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HomeMy WebLinkAboutCAST 2023-17 Southold Town Board - Letter Board Meeting of June 20, 2023 RESOLUTION 2023-569 Item# 5.23 ADOPTED DOC ID: 19268 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2023-569 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JUNE 20, 2023: RESOLVED that the Town Board of the Town of Southold hereby amends resolution 2023-421, adopted at the May 9, 2023 regular Town Board meeting as follows: RESOLVED that the Town Board of the Town of Southold hereby grants permission to CAST, to hold Special Event 2023-17at CAST, 53930 Main RD, Southold,New York as applied for in Application CAST 1 a for Outdoor Movie Night for all ages on Ame 16 June 30, 2023 from 6PM-10PM Provided they adhere,to all conditions on the application, permit and to the Town of Southold Policy for Special. 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. ;L Denis Noncarrow Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Greg Doroski, Councilman SECONDER:Brian O. Mealy, Councilman AYES: Nappa, Doroski, Mealy, Doherty, Evans, Russell Generated June 21, 2023 Page 32 Noncarrow, Denis From: cathy demeroto <cdemeroto@castnorthfork.org> X02 Sent: Friday,June 16, 2023 1:33 PM To: Noncarrow, Denis Subject: CAST Movie Night 17 Denis- / Due to the inclement weather forecasted for tonight, CAST would like to reschedule our Outdoor Movie Night to Friday, June 30, 2023. Time, location and movie will remain the same. The only change for the special event permit is the date. Please let me know if you have any questions. We greatly appreciate your assistance with updating the event permit. Best, Cathy C A S , i - CENTER FOR ADVOCACY I SUPPORT I TRANSFORMATION Cathy A. Demeroto Executive Director Center for Advocacy, Support&Transformation(CAST) 53930 Main Road P.O. Box 1566 Southold,N.Y. 11971 631-477-1717 - Office 410-693-6692 - Cell cdemeroto@castnorthfork.org org ATTENTION: This email came from an external source. Do not open attachments or click on links from unknown senders or unexpected emails. i RESOLUTION 2023-421 ADOPTED DOC ID: 19118 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2023-421 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON MAY 9, 2023: RESOLVED that the Town Board of the Town of Southold hereby grants permission to CAST, to hold Special Event 2023-17at CAST, 53930 Main RD, Southold,New York as applied for in Application CAST la for Outdoor Movie Night for all ages on June 16 from 6PM-1OPM Provided they adhere to all conditions on the application,permit and to the Town of Southold Policy for Special. 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: Sarah E.Nappa, Councilwoman SECONDER:Brian O. Mealy, Councilman AYES: Nappa, Doroski,Mealy, Doherty, Evans,Russell Special Events Committee Application Summary and Recommendation Application name: Address: i . A6(d 119-4-1 Application number: _ CAS Ic Date of Event: u l i #( IRD61Z Time: to Pm -- In P� Date Received by Town Clerk: 141o�1 9M Date Received by Committee: �a(p 107da76 Nature of Event (S): MNif_ YIIOIIr1� -0 OOI� Committee Comments Received by: +s-Fde — — Leslie Weisman Missy Mirabelli _)4, Chief Flatley August Ruckdeschel- County--7oje Heather Lanza ����� �--�---- �rl� Mike Verity Claire Glew � Kevin Webster Committee Recommendation's: Approve as applied Approve with Additional conditions: Hold Public Hearing Deny Special Event No: Resolution No:,QOoIA` L4ak Date:—E5 I q I aaa3 RECEIVE® a�, :g, ` , RECEIVED , APR 2 6 2023 4 3 APR 2 5 2023 Town Attorney's Office Southold Town Clerk TOWN OF SOUTHOLD Town=Code Chapter 205"PuhlieEntertainm'ent and special Event0l, 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. Aliplica[ipii'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$150.00. However,specific details of each event must be included with this application. Alla 1icatiotl5 murtt he subinWM at least 60 business dais before:flee evedt- Appliearits are encoura€ed'to submit appligation s=as earl, as osl s�ib'�e Any,conifi eil applicati6n that'is not siibi fitted 60 or mote businefis dior"toAhe.sc'b'eduled .evertit'tiiay be reieeted or subject'fo a late procescirig fee of 5250 00 iiy the Offcie•of the Tii�vn Clerlt, unless a' aiver.is alitained. Requesting an expedited review must be submitted in writing to the Town Clerk.The Town Clerk will forward all applications to the Special Events Committee for processing. The Committee will obtain comments on all applications from relevant Town, County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. The Town reserves the right to request additional information from an applicant to address issues related to the health,safety,and welfare of the community. When`is a Permit'Required?- All Special Events,per Southold Town Code Article I,Section 205-2(Definitions)must obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings,weddings, graduations, parties or not-for-profit fundraisers do not require permits. Any use of iesidezitial bra il,erly for ti ofit such,as a venue for weddiri s or okiier events is proliil2ited, This aplilicztion is deemed comlilete once.all the.following requireniiifits,arek submitted to the Town Qg.rk Please indictite stibrniss' of the following by checking-aff the boxes and signing below., N�A completed aliplication-'form signed by the owner and the event manager. Applications without {property owner's signature/approval will be rejected. u FEE: Is the application being submitted at least 60 days before the event[ ]Yes [ ]No If Yes,Fee of$ 150 has been submitted If No,Fee of$, has been submitted Updated 8/7/2418 i a a :j The applicant/owner of the property where the special event is proposed to take place must provide a certificate of',rnsura ce.not less than 2 million dollars naming the Tnwn 6f•S6iitli61d as an addifiofial j 'Ensured Because we area small nori-profit,we request a$11M liability limit }I u A ParkiiigL,ventPla�: 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). 4 (See application form for details) .j "Events for three hundred (300) or more people require submission and approval of a traftc_borittcil lar acceptable to the Town of Southold AND a qualified traffic controller must be provided at the event.(See application form for details) KSignature 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. Datert Sr r�rci e' 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 proAde ALL cikhe information xeque—sted Below Incom In ete appl.ieations ME'1LL N.0T be �eviesved. Special Event Permit# Applicant(s)name: CAST- Community Action Southold Town Date of Submission 4/25/23Name of Event., Outdoor Movie Night SCTM#'s 1000-Section 061.00 Block- 04.00 Lots) 019.001 Dates of Each Event: dune 16,2023 If Multiple Dates are requested,applicant must give all information for all dates. Nature of Event: All ages outdoor movie showing Puss In Boots (Please attach a detailed description of EACH event to this application) Time Period(Hours)of Event: From 6pm to 10 pm Town Services requested: ( )Yes 'I(414o If yes,Describe Police Dept._Highway Dept. Describe Services Maximum Number of Persons Attending At One Time: 100 Number of cars expected 40 Is a Tent or other temporary structure being used? rl� Yes[ ]No If yes provide size(s) 9'x 16'screen, porta potty Will food be served?[ ]Yes [4/ o If yes provide number and name(s)of food vendor(s) Updated 8n12018 j - - Suffolk County permit#(s) Will other vendors be on the premises during the event?, j Yes [ ]No If yes how many? Describe Type ofvendor(s) Movie projection company Property Owner(name/address): Community Action Southold Town,53930 Main Road, Southold, NY Contact Person and Contact Tel.#, Cathy Demeroto 631-477-1717 x101 e-mail address cdemeroto@castnorthfork.org Event Location:Street-Hamlet Address:, 53930 Main Road, Southold, NY 11971 gC 1`NT# 061.00 Block: 04.00 Lot(s): 019.001 Mailing Address to Send Event Pen-nit to:. P.O.Box 1566, Southold, NY 11971 Have,any'of the development rights been sold i the Town©f S:outltold'[ ]Yes. tv4No and/or Suffolk County Agricultural Program? [ ]Yes M Na �fves th'either-or:both.alsi�'indicatecin the attached ljlarr the b6utf6fies of the resei-ved•area place,, ( YOU MTTSTA171'ACA A•PARIKINGMNEM MAN TO.n-m- •APPUCA.TiON IF_1'RE, EXPECTED ATTENDANCE°IS 300 OR:MORE PEOPLE:Y"OU MUST ALSO ATTACH A . TRAFFIC CONTROL PLAN Nee next 1240. A Nrkina/ ent Plan may be a survey;site ljlain tin,dl�► aerinl�7ie�"v.ff6r exarii In a Gaogle I,(1111 of. tlie.sub'ec :property:INDICATE O .TI�G'Pi.,A1�i r1LL of the'fmllo�ying informatiorr: 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. `Tr`�if'Cc.Ccinfrol'P1'an 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 trade control lermust-bezn yid -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. O RINER''S SM-NATURE. 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 make any and all inspections necessary in connection with this Special Event. Print name of Owner Signature of Owner - --'` Cathy Demeroto ` ozAl � . Print name of Authorized Person/Representative S4gnature of Wiithoiized Person/Representative PEI21t3ISS1CIJV,TS'HERES�!CtI2ANTEU §VBJEGT TO TF*9(11 '0jk'i1�TG CONDI ION'S: 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-pr6bibited on`ANY Town County or"State Roads or wwits—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-i�ast60'business diys:pt'or: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 1f t .3 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 idhidiii; bnt not.linfited tn'.liarkin ingress/egress/access: ferif sl or'teinorarV stntGture�l or tetnparary saiiifarfaci]ifie5,,stall be cQnclucted ciii Town of'Sonthbld trcltase of TJeye1 men't Y'lits land. 10. NO actik4ies..associated Birt not limited 4'0 iarkiiig.iridress/eglesstacecss, tent(a or IeBlp rarysfricchtret ;.;o"r:teriil2Qrary saiiitary`fa�ilities:.sha)1 be con66ted cin Suffolk Caiiitty Purchase: .of bevelopincnt Riglits land witlioiit a' hermit '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. APPROVED Town of Southold Resolution Number: Date Issued: Updated 8/7/2018 r .arts.- it� CAST OUTDOOR MOVIE NIGHT DATE: FRIDAY,JUNE 16, 2023 TIMELINE: 6:00pm Projection screen setup 7:00pm Event opens to public 8:00pm Movie begins 9:40pm Movie ends LOCATION: CAST Great Lawn (53930 Main Road,Southold) DETAILS: CAST Outdoor Movie Night-Puss In Boots: Last Wish 'PNumber of anticipated guests- 100 o Number of cars expected: 40 (can use CAST lot plus street parldng) -0 Free event.No charge , Pou�}�•w`4;y:::i`*'>,4.i�`A::.�t�.aj5< �` •'S• ��ta�.�,". i ph A i,;s;.t;?,t...'•:;tJ''„?ja'�gL d�°s�Y$Ax>:.,�,a a,Y''' �t, �}az .•y, '?` ty41k 'L •jam sAa�'rt«'pp�>lw±��...i,F�`::�^�,°.� ...:. .:. ”;."+d:Y�,.' .i, " moi..- ::�7',. "5•;' -+^'- str •.-,t'7f�F�is4i: "r:�i�;i�; �"..,',jtci t� �sis- �,, °� yi�L\\ . gR�s 3;,;,'�,�rx�n,�-��''y4haL'c �rr~'?c�', '�r,F'�`l_ .;r;:.'.;,.•r'.. �`�� - -�a;�`•: , '.c>=`.r�:s�,..�r'rF.��;.,<ee»�. <�." 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Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 04/26/23 Receipt#: 309736 Quantity Transactions Reference Subtotal 1 Event Fee CAST 1a $150.00 Total Paid: $150.00 Notes: Payment Type Amount Paid By CK#2984 $150.00 Community,Action Southold Town Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Community,Action Southold Town Po Box 1566 Southold, NY 11971 Clerk ID: SABRINA Internal ID:CAST 1a Inr�: r t Sent Items <`iin box Compose Reply Mark Re: CAST Special Event Killean,Jade<Jade.Killean@S uffol kco u ntyny.Gov> 05/01/2023 at 01:39 PM ti To: Mirabelli, Melissa <melissa.mirabelli@town.southold.ny.us> Details Display Images A For your security, images are not being displayed.Consider this before displaying them. Hi Missy, Regarding the CAST event,we do not have any comments as the property is neither SC PDR nor is it adjacent to County holdings. Thank you, Jade Killean Planner Suffolk County Dept. of Economic Development & Planning Division of Planning & Environment 100 Veterans Memorial Highway, 2nd Floor Hauppauge, NY 11788 631-853-6044 Tel jade.ki[lean@suffolkcountyny.gov From: Mirabelli, Melissa <melissa.mirabelli@town.southold.ny.us> Sent:Thursday,April 27, 2023 1:41 PM To:Visser III, Fredric<fredv@southoldtownny.gov>; Glew, Claire<Claire.Glees@town.southold.ny.us>; Webster, Kevin <kevin.webster@town.southold.ny.us>; McCullough, Lillian<lillianm@southoldtownny.gov>; Killean,Jade <jade.killean @suffolkcountyny.gov> Subject: CAST Special Event Please send me any questions or comments j f..,� •:�3 !!!�,'�. �jissa �+Nkr ra Y 7yy7««••ror� 1 .»;rF;..0 s r t w .'si"�t. From: Glew, Claire Sent: Monday, May 1, 2023 3:33 PM To: Mirabelli, Melissa Subject: RE: CAST Special Event The Assessors have no objection to this event. Clai r&Glzmr Assistant to Assessor Town of Southold Board of Assessors (631)765-1937 (0) (631)765-1356 (F) www.southoldtownny.gov claireg@southoldtownny.gov From: Mirabelli, Melissa<melissa.mirabelli@town.southold.ny.us> Sent:Thursday,April 27, 2023 1:41 PM To:Visser III, Fredric<fredv@southoldtownny.gov>; Glew, Claire<Claire.Glew@town.southold.ny.us>;Webster, Kevin <kevin.webster@town.southold.ny.us>; McCullough, Lillian<lillianm@southoldtownny.gov>; jade.killean@suffolkcountyny.gov Subject: CAST Special Event Please send me any questions or comments ;l Melissa 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. ******************************************************************************************* N11ral✓elli, Melissa From: Flatley, Martin Sent: Thursday,April 27, 2023 2:29 PM To: Mirabelli, Melissa;Verity, Mike; Lanza, Heather;Weisman, Leslie; DeChance, Paul Subject: RE: CAST Special Event I have no objections to this event being approved Martin Flatley, Chief of Police Town of Southold Police Department 41405 State Route 25 Peconic, N.Y. 11958 Tel: 631-765-3115 i 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@town.southold.ny.us> Sent:Thursday,April 27, 2023 1:41 PM To: Flatley, Martin<mflatley@town.southold.ny.us>;Verity, Mike<Mike.Verity@town.southold.ny.us>; Lanza, Heather <heather.lanza@town.southold.ny.us>;Weisman, Leslie<lesliew@town.southold.ny.us>; DeChance, Paul <pauld@southoldtownny.gov> Subject: CAST Special Event Please send me any questions or comments Thank you Melissa 14'1 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 ******************************************************************************************* i This electronic mail transmission may contain confidential or privileged information. If you _. . :._. helieve that youhave received the message in error; please notify the render hy,reply., transmission and delete the message without copying or disclosing it. ******************************************************************************************* 2 From: McCullough, Lillian Sent: Thursday,April 27, 2023 3:00 PM To: Mirabelli, Melissa Subject: RE: CAST Special Event Thanks(again)! No comments—this is not taking place on preserved land. Lillian McCullough Land Preservation Executive Assistant Town of Southold Office:.(631)765-5711 Email: lillianm@southoldtownny.gov From: Mirabelli, Melissa<melissa.mirabelli@town.southold.ny.us> Sent:Thursday,April 27, 2023 1:41 PM To:Visser III, Fredric<fredv@south oldtownny.gov>; Glew, Claire<Claire.Glew@town.southold.ny.us>; Webster, Kevin <kevin.webster@town.southold.ny.us>; McCullough, Lillian<lillianm@southoldtownny.gov>; jade.kiIlean@suffolkcountyny.gov Subject: CAST Special Event Please send me'any questions or comments Melissa 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 Town Hall Annex 54375 Route 25 P.O. Box 1179 ` O� ��' Southold, NY11971 Office: (631) 765-1939 SPECIAL EVENT COMMITTEE TOWN OF SOUTHOLD May 10, 2023 CAST P. O. Box 1566 Southold,NY 11971 Re: Special Event Permit Resolution#2023-421 Dear Kathy, Enclosed please find a copy of the Town of Southold adopted resolution. Please note there may be conditions to this event as stated in,the adopted resolutions. Failure to comply with these conditions will result in revocation of your Special Event Permit. Sincerely, " Melissa M Mirabelli, Secretary to Town Attorney Encl. 2984. COMMUNITY ACTIOWSOUTHOLD TOWN.INC. PO BOX 1566 SOUTHHOLD,NY 11971 50-666/214 PAYc TO THE ORDER OF a � _ DOLLARS L DIME FOR . — — �-ii'00-29841i :1:0.2: '40.666.71: 08000..25 i i6.ii' Born, Sabrina From: Born, Sabrina Sent: Wednesday,April 26, 2023 11:38 AM To: Mirabelli, Melissa; Noncarrow, Denis; Norklun, Stacey Subject: Emailing: CAST 1a_20230426113724.pdf Attachments: CAST 1 a_20230426113724.pdf Please see attached special event application from CAST.They had a note on it that they will be handing in the ins. certificate separately sometime this week. Thank you, ,Sa�,nusa7?Z�on� Sabrina M. Born Sub-Registrar& Deputy Town Clerk Senior Account Clerk Southold Town Clerk's Office 53095 Route 25 P.O. Box 1179 Southold,NY 11971 Ph: 631-765-1800 ext. 1226 Fax: 631-765-6145 Your message is ready to be sent with the following file or link attachments: CAST 1a_20230426113724.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 ^ ' ® DATE(MM/ ) A (( (Jv/RQ CERTIFICATE OF LIABILITY INSURANCE 04/27/20232023 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 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 Lauren Murphy NAME: Roy H Reeve Agency,Inc. arcNNo Ext: (631)298 4700 ac,No: (631)298-3850 PO Box 54 E-MAIL Imurphy@royreeve.com ADDRESS: 13400 Main Road INSURER(S)AFFORDING COVERAGE NAIC# Mattituck NY 11952 INSURERA: Philadelphia Indemnity Ins Co 18058 INSURED INSURER B: Community Action Southold Town Inc(CAST) INSURER C: PO BOX 1566 INSURER D: INSURER E: Southold NY 11971 INSURER F: COVERAGES CERTIFICATE NUMBER: CL228117499 REVISION NUMBER: THIS IS TO CERTIFY THATTHE 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. INSRPOLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD 'POLICY NUMBER MM/DD MM/DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE100,000 CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ 5,000 A PHPK2436408 08/16/2022 08/16/2023 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- LOC PRODUCTS-COMP/OP AGG $ 1,000,000 POLICY El JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED -'� PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLALIAB OCCUR •(` EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE •.,'`" AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN STATUTE ER' ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ 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,may be attached if more space Is required) RE: 6/16/23-Movie Night Fundraiser Town of Southold is included as Additional Insured with respect to General Liability. 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 AUTHORIZED REPRESENTATIVE Southold NY 11971 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD