HomeMy WebLinkAboutBetty's Boutique ��gUFfOF,f` RESOLUTION 2024-409
ADOPTED DOC ID: 20221
THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2024-409 WAS
ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON
MAY 7, 2024:
RESOLVED that the Town Board of the Town of Southold hereby authorizes a refund in the
amount of$150.00 to Marje and David Ames, on behalf of Betty's Boutique, 15900 Main Road,
Mattituck,NY 11952, for a Special Event fee that is not required under Town Code §205-3B(3).
Denis Noncarrow
Southold Town Clerk
RESULT: ADOPTED [UNANIMOUS]
MOVER: Greg Doroski, Councilman
SECONDER:Brian O. Mealy, Councilman
AYES: Doroski, Mealy, Smith, Krupski Jr, Doherty, Evans
Permit#:
TC Checklist for Special Events (Farms/Wineries/Private Events)
Applicant Name: C,_J 1M-C 4- l S t t C&
Date Received: _l ^ I I L Number of Events on Application:
(max of 6 per application) 12q
q
completed)
Application(all 6 pages p )
Fees to be collected:
✓Application fee($150.00)
Late Application fee($250.00-if application is received less than 60 days)
✓Current Certificate of Ins.
✓ Application sent for approvals to the following people: /
✓Gwynn Schroeder ✓Denis Noncarrow ✓ Stacey Norklun
After emailing application and all applicable paperwork to the people above, put application in
`pink' pending folder.
Mudd, Jennifer
From: Mudd,Jennifer
Sent: Friday,April 19, 2024 12:55 PM
To: Norklun, Stacey; Schroeder, Gwynn; Stype,John
Cc: Noncarrow, Denis; Born, Sabrina
Subject: Special Event Application (Betty's Boutique Yard Sale Fundraiser)
Attachments: Betty's Boutique Yard Sale Fundraiser.pdf
Good Afternoon,
Please see attached special event application from Marja Ames for `Betty's Boutique Yard Sale Fundraiser' for
NFAWL.
Thank you,
_Jew
Jennifer M. Mudd
Sub-Registrar and Deputy Town Clerk
Account Clerk
Southold Town Clerk's Office
53095 Route 25
P.O.Box 1179
Southold,NY 11971
Phone: 631-765-1800 ext. 1274
Fax: 631-765-6145
1
RECEIVED
APR 19 2024 � '�
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 application-s must be submitted at least 60 business days before the event. Applicants
are encouraged to submit applications as early as possible. -
Any completed application that is not submitted 60 or more business days prior to the scheduled
event may be rejected or subieet to a late processing fee of$250.00 by the Office of the Town Clerk,
unless a waiver is obtained. Requesting an expedited review must be submitted in writing to the Town
Clerk. The Town Clerk will forward all applications to the Special Events Committee for processing.
The Committee will obtain comments on all applications from relevant-Town, County amd/or State
agencies and will forward completed applications to the Town Board with a recommendation as to
whether to grant or deny the application.
The Town reserves the right to request additional informatjibn from an applicant to address issues related
to the health, safety, and welfare of the community.
When is a Permit Required?
All Special Events, per Southold Town Code Article I, Section 205-2 (Definitions)must obtain a permit.
Occasional events on private residential properties hosted by the owner thereof that are by invitation such
as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits.
Any use of residential ropei for profit such as a venue for weddings or other events is prohibited.
This application is deemed complete once all the following requirements are submitted to the Town
Clerlix Please indicate submission of the followin by checkinp, off the boxes and signink below.
A completed application form signed by the owner and the event manager. . Applications without
p- perty owner's signature/approval will be rejected.
FT FE . Is the application being submitted at least 60 days before the'event ] Yes [ ]No
If Yes, Fee of$ S has been submitted
❑ If No, Fee of$ has been submitted
Updated 8/7J2018
rlThe 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
�Ian acceptable to the Town of Southold AND a qualified traffic controller must be provided at the
ent. (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.
-�)—`
2a'
Dated Signa ur
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.
i
Updated 8/7/2018
1rZZ ®
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:
Date of Submission Name of Event c Yrif i w5e
SCTM#'s I000-Section' �Block- Lot(s)
I/j J'=�"- I/P-1 in, I ll'-w1A)�1-
Dates of Each Even t°-
If Multiple Dates are requested, pplicant must give allinformation r all dates.
Nature of Event: ��4���� � i,��1� For-
__T_
(Please attach a detailed description of EACH event to this application)
Time Period (Hours) of Event: From qaimto m
Town Services requested: ( ) Yes (,-)No If yes,Describe Police Dept._Highway Dept.
Describe Services
Maximum Number of Persons Attending At One Time: - umber of cars expected n
Is a Tent or other temporary structure being used? [ ] Yes [i]'�Io If yes provide size(s)
Will food be served? [ ] Yes L..-no If yes provide number and name(s)of food vendor(s)
Suffolk County permit# (s)
Will other vendors be on the premises during the event? [ ] Yes [hNo If yes how many? Describe
Type of vendor(s)
I bacc. Moe t act .
Property Owner(name/address): + f7h U 1�i
I
Contact Person and Contact Tel ft
e-mail address C (7Q
Updated 8/7/2018
• Event Location: Street-Hamlet Address:i �� Main 4�1
SCTM#
Will any services be requested [ ]Yes L J-1Go. If Yes describe Police Highway Other:
Mailing Address to Send Event Permit to: non /
Have any of the development rights been sold to the Town of Southold [ ] Yes [r} e and/or Suffolk
County Agricultural Program? [ ] Yes f j]T,�o 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 ATTENDANCF 00 OR MORE PEOPLE YOU MUST ALSO ATTACH A
TRAFFIC CONTROMTAN see next a e
A Parkin /Event Plan may be s�ey, e plan and/or aerial view for example Goo le Earth of
the subject Property. IND146ATE ON THE PLAN ALL of the following information:
A parking/event plan sho ing:
(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.
(l 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 requi mission and approval of a traffic control
plan, acceptable to the Town of Southold. AND a ified traffic controller must be provided. Please
attached a written description and/or nota n the parking event plan the following: 1)Who will be
conducting traffic, 2) Where they w' e stationed on site, 3) How they will direct the entrance,
circulation, parking, and exitin 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 he 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 herehy swear or affirfn 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 he any material changes regarding
to this application. .
Furthermore,I herehy 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.
6
Print nam o Owner n ur caner
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 des 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 structures) or temporary 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 temporat�- structures) 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
ClienW:13133 AMEDA
ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMJDDJYYYY)
03/26/2024
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 WANED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on
this certificate does not confer any rights to the certificate holder In lieu of such endorsement(s).
PRODUCER tk(A)ANTEA:cT Heather M.MacPherson
FAX
Am AfC aden Gay Agencies,Inc. PHONE 631 324-0041 Afc No.631 32"671
No Ert
11 Gay Road ; HMacpherson a&madengay.com
P.O.Box 5004 INSURER(s AFFORDING COVERAGE NALCB
East Hampton,NY 11937 INSURER A:Privilege Underwriters Reciprocal Exch 12873
INSURED -INSURERS:
Mr.David Ames INSURERC:
Mrs.Marja Ames INSURERD:
15900 Main Road INSURERE:
Mattituck,NY 11952 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 POLICY POLICYEXP UMfrs
IN R TYPE OF INSURANCE I D U POLICY NUMBER MMJDD D
A COMMERCIAL GENERAL LIABILITY H0233563702 D8111812023 08118/2024 EEAgCMHp�OECCTURRRENCE $1 000 000
CLAIMS-MADE OCCUR PREMISES Ea Errente $
X Personal Liab. MED EXP(Any one person) $10 000
hGEN'
Medical Paymnts PERSONAL&ADV INJURY s
LAGGREGATELIMITAPPLIESPER: GENERAL AGGREGATE S
PRO- PRODUCTS-COMP/OPAGG $
POLICY El JECT LOG
$
OTHER
COMBINED SINGLE LIMIT
AUTOMOBILE LUIBILITY Fa accident
BODILY INJURY(Perperson) S
ANY AUTO
W OS ONLY SCHEDULED
SC PULED BODILY INJURY(Per accident) $
HIRED NON-OWNED PROPERTY DAMAGE S
AUTOS ONLY AUTOS ONLY Per ecddeM
S
A UMBRE I A LIAR X OCCUR EX233664102 D811812023 0811812024EACH OCCURRENCE $5 000 000
EXCESS UAB CLAIMS-MADE AGGREGATE S
DEO I I RETENTIONS
WORKERS COMPENSATION ISMITE
PER
AND EMPLOYERS'LIABILITY
ANY PROPRIETORJPARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT S
NIA
OFFICERIMEMBEREXCLUDED?
(Mandatory in NH) EL DISEASE-EA EMPLOYEE $
If yes,describe under E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OFOPERATIONS belay
DESCRIPTION OF OPERATIONS/LOCATIOOIS/VFJIICLFS(ACORD 901,Addrt[onal Remarks schedule,may be allached ff more space Is requited)
16900 Main Road,Matfibuck,NY 11952
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Town of Southold THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
AUTHORIZED REPRESENTATIVE
'61998-3019 ACORD CORPORATION.All rights reserved.
ACORD 25(2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD
..--- ----- --- HXM
Town of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Date: 04/19/24 Receipt#: 325894
Quantity Transactions Reference Subtotal
1 Event Fee BBYS1a-f $150.00
Total Paid: $150.00
Notes:
Payment Type Amount Paid By
CASH $150.00 Betty's Boutique, Yard Sale
Fundraiser
Southold Town Clerk's Office
53095 Main Road, PO Box 1179
Southold, NY 11971
n
Name: Betty's Boutique, Yard,Sale Fundraiser
Ames, Marja & David
.15900 Main Road
Mattituck, NY 11952
Clerk ID: JENNIFER Internal ID: BBYS1a-f