold its Flea Market/Yard Sale on June 15, 2019 (rd 6/16/19). A certified copy of this resolution is enclosed along with the Town of Southold Policy for Special Events on town Properties and Roads. Failure to heed the policy may result in the loss of Clean-up deposit. An insurance policy naming the Town of Southold as additionally insured has been filed with this office. No police presence required. If you have any questions please contact me at the Town Clerk's office at 631-765-1800. Good Luck with your event. Sincerely, L Lynda M Rudder Deputy Town Clerk enc Southold Town Board - Letter Board Meeting of May 7, 2019 RESOLUTION 2019-401 Item# 5.4 ADOPTED DOC ID: 15175 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2019-401 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON MAY 7, 2019: RESOLVED that the Town Board of the Town of Southold hereby grants permission to the Cutchogue-New Suffolk Historical Council to hold their annual Flea Market/Yard Sale on the Village Green, Cutchogue, from 8:00 am—3:00 pm on June 15, 2019 (rd 6/16/19), provided they adhere to the Town of Southold Policy for Special Events on Town Properties and Roads. No Police assistance is required. All Town fees for this event, with the exception of the Clean-up Deposit, are waived. Elizabeth A.Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Jill Doherty, Councilwoman SECONDER:William P. Ruland, Councilman AYES: Dinizio Jr, Ruland, Doherty, Evans, Russell ABSENT: Robert Ghosio Generated May 8, 2019 Page 22 d 0 41� 41 ELIZABETH A.NEVILLE,MMC Town Hall,53095 Main Road TOWN CLERK P.O.Box 1179 ce Z Southold,New York 11971 REGISTRAR OF VITAL STATISTICS ® .� Fax(631)765-6145 MARRIAGE OFFICER aQt' Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER �.( dl► www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK RECEIVED TOWN OF SOUTHOLD OR 2 0 203 APPLICATION FOR A PERMIT TO HOLD A SPECIAL EVENT Southold Town Clerk Please provide ALL of the information requested below. Incomplete applications WILL NOT be reviewed. Date of SubmissionV1 Name of Event Name of Organization: C ( V Is this a Not-For-Profit Event?Yes/No � Contact's Name: f Mailing Address: -d q-76�,G Contact's Phone Number: &- j I j Contact's Email Address: Od-AZCO / Event Location and Site Diagram: UL (Use additional paper if ecessary) Event Date(s): l 1f \ I I (Include set up a d shu down times and dates) Nature of Event: / (Please attach a detailed description to this application) Time Period (Hours)of Event: From to Maximum Number of Expected Attendees: 0C Specify any special requirements (i.e. road closure, police presence): L Revised 8/5/15 t C � If a Tent or other temporary structure will be used please contact the Southold Town Building Department at 631-765-1802 Mailing Address to Send Event Permit to: c,?�Oo fM V Event Fees: $250 for events with less than 1000 expected attendees $500 for events with 1000 or more expected attendees Clean-up Fees (Can NOT be waived): $1,500.00 Clean-up for Bicycle and/or Running Special events (ONLY) $250 or more Clean-up deposit all other events CERTIFICATE OF INSURANCE REQUIRED: Not less than $2,000,000 naming the Town of Southold as an additional insured. ***NOTE: PLEASE SEE ATTACHED REVISED, ADOPTED TOWN POLICY*** Additional information and requirements may be required as deemed necessary by the Town Board. I(VIA Ro OAO��4m- Print name of Authorized Person filling out Signature of Authorize6 Person filling out application application *Upon the request by applicant,the Town Board may waive in whole or in part any of the application requirements. oej)�Z Revised 3/21/16 2 � • l CUTCNEW-01 DNUHFER AcoRo° CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 3/20/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME East End Insurance Agency PHONE P.O.Box 1406 (AIC,No,Ext):(631)765-3811 FAX Ne):(631)765-3846 Southold,NY 11971 ADDRI ESS: INSURERS AFFORDING COVERAGE NAIL# INSURER A:MARKEL INSURANCE COMPANY INSURED INSURER B: Cutchogue New Suffolk Historical Council INSURERC: P.O.Box 714 INSURER D: Cutchogue,NY 11935 INSURER E• INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LT INSD MM/DD MM/DDIYYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR HUP1488-02 5/1/2019 5/1/2020 PREMISES ETORENTED 100,000 X PREM ES Ea occurrence $ MED EXP(Any oneperson) $ 5'000 PERSONAL&ADV INJURY $ 1'000'000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY JERCOT- LOC PRODUCTS-COMPIOP AGG $ 2'000'000 OTHER HIRED NON OWN A $ 1,000,000 ACOMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accident $ ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ $ UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N TATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE F_ NIA E L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder is included as additional insured for all events held by the named insured during the policy term CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Southold THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1179 Southold,NY 11971 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. 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Historical Cncl Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Cutchogue, -new Suff. Historical Cncl P o. Box 714 Cutchogue Village Green Cutchoque, NY 11935 Clerk ID: BONNIED Internal ID.6.15 19 l ' Rudder, Lynda From: Flatley, Martin Sent: Friday, April 26, 2019 12:57 PM To: Rudder, Lynda Cc: Kruszeski, Frank; Blasko, Regina Subject: RE:flea market Lyn, I think I already responded to this event. It is planned for the same weekend as the Strawberry Festival and they are requesting the road shut down as well. We have all of our resources tied up at the Festival, especially on this date, Saturday the 15th where the Festival runs from 9 am until 11:30 pm. I believe this is the first time they are running this event? I don't remember any other event conflicting with the Strawberry Festival. I doubt if we would be able to assign an officer to this event, and I don't think it is safe to close a road down without a police presence. Would they be open to another date? Martin Flatley, Chief of Police Southold Town Police Department 41405 State Route 25 Peconic, New York 11958 631-765-3115 -----Original Message----- From: Rudder, Lynda Sent:Thursday, April 25, 2019 9:58 AM To: Flatley, Martin <mflatley@town.southold.ny.us>; Blasko, Regina<rblasko@town.southold.ny.us>; Kruszeski, Frank <fkruszeski@town.southold.ny.us> Subject: flea market Importance: High Please provide approval/disapproval and cost analysis for attached,thank you 1 Doroski, Bonnie From. Spiro, Melissa Sent: Tuesday,April 02, 2019 1:36 PM To: Doroski, Bonnie; Blasko, Regina; Doroski, Melanie; Duffy, Bill; Fisher, Robert; Flatley, Martin; Hagan, Damon; Kruszeski, Frank; Norklun, Stacey; Silleck, Mary Subject: RE: Emailing: spec evnt-c-ns hist scty_20190402131732 This is not Town preserved land. Melissa -----Original Message----- From: Doroski, Bonnie Sent:Tuesday,April 02, 2019 1:20 PM To: Blasko, Regina <rblasko@town.southold.ny.us>; Doroski, Melanie<Melanie.Doroski@town.southold.nv.us>; Duffy, Bill <billd@southoldtownny.gov>; Fisher, Robert<Robert.Fisher@town.southold.nv.us>; Flatley, Martin <mflatley@town.southold.ny.us>; Hagan, Damon <damonh@southoldtownny.gov>; Kruszeski, Frank <fkruszeski@town.southoId.ny.us>; Norklun,Stacey<Stacey.Norklun@town.southold.ny.us>;Silleck, Mary <marvs@town.southold.ny.us>; Spiro, Melissa <Melissa.Spiro@town.southold.ny.us> Subject: Emailing: spec evnt-c-ns hist scty_20190402131732 Please review the attached application received from the Cutchogue-New Suffolk Historical Society. Please send any comments/concerns to this office. Thank you. Your message is ready to be sent with the following file or link attachments: spec evnt-c-ns hist scty_20190402131732 Note:To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. 1 9k '�.r Wim,, �� f' Ur i [4 tz S aT O PF r•c�` y he tn cn ! / P � •y '�CUTGi{JE,U$ FES&'LiBEAiLY, �� `,y l� '' p 410 8 ..Shob racy G - .611 tp <N 1 at O- W q•g \l Sdrerct�nt�na�eMavrYork��fc 5•�•�•so VMS- 1•'4 1 .� o.�+^�d+ld�etarrpwiq.++oslrrrfrtg -°� 1 � n,•r.-AwAlwrabowmidpw •.��eons Maa�,dd Mai a If►�fM11�ls7�wv1 ISaI�E* c•+wmbrpont�wloanea� . 5kr;asardMdrrntYMl�Mtori� ='q ` d u "m-.�rtaa�r+a`nynnclhencferrS'1 '}`� Rudder, Lynda From: Flatley, Martin. Sent: Friday, April 26, 2019 4:07 PM To: Rudder, Lynda Subject: RE: flea market Then I have no objections to this event being approved. I will provide him with traffic cones for a crosswalk across Rt. 25 Martin Flatley, Chief of Police Southold Town Police Department 41405 State Route 25 Peconic, New York 11958 631-765-3115 -----Original Message----- From: Rudder, Lynda Sent: Friday, April 26, 2019 3:40 PM To: Flatley, Martin <mflatley@town.southold.ny.us> Cc: Kruszeski, Frank<fkruszeski@town.southold.ny.us>; Blasko, Regina <rblasko@town.southold.ny.us> Subject: RE: flea market Importance: High Hi Chief, I just spoke with Robert Snowden regarding the "Flea Market". This is a yard Sale that they have every year. They changed the name hoping to get more people. The map he submitted shows the road blocked. I have verified with Mr. Snowden that the road will NOT be blocked, no snow fencing and no police presence is required for this event. Attached is a map with the road open. I outlined the area that they will be using for the "flea market/yard sale" -----Original Message----- From: Flatley, Martin <mflatley@town.southold.ny.us> Sent: Friday,April 26, 2019 12:57 PM To: Rudder, Lynda <lynda.rudder@town.southold.ny.us> Cc: Kruszeski, Frank<fkruszeski@town.southold.ny.us>; Blasko, Regina <rblasko@town.southold.ny.us> Subject: RE:''flea market Lyn, I think I already responded to this event. It is planned for the same weekend as the Strawberry Festival and they are requesting the road shut down as well.We have all of our resources tied up at the Festival, especially on this date, Saturday the 15th where the Festival runs from 9 am until 11:30 pm. I believe this is the first time they are running this event? I don't remember any other event conflicting with the Strawberry Festival. I doubt if we would be able to assign an officer to this event, and I don't think it is safe to close a road down without a police presence.Would they be open to another date? Martin Flatley, Chief of Police Southold Town Police Department 41405 State Route 25 Peconic, New York 11958 i 631-765-3115 -----Original Message----- From: Rudder, Lynda Sent: Thursday, April 25, 2019 9:58 AM To: Flatley, Martin<mflatley@town.southold.ny.us>; Blasko, Regina <rblasko@town.southold.ny.us>; Kruszeski, Frank <fkruszeski@town.southold.ny.us> Subject: flea market Importance: High Please provide approval/disapproval and cost analysis for attached, thank you 2