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HomeMy WebLinkAboutSparkling Pointe 2024-36 RESOLUTION 2024-700 ADOPTED DOC ID: 20509 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2024-700 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JULY 30,2024: RESOLVED that the Town Board of the Town of Southold hereby grants permission to Sparkling Pointe, to hold Special Event 2024-36 at the Sparkling Pointe, 39750 County Road 48, Southold,New York as applied for in Application SP2a-c for weddings on 8/17/24, 10/13/24 and 10/19/2024, ending no later than I IPM. This event is approved with the following conditions: 1. All parking of vehicles for this event must be as shown on the plan submitted with the special event application. 2. Maximum number of vehicles allowed on site for this event is 58. 3. No parking for this event is permitted on land where development rights have been sold. 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 Noncarrow Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Jill Doherty, Councilwoman SECONDER:Brian O. Mealy, Councilman AYES: Doroski, Mealy, Smith, Krupski Jr, Doherty, Evans Noncarrow, Denis From: Noncarrow, Denis To: Amanda Czartosieski Subject: Special event resolution Attachments: Printout-20509-1034-M63873.doc Hi Amanda, I hope you are doing well.See attached for your special event info. Talk soon. Denis Noncarrow Southold Town Clerk. Town of Southold, New York .www.southoldtownny.g v denisn@southoldtownny.gov 631-765-1800 CONFIDENTIALITY NOTICE: This communication with its contents may contain confidential and/or legally privileged information. It is solely for the use of the intended recipient(s). Unauthorized interception, review, use or disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy Act. If you are not the intended recipient, please contact the sender and destroy,all copies of the communication. RECEIVED 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 Suffo�k 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 may be rejected or subject to a late processing fee of$250.00 by the Office of the Town Clerk, unless a waiver is obtained. Requesting an expedited review must be submitted in writing to the Town Clerk.The Town Clerk will forward all applications to the Special Events Committee for processing. The Committee will obtain comments on all applications from relevant Town, County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. The Town reserves the right to request additional information from an applicant to address issues related to the health, safety, and welfare of the community. When is a Permit Required? All Special Events, per Southold Town Code Article I, Section 205-2(Definitions)must obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits. Any use of residential prope , for profit, such as a venue for weddings or other events is prohibited. This application is deemed complete once all the following requirements are submitted to the Town Clerk: Please indicate submission of the following by checking off the boxes and signing below. A completed application form signed by the owner and the event manager. Applications without property owner's signature/approval will be rejected. FEE: Is the application being submitted at least 60 days before the event Yes No pp g Y �j � � If Yes,Fee of$ has been submitted ❑ If No,Fee of$ 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) I Tvents for three hundred (300) or more people require submission and approval of a traffic control Ilan 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 g p �Y Pp g 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 submi ed all th information required above in connection with my application. (�kted aq D 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 Please provide ALL of the information requested below.Incomplete applications WILL NOT be reviewed. > Special Event Permit# Applicant(s)name• Aft l p—�c6Vl�s Date of Submission Q L4 1 a:same of Event sl �Veldfs' Lo 1-e SCTM#'s 1000-Section 9LI Block- 0 Lot(s) Dates of Each Event: O 13 �-t-� [ l q If Multiple Dates are requested, applicant must give all information for all dates. Nature of Event:Wb4cli 1 G, S , ) l i Z 29J-C&V_ (Please attac a d a led description of EACH event to�this application) I I Time Period(Hours)of Event: From V ct r i-e to no l aj p +iAc•y\ l L Town Services requested: ( )Yes Ql�­No If yes,Describe Police Dept._Highway Dept. Describe Se es Maximum Number of Persons Attending At One Time YC1.