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HomeMy WebLinkAboutShamrock Christmas Tree Farm 2021-37 1 7 r�rc. �Tl��SISt�FQ(K N Z. }t Office of the Town Attorney Town of Southold Town Hall Annex, 54375 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone : 631-765-1939 Facsimile: 631-765-6639 MEMORANDUM To: Ms. Elizabeth A. Neville, Town Clerk From: Missy Mirabelli Secretary to the Town Attorney Date: July 15, 2021 Subject: Special Event- Shamrock Christmas Tree Farm SCTF2a-f With respect to the above-referenced matter, I am enclosing the original Agreement. Thank you. mmm Enclosures Cc: Denis Noncarrow 1 ' Special Events Committee Application Summary and Recommendation Application name: , nQ- j�Vj S�I,nmQ,�l Address: 010(085 ML Jn Rd., Application number: Date of of Event: lolq , 16116 , 1011(0 , IyI(-4 , ofx a4- d 161ay Time: qk— '6 PA Date Received by Town Clerk: (D o,IQ 1010a� Date Received by Committee: 136c_�-[ Nature of Event (S): Committee Comments Received by: " Denis Noncarow V Melissa Spiro Leslie Weisman Missy Mirabelli 1-4 Chief Flatley �. August Ruckdeschel- County�L � Heather Lanza James Easton Mike Verity Claire Glew Bill Duffy Kevin Webster Committee Recommendation's: Approve as applied Approve with Additional conditions: Hold Public Hearing Deny Special Event No: Resolution No: ab' -�0 Date: RECEIVED '7""' JUN 30 : rr TOWN ATTORNEY' � RECEIVED S OFFICE �) APPLICATIQI� FOR A PERART TO HOLD A DUH 2 9 2021 SPECIAL EVENT Pleasei3rolde,a of the information requested below.Incomplete applications NkUL NOT be Southold jeQWtj. .�'` Special Event Permit# Applicant(s)name:ti�'2.Y -9-''! �• '�7 J ��'! Date of Submissiony^M 9vd/ Name of Events R0'�"' A ii ,,f4�+ �f Sf7ara�ocl4 `- 'uT�"'`f SCTM4's 1000-Section47 3f8l Block-j-0e_3 —S Lot(s) -_ Dates of Each Event: jo _9 If Multiple Dates.are /requested,applicant must give all information for all dates. Nature of Event: y'!�C� Rur- /'► .S F�!!�r'/' M '��' �7L (Please attach a detailed description of EACH event to this application) Time Period(Hours) of Event: From L7 to Town Services requested: ( )Yes (k No If yes;Describe Police Dept. Highway Dept. Describe Services --S C e u 7'F-1,PFA'eC Maximum Number of Persons Attending At One Time: 3tco o Number of cars expected/Ur7 Is a Tent or other temporary structure being used? Yes[ ]No If yes provide size(s) /0 X/o Will fboq be served? Yes [ ]No If yes provide number and name(s)of food vendor(s) S,ls n rii KN �.'11 fE.sf end CL%,& Suffolk County permitn(s) p7' C, ♦.nw f Will other vendors be on the premises during the event?[ ]Yes/ / [ ]No If yes how many? / /Describe / Type of ven)dor(s)MA4 FiiyA Pofe-O 64:43 ,` /►,-41 I;,A iS 0&'-�-j j W /S✓d ry 4"•d f 7t 1 +✓f7 Sa��!/f +SVtfLy L.n' vi,! Iris C Property Owner(name/address). f ` a � ,-f'vclt Contact Person and CoontactTel.# j� -^r�T'�' 'tfa S�-r�nre-sae., f6 31 V.:c Q/ALOC e-mail address -5 1 H rl xy G t/ t�'<< AJ f J ip!!r et h vy t C r k-1 Event Location: Street-Hamlet Address: / ��in r � " f '-�Vc scT1�R#�17388q lO�,`3 ~ 5� y� Will any services be requested [ ]Yes [ ] No. If Yes describe Police Highway _Other: Mailing Address to Send Event Permit to: y d &K /97�, 1 J4/I - ua IV y ^i 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 !! A Parkine/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) El 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) 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. Dated rraun e Activities associated with outdoor public events are strictlj, prohibited fi•onr 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 Countj,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 Countj-Bureau of Public Health Food Protection Unit. , ,� �'.-� ',� �' off'� ;,�'�>5' .�...,.,�•�,�� - _ ..r, 51 5 Ile 5 X.t - Z ftP � - • K ( ,,y s�,. ... r �. '� +ems rv.,,�d ... t i• ,. e'_]w,�I.+ "'W ISM �,..y,T v.l4• .r4 1 ,y '� 3 rY �` ►r..�s off, �.-,., .-,�.- �`�.�.�� ,. 40.•lipr a — ' 'aj. 'tr" � i�* s'.��l'GY �.. .if'•i't!r �' �►. •��� �•.+F.'!".w sra..,.:;�., "'}N`' .. ........... . ......................... CERTIFICATE OF LIABILITY INSURANCE DATE /29/iozl2021 Y) ACQRfa osa THIS CERTIFICATE IS ISSUED ASA 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 WANED,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 CONNTTACT Carol Losquadro E,11Roy H Reeve Agency,Inc. PHON€11' , (631)298-4700 FAX No): (631)298-3850 PO Box 54 DDR q uadro@y ADDRESS: clos ro reeve.com A 13400 Main Road INSURERIS AFFORDING COVERAGE NAIC N Mattituck NY 11952 INSURER A: Atlantic Casualty INSURED INSURER B: Shamrock Tree Company Inc INSURER C: INSURER D; PO Box 1472 INSURER E: Mattituck NY 11952 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2162914764 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 1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. N H TYPE OF INSURANCE POLICY€FF POLICY1EXPLTR 1 D POLICY NUMBERYM/ODIYYW MM/DO/ LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 2,000,000 DAMAGE Iu EWED 100,000 CLAIMS-MADE �OCCUR PR IS S Ea occurrence S MED FRCP(Any one person) S 5,000 A Y N L131002687-1 09/18/2021 10/301PERSONAL&ADV INJURY S 2.000;000 M'OTHER: LAGGREGATELIMITAPPLIESPER: GENERAL AGGREGATE S 2,000,000 POLICYJJERG LOC PRODUCTS-COMP/OPAGG S 2,000,000 I S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS r 1 HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Par amyl $ UMBRELLA LIAR OCCUR EACH OCCURRENCE s EXCESS LIAR HCLAIMS-MADE AGGREGATE S DED RETENTION S S WORKERS COMPENSATION STARTLfTE EOlR`H- AND EMPLOYERS'LIABILITY TA YIN ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E DISEASE-EA EMPLOYEE $ If yes,descnbe under DESCRIPTION OFOPERATIONS below E.L DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) 4745&2286 Elijahs Lane,Mattituck,NY 11952 Pumpkin Patch 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. 53095 Main Road AUTHORIZED REPRESENTATIVE PO Box 1179 Southold NY 11971 t ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD tc ' TOWN OF SOUTHOLD To,syn Code Chapter 205 "Public Entertainment and Special Events" SPECIAL EVENT PERMIT INSTRUCTIONS AND APPLICATION FORM Applications for a Special Event Pennit 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. V r 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 5150.00. 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. 'env completed application that is not submitted 60 or more business days prior to the scheduled event may be r•elected or subject to a late processing fee of 5250.00 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 coinments 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 pennit. 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 pen-nits. 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 followine by checking off the boxes and sic-mina below. A completed application form signed by the o,%mer 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 M/Yes [ )No 1 If Yes,Fee of$ has been submitted �1 If No.Fee of S has been submitted Furthermore,I hereby authorize Code Errforcentent Personnel of the Town of Southold to enter the property during the hours of the permitted special event to in e ny an I inspections necessary!in connection with this/Special Event. Print n rite of Owner ure of Print name of Authorized PersonlRepresentative Signature of Authorized Person./Representative PERMISSION IS HEREBY GRANTED.SUBJECT TO TIDE FOLLOWING CONDITIONS: 1. By acceptance of this penrut, 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.Parldttg is strictly rohibited 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 ineet 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 temporay 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 regrulations. 9. NO activities associated with this event. including but not limited to uarkinyin 7re�ss/e_ esslaccess. tent(s)or temporary structures? 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. ineresstegress(access tent(s) or temporary structure(s) or temporary sanitary facilities shall be conducted on Suffolk Countv Purchase of Development Rights land without a pennit issued by the Suffolk County l=annland Committee. 11.Issuance of this pen-nit 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 buildings} 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 snake an_y and all inspections necessary in connection with this Special Event. 16. ADDITIONAL CONDITIONS: ANY VIOLATIONS INCON`N`ECTION WITH THE CONDITIONS LISTED HEREIN WILL TERMINATE THIS PERMIT. APPROVED Town of Southold Resolution Number: Date Issued: Have any of the development rights been sold to the Town of Southold( ]Yes [X] No and/or Suffolk County Agricultural Program? ( )Yes [�] No If ves 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 P.ARKII\G/EVENT PLAN TO THIS APPLICATION IF THE EXPECTED ATTE\DANCE IS 300 OR IIORE PEOPLE.YOU.-MUST ALSO ATTACH A TRAFFIC CONTROL PLAN(see next vase) A Parldne/Event Plan may be a survev.site plan and/or aerial view(for example Goodie Earth)of the subieet properly.INDICATE ON THE PLAN ALL of the folio-wing 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. (S) The layout of any parking area for automobiles and other vehicles and the means of ingress and eeress for such parking areas. The parking spaces must allow for 300 sq.fr. 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. (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 foruse by Southold Town Police. 0WNER-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 lin«ted 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 affrrtn that the information contained herein and attachments hereto are trite 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.. r ' Mirabelli, Melissa From: Spiro, Melissa Sent: Wednesday, June 30, 2021 9:36 AM To: Mirabelli, Melissa Subject: RE: Shamrock Special Event This is not Town preserved land. Melissa Spiro From: Mirabelli, Melissa Sent: Wednesday,June 30, 20219:35 AM To: Easton,James<jamese@southoldtownny.gov>; Spiro, Melissa <Melissa.Spiro@town.southold.ny.us>; Glew, Claire <Claire.Glew@town.southold.ny.us>; Webster, Kevin<kevin.webster@town.southold.ny.us>; Allegue, Lauren <Lauren.Allegue@suffolkcountyny.gov>; Amakawa, Andrew<Andrew.Amakawa@suffolkcountyny.gov> Cc: Ruckdeschel,August<August.Ruckdeschel@suffolkcountyny.gov> Subject: Shamrock Special Event This is a second special event at Shamrock. Please send any questions or comments to me.Thank you ;M1lelis:sa,V Ifirabelli Secretary to the Town Attorney Town of Southold Southold Town Hall Annex 54375 Route 25 ( Main RD) P.O. Box 1179 Southold, NY 11971 Office (631) 765-1939 Fax (631)765-6639 i Mirabelli, Melissa From: Flatley, Martin Sent: Wednesday, June 30, 2021 9:43 AM To: Mirabelli, Melissa; Verity, Mike; Duffy, Bill; Lanza, Heather; Weisman, Leslie; Noncarrow, Denis Subject: RE: Shamrock Special Event#2 1 have no objections to either of these applications at Shamrock 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. From: Mirabelli, Melissa <melissam@southoldtownny.gov> Sent: Wednesday,June 30, 20219:27 AM To:Verity, Mike<Mike.Verity@town.southold.ny.us>; Flatley, Martin <mflatley@town.southold.ny.us>; Duffy, Bill <billd@southoldtownny.gov>; Lanza, Heather<heather.lanza@town.southold.ny.us>; Weisman, Leslie <lesliew@town.southold.ny.us>; Noncarrow, Denis<denisn@southoldtownny.gov> Subject: Shamrock Special Event#2 Here is a second special event for Shamrock as always please send questions and comments to me Melissa/M. Mirabelli Secretary to the Town Attorney Town of Southold Southold Town Hall Annex 54375 Route 25 ( Main RD) P.O. Box 1179 Southold,NY 11971 Office (631) 765-1939 Fax (631)765-6639 i Mirabelli, Melissa From: Allegue, Lauren <Lauren.Allegue@suffolkcountyny.gov> Sent: Wednesday, June 30, 2021 9:55 AM To: Mirabelli, Melissa; Easton, James;Spiro, Melissa; Glew, Claire; Webster, Kevin;Amakawa, Andrew Cc: Ruckdeschel,August Subject: RE: Shamrock Special Event Hi Ms. Mirabelli, We do not have objections or comments to this Special Event since the properties and surrounding adjacent properties are not on SC PDR land. , rbc Lauren Allegue nM 4.,, J ,r f 0 Planning Aide Suffolk County ` Dept.of Economic Development and Planning 100 Veterans Memorial Highway,2nd Floor Hauppauge,NY 11788 (631)853-6044 From: Mirabelli, Melissa <melissam@southoldtownny.gov> Sent: Wednesday,June 30, 20219:35 AM To: Easton,James<jamese@southoldtownny.gov>; Spiro, Melissa <Melissa.Spiro@town.southold.ny.us>;Glew, Claire <Claire.Glew@town.southold.ny.us>; Webster, Kevin <kevin.webster@town.southold.ny.us>; Allegue, Lauren <Lauren.Allegue@suffolkcountyny.gov>; Amakawa, Andrew<Andrew.Amakawa@suffolkcountyny.gov> Cc: Ruckdeschel, August<August.Ruckdeschel @suffolkcountyny.gov> Subject: Shamrock Special Event ATTENTION: This email came from an external source. Do not open attachments or click on links from unknown senders or unexpected emails. This is a second special event at Shamrock. Please send any questions or comments to me.Thank you Melissa 111. Mirabelli Secretary to the Town Attorney Town of Southold Southold Town Hall Annex 54375 Route 25 ( Main RD) P.O. Box 1179 Southold,NY 11971 Office (631) 765-1939 i Mirabelli, Melissa From: Easton, James Sent: Wednesday, June 30, 2021 10:30 AM To: Mirabelli, Melissa Subject: RE: Shamrock Special Event#1 I have no objection to both Shamrock applications. Thanks, James Easton Fire Marshal, Town of Southold 3amesEccsoutholdtoNvnnv.Lov (W)631-765-1802 - H z oy • PRIt%ELEGF.D,4,VDCOiVFIDENTIALCOMMUNICATION CONFIDENTI,4LITYNOTICE: Thiselectronicmail transmission is intended only for the use of the individual or entity to ivhich it is addressed and may contain `rfl confidential h#brrnation belonging to the sender which is protected byprivilege. If:you are not the intended recipient,you are herel?y notified that any disclosure, copying, distribution, or the taking Qf airy action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error,please note the sender immediately by e-mail and delete the original message. From: Mirabelli, Melissa<melissam@southoldtownny.gov> Sent: Wednesday,June 30, 20219:29 AM To: Spiro, Melissa <Melissa.Spiro@town.southold.ny.us>; Glew, Claire <Claire.Glew@town.southold.ny.us>; Webster, Kevin<kevin.webster@town.southold.ny.us>; Easton,James<jamese@southoldtownny.gov>;Amakawa,Andrew <Andrew.Amakawa@suffolkcountyny.gov>; Allegue, Lauren <Lauren.Allegue@suffolkcountyny.gov> Cc: Ruckdeschel, August<August.Ruckdeschel@ suffolkcountyny.gov> Subject: Shamrock Special Event#1 Please send any questions comments to me please and thank you A4 ttleli.ssa %i1 Mirabelli Secretary to the Town Attorney Town of Southold Southold Town Hall Annex 54375 Route 25 ( Main RD) P.O. Box 1179 Southold,NY 11971 Office (631) 765-1939 Fax (631)765-6639 1 Mirabelli, Melissa From: Noncarrow, Denis Sent: Wednesday, June 30, 2021 1:57 PM To: Leslie Weisman Forward; Mirabelli, Melissa;Verity, Mike; Flatley, Martin; Duffy, Bill; Lanza, Heather; Weisman, Leslie Subject: RE: Shamrock Special Event#2 Looks good. Denis Noncarrow Government Liaison Officer Town of Southold, New York www.southoldtownny.qov denisn@southoldtownny.gov 631-765-5806 CONFIDENTIALITY NOTICE: This communication with its contents may contain confidential and/or legally privileged information. It is solely for the use of the intended recipient(s). Unauthorized interception, review, use or disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy Act. If you are not the intended recipient, please contact the sender and destroy all copies of the communication. From: Leslie Weisman Forward Sent: Wednesday,June 30, 20211:47 PM To: Mirabelli, Melissa <melissam@southoldtownny.gov>;Verity, Mike <Mike.Verity@town.southold.ny.us>; Flatley, Martin <mfIatley@town.southoId.ny.us>; Duffy, Bill<billd@southoldtownny.gov>; Lanza, Heather <heather.lanza@town.southold.ny.us>; Weisman, Leslie <lesliew@town.southold.ny.us>; Noncarrow, Denis <denisn@southoldtownny.gov> Subject: RE:Shamrock Special Event#2 Both applications are a repeat of past applications and should be fine. Leslie From: Mirabelli, Melissa [maiIto:mel issamCa�southoldtownnv.clov] Sent: Wednesday, June 30, 20219:27 AM To: Verity, Mike; Flatley, Martin; Duffy, Bill; Lanza, Heather; Weisman, Leslie; Noncarrow, Denis Subject: Shamrock Special Event #2 Here is a second special event for Shamrock as always please send questions and comments to me Melissa 11-1. Afirahelli Secretary to the Town Attorney Town of Southold Southold Town Hall Annex 54375 Route 25 ( Main RD) P.O. Box 1179 Southold, NY 11971 i Office (631) 765-1939 Fax(631)765-6639 2 ' 1 Mirabelli, Melissa From: Mirabelli, Melissa Sent: Thursday, July 8, 2021 10:51 AM To: Glew, Claire Cc: Webster, Kevin; Duffy, Bill Subject: RE: Shamrock Special Event Claire & Kevin, are you advising against this Special Event of Farmers Market and U-Pick Pumpkins a Shamrock? I understand they have ag exemptions felissa A1. AIirahelli Secretary to the Town Attorney Town of Southold Southold Town Hall Annex 54375 Route 25 ( Main RD) P.O. Box 1179 Southold,NY 11971 Office (631) 765-1939 Fax (631)765-6639 From: Glew, Claire<Claire.Glew@town.southold.ny.us> Sent: Wednesday,July 7, 202110:02 AM To: Mirabelli, Melissa <melissam@southoldtownny.gov> Cc:Webster, Kevin<kevin.webster@town.southold.ny.us> Subject: RE:Shamrock Special Event Missy, Below is the information for the special events applications on the following parcels: 108.-3-5.43—does not have an ag exemption 108.-3-5.44—receives an Ag Exemption on 8.9 acres of 9.43—only.53 acres are not receiving the exemption 108.-3-5.45—receives an Ag Exemption on the entire 6.71 acres—The event is on this tax map number as per the application. To receive the Ag Exemption the property must be in Agricultural Production or be used as support land. Best Regards, Cla,�re.,Claw Assistant to Assessor i Town of Southold Board of Assessors (631)765-1937 Phone (631)765-1356 Fax www.southoldtownnV.gov claireg@southoldtownny.gov From: Mirabelli, Melissa<melissam@southoldtownny.gov> Sent:Wednesday,June 30, 202111:38 AM To: Glew, Claire <Claire.Glew@town.southold.ny.us> Subject: RE: Shamrock Special Event You got it Claire thank you so much..... hope you are staying nice and cool today Q Afelissa Al Mirahelli Secretary to the Town Attorney Town of Southold Southold Town Hall Annex 54375 Route 25 ( Main RD) P.O. Box 1179 Southold,NY 11971 Office (631) 765-1939 Fax (631)765-6639 From: Glew, Claire<Claire.Glew@town.southold.ny.us> Sent:Wednesday,June 30, 202111:28 AM To: Mirabelli, Melissa <melissam@southoldtownny.gov> Cc:Webster, Kevin<kevin.webster@town.southold.ny.us> Subject: RE:Shamrock Special Event Missy, Parcels on application for both applications: 108.-3-5.43—does not have an ag exemption 108.-3-5.44—receives an Ag Exemption on 8.9 acres of 9.43—only .53 acres are not receiving the exemption 108.