HomeMy WebLinkAboutCAST 60th Anniversary Special Event Master Permit#: of 1 JT J
TC Checklist.for Special Events (Farms/Wineries/Private Events)
Applicant Name: C J V
Type of Event(i.e. Community Event,Wedding, etc.):
Application(Master/I"Event) Date Received: 3 /31 /202D
Addendum(s)
No. of Addendums attached: Date Received: / /202
Same type of event as Master? Y N
Fees to be collected:
JMaster/1s`Event fee($300.00) Date Received: O� /62 /oZO $300.00
Addendum(s) ($50/Addendum) Date Received: / / Total Due: $
Late Application fees: $500.00 - 30-59 days before event Total Due: $
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$1,000.00 - 14-29 days before event Total Due: $
Total Paid: $
Check#(s):
Current Certificate of Ins.
Hold Harmless Agreement
Application sent for approvals to the following people:
Gwynn Schroeder V Denis Noncarrow Stacey Norklun
After emailing application and all applicable paperwork to the people above, put application in
`pink' pending folder.
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PIEDo" MAR.8 1 2025
SUPERVISOR'S OFFICE
TOWN OF SOUT11oLI)
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 As 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$1000 late fee.Late fees will also apply to
late event addenda.
PLEASE NOTE:
NO APPLICATIONS WILL BE ACCEPTED WITHIN 14 DAYS BEFORE THE SPECIAL
EVENT DATE. !
IMCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED:
The Committee will obtain comments on all applications from relevant Town,County-'and/or State agencies
and will forward completed applications to the Town Board with a recommendation as to whether to grant
or deny the application.
The Town reserves the right to request additional information from an applicant to address issues related to
the health,safety,and welfare of the community.
When is a Permit Required?
All Special Events,per Southold Town Code Article I, Section:205-2 (Definitions)must obtain a permit.
Occasional events on private residential properties hosted by the owner thereof that are by invitation such
as family gatherings,weddings,graduations,parties or not-for-profit fundraisers do not require permits.
Any use of residential property for profit,such as a venue for weddings or other events is prohibited.
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This application is deemed complete once all the following requirements are submitted to the Town
Clerk: Please indicate submission of the following by checking off the boxes and signing below.
VA completed application form signed by the owner and the event manager. Applications without
,�roperty owner's signature/approval will be rejected.
10"FETE: Is the application being submitted at least 60 days before the event[ Yes [ ]No
L�I f Yes,Fee of$ 300 has been submitted
❑ If No,Fee of$ has been submitted
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''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
VA 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
VA valid Certificate of Occupancy in all buildings used during the special event.
&rA Parking/Event Plan: consisting of a survey, site plan and/or aerial view of the subject property that
includes the locations of on-site parking, sanitary facilities, and tents or other temporary structure(s).
(See application form for details)
❑ Events for three hundred(300)or more people require submission and approval of a traffic control plan
acceptable to the Town of Southold AND a qualified traffic controller must be provided at the event.
(See application form for details)
"Signature of Property Owner on the application authorizing Code Enforcement Personnel of the Town of
Southold to enter the subject premises during the hours of the event to ensure compliance with any and
all special event permit conditions.
My signature below affirms that I have submitted all the information required above in connection
with my application.
3/31/25
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.
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MASTER APPLICATION FOR A PERMIT TO HOLD A SPECIAL EVENT
PLEASE PROVIDE ALL OF THE INFORMATION REQUESTED BELOW
INCOMPETE APPLICATIONS WILL NOT BE ACCEPTED
FOR INTERNAL USE ONLY
Special Event Master Permit#:
M5T I a-
Date of Submission: 3/31/25 Applicant's Name&Title: Erica Steindl
Applicant's Phone: (631)477-1717 Email: esteindl@castnorthfork.org
Property Owner(if different from above): Community Action Southold Town, Inc. (CAST)
Owner Phone: (631)477-1717 Email:—esteindl@castnorthfork.org
Contact Person(if different from above):
Contact Phone: Email:
Event venue: Community Action Southold Town, Inc. (CAST)
Venue Address: 53930 Main kd Hamlet Southold
SCTM#'s 1000-Section Block Lots)
Name of Events) CAT`s 60th Anniversary Celebration &Appreciation Event
Type ofEvent(s): Anniversary Celebration, Community &Volunteer appreciation
(Please complete one addendum below for each individual event)
Date(s)of Event(s): May 312025
Is there an approved site plan for the event venue?Yes [.A No [ ]
Maximum Number of Persons Attending at One Time(including staff): 200
Max#of Cars Expected at Any One Time: 20 in our parking lot, 20 municipal lots, 20 side streets
Is a tent or other temporary structure being used?Yes[✓J No [ ] If yes,provide of tent provide size(s):
10Hx7W
Have any of the development rights been sold to the Town of Southold[ ]Yes V No and/or Suffolk
County Agricultural Program? [ ]Yes V 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 [,,/]No[ ] If yes,you may be eligible to request
a waiver of the special event fee,with the submission of verification and a written request.with this application.
Mailing Address to Send Event Permit to: 53930 Main Rd Southold NY 11971
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EVENT"AICATIONADDENDUM
Please complete one form for each event
Applicant/Venue: Community Action Southold Town, Inc. (CAST)
Date of Event: May 312025 Master Permit#(if previously issued)
S=Time: 5:30 PM End Time: 8:30 PM
Is this special event consistent with the Master Application stibmittedlapproved for this type of event?For example,
does this event comply with the initial parking plan,maximum number of attendees,and the size and placement of
tent(s)applied for or approved? Yes[ ]No ].If no,what amendments to the permit are being requested?
Will food be served? Yes No TBC If yes,provide following:
Vendor Name: Suffolk County perniift
Vendor Name: -Suffolk County permit#:
Will outside vendors be serving alcohol? Yes LA No If yes,provide:
Vendor Name: Liquor License#
Vendor Contact Name: Cell Phone:
Will non-food/alcohol vendors be on the premises during the event? Yes UNo If yes,provide:
Describe type of vendor(s) Number of vendors:
Day of Event Contact Person: Erica Steindl Phone: 631-477-1717
E-mail address(print clearly) esteindlpcastnorthfork.org
Will any Southold Town services be requested Yes(Describe below) kjNo.
Police Highway Other
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Will a security company be used for any of the events? Vyes No.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: 'Platinum Parking &Security
Contact Name: Wayne Sailor Cell Phone: 631-300-8745
Duties to be performed: Parking & Security
Please use additional pages if more are needed.
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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,
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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
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 Signature of Owner
Erica Steindl Erica Steindl
Print name of Authorized Person/Representative Signature of Authorized Person/Representativ
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PERMISSION IS HEREBY GRANTED,SUBJECT TO THE FOLLOWING CONDITIONS
(PLEASE READ CAREFULLY):
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 maybe 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 maybe catered subj ect.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 rg ess/egress/access,
tents or temporary 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 path
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, and possesses a valid
Certificate of Occupancy for any building the public will occupy or used during the special event.
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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:
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HOLD HARMLESS AGREEMENT
The applicant CAST 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:
Name: Erica Steindl ,Authorized Agent
Community Action Southold Town, Inc.
On behalf of
(Name of Business Entity)
May 31, 2025
Dates of event(s):
DANIELLA MENJIVAR
Sworn to before me this Notary Public-State of New York
NO.01ME0009089
Day of A Urch , 202$ Qualified In Suffolk County
My Commission Expires Jun 5,2027
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• Outdoor speaker system in use during the event and
CAST 60t'' AI1111VePS8Cy Parking/Event Plansmall outdoor tent near Main Rd entrance.
Event Date Saturday, May 31, 2025 The entire main building, upstairs of"the frame church;'
will be accessible to attendees and employees during
the event.
Inside there are 2 upstairs toilets for the event.
Fire extinguishers are in the upstairs&.downstairs.
Platinum Parking&Security will control parking
&security &once at capacity refer attendees to
area municipal lots&side streets.
40p,� We will also send parking
r information to guests in advance
�(� Mo-�`Q,na` `'�•� of the event,with information on
y,.e $ lots&side streets.
a+
W `V +14 ,
1 hx7w
private utdoorr
speakers
j ingress
egress stager outdoor stage*
indoor public „$ port-a- otty
t1 �cN outdoor public .
m r
'�fllLmm
All exits available for emergencies.
__ Temporary facilities are 2 port a potties.
Music&temporary stage setup outside
--weather permitting.
bay +�f SK Audio will provide sound,including
outdoor speakers,mixer&wiring that
connects to our electrical outlets.
s, 5� +
No outdoor lighting generally,but exit
j� Platinum Parking ads doors will be lit.
&Security
+2 Property size minus parking lot
is
184'W x 149'L
0
Frame church is 53.5'W x 78'L
�t up to 20 vehicles'
�f Lot is 51'W x 74'L
0151,
t
guFFOi,� ,' Town of Southold
5/4/2018
P.O.Box 1179
53095 Main Rd
Iip
4A, �o Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 39629 Date: 5/4/2018
THIS CERTIFIES that the building COMMERCIAL
Location of Property: 53930 Route 25, Southold
SCTM#: 473889 Sec/Block/Lot: 61.4-19.1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
2/22/2016 pursuant to which Building Permit No. 40502 dated 3/2/2016
was issued,and conforms to all of the requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
alterations for an Opera House in an existing commercial building as applied for.
The certificate is issued to Olivanne LLC
of the aforesaid building. '
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 40502 3/9/2017
PLUMBERS CERTIFICATION DATED
Aut o ' e Signature
Town of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Date: 05/02/25 Receipt#: 339479
Quantity Transactions Reference Subtotal
1 Event Fee CAST 1 a $300.00
Total Paid: $300.00
Notes:
Payment Type Amount Paid By
CK#3530 $300.00 C A S T,
Southold Town Clerk's Office
53095 Main Road, PO Box 1179
Southold, NY 11971
Name: C A S T,
53930 Main Rd
Po Box 1566
Southold, NY 11971
Clerk ID: SABRINA Internal ID:CAST 1a
Born, Sabrina
From: Born, Sabrina
Sent: Friday, May 2, 2025 12:52 PM
To: DeChance, Paul;Johnson, Benjamin; Noncarrow, Denis; Norklun, Stacey; Schroeder,
Gwynn
Subject: Special Event-CAST 1a
Attachments: CAST 1 a_20250502125858.pdf
Importance: High
Good Afternoon,
Please see attached Special Event Application from CAST for an event on May 31, 2025.
Thank you,
,Saenuza??Z�on�
Sabrina M. Born
Deputy Town Clerk &Sub-Registrar
Senior Account Clerk
Southold Town Clerk's Office
53095 Route 25 -
P.O. Box 1179
Southold,NY 11971
Ph: 631-765-1800 ext. 1226
Fax: 631-765-6145
Your message is ready to be sent with the following file or link attachments:
CAST 1a_20250502125858.pdf
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attachments. Check your e-mail security settings to determine how attachments are handled.
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REMARKS.
v.
DATE".
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Noncarrow, Denis
To: esteindl@castnorthfork.org
Cc: Sabrina Born (sabrina.born@town.southold.ny.us); Mudd,Jennifer
Subject: Resolution for event
Attachments: CAST.pdf
Hi Erica
Please see attached information on your event,Any questions please give us a call.
Your message is ready to be sent with the following file or link attachments:
CAST
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attachments. Check your e-mail security settings to determine how attachments are handled.
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