(_k_-S Number of cars expected V Q, tS vix �S Is a Tent or other temporary,structure being used? K] Yes [ ]No If yes provide size(s) Will food be se Md? Yes /�[ ]No If yes provide number and name(s)of food vendor(s) �' GQ„ 0 4 Suffolk County permit#(s) i Will other vendors be on the premises during the p event?X ]Yes [ ]No If yes how many?V(,I�l Q SQ SDescribe Type of vendor(s),1: - r Qom, ► a, Property Owner(name/address): Q. Contact Person and Contact Tel.# �ct k/ tq—1 J e-mail address 0.'( ZQ)rlz st-C S l:�a Spcwktt'o-o Qo 1lf-e , cou rr l J. Event Location: Street-Hamlet Address: 0)0 1 Yb (ALAd �til RA S 61A_6vz d " L[ a j I SCTM# Will any services be requested [ ] Yesio. If Yes describe Police Highway Other: Mailing Address to Send Event Permit to: Updated 8/7/2018 Have any of the development rights been sod to the Town of Southold [ ] Yes [ o and/or Suffolk County Agricultural Program? [ ] Yes o If es to either or both also m to on the attached plan the boundaries of the reserve ar 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) 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. (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 Funhermore,I hereby authorize Code Enforcement Personnel of the Town of Southold to enter the property during the hours of the permitted special event tTmake and all sections necessary in connection with this Special Event. Print name of Owner 61gnature of Owner Print name of Authorized Perso epresentative atur of Aut orized Perso sentative 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 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 to parking,. in er ss/egress/access, tents 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 Updated 8/7/2018 froth 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 8n12018 SPARKLING POINTE M ETH O D E CHAMPENOISE To Whom This May Concern: Please accept this application for Special Events/Weddings to be held at Sparkling Pointe. It is our goal to obey the rules and of course be respectful of our neighbors during all events.All private events held at Sparkling Pointe will end no later than 11pm.We do not allow weddings and private events to have guests exceed our approved indoor occupancy. Please let me know if I can be of further assistance. I.can be reached any time via email at aczart6sieski@sparklingpointe.com or at the office at 631-765-0200. J OXAA� Amanda Czartosieski Private Events Manager Sparkling Pointe Vineyards and Winery 39750 COUNTY ROAD 48. SOUTHOLD, NEW YORK 11971 p. 631.765.0200 0 1=. 631.765.5264 www.sparklingpointe.com SPARKLING POINTE M E TH ODE C H A M P E N O ( S E Nature of Event Description: Sparkling Pointe holds private events and weddings on site.When applicable,.tents are set up in the back of the building. However, not all events require tents. Restrooms are contained inside of the building. During these weddings and special events,we are closed to the public.All weddings and 1-11 p va events end no later than 11pm. ands Cgartosieski Private Events Manager Sparkling Pointe Vineyards an Win ry -1000 39750 COUNTY ROAD 48. SOUTHOLD. NEW YORK 11971 p: 631.765.0200 • f. 631.765.5264 www-sparklingpointe.com We estimate 60 cars per wedding/event. We have 41 parking spaces and are able to park 10 cars on the east side of our property and up to 20 cars in the driveway to the west without blocking the flow of traffic. V. IN- .,yam`ram- / i. •`S - e+1�` , `'�• =r lei R l' a O • ron.ro wvrxar o+.r.r�t xor Gl OlCD rrlr�r(r M,rwr p OUNTY ROAD 46 •�;:xwr NORTH ROAD G •�:.�. XIST, TRY Y OQ Y _ W 0 W O`C s.sv rm rwi.a. g s•+�e p ie• o..r a of Z Q OQ EXIS ~Q, Q ENTRY AND og1 :!•. '�C� 'I o,f^f EXIT Z € I o A a 6"GA N ao' .. ovewLL 917E PLAN "'" mo a , I ITT11111111 IF p e ua6 A i sTIQ'i q. � uru ]4� � °A �..e.rr..e+w rt•im r••rra• • , P4RTIAL SITE PLAN """' """'"" ""'warn. APPROVED tY H.. ENLARGED SCALE: a• -0 �•�•° row.ora Mr.rHm r•.r sR."ra.n. SfTE PARKING CALCULATIONS T e.w."e PLAN RETAR,AMA urww"arw:a uwpa ratan OFTMG ARM ;nrrnw rRrrAfi al Oarp map Envcnm TA rn Nar ruwrlarnr aM[rT Wr T•p�71A"ROOM In raw WArA�.rnlrp P•lr tw rr.pll Rl.u•Hr d.n. o I Ok WChON Al1EA�. M�israRr � —Mrawne�.rw.raa=-�"2 Mrarnrr wwrr.mrY n. ` �u1LL.A1tl.N�.fJ•Am1Rmr�t1WH"KTa SITE PLAN APPROVAL•AMENDED 4 \ � r • • 4 44 ffJ {' ffJ/ y O IJ J�• `�; � f , � '�,r* �+•/ � a✓,�,.' �/,r;.x Alt,a►f ,+.