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Home My WebLink AboutCutchogue FD - Drive in Movie Night ®�®%UFF0(��® ELIZABETH A.NEVILLE,MMC Town Hall,53095 Main Road TOWN CLERK ® P.O.Box 1179 CO2 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS p Fax(631)765-6145 MARRIAGE OFFICER T'� ®� Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD April 21, 2021 Thomas Shalvey Cutchogue Fire Department 260 New Suffolk Road Cutchogue,NY 11935 Dear Mr. Shalvey: The Southold Town Board, at its regular meeting held on April 6, 2021, granted permission to the Cutchogue Fire Department to hold Drive in Movie Night May 14 (rd May 15), 2021. 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. Applicant must comply with all executive orders of the State of New York. Please contact Captain Kruszeski at the Police Department, 631/765-2600 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 April 6, 2021 0° RESOLUTION 2021-243 Item # 5.4 �411 ADOPTED DOC ID: 16923 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2021-243 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON APRIL 6, 2021: RESOLVED the Town Board of the Town of Southold hereby grants permission to the Cutchogue Fire Department to hold one (1) Drive-in Movie Night, on May 14, 2021, from 7:00 pm to 10:00 pm at Peconic Bay Winery, 31320 Main Road, Cutchogue,New York: 1. The file with the Town Clerk a One Million dollar Certificate of Insurance naming the Town of Southold as additional insured; 2. Submit a$250 dqRpsit for clean-up (deposit to be returned after event provided area is cleaned of any debris from event); 3. Coordinate traffic control upon notification of the adoption of this resolution with Captain Kruszeski to the Southold Town Police Department All fees to be waived. Applicant is required to adhere to all conditions on the application and permit and to the Town of Southold Policy for Special Events and subject to the applicant's compliance with all executive orders of the State of New York 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 April 9, 2021 Page 13 l� Y ELIZABETH A.NEVILLE, P.O.sox 1179 MMC .TOWN CLERK 03F �®Z Southold,New York 11971 � ., REGISTRAR OF VITAL STATISTICS Fax(631)765-6145 Telephone(631)765-1800 MARRIAGE OFFICER cop Z www.southoldtownny.gov RECORDS MANAGEMENT OFFICER FREEDOM OF FORMATION �� IN ® ®�� OFFICER Town Hall,53095 Main Road OFFICE OF TBE TOWN CLERK TOWN OF SOUTHOLD RECEIVED MAA z 4 2021 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 March 12,2021 Name of Event Cutchogue FD Drive-in Movie night Name of Organization: Cutchogue Fire Department Is this a Not-For-Profit Event?Yes/No Yes Contact's Name: Thomas Shalvey Mailing Address: 260 New Suffolk road Cutchogue,NY 11935 Contact's Phone Number: 631-764-0267 Firehouse 6310734-6907 Contact's Email Address: fdxchief@gmail,com Event Location and Site Diagram: 31320 Main Road Cutchogue Peconic Day Winery (Use additional paper if necessary) Event Date(s): May 14,2021 rain date May 15,2021 (Include set up and shutdown times and dates) Nature of Event: Drive-in Movie (Please attach a detailed description to this application) Time Period(Hours)of Event:From 1900 to 2200 Maximum Number of Expected Attendees: 250-400 Specify any special requirements(i.e.road closure,police presence): TCO Officer for traffic on Rt.25 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: Cutchogue Fire Department 260 New Suffolk Road Cutchogue,NY 11935 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): $ 00 Clean-up for Bicycle and/or Running Special events (ONLY) $250 9kmore Clean-up deposit all other events CERTfF OF INSURANCE REOUIRED:Not less than 52,000,000naming the Town of Southold as an additional insured. ***NOTE: PLEASE SEE ATTACHED REVISED, ADOPTED TOWN POLICE*** Additional information and requirements may be required as deemed necessary by the Town Board. _20 1n c�nv, ug S Is 1n A V C'-1 Print name of Authorized Person filling out Signature of Authorized Person filling out appliion application *Upon the request by applicant,the Town Board may waive in whole or in part any of the application requirements :E J 0 -1-e e_ SJ R � 1� -�� R� _Q?�Yi�w��n.l 77 pParking Pla'n ' 1 Movie Night •r L tilt 11 iX'� Ty� t•'Y � 'r - �•'�.ns:•_f it r� �� I i� 1� �!