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HomeMy WebLinkAboutMattituck Cub Scout Pack 39 - Cub Mobile Race Ar NIV ELIZABETII A.NEVILLE MMC ® Town Hall 53095 Main Road TOWN CLERK 4 -� P.O.Box 1179 Southold,New York 11971 REGISTRAR,OF VITAL STATISTICS :- ® -�- Fax(631)765-6145 MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER ®1 ' ��® Telephone oldtownny.gov 765-1800 www.southoldtownny.gov OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF'SOUTHOLD October 14, 2021 Richard Jernick 1070 Pine Tree Road Cutchogue, NY 11935 RE: Cub Mobile Dear Mr. Jernick: The Southold Town Board, at its regular meeting held on October 5, 2021, granted permission to the Mattituck Cub Scout Pack 39 to hold its annual Cub Mobile race on October 23, 2021. 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. Very truly yours, Lynda.M Rudder Southold Deputy Town Clerk Enc. Southold Town Board - Letter i Board Meeting of October 5, 2021 RESOLUTION 2021-778 Item # 5.20 --ADOPTED DOC ID: 17430 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2021-778 WAS ADOPTED AT THE REGULAR MEET-I-N_G OF THE SOUTHOLD TOWN BOARD ON OCTOBER 5, 2021: _ _ -_- RESOLVED that the Town Board of the Town of Southold hereby granted permission to Pack 39 Cub Scouts to hold its annual Cubmobile Soapbox Derby Race on October 23, 2021 from 6:00 AM to 2:00 PM on the North side of Eastside Avenue, Mattituck,provided they adhere to the Town of Southold Policy for Special Events on Town Properties and Roads. All Town fees for this event are waived. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Jill Doherty, Councilwoman SECONDER:Louisa P. Evans, Justice AYES: Nappa, Dinizio Jr- Doherty; Ghosio, Evans, Russell Generated October 6- 202 1 Pa`e 30 Uzi f j ELIZABETH A.IVEVILLE MMC moi' Town Hall,53095 Main Road ���'�'•,����-'�� TOWN CLERK � �" P.O,Box 1179 c� +� '�' Southold,New York 11971 r + -6145 REGISTRAR OF VITAL STATISTICS Fax(631)765� �`�,„, - �.�-. , Tele MARRIAGE OFFICER hone 631 765-1800 P ( ) RECORDS MANAGEMENT OFFICER ' k' � " all, www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER x • RECEIVED OFFICE OF THE TOWN CLERK TOWN OF SOiJTHOLD SEP 2 7 2021 APPLICATION FOR A PERMIT TO HOLD A Southold Town Cleric G SPECIAL EVENT Please �rpvirlc �1LL of t'hc inPot m��lir�n rec ucstetl 1�clo�iF.peons lett r> >>ficatians Z�'iLL NOT be reviewed. r q Date of Submission 123 Z _ Name of Even — -- �u3 mp31LjL t Name of Organization: r'l y�r1'Netc C'Vis S(�s� PAM S9 Is this a Not-For-Profit Event? s/No___,•_________— Contact's Name: � J6APicv, Mailing Address: I U`?� PINS Ai[& i� G�C�fdl,Nrtt f Igo Contact's Phone Number: (OS' 83Lf 2)6T) Contact's Email Address: Event Location and Site Diagram: fzAO S i� AVM 020A 3Ai LL �f,AeN Z 44Af&P (Use additional paper if necessary) vl« ANa MPTTITUM 1(� 21 O(�do ~ I L)6b Event Date(s): — (include set up and shutdown times and dates) Nature of Event: POsK CK '94�� (Please attach a detailed description to this application) Time Period (Hours) of Event: From to I q6o Maximum Number of Expected Attendees:_ 80 Specify any special requirements(i,e. road closure, police presence): __ -- — C,L bSf� E.AM s 1 NA 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: .i v�� Pl►J� z 2� Ct32 Event Fees: $250 for events with less than 1000 expected attendees PL AVZ- owk- AL 3 FkL $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 CI IZTIFICATI�.OI+' INSURANC–F, I2C Ulilie"1); Not less than $2,000,000 naming the Town of Southold as an additional insured. ***NOTE: PLEASE SEE ATT ACHED REVISED2 ADOPTED TOWN POLICY*** Additional information and requirements may be required as deemed necessary by the Town Board. Print name of Authorized Person filling out Signature of Authorized Person filling 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 aco CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 11 07/22/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LDER. 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 Marsh&McLennan Agency LLC PHONE Laura Craig FAX 8144 Walnut Hill Lane, 16th Floor Arc o >tt 972-770-1402 (AIC'No):972-770-1699 Dallas TX 75231 ADDRESS: laura.craig@marshmma.com INSURERS AFFORDING COVERAGE NAIC# INSURERA:Evanston Insurance Company 35378 INSURED INSURER B Boy Scouts of America National Council and All of Its affiliates and subsidiaries Suffolk County Council#404 INSURER CINSURER D: 7 Scouting Blvd. INSURERE: 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 ADDL SUBR POLICY EFF POUCY EXP LTR TYPE OF INSURANCE I S POLICY NUMBER MMIDD MM/DD/YYY LIMITS A X COMMERCIAL GENERAL LIABILITY MKLV4PBC001681 3/1/2021 3/1/2022 EACH OCCURRENCE $1,000,000 CLAIMS-MADE � Fa OCCUR DAMAGE TO a TED PREMISES occurrence $1,000,000 MED EXP(Any one person) $ PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERALAGGREGATE $10,000,000 POLICY❑PRO JECT F—]LOC PRODUCTS-COMP/OP AGG $ 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 A X UMBRELLALIAB OCCUR MKLV4EUL103145 3/1/2021 3/1/2022 EACH OCCURRENCE $6,500,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $13,000,000 DED I X I RETENTION$, $ WORKERS COMPENSATION PER I OTH- AND EMPLOYERS'LIABILITY Y I N STATUTE I I ER ANYPROPRIETOR/PARTNER/EXECUTIVE E L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED� ❑ NIA (Mandatory In NH) E L.DISEASE-FA EMPLOYEE $ If yes,descnbe 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 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 Doroski, Bonnie From: Doroski, Bonnie Sent: Monday, September 27, 2021 12:18 PM To: Blasko, Regina; Burke,John; Doroski, Melanie; Duffy, Bill; Fisher, Robert; Flatley, Martin; Hagan, Damon; Kruszeski, Frank; Mirabelli, Melissa; Norklun, Stacey; Spiro, Melissa Subject: Emailing: cub mobile pack 39_20210927122205.pdf Attachments: cub mobile pack 39_20210927122205.pdf Please find attached the request from Pack 39 for their cub mobile event 10/23. If there are any comments/concerns please notify this office. Thank you. Your message is ready to be sent with the following file or link attachments: cub mobile pack 39_20210927122205.pdf Note:To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. 1 Doroski, Bonnie From: Flatley, Martin Sent: Monday, September 27, 2021 2:16 PM To: Doroski, Bonnie; Blasko, Regina; Burke, John; Doroski, Melanie; Duffy, Bill; Fisher, Robert; Hagan, Damon; Kruszeski, Frank; Mirabelli, Melissa; Norklun, Stacey; Spiro, Melissa Subject: RE: Emailing: cub mobile pack 39_20210927122205.pdf I have no objections to this event being approved as in the past.There is no real cost associated with this event as we just drop off barricades to the organizers and they initiate road closure with the neighbors involved. 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: Doroski, Bonnie <Bonnie.Doroski@town.southold.ny.us> Sent: Monday, September 27, 202112:18 PM To: Blasko, Regina <rblasko@town.southold.ny.us>; Burke,John<johnbu@southoldtownny.gov>; Doroski, Melanie <Melanie.Doroski@town.southold.ny.us>; Duffy, Bill<billd@southoldtownny.gov>; Fisher, Robert <Robert.Fisher@town.southold.ny.us>; 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: Emailing: cub mobile pack 39_20210927122205.pdf Please find attached the request from Pack 39 for their cub mobile event 10/23. If there are any comments/concerns please notify this office. Thank you. Your message is ready to be sent with the following file or link attachments: cub mobile pack 39_20210927122205.pdf Note:To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. 1 Supt. of Highways Departments News Media Town of Southold P O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 09/27/21 Receipt#: 287213 Quantity Transactions Reference Subtotal 1 Clean-Up Deposit 10 23 21 $250.00 Total Paid: $25000 Notes: Payment Type Amount Paid By CK#1160 $250.00 Mattituck, Cutchogue Cub Scout Pack 39 Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Mattituck, Cutchogue Cub Scout Pack 39 1070 Pine Tree Road Cutchogue, NY 11935 Clerk ID: BONNIED Internal ID 10 23 21 `—Vendor No. l Check No. Town of Southold, New York - Payment Voucher �Vendor NameVendor Address Entered by 1 ► n f {- Cu6se-0 U+ �O x l�1� Audit Date VendorTelephone Number ' Town Clerk Invoice Invoice Invoice Net Purchase Order Number Date Total Discount Amount Claimed Number Description of Goods or Services General Ledger Fund and Account Number �� 1�-�CJ•�� (0 a '50 T1.030 i i i Total 50� 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 certify that the foregoing claim 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 verified with the exceptions due and owing,and that taxes from which the Town is exempt are excluded or discrepancies noted,and pZL " , Signatu tle•Deputy Town Clerk Signat e Company Name Date 1k-15-al Title:Deauty Town Clerk Date t1-6_'2 k Southold Town Board - Letter Board Meeting of November 3, 2021 RESOLUTION 2021-843 Item # 5.9 ADOPTED DOC ID: 17493 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2021-843 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON NOVEMBER 3, 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 Old Town Arts & Crafts Guild Inc 6/7/21 $250.00 Robert Kuhne Po Box 392 Cutchogue,NY 11935 Mattituck-Cutchogue Cub Scout Pack 39 9/27/21 $250.00 Richard Jernick PO Box 1011 Mattituck,NY 11952 Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED (UNANIMOUS) MOVER: James Dinizio Jr, Councilman SECONDER:Jill Doherty, Councilwoman AYES: Nappa, Dinizio Jr; Doherty, Ghosio; Evans, Russell Generated November 4. 2021 Page 16