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HomeMy WebLinkAboutShamrock Christmas Tree Farm 2021-47 Southold Town Board - Letter Board Meeting of September 7, 2021 RESOLUTION 2021-704 Item# 5.21 r ADOPTED DOC ID: 17355 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO.2021-704 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON SEPTEMBER 7, 2021: RESOLVED that the Town Board of the Town of Southold hereby grants permission to Joseph Shipman, to hold Special Event 2021-47 at the Shamrock Christmas Tree Farm at 20685 Main Road, Mattituck,New York as applied for in Application SCTF4a&b for two (2) Choose and cut Christmas Trees and Farmers Market. On December 12 and December 18, 2021. All parking must be contained on site. Provided they 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 any and all executive orders of the State of New York. 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. M Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Robert Ghosio, Councilman SECONDER:Louisa P. Evans, Justice AYES: Nappa, Doherty, Ghosio, Evans; Russell ABSENT: James Dinizio Jr Generated September- 8, 2021 Page 30 Fat 4r O 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: Melissa Mirabelli Secretary to the Town Attorney Date: September 9, 2021 Subject: Special Event-Shamrock Christmas Tree Farm -SCTF4a-b With respect to the above-referenced matter, I am enclosing the original application with committee comments and resolution of Town Board approving event. If you have any questions regarding the enclosed, please do not hesitate to call me. Thank you. Cc: Denis Noncarrow /mm Enclosures Y L Special Events Committee Application Summary and Recommendation Application name: ,Tx?-PhI —S ftInWC� hn�iVWTnt -e Fa-riry) Address:X(QR5 V LY10 Rd, )a )C 04 Application number: S T F I4a — b Date of Event: 12k t a� I aoa Time: m Date Received by Town Clerk: aJr ao� Date Received by Committee: �5 Nature of Event (S): Ch6OSe G1�7 Committee Comments Received by: Denis Noncarow Melissa Spiro Leslie Weisman 'C Missy Mirabelli Chief Flatley August Ruckdeschel- County �K Heather Lanza -- James Easton varta7h(w 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: aOa I - L4-' Resolution No: oj0;)` - JQL4 Date: CI I c-7b TOWN OFSOUTHOLD Tdivh Code Chapter 205"Public Entertainment-and-Spccial,tventi-" 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 Bo&d of Appeals and Police Departments, and the Suffolk County Planning Commission. AAJp1J'e4tiofi-fe6: $150.00 per application.Up to six(6)multiple events of the same type, occurring over a period of three months,may be permitte4 on one(1)application fora fee of$150.00. However,specific details of each event must be included with this application. All applications must lye sabmitttd atleast 60,business di.Vs,,'fiqfbre'ihe,event. Appacants are encoyra6edtb�ubifilt Applka_tions-as,early as passible: ,Any comp[eMd,application tkafis-not-submitted 60 or more,business dais prior'twthescbedded event nim;be t6ie6ted'orttibleettoa,late-prot6siti<,Yi'ee'of$250.06ky-the Office of*etTowalcleikl unless a waiver is obtained. Requesting an expedited review must'be submitted in writing to the Town Clerk.The Town Clerk will forward all applications to the Special Events Committee for processing. The Committee will obtain comments on all applications from relevant Town, County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. The Town reserves the right to request additional information from an applicant to address issues related to the health,safety,and welfare of the community. Whenis,a Pernilt,Rpequired? All Special Events,per Southold Town Code Article L Section 205-2(Definitions)must obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits. AM iisqof residentialproperty 'such As � venue-for dp��for profit, 6-for weddings or p obibi a rg ted This applicafiGnis deemed complete onceallthe followinglegulfements'ard sub pitted_to the Town Clerk" Pleaseindicate-submission 6f thefollowbrity by chbeldne'-off kb6b6xe&hnd,M n nbelffir'. A completed "Iid6ii4n form signed by the owner and the event manager. Applications without property owner's signature/approval will be rejected. 0 FEE: Is the application being submitted at least 60 days before the event Yes No ❑ If Yes,Fee of$ has been submitted )tJ, If No,Fee of$ has been submitted RECEIVER APPLICATION FOR A PERMIT TO HOLD A SPECIAL EVENT AUG 7 5 2021 Please provide ALL of the irifoririation reauested helow.Incomplete applications"l- s N&S Clerk reviewed. Special Event Permit#_ Applicant(s)name: c�- -VA Date of Submission d1 `o�l)� lame of Event"7—r� S F4 L 2 SCTM#'s 1'OOMect' 4q " Q_Block- Q - 5 Lot(s), Dates of Each Event:1 If Multiple Dates are requested,applicant must give all information for all dates. Nature of Event- "af (Pld"ase'attkk a,ddtailed'description)of EACH event to this applic tioe.) ��- � -,�� ,�► � =.�,s Tee'� " Time Period(Hours) of Event: From:'• r rz to'�PC n- Town Services requested: { )Yes No If yes,Describe Police Dept. Highway Dept. Describe.Services' Maximum Number of Persons Attending At One Time:, Number of cars,e"xpected i'4 -Isra Tent or other tetxtporary structure being used? Yes [ ]No If yes,provide size(s)lic) �1® Will food be served?[ ]Yes 1- ]No If yes provide number and name(s)of food vendor(s) Suffolk County permit#(s} Will other vendors be on the premises during the event?�`�]Yes [ ]No If yes how many? Describe Type ofvendor(s)�G °Pro'erty ow,ner••(naive/addre�): .�� - `""C Contact Person and Contact Tel.# e-mail address G � , Y" rv^jte ,� 'fie C11✓ Event Location: Street-Hamlet Address:aQ LA SCTM# 1A-i--?-j-q-2!�j 102 15.I1 Will any services be requested [ ]Yes No. If Yes describe Police Highway Other: Mailing Address to Send Event Permit to: `• = :` -- e^ti `�'' - cd - October 3,2019 To whom it may concern, We are requesting this permit in order to have a small farmers market operate between 9 and 5 on 12/;-112/x&The location is 20685 Main Road Mattituck at the Shamrock Christmas Tree Farm.The farmers market will include North Fork Potato t Chip,Woodside Orchards,Surrey Lane Vineyard and Orchard,Salt Bird Cellars, Backyard Brine Pickle Company, Harbor Lights Oyster Co.,Greenport Jerky,and Pellegrini Vineyard.Several of the vendors will be utilizing 8x8 or 10x10 pop up tents to get out of the weather. Sincerely, Joseph Shipman , C t 7 t Have any of the development rights been sold to the Town of Southold[ ]Yes No and/or Suffolk County Agricultural Program? [ ]Yes No Yves to either or•,boffi, o indi ate on thea attaclicd plan•tho boghdaries of the reserved ea upon which the.event will take place. YOU NIVST•A:TTACIT'A-PARK MIG/EVENT-PLAN T®'T101TS APPLTCA`T- TON-I'TRE UftcTEi3ATfiF,NDA1`1Ct IS 300 CR'MORE PEOPLE,YOU MUST ALSO ATTACH A TRAFRC`CONTROL PLAN,(see next p42el A Parltiu /Event Plan znay'be=a.suryeY;site plan andlor aerW view ftr exairaple Cbo Ie lEartli) of ,the suliiect'prgrt 6 ty IIXDICA:MI:6 t_TSIV PLAN ALL of the fdllowhig informations- A parkinglevent 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 terpporary utilities to be installed for the event,if any. (8) Thedayout 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 6utdbor music;loudspeakdt° -and,othet"sounds which will be used, if any,�And the type and location of speakers and other,auldi+o_equipmerit. (11) A description of emergency access and facilities related to tli&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''traflic controller nu'stbe�pro`ided.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 S GNATURE: 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 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.. u The applicant/owner of the property where the special:e,,vetit is proposed-'to,tai�e,pi�cc Masiprovide a ceitificate of"insuraAde not less,thaii 2 million-dollars naming the Town ofSouikold:as.an-additional. insured A Parking/Event flan: consisting of a survey, site plan and/or aerial view of the subject property that includes the locations of on-site parldng, sanitary facilities, and tents or other temporary structure(s). tpr(See application form for details) w Events for three hundred (300) or more people require submission and approval of a.traffic control Ilan 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. 