-3-5.45—receives an Ag Exemption on the entire 6.71 acres—The event is on this tax map number as per the application. Please hold off on making a decision until Kevin is back in the office next week. Thank you. 2 Cla 4;re,Cle w Assistant to Assessor Town of Southold Board of Assessors (631)765-1937 Phone (631)765-1356 Fax www.southoldtownny.gov claireg@southoldtownny.gov From: Mirabelli, Melissa <melissam@southoldtownny.gov> Sent: Wednesday,June 30, 20219:35 AM To: Easton,James<jamese@southoldtownny.gov>; Spiro, Melissa <Melissa.Spiro@town.southold.ny.us>; Glew, Claire <Claire.Glew@town.southold.ny.us>; Webster, Kevin <kevin.webster@town.southold.ny.us>;Allegue, Lauren <Lauren.Allegue@suffolkcountyny.gov>;Amakawa, Andrew<Andrew.Amakawa@suffoIkcountyny.gov> Cc: Ruckdeschel,August<August.Ruckdeschel@suffolkcountyny.gov> Subject: Shamrock Special Event This is a second special event at Shamrock. Please send any questions or comments to me.Thank you Melissa Al J11irahelli Secretary to the Town Attorney Town of Southold Southold Town Hall Annex 54375 Route 25 ( Main RD) P.O. Box 1179 Southold,NY 11971 Office (631) 765-1939 Fax (631)765-6639 3 Mirabelli, Melissa From: Webster, Kevin Sent: Thursday,July 8, 2021 11:40 AM To: Mirabelli, Melissa; Glew, Claire Cc: Duffy, Bill Subject: RE: Shamrock Special Event Hi Missy, After reviewing the map in the application it appears that the land that is being used is not receiving an agricultural exemption. Thank you for the follow up. Kevin Webster Chairman, Southold Town Board of Assessors 53095 Route 25 PO Box 1179 Southold NY 11971-0959 631-765-1937-Phone 631-765-1356-Fax From: Mirabelli, Melissa <melissam@southoldtownny.gov> Sent:Thursday,July 8, 202110:51 AM To: Glew, Claire<Claire.Glew@town.southold.ny.us> Cc:Webster, Kevin<kevin.webster@town.southold.ny.us>; Duffy, Bill <billd@southoldtownny.gov> Subject: RE:Shamrock Special Event Claire & Kevin, are you advising against this Special Event of Farmers Market and U-Pick Pumpkins a Shamrock? I understand they have ag exemptions K6 "(I Afelissa 41. .1firabelli Secretary to the Town Attorney Town of Southold Southold Town Hall Annex 54375 Route 25 ( Main RD) P.O. Box 1179 Southold, NY 11971 Office (631) 765-1939 i Fax (631)765-6639 From:Glew, Claire<Claire.Glew@town.southold.ny.us> Sent: Wednesday,July 7, 202110:02 AM To: Mirabelli, Melissa <melissam@southoldtownny.gov> Cc:Webster, Kevin<kevin.webster@town.southold.ny.us> Subject: RE: Shamrock Special Event Missy, Below is the information for the special events applications on the following parcels: 108.-3-5.43—does not have an ag exemption 108.-3-5.44—receives an Ag Exemption on 8.9 acres of 9.43—only .53 acres are not receiving the exemption 108.-3-5.45—receives an Ag Exemption on the entire 6.71 acres—The event is on this tax map number as per the application. To receive the Ag Exemption the property must be in Agricultural Production or be used as support land. Best Regards, Cla.�reg Clew Assistant to Assessor Town of Southold Board of Assessors (631)765-1937 Phone (631)765-1356 Fax www.southoIdtownny.gov claireg@southoldtownny.gov From: Mirabelli, Melissa <melissam@southoldtownny.Rov> Sent: Wednesday,June 30, 202111:38 AM To: Glew, Claire <Claire.Glew@town.southold.ny.us> Subject: RE: Shamrock Special Event You got it Claire thank you so much..... hope you are staying nice and cool today Q Melissa M. 1lfirabelli Secretary to the Town Attorney Town of Southold Southold Town Hall Annex 54375 Route 25 ( Main RD) 2 4 0 . P.O. Box 1179 Southold, NY 11971 Office (631) 765-1939 Fax (631)765-6639 From: Glew, Claire<Claire.clew@town.southold.ny.us> Sent: Wednesday,June 30, 202111:28 AM To: Mirabelli, Melissa <melissam@southoldtownny.gov> Cc:Webster, Kevin<kevin.webster@town.southold.ny.us> Subject: RE: Shamrock Special Event Missy, Parcels on application for both applications: 108.-3-5.43—does not have an ag exemption 108.-3-5.44—receives an Ag Exemption on 8.9 acres of 9.43—only .53 acres are not receiving the exemption 108.-3-5.45—receives an Ag Exemption on the entire 6.71 acres—The event is on this tax map number as per the application. Please hold off on making a decision until Kevin is back in the office next week. Thank you. Cla rel Glow Assistant to Assessor Town of Southold Board of Assessors (631)765-1937 Phone (631)765-1356 Fax www.southoldtownny.gov claireg@southoldtownny.gov From: Mirabelli, Melissa<melissam@southoldtownny.gov> Sent: Wednesday,June 30, 20219:35 AM To: Easton,James<iamese@southoldtownny.gov>; Spiro, Melissa <Melissa.Spiro@town.south old.ny.us>; Glew, Claire <Claire.Glew@town.southold.ny.us>; Webster, Kevin <kevin.webster@town.southold.ny.us>;Allegue, Lauren <Lauren.Allegue@suffolkcountyny.gov>; Amakawa,Andrew<Andrew.Amakawa@suffolkcountyny.gov> Cc: Ruckdeschel, August<August.Ruckdeschel@suffolkcountyny.gov> Subject: Shamrock Special Event This is a second special event at Shamrock. Please send any questions or comments to me.Thank you 3 ;� Melissa Al Mirabelli Secretary to the Town Attorney Town of Southold Southold Town Hall Annex 54375 Route 25 (Main RD) P.O. Box 1179 Southold,NY 11971 Office (631)765-1939 Fax (631)765-6639 4 SETTLEMENT AGREEMENT AND RELEASE This Settlement Agreement and Release ("Agreement") is made by the State of New York ("State") by and through SUNY Stony Brook Hospital ("SBH"), a general hospital licensed under Article 28 of the New York Public Health Law, located at 101 Nicolls Road, Stony Brook,New York, and the Town of Southold, located at 53095 NY- 25, Southold,New York("Town"),and is effective as of July 1,2021. WHEREAS, former Town employee George Sullivan, 275 Mid Farm Road, Southold, New York, incurred charges for medical services at SBH from December 25, 2014,through February 13,2015 (the"Settlement Period"); and WHEREAS, at the time of his admission to SBH on December 25, 2014, Mr. Sullivan had health insurance coverage with the Town through the Town's insurer Island Group; and WHEREAS, total SBH charges for Mr. Sullivan's admission were $608,417.65, the Island Group Rate of 75% of total charges brought total charges to $456,313.18, and to date Island Group on behalf of the Town has paid $139,858.57, bringing the current balance due to SBH to$316,454.67;and WHEREAS, SUNY SBH has demanded payment of the claim from the Town; and WHEREAS, the State having a right of action against George Sullivan and the Town to recover the principal sum of$316,454.67, plus the cost of service of process, which is the cost for medical services rendered;and NOW,THEREFORE,the parties wishing to settle the dispute between them as to SBH 's demand to the Town for the payment of all claims arising during the Settlement Period, for and in consideration of the representations made, actions to be undertaken, and payments to be made as set forth herein. IT IS HEREBY AGREED AS FOLLOWS: 1. Settlement and Release of all claims arising during the Settlement Period. A) The Town agrees to pay to SBH $150,000 in-M satisfaction of SBH's demand for payment of this claim within 30 days of the effective date of this Agreement. B) In consideration of the payment described in paragraph I(A) and the other terms of this Agreement, the parties hereto, on behalf of their principals, officers, directors, employees, former employees, agents, predecessors, successors and assigns, both individually and in their official capacities, hereby mutually release and discharge each other, and their principals, officers, directors, employees, former employees, agents, predecessors, successors and assigns, both individually and in their official capacities, from any and all causes of action seeking payment of any claims for SETTLEMENT AGREEMENT AND RELEASE This Settlement Agreement and Release("Agreement")is made by the State of New York("State'l by and through SUNY Stony Brook Hospital("SBH'),a general hospital licensed under Article 28 of the New York Public Health Law,located at 101 Nicolls Road,Stony Brook,New York,and the Town of Southold,located at 53095 NY- 25,Southold,New York("Town',and is effective as of July 1,2021. WHEREAS, former Town employee George Sullivan, 275 Mid Farm Road, Southold,New York,incurred charges for medical services at SBH from December 25, 2014,through February 13,2015(the"Settlement Period");and WHEREAS,at the time of his admission to SBH on December 25,2014,Mr. Sullivan had health insurance coverage with the Town through the Town's insurer Island Group;and WHEREAS,total SBH charges for Mr.Sullivan's admission were$608,417.65, the Island Group Rate of 75%of total charges brought total charges to$456,313.18,and to date Island Group on behalf of the Town has paid$139,858.57,bringing the current balance due to SBH to$316,454.67;and WHEREAS,SUNY SBH has demanded payment of the claim from the Town; and WHEREAS,the State having a right of action against George Sullivan and the Town to recover the principal sum of$316,454.67,plus the cost of service of process, which is the cost for medical services rendered;and NOW,THEREFORE,the parties wishing to settle the dispute between them as to SBH's demand to the Town for the payment of all claims arising during the Settlement Period,for and in consideration of the representations made,actions to be undertaken, and payments to be made as set forth herein. IT IS HEREBY AGREED AS FOLLOWS: 1. Settlement and Release of all claims arising during the Settlement Period. A) The Town agrees to pay to SBH$150,000 in full satisfaction of SBH's demand for payment of this claim within 30 days of the effective date of this Agreement B) In consideration of the payment described in paragraph 1(A)and the other terms of this Agreement,the parties hereto, on behalf of their principals, officers,directors,employees,former employees,agents,predecessors,successors and assigns,both individually and in their official capacities,hereby mutually release and discharge each other, and their principals, officers, directors, employees, former employees,agents,predecessors,successors and assigns,both individually and in their official capacities,from any and all causes of action seeking payment of any claims for 1 140 RESOLUTION 2021-574 ADOPTED DOC ID: 17224 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2021-574 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JULY 13,2021: RESOLVED that the Town Board of the Town of Southold hereby grants permission to Jonathan Shipman, to hold Special Event 2021-37 at The Pumpkin Patch at Shamrock Christmas Tree Farm, 20685 Main RD, Mattituck,New York as applied for in Application SCTF2a-f a for U- Pick Pumpkins and Farmers Market on October 9, October 10, October 16 October 17, October 23 and October 24, 2021 from 9AM- 5PM. All parking must be contained on site. Provided they adhere to all conditions on the application,permit and to the Town of Southold Policy for Special Events. This permit is subject to revocation if the applicant fails to comply with any of the conditions of the approval or is unable to properly control traffic flow into and out of the event. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Sarah E.Nappa, Councilwoman SECONDER:James Dinizio Jr, Councilman AYES: Nappa, Dinizio Jr,Doherty, Ghosio, Russell ABSENT: Louisa P. Evans Southold Town Board - Letter Board Meeting of July 13, 2021 RESOLUTION 2021-574 Item # 5.17 .0 3��`ttiya ADOPTED DOC ID: 17224 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2021-574 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JULY 13, 2021: RESOLVED that the Town Board of the Town of Southold hereby grants permission to Jonathan Shipman, to hold Special Event 2021-37 at The Pumpkin Patch at Shamrock Christmas Tree Farm, 20645 Main RD, Mattituck, New York as applied for in Application SCTF2a-f a for U- Pick Pumpkins and Farmers Market on October 9, October 10, October 16 October 17, October 23 and October 24, 2021 from 9AM - 5PM. All parking must be contained on site. Provided they adhere to all conditions on the application, permit and to the Town of Southold Policy for Special Events. This permit is subject to revocation if the applicant fails to comply with any of the conditions of the approval or is unable to properly control traffic flow into and out of the event. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Sarah E. Nappa, Councilwoman SECONDER:James Dinizio Jr. Councilman AYES: Nappa. Dinizio Jr, Doherty, Ghosio, Russell ABSENT: Louisa P. Evans Generated Jule 14. ?U21 Paye 31 RECEIVED S C APPLICATIQI)I R FOR A PERMIT TO HOLD A JUN 2 9 2M SPECIAL EVENT Please groaaiide of the information requested below.Incomplete applications RILL NOT be Southold jeQWfj.k,1erK Special Event Permit#' Applicant(s)name: .,44wh Date of Submission t7"d �/ Name of Event-14t /y�QAs;, '�fe-4 tt SA.0"'ra L[ SCTM#'s 1000-Sectionq7 3 ffq Block- 104-3 -3 Lot(s) ' V3) ' yylf ' yS Dates of Each Event: 10' 9 !o= /t� %G-/� �/0��7 ./0- _60-Z-0).y If Multiple Dates.are y' /regquested,applicant must give all information for all dates. 1 Nature.of Event: �/SCA t�(rr^ k� .S &rl"e m ,1,v kp r (Please attach a detailed description of EACH event to this application) Timc Period(Hours)of Event: From to 5 Town Services requested: ( )Yes W No!/ If yes,Describe Police Dept._Highway Dept. Describe Services -- CC- u#�ed Maximum Number of Persons Attending At One Time: aZ GV Number of cars expected/Uy o,, leSs Is a Tent or other temporary structure being used? [ K] Yes [ ] No If yes Provide size(s) /0 X1 o Will foo be served?[XJ Yes [ ]No If yes provide number and name(s)of food vendor(s) ��s f n r,i �., (�.,`/I lkeit £.ted £vgW& Suffolk County permit#-(s) PT 0066 qyg C, ,,,,y Will other vendors be on the premises durin,the a/vent?[ ]Yes [ J No/ If yes how many? / /Describe / Type ofvendor(s)M,44 lkvy�C 00vt-*1 C41 DS Aai4o liJ�h fS OyJT+ijti "Ale r VA4163 S.,vtV LAr,( V-n /3•.� Property Owner(name/address). 91 ' ' " L �'ir1��-fvcdE Contact Person and Contact Tel.# // -,�T�y� S/Li a+-^+t&, � 3/ ys 6 ?1A.oL e-mail address _54 q/" 1,D t k 71,4( )-/ 75 n 4 oy t C c en Event Location: Street-Hamlet Address:�11 0 0.5 Ag"n 4rd ^*+xlG k SCTM#�734?,f% lob', 3 �� ys Will any services be requested [ ]Yes [ ] No. If Yes describe Police Highway _Other: Mailing Address to Send Event Permit to: Fd au.)( /(/7p 7p, I-If A Ua i( 101 DATE(MM/DD/YYYY) ACo I CERTIFICATE OF LIABILITY INSURANCE 06/29/202, 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 Carol Losquadro NAME: Roy H Reeve Agency,Inc. PHONE (631)298-4700 FAX, (631)298-3850 41CN A/CNo PO Box 54 EMAIL closquadro@royreeve.com ADDRESS: 13400 Main Road INSURER(S)AFFORDING COVERAGE NAIC# Mattituck NY 11952 INSURER A: Atlantic Casualty INSURED INSURER B Shamrock Tree Company Inc INSURER C: INSURER D: PO BOX 1472 INSURER E: Mattituck NY 11952 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2162914764 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 TYPE OF INSURANCEADDLSUBK POLICY EFF POLICY EXP LIMITS LTR IND D POLICY NUMBER MMIDD/YYYY MM/DD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 �/ A N 100,000 CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ 5,000 A Y N L131002687-1 09/18/2021 10/30/2021 PERSONAL&ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY JECT PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATIONPER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER 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) 4745&2286 Elijahs Lane,Mattituck,NY 11952 Pumpkin Patch 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. 53095 Main Road PO BOX 1179 AUTHORIZED REPRESENTATIVE Southold NY 11971 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 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 earlv as possible. Any completed application that is not submitted 60 or more business days prior to the scheduled event may be reiected or subiect to a late processing fee of$250.00 by the Office of the Town Clerk unless a waiver is obtained. Requesting an expedited review must be submitted in writing to the Town Clerk.The Town Clerk will forward all applications to the Special Events Committee for processing. The Committee will obtain comments on all applications from relevant Town, County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. The Town reserves the right to request additional information from an applicant to address issues related to the health,safety,and welfare of the community. When is a Permit Required? All Special Events,per Southold Town Code Article I,Section 205-2(Definitions)must obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits. Any use of residential property for profit such as a venue for weddings or other events is prohibited. This application is deemed complete once all the following requirements are submitted to the Town Clerk: Please indicate submission of the following by checking off the boxes and si2ning below. i?7A completed application form signed by the owner and the event manager. Applications without property owner's signature/approval will be rejected. FEE: Is the application being submitted at least 60 days before the event R,�Yes [ ]No LJ If Yes,Fee of$ 3 has been submitted ❑ If No,Fee of$ has been submitted Fm-thei-more,I hereby authorize Code Enforcement Personnel of the Town of Southold to eater the property daring the hours of the permitted special event to in -e ny arr 1 inspections necessary in connection with this Special Event. LTo3 dr-1 Printn6me of Own� ure of Print name of Authorized Person/Representative Signature of Authorized Person/Representative PERMISSION IS HEREBY GRANTED. SUBJECT TO THE FOLLOWING CONDITIONS: 1. By acceptance of this permit, applicant agrees to adequately supenrise 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 tetmporary 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, tent(s) or t=orary structures) 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: Have any of the development rights been sold to the Town of Southold [ ]Yes [X] No and/or Suffolk County Agricultural Program? [ ]Yes QC]No If ves 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 PL_AMN TO THIS APPLICATION IF THE EXPECTED ATTENDANCE IS 300 OR MORE PEOPLE.YOU MUST ALSO ATTACH A TRAFFIC CONTROL PLAN (see next page) A Parkine/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 followimg 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. (3) 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. (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. Furthermzore,I hereby swear or affirm tliat t/ze 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.. Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 06/29/21 Receipt#: 283900 Quantity Transactions Reference Subtotal 1 Event Fee SCTF2a-f $150.00 Total Paid: $150.00 Notes: Payment Type Amount Paid By CK#2183 $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 Mattituck, NY 11952 Clerk ID: BONNIED Internal ID: SCTF2a-f