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HomeMy WebLinkAboutOysterponds Historical Society -- RECEIVED APPLICATION FOR A PERMIT TO HOLD A JUN - 4 VA SPECIAL EVENT touthold Town Clerk Please provide ALL of the Inforlhation requested beloly.inconiffle-te aal)nlications WILL NOT be reviewed, Special Event Permit V Applicant(s)name:Q,%rMpfa•S J Date of Submission rJ 3 a. Name of Event (jAS Su f'e t1QJA- SCTM#E's 1000-Section . Block- Lot(s) �3 Dates of Each Event: F513 a _ If Multiple Dates are requested,applicant must give all information for all dates. Nature of Event: \A'r\ALAXX` StAm me r' ' _ n e F4 (Please attach a detailed description of EACH event to this application) Time Period(Hours)of Event: From Jr , to O Town Services requested: ( )Yes (f\No If yes,Describe Police Dept. Highway Dept. Describe Services +� Maximum Number of Persons Attending At One Time:oa 5 30o Number of cars expected J Is a*Tent or other temporary structure being used? ]Yes[ ]No If yes provide sizes) So,NA 11 q , to k to 3®xL+5 Will food be served?[ ]Yes [ ]No If yes provide number and name(s)of food vendor(s) r,,V_,a rA S LOYe Law 11%\ 10•- Suffolk County permit#(s) Will other vendors boon the premises during the event?[)(]Yes [ ]No If yes how many? Describe j TiType (s) -'�c�-e' Sir VC-0— 1 e of vendor Property Owner(name/address):O Vls C-ROMS 1A lS Prl C�b St�,t� 11555 V i I kcx t LQ (� Contact Person and Contact Tel.# e-mail address_O rq\CC OZ.') Q\rN%n_\A Event Location:Street-Hamlet Address:3�QV ix+LkC)r— (xt-)g — 1555 V 010.oC LC1r12., Clf'tn+ N Ora ^ 13• i Will any services be requested [ ]Yes ] No. If Yes describe Police Highway Other: i I Mailing Address to Send Event Permit to: (SU S kks kor l'a't SC�•a.4.�-t t Updated 8/7I2018 DENTS NONCARROW Town Hall,63096 Main Road TOWN CLERK P.O.Box 1179 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS s. _ Fax(631)766-6145 MARRIAGE OFFICER ' �, Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER .t+'$ www southoldtownnygov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION FOR A PERMIT TO HOLD A SPECIAL.EVI NT Please Provide ALL of the information requested Velow:Inco►iplete annlications WILL NOT be reviewed. Date of.Submission J u f1 e! Name of Event 0 � 1 0�_2O Q_D S VAS 1 O g-1 C A-t_ScL 1(=_� Name of Organization: 0.H. S Is this a Not-For-Profit Event es o Contact's Name: S 5 A- C-1 0_0C-1,1 E L-T> Mailing Address: ��j 1�� � C��t�V� Q Y 1 tiQ 5� Contact's Phone Number:" J �j 2--�j ;11 Contact's Email Address: 0,k 5 N y �� Event Location and Site Diagram: P 6&1�ATQ-1e_- A-rM I SSS V I LLAG G, (Use additional paper if necessary) Event Date(s); A V\G U ST 2, 2-0 2-5 (Include set up and shutdown times and dates) Nature of Event: �'�� � 5� (Please attach a detailed description to this application) Time Period(Hours)of Event: From M to Q P Maximum Number of Expected Attendees: q Specify any special requirements(i.e. road closure,police presence): 1��' s 4 If a Tent or other temporary structure will be used please contact the Southold Town Building Department at 631-765-1802 Mailing Address to Send Event Permit to; O kA 0AX I PIN1 �k �� 11�15�- Event Fees: $250 for events with less than 1000 expected attendees $500 for events with 1000 or more expected.attendees Clean-up Fees(Can NOT be waived): $1,500.00 Clean-up for Bicycle and/or Running Special events(ONLY) $250 or more Clean-up deposit all other events CERTIFICATE OF"INSURANCE RET 0W.1xT+�D: Not less than$2,000,000 naming the Town of Southold as an additional insured. ***NOTE: PLEASE SEE ATTACHED REVISED,ADOPTED.TOWN. POLICY*-** Additional information and requirements may be required as deemed necessary by the Town Board. Print name of Authorized Person filling out Signature of Authorized Person filling out application application *Upon the request by applicant,the Town Board may waive in whole or in part any of the application requirements. 