9/0-Lq _bdted Activities associated with outdoor public events are strictly prohibited from taking place on land preserved through the sale of,development rights to the Town of Southold, and can only take place on land preserved through the sale of development rights to the County of SVffolk with a permit issued by the Suffolk County Farmland Committee. j If food is to be served, it must be catered and prepared p�f-site by food vendors who hold a permit to operate issued by the Suffolk County Bureau of Public Health Food Protection Unit Furthermore,I hereby authorize Code Enforcement Personnel of the Town of Southold to enter the property during the hours of the permitted special event to make any and all inspections necessary in connection:with this Special Event. Print name of Owner' V Signature of Owner V Print name of Authorized Person/Representative Signature of Authorized Person/Representative PERMISSION IS IIEREBY,6l2 1T1~;I}.SUBJECT T, 6 THE>N OLLO_iING 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 strigtlyproliibited_on;ANY Town„Cop&orState-Roads orj�,i is of . Wav 2. Traf'fic,eontrol at events for-*ee,ltundred(300)oz more people_shall be provided by a qualified traffic controller in:accordance with the,attached,,approved 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. l S. 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.atJeast:60,business-,dans prior to'the scheduledeygnt. 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. NQ activities associated with this event, includirig�but'ji6flimit6d t6rparking- ingLe t egress/access, tezzt sl or ten ora . sfxuc[iire s',or tem orary sa iitax facilities sha Lbe condiieted,on Town.of Southold brchase ofDevdlopment Rights Land. 10.NO activities associated with this event includit-'but nit limited to "•arIairi iiiss/e ess/access touts,or teisi arai sbfactJare(s ,br..,ktn o sanity ,facilities shall`be,cortduoted on Suffolk Coun Purchase of-Develo mont Rights Iand without tea, permit,-issued•1i the- SuffAk Courity Eat land 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. ,q x Shamrock Christmas Tree Farm " 20685 Main Road Mattituck, New York 11952 Choose And Cut Christmas Tree's 631-298-4118 North Fork Potato Chips 2010 Oregon Road Mattituck, New York 11952 10 Varieties Homemade Potato Chips 631-298-8631 Harbor Lights Oyster Company -200 Harbor Light's Drive Southold, New York 11971 Mr.Ted Bucci Private Harvested Oysters 631-740-0985 Greenport Jerky Company ' { Greenport, NewYor�'11947 Homemade Jerky Mr.Vincent Macchirole 516-319-1002 Backyard Brine Inc. 8595 Cox Lane Cutchogue, New York 11935 Homemade Pickles 631-754-1050 Pellegrini Vineyards 23005 Main Road Cutchogue, New York 11935 John 631-734-4111 Salt Bird Cellars 2885 Peconic Lane Peconic, New York 11958 631-871-3204 Woodside Orchards 729 Route 25 Aquebouge, New York 11931 631-722-5770 'WRI c 5� gz- 1.116- jT I 7!iK .4v Fa.r)P7 er.3 -G,k, VA A5 • ,4cP-� asi qo �y1Lkl1 G 1iJ16 b dI�ATItaY86 'S 1�/Q fdlt 1'N G s;N t AN2 Irl A 4 67- Loi r f I i _ 1 p 1:5 IE: t Y 7 r _ V- 6 � r � KYSIF New York State insurance Fund 8 CORPORATE CENTER DR,3RD FLR,MELVILLE,NEW YORK 11747-3129 1 nysifcom CERTIFICATE OF WORKERS' COMPENSATION INSURANCE O © A A A A A A 112523690 ROY H REEVE AGENCY INC ,k 13400 MAIN RD Q PO BOX 54 MATTITUCK NY 11952 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER JOSEPH SHIPMAN DBA TOWN OF SOUTHOLD SHAMROCK PLANT HEALTH CARE 53095 ROUTE 25 985 ELIJAHS LANE PO BOX 1179 MATTITUCK NY 11952 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 11005467-3 796387 04/24/2021 TO 04/24/2022 812312021 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1006467-3, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVENOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS:I WWW.NYSIF.COLSJCERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. S THIS POLICY DOES NOT COVER THE SOLE PROPRIETOR,PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER_ THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:692021299 U-26.3 r I r A-0 V CERTIFICATE OF LIABILITY INSURANCE DATE(MM/°D/YYYY) 08/25/2021 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 Caro(Losquadro - NAME: Roy H Reeve Agency,Inc. A)CNNu Ext (631)298-4700 AICrNn:_ (631)298-3850 PO Box 54 E-MAIL ADDRESS: closgtiadrd@royreeve.com 13400 Main Road INSURER S)AFFORDING COVERAGE NAIC p Mattltuck NY 11952 INSURERA Greenwich insurance Co INSURED INSURER B Joseph Shipman,DBA Shamrock Plant