�-'� �ll , `,i � ,� ,,, - a a�,,�. `+'�`;�`'t,;�_�`�:'�, it _"' ='rte a_ . , - :' r, I� ��• '1r I I k II- li II I �� ;` � `� \� J, a�+l" i l�i`� ii��+f °� :'i� ,I II•' i1�.11 L P %, - - - . ... ,t ,c ,•r. r►gay, ° NM �� - r1 {y'F I I '.Y�'.u- ,,, , �'- ��.r.—��.e. ` " •.+��_ �' =t!l \,�" a � t-;%°' .. r it �l l; 1' .�� G' �r � t •� ',��:^; 1 A fI _ - ,v. .,- -- "`,: sa �`-•r 1` t1 ,�1� �1I -_ ;•, r( .'t � l�'�'•� ��. ,-ij a��, z,` Wx)j- `Y�`+ �.�,., ,;.'.'>�. ,r:.auit�'+-•r.,F;, ~` � moi,.-- , ;i,. :s' Y - �.^ °`•7'�-1r. •v./- Ihs. ,l'; ! ,.�F° � rtdi�d, ��i ,i •5ra"`�'` � T� d f'='' 7 AT %, .'y X;•r .VK _, ,,4� , Y �, ;1,A, 'ft, -�- aA tic . ' 9 'k,�, �.• � '�'' � - — •�''. '?j W,aye,[ u '«. cam ent;ef &k1d er�e - - ,� `ens` e T'4 .e t�`.}• r `� ';4t° «X s >k'� y4 11320 Alaint Road �r t'i1.1'('1'r;('ll('y access IO'A`�<`Tfl'1 Rd only ?s end of, movie fol' N*C FIELD Parking 111all A0,i� JJ+/ r w r AT r y ff ` l Peconic Bay Winery .Q t } , 1 1.�I�T()Il cif` - nap eTall'r sup`pori Wain 4 ' Google 0 ACO®' DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 03/22/2021 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 Debra Slmicich NAME: Roy H Reeve Agency,Inc. (PAH/CON ' o EM, (631)298-4700 FAX(AICNo): (631)298-3850 PO Box 54 E-MAIL dsimicich@royreeve.com ADDRESS: 13400 Main Road INSURER(S)AFFORDING COVERAGE NAIC# Mattituck NY 11952 INSURERA: National Union Fire Is Co of Pittsburgh Pa INSURED INSURER B: Cutchogue Fire District Etal INSURER C: 260 New Suffolk Road INSURER D: INSURER E: Cutchogue NY 11935 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2131214086 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 AIJULISMSKI POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ 1,000,000 MED EXP(Any one person) $ 5,000 A TR0006973-01 04/01/2021 04/01/2022 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER GENERAL AGGREGATE $ 3,000,000 POLICY ❑JET F LOC PRODUCTS-COMP/OPAGG $ 3,000,000 OTHER Liquor Liability $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED TR0006973-01 04/01/2021 04/01/2022 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Charges $ X UMBRELLALIAB OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB HCLAIMS-MADE TR0006973-01 04/01/2021 04/01/2022 AGGREGATE $ 10,000,000 DED I X1 RETENTION$ 0 $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN STATH UTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) EL DISEASE-EA EMPLOYEE $ If yes,descnbe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more space Is required) Town of Southold is listed an an additional insured with respect to Drive in Movie Benefit on5-14-21 with a rain date of 5-15-21 held at 31320 Main Road Cutchogue NY 11935 for above general liability policy as per general liability coverage form VGL101 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 AUTHORIZED REPRESENTATIVE Southold NY 11971 __1 gvj � ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 03/24/21 Receipt#: 278786 Quantity Transactions Reference Subtotal 1 Clean-Up Deposit 5/14/21 $250.00 Total Paid: $250.00 Notes: Payment Type Amount Paid By CK#000218 $25000 Cutchogue, Fire Department Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Cutchogue, Fire Department 260 New Suffolk Avenue Cutchogue, NY 11935 Clerk ID: LYNDAR internal ID:5/14/21 Rudder, Lynda From: Easton, James Sent: Wednesday, March 24, 2021 11:56 AM To: Rudder, Lynda Subject: RE: CFD movienight I have no concerns with this application moving forward. Thank you, James Easton Fire Marshal,Town of Southold JamesE@southoldtownny.gov (W) 631-765-1802 PRIVELEGED AND CONFIDENTIAL COMMUNICATION CONFIDENTIALITY NOTICE: This electronic mail transmission is intended only for the use of the individual or entity to which it is addressed and may contain confidential information belonging to the sender which is protected by privilege. If you are not the intended recipient,you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error, please notify the sender immediately by e-mail and delete the original message. -----Original Message----- From: Rudder, Lynda <lynda.rudder@town.southold.ny.us> Sent:Wednesday, March 24, 202111:43 AM To: Blasko, Regina<rblasko@town.southold.ny.us>; Doroski, Melanie<Melanie.Doroski@town.southold.ny.us>; Duffy, Bill <billd@southoldtownny.gov>; Easton,James<jamese@southoldtownny.gov>; Flatley, Martin <mflatley@town.southold.ny.us>; Hagan, Damon<damonh@southoldtownny.gov>; Kruszeski, Frank <fkruszeski@town.southoId.ny.us>; Mirabelli, Melissa <melissam@southoldtownny.gov>; Norklun, Stacey <Stacey.Norklun@town.southold.ny.us>;Spiro, Melissa <Melissa.Spiro@town.southold.ny.us> Subject: CFD movienight Importance: High Please approve/disapprove and provide cost analysis i Rudder, Lynda From: Spiro, Melissa Sent: Wednesday, March 24, 2021 11:56 AM To: Rudder, Lynda; Blasko,.Regina; Doroski, Melanie; Duffy, Bill; Easton, James; Flatley, Martin; Hagan, Damon; Kruszeski, Frank; Mirabelli, Melissa; Norklun, Stacey Subject: RE: CFD movienight This is not preserved land. Melissa S. -----Original Message----- From: Rudder, Lynda Sent: Wednesday, March 24, 202111:43 AM To: Blasko, Regina <rblasko@town.southold.ny.us>; Doroski, Melanie<Melanie.Doroski@town.southold.ny.us>; Duffy, Bill <billd@southoldtownny.gov>; Easton,James<jamese@southoldtownny.gov>; Flatley, Martin <mflatley@town.southold.ny.us>; Hagan, Damon<damonh@southoldtownny.gov>; Kruszeski, Frank <fkruszeski@town.southoId.ny.us>; Mirabelli, Melissa<melissam@southoldtownny.gov>; Norklun,Stacey <Stacey.Norklun@town.southold.ny.us>;Spiro, Melissa <Melissa.Spiro@town.southold.ny.us> Subject: CFD movienight Importance: High Please approve/disapprove and provide cost analysis Rudder, Lynda From: Flatley, Martin Sent: Wednesday, March 24, 2021 1:57 PM To: Rudder, Lynda; Blasko, Regina; Doroski, Melanie; Duffy, Bill; Easton,James; Hagan, Damon; Kruszeski, Frank; Mirabelli, Melissa; Norklun, Stacey; Spiro, Melissa Subject: RE: CFD movienight I have no objections to this event being approved Martin Flatley, Chief of Police Town of Southold Police Department 41405 State Route 25 Peconic, N.Y. 11958 Tel: 631-765-3115 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. 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 631.765.2600, (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 <lynda.rudder@town.southold.ny.us> Sent: Wednesday, March 24, 202111:43 AM To: Blasko, Regina <rblasko@town.southold.ny.us>; Doroski, Melanie<Melanie.Doroski@town.southold.ny.us>; Duffy, Bill <billd@southoldtownny.gov>; Easton,James<jamese@southoldtownny.gov>; Flatley, Martin <mflatley@town.southold.ny.us>; Hagan, Damon<damonh@southoldtownny.gov>; Kruszeski, Frank <fkruszeski@town.southold.ny.us>; Mirabelli, Melissa<melissam@southoldtownny.gov>; Norklun, Stacey <Stacey.Norklun@town.southold.ny.us>;Spiro, Melissa <Melissa.Spiro@town.southold.ny.us> Subject: CFD movienight Importance: High Please approve/disapprove and provide cost analysis 1 ACO® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/22/2021 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 Debra Simicich NAME: Roy H Reeve Agency,Inc. pECEIVED aco"N Ext• (631)298-4700 ac No): (631)298-3850 PO Box 54 E-MAIL dsimicich@royreeve.com ADDRESS: 13400 Main Road INSURER(S)AFFORDING COVERAGE NAIC# Mattituck MAR 2 5 20N 11952 INSURERA: National Union Fire Is Co of Pittsburgh Pa INSURED INSURERB: Cutchogue Fire District Etal INSURER C: 260 New Suffolk Road Southold Town Clerk INSURERD: INSURER E: - Cutchogue NY 11935 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2131214086 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 AUUL.5UdK POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RFNTFIr CLAIMS-MADE N OCCUR PREMISES Ea occurrence $ 1,000,000 MED EXP(Any one person) $ 5,000 A TR0006973-01 04/01/2021 04/01/2022 PERSONAL&ADV INJURY $ 1,000,000 GE ATE LIMITAPPLIES PER GENERALAGGREGATE $ 3,000,000 ❑PRO. ❑ POLICY 3,000,000 JECT LOC PRODUCTS:COMP/OPAGG $ OTHER I Liquor Liability $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ -AOWNED SCHEDULED TR0006973-01 04/01/2021 04/01/2022 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Charges $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB HCLAIMS-MADE TR0006973-01 04/01/2021 04/01/2022 AGGREGATE $ 10,000,000 DED I XJ RETENTION$ 0 $ WORKERS COMPENSATIONPER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNEWEXECUTIVE ❑ N/A E L EACH ACCIDENT $ OFFICERIMEMBER 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) Town of Southold is listed an an additional insured with respect to Drive in Movie Benefit on5-14-21 with a rain date of 5-15-21 held at 31320 Main Road Cutchogue NY 11935 for above general liability policy as per general liability coverage form VGL101 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 AUTHORIZED REPRESENTATIVE Southold NY 11971 __1 � ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD