Loading...
HomeMy WebLinkAboutNorth Fork Reform Synagogue J ELIZABETH A.NEVILLE,MMC ��' ��� r �� Town Hall,53095 Main Road ^ j si-0.livw• TOWN CLERK P.O.Box 1179 ® . Southold,New York 11971 ( REGISTRAR OF VITAL STATISTICS Fax(631)765-6145 ...• MARRIAGE OFFICER Q RECORDS MANAGEMENT OFFICER ' �� e � Telephone oldtownny.gov 765-1800 www.southoldtownny.gov OF INFORMATION OFFICER �' OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD September 6,2020 Ellen Zimmerman North Fork Reform Synagogue PO Box 1625 Southold,NY 11971 Dear Ms. Zimmerman. Enclosed please find you clean-up deposit check that you supplied for the Friday evening worship services. Very truly yours, Lynda M Rudder Deputy Town Clerk Ens. T North Fork Reform Synagogue Member of the UWon for Reform Judaism P.O:Box 1625 -,Southold,NY 11971 s• ;;.(631)f 734 2 096 May 20.2020 Re: Application for a Special Events Permit _ For the past 14 years the North Fork Reform Synagogue has held several Friday evening worship services at Kenny's Beach several each summer. The usualattendance is fifteen to twenty,thirty at the most. We assemble at 6:30 pm for a picnic followed by a service and are gone just after the sun sets,usually,by 8:00 pm. We understand that, according the town code attached to the application, a permit is required only if there are more than 50 attendees. However,we are making this application because, although the majority of attendees are residents of Southold Town and have beach parking permits, some who attend are Riverhead Town residents and do not have'parking permits. We are requesting a permit which will allow parking by non-residents for the duration of the beach services which will take place on June 19, July 10, July 24,August•7,August similar permit was granted for our services last year. We will, of course, comply with any restrictions necessary to prevent the spread-,6f C;OV,ID including appropriate social distancing and requiring attendees to wear masks. Thank you for your consideration. RECEIVE® Ellen Zimmerman JNod 2020 Chair,Religious Practices Sotatwn Clerk North Fork Reform Synagogue q17.-qe3 y z-z e i f ��g11FF04 Ell.i '-ABETH A.Ni`ILLE,MMC �s�� G,j, Town Hall,53095 Main Road TOWN CLERK P.O.Box 1179 COD Southold,New York 11971 REGISTRAR,OF VITAL STATISTICS p • Fax(631)765-6145 MARRIAGE OFFICER �jj� OZ' `lhlephone(631)765-1800 RECORDS MANAGEMENT OFFICERvoj „ `j►►a www.southoldtownnygov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION FOR A PERMIT TO HOLD A SPECIAL EVENT Please provide ALL of the information requested below.Incomplete applications WILL NOT be reviewed. Date of Submission May 20, 2020 Name of Event North Fork Reform Synagogue Beach Services Name of Organization: North Fork Reform Synagogue Is this a Not-For-Profit Event?Yes/No Yes Contact's Name: Ellen Zimmerman Mailing Address: P. o. Box 105, East Marion, NY 11939 Contact's Phone Number: 917 903 4228 Contact's Email Address: ezimmerman@naremco.com Event Location and Site Diagram: 'Kenny's Beach (Use additional paper if necessary) Event Date(s): dune 19, July 10, July 24, August 7, August 21 (Include set up and shutdown times and dates) Religious service ureceded by picnic at 13eacn. Acteraezt tc f Nature of Event: own food, wear masks and maintain social distance. (Please attach a detailed description to this application) Time Period(Hours)of Event: From G:00 to 8:15 Maximum Number of Expected Attendees: 25 Specify any special requirements(i.e. road closure,police presence): Allow Parking for Non Residents See attached letter explaining event. h 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: North Fork Reform Synagogue, P. O. Box 1624, Southold, NY 11971 Fees: $250 for events with less than 1000 expected attendees $350 for events with 1000 or more expected attendees $250 or more Clean-up deposit X NOTE: Additional deposit may be required (see attached regulations)and shall be made in an amount determined prior to issuance of the permit based upon the estimated direct costs attributable to additional police,highway and cleanup costs associated with the event. The deposit will be used to cover-such costs and any unused monies will be returned to applicant. CERTIFICATE OF INSURANCE REQUIRED: Not less than$2,000,000 naming the Town of Southold as an additional insured. Additional information and requirements may be required as deemed necessary by the Town Board. Ellen Zimmerman Print name of Authorized Person filling out Sinature o Auth ized Person mg out application application *Upon the request by applicant,the Town Board may waive in whole or in part any of the application requirements. 2 NORTFOR-43 MM GANCONA ACOR©� CERTIFICATE OF LIABILITY INSURANCE DATE(M��z712020 zo2o 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 N CNTAOCT E• Three Village Bennett Agency PHONE FAX 21 Bennetts Rd. (A/c,No,Ext):(631)403-4107 (AIC,No):(631)403-4104 Suite 103 AEon Es .info@threevillagebennettcom East Setauket,NY 11733 INSURERS AFFORDING COVERAGE MAIC# INSURER A:GuideOne Mutual Ins.Co, 15032 INSURED -INSURERB: North Fork Reform Synagogue INSURER C: PO Box 1625 INSURER 0: Southold,NY 11971 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. INSLTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS S 1D D A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,()0(),000 CLAIMS-MADE F;;r--i OCCUR X 122$102 $/7/2019 8R/2020 DAMAGE TEMISESORENTED 1,0()0,000 MED EXP(Any oneperson) 5,000 PERSONAL&ADV INJURY $ 1'()0 ,()00 GEML AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 3,000,000 X POLICY❑jmo F-1 LOC PRODUCTS-COMPIOPAGG 31000,000 OTHER- AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acadent $ ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per amdent $ HIRED NONZ AWNED P OPE% AMAGE AUTOS ONLY AUTOS ONLY era. $ UMBRELLA LIABOCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE S DED I I RETENTION$ $ WORKERS COMPENSATION I PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNERIEXECUTNE E.L.EACH ACCIDENT $ OFRCER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below -EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) insured's use of the Kenny's Beach Parking lot for Summer Religious Serivices on,rune 19,July 10 and 24,August 7 and 21,2020.Regarding the above referenced General Liability policy the Certificate Holder is included as an Additional Insured when required by written contract&only with respect to the negligent acts,errors or omissions of the Named Insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE of Southold THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town TownMain Road ACCORDANCE WITH THE POLICY PROVISIONS. Southold,NY 11971 AUTHORIZED REPRESENTATIVE W.MA7AAL 'r ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD