HomeMy WebLinkAboutPeconic Bay Vineyards 2025-24 DENIS NONCARROW "`. Town Hall,53095 Main Road P.O.
TOWN CLERK Box
Box 1179
Southold,New York 11971 Fax
REGISTRAR OF VITAL (631)765-6145 Telephone(631)
STATISTICS MARRIAGE OFFICER 765-1800
www.soutlioldtownny.gov
RECORDS MANAGEMENT , y'g
OFFICER FREEDOM OF
INFORMATION OFFICER �I!@l }
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO.2025-576 WAS
ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON
JULY 22,2025:
RESOLVED that the Town Board of the Town of Southold hereby grants permission to Peconic
Bay Vineyard,to hold Special Event 2025-24 at the"Peconic Bay Vineyards, 31320 Main Road,
Cutchogue,New York as applied for in Application PBV-2a to hold a catered event in
association with Fireworks on Saturday,August 9th 2025 from 5:OOPM to 10:00 PM,provided
they adhere to all conditions on the application,permit and the Town of Southold Policy for
Special Events.All parking must be contained on site. 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.
w 9 "
Denis Noncarrow
Southold Town Clerk
RESULT: Adopted
MOVER: Councilwoman Doherty
SECONDER: Councilman Doroski
AYES: Councilman Mealy, Councilwoman Smith, Councilwoman Doherty,
Justice Evans, Councilman Doroski, Supervisor Krupski,Jr.
NAYES: None
ei✓ 4o 6
�oSu�F
0 y..
RECEIVED
404
Town Code Chapter 205"Public Entertainment and Special Events"
SPECIAL EVENT PERNUT INSTRUCTIONS AND APPLICATION F@8Mh0ld Town Clerk
Applications for a Special Event Permit are esubject to an inter`-departmental co ordinate dreview liy'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.Avviicants are
encouraged to submit applications as early as possible.,Any application submitted between 59
and 30 days'before the eveni 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 Perniii 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 ornot-for-profit fundraisers do not,iequire permits. . .
Any use of residential property for profit,such as a venue for weddings or other events is prohibited.
1
r -
r
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 sinning below.
❑.A,completed application form signed by the owner and the event manager. Applications without
x rope4 dwnees signature/approval will be rejected.
❑ FEE: Is the application being submitted at least 60 days before the event Yes [ ]No
�, $300.00
&d I?Yes of$ has Been submitted
❑ If No,Fee of$ has been submitted
my` ° �� 7-^ '�i.
The applicant%wner 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
IX A signed and'notarized Hold Hanriless Agreement naming Southold Town
An up-to-date Certificate of Compliance issued by the Southold Town Fire Marshall.or the Town
Building Department
DO A valid Certificate of Occupancy in all buildings used during the.special event.
ffd 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)
DO Events'for three hundred(300)'or more'people requiresubmission and"approval of a traffic control plan
. .
acceptable-to the Town of Southold AND a.qualified ti c controlier-must'be provided'at the.event.
(See-application form for details) '
X 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 t iat I.have"submitted all the information required above in connection
with my application.
-7;
3/31/2025
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
i
MASTER APftlt-X,TION*OR A PERMIT TO HOLD A SPECIAL EVENT
PLEASE PROVEWALLDF-THE-INFORMATION REQUESTED BELOW
INCOMPETE.APPLICATIONS WILL NOT BE ACCEPTED
- -FOR INTERNAL USE ONLY
Special Event Master Permit#:
Date of Submission: -' Mar 2025:;� Applicant's Name&Title: ~ 'Sam Kimball/Winship Media:LLG
Applicant's Phone:..--.. +1 347-931-4340 ___Email:_ sam0winshipmedia.com
Property Owner(if different from above): Crossroads Vineyards DBA Peconic Bay Vineyards
Owner Phone: Ken Cereola 516-946-4897 Q Email: ken@pbvineyards.com
Contact Person(if different from above)':
Contact Phone: �� `1"�1`� Email:
Event Venue: Peconic Bay Vineyards
Venue Address: 31320 Main Rd,Cutchogue, NY 11935 Hamlet
SCTM#'s 1000-Section Block Lot(s) SCTM#103-1-19.12
Name of Event(s) Jazz In The Vines
Type ofEvent(s): jazz performance
(Please complete one addendum below for each individual event)
Date(s)of Event(s): Aug 9,2025-"-` "
Is there an approved site plan for the event venue?Yes [X]No[ ]
Maximum Number of Persons Attending at One Time(including staf fl: 350
Max#of Cars Expected at Any One Time: 175 -
Is.a tent or other temporary structure being used?Yes,[X]No [ ] If yes,provide of tent provide size(s): 40x100 ft.
