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North Fork Country Club
Vendor No. Check No. Town of Southold, New York - Payment Voucher Vendor Name Vendor Address Entered by North Fork Country Club PO Box 725 Cutchogue, NY 11935 Audit Date Vendor Telephone Number 631/734-7139 ext 1 Town Clerk Invoice Invoice Invoice I I Net Purchase Order Number Date Total Discount !Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number i 2020-456 8/2/2020 400.00 j ; 150.00 ref special event fee B.2590.40 _ 250.00 ref event late fee B.2590.40 I � " ! i I Total j 400.00 Payee Certification Department Certification The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing,and that taxes from which the Town is exempt are excluded. or discrepancies note payment is approved. A zj� Signatur 'Title:Deputy Town Clerk Signa re '„ Company Name Date 7/23/20 Title:Deputy ToL Clerk Date.7/23/20 Southold Town Board- Letter Board Meeting of July 28, 2020 4 wFFo4c RESOLUTION 2020-456 Item# 5.12 ADOPTED DOC ID: 16307 i I THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2020-456 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JULY 28,2020: I RESOLVED the Town Board of the Town of Southold hereby ratifies the resolution granting) permission to the North Fork Country Club for their Annual Golf Tournament in Cutchogue for a limited closure of Moore's Lane, from the Main Road to the southerly line of the"Country Club ' Estates" subdivision, total closure from that southerly point south to the northern line of the William Tyree land parcel, and limited closure from that point south to the intersection of Moores Lane and New Suffolk Avenue (closures would permit access to residents of Moores '! Lane and"Country Club Estates"), on Friday, July 24, 2020 from 8:00 AM to 5:30 PM and } Saturday, July 25, 2020 from 8:00 AM to 2:00 PM provided they adhere to the Town of Southold Policy for Special Events on Town Properties and Roads. They must notify Capt. 1 Kruszeski immediately upon the approval of this resolution to coordinate traffic control and be it further RESOLVED that all fees paid by North Fork Country Club be refunded, as this event was not-la Special event but a road closure. The event fee of$150.00 and the $250.00 late file fee charged for special events for a total refund of$400.00. - j I Elizabeth A.Neville Southold Town Clerk I RESULT: ADOPTED [UNANIMOUS] MOVER: Robert Ghosio, Councilman SECONDER:Jill Doherty, Councilwoman AYES: Nappa, Dinizio Jr, Doherty; Ghosio, Evans, Russell 1, I j it - � 1 I i ' I I i, I Generated July 31, 2020 Page 22 - i I M1 'I Town of Southold P.O Box 1179 Southold, NY 11971 i L * * RECEIPT * * * Date: 07/09/20 Receipt#: 271477 Quantity Transactions Reference Subtotal 1 Event Fee nfcc1a $150.00 Total Paid: $150.00 Notes: Payment Type Amount Paid By CK#043594 $150.00 North, Fork Country Club Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: North, Fork Country Club Pob 725 Main Road Cutchoque, NY 11935 Clerk ID: LYNDAR Internal ID:nfccla A Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 07/09/20 Receipt#: 271478 Q Quantity Transactions Reference Subtotal 1 Late Fee nfcc1aa $250.00 Total Paid: $250.00 Notes: Payment Type Amount Paid By CK#043595 $250.00 North, Fork Country Club Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: North, Fork Country Club Pob 725 Main Road Cutchoque, NY 11935 Clerk ID: LYNDAR Internal ID*nfcclaa Southold Town Meeting Agenda- July 28, 20 Page 11 ❑ Supt Hgwys Appt ❑ No Action ❑ Lost 2020-456 CATEGORY: Close/Use Town Roads DEPARTMENT. Town Clerk Road Closures for North Fork Country Club Annual Golf Tournament Financial Impact: Police cost for event-$895.28 RESOLVED the Town Board of the Town of Southold hereby ratifies the resolution granting permission to the North Fork Country Club for their Annual Golf Tournament in Cutchogue for a limited closure of Moore's Lane, from the Main Road to the southerly line of the "Country Club Estates" subdivision, total closure from that southerly point south to the northern line of the William Tyree land parcel, and limited closure from that point south to the intersection of Moores Lane and New Suffolk Avenue (closures would permit access to residents of Moores Lane and "Country Club Estates"), on Friday, July 24, 2020 from 8:00 AM to 5:30 PM and Saturday, July 25, 2020 from 8:00 AM to 2:00 PM provided they adhere to the Town of Southold Policy for Special Events on Town Properties and Roads. They must notify Capt. Kruszeski immediately upon the approval of this resolution to coordinate traffic control and be it further RESOLVED that all fees paid by North Fork Country Club be refunded, as this event was not a Special event but a road closure. The event fee of$150.00 and the $250.00 late file fee charged for special events for a total refund of$400.00. ✓'Vote Record-11e96lution'RES=2020-456 ❑ Adopted ❑ Adopted as Amended — ❑ Defeated ( Yes/Aye No/Nay I Abstain f Absent ❑ Tabled Sarah E Nappa ----------------- ❑ C ❑ ❑ I ❑ ❑ Withdrawn James Dmizio Jr ❑ ❑ ^❑ — ❑ Supervisor's Appt -- — ❑ Tax Receiver's Appt Jill Doherty — 4� ❑ —❑-- ❑ ❑ ❑ Rescinded Robert Ghosio i ❑ ❑ ❑�— ❑ ❑ Town Clerk's Appt Louisa P Evans ❑ ❑ ❑ ❑ ❑ Supt Hgwys Appt -- -- — — Scott A Russell Cl ❑ ❑ ❑ ❑ No Action ❑ Lost Southold Town Meeting Agenda- July 28;.. -,, Page 12 2020-457 CATEGORY: Budget Modification DEPARTMENT: Information Technology 2020 Budget Modification-Information Technologies Financial Impact: Move funds to an unfunded account RESOLVED that the Town Board of the Town of Southold hereby modifies the 2020 budget as follows: From: A.1680.1.100.200 Overtime Earnings $3000.00 Total $3000.00 To: A.1680.1.100.300 Vacation Earnings $3000.00 Total $3000.00 ✓Vote Record-Resolution RES-2020-457 ❑ Adopted ❑ Adopted as Amended - ------ -— - - -- C - - -- - - --- -.. ❑ Defeated Yes/Aye No/Nay _ Abstain 3 Absent ❑ Tabled Sarah E.Nappa ❑�— ❑ ❑ ❑ ❑ Withdrawn James Dmizio Jr - ❑ - ❑ ~- '—'l7-- —-�- -- ❑ Supervisor's Appt -- ----- --- r ---- - - --i- -- Jill Doherty ( ❑ ❑ 111 ❑ ❑ Tax Receiver's Appt _ — --- - ❑ Rescinded Robert Ghosio ❑ ❑ ❑ ❑ Town Clerk's Appt Louisa P Evans I El l— ❑ ❑ j ❑ ❑ Supt Hgwys Appt Scott A.Russell ❑ ii ❑ ❑ —� --- ❑ No Action - --------- -- ----- - ❑ Lost 2020-458 CATEGORY. Property Usage DEPARTMENT.• Recreation Approve Use of Downs Farm RESOLVED that the Town Board of the Town of Southold does hereby grant permission to the Wilderness Traveling Museum to use Downs Farm for nature programs for children on Monday, August 3 through Friday, August 7 from 9:00 a.m. - 3:00 p.m. Applicant has filed a Two Million RESOLUTION 2020-456 ADOPTED DOC ID: 16307 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2020-456 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JULY 28,2020: RESOLVED the Town Board of the Town of Southold hereby ratifies the resolution granting permission to the North Fork Country Club for their Annual Golf Tournament in Cutchogue for a limited closure of Moore's Lane, from the Main Road to the southerly line of the "Country Club Estates" subdivision, total closure from that southerly point south to the northern line of the William Tyree land parcel, and limited closure from that point south to the intersection of Moores Lane and New Suffolk Avenue (closures would permit access to residents of Moores J Lane and "Country Club Estates"), on Friday, July 24, 2020 from 8:00 AM to 5:30 PM and Saturday, July 25, 2020 from 8:00 AM to 2:00 PM provided they adhere to the Town of Southold Policy for Special Events on Town Properties and Roads. They must notify Capt. Kruszeski immediately upon the approval of this resolution to coordinate traffic control and be it further RESOLVED that all fees paid by North Fork Country Club be refunded, as this event was not a Special event but a road closure. The event fee of$150.00 and the $250.00 late file fee charged for special events for a total refund of$400.00. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Robert Ghosio, Councilman SECONDER:Jill Doherty, Councilwoman AYES: Nappa, Dinizio Jr, Doherty, Ghosio, Evans, Russell J ` RECEIVED JUL - 9 2020 r Southold Town Clerk TOWN OF SOUTHOLD Town Code Chapter 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 days prior to the scheduled event may be rejected or subject to a late processing fee of$250.00 by the Office of the Town Clerk, unless a waiver is obtained. Requesting an expedited review must be submitted in writing to the Town Clerk.The Town Clerk will forward all applications to the Special Events Committee for processing. The Committee will obtain comments on all applications from relevant Town, County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. The Town reserves the right to request additional information from an applicant to address issues related to the health, safety,and welfare of the community. When is a Permit Required? All Special Events,per Southold Town Code Article I, Section 205-2 (Definitions)must obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits. Any use of residential prope , forrp ofit; such as a venue for weddings or other events is prohibited. This application is deemed complete once all the following requirements are submitted to the Town Clerk: Please indicate submission of the following by checking off the boxes and signing below. ❑ A completed application form signed by the owner and the event manager. Applications without property owner's signature/approval will be rejected. ® FEE: Is the application being submitted at least 60 days before the event [ ]Yes [ I No ❑ If Yes,Fee of$ has been submitted LA If No,Fee of$ 1,1"P.v e has been submitted Updated 8n12018 APPLICATION FOR A PERMIT TO HOLD A SPECIAL EVENT Please provide ALL of the information requested below.Incomplete applications WILL NOT be reviewed. \ 1 Special Event Permit# Applicant(s)name: N®r-}� �r CoO��r CV-3 b Date of Submission - 7 Z�j Name of Event SCTM#'s 1000-Section Block- Lots) Dates of Each Event: -71 1.0 -7 L T 9.0 If Multiple Dates are requested, applicant must give all information for all dates. Nature of Event: 6—,a `� 77N%%4 r N G w- 4-� (Please attach a detailed description of EACH event to this application) 7 z-K: il-Nw. - 5"'.10 e Time Period(Hours) of Event: From to Town Services requested: ( )Yes ( )No If yes,Describe Police Dept. Highway Dept. Describe Services �y c�� C.,\osy N%-e C MOy r P-s L,At N at) Maximum Number of Persons Attending At One Time: l Z0 Number of cars expected Is a Tent or other temporary structure being used? [ ]Yes [ No If yes provide size(s) Will food be served?[ ]Yes [ ]No If yes provide number and name(s)of food vendor(s) Updated 8/7/2018 1 LThe 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 Parking/Event 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 Ilan acceptable to the Town of Southold AND a qualified traffic controller must be provided at the event. (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 I have submitted all the information required above in connection with my application. -7 '1 ZD Dated Signature G c� 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. Updated 8/7/2018 Suffolk County permit#(s) Will other vendors be on the premises during the event?[ ]Yes [VJ/No If yes how many? Describe Type of vendor(s) �^ Property Owner(name/address): 14r `�o�� J r cv3 Contact Person and Contact Tel.# c��- hc.o� �J {L�'L &:3: 7 3 !'-' -7 t 3 ` e-mail address pV,e.'% tapr Cgs W'. �^ \ Event Location: Street-Hamlet Address: 1"\o o re-, J W'r1 ,L SCTM# Mailing Address to Send Event Permit to: 4 2— MC,,Q Have any of the development rights been sold to the Town of Southold [ ]Yes [)]No and/or Suffolk County Agricultural Program? [ ] Yes [X]No If yes to either or both; also indicate on the attached plan the boundaries of the reserved area upon 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,YOU MUST ALSO ATTACH A TRAFFIC CONTROL PLAN(see next page) A Parking/Event Plan may be a survey, site plan and/or aerial view (for example Google Earth) of the_subject property.INDICATE ON THE PLAN ALL of the following information: A parking/event 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 structure(s)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. Updated 8/7/2018 (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 qualified traffic controller must be provided Please attached a written description and/or notate on the parking event plan the following: 1)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 any and all inspections necessary in connection with this Special Event. Print name of Owner CC-o Signature wner jwv��1-�p� tom• -S�Ott-�Z- i�- Print name of Authorized PersonAepresentative - ignature of orized Person/Representative 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. Parking is 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. Updated 8/7/2018 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, ingress/egress/access, tent(s)or temporary structure(s) 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, tents or temporary structure(s), or temporary 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 times. 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 permit.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: Updated 8/7/2018 NORTFOR-14 JSCHNECK '4�vRo® CERTIFICATE OF LIABILITY INSURANCE DATE 7/8/2 D/YYYY) /$nozo 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: Neefus Stype Agency PHONE 711 Union Ave. (a/c,No,Ext):(631)722-3500 jXCC,No):(631)722-3591 Aquebogue,NY 11931 Ao REss:info@nsainsure.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Illinois National Insurance Co INSURED INSURER B: North Fork Country Club Inc INSURER C PO Box 725 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER DD M/DD LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR06-LX-007509385-19 12/31/2019 12/31/2020 DAMAGE TO RENTED 300�000 X PREMISES Ea occurrence $ X LIQUOR LIAB SEE REMK 15,000 MED EXP An one person) $ PERSONAL BADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 3,000,000 POLICY❑PE� LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER $ 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 LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I I ER ANY PROPRIETOR/PARTNER/E OFFICER/MEMBER EXCLUDED H N/A E L EACH ACCIDENT XECUTIVE $ (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 an Additional Insured on the General Liability Policy in regards to the Men's Invitational Golf Tournamant from 7/24/20-7/25/20 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 The The T Route S ACCORDANCE WITH THE POLICY PROVISIONS. Southold,NY 11971 AUTHORIZED REPRESENTATIVE I ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD V_$250 for events with less than 1000 expected attendees $500 for events with 1000 or more expected attendees Clean-up Fees(Cannot be waived): $1,500.00 Clean-up for Bicycle and/or Running Special events(ONLY) V$250 or more Clean-up deposit all other events CERTIFICATE OF M M A.IV .F R .O 1IRF.D: Not less than$2,000,000 naming the Town of Southold as an additional insured. ***NOTE: PLEASE SEE ATTACHED REVISED, ADOPTED TOWN POLICi'***- Additional information and requirements may be required as deemed necessary by the Town Board. A - C!eu'116� Peter Cowan , Print name of Authorized Person filling out Signature of Authorized Person filling out application application *Upomthe request by applicant,the Town Board may waive in whole or in part any of the application requirements. Revised 3/21/162 162 Neville, From: Rudder, Lynda Sent Thursday,July 23, 20Z0I0.lSAM ' To: Neville, Elizabeth Subject: RE- NFCountry Club SEPermit & road closing? � The application was received on 7/9 and sent around. I don't remember getting any replies but I remember him telling nnethe TAoffice told him toapply a,ndsee what happens. The application should beinthe pending plastic pocket inmy cubicle next tothe window Fronm: NeviUe,.E|izabeth <E.Neville @town.southold.nV.us> Sent:Thursday,July 23, Z02O10:I0AN To: Rudder, Lynda Subject: NFCountry Club SEPermit 8' road closing? Importance: High Doyou know anything about this? They said they spoke tosomeone both inthe Town Attorney's Office and Town Clerks' Office. They said they mailed their application inover two (J) weeks ago. But, | cannot find any application, permit orcorrespondence. Steve Swarza said someone in the Town Clerk's Office told him they would take care of getting aresolution onthe Town Board meeting for the road closing? Elizabeth A.Neville Southold Town Clerk, Registrar o[Vital Statistics, Records Management Officer; FOIL Officer Marriage Officer 90Box >179 ` Southold,NYl|97| Tel.63l765'}XO0,Ext. 228 Fax 631765-6145 Cell 631466-6064 / ` / ' � z ` Southold Town Board - Letter Board Meeting of April 23, 2019 RESOLUTION 2019-369 Item#5.13 ���•�,,°�� ADOPTED DOC ID: 15150 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2019-369 WAS ADOPTED A.T THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON APRIL 23,2019: RESOLVED the Town Board of the Town of Southold hereby grants permission to the North Fork Country Club for their Annual Golf Tournament in Cutchogue for a limited closure of Moore's Lane, from the Main Road to the southerly line of the"Country Club Estates" subdivision,total closure from that southerly point south to the northern line of the William Tyree land parcel, and limited closure*from that point south to the intersection of Moores Lane and New Suffolk Avenue (closures would yermit access to residents of Moores Lane and "Country Club Estates"), on Friday, July 19,2019 from 8:00 AM to 5:30 PM and Saturday, July 20, 2019 from 8:00 AM to 2:00 PM provided they adhere to the Town of Southold Policy for Special Events on Town Properties and Roads. They must notify Capt. Kruszeski immediately upon the approval of this resolution to coordinate traffic control. Elizabeth A.Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: James Dinizio Jr, Councilman SECONDER:William P. Ruland, Councilman AYES: Dinizio Jr, Ruland,Doherty, Ghosio,Evans,Russell Page 30 Generated April 24, 2019