2 HOLD HARMLESS AGREEMENT The applicant 3 J5 i EP-ION?S FhSTa2i tAL- of this Special Permit shall defend, soc\tom 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: Name: ,Authorized Agent On behalf of: l L(L 90Iv 5 NZS i c (Name of Business Entity) f Dates of event(s): Sworn to before me this Day of ,20 - s Noncarrow, Denis From: Maria McBride <mariamcbride.northfork@gmail.com> Sent: Monday,June 2, 2025 8:18 AM To: Noncarrow, Denis Subject: Oysterponds application to reveiw, Eent date 8/2/25 Attachments: ohs2025 event permit 2025-06-02_074938.pdf Great to say hello and thanks for looking this application over before we finalize, sign and drop off later today. I left a couple of blanks on the application because I want to confirm# of guests expected with OHS, usually about 300 We are securing the COI for 2m Thank you, Maria McBride mobile: 212-689-8798 Event date: Aug 2,Spm-7:30pm . yHm i _ -sg4a4 1 2 � M f e. ATTENTION: This email came from an external source. Do not open attachments or click on links from unknown senders or unexpected emails. i e K4cm C E R�f'HE) o�,1�e4�FFO�,���G JUN - 2 2025 ®�� • o�� Southold Tor;.,>fn Cfir' s TOWN OF SOUTHOLD Town Code Chanter 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,Police Department, Government Liaison Officer,and Suffolk County Planning. Application fees: Special Events of the same type: $300 for an initial,master application and the first event.Each subsequent event of the same type, up to(or unlimited or limited to)(x?)events, requires a fee of$50. All special events require a one-page addendum including the specifics of each individual event. Different types of events require a separate and complete initial,master application. All applications must be submitted at least 60 business days prior to the event.Applicants are encouraged to submit applications as early as possible.Any application submitted between 59 and 30 days before the event will be charged an additional $500 late fee. Any application submitted between 29 and 14 days will be charged a$1000 late fee.Late fees will also apply to late event addenda. PLEASE NOTE: NO APPLICATIONS WILL BE ACCEPTED WITHIN 14 DAYS BEFORE THE SPECIAL EVENT DATE. IMCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED. The Committee will obtain comments on all applications from relevant Town,County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. The Town reserves the right to request additional information from an applicant to address issues related to the health,safety,and welfare of the community. When is a Permit Required? All Special Events,per Southold Town Code Article I,Section 205-2 (Definitions)must obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings,weddings,graduations,parties or not-for-profit fundraisers do not require permits. AM use of residential property for profit,such as a venue for weddings or other events is prohibited. 1 This application is deemed complete once all the following requirements are submitted to the Town Clerk: Please indicate submission of the following by checking off the boxes and signing below dA completed application form signed by the owner and the event manager. Applications without property owner's signature/approval will be rejected. ❑ FEE: Is the application being submitted at least 60 days before the event[ ]Yes [ ]No ❑ If Yes,Fee of$ has been submitted ❑ If No,Fee of$ has been submitted E 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 signed and notarized Hold Harmless Agreement naming Southold Town ❑ An up-to-date Certificate of Compliance issued by the Southold Town Fire Marshall or the Town Building Department ❑ A valid Certificate of Occupancy in all buildings used during the special event. N - I - �S n . A Parkin vent Plan: consisting g 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) F/Signature of Property Owner on the application authorizing Code Enforcement Personnel of the Town of Southold to enter the subject premises during the hours of the event to ensure compliance with any and all special event permit conditions. My signature