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Home My WebLink AboutKontokosta Winery 2022-26 41, 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: Mr. Denis Noncarrow, Town Clerk From: Melissa Mirabelli Secretary to the Town Attorney Date: May 25, 2022 Subject: Special Events —Kontokosta Winery KW1a-c With respect to the above-referenced matter, I am enclosing the original application with committee comments and resolution of Town Board approval of event. If you have any questions regarding the enclosed, please do not hesitate to call me. Thank you. Cc: /mm Enclosures Special Events Committee Application Summary and Recommendation Application name: Address: say UYN LM Application number: Date of Event: -*I i to� pa no i I{o poa?- Time: 5 Pf�- 11 •166P Date Received by Town Clerk: 5 I q i Date Received by Committee: -51 q I as Nature of Event (S): Committee Comments Received by: Ben s-Nefteamw Melissa Spiro Leslie Weisman Missy Mirabelli Chief Flatley August Ruckdeschel- County X Heather Lanza James Easton Mike Verity Claire Glew Kevin Webster Committee Recommendation's: Approve as applied Approve with Additional conditions: cn&(,O—j �o Hold Public Hearing Deny Special Event No: °- Resolution No: a Date: ACcl CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDM") -5�RF 05103/2022 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 ADOITIONAL INSURED,the poltey(les)must be.endprsed. SUBROGATION IS WAIVED.,subject to `thIa:6i na and conditlans of thb policy,asitaln policies may requlie an endorsement. A°statN omont ori this certificate door not confer rights to the Cdrtiticato,hoider.1h Ileu of such ondoreimont s. PRODUCER 12406' EILEEN.CUSHMAN GEORGE FORMES PHONE 631722=4100 ice" 0;631-722-0500 1116 MAIN ROAD SUITE A2 fnMOAII. :EILEEN:CUSHMAN' ERICAWNATIONAL.COM P.O.BOX 2336 INSURMSI AFFORDING COVERAGE NAIC o AQUEBOGUE,NY 11931 NisURBRA:FARM FAMILY C6§UALTY INS.CO. INSURED JEMCO WINERY ASSOCIATES INC asuRERE: DBA KONTOKOSTA WINERY INSURER C: POB 67 wsURERD• GREENPORT.NY 11944 INsuma: INsuaeR P 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 WTH 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. !MSR AP INSURANCE POLICYRULIBER FMMArr7om CP LIM178 A XX COMMERCIAL GENERALLDIBILITY X 3101X3113 01/04/2022.01104/2023:EACH000URRENGE s 1.000.000 D-AVAGE To CLAIMS-MADE 51OCCUR P i $ -20=0 MED"EXP(Ai1T.orieyaron " : S 10'000 PERSONAI'XADVINJURY 3' 1000.000. AL)LI'Y AGGREGATE LIMB APPLIES PER: GENERALAGGRECATE S 2 000 000 Q JET FILOC PRODUCTS=COMPIO0A.. .S 2;0.00;000 OTHER f A' AVToMOBILIZIUABILrTY 3152C7221 01/04/2022 1/04/2023 �'� !NEO. 'HOLE MIT f 1;000000 ANY AUTO BODILY INJURY(Per person) I ALL LO3NE SCHEDULED BODILY INJURY(Par aorident) i AUTO HIRED AUTOS NON-OWNED PROPER .DAMAGE S AUTOS A X UMBRELLALLABXX OCCUR 3101 E1860 1/0412022 01/04/2023 €A&bCCURkN6#.. s 5,000,000 EXCESBLug CLAIMS-MADE AGGREGATE. S DEQ., RETENTION'S s: WORKF.R8 COAIPAH;SATION A ANoEM0,.LOYP1 WILM, 3101W8176 1/04/2022 01104/2023 XX � Ern' ANYPROPRIETOfi?ARiNER/E%ECUTR/E YQ El.EACH'RCCIDENT S�100000 NIA OFFICER EMBEREXCLUDED7 Obh4alorll MNH1 E.L.DISEASE-ET,EMPLOYE S` 100 000 Opeude0MOffic PI nISEISE-POL1CiYLIMIT s 600.000 DESCRIPTION OF OPERATIONS COIDw • DEDCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 161,A"Oond Romadla Sohadulo,may be atnohed It mora ppaoa Is mgglmd) CERTIFICATE HOLDER AS ADDITIONAL INSURED' $1,000,000.LIQUOR LIABILITY PER OCCURANCE INCLUDED IN POLICY 3101X3113 .cER'T(F1cAiTF-446 bER CANCELLATION. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF SOUTHOLD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 1179 SOUTHOLD NY 11971 AUTHOR&., it6BfiNTATNE © 8-20.14 ACORD CORPORATION. All rights reserved. ACORD 26(20141011 The ACORD name and loco are realstered marks of ACORD Mirabelli, Melissa From: Glew, Claire Sent: Monday, May 9, 2022 2:40 PM To: Mirabelli, Melissa Subject: RE: Special Event- KW1 a-c Hi Missy, There are no exemptions where this event is taking place. MLxelClew Assistant to Assessor Town of Southold Board of Assessors (631)765-1937 Phone (631)765-1356 Fax www.southoldtownny.gov claireg@southoldtownny.gov From: Mirabelli, Melissa<melissa.mirabelli@town.southold.ny.us> Sent: Monday, May 9, 2022 2:33 PM To:Spiro, Melissa <Melissa.Spiro@town.southold.ny.us>; Easton,James<jamese@southoldtownny.gov>;Glew,Claire <Claire.Glew@town.southold.ny.us>;Webster, Kevin<kevin.webster@town.southold.ny.us>; Killean,Jade <Jade.Killean@suffolkcountyny.gov> Cc:Amakawa,Andrew<And rew.Amakawa @suffolkcountyny.gov>; Ruckdeschel,August <August.Ruckdeschel@suffolkcountyny.gov> Subject:Special Event- KW1a-c Please send any and all questions or comments to me r' Afelissra 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 1 Fax(631)765-6639 ******************************************************************************************* This electronic mail transmission may contain confidential or privileged information. If you believe that you have received the message in error, please notify the sender by reply transmission and delete the message without copying or disclosing it. ******************************************************************************************* 2 Mirabelli, Melissa From: Easton,James Sent: Monday, May 9, 2022 3:55 PM To: Mirabelli, Melissa Subject: RE: Special Event - KW1a-c 1 have no