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HomeMy WebLinkAboutBorghese Vineyard 2023-52 RESOLUTION 2023-903 ADOPTED DOC ID: 19592 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2023-903 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON OCTOBER 24, 2023: RESOLVED that the Town Board of the Town of Southold hereby grants permission to Borghese Vineyard,to hold Special Event 2023- 52, location of event will be 17180 Route 48, Cutchogue,New York as applied for.in Application BV2a for a Wedding on October 20, 2023 from 5PM-10:30PM, . 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 O��SISFFU��-�o 0 o • ti�ol �ao� 1 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: October 25, 2023 Subject: Borghese Vineyard -BV2a 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 Special Events Committee Application Summary and Recommendation Application name: Cl tiQ�l �,If�t h Q ft'�'�1,� �a e AddressX;1tO c 49 9 Cu,4chrqju-v, NY H93� Application number: Date of Event: Time: J Date Received by Town Clerk: Q� Date Received by Committee: to I'm �Aoa: Nature of Event (S): on Committee Comments Received by: Government Liaison Lillian McCullough Leslie Weisman Missy Mirabelli Chief Flatley Mikael Kerr- County Heather Lanza Andrew Amakawa-County- 0rW1S'c1 A= Mike Verity Fred Visser III �`� Paul DeChance Kevin Webster/ Claire Glew Committee Recommendation's: X Approve as applied Approve with Additional conditions: Hold Public Hearing Deny Special Event No: J Resolution No: � Date: Db ,) .c1�� u'= tC �G' 6o = RECEIVE® CAI Al OCT 2 0 2023 Town Attorney's Office 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. Aiipliciition fet: .$15'0.00 pe :appl cat)oa . Up to six.(6) multiple even 'of the same type, occurring over a peri'gd of,thrce-months;it ay:be permitted on one(J)app)ication fora fee of$.1.50 0. Howev',--specific detail:s,of_cacl7 CV,cnt•must bic.incltildcd with this dpolication. All applications must be submitted at least 60 business days.before.the event. Ap.pl.icants are encouraged to subniit'applicatimis as earlv as possible.. Anv &o)ritiltted aptiiication that is not siibnlitted 60 or more biisiness:.tlays prior to the scheduled. event '"- tic i cieCteil or subject to'a late processing fee of S?50 00 bv.the'O1.Rce of the Tojvn;Clet l•, uriiess:a Eyaivci`:is 6bthfl ie`il. ,Requesting:an;_e pedi d ,tn .reviewust bc::sul5mittted in writing to theTVwn Clet`k "l'lie 7'otivn. lcrlc�yill foa��� i d:all applicafiions to tltc S,pecial.E�7�nts Gon�mittee for processin- 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.R_ equired? All Special Events, per Southold Town Code Article 1:,Section 205-2(Definitions)must obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits. Any use of.residential property for profit such as avenue for weddings or•other events is_prohibited. This application is d&med complete once all the following requirements are submitted to the Town Clerk" �N6,ise indicate subrlission of the'followiriP=by checkiiia ofi the boxes and si&iirie_below. VA completed ajihlication form signed by the owner and the event manager.; Applications without property owners signature/approval will be rejected. ❑ FEE: Is the application being submitted at least 60 days before the event [ ] Yes No i✓ If Yes. Fee of$ h_ has been submitted KNo, Fee of S t/� has been submitted Updatcd 8/7/2018 a 1�1 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 Totyt1 of&®diold.as:in additional insured .A Park)ngfEVgnt 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 regtiire submission and approval of a traffic control plan accept�ible to the Town of Sbutho.Id AND a giialiFled traffic controller must,be pi°ot�ided 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. r atetl. . rgt:at r Activities associated with outdoor public events are strictly prohibited from taking place on land preservett tltttitrgl: tlrcr sale of devveloptiierrt rights to the.Town of Southold, and can only tgke,plirce on land preserved thrari�h the sale of,develapingilt,rights in the Coi�tY}�of SriffnlC* with a permit:issrretl by the Suffolk County Farmland Committee. If food is to b.'e served, it must lig.cgtored and.pr,pared off.-site.bj'fr�r�d r eudttrs who hold a permit to operate issareillit�the Syffnik:Cotctit litrrcate of Abuc mealtlt ?rooet`Proteetiou Unit. Upd=d 8/7"."2018 . SNµf.n•'.-n yr�guFFO ,f rJ C`; 14k- S4i APPLICATION FOR A PERMIT TO HOLD A SPECIAL EVENT Picase provide ALL of the i0by-,rhation reciuested below Incomplete-applicatibnsVILL.NOT be reviewed. z f Special Event Permit# f Applicant(s)name: Date of Submission- Name of Event 1,m SCTM Ws 1000-Section t71 ,...,Block- oC Lot(s)A. Dates of Each Event: P If Multiple Dates are requested,applicant must give all information for all dates.. Nature of Event: �kTlease'--a ch a detailed description of EACH event to this application) Time Period(hours)of Event: From to,_ 0�_�y YYi Town Services requested: ( )YesNo If yes,Describe Police Dept._highway Dept. _ Describe Services Maximum Number of Persons Attending At One Time: 1 J _Number of cars expected C, Is a Tent or other teiiiporary strUcture being used? K, Yes[ ]No If yes yovj c sizes) tJ i`/ f�.gl t --4 t ,rdls"�,1 Wit' �' `h Wila,food be served?[ Yes [ ]No If yes provide number and name(s)of food vendors) ,,atar �. -� F1a YA", ` � ., Suffolk County permit# Will other vendors be on the premises during the event? [ ]Yes X No If yes how many?________Describe Type of vendor(s) Property Owner(name/address): ' f �G� ►'�3 - — . Contact Person and Contact Teh# e-mail address':'+yCt �"AYt Updated 8/7/2018 tEvent Location: Street-Hamlet Address: __ -------�- ,t- Will any services be requested [ ]Yes M No. If Yes describe Police Highway Other: Mailing Address to Send Event Permit to: �- r� Have any of the development rights been sold to the Town of Southold [ ] Yes jx]No and/or Suffolk County Agricultural Program? [ ]Yes [ ]No If yes to either or both,also indicate on the ttaclied`flan the bowYdaries of the reserved iirei iipdii which'tlie`!eyent will take pace,. YOU INRIST ATTACH A PARKING/EVENT PLAN TO THIS APPLICATION IF THE lv+�X XTED ATTENDANCE IS 300.OR MORE PEC)S'LE.YOU MUST ALSO ATTACH A TRA. I IC CONTi2i0LPLANN7dsee fjxt na961 A Pai liin"Vent Plan may be a survey site plan and/or aerial view (for exaninle Goole Earth) of the sublect pibpertIII Il\WICATE OfN TI1E PLAN ALL.of the fai}o�vitrtY.�nforn>atlon: A prk,inglevelit,flan=slrowin :, (;l) `Ibet .size ofthe proPcrty'and its'location in relation to abutting streets or highways. ( ) Tliesize.and lcicatioti;ai`an existing buildings)or stfawi-40 that will be in operation during'the- gou'rse.ofthe,ev6ntand any proposed building, slruetufc, or signs to be'.e"reefed 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 oi'any parking area-or autaii�obiles and other vehicles and the means of ingress and;cgVess;f�t such,.palking;areas. The;ptirk,ing spaces must allow for 300 sq. ft. per'egr. (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 atad oth&'A-0 lio equipment. (1 1) A description of emergency access and f:;cilities relate. W the eveizt. (12) Provisions to dispose of any garbage, trash, rutibislt`ot Ciiher refuse.. (13) Location and description of any additional lighting to be utilized in conjunction with the event. (14) Location of sanitary facilities on site. °Trafiice'Coittrbl 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, ANDti�.gnzlifierl Sri:{7iG controller must,be t5roviiletl..Please attached a written description and/or notate on the parking event plan the following: l}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 lin-use by Southold Town Police. Updated 8/7/2018 oWNER IS SIGNitTURE: 1 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(lie information contained herein and attachments hereto are trite 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 con ectidn with this Special Event. Frit t name of Owner Si attire ner Print name of Authorized Person/Representative Signature of Authorized Person/Represeniative �ERMISSI(}NIS.II)GI?�EI3'1'GRi11YT`EI} SCJ'I3.T)�CT'T+O T�[C OW_NG wCONI)xTIC)14S; 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. l Afk-Inn`ia sirictly prohi>aitecl on ANY TU«%Il; Caruity or State IZaads or Tei 18 65 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) squAte feet in size may be displayed not lunger than thirty (30) days before this event, and removed immediately after the event. Directional p.orkirg signs shall be adequately displayed. 4. Applicant ind'niiiifes.and holds harmless the Town of Southend from all claims, dama'ges,.:eNpenses, suits and losses:iriclitding but not limited to attorney's fees arising from activities under this pennit. 5. `l'eiit proposals must :repeive permit appioval,,frorn the Southold Town Building Inspector before placeni. ;on th&property and must meet all fire anal s4Pety 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'bctsii ess days prion to tlte-scheduled event. 