below affirms that I have submitted all the information required above in connection with my application. Dated Signature Activities associated with outdoor public events are strictly prohibited from taking place on land preserved through the sale of development rights to the Town of Southold, and can only take place on land preserved through the sale of development rights to the County of Suffolk with a permit issued by the Suffolk County Farmland Committee. If food is to be served, it must be catered and prepared off-site by food vendors who hold a permit to operate issued by the Suffolk County Bureau of Public Health Food Protection Unit. 2 MASTER APPLICATION FOR A PERMIT TO HOLD A SPECIAL EVENT PLEASE PROVIDE ALL OF THE INFORMATION REQUESTED BELOW INCONIPETE APPLICATIONS WILL NOT BE ACCEPTED FOR INTERNAL USE ONLY Special Event Master Permit#: Date of Submission: 2 - 202 Applicant's Name&Title: eiy 4 1 �ac r Applicant's Phone:����_"jZ.�7 �.�gjt� Email: V w Property Owner(if different from above): Owner Phone: Email: QQ Contact Person(if different from above): Contact Phone: _ Email: ex. ��U1 Event Venue:p�J k 1 U LY, 2 1?!�ZY— ,� Venue Address: 15 7 b 5 �r� �, (1tu� Hamlet ��i�'_Ini E�-Y O_ SCTM#'s 1000-Section_ Block Lot(s) Name of Event(s) 5u ()-\m b�/{��.��" Type of Event(s): A-` 11 1 u i5k-k —(�j (Please complete one addendum below for each individual event) Date(s)of Event(s): Am,,, 2, 20 2r:�> Is there an approved site plan for the event venue?Yes [VNo [ ] Maximum Number of Persons Attending at One Time/(including staff):'�""i d� Max#of Cars Expected at Any One Time: � `� S� 00 V 1(Arl! Is a tent or other temporary structure being used?Yes-f e]No [ ] If yes,provide of tent provide size(s): j l yOUL 'SC-ONWE -MN-5- Zo 3cp Have any of the development rights been sold to the Town of Southold[ ] Yes [✓f No and/or Suffolk County Agricultural Program? [ ]Yes [I]'No If yes to either or both,also indicate on the attached plan the boundaries of the reserved area upon which the event will take place Is this event being held to benefit a charitable organization?Yes [✓10No[ ] If yes,you may b eligible to request a waiver of the special event fee,with the submission of verification and a written request.withs application. Mailing Address to-Send-Event Permit to: TO CJQ k G{`}'` 3 O1jSTE2(-bN-� S SPECIAL EVENT APPLICATION ADDENDUM Please complete one form for each event Applicant/Venue: Date of Event: ' 7i07i5 Master Permit#(if previously issued) Start Time: 5 P (y) End Time: 730 Is this special event consistent with the Master Application submitted/approved for this type of event?For example, does this event comply with the initial par ' g plan,maximum number of attendees,and the size and placement of tent(s)applied for or approved? Yes [VNo [ ].If no,what amendments to the permit are being requested? Will food be served?[ees [ ]No If yes,provide following: `_ 2 Vendor Name: -dd�110011S t'I-e_LAA p Suffolk County permit#: 1 J�� Vendor Name: Suffolk County permit#: Will outside vendors be serving alcohol?[✓Yes [ ]No If yes,provide: Vendor Name A e: �5 PeA-- � jA• • iqu1FLicense# q 12 J Vendor Contact Name: `1 Cell Phone: j � 73 Will non-food/alcohol vendors be on the premises during the event? [ ]Yes g***No If yes,provide: Describe type of vendor(s) Number of vendors: Day of Event Contact Person: I'` "_1fa_- ��9 Cl� Phone: Z1 Z (0 b T E-mail address (print clearly)_C"F-1 'CA-J���1( y kV n`r ►V1�ZN -CRa Will any Southold Town services be requested [] Yes(Describe below) [ Police Highway Other Will a security company be used for any of the events? [ ]Yes [vl'N* o.If yes,provide the following:name, address and cell number of the security company which will work on the premises, and a description of the duties to be performed: Security Company: Contact Name: Cell Phone: Duties to be performed: Please use additional pages if more are needed. 4 YOU MUST ATTACH A PARKING/EVENT PLAN TO THE MASTER 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. 