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RECEIVED R , PEAR 2 3 202 Southold Town Clerk TOWN OF SOUTHOLD OLIO 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$250.00 by the Office of the Town Clerk, unless a waiver is obtained. Requesting an expedited review must be submitted in writing to the Town Clerk. The Town Clerk will forward all applications to the Special Events Committee for processing. The Committee will obtain comments on all applications from relevant Town, County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. The Town reserves the right to request additional information from an applicant to address issues related to the health,safety,and welfare of the community. When is a Permit Required? - All Special Events,per Southold Town Code Article 1, Section 205-2(Definitions)must obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits. Any use of residential property for profit, such as a venue for weddings or other events is prohibited. This application is deemed complete once all the following requirements are submitted to the Town Clerk: Please indicate submission of the following by checking off the boxes and signing below. A completed application form signed by the owner and the event manager. Applications without property owner's signature/approval will be rejected. FEE: Is the application being submitted at least 60 days before the event[X]Yes [ ]No If Yes,Fee of$ 150.00 has been submitted ❑ If No,Fee of$ has been submitted Updated 8/7/2018 ❑X The applicant/owner of the property where the special event is proposed to take place must provide a certificate of insurance not less than 2 million dollars naming the Town of Southold as an additional Sinsured-) ;.!'-A"11 A Parking/Event Plan: consisting of a survey, site plan and/or aerial view of the subject property that ' ' `i 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 plan acceptable to the Town of Southold AND a qualified traffic controller must be provided at the event. (See application form for details) Signature of Property Owner on the application authorizing Code Enforcement Personnel of the Town of Southold to enter the subject premises during the hours of the event to ensure compliance with any and all special event permit conditions. My signature below affirms that I have submitted all the information required above in connection with my application. 3-1 e-,2 D.2� a5'�L__ Dated Sign tur 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 • 1 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)name: Anne Spooner Date of Submission 3/14/2022 Name of Event The Music Project-Outdoor concerts and Stargazing SCTM#'s 1000-Section 70 Block- 8 Lot(s) 2 Dates of Each Event: 5/28 or 6/4 (rain) 6/11 or 6/19 (rain) 7/2 or 7/23 (rain) If Multiple Dates are requested,applicant must give all information for all dates. Nature of Event: see attached (Please attach a detailed description of EACH event to this application) Time Period(Hours)of Event: From 7pm to 10:30pm Town Services requested: ( )Yes (X)No If yes,Describe Police Dept._Highway Dept. Describe Services Maximum Number of Persons Attending At One Time: 100 Number of cars expected 25-35 Is a Tent or other temporary structure being used? [X] Yes [ ]No If yes provide size(s) A 12 foot x 16 foot temporary wood platform, 6 inches off the ground, will be provided for the performers. Will food be served? [ ]Yes [X]No If yes provide number and name(s)of food vendor(s) Updated 8n12018 Suffolk County permit#(s) Will other vendors be on the premises during the event? [ ]Yes [X]No If yes how many? Describe Type of vendor(s) Property Owner(name/address): Contact Person and Contact Tel.# Anne Spooner, President. Phone: 631-566-6915 e-mail address anne.verticchio@gmail.com Event Location: Street-Hamlet Address: 1115 Main Bayview Rd., Southold NY 11971 SCTM# Mailing Addre'ss's fo Send Event Permit to: PO Box 1204, Southold NY 11971 Have any of the development rights been sold to the Town of Southold[ ]Yes [X]No and/or Suffolk County Agricultural Program? [ ] Yes [X]No If yes to either or both, also indicate 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 page) A Parking/Event Plan may be a survey, site plan and/or aerial view (for example Google Earth) of the subject property.INDICATE ON THE PLAN ALL of the following information: A parking/event plan showing: (1) The size of the property and its location in relation to abutting streets or highways. (2) The size and location of any existing building(s)or structure(s)that will be in operation during the course of the event and any proposed building, structure,or signs to be erected temporarily.for the event. , (3) The location of the stage or tents, if any. (4) The designated areas of use for spectators, exhibitors,vendors, employees and organizers. (5) Location of all entries and exits. (6) The location of all fire extinguishers and other fire safety equipment. (7) The location of all 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 I (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 the Town of Southold to enter the property during the hours of the permitted special event to m ny and all inspections necessary in connection with