�` r -y •` 2023 202" 4 I CREEKSIDE CATERING ; f Restaurant: La Plage p. (631) 744-9200 = laplagerestaurant@yahoo.com I 9 i " •; -Y laplagerestaurant.com t, Contact: Wayne Wadington EAST END EVENTS CATERING, INC. r J Restaurant: C)'s American Grill p. (631) 379-2070 y cjagr@optonline.net _ _ :- �_,__,�__,•_ _ { eastendeventscatering.com Contact: Chris Richards GRACE & GRIT EVENTS a" F ull Service Catering and Event Planning �• p. (631) 876-5221 riva@graceandgritevents.com graceandgritevents.com I ' Contact: Riva Weiss ' t ( - IRISH COFFEE PUB CATERING Restaurant: Irish Coffee Pub ? it D. p. (631) 277-0007 ^-" >.ti a : ?� ' �: ;_ :- I catering@irishcoffeepub.com 1 �.^fit ' .{"' �,;v irishcoffeepub.com ` . '. Contact: Stephen Mahood LOMBARDI'S LOVE LANE Lombardi's Love Lane Market C I p. (631) 298-9500 ! ! lauren@lombardicaterers.com ? lom bard islovelanemarket.com x ; Contact: Lauren Lombardi � j + PLATED SIMPLY " .',:r Full Service Catering and Event Planning p. (631) 298-7077 even ts@platedsimply I '• platedsimply.com 1 I ' Contact: Liz Werkmeister ac:very CERTIFICATE OF LIABILITY INSURANCE y 02/15/2023 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)mu st'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 endorsements. RODUCER CONTACT Matthew Daley Farm Family Insurance PHONE 631-744-3350 FAx No;631-744-3383 IAIC.,No.85 Echo Ave_Suite 2 n DR Ss: matt.daley@farm-family.com Miller Place, NY 11764 INSURERS AFFORDING COVERAGE NAIC# INSURER A: Farm Family Casualty Insurance Co. 13803 ISURED INSURER B: United Farm Family Casualty Insurance Co. 29963 Sparkling Pointe LLC/Threshold Blue LLC INSURER C 39750 County Road 48 INS URERD: INSURER E: Southold NY 11971 INSURER F :OVERAGES 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. SR TR TYPE OF INSURANCE ADDL UBR POLICPOLICY NUMBER MMIDDY EFF MMIUDO EXP LIMITS A X COMMERCIAL GENERAL LIABILITY X. 3101X7436 08/31/22 08/:31/23 EACH OCCURRENCE $. 1,000,000 DAMAGE TO RENTEIF CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ 100,000 MED EXP Any one person $ 51000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 X POLICY❑JECTT F LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ B AUTOMOBRELUIBILITY 3101C3305 08/31/22 08/31/23 E6.Wd DtsINGLEUMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person)• $ OWNED. X SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS. X HIRED X NON-OWNED PROPER DAMAGE $ AUTOS ONLY AUTOS ONLY $ A, X UMBRELLALUIB x OCCUR 3101E2535 08/31/22 08/31/23 EACH OCCURRENCE $ 10,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 10,000,000 DE D -RETENTION $ WORKERS COMPENSATION AND EMPLOYERS'U ABILITY YIN STATUTE ERA. ANYPROPRIETORIPARTNER/EXECUTIVE El N/A E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDEDI (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If es,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ -ESCRIPTION.OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more spate Is required) 'HE TOWN OF SOUTHOLD IS LISTED AS AN ADDITIONAL INSURED ON POLICY 3101X7436. :ERTIFICATE HOLDER CANCELLATION. TOWN OF SOUTHOLD 53095 ROUTE 25 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE SOUTHOLD, NY 11971 THE EXPIRATION' DATE THEREOF, NOTICE WILL BE DELIVERED' IN' ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserver Noncarrow, Denis To: Amanda Czartosieski Cc: Sabrina Born (sabrina.born@town.southold.ny.us); Mudd,Jennifer; Paul D;Johnson, Benjamin Subject: Emailing: hold harmless Attachments: hold harmless.pdf HI Amanda, I hope you are doing well.We need this agreement attached signed and we need the insurance certificate to be 2 million for each occurrence. Any questions please give us a call.We will hold this off to the side till we get these documents. Thank you Denis Noncarrow Southold Town Clerk. Town of Southold, New York www.southoldtownny.gov denisn@southoldtownny.gov 631-765-1800 CONFIDENTIALITY NOTICE:This communication with its contents may contain confidential and/or legally privileged information. It is solely for the use of the intended recipient(s). Unauthorized interception, review, use or disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy Act. If you are not the intended recipient, please contact the sender and destroy all copies of the communication. Your message is ready to be sent with the following file or link attachments: hold harmless 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 HOLD HARMLESS AGREEMENT The applicant of this Special Permit shall defend, indemnify and hold harmless the Town of 1 ! Southold, its officers, employees, and representatives from and against any-and all damages, I , ! liability,judgments, losses, and expenses, including but not limited to attorney's fees, including