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HomeMy WebLinkAboutBrick Cove Marina - Community/Family/Boater BBQ - Fun Day - Music 4S a_—� APPLICATION FOR A PERMIT TO HOLDFcationsAa RECEE IVED SPECIAL EVENT Please provide ALL of the information requested below. Incomplete a �A' reviewed. Special Event Permit# Applicant(s)name: � � ��C K'r db� 3 t9-9ce� Date of Submission 4-Z42- 1 4'z 1 Name of Event rce,mc(Q F�N 1�r41f5 — ��$ ►36ea SCTM#'s 1000-Section Block- Lot(s) ) M-Dates of Each Event: Z 1 :71 Z 1 4s -z ZZ Z 4 b-I/Z) �U�c� ►�� /-r/ts��%kA 9- A& &i h C49-�eS�_ s�L' 2;'e y cs�n� V If Multiple Dates are requested, apppeant must give all information for all dates. Nature of Event: L"MUA e ��rn�� 060 V.4J —/�clxC� (Please attac a detailed description of EACH event to this application) Time Period(Hours) of Event: From to _ �✓1 Town Services requested: ( ) Yes (K)No If yes,Describe Police Dept. Highway Dept. Describe Services Or— 0-),(t c/y rbltlgr `- �� �S /U-e.,-J e r Zai ©r Maximum Number of Persons Attending At One Time: /OCA M Number of cars expected _ 3e) P Is a Tent or other temporary structure being used? [)4] Yes [ ] No If yes provide size(s) Will food be served? [7C]Yes [ ] No If yes provide number and name(s)of food vendor(s)r9-,9z), %Li AS TGG Suffolk County permit#(s) Will other vendors be on the premises during the event? [ 4 Yes [ ]No If yes how many? 'oZ Describe Type of vendor(s) Oraf� ��cu rci ' 7s yC ' (i e. 745���, 1 V t7C' ' � 7 v /a, Property Owner(name/address):,4ivbruu �cj6n 7q oYa:l�l&ea. ! t�rov12' �}/ !1 a��� j1A4zYean/ t NY!(y39 Contact Person and Contact Tel.# �i�,q�C �A/L� G A4 5lb y;,?v/7 t// eel/ e-mail address �i�CLI�e C? hR/&IZO& c d 007/0 Event Location: Street-Hamlet Address: J 1-1271- t6 C(g2tr/� SCTM# Will any services be requested [ ]Yes 1A No. If Yes describe Police Highway Other: Mailing Address to Send Event Pernut to: sagoe e7 /�Gt/!!2 �L✓ sxf? �G k �v2 AS 7- lU V -Further»tore,I hereby authorize Code EnforcementPersonnel 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. I'me,J JtAcoma�t/ Print name of Owner Signature of Owner PeRf *jv) Print name of Authorized Person/Representative Si ature of Authorized 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. 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 t=pM 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 structures , or temporaW sgpiary 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: After investigation and inspection the Board finds that the applicant requests permission to organize a membership club, Young's Boatyard and Marina, Sage Boulevard, Greenport, New York_ The findings of the Board are that the Board is in agreement with the reasoning of the applicant. The Board finds that the public convenience and we3.fare and justice will be served and the legally established or per- mitted use of neighborhood property and adjoining use districts will not be permanently or substantially injured and thia spirit of the Ordinance will be observed. THEREFORE IT WAS RESOLVED, Howard H. Zehner, Young's Boat- yard and Marina, Sage Boulevard, Greenport, New York be! GRANTED permission to organize a membership club as applied for, subject to the following condition: The Board will review the applicant's operation by August 1, 1977, to insure that the parking facilities are adequate. Vote of the Board: Ayes: - Messrs: Gillispie, Bergen, Hulse, Doyen. i - � r RECEIVED AND FILED BY THE SOL'T LLL TOWN CLERI, DATL IIS17(v t.1OUR Town Town of-Soufk_;Id ' __'�:,`=. �:�_ 4i�-71--,---'-'-----'a--�F,�tle m� _ -",O��-=:� - _, 14"-­--,,,'P-A- ­ ��,� .1;i7 ­;� vp_��7--��_ i,7.-�!.2.�"-,-7��l�D-�-,,f,�,.--rtc�7-T:.F-�-,�.-,,�F�,,,---i;-v2-,-]�--:�----7 - . �kl�ll ," "' --'--" j,4! .7,-,',,,, �7��%"-% �,-�,� .,� _;j�..�,,,,_',,�,'�;,- - -�P-, -,._T��1_1.1-1 1'171!�Pll T_I-In,,.-,-4- ,"-,-,z- , ,­� IWS ,A .,; , _1'1_,�,1�1�-ll,i­ .I 1� P� -, , ,_�0­3 ',"!`� p ,�M �,�.�l 3� ,-,4.I -,,11., �', -""': -".�`�-_­ ,:, &­ t�Z+I�--?­-- , Z�­�.-,,-'I,,-,.-4)�­��__i-. Ne�'�Q�,*M` -teT, ejmft&h(-, , - . ", , 0 R"stil .� ­ ­�,'l.-I,,­sll­ �4- ,,_,_.-,.. - -, '.`,:l:--.,-._�' , _.,.- .,- .R�" ,�?Z41�F,t: "', z�6', ,.� 4r�,;,__ - ,�_,,-�,�". f'z,l.k-,,,� -­`.,.',,�:�1%-�.'I.�'-',%!'��,F.,'��-'5--I"',--:1.- �,;,- , ,� �. - __. 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'� 1: .. , L 'moi �Y Ww :y. r NMI Mgt- 3'r.