Have any of the development rights been sold to the Town of Southold[ ]Yes[X]No and/or Suffolk
County Agricultural Program? [ ]Yes [X];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[x l If yes,you,inay'be eligible to xcquest
a waiver of the special event fee,with the submission of verification and a written request.with this application.
Sam Kimball//Winship Media LLC, PO BOX 368
Mailing Address to Send Event Permit to: Westhampton,NY 11977
3
r ,
r '
SPECIAL EVENT.APPL-ICATION ADDENDUM
{ Please complete one form:.for;each event;,
Applicant/Venue: Winship Media and Peconic,Bay Vineyards
1,
Date of Event: Aug 9,202s Master Permit#(if previously issued)
Start Time: 5 PM End.Time: 9:30 PM
Is this special event consistent with the Master Application sabmAted/approved 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?[A Yes [ ]No' If yes,provide following:
Vendor Name: Peconic Bay Vineyards(the venue), Suffolk County permit#: -
Vendor Name: �_. .- �Suffolk County permit#:
Will outside vendors be serving alcohol? [ ]Yes [ ]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 W No' If yes,provide:
Describe type of vendor(s) Number of vendors:
Day of Event Contact Person: Sam Kimball Phone: +1 347-931-4340
E-mail address(print clearly) sarnOwinshipmedia:com
Will any SoutholdTown services be requested [ Yes(Describe below) [ ]No.
Police Highway Other X 1 Traffic Control officer
Willa security company be used for any of the events? '[ ]Yes [X]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: Regular in-house security personnel at Peconic Bay Vineyards
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 nezt•-Uage)
A Parkiing/Event Plan may-be a survey,�site nlan4nd/or,aerial view•(for ezamt le GoogleZart ,of
the subiect property:INDICATE10N,THETLAN ALL ofthe followiinzinformation: ::'
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. t,
(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 fine 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 forJ06sq.K.
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'SSIGNATURE:
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 aff 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
circulation,parking,and,exiting of cars on site,and 4)Contact information for use by Southold Town
Police. _
OWNER'SSIGNATURE:
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 actvaties under this event: Furthermore,I hereby swear or affirm that_ he.
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 Even
Print name of Owner Signature'of Owner .
Ken Cereola
Print,name,of Authorized Person/Representative Signature of Authorized Pe"n/Representative
6
PERMISSION-19HEREBY GRANTED,SUBJECT TO THE'FOLLOWING COMMONS: "
_ '"(PLEASE READ CAREFULL'Y)i` - .
1. By acceptance of thiss permit, applicant'agrees`-tos adequately supervise`and direct all packing to'be on
the premises'of at another'site;and`to'provide parkirigassistants and'any additional traffic controls necessary-
for this event.Parking is strictly MInbited 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-proiided 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 pemiit.
5. Tent proposals must receive permit approval from the Southold TownBuilding--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 da s prior to the scheduled event.
7. Adequate temporary sanitary facilities must be provided by applicant forthis 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 subject to all Suffolk County
Department of Health regulations.
9. NO activities associated with this event, including but not limited to parking, ingress/egress/access,
tent(s)or temporary structures) or temporary sanitary facilities shall be conducted on Town of Southold
Purchase of Development Rights land.
10. NO activities associated with this event, including but not limited to parking, ingress/egress/access,
tent(s) or temporary structures) or temporary sanitary facilities shall be conducted on 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.
7
14.-Music,'when outdoors,is,required to stop at the time specified in the permit.Placement of the .
speakers must be ina location tfiat 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
TERTVMATE THIS PERMIT. ;
APPROVED Towa:of.Southold
Resolution Number: Date Issued:
8
HOLD HARK L'ESS AGREEIV>ENT'
The applicant `Winship Media 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 attorneys 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: Sam Kimball ,Authorized Agent
On behalf of: Winship Media
(Name of Business Entity)
Dates of event(s): August 9,2025
Sworn to`before me'`this
Day of , 20
9
Southold Town 2025 Special,Event Application Policy Changes
Item Old Policy New Policy Notes
1.ApplicRI One application for up One"Master Application"for No limit on number of events, but this
to six events of the events of the same type, plus may be re valuated periodically.
same type. For a one-page addendum for
example,weddings. each individual event. Master Please fill in all fields on the application. If
applications reviewed by the . a field does not apply to.the event,please
All'applications are entire committee. indicate N/A(not applicable).
reviewed by the entire
committee. Addendum reviewed by the. The Addendum to the application
Government Liaison Officer' required particulars about each individual
Incomplete (GLO)unless there is.a. , event,for example,food;vendors,or
applications were significant change from the amendments to the approved Master
accepted,although Master Application. Application.
required.