this Special Even Amaa, SPaa�u �6t�s�n� PrMt name of Owner Signa caner Ai1lltf_ Seem-� ®/Lest Print name of Authorized Person/Representative Signa Vutliorized 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, tents 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. I 16. ADDITIONAL CONDITIONS: ANY VIOLATIONS IN CONNECTION WITH THE CONDITIONS LISTED HEREIN WILL TERMINATE THIS PERMIT. APPROVED Town of Southold Resolution Number: Date Issued: i Updated 8/7/2018 The Music Project—Outdoor concerts and Stargazing Custer Institute, Inc. is a 501(c)(3) not-for-profit organization and a chartered educational institution, established in 1927,which is staffed entirely by volunteers. It is registered with New York State as a charitable organization. All programs, including those listed here, are offered as a benefit to the local community and those who visit us from the regional area. Any money raised is used to offset operational costs and to pay the performers for their services. Custer Institute will be offering these 3 concerts for the 2022 year. Since the COVID-19 pandemic has encouraged us to move programs outdoors,we will hold these concerts outdoors under the stars this year to promote social distancing and safe gathering practices. These will be held on our lawn. The details for each program can be found below. There will be a temporary 12'x16' platform set up for the musicians that will be removed on the following business day after each performance. This platform . provides a dry,flat surface for the performers and is only approximately 6 inches off the ground. Thee will be sound amplification, as needed,that will include two 12 inch speakers with mixer amplifier or similar sound system that will project sound towards the audience. Some outdoor LED portable stage. lighting on tripods will be used to illuminate the performers and will be directed toward the stage and terminate on the wail of the main building: We will be conscious not to amplify the sound so as to be a nuisance for neighbors. We will also set up the lighting so that it will not trespass onto neighboring properties. There will be astronomical observing occurring concurrently, so this stage lighting will be minimal. We will have directional traffic signs set up for parking and one volunteer staff person will conduct traffic control before,during, and after the event(s) utilizing an illuminated traffic wand. MAY 28, 7:OOPM. (RAIN DATE JUNE 4, 7.00PM). RITES OF SPRING MUSIC FESTIVAL. The Rites of Spring Music Festival returns to Custer Observatory,presenting this 7th edition live performance outdoors under a NoFo sunset! Rites of Spring New Music Ensemble(R o S Ensemble)is a group that embodies the spirit of the new music culture and is dedicated to performing innovative, collaborative, and exciting works of living composers and the important contemporary works from composers of the recent past. Music is diversifying and changing. R a 5 Ensemble aims to showcase this growth by bringing people together, and focusing on what is happening today in the global arts world. This program presents new music by Hull,Seo,Andres, Crowell and classic contemporary music by Steve Reich for a very exciting evening of music and stargazing! Following the concert, Observatory staff will provide guided tours of the night sky(weather permitting) through our many telescopes on site, including the apochromatic Zerochromat telescope in our historic observation dome. JUNE 11,8:OOPM. (RAIN DATE JUNE 18,8:OOPM). AN AMERICAN SUNRISE. Join us for an exciting evening of traditional indigenous music, an exhibit featuring Native American archaeoastronomy, and poetry of the first Native American poet laureate under the stars! 1 I In this outdoor concert,Sicanni Purizaca will perform Andean traditional flute music that highlights the culture of people indigenous to the Americas and music that originated in the Andes Mountains of Peru. Its traditional sounds are based on ancient musical instruments such as native bamboo and wooden flutes, and drums from leather of native animals. Many of the rhythms that Sicanni integrates into his music were discovered from different areas of the Americas. With the traditional music elements and some contemporary instruments,Sicanni and his ensemble make the traditional music enjoyable and rich while keeping the roots of the native sounds! Included in the presentation will be readings of excerpts from the chosen poetry collection "An American Sunrise"by performance company Teatro Yerbabruja, emphasizing the importance of astronomy to indigenous cultures. "An American Sunrise"is a nationally best-selling poetry collection from the first Native American poet laureate of the United States,Joy Harjo.Joy's collection "reveals glimpses of life in Oklahoma's Muscogee Creek Nation alongside delicately rendered ruminations on memory,family and s healing"(Drew Tewksbury, Los Angeles Times) Sicanni Purizaca was born in Peru and has been playing traditional native american flutes for almost 30 years. He has recorded seven albums,four of which include his own musical compositions. Sicanni has travelled many countries and across the nation sharing his music. He has also taught native american flute playing at schools, in seminars and workshops. Currently he resides in Long Island, NY and is producing and recording a new album to be released in 2023. This program is conducted in partnership with Teatro Yerbabruja, the Southold Indian Museum and the Shinnecock Indian Nation and is the final event in a National Endowment for the Arts BIG Read Long Island series presented by Yerbabruja. Showcasing a diverse range of themes, voices, and perspectives, the NEA Big Read aims to inspire meaningful conversations, artistic responses, and new discoveries and connections in each community. Following the presentation, Observatory staff will provide guided tours of the night sky(weather permitting)through the many telescopes on site, including the feature telescope in the Institute's historic observation dome. JULY 2,9:OOPM. (RAIN DATE JULY 23,9:OOPM). GENE CASEY AND THE LONE SHARKS. Celebrate the summer with a live outdoor concert by Gene Casey and the Lone Sharks under the North Fork starry night sky. Join us for a live outdoor concert under the stars with Gene Casey and the Lone Sharks! A local legend with a self-described"rough-hewn and honest"style, Casey helped develop the North Fork music scene before one existed and has developed a reputation for his fun, upbeat performances that bring the crowd to their feet(The Sound of the North Fork, Northforker June2019). i Gene's original music met with great acclaim and received significant local and international radio play. Several of his roots-drenched songs have been used in "A Prairie Home Companion"and on the soundtracks to television and feature films,including "Justified"and "Sons of Anarchy", the 2012 thriller "The Tall Man"starring Jessica Biel, the 2013 release "The Killing Season"starring Robert DeNiro, and Rob Reiner's "Being Charlie." In 2015, Gene, "the premier barroom troubadour of Eastern Long Island"(Josh Alan Friedman)received the Long Island Sound Award by the L.I. Music Hall of Fame, 'for contributions to the Island's musical landscape." Following the concert, Observatory staff will provide guided tours of the night sky(weather permitting) through our many telescopes on site, including the apochromatic Zerochromat telescope in our historic observation dome. ACo® CERTIFICATE OF LIABILITY INSURANCE FDATE(MWDD/YYYY) 03/14/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not conferrightsto the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Sarah Arebalo NAME: Roy H Reeve Agency,Inc. PHONE (631)298-4700 FAX631 298-3850 A/C No Ext): AIC,No: ( ) _ PO Box 54 E-MAIL sarebalo@royreeve.com ADDRESS: 13400 Main Road INSURER(S)AFFORDING COVERAGE NAIC# Mattituck NY 11952 INSURER A: Hartford Underwriters Ins Co 30104 INSURED INSURER B: ,. Custer Institute Inc: - INSURER C: PO BOX 1204 INSURER D: INSURER E: Southold NY 11971 INSURER F: COVERAGES CERTIFICATE NUMBER: CL222816227 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,TERMOR CONDITION OF ANY CCI4TRACT 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 AUUL bUNKI POLICY EFF POLICY EXP LTR - TYPE OF INSURANCE INSD WVD POLICY NUMBER _ MM/DD MM/DD/YYYY LIMITS _ X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE FSIOCCUR DAMAETORENTED PREMISES Ea occurrence $. 1,000,000 MED EXP(Any one person)- $ 10,000 A Y 12SBAAF4KDS 02/28/2022 02/28/2023 PERSONAL&ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 4,000,000 POLICY❑JEST LOC PRODUCTS-COMP/OPAGG $. 4,000,000 OTHER: Terrorism $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY Peraccident AUTOS ONLY AUTOS ( ) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Peraccident $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ _ DED I I RETENTION.$ $ WORKERS COMPENSATION - PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE. ER ANY PROPRIETOR/PARTNERIEXECUTIVE ❑ N/A E.L.EACH ACCIDENT_. $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) - E.L,DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space Is required) Town of Southold is included as Additional Insured with respect to General Liability as per the terms and conditions of policy form SL 30 32 06 21-Blanket Additional Insured by Contract.30 Day Notice of Cancellation applies per policy form SL 90 13 10 18. CERTIFICATE HOLDER CANCELLATION - SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1179,54375 Route 25 AUTHORIZED REPRESENTATIVE Southold NY 11971 ©1988-2015 ACORD CORPORATION: All rights reserved. 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Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 03/25/22 Receipt#: 295620 Quantity Transactions Reference Subtotal 1 Event Fee Cl1a-c $150.00 Total Paid: $150.00 Notes: Payment Type Amount Paid By CK#193 $150.00 Custer, Institute Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Custer, Institute Po Box 1204 Main Bayview Road Southold, NY 11971 Clerk ID: LYNDAR Internal ID:Clla-c Rudder, Lynda From: Rudder, Lynda Sent: Friday, March 25, 2022 1:40 PM To: Mirabelli, Melissa; Noncarrow, Denis Subject: Special Event C11 a-c Attachments: custer_20220325084853.pdf Your message is ready to be sent with the following file or link attachments: custer_20220325084853.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