7. Adequate temporary sanittiy facilities must be provided by applicant for this event and applicant agrees to remove the tempritoe..y 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 Qarking, inareSs/egress/access. tents or temporar strttetttre s or.tem orar.y sanit<tr1 facilities, shall be canducted.on Town of Southold Purchase o Deevelzsptxie RiRidltfis lansl. Updated 8/7/2018 10. NO activities associated with this event includint but not_limiteYd-to...Varking. inkrcsslcgAslaecass; ie, shall-be conducted on SuffJlk_Q01"itV sirui��urc(�)� or A jLbrA!!Y S1111-itary:fa tents') or tempc Purchase: ofDe_ve�[Wmcal_ Rights land. NAthout a pinill—it —IS -Suffolk CountyFr1raildilid 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. be prp)?idc�d for em"erg6ndyvebicles,to,all public as�sqrnhly areas, all'bt._iildin)�s,all'-work 12. A�oess'shall 'its aad exit-�a ths 'may occur e 'ireas"-artd.grty. additional area where-ernergenci.'6s- . Two,, mergency-fire ex, y or remote aiij and wa t'- s0d area, shall rem, from the bfflldin$(�) on the PrOpOrty, to .1 public unobstructed at all times. 13. Owner assures full compliance with all fire, safety, building, and other Town laws. ent 14. Music,when outdoors,.is required to stop at the time specified in the permiL, 'M . of the speakers must be in al'66ation 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 t1le hours of the special event to make any and all inspections necessary in connection with t1lis Special Event. 16. ADDITIONAL CONDITION& 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 anEiIS EM -121 POW I in BARBAGKDR01'(U i 1 u Y SEATIN6GHAitT VAR ALL • . WKVROP(1) AFTERTH[ "l I t TONE I 4J8 X' ens Ire / i cl I u \ o �. . BAS - '-- - - ---- -- - - - ---- -- I \ I IBRIM_s I — -(� &Acemlkop(3 C� Y�4D YIALL TOTAU \ �, � \ • • f f \ (' STTtIN�LI6HT5- \ 100FT STRM55 MAV FORK r-� r-� 1 \ r-N \ STANIMS I`fEIbHT BAR \ \ f \ ! \ f TABLES(6) EAT ME a e COLT VINGEl1T5 rl MAIN BAR f�EcEprom SITF lAYOUT joHmSEN-COMMOLLY WEDDING OCTOBER 20TH,2023 AS NOTED - LIFE SAFETY DRAWING LEGEND EXIT TO THE EXTERIOR G`s'^RATOR E----+ EXIT TRAVEL DIRECTION AND DISTANCE FEa FRE EKTINSUISHER raT SUPPORT 4 t.OLUD'M ® ILLUMINATED EXIT SIGN .TcM?.CJTI.I ;, J hEAAI'EiR 4- ,^ NEATER HEATER COMMERCIAL HEATER-BOK STU5 VAF!J £ . 0 4C 6._O FE __ _ GSIERATOR 5,500 WATT 6ENERATOR } —•~ it X q1,0., I, LL4 Ll, ln'— LIFE SAFETY NOTES cr I TOTAL SF. `� ` }• r_ "TABLE I r� $ t 4 OCCUPANT LOAD BY TABLE 10045::2400/11&0 OrrUFIANT-- = - OC UPANTT LOAD BY ACTUAL COJM1T= I 1 {B'_0'X 21' f I` F7- bMAXIMUMEXIT 150 00CUPANT5 OCCUPANT LOAD.u-, '� NUKMR DF EX175 REOUIRED.2 NUh>BE9R OF EXITS PROVIDED.4 r1r ' y (^f1NUMBER OF ILLUMINATED f'_XI7 516N5 PROVIDED:A FE` >f1 �'S'113i4:. � � � r i� I FE_ NIMSER OF FIRE EXTINWSHER5 PROVIDED.4 JIL",. �}',�.am>1 �, W�.>��.ff � . ' '�*y ��. EXIT SEPARATIOVERALL DISTANCE:T2'-I" EXIT SEPARATION DISTANCE,40'-O' �nEXIT SEPARATION/OVERALL DISTANCE=M TRAVEL DISTANCE ALLOWED. 100'-0' ACTUAL MAXIMUM EXIT TRAVEL 1715TANCE" NEATER -�-y-t�_,.,......:.M„.,.;_...-_.:...;:.:,:.>.....,_: _. __ _. } .. NOTE:ALL M TERATORSTD BE MINIMUM (�I- I, tt�'�,`I 20'-O'FROM TENT ! })� fY� 1I �}1 I NOTE,51DEWALL5 AND HEATERS SHALL ONLY � .-. .- L;__.,, .lC--� I BE USED IF WEATHER REQUIRES 1' U_s 1- �} . '�� �� , li1DE d 6RGOM L411. �)ail rr I rt V-4' Off. -.#•�j ^4: 0- �_ _: �_(� ___--.__---- -------- - --- ^�?-------= 6NE 7 7 FLOOR PLMAIFF.SAFM PLAN �5/ L®O R JOH94SEN-CONNOLLY gr”LA N OCTONR 20TH,2023 — 1/4'= 1'-O" DATE(MWDONYYY) CERTIFICATE OF LIABILITY INSURANCEF 10!2012023 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(ids)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 Ileu of such endorsement(s). PRODUCERAME..CONTACT NAM . Danielle Flinter _ ,N JSM Brokerage,Inc PHONE (631)765-2777 ll FAx ..NI�� 3 1(WC•14o Danielle FlinterE-MAIL ADDRESS: "igI g dariieile smbrvkera e:com ' PO Box 273 INSURERS AFFORDING COVERAGE NAIC# Mattituck NY 11952wsuRERA: Lloyds Syndicate 2623 AA-112862; INSURED INSURER B: Lloyds Syndicate_623 AA-112662:. Castello di Borghese LLC INSURER C: c/o Giovanni Borghese INSURERD: 17150 Middle Rd INSURER E Cutchogue NY 11935 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,CONDIT,IONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. `CTR TYPE OF INSURANCE ADDL 3 vr) POLICY NUMBER PAMIDDf EFF (Mf.POdCYPDD 8XP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE g 2,000,000 . CLAIMS MADE GET-0 RENTED OCCUR PREMISES.tbtherlhanrncl $ 2,000,000 Host Liquor Liability .MED EXP(Any one person) $ 5,000 A }{ Retail LgorLibility Y N EH-771323-L3333638 10/20/2023 10!21!2023 pERSONALBADVINJURY 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: 7:29 AM 12:01 AM GENERAL AGGREGATE $ 2,000,000 POLICY 0 jE OT LOC 'PRODUCTS-COMPIOP AGG s 2,000,000 OTHER. Deductible $ 1,000 AUTOMOBILELIABILITY CO IN DSINGLELIMIT $ Ea"o Cant _ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTl'.DAMAGE $ AUTOS ONLY - AUTOS ONLY Wer a6dd6nt $ UMBRELLALIAB OCCUR :EACH OCCURRENCE $." ... . EXCESS LIAR CLAIMS-MADE AGGREGATE $ 'OED I I RETENTIONS WORKERS COMPENSATIONNr R ( vTN- AND EMPLOYERS'LIABILITY YIN J.STATUTE ER -- ". ANYPROPRIETOR(PARTNERIExECUTIVE .. E.L.EACH.ACCIDENT $ -. .. OFFICERIMEMBEREXCLUDED7 NIA (Mandatory In NH) E.L.DISEASE-FA EMPLOYEE $ "........ If i under .DESCRIPp TION OF OPERATIONS below ... E.L.DISEASE-POLICY LIMIT $ I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarhe-Schedule,may he attached if mare space Is required) Certificate holder listed below is named as additional insuredper attached CG 20 26 04 13.Attendance:150,Event Type:Bartender at an Event. CERTIFICATE HOLDER _. CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Southold AUTHORIZED REPRESENTATIVE 53095 NY-25 Danielle Flinter Southold NY 11971 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD . Policy Number: EH-771323-L3333638 CG 20 26(Ed. 04/13) i ' THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. j ` ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: I COMMERCIAL GENERAL LIABILITY COVERAGE PART 1 Schedule Name of Additional Insured Person(s)or Organization(s): -- — -- Town of Southold 53095 NY-25 Southold,NY 11971 3 3 i I J I 1 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. SECTION II -WHO IS AN INSURED is amended to include as an additional insured the person(s)or organization(s) shown in the Schedule, but only with respect to liability for"bodily injury,""property damage"or"personal and advertising injury"caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: — 1. in the performance of your ongoing operations; or j 2. in connection with your premises owned by or rented to you. I However: j 1. the insurance afforded to such additional insured only applies to the extent permitted by law;and I2. if coverage provided to the Additional Insured is required by a contract or agreement,the insurance afforded to J such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these Additional Insureds,the following is added to SECTION III -LIMITS OF INSURANCE: If coverage provided to the Additional Insured is required by a contract or agreement,the most we will pay on behalf of the Additional Insured is the amount of insurance: 1. required by the contractor agreement;or ! 2. available'under the applicable Limits of Insurance shown in the Declarations; whichever is less. i This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. I ©Insurance Services Office, Inc., 2012 CG 20 26(Ed.04/13) (Page 1 of 1) I i I Mirabelli, Melissa From: Glew, Claire Sent: Friday, October 20, 2023 11:20 AM To: Mirabelli, Melissa Cc: Webster, Kevin Subject: RE: Special Event Borguese Vineyards There are no exemptions where the event is being held. Cl air& 6 tzmr 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: Friday,.October 20,2023 11:01 AM To: McCullough, Lillian <lillianm@southoldtownny.gov>;Visser III, Fredric<fredv@southoldtownny.gov>; Glew, Claire <Claire.Glew@town.southold.ny.us>;Webster, Kevin<kevin.webster@town.southold.ny.us>; mikael.kerr@suffolkcountyny.gov; Christina.Hamm@suffoIkcountyny.gov Subject:Special Event Borguese Vineyards Importance: High Just received this Special Event Application please send comments to me ASAP thank you so much. 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. ******************************************************************************************* MAIN COUNTY ROAD 49 ENTRANCE ACCESS ROAD n BORGHV ESE __ • TRUCK AWN PARKlIt6 us VINES ell iS3t9JD1 - ' <i. bUILDiRi6 CE ONT :,, CaE�TTI�i TENT CATION WOODED AWA M NNT13 M siTE OLAN-BO HESE ViNETARD {1 JOHNSIN-CONNOLLY WEDDING — SITE , v OCTOBER 20TH,2023 N.T.S. Mirabelli, Melissa From: McCullough, Lillian Sent: Friday, October 20, 2023 11:15 AM To: Mirabelli, Melissa Subject: RE: Special Event Borguese Vineyards Hi Missy, The event as proposed is not taking place on DRS land, so no comments from me. I defer to any comments from the County, as the tent will be located on rights intact land surrounded by farmland the County preserved (see snip below— blue x=tent location; green = County DRS land) From: Mirabelli, Melissa<melissa.mirabelli@town.southold.ny.us> Sent: Friday, October 20, 2023 11:01 AM To: McCullough, Lillian <lillianm@southoldtownny.gov>;Visser III, Fredric<fredv@southoldtownny.gov>; Glew, Claire <Claire.Glew@town.southold.ny.us>; Webster, Kevin <kevin.webster@town.southold.ny.us>; mikael.kerr@suffolkcountyny.gov; Christina.Hamm@suffolkcountyny.gov Subject:Special Event Borguese Vineyards Importance: High Just received this Special Event Application please send comments to me ASAP thank you so much. Melissa M. Mirabelli Secretary to the Town Attorney Town of Southold Southold Town Hall Annex 1 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 10/20/23, 12:29 PM GIS VIEWER .. 17180 County Route 48 Cu X w Show search results for 17180... Tax Map#:1000-101.00-02.00-018.005 PARCEL ID 1000101000200018005 ADDRESS CITY ' ZIPCODE ACRE CALCULATED 1.125000 LAND USE 311:VACANT CODE RESIDENTIAL CASTELLO DIBORGHESE OWNER LLC Zoom to ' m o, v` w t � 700ft https://gisapps.suffolkcountyny.gov/gisviewer/ 1/1 10/20/23, 12:32 PM GIS VIEWER 17180 County Route 48 Cu X Q Show search results for 17180... '% f qa M #:1 -1 1 -02.00-018.006 Tax Ma 000 0 00 PARCEL ID 1000101000200018006 ADDRESS CITY ZIP CODE ACRE CALCULATED 12.602000 LAND USE 129:FIELD CROPS W/ACQ �a CODE DEV RIGHTS ' CASTELLO DI BORGHESE LLC OWNER .COUNTY OF SUFFOLK jo �20oft https://gisapps.suffolkcountyny.gov/gisviewer/ 1/1 Mirabelli, Melissa From: Mirabelli, Melissa Sent: Friday, October 20, 2023 4:08 PM To: Rudder, Lynda; Noncarrow, Denis Subject: Reso to be added- Special Event RESOLVED that the Town Board of the Town of Southold hereby grants permission to Borghese Vineyard, to hold Special Event 2023- ,location of event will be 17180 Route 48, Cutchogue,New York as applied for in Application BV2a a for Wedding on October 20, 2023 from 5PM-10:30PM, . 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. Ifelissa 11 Al'irabelli 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 r by� RECEIVED OCT 2 0 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, occurring over a period of three months, may be permitted on one(1) application for a fee of$150.00. However, specific details of each event must be included with this application. All applications must be submitted at least 60 business days before the event. Applicants are encouralZed to submit applications as early as possible. Any completed application that is not submitted 60 or more business days prior to the scheduled event may be rejected or subject to a late processing fee of$250.00 by the Office of the Town Clerk, unless a waiver is obtained. Requesting an expedited review must be submitted in writing to the Town Clerk. The Town Clerk will forward all applications to the Special Events Committee for processing. The Committee will obtain comments on all applications from relevant Town, County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. The Town reserves the right to request additional information from an applicant to address issues related to the health, safety, and welfare of the community. When is a Permit Required? All Special Events, per Southold Town Code Article I, Section 205-2 (Definitions)must obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits. Any use of residential property for profit such as a venue for weddings or other events is prohibited. This application is deemed complete once all the following requirements are submitted to the Town Clerk: Please indicate submission of the followinlZ by checkinIZ off the boxes and si2niny' below. A completed application form signed by the owner and the event manager. Applications without property owner's signature/approval will be rejected. ❑ FEE: Is the application being submitted at least 60 days before the event [ ] Yes X No ❑ If Yes. Fee of$ has been submitted If No, Fee of$ JC/� has been submitted Updated 8/7/2018 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 plan acceptable to the Town of Southold AND a qualified traffic controller must be provided at the event. (See application form for details) Signature of Property Owner on the application authorizing Code Enforcement Personnel of the Town of Southold to enter the subject premises during the hours of the event to ensure compliance with any and all special event permit conditions. My signature below affirms that I have submitted all the information required above in connection with my application. batedt Mignat Activities associated with outdoor public events are strictly prohibited from taking place on land preserved through the sale of development rights to the Town of Southold, and can only take place on land preserved through the sale of development rights to the County of Suffolk with a permit issued by the Suffolk County Farmland Committee. If food is to be served, it must be catered and prepared off-site by food vendors who hold a permit to operate issued by the Suffolk County Bureau of Public Health Food Protection Unit. Updated 8/7/2018 APPLICATION FOR A PERMIT TO HOLD A SPECIAL EVENT Please provide ALL of the information requested below.Incomplete applications WILL NOT be reviewed. D Special Event Permit# I Applicant(s) name: i'0'VC►hr, Date of Submission I oh. d� Name of Event /)P1 SCTM #'s 1000-Section 1 (7I Block- Lot(s) Dates of Each Event: )0 ® �. If Multiple Dates are requested, applicant must give all information for all dates. Nature of Event: Ue- �� (Please a ach a detailed description of EACH event to this application) Time Period (Hours) of Event: From to 0 Y>7 Town Services requested: ( )Yes (( No If yes, Describe Police Dept._Highway Dept. Describe Services Maximum Number of Persons Attending At One Time: _Number of cars expected CO Is a Tent or other temporary structure being used? (X ] Yes [ ] No If yes rovi e ize(s) (1 �J ucWill food be served? [§14 Yes [ ]No If yes provide number and name(s) of food vendor(s) > h44 r1A F]'" 611g oo-63,q , �Suffolk County permit# (s)p�a��/��d QQ -ir P I l�r1Sl��q� Will other vendors be on the premises during the event? [ ] Yes [X]No If yes how many? Describe Type of vendor(s) Property Owner(name/address): ✓O�'1✓r} �� x q<2 6,4Jd uio — .S"3 �1L4S Contact Person and Contact Tel.# e 4 — t e-mail address jY4°U9eAhn; In CL 01 Updated 8/7/2018 Event Location: Street-Hamlet Address: I Com/'(Glh M 9,.r SCTM# OD®^IOl• " ^) . Will any services be requested [ ] Yes [X] No. If Yes describe Police Highway Other: Mailing Address to Send Event Permit to: 1/ xr' C; D r h 1✓r ^�( Have any of the development rights been sold to the Town of Southold [ ] Yes [�] No and/or Suffolk County Agricultural Program? [ ] Yes [ ] 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 pate) A Parkinj!/Event Plan may be a survey, site plan and/or aerial view (for example Google Earth) of the subject property. INDICATE ON THE PLAN ALL of the following information: A parking/event plan showing: (1) The size of the property and its location in relation to abutting streets or highways. (2) The size and location of any existing building(s) or structure(s)that will be in operation during the course of the event and any proposed building, structure, or signs to be erected temporarily for the event. (3) The location of the stage or tents, if any. (4) The designated areas of use for spectators, exhibitors, vendors, employees and organizers. (5) Location of all entries and exits. (6) The location of all fire extinguishers and other fire safety equipment. (7) The location of all temporary utilities to be installed for the event, if any. (8) The layout of any parking area for automobiles and other vehicles and the means of ingress and egress for such parking areas. The parking spaces must allow for 300 sq. ft. per car. (9) A traffic control plan for vehicles entering and leaving the site for the proposed event. (10) Plan for the use of live outdoor music, loudspeakers and other sounds which will be used, if any, and the type and location of speakers and other audio equipment. (1 1) 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. Updated 8/7/2018 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 trite 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 cont ection with this Special Event. D ), ,;% Pri t name of Owner Signature o ner Print name of Authorized Person/Representative Signature of Authorized Person/Representative PERMISSION IS HEREBY GRANTED SUBJECT TO THE FOLLOWING CONDITIONS: 1. By acceptance of this permit, applicant agrees to adequately supervise and direct all parking to be on the premises or at another site, and to provide parking assistants and any additional traffic controls necessary for this event. Parking is strictly prohibited on ANY Town County or State Roads or Rights of Way. 2. Traffic control at events for three hundred (300) or more people shall be provided by a qualified traffic controller in accordance with the attached, approved traffic control plan. 3. One "on-premises" sign not larger than six (6) square feet in size may be displayed not longer than thirty (30) days before this event, and removed immediately after the event. Directional parking signs shall be adequately displayed. 4. Applicant indemnifies and holds harmless the Town of Southold from all claims, damages, expenses, suits and losses including but not limited to attorney's fees arising from activities under this permit. 5. Tent proposals must receive permit approval from the Southold Town Building Inspector before placement on the property and must meet all fire and safety codes. 