Loading...
HomeMy WebLinkAboutPellegrini Vineyards 2023-19 RESOLUTION 2023-449 ADOPTED DOC ID: 19145 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2023-449 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON MAY 23,2023: RESOLVED that the Town Board of the Town of Southold hereby grants permission to Pellegrini Vineyards to hold Special Event 2023-19 at Pellegrini Vineyards, 23005 Main RD Cutchogue,New York as applied for in Application PV 1 a-f for Weddings: May 27, June 9, and June 23, 2023 from 5:30PM- 11PM. Provided they adhere to ALL conditions on the application, permit and to the Town of Southold Policy for Special Events. This permit is subject to revocation if the applicant fails to comply with any of the conditions of the approval or is unable to properly control traffic flow into and out of the event. Denis Nonearrow Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Sarah E.Nappa, Councilwoman SECONDER:Brian O. Mealy, Councilman AYES: Nappa,Doroski, Mealy, Doherty, Evans, Russell �O��"g�FF4CK�oli o O � COD Office of the Town Attorney Town of Southold Town Hall Annex, 54375 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone : 631-765-1939 Facsimile: 631-765-6639 MEMORANDUM To: Mr. Denis Noncarrow, Town Clerk From: Melissa Mirabelli Secretary to the Town Attorney Date: May 24, 2023 Subject: Special Events—Pellegrini Vineyards (PV1a-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. /mm Enclosures Application Summary and Recommendation Application name: ,1 t Address: `kqm) Application number:_ V V I a,—C Date of Event: 5 Time: •V 'Pry) " It. 0o Pnn Date Received by Town Clerk: 41-2 Date Received by Committee: 'S 1 o« Nature of Event (S): t Committee Comments Received by: Leslie Weisman Missy Mirabelli Chief rlatley 3( August tRuckdeschel- County—� O Heather Lanza ' awn Pr-e0i Mike Verity ls� Claire Glew PWA -Y Kevin Webster Committee Recommendation's: Approve as applied Approve with Additional conditions: Hold Public Hearing Deny Special Event No:_ -A-�r�� Resolution No: Date: s II a31 aoa3 j py I RECEIVED ` ' ` ` .: •�' APR 2 8 2023 S6uthoId Town Clerk TOWN OF SOUTHOLD Town Gide Chapter 205"Public Enterfaiiath'6iat and.`S"ecial'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. Apiication fee: $150.00 per application up to six (6) multiple events of the same type 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 beforeAlie event: hp In icants are encou"rammed to submit apnliCatiaiis as Ottl 1juAle' .A�ny completed 'application that is nit submitted 66,or more business days-prior to the scheduled eovnt m�v'be re)ected'or istibiect to a late processing fee of$150.66 by the office of the'Tawn Clerk; finless-a waiver is'obtained: Requesting an expedited review must be submitted in writing to the Town Clerk.The Town Clerk will forward all applications to the Special Events Committee for processing. The Committee will obtain comments on all applications from relevant Town, County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. The Town reserves the right to request additional information from an applicant to address issues related to the health,safety, and welfare of the community. ben.is a Kermit R'equi'red? All Special Events,per Southold Town Code Article I,Section 205-2(Definitions)must obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits. Anv u§e of residot dal propert° for profit such as a venue for weddings or"other events is prohibits . "I`his applicatio-n is deemed complete oatcc.all the folloMng requirements are submitted io thelown Clerk P16 se Indic ate submission of the following by cliccking of tixe"bore a'nd'Agning below.ry . A completed application form signed by the owner and the event manager. Applications without property owner's signature/approval will be rejected. g-FEE: Is the application being submitted at least 60 days before the event[ j Yes- No ❑ If Yes,Fee of$ has been submitted e-7 aG' 00 If No,Fee of$ ��G. has been subtnitted" �,H � �- SG o0 Updated 8/7/2018 ���� CV O B . The applicant/owner of the property where the special event is proposed to take place must provide a tdrtificate of irisurabce:not less than 2 million dollars naming the T&Vn.:of Sout6ld iis°.ati additionfal insured A Aarking/RVentTIan: 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) �/�_ Eyents,fbr three hundred (300) or more people require submission and approval of a traffic control pha 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. V/7-7 a. 3 - Dated Signature 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 �'r%;�se:pi-ovide ALL of tare information requested belb�v Incttrr°t 'lete a�rilic�itions VVI��I N()T be - reviewed. Special Event Permit# Applicant(s)name:. R/64r"A Date of Submission 7A3 Name of Event Ve Wj.111L5z SCTM#'s 1000-Section t 0 Block- Lot(s) r5 7 Dates of Each Event: : If Multiple Dates are requested,applicant must give all information for all dates. Nature of Event: _ H 5 (Please attach a detailed..description of EACH event to this application) Time Period(Hours)of Event: From 5 3*e-to 06)-P Town Services requested: ( )Yes QC)No If yes,Describe Police Dept._Highway Dept. Describe Services MIA Maximum Number of Persons Attending At One Time:__Number of cars-expected... Is a Tent or other temporary structure being used? [X]Yes[ ]No If yes provide size(s). X'. Will food be served?[ Yes�_ ]No .If yes provide number and name(s)of food:veiid"or(s) - . -� /%- Suffolk County permit# Will other vendors be on the premises during the event? Yes [ ]No If yes how many? z- Describe Type of vendor(s) w N• / I!GC 6t d ( -� `s Property Owner(name/address):' Y °l ., `�/ � /-5.- "� � �vge�' Contact Person and Con/tact Tel.# .. ra� fti li%. L.aC1 S n-- / ,.'�/ --7 34 `f'/// x'7,v 7 e-mail address �o.�,w /e /' 'f' r/ �•► e. ...�?f'c1 5 ea �"� Event Location:Street-Hamlet Address: '�.l�O} at:K /{a<G� Com.y/'�� -�'�e Y 1 Will any services be requested [ ]Yes M-No. If Yes describe Police Highway Other: Mailing Address to Send Event Permit to: Updated 8/7/2018 Have any of the development rights been sold to the Town of Southold[ ,]Yes M(No and/or Suffolk County Agricultural Program? [ ]Yes [XNo ifwhs to either or�oth also indicate on t!L attached plan the boundaries of the reserved-area upon which`the event'vVill.:take'place 'YOU i�'ICIS'1'A`P'i`AGI�"A PA1tKI1`d 'IEVIENT"Pt;•A,N"I'O't'HiSAP.EI:ICr1Tl!ON I�'THE EXPECTED ATTENDANGE,TS"300'OR MORE'PEOP)C;E:i!OU NCUST',AI SO ATTACH'A TIi AIFrIC'CONTROL PLAN"(see n� A larking/Event Plan niay lie a "ttrvey, cite'plan and/ar aerial view (for exgmnle Google;Fartlil of the suliject"pi o iert INDICATE ON THE Eli',AN ikl,,L of the"'fallowing iiifeirn anon: 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 facilitiesrelated 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. (14) Location of sanitary facilities on site. Tiaffie Control Platt 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 dualified traffic>conttroller mtisfbe 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. O1trM!,V SIGNATfIIi'.Ir'• Ian: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 Tows:immediately should there be any material changes regarding to this application. . Updated 8/7/2018 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 AX Print name ofOwner Signature iSf Owner Print name of Authorized Person/Representative Signature of Autho" eisorMepfesehfative PrR1NISSI()1V X HFREBI'i IiA1V 1 EIS S Il[3II�!"T TO TAE FOLLO�VIN(:.COND�TIONS: 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 6t State Roads 6r Right's 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 irmnediately 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. S. Tent proposals must receive pen-nit 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 lirrsiness dayc,piior to-the scheduled,eyerlt. 7. Adequate temporary sanitary facilities must be provided by applicant for this event and applicant agrees to remove the ternporary facilities from the premises within 48 hours after the day of the event. 