Applications reviewed by the In the past,common omissions on
Govt Liaison Officer for applications have been S&W,SC Vendor
completion,before submitted ID#s,errors on Cert.of Insurance,and
to the Town Clerk. If the GLO parking plans without dimensions.
is unavailable,the Clerk's
office will certify the
application is complete.
2.Applieation fees The increased fees reflect more
$150 for up to six $300'for the Master accurately the staff time used to review.
events. Application and first event.
The$50 fee is more equitable for venues
$50 for each subsequent holding fewer events of the same type vs.
event. those holding many.
3. Late fees $250 if submitted less If submitted between 59 and No application will be accepted 14 days
than 60 days prior to 30 days prior to the event, prior to the event to ensure the Town
the first event. the applicant will be charged Board has time to consider and approve.
an additional late fee of$500.
Late fees apply to late submission of
If submitted between 29 and addendum as well.
15 days prior to the event a
$1000 late fee applied.
4. Required Checklist required,but $2million C of I now required
Documents frequently omitted on A Certificate of Compliance may be issued
Checklist submitted applications. Added to Check List by the Fire Marshal or by the-Building
Hold Harmless Agreement Dept.
A minimum of$1 B. Certif.of Compliance for
million Certificate of Building& Fire Inspection It is the applicant's responsibility for
Insurance(C of I), C. C/O for any building used contact the Town for the yearly fire and
naming Southold Town during the special event building inspection.
as an additional
insured. The check list on page 2 of Additional fees may be charged if a
the application must be reinspection is needed per fire marshal or
completed before the Building Dept.fee schedule.
application will be accepted.
Jazz In The Vines event 8/9/2025 Ma'nR
� a
Peconic Bay Vineyards, Southold NY Traffic Control here at
Venue Entry & Exit
Event is self contained on back lawn, under tent.
It does not take place in the building.
SCTM#103-1-19.12
t '
0+�
Ticketholders
Entry/Exit
Parking this way, to fi
225 parking spaces
Emergency Access Loading Area
EVENT
~ dIS HERE •• •
i
v 110 3 1
a
a ` �
•'• ��.e._' -•mow �.,-•� .,.. ��_ ����� � � r � �
.\���., K �
EVENT
IS HERE ✓ 1� -
IA t
•
Parking Spaces
,R
4
HOLD HARMLESS AGREEMENT
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 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: v`^
Name: ,Authorized Agent
On behalf of:
(Name of Business Entity)
Dates of event(s):
tt ((�
Sworn to before me this `1
Day of J-U t L ,20J6_.
TIFFANY J BEREZNY
Notary Public-State of New York
No.01 BE6284112
Qualified in Suffolk County
My Commission Expires 06/17/2025
^ '
^ ,
TOWN DFSOUTBOL0—FIRE MARSHAL
54375 MAIN ROAD P. O. BOX ll790OlJTBOLD,NYl /97l'8959
OFFICE (63l) 7d5'l8O%FAX(63l) 765-9502 |
.
URE
ESTABLISHMENTNAME: DATE:
Peconic Bay Winery 5/16/25
ADDRESS:31320 Main Road Cutchogue, NY 11935 FIRE DISTRICT:Southold
NAME OF OWNFRIAGENT PRESENT: HAS OCCUPANCY CHANCED SINCE LAST VISIT?
NATURE OF INSPECI'IONfl'ES'FINGIMAINI"ENANCE:
Annual Fire Insprction
NAME OF CENTRAL STATION: 7;���
Statewide Monitoring, Corp E 9TO CENTRAL ST ATION:718-392-6666
TYPEOFSYSTEM: MANUALD AUTOMATICR VOICE EVACUATION 0 OTHERO CENTRAL STATION 0i REMOTED PROPRIETARY0 AUX0
Carbon Monoxide integrated: Yes [0] NoF
LIST ANY/ALL DEFICIENCIES
WERE THESE DEFICIENCIES CORRECTED?YES NO IF NOT,WHY?