�•^',,� "s , '- .: _.aFP .v 6RICCOV-01 LSE IQ_ CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYM 4/23/2021 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 iWAIVED, 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 CO FACT LOIS Serlo Fleetwood Insurance Group PHONE FAX 100 Talbot Blvd. (AIC,No,Edj:(443)282-3133 (AIC,No):(410)778-0304 Chestertown,MD 21620 dFD'o IREss:lois@fleetwoodins.com INSURERS AFFORDING COVERAGE MAIC# INSURER A:The Travelers Indemnitv of Connecticut 25682 INSURED INSURER B. Sage Basin Partners-,LLC DBA Brick Cove Marina INSURER C: PO BOX 12 1 INSURER D: East Marion,NY 11939 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 SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER DNYYY1, (MMID0800M LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR ZOL71N3292320ND 10/20/2020 10/20/2021 DAMAGE-TO RENTED 1;000,000 X PREMISES Ea occurrence $ MED EXP one n $ 100,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑JEa F LOC PRODUCTS-COMPIOPAGG $ 2'000'000 OTHER: $ AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT Ea accident)- $ ANYAUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ AUTOS ONLY AUTOS ON Y PerOa�deM AMAGE $ UMBRELLA LIAROCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS' YIN LIABILITY STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,descnbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Additional insured: Southold Town Hall CERTIFICATE HOLDER I CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Southold Town Hall THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 54375 Main Road ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1179 Southold,NY 11971-1179 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and_logo are registered marks of ACORD v �'. ¢ . '' MICHAEL J.VERITY • 9 ®�, Chief Buildin RECEIVED wx� { �s VT Southold Town Hall 54375 Main Road _ P.O.Box 1179 APR 2&29231)765-Iso- ly � Southold,Newyork 119 I-1179 Fa�(631)765-9502 "ke verity@ town.southold.ny.us TOWN OF SOUTHOLD Town Code Chapter 205 "Public Entertainment and Special Events" SPECIAL EVENT PERAHT L�NSTRUCTIONS A1ND AIPi'LICATiON 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 mat,be rejected or subject to a late processing fee of$250.00 by the Office of the Town Clerk, unless a waiver is obtained. Requesting an expedited review must be submitted in writing to the Town Clerk.The'Town Clerk will forward all applications to the Special Events Committee for processing. The Committee will obtain comments on all applications from relevant Town, County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. The Town reserves the right to request additional information from an applicant to address issues related to the health,safety,and welfare of the community. When is a Permit Required? All Speciall Events,per Southold Town Code Article I,Section 205-2(Definitions)must obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits. Any use of residential property for profit such as a venue for weddings or other events is prohibited. This application is deemed complete once all the following requirements are submitted to the Town Clerk: Please indicate submission of the follwnv ing by checking off the boxes and signing below. ❑ A completed application form signed by the owner and the event manager. Applications without property owner's signature/approval will be rejected. AFEE: Is the application being submitted at least 60 days before the event M Yes [ ]No If Yes,Fee of$ 5�O has been submitted ❑ If No,Fee of$ has been submitted t Have any of the development rights been sold to the Town of Southold[ ]Yes M No and/or Suffolk County Agricultural Program? [ ] Yes [o4 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 nage) A Parldng/Event Plan may be a survey, site plan and/or aerial view (for example Google Earth) of the subiect 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. y(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. r(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 PIan 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 Towit 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.. LJ 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 LIS 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 plan acceptable to the Town of Southold AND a qualified traffic controller must be provided at the event. (See application form for details) 6? tsignature 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 inform ion required above in connection with my application. 2( 2( D to S' nature 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 tire 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 ofPublic Health Food Protection Unit Town of Southold P.0 Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 04/28/21 Receipt#: 280110 Quantity Transactions Reference Subtotal 1 Event Fee SBP 1 a-f $150.00 Total Paid: $150.00 Notes: Payment Type Amount Paid By CK#151 $150.00 Sage, Basin Partners Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Sage, Basin Partners Dba Brick Cove Marina Po Box 12 East Marion, NY 1939 Clerk ID: BONNIED Internal ID-SBP 1 a-f