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 tgan rking in rg esdegress/accest td (�)ctr"tet)ipor sthictirr�l 6r:t tianitarv�acilit�u It 1,� 16o_'r.i i,_ducted-on'Gown of Southold Purchase of'Deye1612iieiit Rights land: 10. NO activities associated with this event irfciuding-lidt-riot litnifed to ap rkin ;•.iii' ess/egress/access:: t t s r st r temporary a •t � i "t' . shall'bp conducted on Surf(ilk Puchase, of beveloMent Ri_6N land' without a permit issued by the Suffolk. County T anrland. :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 Updated 8/7/2018 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: C Updated 8/7/2018 DATE(MM10D(YYYII) � = CERTIFICATE OF LIABILITY INSURANCE 04/25/2023 THIS CERTIFICATE ISISSUED 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:endorsem©nt(5). ;CONTACT PRODUCER NAME: PHONE 631-727-7767 Farm Family Casualty Insurance Company AHOs,0 631-727-7767 --- A c No 18 First StreetAE-MAIL DDRESeric.kirk@farm.family.com DDRS: Riverhead,NY 11901 Ukk(Sl AFF6rt61riNalci{ INsuRERA': Farm FaMily,CasualtY Insurance 13803 INSURED INSURER 0: Pellegrini Vineyards LLC INSURER C: 23005 Main Road INSURER D! INSUREf2 E Cutchogue NY 11395 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 'THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF FOLICY ExP.- LIMITS . LTR' TYPEOFINSURANCE _ POLICYNUMBER MMIDON YY 'MM/ODtYYW A X COMM I ERCIAL GENERAL LIABILITY X 3152133148 05103/2022105103/2023 EACH'bCCURRENCE s 1,000,000 05/03(2023105103%2024 OAM7^ D REN l rV CLAIMS-MADE Q OCCUR P ISES Ea oecmrc,mel, $ X Ligour Liability MeD EXP(Any one person) s 5'1000. 31521_6607 05/03(2022 05/03/2023 PERSONAL&ADV INJURY s 1,000,000 05/03.12023 05/03/2024 2,000,000 GEWL AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE 5 X ' CT F-1LOC 31521_6608 05125/202205/2512023 PRODUCTS'-COMPIOPAGG 'S 1,000,000 POLICY� aTHEIi: B AUTOMOBILELIABILITY X 3152C4531 06/'15/2022 D6/1512023 COMBINED WSINGIELIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) S OWNEDSCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS PROPERTY DAMAGE HIRED NON-OWNED er'acccciiddem $ AUTOS ONLY AUTOS ONLY C X UMBRELLA LIAB I' occuR X 315288064 05/03/2022 05/03/2023;EACH 06661IRENCE $ 3 00.0,000 ExcEss uae ctniMs IrAtaE 05/03%2023 05!03(2024 AGGREGATE S DED I X I RETENTIONS 10=0 S WORKERS COMPENSATION - 'P$TER ERTH- AME• .'E " AND EMPLOYERS'LIABILITY ' ANYPROPRIETORIPARTNERtEXECUTiVE' YIN E.L:EACH ACCIDENT S' OFFICERIMEMSEREXCLI. N I A (Myyandatory in NH) E.L:OISEASE=EA EMpL""OYES $ AESt RIPTION OF OPERATld14S 6bi8%v E L DISEASE=POLICY LIMIT 5. D Liquor Liability X 3152F6081 0 /22/202 500,000/1 'Q0 ,000 0' /22'x202„ DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if.more space Is required) CERTIFICATE HOLDER IS LISTED AS ADDITIONAL INSURED 05/27/23, 06/23/23, 06/29/23, 09/16/23, 09/23123, 9/30/23 10/07/23 CERTIFICATECANCELLATION ` HOLDER. _ _ Town Of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 53095 Route 25 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1179 Southold, NY 11971 AUTHORIZED REPRESENTATIVE Kirk Associates LTD ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD np it 1� - f-; s �ihi ``� 'yam �'��`'• •w1�,....1 ' a tL �. >+10.06 :R SEE SEC.NO.102 „y 04.20.09 . .,`,.. 01.31-00 CIN MFdCN _—______ZZ—__ 04.20-00 N7t+m° IMICN--_ZZ-- --—---�----- FOR PCL ND. °•/ 05-17-00 SEESEC.NO. .:;,•. / 05-05-OD .lu 243 102.04-000.7 104'.w ..y -G• 24A 3.9A �Cp 12.27-06 34.2A 03.14-01 I "cmwmoF5007H0Lf/ 04.12af I wLt�"XlW'4tw ?� - oa-o" 10 2541 I 242.' _ 1-03.01 01-1402 03-12-0328 oc�ao3 1 1�1 fi Y 040:4400' I °4 `1b u•544' l 132 1227.00 , 47-IA 0+•22-07 PECOMC LAND TRUST,MC 06-0.`.47: I S ; .. -.�ti• F� ot21-09' I pOxvaFsOunrotn . us.2z-to nevEfnrueNrwexrs) b- a.,s'.: , 05.74-13 �n �r•- . 8422-13 23 d, _ �� . a ( C. N •16 :p 241 �1 I tl 2t' v all, e P 2! 24 �V IS10.1 r 40 530A(c) J'•` `" .d` - N n. 229 ' 1C M1 04 2.11 05. 1.4A 2 a 1 OA 231 .� •. 2:13! "Y T IAA 6.7 98�'ri 110A' :y •� PECANtC' "214 1'AHDSft= {NOEVLI.70�YscuMoc A. .•� - 5230 \y 4: 215 • � � 279 � 24.7A(Q :a 72 40 a 'D - 5 20A •6� m , r �7 vv t 0.9 SAA 0"7^' v . 1,7A(c) PE00MC LAND1RUS1 ',v, to 20A FORPCLNO. 20 'ry .FpRPCI.NO. ` FOR PCL NO. SEE SEC.NO. L�;t1 S SEC.ND. 37 'E 11 11A SEE SEC.NO. 115414003.3 1.1A(e) 116-01-003.5 at54)1�007_ Naas cs?w-_ r: tfATON �--r-- 'urchtimFri�o�¢•t•:c�uLrn � - —.�� ixtlorG�lti _Sq�� �h�Rr.uUw •—"���•' :NEWMNTEtW KIF mfWe .` qgerry MRNli� SWptrWy.la (21) yaw O m . ,(: Lyer Gar+Ps �T�", YYrOYf�f ll� �N�+��- IUr1alONdli..�-16i_�� _.•YvWW � �� D�AO.,.dm � �_ Lpe prMw ��L��, MOd�atltN1Y���•�•�' MIK � -_ E .v- Su.dOarIwv •�a� MOa'CIH ����— Wa.�0.Nf11�-��YRI.� N � anlFm 9 Vay�lb Sw.Dk.b' w D wAnra. . ' _-_ _��-=t•,�... - ,._ —_— — 1. w'f s @ROF' �ifY CiW.NA$ t _ -••J�4f4imE'- s•:jr... r� -• `�i••."'— 4.4 j • •rlrtV4'r1h91m; . -VftrC/.mss[ - ,, 'y,-/f_ • ,n.,,'1-� 3 -,.-�• 4 (ai](a•Reff>T,a --- riCl,ftsi a,•,nl , .•[r V�� _ (. .r:.vg• ,c.mest_ t.rr,na - al: T. '. -f® r y'`, J .-`�'- '`, • ,: •,tT2 tuc, nmva •'�:. "':t • O t � , •�'�;+o'i•{:rr' '�F '•:rir,�b' :r fr1{:fr'rfri .[� _ - ` �.��.�.:.' �""c` ` ,Q•' � .�.::.. `� �Y,r;.^ �F f-: ;`�!y.r, •.:: r.�;:`><J."L• ;•�f/ ';,rr'�`�?•;. 1.1.s o �- .. .mim. ,, `,: i .. \. _:G:•';: �;. .Z I .,f..�.•.ef. .am -,•Ioc't *'' ��I�''r�I.l�• •t.}y,Y..'�% r •, .., Z' . EL U 5 . , •� _ -!: .fir `'``- �.. °'=' - r't.w1i,�.T . . t'•a eea••:s .�(a iris """'.•'""r"'� � ?' �f etR1µ`L.tSc.aeiTiikl.ea '• . i i. ,ftl •"i'f� t '.\ctxYia•C:•...-cv.T' �6R. a � y\ a�•1 T , {; PARP M.CALUCATIOtdS SfiEDATA..._- :� le . . • �� ^�•, • ��y• y� • :' • 4 1•/Il,•v .y,•.t!.•: .l.tl Ian<....�'•�aiaL'•1. bRl.i r•,-,W!+N�.,hrinl yya�� .• 1t-['•:}^•s_'^^7' .�!� •- � �•. , r.a.aSy,...+e S.. •[ ,..•Iv.•f .I•r.,.. *.u•w1,'•i.�'\a�lfl, - L'�L:•✓--H�1•. I ..Owi1tGJ:1]•+tl, 4•�H•i.•h4rf:,•t.[ ..1•IK 6 ..I M.0 • I i Ifr-••.r - - - f.:.e4H.•. ]Ilt•f I.•(t•((v \.i., . od•\\y] v�Wf•]m\.c..4v 11•el (UIy LLlCRLTC ls••rG� � .'. � '•4..qt,•4af� :•l1� L.•:wL Y ...y. ••Wf r �'\ �i,r . na1..m•.'w,lc-., -�� .. ., t - �• i's•A\t�•••�, hu.a ,.r(.tw s ,.,..(:e. n.,-•+, "i�::*f nGr.r l,f�•....: `t 4.,Iw. NO; �VE}.{ rli'•.LTHI�- - '] s:am,wtrt �u.e L•�'n:ic iisq.y( e ��r1.C�-ElFtQIK( Eft, IL�_ �; ..eff.w•gr,,.,.;,,r., u e.` .. K +y1}MI[tttV; 1 ..r•\i.n,•Nq 4+•'R ,. 1kt .e..-.. � ..•� L ••a'.•d,.rtlr!( is r4r • a":M;.t+ • � F�.. , .._ t.rya}..o.l'JI•S .t 'f a /�..1-+1..- iN Q dFx O.It LLl1`•tV. l-J, ������/ryya2+-+.�•4�as •au;.,.tt,- lRA ' ..w1.,t�••, ..iu o.w.�aL� °,I • RM,-.. f!4 •r•vwocq 'L',wi.t t••4 :M•C -ce41c0at'+ 4"++. .b•tf _ t` s...-i uen n,L Ir' b•C :V. 'iyC, t,i,ht. �\.��rcr�, .. a.' _ ,..+a.�..",•arf\.:.r , t1935 SITE l �•`--: �F..•.=ne..• `'.. -O k • .«.."`m- INFORIftAT10 (f } GcPTG'''f�vf;.scoeeAC?�1J5aJ.R O,y ^ / j r �- i, SP-2.:i 5 � / Af N - �- f ZONING BOARD OF APPEALS ' few.. .1,�. • Gazebo `•, Vineyard Fields }u�; • patio -,• %Wine Storage • y'' s. bathrooms 'c office . Entrance, + '' 51 li 36" .. y i. t`T•. Y Pon tdni;,Iftcryineyards 23 b85 finaid!� ad' t Cutctsae,: -1935 . -• 631`7,. Main Road jf t _ Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 04/28/23 Receipt#: 309817 Quantity Transactions Reference Subtotal 1 Event Fee PV 1a-c $150.00 1 Event Fee PV 2a-d $150.00 1 Late Fee PV 1 a-c Late $250.00 Total Paid: $550.00 Notes: Payment Type Amount Paid By CK#36519 $550.00 Pellegrini,Vineyards Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Pellegrini,Vineyards 23005 Main Rd. Cutchogue, NY 11935 Clerk ID: SABRINA Internal ID:PV 1a-c Late ' FRbp>oTY OWHER$• ".3 .. •rnaL\Ir msaea: 1111IL<f»ra •,^• � /: '���_:'! <..•^. ..i—.(, f 1 i«at+x•!<aLh L*a+mct' <\+Iwe e..r< ;'" '� .t<, ,f''•,•'� ,. -c a. ! t{—•ice-*�% ,� ,j 1, .. .n qai.... .a<nov (-'`:....:J '�J, O '<tp'G � 2 �JS'%u----•. ti:�'� /:'�'. .<l,.J.-r;'* :�:r.� jy +.L alga 1.1'af r...a - _ :S CMZ'' w -.1'Ii•.. !'{''' •.P.,�' ,/':�:7:(. •,f 1 t�' .;� W O .`-t ,. ,,..�wi�- �C' '1.'rt• �!�, � •r�'t�`.<. �M`���•t'i:� ZI n •lu+Y Ic.a. ^• lYLnaa •.. O ^ ..�,}.••.,f,• ,�.r .,. t'lr. �:.. � .0l+latclurl •_. '.Jaoou,�i.o,en .1J \. .- .- ...• "1u4.i_ ,. :;!• Chef �!'.•��. `` t/.7^•.�� f.f�:. / U.l y '.;.Y �•;rY ;iJ•!t- 'ar%f;.%yam' </ !-. .lf j. ® y y rr•Yglc.mmr-•- m{ee. ... ... 1' Y :/•T 1• /j V \;;, • • a>it}'Z'.``,I,�, +'•�`/,. fr'�}�,r` �/J _ �, µ -<.o u tn.lLw u a.l.rf i®.Ik•-.a+<l.r - N L '�� ! �:.:Ff i��� •! <• .i`�..;a1: j,::�;' z�' . a Y.t'(+1{<pL(a•rl�< .«111[a.aaw., o /r/*'Jr •�I% f. .,•< ` 1`'• 7 I: ell r6. i A.:C e ' ' <�onyG rr•N+s p1rYa1 i Ir11a:. OS<.•paq+•w«,1•Y!M `31e•. 't -• � ....�.L.. KEY PLA. : •� w,K »a- �e".ti•'(`o` �q s arf<wIdFK..T ., � •. .i^aMa. .• .11<.,.f•..Ia N•4-I�f«!tll'r•, �.».'�:L: ' cmF�•f�110•OC•TTI{�ICO' ,. '. •- , ... 1 W xlfs[t?JC:.xh'cov• .�4. ° +' '; - C LA7fONS: SffE DATA r-- •: _ - PAA i.iGCA-U' ..ry .�•'.._ - - - __ i:�. � . � l T . V�<it•• '' L—f_Rli^Sf •cl1'( IY41•H•1.1 ...,. .O � 4-v<<i.s: Y.�Y111.• �• `• �� _ ..-��, y - I.a 1•Ia«it' a ai�'.• w,r• n•\ra W Jryu. Il.arina - 1}ti - �— � •�• �'•'' • • `-•�"Su^��t'1'i Sni.L .1 1�IW v •t y.�• ��i1a -..• L�:c•.%-�� r.:.:.�i'.•.., ;`_' uwG.J<ad.b•.1Y�� .. •r, a. ....r.. i <.r.e-s+estt�. L 1..I Sw•Y .-'w,.. '.S.Y•a. •e!-ti+�r.law+y..w� u�l \a�"t^ bJe•Ra^Lc p:!Ti. ,•', - - .. .., r '� 1. 2 <"�MK�{•dn! �iU C w<1 t.w.e ..a•r+• r'•I.L '. ' , 9• 1• r (/•.IMS•1•I�C " .�•I• ' • • • h Mp1aM, l.n . .Iw Y .aa.• YR.••.: (L•�-p�. • • i, t, f • [•rC•u•twe.p 11«a< L.1 1 Iw•Y :.IN•..ear .•1••1 Y• \ �t-" 'mlans>:rn ►Je;�.:na-_J • 1�•rwzty "Vit. � . �.' r: :�, ia«.L a..1 L«.� r•••. Ilw �.;�at... ala.i, s�4i1.�1�', e¢�G f'IErli P�mHLI. 1 r awVq,<:r: •.y.t u t a..t L.<.y.w �% TC$in INQ' ' '�aC r'-(fi ' raat�,od Wn'I•' L. ��y�+ gflp <•.-<'•^Snwa a;.'t< o.., . •W/YSF �.Nw<. giy:�f'' ail.. .�. .<�•••Ia.l a+\ atm o...«oaro '� t•.u.:Il1a a L. - ''L'oNtflFa MM •' Jr" = F �w.�1,.r'Ie�ea nlc:� we •:1i.C. I1915, a SITE 1 -�. _ „•• :� '� ..._,,:-,. .law 1.\::t..:� ::�.r:,,... �� '1�- I �fFITW CQ tifO.1C ` t- n• Mui�!i1 r 2. • •�.+G�GR=ET•c Sa:lafC .{� LI ZONING 80ARD OF APP ALS I ; M. 4 ;f:g -S •! •iY X,; MP '•' ,� 4; azeba "'' VtneyerdFields 'i' lv ' • ` QY .- ..� _. .. •,fit }tet• • - Pat ,��J�.. -= ,, . !• wi71e.S`fOPBge af:' ' • Iik bathrooms :. offica ` Entrance ■ PArkbig 3b" • PdllegrinY !ineyards • 23.0.65 fi%Yain!' dad „1935 631',i .4-1 - n 1 Main Road aco . t • Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 04/28/23 Receipt#: 309817 Quantity Transactions Reference Subtotal 1 Event Fee PV 1a-c $150.00 1 Event Fee PV 2a-d $150.00 1 Late Fee PV 1 a-c Late $250.00, Total Paid: $550.00 Notes: Payment Type Amount Paid By CK#36519 $550.00 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 1a-c Late Inh�: • r t Sent Items <`�nbox Compose ,f� �= L,CICLCU, LCIIIJ? S Reply Mark ' , . s Re: Pellegrino Vineyards 2nd Special Event Application Killean,Jade <Jade.Killean@S uffolkco u ntyny.Gov> 05/01/2023 at 02:10 PM To: Mirabelli, Melissa<melissa.mirabelli@town.southold.ny.us> Details I Display Images A For your security, images are not being displayed. Consider this before displaying them. Hi Missy, We do not have objections to these Special Events at Pellegrini Vineyards as long as the adjacent County PDR property is not being used for parking, improvements and activities associated with this event. Thanks, 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: Monday, May 1, 2023 9:50 AM 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>; Killean,Jade <jade.killean @suffolkcountyny.gov> Subject: Pellegrino Vineyards 2nd Special Event Application Please send comments and questions to me on this second application Thank you Mirabelli, Melissa From: Leslie Weisman Forward Sent: Monday, May 1, 2023 12:51 PM To: Mirabelli, Melissa Cc: Flatley, Martin;Verity, Mike; Lanza, Heather;Weisman, Leslie; DeChance, Paul Subject: Re: Special event App 2 Pellegrino No objections to either of these applications Leslie On Mon, May 1, 2023 at 9:49 AM Mirabelli, Melissa<melissa.mirabelli@town.southold.nv.us>wrote: Please send me questions and comments on this second application 11"elissa K Afirrabelli I 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 i 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: Monday, May 1, 2023 10:16 AM To: Mirabelli, Melissa;Verity, Mike; Lanza, Heather,Weisman, Leslie; DeChance, Paul Subject: RE: Special event App 2 Pellegrino I have no objections to either of these applications being approved for Pellegrini Vineyards Martin Flatley, Chief of Police Town of Southold Police Department 41405 State Route 25 Peconic, N.Y. 11958 Tel: 631-765-3115 The information contained in this electronic message and any attachments to this message are intended for the exclusive use of the addressee(s)and may contain information that is privileged,confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient,you are hereby notified that any review, retransmission,conversion to hard copy,copying,reproduction,circulation,publication, dissemination or other use of,or taking of any action, or omission to take action,in reliance upon this communication by persons or entities other than the intended recipient is strictly prohibited. if you have received this communication in error,please(i)notify us immediately by telephone at 639.765.2600, (ii)return the original message and all copies to us at the address above via the U.S.Postal Service,and(iii)delete the message and any material attached thereto from any computer, disk drive,diskette,or other storage device or media. From: Mirabelli, Melissa<melissa.mirabelli@town.southold.ny.us> Sent: Monday, May 1, 2023 9:49 AM 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:Special event App 2 Pellegrino Please send me questions and comments on this second application 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 i transmission and delete the message without copying or disclosing it. 2 py I G� RECEIVE® W APR 2 8 2023 Southold Town Clerk TOWN OF SOUTHOLD 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 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 my be rejected or subject to a late processing fee of$250.00 by the Office of the Town Clerk, unless a waiver is obtained. Requesting an expedited review must be submitted in writing to the Town Clerk.The Town Clerk will forward all applications to the Special Events Committee for processing. The Committee will obtain comments on all applications from relevant Town, County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. The Town reserves the right to request additional information from an applicant to address issues related to the health, safety,and welfare of the community. When is a Permit Required? All Special Events,per Southold Town Code Article I, Section 205-2 (Definitions)must obtain a pennit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits. Any use of residential property for profit,such as a venue for weddings or other events is prohibited. This application is deemed complete once all the following requirements are submitted to the Town Clerk: Please indicate submission of the following by checking off the boxes and signing below, A completed application form signed by the owner and the event manager. Applications without property owner's signature/approval will be rejected. VLFEE, Is the application being submitted at least 60 days before the event [ ] Yes No ❑ If Yes,Fee of$ has been submitted /S �- ff 00 If No,Fee of$ 5-G. CPOhasbeen submitted�,H / SG' Updated 8/7/2018 0 p s . ® 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) �*vents for three hundred (300) or more people require submission and approval of a traffic control P_Jan acceptable to the Town of Southold AND a qualified traffic controller must be provided at the event. (See application form for details) IM 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. Dated Signature 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 8n12018 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: pelel9fl-41 Date of Submission Z Name of Event Ve d art t! ri,H i V,rte SCTM#'s 1000-Section Q Block- Lot(s) 6j 7 i Dates of Each Event: 23 3 s. If Multiple Dates are requested,applicant must give all information for all dates. Nature of Event: �✓' (Please attach a detailed description of EACH event to this application) Time Period(Hours)of Event: From : N �"'to Town Services requested: ( )Yes ()C)No If yes,Describe Police Dept._Highway Dept. Describe Services /V ZA Maximum Number of Persons Attending At One Time:_L7.!�_ Number of cars expected_ i Is a Tent or other temporary structure being used? [X] Yes [ ]No If yes provide size(s) TO Will food be served? [ Yes� ]No If yes provide number and name(s)of food vendor(s) Q q Kd Fy'--h efa tered /r- y-eK-i S Suffolk County permit#(s) P To eiv 2. Will other vendors be on the premises during the event?[�(]Yes . [ ]No If yes how many? Describe Type of vendor(s) I/ N //�atd Property Owner(name/address): /t i 1 f �e fle s� •�, 3/5 /cwt�e/' �''P�Cv/ "`' v� Contact Person and Contact Tel.#��D�.L. 4✓. otr 5 / G 3/ '7 3 — `f l// .� 7 e-mail address �o st �_� }�f 2//e qr','a ✓ ''1 •e Event Location: Street-Hamlet Address: Z ©O / oz:PL A ej d 4y/-If 'Ze- V V Y / 3 SCTM# Will any services be requested [ ]Yes M—No. If Yes describe Police Highway Other: Mailing Address to Send Event Permit to:_;_70OS tCoy'! 40 z �d/���9 ve, �/� l 3 S Updated 8/7/2018 Have any of the development rights been sold to the Town of Southold [ ]Yes No and/or Suffolk County Agricultural Program? [ ] Yes I"No If yes to either 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) 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. (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. . Updated 8/7/2018 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 Owner Print naive of Authorized Person/Representative Signature of Author' erson/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 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. 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, tents, 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 toap rking. ingress/egress/access. tents 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 Updated 8/7/2018 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 �►`�o DATE(MMIDDIYYY`() CERTIFICATE OF LIABILITY INSURANCE 04/25/2023 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(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). CONTACT PRODUCER NAME: Farm Family Casualty Insurance Company PAH21 o 631-727-7767 FAX,Nu:631-727-7941 18 First Street AD RIESS: eric.kirk@farm-family.com Riverhead, NY 11901 INSURERS AFFORDING COVERAGE NAIC#. INSURERA: Farm Family Casualty Insurance 13803 INSURED INSURER B: Pellegrini Vineyards LLC INSURERC: 23005 Main Road INSURER 0: INSURER E: Cutchogue NY 11395 INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT 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 i D L SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDD MM/OD/YYYY A X COMMERCIAL GENERAL LIABILITY X 3152G3148 05/03/2022 05/03/2023 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR 05/03/2023 05/03/2024 DAMAGE T RENTED PREMISES Ea occurrence $ X Liqour Liability MED EXP PERSONAL(Any&ADV INJURY $ 1,000,000 one person) S 5,000 31521_6607 05/03/2022 05/03/2023 05/03/2023 05/03/2024 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S X POLICY❑JECT F1 LOC 31521_6608 05/25/2022 05/25/2023 PRODUCTS-COMP/OP AGG $ 1,000, 00 OTHER: B AUTOMOBILE LIABILITY X 315204531 06/15/2022 06/15/2023 Ea eaaldeolslNGLE LIMIT $ 1,000, 00 ANY AUTO BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS PROPERTY DAMAGE HIRED NON-OWNED Per accident $ AUTOS ONLY AUTOS ONLY C X UMBRELLALIAB OCCUR X 315288064 05/03/2022 05/03/2023 EACH OCCURRENCE S 3,000,000 EXCESS UAB HCLAIMS-MADE 05/03/2023 05/03/2024 AGGREGATE S DED I X I RETENTIONS 10,000 ER _ $ WORKERS COMPENSATION IST TATUTE ERH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ DESCdescribe under RIPTION OF OPERATIONS below IfsE.L.DISEASE-POLICY LIMIT $ D Liquor Liability X 3152F6081 08/22/202;/22/2023 500,000/1,00 ,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER IS LISTED AS ADDITIONAL INSURED 05/27/23, 06/23/23, 06/29/23, 09/16/23, 09/23/23, 9/30/23 10/07/23 CERTIFICATE HOLDER CANCELLATION Town Of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 53095 Route 25 THE EXPIRATION DATE THEREOF, NOTICE, WILL BE DELIVERED IN PO Box 1179 ACCORDANCE WITH THE POLICY PROVISIONS. Southold, NY 11971 AUTHORIZED REPRESENTATIVE Kirk Associates LTD @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 4 e l � L�•� � . 3. 'r: t r ti t .�f� t ` �' a �r 1 .• L� �` -� -� � � - '' `• rst � 1 t Rho L x9 t.i -alp f x4v 74 Al IF fir'. I,' ,' ��,. 'I J 1�> e• _ i t' �: I r I'..fin'"' , „� � tib, ,� , ' _ •� ��• t ,�c t` ��� �t {.t'Vy t{� t• q l.r� ,' �, `e _ t y /'' rh r' - �` �! � x,�;:il<,i' xf ' •`1y, � v,P�f+!�^.y, �jeR•€, �,., fi ��,� f rf.� Pw1Si � t r t� ,� --.� r y. rt. w�f,tR y `<��y;t�ita: � e. i. .t �`` 1f f '•��) r r ,i ' ?r,! 'Fa.•',' F r� MPJ [ i 9 i !•j R t, 1- J(J - �_ ` 'J-; �{�1,��'� 4 'i1.. I` , ,. r I i i'f - ,e Yb • l`' s . , AD-98 SEE SEC.NO.102 06-28-99 MATCH 01-31-00 'n UN --------�------. 0420-00 N31fi 402w - -Z------ . FOR PCL NO MATCH ------ / 0517-00 ---�--- p [A _ ,� SEE SEC.N0. 05-26-00 0(-05.00 Z 24.3 102-04-006.1 10.03-00 q 24.4 3.9A qfL l 12-27.00 34.2A �Ls 0314-01 I t7oWN OF SOUINOID \0 a'• D4-12-01 4 m oEVELO.FSO IONT3) 0600-01 I �� 4P 10-2501 I 242 0 11-0&01 01-14-02 I L '� 25 0312-03 0430-0.9 J �\�j"'(126` 1}03 I o 10-0 A I 12A( 12 04-26-05 m o 4! ry1 ry. 04-03-00 I 1, '9 '�'• ,� a Q&10-05 I $ O I 12-1506 13.2 7 ,tp g 12-27-06 I 42AA 01-22-07 PECONIC LAND TRUST.INC b .