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HomeMy WebLinkAboutSparkling Pointe 2019-25 U(Dwm, OF L M) ^„?+f•r 6m....+W ✓"r �' ,�" 5.:,.au:WOY f"i ' ' ta6eJr.ee1 m...J (THIS PERMIT MUST BE KEPT ON THE PREMISES) Name of Event : 'Private Wedding Permit-No. : SPV 2a Type(s) of Event : Wedding Location-of Event Sparkling Point Vineyard Date(s) of Event : September 27., 2019 Time of Event : 12:00 PM 11:00 PM (THIS REKNIT MUST BE KEPT ON THE PREMISES) Name of Event : Private Wedding Permit No. : SPV 2b jype(s) of Event : Wedding to,cafi,bn of,Evght : Sparkling Point Vineyard Date(s) of Event : October 4, 2019 Time of Event : .12:00 PM - 11:00 PM VQ) ZFECOZ4L PERNEW �THM PERWT MUST BE KEPT ON THE PREWSES) Name of Event : Private Wedding Permit No. : SPV 2c Typ6(s),of,Eveht : Wedding Location of Event : Sparkling Point Vineyard Date(s) of Event : October S, 2019 Time of Event : 12:00 PM - 11:00 PM RECEIVED . ) Z= � M Ay 7 2019 Southold Town Clerk TOWN OF SOUTHOLD Town Code Chanter 205 "Public Entertainment and Special Events" SPECIAL EVENT PERMIT INSTRUCTIONS AND APPLICATION FORM Applications for a Special Event Permit are subject to an inter-departmental coordinated review by the Southold Town Board,Town Attorney,Town Assessors,Land Preservation,Building,Planning,Zoning Board of Appeals and Police Departments,and the Suffolk County Planning Commission. Application fee: $150.00 per application.Up to six(6)multiple events of the same type, occurring over a period of three months,may be permitted on one(1)application for a fee of$150.00. However,specific details of each event must be included with this application. All applications must be submitted at least 60 business days before the event. Applicants are encouraged to submit applications as early as possible. Any completed application that is not submitted 60 or more business dans prior to the scheduled event may be rejected or suhiect to a late�processing fee of$250.00 by the Office of the Town Clerk, unless a waiver is obtained. Requesting an expedited review must be submitted in writing to the Town Clerk The Town Clerk will forward all applications to the Special Events Committee for processing. The Committee will obtain comments on all applications from relevant Town, County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. The Town reserves the right to request additional information from an applicant to address issues related to the health,safety,and welfare of the community. When is a Permit Required? All Special Events,per Southold Town Code Article I, Section 205-2(Definitions)must obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits. Any use of residential proyerty for profit;such as a venue for weddings or other events is prohibited. This application is deemed complete once all the following requirements are-submitted to the Town Clerk: Please indicate submission of the following by-checking off the boxes and signing below. A completed application form signed by the owner and the event manager. Applications without property owner's signature/approval will be rejected. \P1 \I FEE: Is the application being submitted at least 60 days before the event�J Yes [ J No C If Yes,Fee of$ 1 has been submitted ❑ If No,Fee of$ has been submitted The applicant/owner of the property where the special event is proposed to take place must provide a .certificate of insurance not less than 2 million dollars naming the Town of Southold as an additional- insured A-Parkin JEvent Plan: consisting of a survey,site plan and/or aerial view of the subject property that includes the locations of on-site parking, sanitary facilities, and tents or other temporary structure(s). (See application form for details) Events for three hundred (300) or more people require submission and approval of a traffic control n acceptable to the Town of Southold AND a qualified traffic controller must be provided at the eve (See application form for details) Signature of Property Owner on the application authorizing Code Enforcement Personnel of the Town of Southold to enter the subject premises during the hours of the event to ensure compliance with any and all special event permit conditions. My signature below affirms that l have submitted all th ' formation required above in connection with my application. q I d -st (LI ,--- Dated Si ature y/ oII 1and� cc��/�' ���s Activities associated with outdoor public events are strictly prohibited from taking place on land preserved through the sale of development rights to the Town of Southold, and can only take place on land preserved through the sale of development rights to the County of Suffolk with a permit issued by the Suffolk County Farmland Committee. If food is to be served, it must be catered and prepared off-site by food vendors who hold a permit to operate issued by the Suffolk County Bureau of Public Health Food Protection Unit. RECEIVE® f APPLICATION FOR A PERMIT TO HOLD A MAY 7 2019 SPECIAL EVENT Spa-Q, I �RW Town Vrr " Please provide ALL of the information requested below.Incomplete applications M9L a _. reviewed. i Special Event Permit# Applicant(s)name:,C--) n CA Date of Submission Ad 6 1 n;45 -]ame of Eventpr `C_ S Q SCTM#'s 1000-Section 0 Block- Q Lot(s) Dates of Each Event: &Opplic 0 UjQ- �If Multiple Dates are requant must give al information for 11 dates. Nature of Event:�U r �nGI S (Please attach a detailed descrig�tion of EACII event to this application) Time Period(Hours)of Event: From\ V-I f,,� to �'� I M Town Services request ( )Yes / No If yes,Describe Police Dept. Highway Dept. Describe Services - C�U�.SfS Maximum Number of Persons Attending At One Time: Number of cars expected 0--16 Yv70: J c( to Is a Tent or other temporary structur being used? ]Yes[ ]No ye,krovide size(s) 1�S m I1"of I 6�- 'tw 'r-3 G� (,OX cY 7,0?c lQ Or ZfJI<Z4 IL W�1+�^i be served? ]Yes [ ]No If yes provide number and name(s)of food vendor(s)sec cL z-cKjyJ Suffolk County permit#(s) Will other vendors be on the premises during the event!]Yes [ ]No If yes how many? YeS Describe Type of vendors)I-i LA(a1,11pff<)4ffl�S__ Ajv Property Owner(name/address): P=n( CL) M l 10 &WL�u 1jI Contact Person and Contact Tel.# Pwa rX a c2��Su_'�k-_1 e-mail address IESki @ GOO LI ince Doi h+Q-' Event Location:Street-Hamlet Address: -7- T ISS' -I S01 l Vy ( 19� I SCTM# 1z �� � G,3 ah WI—) Will any sere' es be requested [ ]Yes )(No. If Yes describe Police Highway Other: Nf 14 Mailing Address to Send Event Permit to: �q��� W`f l Have any of the development rights been so d t the Town of Southold[ ]Yes ]No and/or Suffolk County Agricultural Program? [ ]Yes No If Yes to either or,boft also cate on the attached•than the boundaries of the reserved r ulion which the event will take place. YOU MUST ATTACH A PARKING/EVENT PLAN TO THIS-APPLICATION IF THE, EXPECTED ATTENDANCE IS-300 OR-MORE_PEOPLE,XOU MUST ALSO ATTACH A TRAFFIC CONTROL PLAN(see next:page) A ParldnWEvent Plan mav'be a survey,site plan and/or aerial view(for-.example Google Earth)of the subiect tiropei-tVINDICATE ON THE PLAN ALL of the foIIowinp__information: A parkinglevent plan showing: (1) The size of the property and its location in relation to abutting streets or highways. (2) The size and location of any existing building(s)or structures)that will be in operation during the course of the event and any proposed building,structure,or signs to be erected temporarily for the event. (3) The location of the stage or tents,if any. (4) The designated areas of use for spectators,exhibitors,vendors,employees and organizers. (5) Location of all entries and exits. (6) The location of all fire extinguishers and other fire safety equipment. (7) The location of all temporary utilities to be installed for the event,if any. (8) The layout of any parking area for automobiles and other vehicles and the means of ingress and egress for such parking areas. The parking spaces must allow for 300 sq.ft. per car. (9) A traffic control plan for vehicles entering and leaving the site for the proposed event. (10) Plan for the use of live outdoor music,loudspeakers and other sounds which will be used, if any,and the type and location of speakers and other audio equipment. (11) A description of emergency access and facilities related to the event. (12) Provisions to dispose of any garbage,trash,rubbish or other refuse. (13) Location and description of any additional lighting to be utilized in conjunction with the event. (14) Location of sanitary facilities on site. Traffic Control Plan Events for three hundred(300)or more people also require submission and approval of a traffic control plan,acceptable to the Town of Southold,AND a C ualified traffic controller must be provided.-Please attached a written description and/or notate on the parking event plan the following: i)Who will be conducting traffic,2)Where they will be stationed on site,3)How they will direct the entrance, circulation,parking,and exiting of cars on site,and 4)Contact information for use by Southold Town Police. OWNER'S SIGNATURE: I am the Owner of the Property where this event is to be held and I agree to comply with the laws, rules,regulations,conditions,and requirements of the Code of the Town of Southold,including but not limited to the conditions listed below,as well as all other applicable agency rules and regulations pertaining to the activities under this event. Furthermore,I hereby swear or affirm that the information contained herein and attachments hereto are true and correct to the best of my knowledge, and agree to provide notice to the Town immediately should there be any material changes regarding to this application.. Furthermore,I hereby authorize Code Enforcement Personnel of the Town of Southold to enter the property during the hours of the permitted special event to make y and all in tions necessary in connection with this Special Event � St G zl Print name of Owner i ature Owner Am wI - aarhoc Print name of Authorized Person/Representative ignature f Authorizn3nlRepresentative PERMISSION IS HEREBY GRANTED, SUBJECT TO THE FOLLOWING CONDITIONS: 1. By acceptance of this permit, applicant agrees to adequately supervise and direct all parking to be on the premises or at another site, and to provide parking assistants and any additional traffic controls necessary for this event. Parking1s,strictly prohibited on ANY Town.County or State Roads or Rights of Way. 2. Traffic control at events for three hundred(300)or more people shall be provided by a qualified traffic controller in accordance with the attached,approved traffic control plan. 3. One "on-premises" sign not larger than six (6) square feet in size may be displayed not longer than thirty (30) days before this event, and removed immediately after the event. Directional parking signs shall be adequately displayed. 4. Applicant indemnifies and holds harmless the Town of Southold from all claims, damages, expenses, suits and losses including but not limited to attorney's fees arising from activities under this permit. 5. Tent proposals must receive permit approval from the Southold Town Building Inspector before placement on the property and must meet all fire and safety codes. 6. This permit is valid only for the time, date, place and use specified above, and for the designated event. Each additional day will require a separate permit application, fee, and related documents for review,etc.at least 60 business days.-prior to the scheduled event. 7. Adequate temporary sanitary facilities must be provided by applicant for this event and applicant agrees to remove the temporary facilities from the premises within 48 hours after the day of the event. 8. On-site food-preparation is NOT permitted, although food may be-catered subject to all Suffolk County Department of Health regulations. 9. NO activities associated with this event, including but not limited to parking._inQress/egress/access, tent(s)or temporary structurefs).or temporary sanitary facilities.shall be conducted on Town of Southold Purchase of Development Rights land. 10. NO activities associated with this event;including but not limited to parking; ingress/egress/access. tent(s) or temporary structure(s), or temporarw sanitary facilities, shall be conducted on Suffolk County Purchase of Development Rights land without a permit issued by the Suffolk County Farmland Committee. 11.Issuance of this permit does not authorize in any manner the occupancy of any building exceeding the legal limitations under the fire code or other codes which would prohibit such increased occupancy. 12. Access shall be provided for emergency vehicles, to all public assembly areas,all buildings,all work areas and any additional area where emergencies may occur. Two emergency-fire exits and exit paths from the building(s) on the property, to a public way or remote safe area, shall remain open and unobstructed at all tunes. 13. Owner assures full compliance with all fire,safety,building,and other Town laws. 14. Music,when outdoors,is required to stop at the time specified in the pen-nit.Placement of the speakers must be in a location that affords the greatest protection from noise intrusion upon adjacent properties. 15. Owner will allow access to Code Enforcement Personnel of the Town of Southold during the hours of the special event to make any and all inspections necessary in connection with this Special Event. 16. ADDITIONAL CONDITIONS: ANY VIOLATIONS IN CONNECTION WITH THE CONDITIONS LISTED HEREIN WILL TERMINATE THIS PERMIT. APPROVED Town of Southold Resolution Number: _ Date Issued: SQ�o SITE DATA ,"a`"•,,;^"1 .. .rnr. INe>Ala1" INwcwlmrre • fINNe11 __-���p�b 1 tt� ` � •• IBR rU 0d�"�NI� 1 rawo AC ul.Irm ..� SEE ENLARGED SITE �J'] a LB !`7�`J} 9 uu n W tANsxEEre zoNwn u lJ �..r..m... ..aa . AC ®o _ N°Y+1O00R1Ot�un"mn .Z z \ .uNN4R�Y lY.YrYn I�iLA�N Wrwa 'fu `— 0 ~ C ?— �`"' "` '° LOCATION MAP 0 SLB 1 + �J/c owl I1/ ow 11x1+"1 Power/ .� \ \ - � •+ < (� I� Z S I LI 1 1 I\ va1N N _ — / I\_ jL o If O I I \ PARKING CALCULATIONS N \ � II n.�1rm.RaY�IeR+NnamnTlmf� Elml® II_ o,.o...,�,N � 4"RWEIrm 1108 im _•uu\�fe ��\.\.\� / SU NBY:N88If of \ • MJ m. [A 1011 SO4GL& 1•.ICO'S SITE PLAN ; � ��:;e SNE[TT RE SCALE:1'a 100•-0" ""�100'1f1 OVERALL SITE PLAN 9NlETRP 1 � ! SITE PLAN APPROVAL-AMENDED e I REVISED I ��� 19TN6 DRIVeRAY GL05t:p Oge0er a4 Mn 1 SERENBFq Je,tDJf ! -- OUNTY ROAV 4S NORTH ROAD O NEW uuiw�na P O WP.191 � EXIST. O NTRY C J u } X. Y W" 5 W /1i J Deet 9T I - LU p O F- o z V EXIS ( , av -COO O ENTRY AND Q, oEXIT R ljzB.�•E apyFe .�^• S:` tw e r a IM. a Z 1 "= � aNMreVir-. _ - - W - -8 Gmm-A j u 1 J Ya• I � hof• ac a u. •It"Va "mm ,,�e arlau nn` VI �J p!I emr�ao.e ~ NOTEI \IaamoE a�or�w� SEE III FOR TArN FFMTPTMTFT OVER7SITE FLAN . I I r na I LAI I . nN r'N9tK I 1``11 lllllll [ . $ fJ1ECRp°h RwIENmg rer r•.IR 4TIONa• 1 "TL AAE . ]9• / TxRreoE AVA=IwrAu.wven eAeraq ° T-•ErJr PARTIAL SITE PLAN RusHNa AD IrJ.,A.beeaR „ ,Tmx I APPROVED BY yy�e1� �tuearr rAarw SCALE:1 e yD•.D• FW1NMa IOAW �mA•A• r ..vwma u.TIDa R ENLARGED rowel or fourllolo "''m reMeY:rM.rl•NIINNN, 1e1ACAErA SITEPARKNG CALCULATIONS PLAN RTVIAA m ROOF BTRIICRIRF UMSTING RDA • ROOMRflMfaa frfM 1FIyr ante"Wn RAJaE RuIee•01nI rrAraCr rnOY. NE,NSTORAG fTqMWNFWCRUEFyIPOOUCTIMA f+RfrswfaesA� uslAme veE•m rmeNErRlarremrrooE TOlAI IARNNOSIAaae REL{N®aEl oR ar bAtEf mla�wEm ewet�N.R ITOIAl IAgI°e0 e1AC[f IREVDeDNpARa aOWR aRfMR `i"� 517E PLAN APPROVAL.AMENDED `` SPARKLING POINTE METH 0DE CHAMPENOISE Nature of Event Description: Sparkling Pointe holds private events and weddings on site. When applicable,tents are set up in the back of the building. However, not all events require tents. Restrooms are contained inside of the building. During these weddings and special events, we are closed to the public.All weddings and privat vents end no later than 11pm. anda Czartosieski Private Events Manager Sparkling Pointe Vineyards and Winery • � e • 39750 COUNTY ROAD 48. SOUTHOLD, NEW YORK 11971 p. 631.765.0200 • F. 631.765.5264 www.sparklingpointe.com SPARKLIN' G POINTE METH 0DE CHAMPENOISE To Whom This May Concern: Please accept this application for Special Events/Weddings to be held at Sparkling Pointe. It is our goal to obey the rules and of course be respectful of our neighbors during all events.All private events held at Sparkling Pointe will end no later than 11pm. We do not allow weddings and private events to have guests exceed our approved indoor occupancy. Please let me know if I can be of further assistance. I can be reached any time via email at aczartosieskiPsparklingpointe.com or at the office at 631-765-0200. Amanda Czartosieski Private Events Manager Sparkling Pointe Vineyards and Winery 0 39750 COUNTY ROAD 48. SOUTHOLD, NEW YORK 11971 p. 631.765.0200 ® f. 631.765.5264 www.sparklingpointe.com 39750 Middle Rd-Google Maps 4/4/18,10:16 P Go(-)gle Maps 39750 Middle Rd 48 48 l N4 ' .b yy • ' y� a ...y i�_ �' �'�,k ...t ' IVY 41 Ae WWI iL 1b a y +• ' P • - Imagery 02018 New York GIS,Map data 02018 Google 20 ft � ( , �,V.� G I e 111 �1 GX.Vt " f CUV cJ2,S r-�Fp ev oAA 2 o co-ly-s w'� 4-k oYv%v-� w +�/� fie,s uw l �- block- n 9 +Y a P( https://www.google.com/maps/place/39750+Middle+Rd,+Southold,+NY+11971...sOx89e89a3947363969:Ox9f513cdde712eddf!8m2!3d41.0619034!4d-72.4450352 Page 1 of 1 �.a,.�.,�a.�..�b,�.�,o,��.�.a,�a,�.,oa.�.�.�.,aa,�a.�,�.�,o..,oa.�,.�. ,� .a,�.a .�a.�.�.,�.a,�,�.,a„�.a.,�.a,�,a.� .m.. .�.�,•e,� .. GYiAe?��i� 2 .01: 9 - 2020 Y�'�1'S' ,yen '.� d� a �r '.�\.�. v � f CREEKSIDE CATERING Y t'� Restaurant: La Plage � a. :• " p. (631) 744-9200 t ,!T'x`t '�, Z ,A�,� 4¢,�••v.,fi tib:�5 ,•, aM :e �. laplagerestaurant@yahoo.com www.laplagerestaurant.com 1 [ Contact: Aubrie Goss-Bohrer „' :. .• .x, EAST END EVENTS CATERING, INC. I Restaurant. CJ's American Grill p. (631) 356-5078 cjagr@optonline.net ` — A. eastendeventscatering.com '' 1 ?' i"j'<' Contact: Chris Richards j ' , � may.<. yaa•µ S! GRACE & GRIT EVENTS Full Service Catering and Event Planning p. (631) 876-5221 stephanie@graceandgritevents com a •`ti `'-': www.graceandgritevents.com j 3 j w ��. :.�-ter '?`^,; .•',;;;��'•��' „�" Ip � °" `' Contact: Stephanie Pincar-Coleman ! ° f, e„ t, 1 }I i i �_� �• 3 �;I''' .�,. ,Wia �� � IRISH COFFEE PUB CATERING I "" �, v' .� e, '; ;,<• i Restaurant: Irish Coffee Pub lam ' p. (631) 277-0007 s."'y�r catering@irishcofFeepub com www.irishcoffeepub.com t t. Contact: Stephen Mahood PLATED SIMPLY Full Service Catering and Event Planning j a p. (631) 298-7077 events@platedsimply .�� www.platedsimply.com ! Contact: Liz Werkmeister fyf 1 i , 1 •owowamo.�waaeoeawww.w•owwwwrowoaooa+oow,oroww<eoew�oeaeoeeee,»aeroww+erow•oeoeoow.oxv0000ewoeoowvoowww000w•ooavvwvuoaoovewoww+aeeeroww•000eu00000wawocooeoaovow,wvroeueeeeeevemw.waw.wavwwrowe.<aeeeeoeroaw�000evroxwaooeaw+oo DENISNONCARROW a, .; Town Mall Chairperson : ,, .° }° ~~,t4°:, 53095 Route 25 vp denisn@asoutholdtownny.-ov `s" Southold, NY 11971 Office: (631) 765-5806 SPECIAL EVENT COMMITTEE TOWN OF SOUTHOLD Dear Property Owner or Event Planner: On July 3,2018 the Southold Town Board amended Chapter 205 of the Town Code, "Public Entertainment and Special Events." As a result, a special event now applies to all properties in Southold Town,not just the wineries, and is no longer related to the legal occupancy of a building, or whether it is held indoors or outdoors. Rather, the current definition describes a special event as any activity that is currently not a permitted use of the property in the applicable zone district or that exceeds the existing parking capacity on site. For your convenience, I am enclosing a copy of Chapter 205-2-Definitions. The entire chapter dealing with special events may be found on the internet at https://ecode360.com/5159441. In addition, a list of permitted uses for each Town zoning district can be found online at https://ecode360.com/51_61767. A link to the Town Code can also be found on the home page of the Town's website. In response to these changes,the instructions and application form for obtaining a permit to hold a special event have been updated which we are enclosing herein for your information. Copies are also available as a downloadable file from the Town's website. These forms are very similar to those previously used but include revisions to the fee schedule and time frame for submission, and explain when a permit is required,how to fill out an application,the regulations that have to be followed, and how an application is reviewed by the Chairperson and the Special Event Committee.Please note that applications are no longer to be submitted to the Office of the Zoning Board of Appeals but rather the Office of the Town Clerk, and that final decisions are now made by the Southold Town Board. If you have any questions about the activities or even at now require a special event permit,or if we can be of further assistance,please feel a to c nta't us. ricer enis Noncarrow Chairperson Special Event Committee Town Hall Annexi; Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 rf t P.O.Box 1179 �y ' Southold,NY 11971-0959 v wz. A 3X; BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR A TENT PERMIT FEE: $50.00/TENT DATE: SCTM41000- - SUPPLIER OF TENT: A x., ADDRESS: i? PHONE No. PROPOSED TENT USE: SIDES: ),YES ( )No 3 DATE ERECTED: USED: :.REMOVED: SvE.O'TENT/COLOR(APPLICATION REQUIRED FOR EACH TENT): , FLAME RETARDANT CERTIFICATE: ( ) INCLUDED ( )ON TENT TENT LOCATION: OWNER OF SITE: TELEPHONE NUMBER AT SITE: MAILING ADDRESS OF CLIENT: THIS PERMIT IS VALID FOR DAYS FROM THE DATE ERECTED. SPECIAL EVENTS PERMIT REQUIRED? R NO ❑YES PERMIT# ( ) APPROVED ( ) DISAPPROVED BUILDING INSPECTOR DATE TentApp-19 Town of Southold, NY Thursday,January 31,2019 Chapter 205. Public Entertainment and Special Events Article I. General Provisions § 205-2. Definitions. As used in this chapter, the following terms shall have the meanings indicated: PARKING CAPACITY For the purposes of this chapter, parking capacity shall be the number of cars, limousines or buses permitted on the site according to a site plan approved by the Town of Southold Planning Board. SPECIAL EVENT Any temporary gathering, demonstration, performance, exhibition, amusement or activity that is not currently a permitted use of the property in the applicable zoning district or which requires a parking area to accommodate all vehicles transporting attendees to the event that is larger than the existing parking capacity of the site that is conducted or sponsored, by a person, organization, entity or association, including, but not limited to, carnivals, circuses, fairs, bazaars, outdoor shows and concerts, parades, walks, runs, marathons, bicycle races or motorcycle rallies, which may involve one or more of the following: A. The closing of a public street. B. The use, blocking or restriction of Town property, roads or rights-of-way; C. The use of amplified sound exceeding the standards set forth in Chapter 180 of the Town Code. D. The sale of merchandise that is not ordinarily sold in the normal course of the applicant's business. E. The sale or service of food to the public with the exception of the following: (1) On land used in agricultural production, the sale or service of food products composed primarily of ingredients produced on site; or (2) On land used in agricultural production that maintains a winery or farm winery license issued by the New York State Liquor Authority, the sale or service of food items which customarily complement wine tastings and that are ordinarily consumed while standing or walking and without the need for utensils. F. The substantial increase or disruption of the normal flow of traffic on any street or highway. G. The placement of portable toilets. H. The placement of temporary no-parking or directional signs or banners. 