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HomeMy WebLinkAboutEast End Hospice Tree of Lights O�os�f F ELIZABETH A.NEVILLE,MMC �� �/y Town Hall,53095 Main Road TOWN CLERK ® P.O.Box 1179 sn = Southold,New York 11971 REGISTRAR OF VITAL STATISTICS Fax(631)765-6145 MARRIAGE OFFICER '�� 01` Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER www.southoldtownny.gov OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD November 15, 2021 Debbie Doyle East End Hospice PO Box 1048 Westhampton Beach,NY 11978 Dear Mrs. Doyle: The Southold Town Board, at its regular meeting held on November 3, 2021, granted permission to the East End Hospice to hold its annual Tree of Lights Memorial Service on December 5, 2021 1:00 pm to 3:30 pm.. A certified copy of the resolution is enclosed. An insurance policy naming the Town as additionally insured has been filed with this office. Please be sure to contact Captain Kruszeski, at the Police Department, 765-2600, as soon as possible,to coordinate traffic control if required Very truly yours, c5A 41 C�'� Lynda M Rudder Southold Deputy Town Clerk Enc. Southold Town Board - Letter Board Meeting of November 3, 2021 RESOLUTION 2021-844 Item# 5.10 �3 "3pf f y°ate ADOPTED DOC ID: 17494 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2021-844 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON NOVEMBER 3, 2021: RESOLVED that the Town Board of the Town of Southold hereby grants permission to East End Hospice to hold its East End Hospice Tree of Lights on the Cutchogue Village Green on December 5, 2021 from 1:00 PM to 3:30 PM,provided they adhere to the Town of Southold Policy for Special Events on Town Properties and Roads. All Town fees for this event, with the exception of the Clean-up Deposit, are waived. Elizabeth A.Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Jill Doherty, Councilwoman SECONDER:Robert Ghosio, Councilman AYES: Nappa, Dinizio Jr, Doherty, Ghosio, Evans, Russell Generated November 4. 2021 Page 17 k t ELIZABETTi A.NE'VILLE MMC � ��' _•�'��::; ,'•c�;,'' Town Hall,53095 Main Road "��, 6q, � kE,"� P.O.Box 1179 TOWN CLERK - J `°`` Southold,New York 11971 Fax(631)765-6145 REGISTRAR OF VITAL STATISTICS ,M,+ MARRIAGE OFFICER ��, .�'�� ` 4>•-. � .`r �� Telephone(631)765-1800 =;t www.southoldtownny.gov RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER h ®C k Eck „(, 'r 4& OFFICE OF THE TOWN CLERK RECEIVED TOWN OF SOUTHOLD OCT 2 1 2021 APPLICATION FOR A PERMIT TO HOLD A Southold Town Clerk SPECIAL EVENT Please provide ALL ol'tlie informuliou rcc nested below.11jcoo1lett a >>licatians WILL No'r be reviewed. c �b-� zA 4" ._z CM Z I Date of Submission _ --— -- Name of Event_ Name of Organization: Is this a Not-For-Profit Event?-dt- Yes/No_ -,P i Contact's Name: Mailing Address: RO _ ) to- f,, G 3 1 . Contact's Phone Num e. Contact's Email Address: Event Location and Site Diagram', (Use additional paper if necessary) q r 53 , 3O P Event Date(s): 5 �-- (include set up and shut<o�vn times and dates Lca—tiPn—) �( Nature of Event: CZ k 41 ��'C.(Please attach a detaile escription to this appf 0 Time Period(Hours) of Event: From to Maximum Number of Expected Attendees: _- _—.3 O — • -- f Specify any special requirements(i.e.road closure,p police presence): 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 :n r /_ Mailing Address to Send Event Permit to: /y CA Evens Fees: 5250 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) $250 or more Clean-up deposit all other events Cl It"l'll'lC'��I'1' ()1� li\SIIRAiV('1', Rf,QUlju',D: Not less than$2,000,000 naming the Town of Southold as an additional insured. ***Ir1O E: 13 LEASE SK,E AIrTA C;1-1 V D REVISED ADOPTED TOWN POLIO'*** Additional information and requirements may be required as deemed necessary by the Town Board, —�-_- - Si re o utho zed Person g out application Print name of Authoriz Pers n filling out g application *Upon the request by applicant,the Town Board may waive in whole or in part any of the application requirements. 2 Revised 3/21/16 a, a ► Client#:3328 EASTEND46 ATE(MMIDOIYYYY) ACORD.. CERTIFICATE OF LIABILITY INSURANCE DoaroM12o21 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 IELOW.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 any rights to the certificate holder In lieu of such endorsement(s). PRODUCER NAME: Commercial Support Edgewood Partners Ins.Center AHrc°NNe E:1:631 324-1440 ac No: 40 Marcus Drive ADDE-MAIL certificates@cookmaran.com 3rd Floor INSURERS AFFORDING COVERAGE NAIC N Melville,NY 11747 Nat'l Union Fire Ins Co Pittsburgh PA 19445 INSURER A: 9 INSURED INSURER B: East End Hospice Inc INSURER C P.O.Box 1048 Westhampton Beach,NY 11978 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE,AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, �N EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE ASDL WVD POLICY NUMBER MMIDDY POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY VHNUHGO01102701 04/0112021 0410112022 EACH OCCURRENCE S1000000 CLAIMS-MADE DIOCCUR PREMISES EaocaE�nce 31,000,0()o MED EXP(Any one person) S50,000 PERSONAL 8 ADV INJURY $1,006,000 GENL AGGREGATE LIMIT APPLIES PER' GENERAL AGGREGATE s3,000,000 X POLICY EIJECT LOC PRODUCTS-COMPlOPAGG 53 OOO,OOO OTHER $ AUTOMOBILE LIABILITY VHNUHA001103601 0410112021 04/011202 EO aBudEeDnI51NGLE LIMIT 51,000,000 ANY AUTO BODILY INJURY(Per person) 5 OWNEDSCHEDULED BODILY INJURY(Per eccidenl) S AUTOS ONLY X AUTOS HIRED NON-OWNED PROPERTY DAMAGE 5 X AUTOS ONLY X AUTOS ONLY Per acadenl S A UMBRELLA LIAR I X I OCCUR VHNUHX001103701 0410112021 04/01/2022 EACH OCCURRENCE $5000000 X1 EXCESS LIAR CLAIMS-MADE AGGREGATE $6,000,000 DED RETENTIONS S WORKERS COMPENSATION PER i OTH- AND EMPLOYERS'LIABILITY OFFICERMEMBER EXCLUDED?ECUiIVE� NIA E.L.EACH ACCIDENT S (Mandatory In NH) E.L.DISEASE-EA EM1IPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT 5 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD Jai,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 1179 ACCORDANCE WITH THE POLICY PROVISIONS. Southold,NY 11971-0000 AUTHORIZED-RE_PREESENTA71VE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD #S30105401M3010485 CCUMM Rudder, Lynda From: Flatley, Martin Sent: Friday, October 22, 2021 2:43 PM To: Rudder, Lynda; Blasko, Regina; Doroski, Melanie; Duffy, Bill; Easton,James; Hagan, Damon; Kruszeski, Frank; Mirabelli, Melissa; Norklun, Stacey; Spiro, Melissa Subject: RE: East End Hospice Tree lighting I have no objections to approving this as in the past Martin Flatley, Chief of Police Town of Southold Police Department 41405 State Route 25 Peconic, N.Y. 11958 Tel: 631-765-3115 The information contained in this electronic message and any attachments to this message are intended for the exclusive use of the addressee(s) and may contain information that is privileged,confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient,you are hereby notified that any review, retransmission, conversion to hard copy, copying, reproduction, circulation, publication, dissemination or other use of, or taking of any action, or omission to take action, in reliance upon this communication by persons or entities other than the intended recipient is strictly prohibited. If you have received this communication in error, please (i) notify us immediately by telephone at 631.765.2600, (ii) return the original message and all copies to us at the address above via the U.S. Postal Service, and (iii) delete the message and any material attached thereto from any computer, disk drive, diskette, or other storage device or media. -----Original Message----- From: Rudder, Lynda <lynda.rudder@town.southold.ny.us> Sent: Friday, October 22, 202110:36 AM To: Blasko, Regina <rblasko@town.southold.ny.us>; Doroski, Melanie<Melanie.Doroski@town.southold.ny.us>; Duffy, Bill <billd@southoldtownny.gov>; Easton,James<jamese@southoldtownny.gov>; Flatley, Martin <mflatley@town.southold.ny.us>; Hagan, Damon <damonh@southoldtownny.gov>; Kruszeski, Frank <fkruszeski@town.southold.ny.us>; Mirabelli, Melissa <melissam@southoldtownny.gov>; Norklun, Stacey <Stacey.Norklun@town.southoId.ny.us>;Spiro, Melissa <Melissa.Spiro@town.southold.ny.us> Subject: East End Hospice Tree lighting Please provide approval/disapproval and cost analysis if any,thanks. 1 Rudder, Lynda From: Duffy, Bill Sent: Monday, October 25, 2021 9:13 AM To: Rudder, Lynda Subject: RE: East End Hospice Tree lighting 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 -----Original Message----- From: Rudder, Lynda <lynda.rudder@town.southold.ny.us> Sent: Friday, October 22, 202110:36 AM To: Blasko, Regina <rblasko@town.southold.ny.us>; Doroski, Melanie<Melanie.Doroski@town.southold.ny.us>; Duffy, Bill<bilid @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: East End Hospice Tree lighting Please provide approval/disapproval and cost analysis if any,thanks. 1 Rudder, Lynda From: Spiro, Melissa Sent: Monday, October 25, 2021 10:29 AM To: Rudder, Lynda Subject: RE: East End Hospice Tree lighting This is not considered preserved land. Melissa S. -----Original Message----- From: Rudder, Lynda Sent: Friday, October 22, 202110:36 AM To: Blasko, Regina <rblasko@town.southold.ny.us>; Doroski, Melanie<Melanie.Doroski@town.southold.ny.us>; Duffy, Bill <billd@southoldtownny.gov>; Easton,James<jamese@southoldtownny.gov>; Flatley, Martin <mflatley@town.southold.ny.us>; Hagan, Damon<damonh@southoldtownny.gov>;,Kruszeski, Frank <fkruszeski@town.southold.ny.us>; Mirabelli, Melissa <melissam@southoldtownny.gov>; Norklun, Stacey <Stacey.Norklun@town.southold.ny.us>;Spiro, Melissa <Melissa.Spiro@town.southold.ny.us> Subject: East End Hospice Tree lighting Please provide approval/disapproval and cost analysis if any,thanks. 1 h Town Hall,53095 Main Road ELIZABETH A. NEVILLE, C , TOWN CLERK P.O.Box 1179 � Fl Southold,New York 11971 REGISTRAR OF VITAL STATISTICS Fax(631)765-6145 MARRIAGE OFFICER Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK CI VED TOWN OF SOUTHOLD APPLICATION FOR A PERMIT TO HOLD A Southold Town Clerk SPECIAL EVENT lests�^ ���a�a�Y1^."� Ia1t"slao i�aNs�m-au»�1i aur Ma.1laa��wt�.��l karl�rr�°°. l�ae°aataa�l�ut��y„1�1�a.:�Cirrua��",�Il�l ;�tl'Y'w9r�„�.^ ! v'ielyed. Date of Submission .� ,�. m .— ..---. -—a t (r �. � �MQrllil. 5Vr6. Name of Event_ N d _ eni7 *a � aa��e of Or=��s`���atoort, _..�._�.._.........�._—w ...— �.....�. Is this a Not-For Pa°ofit Ev o ��. —u�. —._ Contact's Name: we Cvlailing Add-Fess Cs a tact s l l rw°se N�anaber; —4� _ 0LI- ' Contact's Email Address: _ dciq e'- [flail I , .— B �T- Event Location and Site Diagram (Use additional paper if necCsaaY) v n t _ yy . Event D(te( s): 0-I Include set p and shwttip n times and dates t. Nature of EventReotk(� - (Please attach a detailed description to this applar,ati ny Time Period (Hours) of Event: From �. to Maximum Number of Expected Attendees: _ -- _ �... ... Y M, Plice i�resefWe): _ .......__., Specify an s P special r�,u i gents(a,�a:. road c io��a ��. Revised 13/5/15 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: ilk Event Fees: { $250 for events with less than 1.000 expected atteridee'q no r ! U it $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 1l:unning Special events (ONLY) $250 or more Clean-up deposit all other events N;l2'I'1! Wi' 'I'1^= O1'' 'l! tilel' �� C"1° 121:f: tJiltl l : Not less than$2,000,000 naming the Town of Southold as an additional insured. **"'N0T ; l'I EikSE I+ A'111"�"(, :[-Ili [ E I17� ADOPTEDTOWN POLI�"'*** _Jc Additional information and requirements may be required as deemed necessary by the Town Board. bb, � ._Print name of Autl�ortiang_0U_t"__, Sid„ e e aathc zed? son„tllt kt out application application *Upon the request by applicant,the Town Board may waive in whole or in part any of the application requirements,. 2 Revised 3/21/16 Client#: 3328 EASTEND46 DATE(MMIDDIYYYYJ ACORD. 0410612021 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 IELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPOR'TTANT:if tlla cer(Ifl�rate holder is an ADDITIONAL�INSURED,the policy(ies)must have ADDITIONAL INSURED provisions oren`d"o rsed. 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 any rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT rIAMD Commercial SulJpcalt Edgewood Partners Ins.Center priP_"_ 01Frl -631 324-1440 rA � s . ,...._ 9 40 Marcus Drive EMAIL ............ ct;Iti i'D�Ites �1'ccrokmaran.com ......IT. _-. 3rd Floor _ INSURER(S)AFFORDING COVERAGE ,,mmmIT NAIC# Melville NY 11747 µINSURER A:Nat'l Union Fire I�ns..C_o Pittsb_u_rg h PA �.�19446 INSURED East End Hos Ice Inc isue RB: LM p ERR P.O.Box 1048 Westhampton Beach, NY 11978 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED f0 Tl-iE 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. ......................TYPE OF INSURANCE _ PGJ LI CY NU MIIEIR.... ....a_._., .,.. a�m. ........ Iry R DOLSUBIE POIICY POLICY ExP LT COMMERCIAL GENERAL LIABILITY 11 IT 0 VHNUH0001102701 mm .0410112021 04101120.E EACH OCCURRENCE .S LIMITS CLAIMS-MADE OCCUR RE.. �arP5f"�, akr LIFO F�Pgrv„h�erynFrP wul s°�OJ000.. PERSONAL 8 AOV INJURYSl 000 000 - IGENLAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATEI S3 D�OO,OOO I41 PRoOucTS-CC75II'0P A0.2 >�3,000„000 PYX POLICY .IEr;.T' LOC — S AUTOMOBILE LIABILITY VHNUHAD011036 4101/2021 .'IHLR COMaINEO GINGL LI T 01 0 oa/o1/202��n nTd,III 1r00o,000 ANY AUTO tBOOILY INJURY(Per person) S X BODILY INJURY Per accld AUTOS ONLY AUTOS ( enl) 5 OWNED SCHEDULE[) XPROPERTY ,a 5l±TY "�MAGF 5 ' AUTOX S ONLY AUTOS ONLY _ ..°•-' S A � U OCCUR VHNUHX001 Fnnn 0. X Exc ss LIAeA® rLAr ss Mntar — 103701 84/0112021 04101 202 AG� c clJ R rac:GREGsa Ck04 O0 60 OEO RE1EN310NS ._-... - _..�....,.. WORKERS COMPENSATION PEI't OTH E.L. ER'._. AND EMPLOYERS'LIABILITY EAC/IAC E ANY II DPr�n TORIPARTNERPEAE'.CUII'�E:�d ru DLrrT s ro� n E L.E+"4CI I AC"r'C 01"FI ER In BER EXL.I,UDED1 NIA ...,.. ....� ..� I rY I I[OYEE II m„ule5'esiLvo unrdw, k"dnSCi'%Ii�l'COh1 01'OI^�ERawNIOP�p51^:e.Icur: E..I,DISE/Zr,-POLICY LVWdUT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 1111,Addlllonal Remarks Schedule,may be attached 11 more space Is requlredl mm CERTIFICATE HOLIDE;R, CANCE6L TION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Southold THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 1179 ACCORDANCE WITH THE POLICY PROVISIONS Southold,NY 11971-0000 AUTHORIZED REPRESENTATIVE O 1968-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD 53010540/ 3010485 CCUMM