objection to this event taking place. Thank you, James Easton Fire Marshal jamese@southoldtownny.gov (W) 631-765-1802 PRiVELF,GED AND CONFIDENTIAL COMMUNICATION CONFIDENTIALITY NOTICE: This electronic mail transmission is intended only for the use of the individual or entity to which it is addressed and may contain confidential infonnation belonging to the sender which is protected by privilege. if you are not the intended recipient,you are hereby notified that any disclosure,copying,distribution,or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error,please notify the sender immediately by e-mail and delete the original message. From: Mirabelli, Melissa<melissa.mirabelli@town.southold.ny.us> Sent: Monday, May 9, 2022 2:33 PM To:Spiro, Melissa<Melissa.Spiro@town.southold.ny.us>; Easton,James<jamese@southoldtownny.gov>; Glew,Claire <Claire.Glew@town.southold.ny.us>;Webster, Kevin<kevin.webster@town.southold.ny.us>; Killean,Jade <Jade.Killean@suffolkcountyny.gov> Cc:Amakawa,Andrew<Andrew.Amakawa@suffolkcountyny.gov>; Ruckdeschel,August <August.Ruckdeschel@suffolkcountyny.gov> Subject:Special Event-KW1a-c Please send any and all questions or comments to me Melissa 11. 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 ******************************************************************************************* This electronic mail transmission may contain confidential or privileged information. If you 1 believe that you have received the message in error, please notify the sender by reply transmission and delete the message without copying or disclosing it. ******************************************************************************************* 2 Mirabelli, Melissa From: Spiro, Melissa ' Sent: Monday, May 9, 2022 3:53 RM To: Mirabelli, Melissa Subject: RE: Special Event- KW1a-c This is not preserved land. Melissa S. From: Mirabelli, Melissa Sent: Monday, May 09, 2022 2:33 PM To:Spiro, Melissa<Melissa.Spiro@town.southold.ny.us>; Easton,James<jamese@southoldtownny.gov>;Glew,Claire <Claire.Glew@town.southold.ny.us>;Webster, Kevin<kevin.Webster@town.southold.ny.us>; Killean,Jade <Jade.Killean@suffolkcountyny.gov> Cc:Amakawa,Andrew<And rew.Ama kawa @suffol kcou ntyny.gov>; Ruckdeschel,August <August.Ruckdeschel@suffolkcountyny.gov> Subject:Special Event-KW1a-c Please send any and all questions or comments to me .Velissa 11`Jr 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 This electronic mail transmission may contain confidential or privileged information. If you believe that you have received the message in error, please notify the sender by reply transmission and delete the message without copying or disclosing it. ! ^ . . . � | Mirabelli, Melissa From: Lanza Heather � � Sent: Monday, May 9, 20224:02RN To: F|atley, Martin; Leslie Weisman Forward; Mirabelli, Melissa;Verity, Mike; Burke,John; Weisman, Leslie i RE: Special EventKonakosta KVV10-c Iagree with asking for uuearlier stop time of1Ci | From: Flatley, Martin ' Sent May O9, 2O2Z3:58PK8 To: Leslie Weisman Fonmard<|es|iekxveismnan@gnnai|.comn>; Mirabelli, Melissa «nnelissa.noirabe||i@toxvn.southo|d.ny.us>;Vehty, Mike<K8ike!Veritv@toxvn.southo|d.my.us>; Burke,John <johnbu@southoldtownny.gov>; Lanza, Heather<heather.[a 6�a @town.southold.ny.us>;Weisman, Leslie <|es|iexx@toxxnsoutho|d nyus� ' ' ' ! Subject: RE:Special Event KonakosLaWinery KVV1a'c � / |would suggest 1O-1O:30pm. He is going to call and complain,anyway but this is a little more reasonable Martin FUatley, Chief of Police TOVVO of Southold Police [}epa[tDOe[d 414O5State Route 25 PecoOic. N.Y. 11858 Tel: 631-765-3115 � ' | The information contained in this electronic message and any attachments to this message are�ded for the exclusive use of the addressee(s)and may contain information that is privileged,confidential and exempt from disclosure under law. If the readerofthis message isnot the intended recipient.you are hereby notified that any review,retransmission,converst.on to hard copy.copying,reproduction,circulation,publication, dissemination orother 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,(fi)return the original message and ail copies to us at the address above via the U.S.Postal Service,and(ifi)delete the message and any material attached thereto from any computer,disk drive,diskette,or other storage device or media. From: Leslie Weisman Forward Sent: Monday, May 9, 2O233:36PK8 ! To: F|at|ey, K8artin< MirabeUi, Melissa Verity, Mike Burke,John Lanza, Heather >;VVeismnan, Leslie Subject: RE:Special Event KonakostoWinery KWla-c i Agreed no issued with the event but the music I an issue. If last.year the music was required to end at 11Pm can we suggest 1OPK4this year based onprior complaints? � Leslie From: Flatley, Martin Sent: Monday, May 9, 2022 3:15 PM � z To: Mirabelli, Melissa; Verity, Mike; Burke, John; Lanza, Heather; Weisman, Leslie Subject: RE: Special Event Konakosta Winery KW1a-c I have no objections to these events being approved, however{ I would like to see the music off earlier as well.We have a neighbor that complains about the music all of the time when there is a wedding/event at Brecknock Hall. i Martin Flatley, Chief of Police Town of Southold Police Department 41405 State Route 25 Peconic, N.Y. 11958 Tel: 631-765-3115 i j 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 639.765.2600, (ii)return the onginat message and all copies to us at the address above via the U.S.Postal Service,and(iii)delete the message and any material attached thereto from any computer, disk drive,diskette,or other storage device or media. From: Mirabelli, Melissa<melissa.mirabelli@town.southold.ny.us> Sent: Monday, May 9, 2022 2:31 PM To:Verity, Mike<Mike.Verity@town.southold.nv.us>; Burke,John<johnbu@southoldtownny.gov>; Lanza, Heather <heather.lanza@town.southold.nv.us>;Weisman, Leslie<lesliew@town.southold.nv.us>; Flatley, Martin <mflatley@town.southold.ny.us> Subject:Special Event Konakosta Winery KW1a-c i Please send comments and or questions to me please and thank you IVIelissa.All Ifirabelli { Secretary to the Town Attorney Town of Southold i Southold Town Hall Annex 54375 Route 25 (Main RD) P.O. Box 1179 Southold,NY 11971 Office (631) 765-1939 Fax(631)765-6639 This electronic mail transmission may contain confidential or privileged information. If you believe that you have received the message in error, please notify the sender by reply transmission and delete the message without copying or disclosing it. 2 Mirabelli, Melissa From: Killean,Jade <Jade.KiIlea n@suffolkcountyny.gov> Sent: Tuesday, May 10, 2022 3:16 PM To: Mirabelli, Melissa; Spiro, Melissa; Easton,James; Glew,Claire;Webster, Kevin Cc: Amakawa, Andrew; Ruckdeschel, August Subject: RE: Special Event- KW1 a-c Hi Missy, Regarding the event at the Kontokosta Winery,we do not have any comments as the property is neither SC PDR nor is it adjacent to County holdings. Thank you, ,jade xiCCean Planner Suffolk County Dept.of Economic Development&Planning Division of Planning&Environment 100 Veterans Memorial Highway,2°d Floor Hauppauge,NY 11788 631-853-6044 Tel 4��4Nf-1c5p,�y ` F Q f�•�? " TTI .. � J `0U�A praotiCeGREEN Save a free.Read.donpr;ni,en+air`s. CONFIDENTIALI TY NOTI CE." This electronic mail transmission is intended solely for the use of the individuallentity to whom it is addressed and may contain confidential information belonging to the sender. If you are not the intended recipient,you are hereby notified that any disclosure,copying, distribution,or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error,please notify the sender immediately by e-mail and delete the original message. Vaccination = Freedom from COVID-19 Help Suffolk County get back to normal COVID vaccines are safe, effective and free From: Mirabelli, Melissa<melissa.mirabelli@town.southold.ny.us> Sent: Monday, May 9, 2022 2:33 PM 1 To:Spiro, Melissa <Melissa.Spiro@town.southold.ny.us>; Easton,James<jamese@southoldtownny.gov>;Glew, Claire <Claire.Glew@town.southold.ny.us>;Webster, Kevin<kevin.webster@town.southold.ny.us>; Killean,Jade <Jade.Killean@suffolkcountyny.gov> Cc:Amakawa,Andrew<And rew.Amakawa @suffolkcountyny.gov>; Ruckdeschel,August <August.Ruckdeschel@suffolkcountyny.gov> Subject:Special Event-KW1a-c ATTENTION: This email came from an external source. Do not open attachments or click on links from unknown senders or unexpected emails. Please send any and all questions or comments to me Allelissa M. Afirabelli 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 This electronic mail transmission may contain confidential or privileged information. If you believe that you have received the message in error, please notify the sender by reply transmission and delete the message without copying or disclosing it. 2 Mirabelli, Melissa From: Leslie Weisman Forward Sent: Wednesday, May 18, 2022 12:59 PM To: Mirabelli, Melissa; Lanza, Heather,Weisman, Leslie; Flatley, Martin;Verity, Mike; Burke, John Cc: Spiro, Melissa; Easton, James; Glew, Claire;Webster, Kevin Subject: RE: Kontokosta Winery Since the applicant has not complied with all the conditions of previous approvals by the Town Board I suggest denying this application as stated in all standard resolutions. Leslie From: Mirabelli, Melissa [mailto:melissa.mirabelli@town.southold.ny.us] Sent: Wednesday, May 18, 2022 11:38 AM To: Lanza, Heather; Weisman, Leslie; Flatley, Martin; Verity, Mike; Burke,John Cc: Spiro, Melissa; Easton, James; Glew, Claire; Webster, Kevin Subject: Kontokosta Winery Good morning All, As per request of the committee I spoke with Mr. Kontakosta who was not understanding that he was told last year was the last time they would be permitted to have wedding music until 1113M. I have the email from Denis'conversation with him stating that he would contract the 2022 brides for 10PM end time.This application still is asking for 11:30 and Mr. Kontaksosta basically stated he is only doing three weddings and he claims he has always done this and admitted they still went until 11:30 last year. Ignoring our condition on his resolution for ending at 11PM sharp. I have attached this years application again for everyone as well as last years communications as well so all can review. Please let me know how this committee would like to go forward with this application. JVelissa Al. Affirabelli 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 This electronic mail transmission may contain confidential or privileged information. If you believe that you have received the message in error, please notify the sender by reply transmission and delete the message without copying or disclosing it. Mirabelli, Melissa From: Flatley, Martin Sent: Wednesday, May 18, 2022 11:59 AM To: Mirabelli, Melissa; Lanza, Heather;Weisman, Leslie;Verity, Mike; Burke,John Cc: Spiro, Melissa; Easton,James; Glew, Claire; Webster, Kevin Subject: RE: Kontokosta Winery I still have no objections to approval, but still maintain that music should not be permitted as late as 11:30pm. It should at the very least be consistent with last year's end time of 11pm. 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 639.765.2600,(ii)return the original message and all copies to us at the address above via the U.S. Postal Service,and(III)delete the message and any material attached thereto from any computer, disk drive,diskette, or other storage device or media. From: Mirabelli, Melissa<melissa.mirabelli@town.southold.ny.us> Sent:Wednesday, May 18, 2022 11:38 AM To: Lanza, Heather<heather.lanza@town.southold.ny.us>;Weisman, Leslie<lesliew@town.southold.ny.us>; Flatley, Martin <mflatley@town.southold.ny.us>;Verity, Mike<Mike.Verity@town.southold.ny.us>; Burke,John <johnbu@southoldtownny.gov> Cc:Spiro, Melissa<Melissa.Spiro@town.southold.ny.us>; Easton,James<jamese@southoldtownny.gov>; Glew, Claire <Claire.Glew@town.southold.ny.us>;Webster, Kevin<kevin.webster@town.southold.ny.us> Subject: Kontokosta Winery Good morning All, As per request of the committee I spoke with Mr. Kontakosta who was not understanding that he was told last year was the last time they would be permitted to have wedding music until 11PM. I have the email from Denis'conversation with him stating that he would contract the 2022 brides for 10PM end time.This application still is asking for 11:30 and Mr. Kontaksosta basically stated he is only doing three weddings and he claims he has always done this and admitted they still went until 11:30 last year. Ignoring our condition on his resolution for ending at 11PM sharp. I have attached this years application again for everyone as well as last years communications as well so all can review. Please let me know how this committee would like to go forward with this application. M r J11e' ivsa,W.Afirabelli 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 This electronic mail transmission may contain confidential or privileged information. If you believe that you have received the message in error, please notify the sender by reply transmission and delete the message without copying or disclosing it. 2 RESOLUTION 2022-461 ADOPTED DOC ID: 18130 .THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2022-461 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON MAY 24,2022: RESOLVED that the Town Board of the Town of Southold hereby grants permission to Kontokosta Winery,to hold Special Events 2022-26 at the Kontokosta Winery, 825 North RD, Greenport,New York as applied for in Application KWla-c for weddings on July 16,July 30 and October 15, 2022 from 5PM to 10:30PM, subject to the following conditions: 1. Music must end at 10:30PM sharp; 2. All parking of vehicles for this event must be as shown on the plan submitted with the special event application. Provided they adhere to ALL conditions on the application,permit and to the Town of Southold Policy for Special Events and subject to the applicant's compliance with 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. Denis Nonearrow Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Greg Doroski, Councilman SECONDER:Louisa P. Evans, Justice AYES: Nappa, Doroski,Mealy, Doherty, Evans,Russell RECMIVED Vt MAYm AY Q22 219 0 Town Cle 00LIthold Town Clerk TOWN OF SOUTHOLD Town Code Chanter 205"Public Entertairtmerat and S ec'al ev n#s" SPECIAL EVENT PERMIT INSTRUCTIONS AND APPLICATION FORM Applications for a Special Event Permit are subject to an inter-departmental coordinated review by the Southold Town Board,Town Attorney,Town Assessors,Land Preservation,Building,Planning,Zoning Board of Appeals and Police Departments,and the Suffolk County Planning Commission. Application fee: $150.00 per application.Up to six(6)multiple events of the same type, occurring over a period of three months,may be permitted on one(1)application for a fee of$150.00. However,specific details of each event must be included with this application. All appReations must be subm-ittcc ut estst b l bnsinesti cavi; bet4rre the event Anrrliearits are enctouragged to submit applications as Orly as-Possible. Any egin tleted application that is not submitted 6t) car mgre business*days prior to the scheduled :event maybe rejected or siihiecto a lite-prircessinb fee of$250.041y the Office of the T6wn Clerk, unless a Waiver is oliiaiined. Requesting an expedited review must be submitted in writing to the Town Clerk.The Town Clerk will forward all applications to the Special Events Committee for processing. The Committee will obtain comments on all applications from relevant Town, County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. The Town reserves the right to request additional information from an applicant to address issues related to the health,safety,and welfare of the community. When is a Permit Required? All Special Events,per Southold Town Code Article I,Section 205-2(Definitions)must obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits. Any use of-residential rro iext-for-profit such as a venue for-weddings or other events is prohibited. This nnrilicafibn is deemed coriiplete once all the folloid ig re uirernents are submitted to`the TOWn Clerk: Please indicate submission cif the following by checkrng-vff the}rotes and Signing below. CA completed appl_kation form.signed by the owner and the event manager. Applications without property owner's signature/approval will be rejected. VEE: Is the application being submitted at least 60 days before the event Yes [ ]No 11 f Yes,Fee of$ has been submitted 11 If No,Fee of$ has been submitted Updated 8/7/2018 The applicantlowner 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 UPParkiij�/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) K- Zents for three hundred (300) or more people require submission and approval of a traffic control r acceptable to the Town of Southold AND a qualified traffic controller must be provided at the e ent.(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 theinfo. dation required above in connection with my application. t D ter! k �Yure 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 Suffolk with a permit issued by the Suffolk County Farmland Committee If food is to be served, it must be catered and prepared off-site by food vendors who hold a permit to operate issued by the Suffolk County Bureau of Public Health Food Protection Unit. Updated 8/7/2018 APPLICATION FOR A PERMIT TO HOLD A SPECIAL EVENT Please provide ALL ofthe-informafiou requested below Yncompiete 9ppricathins WILL NOT be reviewed. Special Event Permit# Applicant(s)came h , Date of SubmissionL hl-c Name of Event SCTM#'s 100078,ection Block:H� Lot(s). Q Dates of Each Event: 1o1 If Multiple Dates are requested,applicant must give all information for all dates. Nature ofEyerit; 1.� J�) (PIeaseattach a deill*d description of EACH event to this application) Time Period(Hours)of Event: From to_ Town Services requested: ( )Yes V, No If yes,Describe Police Dept. Highway Dept. Describe Services Maximum Number of Persons Attending At One Time: Number of cars ezpccted is a Tent.or other temporary structure being used?[ Yes[ ]No If yes provide:si7e.(s):JJBj--)—= Will food be served? �'es [ ]No If yes provide numb&and names),of food yendor(s) jJ � l Updated INH (((��"' j t �� 1 •a : 8/ Suffolk County permit#:(s) Will other vendors be on the premises during the event? es [ ]No If yes how many? Describe r qn Type ofvendor(s)�t��t��l �f � + ' Property Owner(name/address):'W E1 Kt S' .t ' �r� lz' / W Contact Person and Contact Tel.# L� j e-mail address /'' ` LM r hIUEvent Location:Street-Hamlet Address: I � ( " Mailing Address to Send Event Permit to: Have any of the development rights been sold`to the Town of Southold[ ]Yes ]No and/or Suffolk County Agricultural Program? [ ]Yes `I No; If yes to either of-both also it i"cate o ,e attache . lan`theboundaries of"the reserved-area upon which the event will talce.plaee. y(jYj 1►l C1ST A'T p�ICN A PARKIN(Y/EVENT L_ANTt?_THIS i4PP7 TCATtON IF THE MECTEO ATTENDANCE 1S300-OR-MO I F,.PEOPLI+',l_Q i[ytu�t a,SO AT—TACH A TRAFFIC CONTI2�AN`(seen nA iiagel Parkzn /Event Plan may be a survey, site plan and/or aerialyiteiv(for exrtmpie Google Earth) of the subject pronerty_1<i�DICATE ON THE PLAN ALL of the folio,,vrng.information. A parking/event plan showing: (1) The size ofthe prbperty and its location in relation to abutting streets or highways. (2) The size and`location of any existing building(s)or structure(sj that will be in operation during the course of the event and.anypropased building,structure;or signs to be erected temporarily for the event. (3) The location of the stage or tents,if any. (4) The designated areas of use for spectators,exhibitors,vendors,employees and organizers. (5) Location of all entries and exits. (6) The location of all fire extinguishers and other fire safety equipment. (7) The location of all temporary utilities to be installed for the event,if any. (8) The layout of anyparking area for automobiles and other vehicles and the means of ingress and egress for such parking:areas, The.parking spaces must allow for 300 sq.ft. per car. (9) A traffic control plan for vehicles entering and leaving the site for the proposed event. (10) Plan for the use of live outdoor music,loudspeakers and other sounds which will be used, if any,and the type and location of speakers and other audio equipment: (11) A description.of:emezgencyaccess and facilities related to-the event. (12) Provisions to dispose of any garbage,trash,ruvbisli or:othcr refuse: (13) Location and description of any additional lighting to be utilized in conjunction with the event. i Updated 8/7/2018 (14) Location of sanitary facilities on site. Traffic ontrcfl Eign Events.f6f'three hundred(100)or more people also require submission And-approval of atrafeic control plan,acceptable to the Town of Southold,AND'a-qv lified traffliQ controller must be provided.Please attached a written des6ription and/or notate on the parking event plan the following: 1)Who will be g traffic,2)W� conducting . ..re they will be stationed*.on site,-'3)flow they will direct the entrance,, . e circula'tion.parkitig,and wdting of cars on sitej.and 4)Contact information for use by Soutliold Town Police. 0 RWE�R'SIGNATURE: SIGP _R I am the Owner of the Property where this event is to be held and I agree to comply with the laws, rules,-re lationS,con f the Town of Southold,including but gu ditions,and requh ments of the Code o agency.not lj#diedth-the conditions listed below,as well as all other applicable rules and regulations pertainj#g-to.theactivities under this event Furthe0nore,I hereby swear or affirnt that the illyorlilqd9n contained herein and attachments hereto are true and correct to the best of.#ty.knowledge, and agkee.to provide notice to the Town UPitteeffidely should there be any.1naterial,changes regardhi- to this application. Furthermore,I hereby authorize Code Enforcement Personnel oftlla Town of Southold to enter the property during the hours of the permitted special event to tyand all inspections necessary in connection with this Special Event -Print-name of Owner Si a re of Owner Print name of Authorized Person/Representative Signature of Authorized Person/Representative PERIVITSS><(3N IS IIERFBy GRA NTEJ),SiTg&&TO M. VOLLOWING COMMONS: 1. By acceptance of this permit, applicant to supervise and direct all parking to be on .plicant-agre� up the premises or at another site,.and to proNdde .parking assistants� and any additional traffic controls necessary for this event.Prar—kib-g-is.stirictly,pro. ted-on ANY ToNyn. C6upV.of State Roads Of i9bts.of Way- 2. Traffic control at events for three hundred(300)or more people shall be provided by a qualified traffic controller in accordance with the attached,approved traffic control plan. 3. One "on-premis"e*'s" sign not larger than six-(6) square:feet in size may be displayed not longer than. thirty (30) days before this event, and removed iminediately after the event. Directional parking signs shalt be adequately displayed. 4. Applicant indemnifies and holds harmless the Town of Southold from all claims, damages,:expenses, suits and losses I including but not limited to,attorney's fees arising from activities under this P-Prinit. 5. Tent proposals-unlit receive permit appTOVal from the Southold Town Building Inspector before placement on,-the.property and must meet all fire:andsafety 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 I*ea§t 6-0 business da�s li-Jor to the MT-ol. 7. Adequate temporary sanitary facilities must be provided.by for this event acid applicant agrees to remove the temporary facilities from the pr&riiigeg-within 48 liour.s after the day of the event. Updated 8n/201 8 is 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 t11is event iucludim bpt not limited to'nairkina ingresc egress/access fent(s)or temnorarystructure s or temporary sanii=facilities:shall.be conducted on Town:of Southold Purchase o_ff evelJ6�ment Riah_ts land. 10. NO activities associated with this event including but not limited to narlcina innress/egress/access; tent's)'or�terrigorary structure,5), or temporal ry sanitary facilities shall be conducted on Suffolk C un :Purchase of Develop=t Rights land Without a �jaermit issued by the Suffolk C' un_. _ty Fannlai Coriiniittee. 11.Issuance of this permit does not authorize in any manner the occupancy of any building exceeding the legal limitations under the fire code or other codes which would prohibit such increased occupancy. 12. Access shall be provided for emergency vehicles,to all.public assembly areas,•all buildings,all work .areas and any additional area where emergencies may occur. Two.emergency-fire exits and exit paths from the. buiiding(s) ori the property., to :a public flay or remote safe area, shall remain open and unobstructed at all times. 13. Owner assures full compliance with all fire,safety,building,and other Town laws. 14. Music;when:outdoors,is.required to stop at the Halle specified in the permit Placement of the speakers must be in.a.location that affords the greatest protection from noise intrusion upon adjacent properties. 15. Owner will allow access to Code Enforcement Personnel of the Town of Southold during the hours of the special event to make any and all inspections necessary in connection with this Special Event 16. ADDITIONAL CONDITIONS: ANY VIOLATIONS IN CONNECTION WITH THE CONDITIONS LISTED HEREIN WILL TERMINATE THIS PERAM. APPROVED Town of Southold Resolution Number:. Date Issued: Updated 8n12018 Mm'r'f,{a ,d +r a. ids {„ , 7" *x"Rf'"''}.✓. a1P3 �r� �`^� er , .- ' � {w--, r�j aaad r�c al,,`}^ "u., N-.,,,�y., #�• s t < x. x„ J� ,mow^ $ # t} t�; �v 4, py rJa rel r✓,h,t t.�,��,p0 Q�.:.. # �r>�'�{k:S. rtl. ,'"��?` ,x✓'i'i•��,t�''rr .,,�.a'' L:cy• � '. a. 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"•L�2•... ♦ , tisk = . hi ) !^ ••,„ �e r �:,ar xx.�,s # �s w� ,t'Y��&vr �:'',,'�"� t"''•,� v ,•;I�'` $F . .. .s'' ^L....: ..3''F.'•'t'�c�8w,"��s '^ r�T4,,-,ris�.s®.t •},-�a.R,.� .:. t_e a . r RECEIV D MAY - 9 2022 3"111thold Town Clerk TOWN OF SOUTHOLD r Town Code Chapter 205 "Public Entertainment and Special Events" SPECIAL EVENT PERMIT INSTRUCTIONS AND APPLICATION FORM Applications for a Special Event Permit are subject to an inter-departmental coordinated review by the Southold Town Board,Town Attorney,Town Assessors,Land Preservation,Building,Planning,Zoning Board of Appeals and Police Departments,and the Suffolk County Planning Commission. Application fee: $150.00 per application. Up to six (6) multiple events of the same type, occurring over a period of three months,may be permitted on one(1)application for a fee of$150.00. However, specific details of each event must be included with this application. All applications must be submitted at least 60 business days before the event. Applicants are encouraged to submit applications as early as possible. Any completed application that is not submitted 60 or more business days prior to the scheduled event may be rejected or subject to a late processing fee of$250.00 by the Office of the Town Clerk, unless a waiver is obtained. Requesting an expedited review must be submitted in writing to the Town Clerk.The Town Clerk will forward all applications to the Special Events Committee for processing. The Committee will obtain comments on all applications from relevant Town, County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. The Town reserves the right to request additional information from an applicant to address issues related to the health, safety, and welfare of the community. When is a Permit Required? All Special Events,per Southold Town Code Article I, Section 205-2 (Definitions)must obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits. Any use of residential property for profit, such as a venue for weddings or other events is prohibited. This application is deemed complete once all the following requirements are submitted to the Town Clerk: Please indicate submission of the following by checking off the boxes and signing below. �/A completed application form signed by the owner and the event manager. Applications without property owner's signature/approval will be rejected. J2"'_FEE: Is the application being submitted at least 60 days before the event Yes [ ]No If Yes,Fee of$ \J has been submitted ❑ If No,Fee of$ has been submitted Updated 8/7/2018 UThe 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 insure AParking/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) Events for three hundred (300) or more people require submission and approval of a traffic control la acceptable to the Town of Southold AND a qualified traffic controller must be provided at the e nt. (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 theinfo tion required above in connection with my application. D t g ture 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 Suffolk with a permit issued by the Suffolk County Farmland Committee. If food is to be served, it must be catered and prepared off-site by food vendors who hold a permit to operate issued by the Suffolk County Bureau of Public Health Food Protection Unit. Updated 8/7/2018 APPLICATION FOR A PERMIT TO HOLD A SPECIAL EVENT Please provide ALL of the information requested below.Incomplete applications WILL NOT be reviewed. Special Event Permit# Applicant(s)nameN)�DLEb WMI Date of Submission Name of Event , SCTM#'s 1000-Section 3 Block- Lot(s) Dates of Each Event: 'rl h fp 1 130 If Multiple Dates are requested,applicant must give all information for all dates. Nature of Event: � tt � fr �� (Please aach a detailbd description of EACH event to this application) Time Period(Hours)of Event: From 5 PW to_ . Town Services requested: ( )Yes VNo If yes,Describe Police Dept. Highway Dept. Describe Services Maximum Number of Persons Attending At One Time: Number of cars expectedt/ Is a Tent or other temporary structure being used? [Y–Yes [ ]No If yes provide size(s) Will food be served? es [ ]No If yes provide number-and name(s)of food vendor(s) Updated 8/7/2018 /// (V1 Vl 1 F L f 1 h� low 1 II LC- COAQ Suffolk County permit#(s) Will other vendors be on the premises during the event?[� j Yes [ ]No If yes how many? Describe Type of vendor(s) l Dn Property Owner(name/address): �l / � (� -1 k__J ba'-Rr'Dl I IV Contact Person and Contact TelX"Bat[ r—c (n p`1- 1 — (oq- l e-mail address bc I LCrMKcst&um . o V 1 Event Location: Street-Hamlet Address:e26 ND(4h W-Pid 1 1 k SCT Mailing Address to Send Event Permit to: 1"1 icro I KnIbLeEb (off Have any of the development rights been sold to the Town of Southold [ ]Yes ]No and/or Suffolk County Agricultural Program? [ ] Yes V1 No If yes to either or both, also i tcate on the attached plan the boundaries of the reserved area 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 nage) A Parking/Event Plan may be a survey, site plan and/or aerial view (for example Google Earth) 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 temporary utilities to be installed for the event, if any. (8) The layout of any parking area for automobiles and other vehicles and the means of ingress and egress for such parking areas. The parking spaces must allow for 300 sq. ft. per car. (9) A traffic control plan for vehicles entering and leaving the site for the proposed event. (10) Plan for the use of live outdoor music,loudspeakers and other sounds which will be used, if any, and the type and location of speakers and other audio equipment. (11) A description of emergency access and facilities related to the event. (12) Provisions to dispose of any garbage, trash,rubbish or other refuse. (13) Location and description of any additional lighting to be utilized in conjunction with the event. Updated 8/7/2018 (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. . Furthermore,I hereby authorize Code Enforcement Personnel of qft Town of Southold to enter the property during the hours of the permitted special event to make t, and all inspections necessary in connection with this Special Even v PAZ— Print name of Owner S' a re of 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) or more people shall be provided by a qualified traffic controller in accordance with the attached, approved traffic control plan. 3. One "on-premises" sign not larger than six (6) square feet in size may be displayed not longer than thirty (30) days before this event, and removed immediately after the event. Directional parking signs shall be adequately displayed. 4. Applicant indemnifies and holds harmless the Town of Southold from all claims, damages, expenses, suits and losses including but not limited to attorney's fees arising from activities under this permit. 5. Tent proposals must receive permit approval from the Southold Town Building Inspector before placement on the property and must meet all fire and safety codes. 6. This permit is valid only for the time, date, place and use specified above, and for the designated event. Each additional day will require a separate permit application, fee, and related documents for review,etc. at least 60 business days prior to the scheduled event. 7. Adequate temporary sanitary facilities must be provided by applicant for this event and applicant agrees to remove the temporary facilities from the premises within 48 hours after the day of the event. Updated 8/7/2018 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, ingress/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. 12. Access shall be provided for emergency vehicles, to all public assembly areas, all buildings, all work areas and any additional area where emergencies may occur. Two emergency-fire exits and exit paths from the building(s) on the property, to a public way or remote safe area, shall remain open and unobstructed at all times. 13. Owner assures full compliance with all fire, safety,building, and other Town laws. 14. Music,when outdoors, is required to stop at the time specified in the permit.Placement of the speakers must be in a location that affords the greatest protection from noise intrusion upon adjacent properties. 15. Owner will allow access to Code Enforcement Personnel of the Town of Southold during the hours of the special event to make any and all inspections necessary in connection with this Special Event. 16. ADDITIONAL CONDITIONS: ANY VIOLATIONS IN CONNECTION WITH THE CONDITIONS LISTED HEREIN WILL TERMINATE THIS PERMIT. 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'�' v ^�'s r:f✓,7�;*,!,rt r. r++r"`. 3 . t• r G,r '�,.., • Amo® CERTIFICATE OF LIABILITY INSURANCE °A'E`MMI°°"'""' 05103/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must 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 endoreemen a. PRODUCER NAMer EILEEN CUSHMAN GEORGE FORMESPHONH 831-722100 P ,:631-722-4500 1116 MAIN ROAD SUITE A2 EiMiLt •EILEEN.CUSHMAN MERICAN-NAT.IONAL.COM P.O.BOX 2336 INSU S AFFORDING COVERAGE MAIC 0 AQUEBOGUE,NY 11931 INSURER A:FARM FAMILY CASUALTY INS.CO. INSURED JEMCO WINERY ASSOCIATES INC INSURER e: DBA KONTOKOSTA WINERY INSURERC: POB 67 INSURER D: GREENPORT,NY 11944 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS 70 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POUCYNUbIBER ADOL BURR POLICY EFF POUCYEXP LIMITS LTRRPNIM A XX COMMERCWLGEMERALUAStUrY X 3101X3113 01/04/2022 01/04/2023 EACH OCCURRENCE S 1,000,000 DAMAGE TO RENTE57-- CLAIMS•MADE RR OCCUR S 250,000 MED EXP(Any one roan) 5 10,000 PERSONAL 8 ADV INJURY 5 1.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 2,000,000 XX JE°T LOC PRODUCTS•COMPIOP AGO $ 2,000,000 POLICY[:1 OTHER $ A AUTOMOBILE UASIUTY 3152C7221 01/04/2022 1/04/2023 D IND INGL LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) 5 AU OS OWNED UTOSPRULED BODILY INJURY(Par accident) S NON-OWNED OPERTY DAMAGE S HIRED AUTOS AAUTOS wet accidenu S A X UTA RELLAUAG XX OCCUR 31OIE1880 01/04/2022 01/0412023 EACHOCCURRENCE S 55.000,000 EXCESS LIAB I CLAIMS-MADE, AGGREGATE $ DEO I I RETENTIDNS S A WORXERSCOMPENSATION 3101W8176 01/04/2022 01/0412023 XXI RTATUTE AND EMPLOYERS'LUIBILRY ANFICERlIdIETO EXRTNE D9XECUTWE Y=NIA E L.EACH ACCIDENT $ 100,000 OFEBE(Mandatory In NN) E.L.DISEASE-EA EMPLOYEE 5 100,000 dyes.desenbe under E.L.DISEASE.POLICY LIMIT S 5500.000 DESCRIPTION OF OPERATIONS WI. .. DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101.Additional Remarks Schaduls,may W attached If mom space Is mqW rad) CERTIFICATE HOLDER AS ADDITIONAL INSURED 5100,000. LIQUOR LIABILITY PER OCCURANCE INCLUDED IN POLICY 3101X3113 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE F SOUTHOLD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TOWN O PO BOX F S ACCORDANCE WITH THE POLICY PROVISIONS. SOUTHOLD NY 11971 AUTNORULE REBENTnnv4W-Ar"- 0 '9��O S-2014 ACORD CORPORATION. All rights reserved. ACORD 25120141011 The ACORD name and l000 are realstered marks of ACORD a Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 05/09/22 Receipt#: 297905 Quantity Transactions Reference Subtotal 1 Event Fee KW1 a-c $150.00 Total Paid: $150.00 Notes: Payment Type Amount Paid By CK#5381 $150.00 Jemco, Winery Assoc Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Jemco, Winery Assoc P O Box 67 Greenport, NY 11944 Clerk ID: DENISN Internal ID:KW1 a-c