damages arising from injuries or death of persons and damage to property which arise from or are connected with the event in question, or caused by the negligent misconduct, and/or omissions under this Agreement and that of applicant's agents, servants and/or employees. If this Agreement is being executed in a representative capacity,the individual executing this Agreement hereby represents that this action has been authorized. Dated: Sworn to before me this Day of ,20 l f Noncarrow, Denis To: Schroeder, Gwynn Cc: . Sabrina Born (sabrina.born@town.southold.ny.us); Mudd,Jennifer; Franke, Diana; Norklun, Stacey;Johnson, Benjamin; Paul D Subject: Special event/Sparkling point Attachments: Sparkling point_20240617094800.pdf Denis Noncarrow Southold Town Clerk. Town of Southold, New York www.southoldtownnv.aov denisn @southoldtownnv.gov 631-765-1800 CONFIDENTIALITY NOTICE: This communication with its contents may contain confidential and/or legally privileged information. It is solely for the use of the intended recipient(s). Unauthorized interception, review, use or disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy Act. If you are not the intended recipient, please contact the sender and destroy all copies of the communication. Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 06/17/24 Receipt#: 330663 Quantity Transactions Reference Subtotal 1 Event Fee SP 2a-c $150.00 Total Paid: $150.00 Notes: Payment Type Amount Paid By CK#6791 $150.00 Sparkling, Pointe L L C Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Sparkling, Pointe L L C 39750 Cr 48 Southold, NY 11971 Clerk ID: DENISN Internal ID:SP 2a-c R GEIVED JUN 2 6 2024 HOLD HARMLESS AGREEMENT Southold Town Clerk The applicant of this Special Permit shall defend, indemnify and hold harmless the Town of Southold, its officers, employees, and representatives from and against any and all damages, liability,judgments, losses, and expenses, including but not limited to attorney's fees, including damages arising from injuries or death of persons and damage to property which arise from or are connected with the event in question, or caused by the negligent misconduct, and/or omissions under this Agreement and that of applicant's agents, servants and/or employees. If this Agreement is being executed in a representative capacity,the individual executing this Agreement hereby represents that this action has been authorized. Dated: 612c(�Zoycl G CAROLINE M MACARTHUR Notary Public-state of New York NO.01MA6384635 Qualified in Suffolk county My commission Expires Dec 17,2026 Sworn to before me this A J Day of J UN 6- l ® DATE(MM/DDYYYY) A�"' CERTIFICATE OF LIABILITY INSURANCE 06/19/2024 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 WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Matthew Daley Farm Family Insurance AHCN No, Ext: 631-744-3350 M No:631-744-3383 E-M85 Echo Ave-Suite 2 ADDRESS: matt.daley@farm-family.com Miller Place, NY 11764 INSURERS AFFORDING COVERAGE NAIC# INSURERA: Farm Family Casualty Insurance Co. 13803 INSURED INSURER B: United Farm Family Casualty Insurance Co. 29963 Sparkling Pointe LLC/Threshold Blue LLC INSURER C: 39750 County Road 48 INSURER D: INSURER E Southold NY 11971 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 ADDLTYPE OF INSURANCE I=SUER POLICY NUMBER MM DDNYYY MM POLICY EFF POLICY EXP LTR /DD YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X 3101X7436 08/31/23 08/31/24 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �X OCCUR 08/31/24 08/31/25 PAMAGE TO RENTEU__ REMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑ JEo LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY 3101 C3305 08/31/23 08/31/24 O BINEDtSINGLE LIMIT $ 1,000,000 (EaANY AUTO 08/31/24 08/31/25 BODILY INJURY(Per person) $ OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY Per accident $ A X UMBRELLA LIAB X OCCUR 3101 E2535 08/31/23 08/31/24 EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS-MADE 08/31/24 08/31/25 AGGREGATE $ 10,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I I ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? 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,maybe attached If more space Is required) Event dates: 8/17/24, 10/13/24,10/19/24 The Town of Southold is listed as additional insured for general liability on Policy 3101 X7436. CERTIFICATE HOLDER CANCELLATION TOWN OF SOUTHOLD 53095 ROUTE 25 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE SOUTHOLD, NY 11971 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD