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Pellegrini Vineyards 2022-529
O��S�FFO(,�coG o - 0O2 2 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: June 21, 2022 Subject: Special Events —Pellegrini Vineyards PV2a-f 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: V(MO'Y& Address: _crWns Mn Rd Com„ hiin 101 U_� IR35 Application number: T)vao,4 Date of Event: QI(o r 6111—+ ,� , q (A—L , R(aLf Time: c5: �}�1�1 � ���00 Pry) Date Received by Town Clerk: 0 Date Received by Committee: 8[Wa2t Nature of Event (S): _J Committee Comments Received bv: Denis Neftearow �J Melissa Spiro y., Leslie Weisman Missy Mirabelli Chief Flatley -4 August Ruckdeschel- County Y_ Heather Lanza James Easton Mike Verity Claire Glew Wwftf Jvhn&v✓Ia Kevin Webster Committee Recommendation's: Approve as applied Approve with Additional conditions: Hold Public Hearing Deny Special Event No: 3 Resolution No: aoaa`" rJ' aq Date: aoNa., � 4 �yYf �... RECEIVED JUN 2022 AERIE Southold Town Clerk TOWN OF SOUTHOLD T6NVn.Code Chaoter 20 `f`Ptihlic EntertWhrn6nt and Sodcial Evenf§" SPECIAL EVENT PERMIT INSTRUCTIONS AND APPLICATION FORINT 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 Boardof Appeals and Police Departments,and the Suffolk County Planning Commission. t .Applcnfion fes: $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$150.00. However,specific detail&of each event must be included with this application. All ;WVIicatimns must be-submitted at least 60 b siness dkvs before the -event A laeants ,are edcgufaged to suluTMt abplfcations as early as p!6 Al6 Any con; eted:apY)licatta n that is pat-su!)Witted 60 or.more business.c aya Plriar tm a sebtdalelT evertt:inay Fie selected orsiilijecf to a Cafe-mrocessin�g fee of�250'bQ b #fie fitice of fire'i'otvn'Clerk_,. unless a,waiver 1s_obfaiiied: Requesting an expedited review must be submitted in writing to the Town Clerk.The Town Clerk will forward all applications to the Special Events Committee for processing. The Committee will obtain comments on all applications from relevant Town, County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. The Town reserves the right to request additional information from an applicant to address issues related to the Health,safety,and welfare of the community. When•isa PermitRjWu r6!?. All Special Events,per Southold Town Code Article I,Section 205-2(Definitions)inust obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits. Any use rif'resiilentrat iir0 e�rt fur.Drofit,such as_a ventre•forweddings or oilier events is.prohibiYed. i This apIalicati'on is degmed eomplete once.ali fhe�fnllowi�,rea-uireunents'are srrbrnitted Ec :tbe to kPl a;e,indicate' mi ... fh" l `in , the Mid sfttn_i. ,-1. .,. eA completed application form signed by the owner and the event manager. Applications without property owner's signature/approval will be rejected. t FEE: Is:tl a appl cahon:;liein .snbiriittdd at1east'60 days•befare:the event KY69 j.]No If Yes,Fee of$ has been submitted If No,Fee of$ has been submitted Updated 8/7/2018 3 't Tie applicant/owner of the property where the special event is proposed to take place must provide a dere ficate ofin5ucance not less than 2 million dollars naming the Town of South©ld':as an additional j A*!Parking/Evenf-PJan 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 acceptable to the'Town of Southold AND a qualified traffic controller must be provided at the q evem,(See application form for;det&i ). Signature of Property Owner on the application authorizing Code Enforcement Personnel of the Town ofSouthold to enter ttie subject premises during the hours of the event to ensure compliance with any and all special event permit conditions. i My signature below affirms that I have submitted all the information required above in connection with my application. 2 Z. Dated Signature f 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. f 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 Suffglk County Bureau of Public Health Food Protection Unit. I � z t jt i 't i 'r 4 I 3 t i Updated 8/7/2018 F RECEIVE® JUN 3 2022 Southold Town Clerk 1 k APPLICATION FOR A PERMIT TO HOLD A SPECIAL EVENT 1"lease'ok de:ALL 6f the inforritation re uecfed l eiowe Iincorii ilete a plicatiiins V�1T I�1�1fDT'l e reviewed. Special Event Permit# Applicant(s)name: Date of Submission "3 2 z Name of Event SCTM#'s T.00Q=Seetim i -. ('' Brock- 15, 7 c Dates of Each Event:—V10- _1t} _ ZJ If Multiple Dates are requested,applicant must give all information for all dates. dkNature of Event: " q5 S (Please attach a detailed description of EACH event to this application) i Time Period(Hours)of Event: From O to M y Town Services requested: '( )Yes No If yes,Describe Police Dept._Highway Dept. j j Describe Services Maximum Number of Persons Attending At One Time: 7 .Number of cars expeeted Is a Tent or other temporarystructure bei used?[ Yes[ ]No If yes provide size(s) Will food be served?` C 1 Yes, [ ]No If yes provide number and name(s)of food vendor(s) Updated 8n12018 i 7 `t 9 L Suffolk County ermit#'sP'Toov ! TyP () Will other vendors be on the premises during the event?[ ]Yes [X No If yes how many? Describe Type ofvendor(s). 4V'.Qr 0,4�y Property Owner(name/address): Contact Person and Contact Tel.#, k L/e Ld r;►-o 241 7 4 e-mailaddress., Event location:Street-Hamlet Address:: Mailing Address to Send Event Permit to: G��l Have any of the development rights been sold to the Town of Southold [ ]Yes No and/or Suffolk County,Agricultural Program? [ ]Yes [ No If Ves°ta.either or batlia alio indicate' �n'fiiie- attaclted ttlenthe lj'o ihdh ifIhe'fes6rve&hre'a inion Which the%event will take"In ace:. YOU QST A'A"7',CR A PARKIIVGIEVIJNT PLA `l'(D"T>rTifS A;�?l'L��'ATTt31�tT IF E EX 1 C 30 W CD `121+ +€}PE *QU 1 t ST AL !Q J-RAVFIG CQNTR L.PLAN(see=ne% page).. A Parl"g/Eventtlan_may lie a survev slie_plan and/6r aerial v eFv(fol evaniple boogie aiflt)'of, the subject-propert=v.l3 ICAT- 9 ON—, PLAX.ALL.of the followininformatio-m. A parkinglevent 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. t :(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 j , f (14) Location of sanitary facilities on site. ,.Trafrk 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�ualil ed ttaffiiccontroller 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: Oji!'1VERIS-SMA TURE.- I ant 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 illy 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 make any and all inspections necessary in connection with this Special Event: _ Print name of Owner Signature ofOner Print name of Authorized Person/Representative Signature oft utltoiized Person/Representative PHRM18MN IS IM GRANI'ET9` SME CT TaTH ,t-F:)LIC;0WING CONDIT ONS 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.I?arkiiig is"siTictly{imhibited MANY Y Ta vn: Co or fitateRba'ds or Rights:of Way. - 2. Traffic control at eventsFfor three hundred(300)or more people shall be provided by a qualified traffic controller in accordance with the attached,approved traffic control plan. i 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 dnd 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. IrEach additional day will require a separate permit application, fee, and related documents for review,'etc.at least 6o business,dao s prior to the sc}ieehtled'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 hiclud gg but not limited-to p apAcing, ingres legt`eWiccess : - tent(s''or temltorary structure( orfeiimpa sanifary tacilitias shall be--66ndueted:on Town ofS_S-uthold Punc4ase of Develoliment RiAt's and• 10 N6 activities assciciated wifh tl is event including but not Limited to paikirig, iniYressleg_resslaoCesfi' tent sll ai temporary structure(s}, or temnarary saiiif tX facilites shall be conducted an Suffolk County ;Purchase of:Develo inept Rights land without-a-06 it issued:liy the Suffolk C, bVp!y Fai nkfid 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 Enforcers:ent 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. t ` APPROVED Town of Southold t t Resolution Number:.. Date Issued: 4 1 i i Updated 8n12018 I ACORD CERTIFICATE OF LIABILITY INSURANCE BAT 06/02/202 YY) ��-•' ' 0510?/2022 THIS CERTIFICATE IS ISSUED ASA 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 anADDITIONAL-INSURED,the poiicy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION(S WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certlflcate does"not..confer rights to the cortificate:holder In lieu of such endorsement(s). _ PRODUCER CONTACT _ NAMEi Farm Family Casualty Insurance Company: PH o,-C2,11" 631-727-7767 (; No} 631 727 7941 ^ E•rAA L eriCkirl@fatTi-(amUy ain _ __ 18 First Street _."R. DRFss Riverhead,NY 11901 INSURERS)AFFORDING COVERAGE _NAIC A ,. 6N5ugERA:Farm i=a .Casualty1nsurance 13803 :. _.. INSURED ' INSURER B.- Pellegrini :Pellegrini Vineyards1l_C INSURER C: 23005 Main Road ' INSURER D: - - - `• j INSURER E.: --_ Cutchogue NY 11395 INsuRe :Fr. COVERAGES_ CERTIFIGATE',NUNBER; _. REVISION NUMBER:_ THIS IS TO CERTIFY THAT,THE POLICIES-OF.INSURANCE LISTED BELOW HAVE BGEN ISSUED TO THE INSURED NAhMp.ABOVE FOR THE POLICY'PERIOD INDICATED. NOTWITHSTANDING:ANY REWIR[MENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY LIC ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL 7111'TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. DhL[S- POLICY EFF.i POLICPEXP:• . ,LTR TYPE OF INSURANCE 1' , •POLICY NUMBER hIMiDDA!YYY 'IMMfODfY,YYV p - LIMITS -.. A X cdwAMOALGENEWLIABILITY X 3,152G3148 05103/20,2005/03/2021'EACH occuRRrnca _ s 1 ODO 000 i , , DA(�/CGE l`Olkt C A CLftJs•F`IADE�,occuR 3152LG607 �Q5103/2QZ1,05/032022- PREntI$ E'tgeturr noai�,5 X ..LigouL t iabiifty 3152L6608 ; i MED ExP(AnI anre'ptuso r} S' 5 000+ 1 j PERSONAL'tADV.INJURY. s_ 1,_000,000_ GEN'LAGGREGATELIMITAPPLIESPER: 13ENERIt•AGGREGATE �$: 2,000.000 X- POLICV❑j�� LOC �. PRODUCTS CDI tPlOPlGG S 1 OOO OOO B, auronloBllE'unl tirry X', :315231153'( 06/15/2021+06115/20221 iCONIBINEDn,SINGLE.LiMtT s 1',000,000 ANY AUTO I BODILY INJURY(Por.parson) d$ OWNED SCHEDULED t ~ AUTOS ONLY AUTOS BODILY INJURY(Por acc dent) 5' HIRED I AUTOS -OWNED PROP 7Ynf" AG NON AUTOS ONLY v AUTOS ONLYi 1 C X UMBRELLALIA13! OCCUR X 3152138064 105103/202005103/20211 EACROCDURRrz=L s;. 3,000;000 - _._....._..e EXCESS LIAB I cLAInIs.MnDE 05/03/2021sO510312O22j AGGR@GATE `5 _ ,4 -.. ,.. .. ..��.. - Deo I X I RElENT10Ns. 10.000 1YORKFRS COMP$NSATION- ANOEMPLOYERS L)ABILfTY 14TATU C I 1 Ek1 NiYPROPSlfr,OriiPMrN[IYeXECUTIV€ Va N/A: S f£L Et1CY4AGC1r7rNT S _.w, ___ OFFICBitIME>tRFREXCLUDEDd j. 1151.DISEASE I A[h41�LOYEC S. iMandalory1n NH) tryycs,-dascdhdundcr ., .. ; {. . DESCRIPTION OF,OP[RATIONS 6elev� 6L.DISEASE--POLICY UMiT -S: D 'Liquor Liability. X 3152F6081 s/22/20202 �08/2 /2021?500,000/1,000,gp; - 6ESCRIPTION 0F;OPERATtONS.1LOCATIONS I VEHICLhS JAC60101,Addhional Remarks Schodule,may be attached If mero space Is required) 06/24/22 06125!22.07116/22 O8J27/2'2-09/03/22 09/10/22 09117/22 09/23/22 09/24/22 10/01/22 10/07/22 10/08/22 1 10912210/15/22 4 GERTIF{CATE.HOLDER CANCELLATION Town Of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 53095i Route 25 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 1179 ACCORDANCE WITH THE POLICY PROVISIONS. Southold, NY 11971 AUTHORIZED REPRESr:NTATIVE Kirk Associates LTO l ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Go:-*gle Maps L/ f � .�i4ut tig Imagery A2022 Maxar Technologies,New York GIS,Map data©2022 50 ft C 7499 SEE SEC.NO.102 oral-w 04.20-00 6117-M- N�.ih7� � M,PSCH,. i_ {]RN s.NATCR x 05-2600 r' i. .. t FOR PCL NO. / O0:OS80 W d, 2; SEE SEC.Na 740x00. < 1237.00, i 24.4 24.3 102-04-008.1 0344-01I k - 342A3-9A O0:c9x1 I W (TDx oFwurww •1429x1 ' cEVE1oFHE,vrar.,rrs) y3:. ,�..- ,�.' t 03-72-03. 12,0349 1' .2A( 044)3-M 4)3. I In12,27-01, 13.2 v\ 1aT9-0a fP � 1.27-07 42-IA 05fi5-07:„ I 's 1.21-00 PECONIC LAND TRUST,INC +A {;;•:', 03-22-10, I 1 & ,eye }£ fmvm OF soumm 05.1443" < j ` 'E.• OEVF1oPldFMAK,llis) �' ''1' +••;. 05--22-13 - m 5,GAA(c) ° 4 77 A(.)' ,: �a ems, 241 '. 1.3A(c) R 2.8 X. ._ _ '�''. -, .• 10.1 '), 1.3A . . 1 s. � �,. _ UA - s `212 'VA� 2.31 ( 36RA(o) _P 4 , 7 h l MA m �F a T 6 rEcalca' r -„ ..- ' .- •IHt4TRiY^d .1.14 ' NTdiil:saUr' • _ 1`nl:uticviaF�vrt3uirsl. 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Lnlfti Al, Iarti til r . t�r1 � t ' 9l : 06/27/201 FARM WINERYLICENSE EFFECTIVE DATE. ff EXPIRATION DATE: 7/31/2022- SERIAL #: 1045$02 t a }3s r`dt4,Nti`rr tlN�JSu•� 1; „'� ¢' � CE #. 366 ' COUNTY: SUFFOLK - CERTIFICATE 919a. i c :s r r: � ,.. s ""-" .. #. 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Bradley < Chairman u gg ,,I • w 1 �,;rtit BEFORE'COMMENCING OR DOING ANY BUSINESS FOR THE TIME FOR WHICH THIS LICENSE'HAS BEEN ISSUED,THE.SAID`LICENSE•SHALL �� s +� °x jtj 4! ;;4gas ? ' BE'ENCLOSED INA SUITABLE WOOD OR METAL FRAME, HAVING A CLEAR GLASS SPACE,AND A SUBSTANTIAL WOOD OR METALL BACK SO THAT f;sy ,t ora ': THE'WHOLE OF SAID LICENSE MAY BE'SEEN•THEREIN,AND SHALL as BE,POSTEDUP LAND'AT ALL TIMES'DISPLAYED IN A CONSI?ICUOUS PLACE,IN' �yas >iz ti4 yfYf,� - `.-��""�j+,y THE ROOM WHERE SUCH BUSINESS IS CARRIED ON,SO THAT ALL PERSONS VISITING SUCH PLACE MAY READILY SEE THE SAME f r+n a,' }•' s{ 'SLA-FORh9 186.033(IN()9) "; -. - CeTt1fiC3te,NO ' �.4`.�,w�. rw.;• ':; 'i r.0•. w:. +"4�*,ra^Rar,"w.., ... ,+. t >.., .�,r:..; .S '.:v "" ,;J ,,,, 1, r 1 ,�-. 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I s , 1.. 3 a.h" e z. ik � m µ i^ t pazooe o` .ux in' x ^ � ""�;n�' �.. %\.�"?x"\ „, Asx” sr`# `•u F k3�x ::, �" � 1 .. '` ,�,.�:;.: s1 �. � '"�:�u �x .�a=� r s .c �s ,��, I ,.,'�tt"Z• 'A ���` ��' #' i^ .i. y .t .i r Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT Date: 06/06/22 Receipt#: 300347 Quantity Transactions Reference Subtotal 1 Event Fee PV 1a-f $150,00 1 Event,Fee PV 2a-f $150.00 1 Event Fee PV 3a-e ' $150.00 1 Late Fee PV 1 a-f Late $250.00 Total Paid: $700.00 5 Notes: Payment Type Amount Paid By CK#35713 $700.00 Pellegrini,Vineyards Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold,,NY 11971 i . i i I i 3 { i S 3 s Name: Pellegrini,Vineyards j 23005 Main Rd. Cutchogue, NY 11935 Clerk ID: SABRINA Internal ID:PV 1a-f Late Mirabelli, Melissa From: Spiro, Melissa Sent: Thursday,June 9, 2022 10:03 AM To: Mirabelli, Melissa Subject: RE: Special Event Pelligrini Vineyards 2a-f This is not preserved land. Melissa S. From: Mirabelli, Melissa Sent:Thursday,June 09,2022 9:58 AM To: Spiro, Melissa <Melissa.Spiro@town.southold.ny.us>; Easton,James<jamese@southoldtownny.gov>; Glew,Claire <Claire.Glees@town.southold.ny.us>;Webster, Kevin<kevin.webster@town.southold.ny.us>; Killean,Jade <Jade.KiIlea n@suffolkcountyny.gov>;Amakawa,Andrew<And rew.Amakawa @suffolkcountyny.gov> Cc: Ruckdeschel, August<August.RuckdescheI@suffolkcountyny.gov> Subject:Special Event Pelligrini Vineyards 2a-f Please send me any questions or comments Thank you 14N V7: Afelissa M. 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. ******************************************************************************************* 1 Mirabelli, Melissa From: Flatley, Martin Sent: Thursday,June 9, 2022 11:24 AM To: Mirabelli, Melissa Subject: RE: Special Event Pelligrini 2a-f No objections to approval of these events 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. From: Mirabelli, Melissa<melissa.mirabelli@t own.southold.ny.us> Sent:Thursday,June 9, 2022 9:56 AM To: Burke,John <johnbu@southoldtownny.gov>;Verity, Mike<Mike.Verity@town.southold.ny.us>; Flatley, Martin <mflatley@town.southold.ny.us>;Weisman, Leslie<lesliew@town.southold.ny.us>; Lanza, Heather <heather.lanza@town.southold.ny.us> Subject:Special Event Pelligrini 2a-f Same as always send me any questions or comments Thank you Melissa 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 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 1 transmission and delete the message without copying or disclosing it. ******************************************************************************************* z Mirabelli, Melissa From: Lanza, Heather Sent: Thursday,June 9, 2022 10:35 AM To: Mirabelli, Melissa; Burke, John;Verity, Mike; Flatley, Martin;Weisman, Leslie Subject: RE: Special Event Pelligrini 2a-f Looks like these are very similar to ones they had in the past. I do worry about the parking here, but if not complaints in the past,then these should be fine. From: Mirabelli, Melissa<melissa.mirabelli@town.southold.ny.us> Sent:Thursday,June 9, 2022 9:56 AM To: Burke,John<johnbu@southoldtownny.gov>;Verity, Mike<Mike.Verity@town.southold.ny.us>; Flatley, Martin <mflatley@town.southold.ny.us>;Weisman, Leslie<lesliew@town.southold.ny.us>; Lanza, Heather <heather.lanza@town.southold.ny.us> Subject:Special Event Pelligrini 2a-f Same as always send me any questions or comments Thank you Alefissa 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. 1 Mirabelli, Melissa From: Killean,Jade <Jade.KiIlean@suffolkcountyny.gov> Sent: Thursday,June 9, 2022 11:47 AM To: Mirabelli, Melissa Cc: Amakawa,Andrew; Ruckdeschel, August Subject: RE: Special Event Pelligrini Vineyards 2a-f Hi Missy, We do not have objections to these Special Events at Pelligrini Vineyards as long as the adjacent County PDR property is not being used for parking, improvements and activities associated with this event. Thanks, Jade xiCCem L Planner Suffolk County Dept.of Economic Development&Planning Division of Planning&Environment 100 Veterans Memorial Highway,211 Floor Hauppauge,NY 11788 631-853-6044 Tel fFo{ Jj pracficeGREEN Save a tree.Read,don't print,emails. CONFIDENTIALITY NOTICE. This electronic mail transmission is intended solely for the use of the individual/entity 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:Thursday,June 9, 2022 9:58 AM 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 @suffoIkcountyny.gov>;Amakawa,Andrew<Andrew.Amakawa@suffolkcountyny.gov> Cc: Ruckdeschel, August<August.Ruckdeschel@suffolkcountyny.gov> Subject:Special Event Pelligrini Vineyards 2a-f ATTENTION: This email came from an external source. Do not open attachments or click on links from unknown senders or unexpected emails. Please send me any questions orcomments Thank you i Melissa 1117 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. ******************************************************************************************* 2 Mirabelli, Melissa From: Easton, James Sent: Friday,June 10, 2022 10:00 AM To: Mirabelli, Melissa Subject: RE: Special Event Pelligrini Vineyards 2a-f I have no objection to this event taking place. Thank you, James Easton Fire Marshal jai-nese@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 information 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:Thursday,June 9, 2022 9:58 AM 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>;Amakawa,Andrew<And rew.Am a kawa @ suffol kco untyny.gov> Cc: Ruckdeschel,August<August.Ruckdeschel@suffolkcountyny.gov> Subject:Special Event Pelligrini Vineyards 2a-f Please send me any questions or comments Thank you Z-: Afelissa Af Nfirabelli 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. 1 Mirabelli, Melissa From: Leslie Weisman <lesliekweisman@gmail.com> Sent: Thursday,June 9, 2022 11:12 AM To: Lanza, Heather Cc: Mirabelli, Melissa;Verity, Mike; Burke,John;Weisman, Leslie;Flatley, Martin Subject: Re: Special Event PV 3a-e The proposed weddings and birthday party events at Macari, Breeze Hill and Pelligrini have taken place in the past without adverse impacts so no objections from me Leslie Sent from my iPad On Jun 9,2022, at 10:35 AM, Lanza, Heather<heather.lanza@town.southold.ny.us>wrote: Looks like these are very similar to ones they had in the past. I do worry about the parking here, but if not complaints in the past,then these should be fine. From: Mirabelli, Melissa<melissa.mirabelli@town.southold.ny.us> Sent:Thursday,June 9,2022 9:59 AM To:Verity, Mike<Mike.Verity@town.southold.ny.us>; Burke,John<johnbu@southoldtownny.gov>; Lanza, Heather<heather.lanza@town.southold.ny.us>;Weisman, Leslie <lesliew@town.southold.ny.us>; Flatley, Martin<mflatley@town.southold.ny.us> Subject:Special Event PV 3a-e Please send any and all comments to me Melissa If. i17irabelli 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. ***************************************************************************************** 1 Mirabelli, Melissa From: Mirabelli, Melissa Sent: Wednesday,June 15, 2022 12:51 PM To: Noncarrow, Denis; Rudder, Lynda Subject: Pellegrini (PV2a-f) Special Event reso to be added RESOLVED that the Town Board of the Town of Southold hereby grants permission to Pellegrini Vineyards to hold Special Event 2022- at Pellegrini.Vineyards, 23005 Main RD Cutchogue,New York as applied for in Application PV2a-f for Weddings: September 10, September 17, September 18, September 23, September 24 and September 30, 2022 from 5:30PM- 11 PM. 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. Melissa 1111 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. i •o gUFFa(*4s1 RESOLUTION 2022-529 ADOPTED DOC ID: 18197 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2022-529 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JUNE 21,2022: RESOLVED that the Town Board of the Town-of Southold hereby grants permission to Pellegrini Vineyards to hold Special Event 2022-31 at Pellegrini Vineyards, 23005 Main RD Cutchogue,New York as applied for in Application PV2a-f for Weddings: September 10, September 17, September 18, September 23, September 24 and September 30, 2022 from 5:30PM- 11PM. 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 Noncarrow Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Louisa P. Evans, Justice SECONDER:Greg Doroski, Councilman AYES: Nappa, Doroski,Mealy, Doherty, Evans, Russell i Py r1 ' p( FVJ t ��, RECEIVED I ' JUN 3 2072 i Sou thold Town Clerk I i TOWN OF SOUTHOLD _Town Code Chapter 205 "Public Entertainment and Special Events" G SPECIAL EVENT PERMIT INSTRUCTIONS AND APPLICATION FORINT { Applications for a Special 1hvent Permit are subject to an inter-departmental coordinated review by the Southold Town Board,Town Attorney,Town Assessors,Land Preservation,Building,Planning,Zoning Board ofAppeals and Police Departments, and the Suffolk County Planning Commission. i 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 detailslof each event must be included with this application. All avulications must be submitted at least 60 business days before the event Applicants are encouraged to submit applications as early as possible Any completed applicati®n that is not submitted 60 or more business daya-prior to the scheduled event may be rejected or'subject to a late processing fee of$250.00 by the Office of the Town Clerk, unlessia waiver i obtained. Requesting an expedited review must be submitted in writing to the Town Clerk.The Town Clerk will forward all applications to the Special Events Committee for processing. The Committee will obtain comments on all applications from relevant Town, County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. 1 I The Town reserves the right to request additional information from an applicant to address issues related to the liealth,safety,and welfare of the community. When is a Permit Required? All Special Events,per Southold Town Code Article I,.Section 205-2(Definitions)must obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such . as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits. Anv use of residential property for profit, such as a venue for weddings or other events is prohibited. i This alplication is deemed complete once all the following requirements are submitted to the Town Clerk:i Plea indicate bmi ion of the following by checkin ff the boxes and signing to A completed application form signed by the owner and the event manager. Applications_without property owner's signature/approval will be rejected. �y i I FEE: Is the application being submitted at least 60 days before the event XYes [ ]No If Yes, Fee of$ has been submitted If No,Fee of$ has been submitted i Updated 8/7/2018 J ' i I JI I � 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 insured �A Parking/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 ]an acceptable to thel Town of Southold AND a qualified traffic controller must be provided at the event. (See application form for details) I Signature of Property Owner on the application authorizing Code Enforcement Personnel of the Town of'Southold to enter th'e subject premises during the hours of the event to ensure compliance with any and all special event permit conditions. i My signature below affirms that I have submitted all the information required above in connection with my application. I ; - 2 2 bated Signature I I i I Activities associated withi 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 FarmlaI nd Committee. I 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. 1 1 I I I l{ I I I I f f f i ( Updated 8/7/2018 i i I i I i I i I RECEIVED I JUN 3 2022 Southold Town Clerk i i 1 i APPLICATION FOR A PERMIT TO HOLD A j SPECIAL EVENT i Please provide ALL of the information requested below,Incomplete applications WILL NOT be reviewed. l Special Event Permit# i Applicant(s)name: Date of Submission —2,Z Name of Event �,/Q��i�✓c q S SCTM#'s 1000-Section c Block- Lot(s) 2;, 7 it Dates of Each Event: r-111 i If Multiple Dates are reque1 ted,applicant /must give all information for all dates. Nature 1of Event: (Please attach a detailed description of EACH event to this application) Time Period(Hours)of Event: From 3 to I ' Town Services requested: i( )Yes 04No If yes,Describe Police Dept._Highway Dept. Describe Services j �' / I -_C5 Maximum Number of Persons Attending At One Time: 5 Q Number of cars expected_ 0 i Is a Tent or other temporary structure being used? [)�]Yes [ ]No If yes provide size(s) Will food be served? [� Yes [ ]No If yes provide number and name(s)of food vendor(s) Updated 8/7/2018 i i r 9 u dy zw�S Suffolk County permit#(s) P T o a e Will other vendors be on the premises during the event? j[ ]Yes [ No If yes how many? Describe Type of vendor(s) Property Owner(name/address): e °� ooh' (S 1��l ��P.ed' ✓P� �<.j ,l �� �(�`�� Contact Person and Contact Tel.# �� y/r µ- r 7 3't IPc 2eJ e-mail address o ! 4 te t4 t/, --e -W; `- 1 i Event Location:Street-Hamlet Address: 'Z J 00 " �t/►mak®c�� �j � ' SCTM# I t Mailing Address to Send Event Permit to: D� Par rei I Have any of the development rights been sold to the Town of Southold [ ]Yes SCJ No and/or Suffolk County Agricultural Program? [ ] Yes [ No I_f yes to either or both,also indicate on the attache plan the boundaries of the reserved area upon which the event will take place I YOU MUST ATTACH X PARKIN /EVENT PLAN TO TMS APPLICATION IF THE EXPECTED ATTENDANCE IS 300 OR MORE PEOPLE,YOU MUST ALSO ATTACH A TRAFFIC CONTROL PLAN see next panel A Par Plan Plan may be a survey, site plan and/or aerial view (for example Google Earth) of the sAect property.INDICATE ON THE PLAN ALL of the following information: A parking/event plan showing: (1) The size o�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 layoutlof 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. j(10) Plan for the use of live outdoor music,loudspeakers and other sounds which will be used, if any,and he 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 i 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 inform Iation 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 this1 application. . Furthermore,I hereby authorize Code Enforcement Personnel of the Town of Southold to enter the properly during the hoursof the permitted special event to make any and all inspections necessary in connection with this Special Event r Ald �— Print name of Owner Signature of wner I Print nai e of Authorized Person/Representative Signature of 2zed Person/Representative I I PERMISSION IS HEREBY GRANTED,SUBJECT TO THE FOLLOWING CONDITIONS: i i 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 —a 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" signnot 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 bei adequately displayed. i I 4. Applicant indemnifies and holds harmless the Town of Southold from all claims, damages, expenses, suits avid losses including but not limited to attorney's fees arising from activities under this permit. i 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. lEach additional day will require a separate permit application, fee, and related documents for review,ietc. at least 60 business days prior to the scheduled event. I I i 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. I. Updated 8/7/2018 I j i 8. On-site food preparation is NOT permitted, although food may be catered subject.to all Suffolk Country Department of Heitlth regulations. I 9. NO activities associated with this event. including but not limited to parking, ingress/egress/access, tent(sl.or temporary structures or temporary sanitary facilities, shall be conducted on Town of Southold Purchase af Development Rig tc lands i 10. NO activities associated with this event including but not limited to parking, ingress/egress/access, tent(s)r or temporary structure(s), or temporary sanitary facilities, shall be conducted on Suffolk Count ,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. I i 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. 0;rner will allow access to Code Enforcement Personnel of the Town of Southold during the hours sof the special event to make any and all inspections necessary in connection with this Speci I Event. I 16. ADDITIONAL CONDITIONS: I i ANY VIOLATIONS IN CONNECTION WITH THE CONDITIONS LISTED HEREIN WILL, TERMINATE THIS PERMIT. APPROVED Town of Southold I Resolution Number: Date Issued• i a i i I ` I I I I j I i Updated S/7I2018 i I i I i ACO CERTIFICATEI OF LIABILITY INSURANCE DATE(MMIDD"YYY) (a...� 05/02/2022 THIS CERTIFICATE)S 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(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 NAME: _._ ...�---- —�._.._... Farm Family Casualty Insurance Company! ..PHONE -727-7767,Exs) 631 �_ Y �A/c No,:631-727-_7941 18 First Street E-MAIL APSS: eric.kirk@farm-fa_mily.com Riverhead,NY 119011 _ INSURERS AFFORDING COVERAGE __ I __•__^_ I ____ _ INSURER A:Farm Family Casualty_Insurance 13803 INSURED _ -- ----- __ .�_. --'— INSURER B Pellegrini Vineyards LLC ---•••-• _.�___ _._..___--_..._... ..____. INSURERC: 23005 Main Road INSURER O INSURER E: Cutchogue ; NY 11395 INSURERF: COVERAGES I 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. NOTWITIiSTANDING 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 Till: TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I ADDDLL SUBR I POLICY EFF POLICY EXP LTR I TYPE OF INSURANCE I' POLICY NUMBER MMlO.,"Y MMIDDIYYYYI LIMITS A X COMMERCIAL GEOERALLIABILITY {X 3152G3148 05/03/2020'05/03/20211 EACHOCCURRENCE s 1.000,000 F—V-1 31521_6607 05/03/2021 051032022;DAMAGE YO R(3NTED CLAIMS-MADE I "1 OCCUR PR_E_MI_S__ES•(Ea oycurrence),., •,5 „__,_ _ X Ligour Liability _l i 31521_6608 i i MED EXP(Ani one person) s _5,000 i PERSONAL 8 ADV INJURY S 1,000,000 GEN'L AGGREGATE 1.16T APPLIES PER: I l GENERAL AGGREGATE Is 2,000,000 POLICY J rRb- i PRODUCTS-COMPlOPAGG 5 1,000,000 X .CT LOC OTHER: B AUTOMOBILE LIABILITY X 3152C4531 106/15/202106/15/2022`COMBINED SINGLE LIMIT _ S 1,000,000 ANY AUTO i i I BODILY INJURY(Por person) S ^` _ OWNED I SCHEDULED I i AUTOS ONLY AUTOS BODILY INJURY(Poraccident) s ( _ HIRED I NON-OWNED l I FOROPEERTYDAMAGC s '" —' _ AUTOS ONLY i AUTOS ONLY I I I(Per accidonl). i ! S C X I UMBRELLA LIADOCCUR I� X 3152B8064 05/03/202D05/03/202li EACH OCCUR_RENCE__ __ S _3,0_00,00_0__ EXCESS LIARCLAIMS-MADE I IO5/O3/2021'05/O3/2O22i AGGREGATE _ S Dr:O I X REIFNTIONS 10.000 !j — s WORKERS COMPENSATION ' I1 PI i OTIi- AND EMPLOYERS'LIABILITY Y r N j —�_STATUYEE ( ER.•_,_ _—___. __,.. •,,, ANYPROPRIETORIPARt'NERIEXECUTIVE ❑ Q.E.L.EACH ACCIDENT YS OFFICERIMEMBEREXCLUOED? NIA ..._._.__.__.._._._..._.__ _.—_....._..._ (Mandatory In NH) E.L.DISEASE.-I A EM17LO_YEE S It yes,describe under — DESCRIPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMIT S D I Liquor Liability I X 13152F6081 08/22/202008/22/2021!500,000/1,000,000 I DESCRIPTION OF OPERATIONS!LOCATIONS!vritICLES(ACORD 101,Additional Remarks Schedule,maybe attached it more space Is required) 06/24/22 06/25/22 07/16/22 08/27/22 09/03/22 09/10/22 09/17/22 09/23/22 09/24/22 10/01/22 10/07/22 10/08/22 10/09/2210/15/22 I I I I CERTIFICATE HOLDER I CANCELLATION Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 53095 Route 25 i THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Bax 1179 ACCORDANCE WITH THE POLICY PROVISIONS. Southold, NY 11971 I AUTHORIZED REPRESENTATIVE I I 1 Kirk Associates LTD i ©1988-2015 ACORD CORPORATION. All rights reserved. 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I IIgl ISI I of if118 i I I''i.«I'll L11. .nh.1 +"I'll I If A'iI I l°JU 1 1 IUi1gh,lwlrsII liJ11II�l1I 1w Iu16IIIIIII 1, 1°1' 1IJI}I,r i 11I�IVl 1' I`l?t(t11 ! f', �ulll IIII X11:1 t 11.111 I Ill -----1'411!1111-11 I-fill 6111-si I I11C1-.lot 7rt i �r 1II!1 1 9,li f If 111 I I" I! 1 11 11 I U Ki�Yrl,),nrii, 41 l ui 11 i�drt,r(� Ir„�. 1 t.4n'f iutrU,,,ri( 'If I(olrl r i l i .-I _ t I rLr+• 11• � ,�i ie,ll, � ,lra1?�,yl i#il .,.o, f wide hr i r„r 11„t I�:,4 I 11..1.1 I ! i s,ni, ,ierq,i,, l 6`�n..l,dl r4�i41,-,!611i1•u,i { rl ril4-r nayo-' Ilrl 111,.:5. r lll►'111I I1�1711+f jlr�J1 111 4P NOW! 11111 111111r1AylIf III-illf't►#I!llt.11 I , ' i Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 06/06/22 Receipt#: 300347 Quantity Transactions Reference Subtotal 1 Event Fee PV 1a-f $150,00 1 Event Fee PV 2a-f $150.00 1 Event Fee PV 3a-e ' $150.00 1 Late Fee PV 1 a-f Late $250.00 Total Paid: $700.00 Notes: Payment Type Amount Paid By CK#35713 $700.00 Pellegrini, Vineyards Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Pellegrini, Vineyards 23005 Main Rd. . Cutchogue, NY 11935 Clerk ID: SABRINA Internal ID:PV la-f Late