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HomeMy WebLinkAboutBoy Scout Troup 6 Car Show V111 Town Hall,53095 Main Road ELIZABETH A.NEVILLE,MMC P.O.Box 1179 TO" CLERK Southold,New York 11971 REGISTRAR OF VITAL STATISTICS Fax(631)765-6145 MARRIAGE OFFICER 7�7 -e4l. Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK RECEIVED TOWN OF SOUTHOLD JUL 2 1 M21 APPLICATION FOR A PERMIT TO HOLD A Southold Town Clerk SPECIAL EVENT jile information requested 1301mv. ILL_N(Yf bL- Please providc ALL ol'the information IT .reviewed. - Date of Submission Name ofEvent Name of organization: Is this a Not-For-Profit Event? -q /No�— e- Contact's Name: a.,) i Mailing Address; —--------............... Contact's Phone,Number: ane n e- Contact's Email Address: L ) 11 Event Location and Site Diagram-, V (Use additional paper if necessary) additional Event Date(s): S, .+U (Includ set u a d shut own ti es and dates) -5( A Nature of Event: V — --5— J�Nschripti ' to�h A-aU0 q is application) (Please attach a detailed— -am to Time Period (Hours) of Event: From Maximum Number of Expected Attendees: police presence): AC' C-0 vt Specify any special requirements(i.e. road/closure, -ALOA" Revised 8/5/15 If a Tent or other temporary structure will be used please contact the Southold Town Building Department at 631-765-1802 Mailing Address to Send Event Permit to: o. Event Fees: pp ,t \ CX� �C� ���✓\1\V11 $250 for events with less than 1000 expected attendees $500 for events with 1000 or more expected attendees Clean-up Fees (Can NOT be waived): $1,500.00 Clean-up for Bicycle and/or Running Special events(ONLY) x_$250 or more Clean-up deposit all other events CBIYI'II+IC4'I`E[)l+' iNSLIRANCF,REQIJil I;I): Not less than $2,000,000 naming the Town of Southold as an additional insured. ***TOTE. I'LEA.SE SEE ATTACHED REVISED ADOPTED �OWI� POLICY*** Additional information and requirements may be required as deemed necessary by the Town Board. .r Print name of Authorized Person filling out Signa re o Authori erson filling out application application *Upon the request by applicant,the Town Board may waive in whole or in part any of the application requirements. C945e_ &045-ideF WA�tai < � P 2 Revised 3/21/16 t 17 jqS-9 / 14,01 Cu 196-0 � ; u.sed � r°� T' �• � I � '' i ; � !-'o l � s � � T � ; I I o levy c ! OL t I IS f I �! � � l 4 I CExami s � Born, Sabrina From: Born, Sabrina Sent: Thursday,July 22, 2021 3:07 PM To: Blasko, Regina; Doroski, Melanie; Duffy, Bill; Easton, James; Flatley, Martin; Hagan, Damon; Kruszeski, Frank; Mirabelli, Melissa; Norklun, Stacey; Spiro, Melissa Subject: Boy Scout Car Show Attachments: Boy Scout Event_20210722150735.pdf Good Afternoon, Please find an application attached for the Boy Scout Car Show for dates: 9/3/21-9/4/21. Please approve/disapprove and provide cost analysis. Thank you, Deputy Town Clerk Southold Town Clerk's Office 53095 Route 25 P.O. Box 1179 Southold,NY 11971 Ph: 631-765-1800 ext. 1226 Fax: 631-765-6145 1 ,aco CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 11 07/22/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. 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 Laura Craig Marsh&McLennan Agency LLC PHONE FAx 8144 Walnut Hill Lane, 16th Floor A/c o 972-770-1402 AIC No 972-770-1699 E-MADallas TX 75231 ADDRESS. laura.craig@marshmma.com INSURERS AFFORDING COVERAGE NAIC# INSURER Evanston Insurance Company 35378 INSURED INSURER B Bov Scouts of America National Council and All of Its affiliates and subsidiaries ERC Suffolk County Council#404 INSURER 7 Scouting Blvd. INSURER E Medford, NY 11763 INSURER F COVERAGES CERTIFICATE NUMBER:941251576 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 