TESTED AND'APPhAR'TO"'FUNCTION'ASN' OTED IN'THIS'CERTIFfCATION ATTHE TIME OF I-NSPEC.TION I CERTIFYTHAT THIS INSPECTON:BAS:BEEN
INSPECTING FIRM INFORMATION
COMPANY NAME: NYS LICENSE NUMBER:
Lighthouse Security Inc 1f2000022174
INSPECTOR'S NAME:Andrew Santacroce SIGNATUR! DATE:5/16/25
ORIGINAL COPY WITH SIGNATURE |GTDBE SUBMITTED TO THE TOWN DF SOU THOLD FIRE MAR8HAL A
COPY|QTOBELEFTON8/TEATTHEF/REALARNYPANEL �
OFFICE USE ONLY: DATE RECEIVED
`
t3�r�y�ssoc+rc
a TOWN OF SOUTHOLD-FIRE MARSHAL
54375 MAIN ROAD P. 0. BOX 1179 SOUTHOLD,NY 1071-0959
OFFICE(631) 765-1802 FAX (631) 765-9502
FIRE ALARM SYSTEM'
CERTIFICATEfiOF FITNESS:AND TESTING
e
WARNING:NOTIFY ALL`OCCUPANTS AND ANY AGENCIES WHO MIGHTFRESPOND BEFORE;TESTING SYSTEM
FAILURE TO DO'SO MAY RESULT I I:E N GAL ACTION AGAINST,THE INSPECTOR ,
ESTABLISHMENT NAME:Peconic Bay Winery Tasting DATE:5116/.25
ADDRESS:31320 Main Road Cutchog,u.e, NY 11935 FIRE DISTRICT:Southold
NAME OF OWNER/AGENT PRESENT:G rp n G OVe YES ❑ NO®CY CHANGED SINCE LAST VISIT?
NATURE OF INSPECTION/I'ESTING/MAINTENANCE: Annual Fire lnspr..ctlon
NAME OF CENTRAL STATION: PHONE Monitoring Corp . PHONE9TOCENT1.RALSTATION:71.8-392-6.66.6
TYPE OF SYSTEM: MANUAL❑ AUTOMATIC R VOICE EVACUATION❑ OTHER❑ CENTRAL STATION❑ REMOTE❑ PROPRIETARY❑ AUx❑
Carbon Monoxide Integrated: Yes Io No
LIST ANY/ALL DEFICIENCIES
..Replaced. (1 ). SRK Outside. Strobe
WERE THESE DEFICIENCIES CORRECTED?YES■NO IF NOT,WHY?
CERTIFICATION: T A11;EMPLOYEE OF THE INSPECTING FIRM LISTED'•BELOW.DO HEREBY CERTIFY THAT THE ALARM.SYSTEM DESCRIBED:.'
ABOVE WAS INSPECTED IN ACCORDANCE WITH THE APPLICABLE PORTIONS OF NFPA 72(2016 VERSION) PARTICUISARLY CHAPTER,?AS WELL AS ,
TABLE104.3&:SECTION10.&IOFNFPA'72`.THISICERTIF'ICATION�IOES� OT"IMP[YTHATITEMSAEQUII2TNG'DAILY,�WEEK,LY;M'ONTHLVbR
QDARIERLY INSPECTION ORTE$TING-WERE PERFORMED'AT THE SPECIFIED INTERVALS,BUT DOES IMPLY-AT L'"SUCHITEMS WBRE INSPECTED OR
TESTED AND APPEAR`TO FUNCTION AS.NOTED[N'!HIS CERTIFICATION AT THE TIIGIE OF INSPECTION;T CERTIFY THAT THIS INSPECTION HAS J3EEN
PROPERLY CONDUCTED AND ALL OF THE ABOVE,STATEMENTS ARtE TRUE AND,CORR$CT.TO THE BEST OF MY,KNOWLEDGE
INSPECTING FIRTVI INFORiVIATION
COMPANY NAME:Lighthouse Security Inc NYS LICENSE NUMBER, 12�00.022174
COMPANY ADDRESS:1149 Old Country. Rd Ste D5 Rvhd PIIONE:631772772728
INSPECTOR'S NAME:Andrew Santacroce SIGNATURE DATE:5/16/25
ORIGINAL COPY WITH SIGNATURE IS TO BE SUBMITTED TO THE TOWN OF SOUTHOLD FIRE MARSHAL. A
COPY IS TO BE LEFT ON SITE AT THE FIRE ALARM PANEL.
OFFICE USE ONLY: DATE RECEIVED
I
Town of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Date: 06/07/25 Receipt#: 340976
Quantity Transactions Reference Subtotal
1 Event Fee 8/9/2025 $300.00,
Total Paid: $300.00
Notes:
Payment Type Amount Paid By
CK#4308 $300.00 Windship Media
Southold Town Clerk's Office
53095 Main Road, PO Box 1179
Southold, NY 11971
Name: Windship Media
720 Greenwich Media
Suite 8a
New York, NY 10014
Clerk ID: DENISN Internal ID:8/9/2025
i
Noncarrow, Denis
To: Peter Speranza
Cc: Sabrina Born (sabrina.born@town.southold.ny.us); Mudd,Jennifer
Subject: Resolution on Special event
Attachments: PBV 20250723114857.pdf
HI Peter.
Please see attached resolution on your special event.
Any questions please give us a call.
Denis Noncarrow
Southold Town Clerk.
Town of Southold, New York
www.southoldtownny.pov
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.
1