Health Care INSURER C 985 Ell)ahs Lane INSURER D INSURER E. Mathtuck NY 1.1952 INSURER F: COVERAGES CERTIFICATE NUMBER: PL2182315117 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 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 - gUuL - - POLICY hf POLICY-ExP LTR TYPE OF INSURANCE (NSD WAD POLICY NUMBER MMIDDIYYYY MM/DDIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s 1,!)00,01)0 GAMAGE IO REi OED CLAIMS-MADE � m OCCUR PREMISES Ea oewonea S 100,000 MED EXP(Any oie eerscnl s 5,000 A Y NGL-1002187-02 11/30/2021 11/3012022 PERSONA-&ADV INJURY s 1,000,000 GEN'lLAGQRFGATELIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY )-& LOC PRODUCTS-COMPrOP AGG $ 2'000'000 OTNi;s"t. $ AUTOMOBILE LIABILITY - COt.1k31NER-It,IGLE t:IMIT $ 'a :.[!deni) ]'ANY AUTO BOOR INJJRY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS 380DILY INJURY(Per acadent) $ HIRED NON-OWNED - PR3PERTtt1AMAGE $ AUTOS ONLY AUTOS ONLY PCP'dCclBCtst UMBRELLA LIAR- ,'OCCUREACH OCCURRENCE `$ 1.000.600 , A EXCESS LIAB CLAl.rMADE, NEC-6005962-02 1113012021 11130=22 'AGGREGATE $ 1,000,000 DED F, -- iC�N.S 10,000 WORKERS COMPENSATION ' AND EMPLOYERS'LIABILITY ;YIN STT11. I 1 5:11 - ANYPROPRIETORfPARTNERIEXECUTIVENIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? - - (Mandatory In NH) - E L,,DISEASE-EA EMPLOYEE -$ 'Ifyes 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) Certificate holder is named as additional Insured by written contract or agreement according to the terms of policy form CG 2010 0413 PERMIT FOR 11/112021 to 12/31/2021 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 Route 25 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 r Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 08/25/21 Receipt#: 286584 Quantity Transactions Reference Subtotal 1 Event Fee SCTF3a-f $150.00 1 ,v Event Fee SCTF4a-bz.. '$150:00 Total Paid: $300.00 Notes; Payment Type Amount Paid By CK#1308 $300.00 Shamrock, Christmas Tree Farm z 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: SABRINA Internal ID.SCTF4a-b y 4 ? Mirabelli, Melissa From: Spiro, Melissa Sent: Wednesday,August 25, 2021 3:11 PM To: Mirabelli, Melissa Subject: RE: Shamrock Christmas Tree Farm Special Event Application 2 of 2 This is not Town or County preserved land. Melissa Spiro From: Mirabelli, Melissa Sent: Wednesday,August 25, 20212:39 PM To: Webster, Kevin <kevin.webster@town.southold.ny.us>; Glew, Claire<Claire.Glew@town.southold.ny.us>; Allegue, Lauren<Lauren.Allegue@suffolkcountyny.gov>; Ruckdeschel,August<August.Ruckdeschel@suffolkcountyny.gov>; Amakawa,Andrew<Andrew.Amakawa@suffolkcountyny.gov>;Spiro, Melissa<Melissa.Spiro@town.southold.ny.us>; Easton,James<jamese@southoldtownny.gov> Subject: Shamrock Christmas Tree Farm Special Event Application 2 of 2 Application number 2 as always send comments and or questions to me please and thank you 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 i Y t. io Mirabelli, Melissa From: Flatley, Martin Sent: Thursday,August 26, 2021 9:01 AM To: Leslie Weisman Forward; Mirabelli, Melissa;Verity, Mike; Duffy, Bill; Noncarrow, Denis; Lanza, Heather;Weisman, Leslie Subject: RE: Shamrock Christmas Tree Farm application 2 of 2 today I think Leslie makes a good point that should be addressed, but as far as parking and traffic goes, I have no objection Martin Flatley, Chief of Police Town of Southold Police Department 41405 State Route 25 Peconic, N.Y. 11958 Tel: 631-765-3115 UO- 1 The infonnation 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: Leslie Weisman Forward<lesliekweisman@gmail.com> Sent:Wednesday, August 25, 20215:32 PM To: Mirabelli, Melissa<melissam@southoldtownny.gov>;Verity, Mike<Mike.Verity@town.southold.ny.us>; Flatley, Martin <mflatley@town.southold.ny.us>; Duffy, Bill<bilid @southoldtownny.gov>; Noncarrow, Denis <denisn@southoldtownny.gov>; Lanza, Heather<heather.lanza@town.southold.ny.us>;Weisman, Leslie <lesliew@town.southold.ny.us> Subject: RE:Shamrock Christmas Tree Farm application 2 of 2 today I don't know what the rest of you think but in my opinion special events were not intended for this sort of purpose. Rather it was to allow wineries and farms to market their own farm products in ways that were not a regular part of their own daily farm