• a"s-D7 a 01-21.09 I (TONIN OF SOUTHOtD a` 0322-10 '► DEVELOPMENTRIDHIS) 05.14.13 0522-13 I 2.3 O < m I �y/fl SOA(c) O z I/V�1�/ I 77.3A(C) 13.1 l 62A �. O 16 .p 241 c 4 1.3p(c) I t 41 0 23 0 21 P4 wI yy11AYY\A\1'__,//(1` �O 24 6 Pu 11� 1 L 29 10.1 + . PM PM �4. 53.OA(c) x 210 �•' a *' 229 I n d' v Pa 1.4A I 4 9 230 sA f 212 1.tA 111A b . R+1 3 I O 213 �G.y 1.4A &7 36 4. 1.0A "RL 36.4A(c) 1.9A P) PECONIC ' 214 LAND-MUST WN OFS DEVEL0PUFHfRGffM q r 236 \o i 215 = 5.7A(c) I239 PR ,1y _s =I &6 0. z ORAINAOE rm 1.1 rI2.1 24.7A(c) 72 n AREA 1.3A g -.-y 2.S 1 I,pO .� 1\ 5A d D 18 P�nONMEN 's 5 1 aa+ 20A 4 0 a '�► 8.9 3.6Ai Pn 1.7A(c) o a pECOMC UWDTRUST d a) to 2 FOR PCL NO. 20A FOR PCL NO. SFS SEC.NO. m y FOR PCL NO. S 375 SEE SEC.NO. 116.01.003.3 ?< SEE SEC.NO. 1.1A(c) 1.1A 11&01-003.5 - 11&01.007 I -----..-Z?---- N70fififi21-^ x1 -L--------- ----- MATCH Aura L gyrrypltllW idJblmla114 � wLM �-- Iti O+MW --fi-- iQ1JR � -�--� NrptwYW m.,v w /Aroiav� Naw.nla.. �...�.•_ ameo�.n:. � 1....u» --- rnaci.eW --•-- AeMNn 23 121A(d)>121A --•-- mu.aw• WA(.) •U' ••.wdwNW PROPERTY OWNERS, . 1 ,a a•Ji�rasaR"a`"'w M[9Y}N'. < , ' �./" � ���.�` [ •aaYan'•'°I:`N: N•1: "a1�a � / �'y'�,:r- ' •' �I-�`w...J i •< .au•ee rase lY}]aR ®' 1 , , '��" �l •�-�/�—�..1 ` , l 7E-7- 7� aau• ; ti _ d J t /-/ '/`_:4'•r'•:i�'7rll,%�"'`;' w1 a.r.z�r•..v\ f t/ /!:`•••:`.�. {.: .;• .•r•r•%•''.'i•i:' cc u ae.YGba<C\v la•t..a[ "'b , � ;�. 1[ �•is Yf��rr':'ii�'•�.IwYG,4, •�;• : •\�j rS•�'r•'^/''j,/!rr+� .u !llao a:cnN •arc.o�.aY•m• \ . t• r t /a',/ri < �;'.1,:�:,':/;! ' ' Y: 'S!3•.:.. ..fi�r '{r• '!•:'i tr/r:�- ., r! `Z - i u a•�+n.Q a.mmt 1a<i.a¢. " .! .�/ 7•i':i•r/• y r /r.�ir� :'� '!.%r rI jr'!:./// I u aaaa a a r•t,td\a es.m t .sm-4r-m.c f L `cfl�l�" �'.� :i/i�f [} ��% r% %�a. .i:•.� Z I a[ anra awalw.al a war ,ar pau ara � /1!:'1�• •r+!' � r:��f� •,t •• •rii.' ..,! CD/r I �r , � �f 'tip_._'. J • ..as aaNNss 'i2• • oa�.•1.�.•w�1+�•.[t�X-K-•.,.[ • • `�'°"". ..� - KEY 'P 't N..\ a,,.[..�.....«[..... , Y'I/�waasn'��K_cLwl'ro, Auib � w +.wr•[/.an[ �'M.le[.[«w �rw•[ as1.wlFai..* roNar - � •s:1a.NO M[[a 'r"'•�w+•ew�[r.. ` _a• t� �Jc.acnes wea .• .• 1 / 1� t :x .:• i� �, '.I�' _ PARiC1NG CALULATIoNS 1• SITE DATA G:c:•%'�aar.�i •'� m.w.lva.M.1Y r.r�+e.tl� m.c.r \..[tw•a a.d.a..•. ca. LJ�RGTc Y!C. 1 � ,, � c.rwq d«[ :au r. a.\I:...r ••a\_._-. „•,y' 1•rlm�n. ..._,W.• U•!1 ,µW,. ' na.l.+a�'araaac -•l_ ' ( 1 a l.,at�..[ i.n.[ a..[.w K ..a.q..r i•r.«+: cc....e�.,..m. _ . /,�j --11-'� 1 O.w•Nr.M 1vw 4 a..1[«•u :.n R.a. a. ...d•M �•'uH m' :.a.Y� 'fCiA1.eT[O �.pt;}�Ml-1 • La„\.�t� aei. • I 1.fheY. IAN a Lt[lN.•[ .N•r.•.• Yw 1.•i-�4\Iw •L••.[ •Cit r • f G�- Fpv�.[IE,.1;• IThR. ' ..n•.+W Iaa •au K w. ....1 a.a ..IF<•«\ Y\•.. i•..:cC ndCUR81NG1 DETAIL._ M+••l•l•i•r•.•.y.•Yr �" . • hJ Mfl�i\••� 1 •.nM.nll4f«ariL.a�W. • " '�f.[=!� • 6fM1�'+aJ.FaT � �' . • • 4 r+�`�'w. M R •`•tM tRli OJ7 iL¢M7 .Ia•.!1•.Pr1.etr.L '�� i I� •, N1t(n.w !n•r (l.ry':.«` • ���,\.wai,6t�.14 � l00 Yfa a.ty.\• u1 K _ t�11�RR•a.{f}M .!a•li . aaa�•NIaNi�w[ awlq a<I at1 K Ow+.i M:tt 1.7�L+!rbyk M�!'1 'gid t C �w•:\� n\[a .we .:)yy .i3.. �• �_ i - 119SS �{ " �,.«, a, SITE INFOH{AATIO (per ... _ M•.w r ��' ' '- ;. -. m.JFsgan rJe.cp..oe 1 •� 1 vv., SP-2 Iz0(VI(VG SoAPD OF APPEALS • ;��- E Gazebo T:' Vineyard Fields ;lrlry; by .. \ `�� •� .. X47' OL Ir Tf • Pat!ot ,.• �;Wine Storage x° • aj;' b8thro0II1S '4S;' Oi CO ` Entrance, P�rkuigFil 36•• �'� 36 • Pellegrini winery Fmlineyards 230051vtMW *oad cutcho�tle,N ;11935 ' 631.714- '1 Main RoadYfC Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 04/28/23 Receipt#: 309817 Quantity Transactions Reference Subtotal 1 Event Fee PV 1a-c $150.00 1 Event Fee PV 2a-d $150.00 1 Late Fee PV 1 a-c Late $250.00 Total Paid: $550.00 Notes: Payment Type Amount Paid By CK#36519 $550.00 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-c Late Born, Sabrina From: Born, Sabrina Sent: Friday,April 28, 2023 11:52 AM To: Mirabelli, Melissa; Noncarrow, Denis; Norklun, Stacey Subject: Pellegrini Event Apps. Attachments: PV 1 a-c_20230428114237.pdf; PV 2a-d_20230428114308.pdf Please see two (2) special event applications attached from Pellegrini Vineyards. Thank you, 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: PV 1a-c_20230428114237.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