HomeMy WebLinkAboutShamrock Christmas Tree Farm 2020-2 a-d Southold Town Board - Letter Board Meeting of November 17, 2020
RESOLUTION 2020-753 Item# 5.9
ADOPTED DOC ID: 16564
THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2020-753 WAS
ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON
NOVEMBER 17, 2020:
RESOLVED that the Town Board of the Town of Southold hereby grants permission to
Shamrock Christmas Tree Farm to hold four (4) Special Events at the Shamrock Christmas Tree
Farm, 20685 Main Road, Mattituck as applied for in Application SCTF2a-d on December 4, 11,
12 and 13 from 9:00 AM to 5:00 PM, provided they adhere to all conditions on the application
and permit and to the Town of Southold Policy for Special Events.
Elizabeth A. Neville
Southold Town Clerk
RESULT: ADOPTED [UNANIMOUS]
MOVER: James Dinizio Jr, Councilman
SECONDER:Louisa P. Evans, Justice
AYES: Nappa, Dinizio Jr,Doherty, Ghosio, Evans, Russell
Generated November 18, 2020 Page 16
SC 1-�
RECEIVED
NOV 1 2 2020
Southold Town Clerk
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` TOWN OF SOUTHOLD
To`m Code Chapter 265 "Eublic Entex:taiininent 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.
a '
Application $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 anplicatimis inust be siffim teed pit leash 60 husiness days bUoke Eire event. Ap lln cants
are encouraged to submit applications as early as hossil)ie.
Any co ted application that is not s thmitted 60 or more business days prior to the scheilaled
5 _ $
Iin Clerk
tMess 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.
Ahy use of residential 12r_o er, for profit, such as t venue for veddings or other events is prohibited.
This al ?lication is dgemed complete once ll ahs following requirements are submitted to tine Town
Cleric• Please indicate submission of the following byghecking off the boxes,and signing b9ldw,
A completed application form signed by the owner and the event manager. Applications without
property owner's signature/approval will be rejected.
El EM- Is the application being submitted at least 60 days before the event[ ]Yes [ ]No
If Yes,Fee of$� U�9 has been submitted
❑ If No,Fee of$ has been submitted
Updated 8/7/2018
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El 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 Snuthold as an additional
El A Parkinlr/[vent 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)
S
# Events for three hundred (300) or more people require submission and approval of a traffic control
plan acceptable to the Town of Southold AND a qualified traffic controller must be provided at the
event.(See application form for details)
ElSignature 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.
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ale gnature
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
Upgated 8/7/2018
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Nov 1 2 2020
SOuthOld Town Clerk
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APPLICATION FOR A PERMIT TO HOLD A
SPECIAL EVENT
Plepse roytitlgAl�T,oftlDe anfornmation reau sted below Tncoinlplet�e applicatious
reviewed.
Special Event Permit# Applicant(s)name:J p3 e
Date of Submission�� aB.2O Name of Eventa�eye
SCTM#'s 1000-Section y7.3$F8 l-- Block-40-3- '6- I,0t(s)
Dates of Each Event: -I W% 1"L 4-z—
If Multiple Dates are requested,applicant must give all information for all dates.
Nature of Event: an a e.6-g -,10 D c u T e NR 1,5T MA6 rile, `S -
(Please attach a detailed description of EACH event to this application)
Time Period(Hours)of Event: From 1.4 r4 . to. %:� y M
Town Services requested: ( )Yes (,y)No If yes,Describe Police Dept. Highway Dept.
Describe Services E R 7T 4G M 611
Maximum Number of Persons Attending At One Time: :g" Number of cars expected_
Is a Tent or other temporary structure being used?[.Y]Yes [ ]No If yes provide,size(s)
Will food be served?[,} ]Yes [ ]No If yes provide number and name(s)of food vendor(s),E'R6T 611) 0.er:r'S
Updated 8/7/2018
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Com , . �a dt i L G Suffolk County permit#{s) P'Y
Will other vendors be on the premises during the event?[-1']Yes [ ]No If yes how many? Describe
Type ofven6r(s) N.,r 12i/-A;-ji=�,bla.'s,
GQea#optar 3-aa.KY Gq ,pe�cy;,�lio ra aa� .SR&r° iAn Ca66-7R' S
Property Owner(name/address):.5'4ps!gdW 9-- hia mAffl— 9 �ItAg'-S . pit. old" Z&--,4
Contact Person and Contact Tel.# ,j e�C% ,�' G�cd g of ;04 1 -4-g^
e-mail address
Event Location:Street-Hamlet Address: a D 6 9S _eY14 t P. R L� I?'lof.T T r✓G/ e.
SCTMN 41:73 8s 9
Mailing Address to'Send Event Permit to: g��' Lt's s
E
Have any of the development rights been sold to the Town of Southold[ ]Yes [. ]No and/or Suffolk
County Agricultural Program? [ ]•Yes [ ]No j]ry fn citbor cir hug so is dicakon
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� C_CONT,ROL PLAN,(6em '.nags
llh j �` lzi o rLy- TTTPr-'PA L,of,�lfe'follQt�jlsg 611�orn�mtiari, }
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
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(14) Location of sanitary facilities on site.
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IrAffic contmi pLn
Fvcnts for three hundred(300)or more people also require submission and approval of a traffic control
3 -
plan,acceptable to the Town of Southold,AND a qualitird traf/ir c0nti•itllc t Iblist lit:-pi•+')vitled Please
attached a written description and/or notate on the parking event plan the following: 1)Who will be
t 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.
�1 ir�S�RL£zl�A'Tlth`F•
# I ane the Owner of the Property where this event is to be held and I agree to comply with the laws,
i 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,
b and agree to provide notice to the Town immediately should there be any material changes regarding
to this applicadom.
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 Owne`'r, �JSlgruAtr. c7f 0wncr
Print name of Authorized Person/Representative Signature of Authorized Person/Representative
1�� 1CPld l:'s I� lt1?.FIY Gk��1�TTl'�)�S>113.fCCT TO'T'E :F LL01VING C'Oi-101
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. Parkin is�tri�tly��r�hil�itr d � ANY'Tnw�i,S(),t11LY tlt•Stene Roa& of
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 1.12t CO bn4`rtt:tis t�,4,rRf jt�r tri ltic scuds SI.S;�t'd11
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
s
DATE(MMID/YYYY)
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CERTIFICATE OF LIABILITY INSURANCE 09110120202ozo
THIS CERTIFICATE 1S 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
j 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 pollcy(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 Carol Losquadro
NAME:
Roy HReeve Agency,Inc, PHONE. 2 .4700 FAle`(6 ) (631,)•298-3850
Nv}:
PO Box 54 E VAIL : closquadro@royreeve.com
13400 Main Road
INSURER(5)AFFOROING COVERAGE NAICS
Mattituck NY 11952 INSURER A: Greenwich Insurance Co
INSURED INSURER B.
6
Joseph Shipman,DBA:Shamrock Plant Health Care INSURER C:
i 985 Elijahs Lane INSURER D:
� INSURER E:
Mattituck NY 11952 INSURER F'
i COVERAGES CERTIFICATE NUMBER: CL2011311787 REVISION NUMBER:
p 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
i 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,
NSR - AIJUL WUH ---- POLI Eh YOLK LIMBS
LTR TYPE OF INSURANCE INSO WYO POLICY NUMBER Mir1f40 ••LMA2 N YY _
X COMMERCIALGENERALLIABILrrY FACH OCCURRENCE S 1,000,000
._._.I
CLAIMS-MADE ®OCCUR
PREMISES(En iou�ance1 g 100,000
MED EXP(Anv one person) g 5,000
A Y NGL-1002187-00 11/30/2019 11/30/2020 PERSONAL&AOv INJURY $ 1,0001000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE A 2,000,000
POLICY ECT F-1 LOG PRODUCTS-COMP/OP AGG . 3 2.000,000
S '
_ OTHER.
AUTOMOBILE LIABILITY 'GLIF.IBirQ ,$INGLEUhIT
En nCIXdonl
ANY AUTO BODILY INJURY(Per person) $ "
OWNED SCHEDULED BODILY INJURY(per accJdent) S
AUTOS ONLY AUTOS `
HIRED NON-OWNED `PROP,ERTS'DAV,AiiE g
AUTOS ONLY AUTOS ONLY fle ntsisanl
® $
X UMBRELLALIAB OCCUR EACH OCCURRENCE S '000'000
_ A EXCESS�LIIARCLAIMS-MADE NEC-6005962-00 11/30/2019 11/30/2020 AGGREGATE S 1,000,000
OED REtCNflou 5 10'000 S
WORKERS COMPENSATION - STAUTE ER
H•
AND EMPLOYERS'LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVE NIA E,L.EACH ACCIDENT S
OFFICERIMEMBER EXCLUDED? EL.DISEASE•EA EMPLOYEE S
(Mandatory In NH)If yes,describe under
DESCRIPTION OF OPERATIONS below _ EI_DISEASE-POLICY LIMIT S
DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(ACORD 101,Additlorial Remarks Schedule,may be attached It mare space Is required)
Certificate holder Is named as additional Insured by written contract or agreement according to the terms of policy form CG 2010 0413
CERTIFICATE HOLDER 64MCELL.ATION _
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.
53095 Route 25
AUTHORIZED REPRESENTATIVE
PO Box 1179
Southold NY 11971 r fes'? �
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
New York State Insurance Fund 8 CORPORATE CENTER DR,3RD FLR,MELVILLE,NEW YORK 11747-3129
nysif.com
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
A n n n n 112523690 � ��••
ROY H REEVE AGENCY INC _
13400 MAIN RD ❑° I •.
PO BOX 54
MATTITUCK NY 11952 SCAN TO VALIDATE
AND SUBSCRIBE
POLICYHOLDER CERTIFICATE HOLDER
j JOSEPH SHIPMAN DBA TOWN OF SOUTHOLD
SHAMROCK PLANT HEALTH CARE 53095 ROUTE 25
985 ELIJAHS LANE PO BOX 1179
MATTITUCK NY 11952 SOUTHOLD NY 11971
POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE
11006 467-3 503989 04/24/2020 TO 04/24/2021 9/10/2020
THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE
' FUND UNDER POLICY NO. 1006467-3, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR
WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL
OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS ;
OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY.
IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS,
OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS:IIWWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW
YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS.
THIS POLICY DOES NOT COVER THE SOLE PROPRIETOR,PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. ;
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE
COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER
THE COVERAGE AFFORDED BY THE POLICY.
NEW YORK STATE INSURANCE FUND
DIRECTOR,INSURANCE FUND UNDERWRITING
VALIDATION NUMBER:981619538
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Shamrock Christmas Tree Farm '
i 20685 Main Road
Mattituck, New York 11952
Choose And Cut Christmas Tree's
631-298-4118
North Fork Potato Chips
2010 Oregon Road
Mattituck,New York 11952
§ 10 Varieties Homemade Potato Chips
631-298-8631
r
Harbor Lights Oyster Company
200 Harbor Light's Drive
Southold, New York 11971
r
Mr.Ted Bucci
Private Harvested Oysters
631-740-0985 ,
Greenport Jerky Company
Greenport, New York 11947
Homemade Jerky
Mr.Vincent Macchirole
516-319-1002
Backyard Brine Inc.
8595 Cox Lane
Cutchogue, New York 11935
Homemade pickles
631-7541050
Pellegrini Vineyards
23005 Main Road
Cutchogue, New York 11935
John
631-734-4111
Salt Bird Cellars
2885 Peconic Lane
Peconic,New York 11958
631-871-3204
Woodside Orchards
729 Route 25
Aquebouge, New York 11931
631-722-5770
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Imagery 02020 Maxar Technologies,New Nord GIS,Map data 02020 100 ft
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PA
Town of Southold
P.O Box 1179
Southold, NY 11971
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* * * RECEIPT * * *
Date: 11/13120 Receipt#: 276310
Quantity Transactions Reference Subtotal
1 Event Fee SCTF2a-d $150.00
Total Paid: $150.00
Notes:
Payment Type Amount Paid By
CK#6254 $150.00 Shamrock, Christmas Tree
Farm
Southold Town Clerk's Office
53095 Main Road, PO Box 1179
Southold, NY 11971
Name: Shamrock, Christmas Tree Farm
985 Elijahs Lane
Mattltuck, NY 11952
Clerk ID: BONNIED Internal ID SCTF2a-d