operations(like holding weddings on their property where their wine is sold at the event and their venue is rented out and outside caterers are brought in.) Now it seems like everyone wants to do whatever will draw people to their premises to make more money in ways that have little to do with direct marketing of their farm products. It's one thing if a legitimate farmers market organization with members wanted to apply for a special event on someone else's property, but another in reverse. Maybe this is something that Bill and Denis should talk to the Town Board about in executive session.lust my thoughts Leslie From: Mirabelli, Melissa [mailto:melissam(absoutholdtownny.gov] Sent: Wednesday, August 25, 20212:33 PM To: Verity, Mike; Flatley, Martin; Duffy, Bill; Noncarrow, Denis; Lanza, Heather; Weisman, Leslie Subject: Shamrock Christmas Tree Farm application 2 of 2 today 1 This is the second application from Shamrock Christmas tree farm Melissa IOI. 111fir abelli 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 2 Mirabelli, Melissa From: Webster, Kevin Sent: Thursday,August 26, 2021 3:05 PM To: Mirabelli, Melissa Subject: RE: Shamrock Christmas Tree Farm Special Event Application 2 of 2 No issue. 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: Wednesday, August 25,20212:39 PM To: Webster, Kevin<kevin.webster@town.southold.ny.us>;Glew, Claire<Claire.Glew@town.southold.ny.us>; Allegue, Lauren<Lauren.Allegue@suffolkcountyny.gov>; Ruckdeschel,August<August.Ruckdeschel@suffoIkcountyny.gov>; Amakawa,Andrew<Andrew.Amakawa@suffolkcountyny.gov>;Spiro, Melissa <Melissa.Spiro@town.southold.ny.us>; Easton,James<jamese@southoldtownny.gov> Subject: Shamrock Christmas Tree Farm Special Event Application 2 of 2 Application number 2 as always send comments and or questions to me please and thank you Alelrssa 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 i t � � Mirabelli, Melissa From: Noncarrow, Denis Sent: Tuesday,August 31, 2021 10:15 AM To: Mirabelli, Melissa Subject: RE: Shamrock Christmas Tree Farm application 2 of 2 today I think all these Shamrock tree events are good.They seem to be local vendors. As I understand what Leslie is saying, I really think the board needs to visit this at the end of this season. Denis Noncarrow Government Liaison Officer Town of Southold, New York www.southoldtownn y.goy 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: Mirabelli, Melissa Sent:Tuesday,August 31, 20219:31 AM To: Noncarrow, Denis<denisn@southoldtownny.gov> Subject: FW:Shamrock Christmas Tree Farm application 2 of 2 today clf 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 (63 1) 765-1939 Fax (631)765-6639 From: Mirabelli, Melissa Sent:Wednesday,August 25,20212:33 PM To:Verity, Mike<Mike.Verity@town.southold.ny.us>; Flatley, Martin <mflatlev@town.southold.nv.us>; Duffy, Bill <billd@southoldtownny.Bov>; Noncarrow, Denis<denisn@southoldtownny.gov>; Lanza, Heather <heather.lanza@town.southold.nv.us>;Weisman, Leslie<lesliew@town.southold.nv.us> Subject:Shamrock Christmas Tree Farm application 2 of 2 today 1 l f V ; This is the second application from Shamrock Christmas tree farm 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 2 Mirabelli, Melissa From: Lanza, Heather Sent: Thursday, September 2, 2021 10:38 AM To: Leslie Weisman Forward; Mirabelli, Melissa; Noncarrow, Denis;Weisman, Leslie; Flatley, Martin;Verity, Mike; Duffy, Bill Subject: RE: Shamrock Christmas Tree Farm I agree with Leslie—it's really up to the Town Board to decide if things like this are special events or something else. I seem to recall there were traffic issues with this one,maybe three years ago?Did they control the parking and traffic well last year?Did they have it last year with Covid? If they,granted it last year, and there weren't any complaints about it or problems, then I guess it's OK for this year. From: Leslie Weisman Forward Sent:Wednesday,September 01, 20212:10 PM To: Mirabelli, Melissa <melissam@southoldtownny.gov>; Noncarrow, Denis<denisn@southoldtownny.gov>;Weisman, Leslie<lesliew@town.southold.ny.us>; Flatley, Martin<mflatley@town.southold.ny.us>; Lanza, Heather <heather.lanza@town.southold.ny.us>;Verity, Mike<Mike.Verity@town.southold.ny.us>; Duffy, Bill <billd@southoldtownny.gov> Subject: RE:Shamrock Christmas Tree Farm The Town Board granted this same event a permit last year and now there is precedent so I assume they will have no issues with it this time. I still stand by my previous comments that this type of event is a matter for the town board to discuss, not just for this applications, but as a matter of code interpretation going forward Leslie From: Mirabelli, Melissa [mailto:melissam@southoldtownnygov] Sent: Wednesday, September 1, 2021 10:16 AM To: Noncarrow, Denis; Weisman, Leslie; Flatley, Martin; Lanza, Heather; Verity, Mike; Duffy, Bill Subject: Shamrock Christmas Tree Farm Checking on the status of where we stand on these applications that were sent out to everyone on 8/25/2021. The next town board meeting is on Tuesday and we are off on Monday. I have pulled,last years application from this same exact event if anyone wished to see it before giving their final opinion on this application please let me know and I will gladly send it over to anyone Please keep me posted. l Ifelissa Al. 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 Office (631) 765-1939 i RESOLUTION 2021-704 ADOPTED DOC ID: 17355 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2021-704 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON SEPTEMBER 7,2021: RESOLVED that the Town Board of the Town of Southold hereby grants permission to Joseph Shipman,to hold Special Event 2021-47 at the Shamrock Christmas Tree Farm at 20685 Main Road, Mattituck,New York as applied for in Application SCTF4a&b for two (2) Choose and cut Christmas Trees and Farmers Market. On December 12 and December 18, 2021. All parking must be contained on site. Provided they 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 any and all executive orders of the State of New York. 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: Robert Ghosio, Councilman SECONDER:Louisa P. Evans, Justice AYES: Nappa,Doherty, Ghosio, Evans, Russell ABSENT: James Dinizio Jr C oma • �� RECEIVE A U G 2 5 2021 TOWN OF SOUTHOLDotlthgld Town Clerk Town Code Chapter 205 "Public Entertainment and Sn -iaEvent ' 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 fora fee of$150.00. However,speck details of each event must be included with this application. All applications must be submittbd 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 may be reiected or subiect to a late processing fee of$250.00 by the Office of the Town Clerk unless a waiver is obtained. Requesting an expedited review must'be submitted in writing to the Town Clerk.The Town Clerk will forward all applications to the Special Events Committee for processing. The Committee will obtain comments on all applications from relevant Town, County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. The Town reserves the right to request additional information from an applicant to address issues related to the health, safety,and welfare of the community. When is a Permit Required? All Special Events,per Southold Town Code Article I, Section 205-2(Definitions)must obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits. Any use of residential property for profit such as a venue for weddings or other events is prohibited. This application is deemed complete once all the following requirements are submitted to the Town Clerk: Please indicate submission of the following by checking off the boxes and signing below. A completed application form signed by the owner and the event manager. Applications without property owner's signature/approval will be rejected. ❑ FEE: Is the application being submitted at least 60 days before the event[ ] Yes [ ]No ❑ If Yes,Fee of$ 3010 has been submitted V If No,Fee of$ has been submitted RECEIVED APPLICATION FOR A PERMIT TO HOLD A SPECIAL EVENT AUG 2 5 2021 Please provide ALL of the information requested below.Incomplete applications3NUC9erk reviewed. Special Event Permit# Applicant(s)name:`�Q��(� Date of Submissiong- 'aD-I lame of Event v SCTM#'s 1000-Section-l-1 —2 R Block-10 - 3 • Lot(s) 4-A Dates of Each Event:l If Multiple Dates are requested, applicant must give all information for all dates. }� Nature of Event: (Please attach a detailed description of EACH event to this applic tion) Time Period(Hours) of Event: From to _ Town Services requested: ( )Yes �4 No If yes,Describe Police Dept._Highway Dept. Describe Services, Maximum Number of Persons Attending At One Time: o^00 Number of cars expected Is a Tent or other temporary structure being used? Q`]Yes [ ]No If yes provide sizes)0 1 'A 15, -V�j1 Will food be served?[ ]Yes [-]No If yes provide number and name(s)of food vendor(s) Suffolk County permit#(s) Will other vendors be on the premises during the event?l`�]Yes [ ]No If yes how many? Describe Type of vendor(s)see Property Owner(name/address): 1A ` 1, .C)RYj taOlr'Q— Contact Person and Contact Tel.# -J411-2 e-mail addressr--Cl-�, r! l 1 i1� X11✓ Event Location: Street-Hamlet Address:DOLA SCTM# Will any services be requested [ ]Yes *No. If Yes describe Police Highway Other: Mailing Address to Send Event Permit to: c October 3,2019 To whom it may concern, We are requesting this permit in order to have a small farmers market operate between 9 and 5 on a '12/ 12/0&The location is 20685 Main Road Mattituck at the Shamrock Christmas Tree Farm.The farmers market will include North Fork Potato Chip,Woodside Orchards,Surrey Lane Vineyard and Orchard,Salt Bird Cellars, Backyard Brine Pickle Company, Harbor Lights Oyster Co.,Greenport Jerky,and Pellegrini Vineyard.Several of the vendors will be utilizing 8x8 or 10x10 pop up tents to get out of the weather. Sincerely, Joseph Shipman ' '4 Have any of the development rights been sold to the Town of Southold[ ]Yes No and/or Suffolk County Agricultural Program? [ ]Yes No If yes to either or both,also indi ate on the attached plan the boundaries of the reserved iea.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 page) A Parking/Event Plan may be a survey, site plan and/or aerial view (for example Google Earth) of the subject 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 ternporary utilities to be installed for the event,if any. (8) The,,Iayout of any parking area for automobiles and other vehigles 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 tLS 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. 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.. 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 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) KFEvents 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. xq OLO a I bated gna cre Activities associated with outdoor public events are strictly prohibited from taking place on land preserved through the sale of development rights to the Town of Southold, and can only take place on land preserved through the sale of development rights to the County of S,gffolk with a permit issued by the Suffolk County Farmland Committee. _ If food is to be served, it must be catered and prepared off-site by food vendors who hold a permit to operate issued by the Suffolk County Bureau of Public Health Food Protection Unit. Furthermore,I hereby authorize Code Enforcement Personnel of the Town of Southold to enter the property during the hours of the permitted special event to make any and all inspections necessary in connection with this Special Event. 1,10,5 et? I? M4 Print name of Owner )�S�ipaAtref Owner 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 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) oz 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 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 in ess/egress/access tent(s) or temporary structure(s) 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. Shamrock Christmas Tree Farm 20685 Main Road Mattituck, New York 11952 Choose And Cut Christmas Tree's 631-298-4118 North Fork Potato Chips 2010 Oregon Road Mattituck, New York 11952 10 Varieties Homemade Potato Chips 631-298-8631 Harbor Lights Oyster Company .200 Harbor Light's Drive Southold, New York 11971 Mr.Ted Bucci Private Harvested Oysters 631-740-0985 Greenport Jerky Company ' { Greenport, New York-11947 Homemade Jerky Mr.Vincent Macchirole 516-319-1002 Backyard Brine Inc. 8595 Cox Lane Cutchogue, New York 11935 Homemade pickles 631-754-1050 Pellegrini Vineyards 23005 Main Road Cutchogue, New York 11935 John 631-734-4111 Salt Bird Cellars 2885 Peconic Lane Peconic, New York 11958 631-871-3204%,,- Woodside Orchards 729 Route 25 Aquebouge, New York 11931 631-722-5770 � t Vie. �' -- ,-s.,_,;. ,�� r�^,cr •ems.c.�? �;;`�s i+- ys.c �s� � � 1' ,n 4�...�,.rs �.r>. fi�' �' t:' ',� e1•: �_� �,.w +q"� !.,r ..rte \ 4- _ � ,yam ,`. - » ""'t :{1��� ��. i�.r�'^i. w�.,:y �f �._ 1 � � '� , t•. a ie; y -t'jy�' �,� �� :��,.'n.� _-to"51i••c�#�+ �- �:nl'.3 .:z �� d � t-• 34 - .k r � � r � Y ,d'�''y. r�, a..ea T Hifi; f✓'- - �,, ` r:+ ' ;.k�•� ,' ' Ju 4 - • - ��3'��f' /� rev 1_. ��3+y� E+ �� �� .•C ,�, _i,�,; _ S�Lr ry ,S � "P, i �:M. �.. ►� - ��.• � si:>,, n1�� .,,t F, 4y,.:'rc3r a s ..M;.� ,�a ate`t-X z_. ,�.�y /.i F '? �y.!.»-ti �'ra,�« F r.�:�"`"t � � r' ja A yar ;L .•c vM'lis; :f (j'y j_•+r a"+�'^'"��t,,a.�µ' Y% i•. 1•V- �' / - / - - .e .•f�l. a�C't i�Sy't1:'i, ,,,.�✓ar�"�'+-• [-ff,..+ �17�Y�ib�'A�" �f �.s,!r'' ,�.� 'r� �_! ''. _ .� '1? �fc tee Al zv- V;v 1 ql r�'�,�`�'°�.R � m� f.F�' s �may`•,kik Y, �; � �'" � 1 r . �/�,. 1 �� '�'- ;(� �+�� a;rj�}�{...fir` �:" pfyp�ty�20790o0pN.Inlp�ry 02019 Meu T�dv»bq'+l New York 6lSlA�p drt�CL010 UN�od Sacea Teems Sendl^Gb+:4 wh' �- rA A:5 � � - VVI Acle ���. . 614 p.4c i]-K yS G9RS .3.6 ,01,4's d 4��7N12Di 5 �7�rxls N G cf z_ _- i^�g _ SACa .3a0 �,¢ ��ry_ ya"c/plzs s'i"0 ft.�s3 g �(tj; cub' i�,.'�'�'�� � S t$o �� ,•.,.,�_...,...�A...._ . rz ai S >p -rAF�l'� ! =S d 1tJtit r}ABA CO G Ire G Art e q 11,9 c��s ;z a 1,4 i s 0 IN G Loi -` --CAm6 1 rfz i � 4:� s � _ i X , Al • :tJ NYSIF New York State Insurance Fund 8 CORPORATE CENTER DR,3RD FLR,MELVILLE,NEW YORK 11747-3129 nysifcom CERTIFICATE OF WORKERS' COMPENSATION INSURANCE © D ^^^^^^ 112523690 ROY H REEVE AGENCY INC k � 13400 MAIN RD PO BOX 54 MATTITUCK NY 11952 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER JOSEPH SHIPMAN DBA TOWN OF SOUTHOLD SHAMROCK PLANT HEALTH CARE 53095 ROUTE 25 985 ELIJAHS LANE PO BOX 1179 MATTITUCK NY 11952 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE 11006467-3 796387 04/24/2021 TO 04/24/2022 8/23/2021 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1006 467-3, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPSJfWWW.NYSIF.COMfCERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER THE SOLE PROPRIETOR,PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING ( VALIDATION NUMBER:692021299 U-26.3 ACCO 088125/25!22021021 CERTIFICATE OF LIABILITY INSURANCE DAT / Y) 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 Carol Losquadro NAME: Roy H Reeve Agency,Inc acNNo Ext• (631)298-4700 AX(AJCNo): (631)298-3850 PO Box 54 E-MAIL closquadro@royreeve com ADDRESS. 13400 Main Road INSURER(S)AFFORDING COVERAGE NAIC p Mattituck NY 11952 INSURERA: Greenwich Insurance Cc INSURED INSURER B: Joseph Shipman,DBA Shamrock Plant Health Care INSURER C. 985 Elijahs Lane INSURER D INSURER E Mattituck NY 11952 INSURER F COVERAGES CERTIFICATE NUMBER: CL2182315117 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 AUUL15L1HR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDIYYYY MM/DDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE �OCCUR PREMISES Ea occurrence) ccurrence $ 100,000 MED EXP(Any one person) $ 5,000 A Y NGL-1002187-02 11/30/2021 11/30/2022 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY ❑PRO- F—]JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per acadent UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE NEC-6005962-02 11/30/2021 11/30/2022 AGGREGATE $ 1,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION PER OTH- rEMPLOYERS'LIABILITY Y/N STATUTE I I ER PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E L EACH ACCIDENT $ D OFFICER/MEMBER EXCLUDE (Mandatory in NH) E L DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more space is required) Certificate holder Is named as additional insured by wntten contract or agreement according to the terms of policy form CG 2010 0413 PERMIT FOR 11/1!2021 to 12/31/2021 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 Route 25 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 P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 08/25/21 Receipt#: 286584 Quantity Transactions Reference Subtotal 1 Event Fee SCTF3a-f $150.00 1 Event Fee SCTF4a-b $150.00 Total Paid: $30000 Notes: Payment Type Amount Paid By CK#1308 $300.00 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: SABRINA Internal ID.SCTF4a-b