1. The use of any Town services that would not be necessary in the absence of such an event. SPECIAL EVENT COMMITTEE The Special Event Committee, also referred to in this chapter as the "Committee" shall review applications forwarded to it by the Town Clerk's Office. The Committee shall make determinations as to the completeness of the application, request further documentation as it deems necessary as set forth in this chapter, and make recommendations to the Town Board as to whether the application should be granted or denied. The Committee shall consist of: the Government Liaison Officer, who shall act as the Chairperson; the Chairperson of the Zoning Board of Appeals or his or her designee; the Planning Director or his or her designee; the Chief of Police, or his or her designee, and; the Chief Building Inspector, or his or her designee. The Town Attorney shall act as counsel to the Committee. The Town Board shall appoint a secretary to assist the Committee in the processing of applications. ACC) o® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1 04/23/2019 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(les)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 Matthew Daley Farm Family Insurance a/c°"no Ext 631-744-3350 A No:631-744-3383 85 Echo Ave-Suite 2 E-MAIL l matt.dae farm-famil ADDRESS: matt.daley@farm-family.com Y Miller Place, NY 11764 INSURERS AFFORDING COVERAGE NAIC# INSURERA: Farm Family Casualty Insurance Co. 13803 INSURED INSURERB: United Farm Family Casualty Insurance Co. 29963 Sparkling Pointe LLC/Threshold Blue LLC INSURERC: 39750 County Road 48 INSURER D: INSURER E: Southold NY 11971 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 SUER POLICY NUMBER MM/DDPOLICY EFF POLICY EXP LTR /YYYY D MM DNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY x 3101X7436 08/31/18 08/31/19 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ❑X OCCUR 08/31/19 08/31/20 PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 X POLICY F—I JEST 7 LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER $ B AUTOMOBILE LIABILITY 3101C3305 08/31/18 08/31/19OMBINeDtSINGLELIMIT $ 1,000,000 (Ea accid FANY AUTO 08/31/19 08/31/20 BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY x AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY Per accident A X UMBRELLALIAB x OCCUR 3101E2535 08/31/18 08/31/19 EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS-MADE 08/31/19 08/31/20 AGGREGATE $ 10,000,000 r_TDED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I I ER ANYPROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? N/A (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) THE TOWN OF SOUTHOLD IS LISTED AS AN ADDITIONAL INSURED ON POLICY 3101X7436. CERTIFICATE HOLDER CANCELLATION TOWN OF SOUTHOLD 53095 ROUTE 25 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE SOUTHOLD, NY 11971 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 05/07/19 Receipt#: 253855 Quantity Transactions Reference Subtotal 1 Event Fee SP2a-c $150.00 Total Paid: $150.00 Notes: 9/27/19 wedding 10/4/19 wedding 10/5/19 wedding Payment Type Amount Paid By CK#2003 $150.00 Sparkling, Pointe L L C Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Sparkling, Pointe L L C 39750 Cr 48 Southold, NY 11'971 Clerk ID: SABRINA Internal ID.SP2a-c Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 05/07/19 Receipt#: 253855 Quantity Transactions Reference Subtotal 1 Event Fee SP2a-c $150.00 Total Paid: $15000 Notes: Payment Type Amount Paid By CK#2003 $150.00 Sparkling, Pointe L L C Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Sparkling, Pointe L L C 39750 Cr 48 Southold, NY 11971 Clerk ID: SABRINA Internal ID.SP2a-c