6. This permit is valid only for the time, date, place and use specified above, and for the designated event. Each additional day will require a separate permit application, fee, and related documents for review, etc. at least 60 business days prior to the scheduled event. 7. Adequate temporary sanitary facilities must be provided by applicant for this event and applicant agrees to remove the temporary facilities from the premises within 48 hours after the day of the event. 8. On-site food preparation is NOT permitted, although food may be catered subject to all Suffolk County Department of Health regulations. 9. NO activities associated with this event including but not limited to parking ingress/egress/access, tent(s) or temporary structure(s) or temporaa sanitary facilities shall be conducted on Town of Southold Purchase of Development Rights land. Updated 8/7/2018 10. NO activities associated with this event including but not limited to parking ingress/egress/access, tent(s) or temporary structure(s) or temporary sanitary facilities shall be conducted on Suffolk County Purchase of Development Rights land without a permit issued by the Suffolk County Farmland Committee. 11. Issuance of this permit does not authorize in any manner the occupancy of any building exceeding the legal limitations under the fire code or other codes which would prohibit such increased occupancy. 12. Access shall be provided for emergency vehicles, to all public assembly areas, all buildings, all work areas and any additional area where emergencies may occur. Two emergency-fire exits and exit paths from the building(s) on the property, to a public way or remote safe area, shall remain open and unobstructed at all times. 13. Owner assures full compliance with all fire, safety, building, and other Town laws. 14. Music,when outdoors, is required to stop at the time specified in the permit.Placement of the speakers must be in a location that affords the greatest protection from noise intrusion upon adjacent properties. 15. Owner will allow access to Code Enforcement Personnel of the Town of Southold during the hours of the special event to make any and all inspections necessary in connection with this Special Event. 16. ADDITIONAL CONDITIONS: ANY VIOLATIONS IN CONNECTION WITH THE CONDITIONS LISTED HEREIN WILL TERMINATE THIS PERMIT. APPROVED Town of Southold Resolution Number: Date Issued: Updated 8/7/2018 MAIN COUNTY ROAD 48 ENTRANCE ACCESS ROAD O BORGHESE TRUCK IN PARKING MAIN BUILDING CEREMONY VINES VINES RECEPTION/ TENT LOCATION WOODED AM 7 --------fl TRAIN TRACKS SITE PLAN-BORGHESE VINEYARD JOHNSEN-CONNOLLY WEDDING SITE PLAN OCTOBER 20TH,2023 N.T.S. GUEGTs ENTER v23'-0" 60'-0" — — — ——— -�---------o-----------------o---------o--------- -------- WOOD WALL (`\ / I BACKDROP(� / I ® V ® 6'-0'X WINE BAR SEATING CHART // WOOD WALL / ll lyjl BARRTA.t D�P(11 / Y FLOOR- - - ----- -' ^�--1� ^-�1 DANCE --'1� Run C TONE / I Z) D 0 Cl j 21-0.x � D ® D ® I BAR ITE / D CD Z) I I D CD D ® I BArHxooras \ j BRIM n I lU \ I I \ 6------------------o------ -o---------o---------o--------b - - - -- - -- - -� C� WOOD WALL C� I IACKDROP(9 I I \ I I I I STRING LIGHT STRING LIGHTS- \ IOOPT STRINSS NORTH FORK \ I I I I o SHOP I � I � I � STANDTN6 HEIGHT BAR I I \ I I TABLES(8) EAT ME, TACO RLH 6 COLTIV WENTS DRINK ME ISLAND MAIN BAR PIZZA wRRAILER RECEPTION SITE LAYOUT JOHNSEN-CONNOLLY WEDDING OVERALL OCTOBER 20TH,2023 AS NOTED LIFE SAFETY DRAWING LEGEND EXIT TO THE EXTERIOR bNERATOR E----0 EXIT TRAVEL DIRECTION AND DISTANCE �[ FE 9 FIRE EXTINGUISHER TENT SUPPORT Q Y COLUMN o z n g ® ILLUMINATED EXIT SIGN i �TENi OUTLINE ITER HEATER ABp� FEATER COMMERCIAL HEATER-80K BN5 • -- - -----o------------o------------- -------- - o------------o----- ------ r 4 FE _ _ __ __ _ 5,500 WATT GENERATOR I DJC 6�_O•X q�.p" I I I I I I LIFE SAFETY NOTES �._.- ----------- i TOTAL SF:.2AOO BF TABLE I I .. 1 7A9LE 2 r - -I-------- --— ----- , I TABLE 5�� I TABLE 6 `! OCCUPANT LOAD BY TABLE 10045:2400/15= UANTS IV-O'X 21'- i 'I! OGGU�PANT LOAD BY ACTUAL COUNT= OCC130 UPANT LOAD: 160 00217A11T5 . 1 rr i �� I 1 II I I NUMBER OF EXITS REQUIRED:2 (�? " II I I I I (I�' II (I�' I NUMBER OF EXITS PROVIDED:4 r�--1� 1-_ �f I i p i r�i� p ru--�i �- j Ir-n " II �(I�(1 I F, i " p I .. II I NUMBER OF ILLUMINATED EXIT 516N5 PROVIDED:, I FE 1 56 FT TOTAL EXIT TRAVEL i 1 Q i F I NUMBER OF FIRE EXTINSUISHER5 PROVIDED:4 4 -------------------- -- --= g � 200 MAXIMUM ALLOWABLE '" i Qse • H ��i EXIT SEPARATION (1 1 "�Q � I OVERALL SSEARATIONN DISTANCE:40'-0' ` lam; , r, cF oiq I - EXIT SEPARATIOWOVERALL DISTANCE=55% dil d, t] j MAXIMUM EXIT TRAVEL DISTANCE ALLOWED: 1 fl ACTUAL MA7QMUM EXIT TRAVEL DISTANCE" I TABLE 3�� TABLE 4 j TABLE l j TABLE b j 1 NEATER I --. _.-. NOTE:ALL 6ENERATOR5 TO BE MINIMUM 1• - - q11 L------------ -------------------1 .. I II .. I Ij I 20'-0'FROM TENT ; NOTE.51DE11ALLS AND HEATERS SHALL ONLY � I I BE USED IF WEATHER REQUIRES SIDE a GROOM V-4. 1 20'-0' aL r�seTnv I It MININ9M - o------------o------------o-------------a-------- -------------- -------- --o i i FLOOR PLAN/LIFE SAFETY PLAN LS/FLOOR JOHNSEN-CONNOLLY WEDDING OCTOBER 20TH,2023 PLAN ACO CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD"YYY) `� 10/20/2023 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). PRODUCER NAME CT Danielle Flinter JSM Brokerage,Inc acNN g: (631)765-2777 1 FAAx No): Danielle Flinter E-MAIL ll aniee smbrokera ADDRESS: d@I a com g PO Box 273 INSURERS AFFORDING COVERAGE NAIC# Mattituck NY 11952 INSURER A: Lloyds Syndicate 2623 AA-112862: INSURED INSURER B: Lloyds Syndicate 623 AA-112662 Castello di Borghese LLC INSURER C: c/o Giovanni Borghese INSURER D: 17150 Middle Rd INSURER E: Cutchogue NY 11935 INSURER P: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT 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 POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICYNUMBER MM/DD MM/D LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 X CLAIMS-MADE F-1 OCCUR DAMA TO ENTE PREMISES(other than fire) $ 2,000,000 Host Liquor Liability MED EXP(Any one person) $ 5,000 A X Retail Liquor Liability Y N EH-771323-L3333638 10/20/2023 10/21/2023 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 7:29 AM 12:01 AM GENERAL AGGREGATE $ 2,000,000 POLICY❑JECOT- F—]LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: Deductible $ 1,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY AUTOS ONLY AUTOS (Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE OR ANYPROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? N/A (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) Certificate holder listed below is named as additional insured per attached CG 20 26 04 13.Attendance:150,Event Type:Bartender at an Event. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE .DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Southold AUTHORIZED REPRESENTATIVE 53095 NY-25 Danielle Flinter Southold NY 11971 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 1 Policy Number: EH-771323-L3333638 CG 20 26 (Ed. 04/13) 1 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Schedule Name of Additional Insured Person(s)or Organization(s): Town of Southold 53095 NY-25 Southold, NY 11971 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. SECTION II -WHO IS AN INSURED is amended to include as an additional insured the person(s)or organization(s) shown in the Schedule, but only with respect to liability for"bodily injury," "property damage"or"personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. in the performance of your ongoing operations; or 2. in connection with your premises owned by or rented to you. However: 1. the insurance afforded to such additional insured only applies to the extent permitted by law; and 2. if coverage provided to the Additional Insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these Additional Insureds, the following is added to SECTION III -LIMITS OF INSURANCE: If coverage provided to the Additional Insured is required by a contract or agreement, the most we will pay on behalf of the Additional Insured is the amount of insurance: 1. required by the contract or agreement; or 2. available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. © Insurance Services Office, Inc., 2012 CG 20 26 (Ed. 04/13) (Page 1 of 1) Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 10/20/23 Receipt#: 315797 Quantity Transactions Reference Subtotal 1 Event Fee BV-3 $150.00 1 Late Fee BV-3 Late $250.00 Total Paid: $400.00 Notes: Payment Type Amount Paid By CK#13599 $400.00 Borghese, Vineyard Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Borghese,Vineyard Po Box 957 Cutchogue, NY 11935 Clerk ID: DIANAF Internal ID:BV-3 Late Franke, Diana From: Franke, Diana Sent: Friday, October 20, 2023 2:10 PM To: Mirabelli, Melissa Cc: Sabrina Born (sabrina.born@town.southold.ny.us); Noncarrow, Denis Subject: Special Events: Borghese Vineyards Attachments: SpecEvent-BV.pdf Good Afternoon, Please see attached the Application for a Special Event Permit from Giovanni Borghese for Borghese Vineyards received on 10/20/2023 . Thank you, 8aF;l ra p�i-anke Account Clerk Southold Town Clerk's Office (631)765-1800 Ext 1228 i