ADDLSUBRPOLICY EFF POLICY EXP TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM DD//YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY MKLV4PBC001681 3/1/2021 3/1/2022 EACH OCCURRENCE $1,000,000 �OCCUR DAMAGES(RENTED CLAIMS-MADE PREMISES Ea occurrence) $1,000,000 MED EXP(Any one person) $ PERSONAL&ADV INJURY $1,000,000 M'OTHER L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $10,000,000 POLICY❑PRO LOC PRODUCTS-COMP/OP AGG $ JECT $ 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 PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per ac.,dent L $ A X UMBRELLA LIAB OCCUR MKLV4EUL103145 3/1/2021 3/1/2022 EACH OCCURRENCE $6,500,000 EXCESS LIAB Id CLAIMS-MADE AGGREGATE $13,000,000 DED X RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I ER ANYPROPRIETOR/PARTNER/EXECUTIVEEL EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? F NIA (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 I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder Is named as an additional Insured by virtue of a written or oral contract or by the Issuance/existence of a permit or certificate of Insurance but only with respect to operations by or on behalf of the Insured,or to facilities of,or facilities used by the Insured and then only of the limits of liability specified in such contract for the event specified.Primary and Non-Contributory applies as required by written contract or agreement Waiver of Subrogation applies when required by written contract or agreement Sexual Molestation coverage Is Incorporated In the policy and addressed by endorsment and Is subject to the policy period,terms,limits and conditions of the policy. Certificate holders Include directors,officers,agents,owners,volunteers,mortgagees and landlords as required by written contract or agreement. For.All Official Scout Activities CERTIFICATE HOLDER CANCELLATION Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 53095 Route 25 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS Southold, NY 11971 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Born, Sabrina From: Flatley, Martin Sent: Friday, July 23, 2021 8:38 AM To: Born, Sabrina; Blasko, Regina; Doroski, Melanie; Duffy, Bill; Easton, James; Hagan, Damon; Kruszeski, Frank; Mirabelli, Melissa; Norklun, Stacey; Spiro, Melissa Subject: RE: Boy Scout Car Show Attachments: CABoyScoutShow.xls I have no objections to this event being approved. My cost analysis is attached 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(1)notify us immediately by telephone at 639.765 2600, (n)return the ongmal 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: Born,Sabrina <sabrina.born @town.southold.ny.us> Sent:Thursday,July 22, 20213:07 PM To: Blasko, Regina <rblasko@town.southold.ny.us>; Doroski, Melanie<Melanie.Doroski@town.southold.ny.us>; Duffy, Bill <billd@southoldtownny.gov>; Easton,James<jamese@southoldtownny.gov>; Flatley, Martin <mflatley@town.southold.ny.us>; Hagan, Damon <damonh@southoldtownny.gov>; Kruszeski, Frank <fkruszeski@town.southold.ny.us>; Mirabelli, Melissa <melissam@southoldtownny.gov>; Norklun, Stacey <Stacey.Norklun @town.southold.ny.us>; Spiro, Melissa <Melissa.Spiro@town.southold.ny.us> Subject: Boy Scout Car Show Good Afternoon, Please find an application attached for the Boy Scout Car Show for dates: 9/3/21-9/4/21. Please approve/disapprove and provide cost analysis. Thank you, d ow Deputy Town Clerk Southold Town Clerk's Office 53095 Route 25 P.O. Box 1179 Southold,NY 11971 1 Town of Southold Police Department Special Event Cost Analysis Event: Boy Scout Troop 6 Car Show Date(s): September 4, 2021 Location: Peconic Community Center _ Patrol''Allocat� nvoj, ry ,,.wa { :,M.,F,r s v �. �.:.� "ai Reg Hours OT Hrs Hrly Wage Total Comments ,��-- �P >.� .'- Reg Hours OT Hrs Hrly Wage Total Comments CRU;111-41'. V�'�. „ ty, Bicycle�Patrolj'�,� %�a�; _ 01 MarineUnits 7 ~ ..,>.t4Trwv �..,q .:Ysa,;.....�'n -..:r Reg Hours OT Hrs Hriy Wage Total Comments TC Officer#1 8 $18.00 $144.00 TC Officer#2 TC Officer — – TC Officer — TC Officer - -- — 'Rr• "-E: - ^sr- ,.s,..=la''&hT`�,�*,�,.`i�',t •t;�;#.-_ --,..W —--� ,-e•--•,-.., �i„ment,Eosts , m-7- "_' w* daW.��j� ,s LF�'. a���:.:.r,5'„�'� PD Vehicles #of vehicles $/hr Total 1 $10.00 $80.00 $80.0_0 Command Van Marine Patrol Boats Total Department Cost for Event = $224.00 Prepared by Chief M Flatley 7/23/2021 Page 1 Born, Sabrina From: Duffy, Bill Sent: Thursday, July 22, 2021 3:53 PM To: Born, Sabrina Subject: RE: Boy Scout Car Show No objection William M. Duffy, Esq. Town Attorney Town of Southold Southold Town Annex 54375 Route 25 (Main Road) P.O. Box 1179 Southold, New York 11971-0959 Office: 631.765-1939 Fax: 631.765.6639 Email: billd@southoldtownny.gov From: Born,Sabrina <sabrina.born @town.southold.ny.us> Sent:Thursday,July 22, 20213:07 PM To: Blasko, Regina <rblasko@town.southold.ny.us>; Doroski, Melanie<Melanie.Doroski@town.southold.ny.us>; Duffy, Bill <billd@southoldtownny.gov>; Easton,James<jamese@southoldtownny.gov>; Flatley, Martin <mflatley@town.southold.ny.us>; Hagan, Damon <damonh@southoldtownny.gov>; Kruszeski, Frank <fkruszeski@town.southold.ny.us>; Mirabelli, Melissa <melissam@southoldtownny.gov>; Norklun, Stacey <Stacey.Norklun@town.southold.ny.us>; Spiro, Melissa <Melissa.Spiro@town.southold.ny.us> Subject: Boy Scout Car Show Good Afternoon, Please find an application attached for the Boy Scout Car Show for dates: 9/3/21-9/4/21. Please approve/disapprove and provide cost analysis. Thank you, SaAw4 aw Deputy Town Clerk Southold Town Clerk's Office 53095 Route 25 P.O. Box 1179 Southold,NY 11971 Ph: 631-765-1800 ext. 1226 Fax: 631-765-6145 1 ELIZABETH A.NEVILLE,MMC Town Hall,53095 Main Road TOWN CLERK ® P.O.Box 1179 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS p ® Fax(631)765-6145 MARRIAGE OFFICER �'� �� Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER ®j offi �►� FREEDOM OF INFORMATION OFFICER T www.southoldtownny.gov OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD August 20, 2021 Daniel Woods PO Box 67 Peconic,NY 11958 Dear Mr. Woods: The Southold Town Board, at its regular meeting held on August 10, 2021, granted permission to Boy Scout Troop 46 to hold its Annual Car Show on September 3 &4, 2021 (rd September 5, 2021). A certified copy of this resolution is enclosed along with the Town of Southold Policy for Special Events on town Properties and Roads. Failure to heed the policy may result in the loss of Clean-up deposit. An insurance policy naming the Town of Southold as additionally insured has been filed with this office. Applicant must comply with all executive orders of the State of New York. Please contact Captain Ki-uszeski at the Police Department, as soon as possible, to coordinate traffic control. If you have any questions please contact me at the Town Clerk's office at 631-765-1800. Good Luck with your event. Sincerely, Lynda M Rudder Deputy Town Clerk enc Southold Town Board - Letter Board Meeting of August 10, 2021 RESOLUTION 2021-636 Item 4 5.11 �3 ADOPTED DOC ID: 17282 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2021-636 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON AUGUST 10, 2021: RESOLVED that the Town Board of the Town of Southold hereby grants permission to Boy Scout Troop 6 to hold its 31" Annual Antique Car Show on Friday, September 3 and Saturday, September 4, 2021 (rain date Sunday September 5, 2021) from 7:00 AM to 4:00 PM at the Peconic Lane Community Center, Peconic Lane, Peconic, provided they file with the Town Clerk a Two Million Dollar Certificate of Insurance naming the Town of Southold as an additional insured and comply with all the provisions of the Town's Special Permit Policy. All fees associated with this approval shall be waived, with the exception of the clean-up deposit. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Sarah E.Nappa, Councilwoman SECONDER:Jill Doherty, Councilwoman AYES: Nappa, Dinizio Jr, Doherty, Ghosio, Russell ABSENT: Louisa P. Evans Generated AuUust 10. 2021 Page 22 Vendor No. Check No. Town of Southold, New York - Payment Voucher Vendor Name Vendor Address ( Entered by Audit Date Vendor Telephone Number (-v26 — 5 _ qQ) Town,Clerk Invoice Invoice Invoice Net Purchase Order Number Date Total j Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number oa OL-) T1.030 c_ o &0 U'� ! Total j Payee Certification Department Certification The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certil'y that the foregoing clai n is true and correct,that no part has in good condition without substitution,the services properly been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been v ified with the exceptions due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and paymen is pproved, Signatu Title Deputy Town Clerk Signatu a Company Name Date I'�L �2 1 Title:Deputy Town Clerk Date `•f �J p�� Southold Town Board - Letter Board Meeting of September 7, 2021 RESOLUTION 2021-693 Item # 5.10 Ey3 �a�� ADOPTED DOC ID: 17346 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2021-693 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON SEPTEMBER 7, 2021: WHEREAS the following groups have supplied the Town of Southold with a refundable Clean- up Deposit fee, for their events and WHEREAS the Southold Town Police Chief, Martin Flatley, has informed the Town Clerk's office that this fee may be refunded, now therefor be it RESOLVED that Town Board of the Town of Southold hereby authorizes a refund be issued in the amount of the deposit made to the following Name Date Received Amount of Deposit American Legion Post 803 6/29/21 $250.00 Griswold Terry Glover PO Box 591 Southold,NY 11971 Daniel Woods 7/21/21 $250.00 PO Box 67 Peconic,NY 11958 (Boy Scout Car Show) John Perez 8/30/21 $250.00 322 W. 52nd Street, 9339 New York,NY 10019 �, Cx Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED (UNANIMOUS] MOVER: Louisa P_ Evans_ Justice SECONDER:Robert Ghosio. Councilman AYES: Nappa; Doherty; Ghosio; Evans, Russell ABSENT: James Dinizio Jr Generated September 8; 2021 Page 19 Town of Southold P O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 07/21/21 Receipt#: 285108 Quantity Transactions Reference Subtotal 1 Clean-Up Deposit 9/3-4 $25000 Total Paid: $250.00 Notes: SOUIHOtU TOWN CLERK 53095 ROUTE 25 SOUTHOLD, NY 11971 631-765-1800 39300981938909 n— 'hant ID: 8904 i,••,, II• 0004 Store 11. 00Ut Ref A- 80U3 Payment Type Amount Paid By Sale Credit Card-Ref# $250.00 Woods, Daniel xUXYXXHH2919 MASTERCARD Entry Method: Chip Total: $ 250.00 Southold Town Clerk's Office 07/21/21 10:33:17 53095 Main Road, PO Box 1179 Inv a: 000003 Appr Code: 408576 Southold, NY 11971 Transaction ID: 0721MDBI9SHT Apprvd: Online Batchu: 000533 DEBIT MASTERCARD AID. AOOUO000041010 ISI: 6800 I'.R: 000088000 I agree to Fav above total amountaccordine to card 155uer• agreement (Merchant agreement 1t credit voucher) y------------------------------- WOODSiDANIEL Merchant COPY THANK YOUf Name: Woods, Daniel Boy Scout Troop 6 Po Box 67 Peconic, NY 11958 Clerk ID: LYNDAR internal ID 9/3-4