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, 5 ltrrthermore,I hereby authorize Code E'rrforcement Personnel of the Totten ofSotithold to enter the proper(p during the hours of the permitter!special event to Jnetke any and till inspections necessary in connection yvith this Special Event. Print name of Owner Signature of Owner Print name of Authorized Person/Representative Signature of Authorized Person/Representative PERMISSION IS H i REDYGRANTEDo SUBJE,CT TO THE FOLLOWING OWING ONDITION'S; 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. Parkingis strict Lprohibited on ANY Town, County or State Roane or Rights qof 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 i 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 1�ut not 16ited to 412dking, ingress/egress/access, tent(s)or temporary a ►u• ur (s), or t inporaiy sanitaryiliti �,shall be conducted on Town of Southold Purchase of Development Rights laird. 10, NO activities ' tgnt(o or temporary struc ure(s), or t--i poraty a ita1y ac�ilitiP , shall be conducted on Suffolk County Purchase of Development Rights laird without a .Permit issued by the Suffolk County ni land Conmrittee. 11.Issuance of this permit does not atithorize 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 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: 8 Art, OHS Summer Benefit Event Map W PQquatuck Park 1555 Village Lane Orient, NY P___ f Quests will walk into park from Village Lane and stop at registration table (6) vehicle access to check in. Most guests live within walking distance. No parking on site, see parking plan for more details. Tents: (1 ) 11 9'x 59'primary tent _j ► (3) 10'x 10' food service. All tents will have fire extinguishers, (4) toilet trailer (5) Dumpster (6) welcome table Parking on Village Lane oven & Orient Methodist Church. field and at OHS office NX. Poquatuck Park accessible lane *41,13 Al walk in entrance Wjbb H,ouse' 1440 Village Larien i A OHS Bldgs &office 1155 Village Lane AA Layers Google � Oysterponds Historical Society Traffic Control Plan June 2, 2025 application THE EVENT. The annual fundraiser is celebrated in Poquatuck Park at 1555Village Lane, Orient, NY. The event will be open from 5:00-7:30 pm on August 2, 2025. About 275-300 guests are expected to attend. PARKING: Most of the guests live within Orient Village and opt to walk to the event at the Webb House. Typically, fewer than 30 guests will need parking. They can easily park, where permitted, along adjacent village streets.Additional off-street parking is provided for vendors and staff at the offices of the Historical Society, 1155 Village Lane, see notation on attached map. OHS also has permission to use Orient Methodist Church parking field, 1325 Village Lane located one block from the event field. See map. TRAFFIC CONTROL: Since so few people drive to the OHS event, no additional traffic control is needed. Signage clearly marks walking entrance to the Webb House at Village Lane.A staffer or volunteer will be available at the entrance to the site to direct people and answer questions about where to park. Most guests are village neighbors who are very familiar with the village or returning guests who need no instruction. ON SITE CONTACT. OHS office: 631-323-2480. Maria McBride, event planner, mobile: 212-689-8798. Melissa Groeneveld, OHS Office Manager, mobile: 917-270-8946 EMERGENCY PLAN: Should there be an emergency need, Southold Police will be contacted. Emergency access to the event field is available from multiple points: 1440 Village Lane, Skippers Lane and Harbor River Road. HOLD HARMLESS AGREEMENT The applicant � � S I�A O 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: 1 t� Name: ,Authorized Agent I(�rA-QA Ar On behalf of: ©'�5VINTO nks Y S�?/�!1 C� SO-1 (Name of Business Entity) Dates of event(s): Z �� Richard D.Noncarrow, ADayof ime this Notary Public,State of New York No.01 N06224108 -2i $Z Qualified in Suffolk Coun M ty v Commission Expires June 2f�202 9