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HomeMy WebLinkAboutPeconic Comm. School Harvest Festival Franke, Diana From: Franke, Diana Sent: Tuesday, October 15, 2024 9:18 AM To: Schroeder, Gwynn Cc: Born, Sabrina; Mudd,Jennifer; Noncarrow, Denis; Norklun, Stacey Subject: Specia Event: Peconic Community School Attachments: SpecEvPCS-4a.pdf Importance: High Good Morning Gwynn, Please see attached the Application for a Special Event Permit fromt a&Ca mu it h2"UW received on 10/15/2024. Thank you, Account Clerk Southold Town Clerk's Office (631)765-1800 Ext 1228 BLS PCs _qC2 .ate RECEIVED 15 294 ,ar 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 er 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 encouraged to submit applications as early as possible. Any completed application that is not submitted 60 or more-hiLLsiness days prior to the scheduled event may be rejected or subiect to a late processing fee o $250.00 v the Office of the Town Clerk, unless a waiver is obtained. Requesting an expedited review must be submitted in writing to the Town Clerk. The Town Clerk will forward all applications to the Special Events Committee for processing. The Committee will obtain comments on all applications from relevant Town, County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. The Town reserves the right to request additional infonnation from an applicant to address issues related to the health, safety, and welfare of the community. When is a Permit Required? All Special Events, per Southold Town Code Article I, Section 205-2 (Definitions)must obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits. Any use of residential property for profit such as a venue for weddings or other events is prohibited. This application is deemed complete once all the following requirements are submitted to the Town Clerk: Please indicate submission of the following by checking off the boxes and si$!nin2 below. 14 A completed application form signed by the owner and the event manager. Applications without property owner's signature/approval will be rejected. (((( EE: Is the application being submitted at least 60 days before the event [ ] Yes1]No ❑ If Yes, Fee of$ has been submitted "k If No, Fee of has been submitted Updated 8/7/2018 6 he 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 Parking/Event Plan: consisting of a survey, site plan and/or aerial view of the subject property that incJude s the locations of on-site parking, sanitary facilities, and tents or other temporary structure(s). (See application form for details) )d 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. VV-A Dated Signature Activities associated with outdoor public events are strictly prohibited from taking place on land preserved through the sale of development rights to the Town of Southold, and can only take place on land preserved through the sale of development rights to tite 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. C Special Event Permit# Applicant(s) name:9-TEPAPN\�^b c7 " Date of Submission l b 2i Name of Event PAS i7a1yr�l— SCTM Ws 1000-Section , _Block- Lot(s) Dates of Each Event: ocj If Multiple Dates are requested, applicant must give all information for all dates. Nature of Event: (Please attach a detailed description of EACH event to this application) Time Period (Hours) of Event: From I pm to 4pvv,.% Town Services requested: ( ) Yes X No If yes,Describe Police Dept._Highway Dept. Describe Services Maximum Number of Persons Attending At One Time: _Number of cars expected Is a Tent or other temporary structure being used? [ ] Yes [A No If yes provide size(s) Will food be served? [ ] Yes '*X 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 [ No If yes how many? Describe Type of vendor(s) Property Owner(name/address): Contact Person and Contact Tel.# e-mail address Updated 8/7/2018 Event Location: Street-Hamlet Address: Q1C' Corimn�� S��� 2 (46S MA o's C_UTt1 Q'Gl )�SCTM# Will any services be requested [ ] Yes "$A No. If Yes describe Police Highway Other: Mailing Address to Send Event Permit to: 27)(�s mw w )2j) Have any of the development rights been s°'�d to the Town of Southold [ ] Yes [ No and/or Suffolk County Agricultural Program? [ ] Yes L)q.No If yes to either or both, also indicate on the attached plan the boundaries of the reserved area upon which the event will take place. YOU MUST ATTACH A PARKING/EVENT PLAN TO THIS APPLICATION IF THE EXPECTED ATTENDANCE IS 300 OR MORE PEOPLE,YOU MUST ALSO ATTACH A TRAFFIC CONTROL PLAN (see next page) A Parking/Event Plan may be a survey, site plan and/or aerial view (for example Google Earth) 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. 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 true and correct to the best of my knowledge, and agree to provide notice to the Town immediately should there be any material changes regarding to this application. . Furthermore,I hereby authorize Code Enforcement Personnel of the Town of Southold to enter the property during the hours of the permitted special event to make any and all inspections necessary in connection with this Special Event. Print name Of Owner 0 Si ure of Owner Print name of Authorized Person/Representative S�gne of Authorize up rson/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 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 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 HOLD HARMLESS AGREEMENT The applicant �cmu, %v p � 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 or events authorized by resolution of the Town Board of the Town of Southold, 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: Signature: vt-( . Name: ,Authorized Agent C 1 On behalf of: (Name of Business Entity) Dates of event(s): Sworn to before ? S ---- Day of DIANA FRANK NOTARY PUBLIC,STATE OF NEW YORK Registration No.05FR6288691 QEIWft in Suffolk County My Co LwJon n Expires September 09,20 Peconic Community School Grateful Harvest Festival Sunday, October 20th,20241-4pm Parldng/Event Plant (1) - (5)See attached Site Plan (2) Fire extinguishers are located along the hallway,in basement and the hallways of the second floor.Every classroom contains smoke detectors and a voice fire alarm system is installed inside the building. (3) See attached, temporary bathrooms will be provided (4) Parking will be in the lot,as well as along Griffing Street and the Main Road.Parking spaces meet the 300 sq ft. per car requirement (5) Traffic Control Plan. (a) Around 100 vehicles are expected for this event, coming and going through the event time A qualified parking attendant(PCS Security Guard)will direct traffic flow in and out of the school parking lot.This individual will be stationed in the middle of the school parking lot.Entrances and exits will be clearly marked with signage,and the security guard will assist with flow of traffic. (b) PCS can be reached at 631-734-8290 (6) Live music and speakers will be set Up in the stage/performance area (7) Emergency access is via 3 entrances/exits on the school property.Within the building all exits are clearly 1 marked as per local fire code (8) PCS has a dumpster provided by Mattituck Environmental. (9) No additional lighting will be utilized (10)Bathrooms are accessible in the school building,additional portable toilets will be on site as well(marked on site plan) Event Description: A local band will play music.Activities include pumpkin painting,tie-dying tshirts,a clothing sale,and open play. -, . . � � - ,, �, .. ., � ,- �.%- jar�q '�• , /; ;i,,!' �{?,. .;\ ram. `�' ;i� ,�!/; •; lit i i s e i f i \ AP. : �� ` ti . . PECOCOM-01 VGEORGE ACORO� CERTIFICATE OF LIABILITY INSURANCE [__�ATEJMMIDDJYYYY) 10111202 10/ 1/2024 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: Neefus Stype Agency PHONE 711 Union Ave. (A/C,No,Ext):(631)722-3500 FAX No):(631)722-3591 Aquebogue,NY 11931 E-MAIL SS:info@nsainsure.com INSURERS AFFORDING COVERAGE NAIC p INSURER A:Philadelphia Indemnity Ins Co 18058 INSURED INSURER B: Peconic Community School INSURER C: PO Box 273 INSURER D: Aquebogue,NY 11931 INSURER E: 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 TYPE OF INSURANCE ADS L SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR DIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PHPK2601217 9/10/2024 9/10/2025 DAMAGE TO RENTED 100,000 X PREMISES Ea occurrence $ MED EXP(Any oneperson) S 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 3,000,000 X POLICY ZCT LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY PerPerson) $ OWNED SCHEDULED AUTOS ONLY AUTOS SSW BODILY INJURY Per accident S AUTOS ONLY AUOTOS ONS PROPER aCcdent SAGE $ $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LIAR CLAIMS-MADE PHUB881184. 9/10/2024 9/10/2025 AGGREGATE $ DED I X I RETENTION$ 10,000 Gen aggregate $ 2,000,000 WORKERS COMPENSATION OTH- AND EMPLOYERS'LIABILITY Y/N SPTER AT UTE I I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Event Date: October 20,2024-Grateful Harvest from 1-4 Town of Southold is listed as additional insured in respect to general liability per written contract. 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 Town f Souute h ACCORDANCE WITH THE POLICY PROVISIONS. Southold,NY 11971 AUTHORIZED ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 10/15/24 Receipt#: 335507 Quantity Transactions Reference Subtotal 1 Event Fee PCS-4a $150.00 1 Late Fee PCS-4a-Late $250.00 Total Paid: $400.00 Notes: Payment Type Amount Paid By CK#406 $400.00 Peconic, Community School Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Peconic, Community School PO Box 273 Aquebogue, NY 11931 Clerk ID: DIANAF Internal ID:PCS-4a-Late Noncarrow, Denis To: Johnson, Benjamin Cc: Sabrina Born (sabrina.born@town.southold.ny.us); Mudd,Jennifer; Norklun, Stacey Subject: Special event question HI Ben I know Gwynn spoke to you about a SEP that Peconic Community School sent in 5 days before the.event. How do we resolve this as we did take a check. It was sent around but not enough time. I think Gwynn said you were going to put a resolution on about this. Thank you Denis Noncarrow Southold Town Clerk. Town of Southold, New York www.southoldtownny.gov denisn @southoldtownn y.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. 1