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HomeMy WebLinkAbout2003TO: FROM: DATE: RE: Elizabeth A. Neville, Town Clerk Chief Carlisle E. Cochran, Jr. October 8, 2003 Request for Special Permit - Harvest Festival - Oysterponds School District - October 11, 2003 I have reviewed the above request for a special permit. I have no objection to the approval of this permit.. cc: Lt. Martin Flatley ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD SPECIAL PERMIT A Special Permit is hereby granted in accordance with Chapter 71, Section 71.1 B of the Code of the Town of Southold to the Oysterponds PTA to hold their "Annual Harvest Festival" on Saturday, October 11, 2003 from 10:00 AM to 2:00 PM at the Oysterponds Elementary School, 23505 Main Road, Orient, New York, (Rain Date: Sunday, October 12, 2003), provided they file with the Town Clerk a One Million Dollar Certificate of Liability Insurance naming the Town of Southold as an additional insured. October 8, 2003 Certificate of Insurance on File Elizabeth A. Neville Southold Town Clerk Cc: Chief of Police Cochran Superintendent ~of Highways Building Depaxtment *Notice - If a tent is to be erected, you must first obtain a permit from the Southold Town Building Department. .08/10 ,'03 WED 15:00 FAX 516 765 5145 SOUTHOLD CLERK ~001 *** TX REPORT TRANSMISSION OK TX/RX NO CONNECTION TEL CONNECTION ID ST. TIME USAGE T PGS. SENT RESULT 4909 7342315 Police Admlnlst 08/10 14:58 01'34 4 OK V,I_IT~.BETH A. NEVILLE TOWN CLERK REGL~TP. AR OF VITAL STATISTICS MAEP, IAGE OFFICER BECORDS MANAGEMENT OFFICER FEEEnOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 so athol dtown.nortkfork.net OFFICE OF ~ TOWN CI,EHK TOWN OF SOUTHOLD To~ Frol~l: Re: Chief Carlisle E. Cochran, ~r. Town Clerk Elizabeth A. Request for Special Permit tot Oysterponds School Disixiet for Harvest Festival on October ~ 1:2003 Date: October 1. 2003 Please review this request and send me your recommendations in writing, Thank you- ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To~ From: Re: Chief Carlisle E. Cochran, Jr. Town Clerk Elizabeth A. Neville~fi~ Request for Special Permit for Oysterponds School District for Harvest Festival on October 1 i, 2003 Date: October 1, 2003 Please review this request and send me your recommendations in writing. Thank you. PTA Oysterponds School P.O. Box Orient, New York 11957 Ms. Elizabeth A. Neville Southold Town Clerk Southold Town Hall 53095 Hain Road P. O. Box 1179 Southold, NY 11971 Re: Penllit for Harvest Festival PTA Oysterponds, Orient, NY Dear Ms. Neville, The Parent Teachers Association (PTA) of Oysterponds Elementary School In Orient, NY requests a peH¥/it to hold a Harvest Festival on Saturday, October 11, 2003 from loam to 2pm at the Oysterponds Elementary School located at 23405 Hain Road, Orient, NY. (The rain date will be Sunday, October 12, 2003 loam to 2pm.) The appropriate certificate showing the Town of Southold is addiUonally Insured and a map of the location of the Festival are both attached. Please notify me by telephone If any addiUonal Information is needed. Sincerely, Martha Tuthill PTA President Telephone number: 323-2763 CERTIFICATE OF LIABILITY INSURANCE L- -- : -faaouc~e..(585)385-2900 FAX (585)248-3049 THIS CERTIFICATE IS ISSUED AS A MATrER OF INFORMATION C';~,,~='I' M;=n=~= 1~4cf~ M~r~=n~'l' Tn~' ONLYANDCONFERSNORIGHTSUPONTHECERTIFICATE ......... ~ ............. = ...... , .. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 733 Linden Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite A Rochester, NY 14625-2715 INSURERS AFFORDING COVERAGE NAIC# INSURED New York State PTA INSURERA: Cincinnati Tnsurance Company One Nembley Square INSURERE: Albany, NY 12205-3830 INSURERC: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD iNDICATED. NOTWITHSTANDIN~ 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· AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. GENERAL UAB~LITY CPP0735233 07/01/2003 07/01/2004 EACH OCCURRENCE $ 1,000 t 00(] DAMAGE TO RENTED $ 500, 1CU. MS RAOE [~ OCCUR .ED EXP ~V o~e pes~) s 10.000 A PERSONAL & ADV INJURY $ 1,000,00~] GEN'L AGGREGATE LIMtT APPMES PER: PRODUCTS - COMPIOP AGG $ 21000 ~ 00(~ EXCESS~UMBRELLAUABIUTY CCC4486728 07/01/2001 07/01/2004 EACH OCCURRENCE $ 10,000,000 X I CCCUR ~ CU~IMS ~DE A~REC~TE $ 10,000. A S RET~,T~ON $ 10,00~ $ DESCRIPTION OF OPERATIONS I LOCAllORE I VEHICLES I EXCLUS~NS ADDED BY ENrX~RSEMENT I SPECL4L PROVISIONS is repsect to PTA Code #0S-S32 'ertificate holder is additional insured as respect to use of the district's faci]ities for the Harvest :estlval 10/11/03 (rain date 10/12/0~). CERTIFICATE HOLDER Town of Southold P.O. Box 1179 Southold, NY 11971 (~ANG~LLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WiLL ENDEAVOR TO MNL · 10 DAYSWRITTENNOTICETOTHECERTIFICATEHOLDERNAMEDTOTHELEFT, BUT FA/LURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATION OR LIABII~;'rY ACORD 25 (2001108) ©ACORD CORPORATION 1988 /';'3 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. A statement on this certificate does not confer dghts to the certificate holder in lieu of such endorsement(s). 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 endomement(s). DISCLAIMER The Certificate of Insurance on the reveme side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (200'1/08) , ' CERTIFICATE OF LIABILITY INSURANCE 04/01/2003 PRODUCER -- [ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOILneLATION ONLY NEW YORK SCHOOLS ~NSURANCERECIP~I~[~/[~ AND CONFERS NO RIGH~ UPON THE CERTIFICATE HOLDER. THIS 377 OAK STREEF CERTIFICATE DOES NOT A~END, F~TEND OR ALTER THE GARDEN CITY, NY 11530 ~v.~' COVERAGE AFFORDED BY THE POLICIES BELOW. 2 ?~ c'i~ INSURERS AFFORDING COVERAGE r i~UREI) INSURER Ac NEW YORK SCHOOLS INSURANCE RECIPROCAL Oysterponds UFSD ~ 23405 Main Road Southold Town Clerl ,' ,NSURER C P.O. Box 98 ' INSURER ~ Orient, NY 11957 INSUREr. E COVERAGES i THE POLIC[£S OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUKED NAMED ABOVE FOR THE POLICY pEKIOD INDICATED. NOTWITHSTANDING ANY I REQUIREMENT, TEILM OR CONDITION OF ANY COlX~FRACT OR OTHER DOCUMEN~ WITH RESPECT TO WNlCH THiS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSUILs3qCE AFFORDED BY THE POLICIES DESCRIBED HEREIN iS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIM S. POLICY NUMBER SSPOYP~I POLICY EFI~CTIVE J POLICY EXHRATION DATE (MM/DDIYY)j DATE (MMIDD/YY) 07/01/2002 07/01/2003 EXCESS LIABILITY I XJ OCCUR ~ CLAIMS MADE ~ DEDUCTIBLE J'~ RETENTION $ SCHOOL BOARD LIABILITY ECLOYP001 07/01/2002 07/01/2003 LIMITS EACH OCCURRENCE : $ I,O00,O00 FIRE DAMAGE (Any one fire) : $ 1.000,000 ME?_EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY j $ 1,000,000 PRODUCTS- COMP/OP AGG ~ 1,000,000 COMBINED SINGLE LIMIT ! $ (E_a. Accident) _ BODILY INJURY (Per I~XSOn) i $ BODILY INJURY (Per accident) PROPERTY DAMAGE $ (Per accidcnlt) I AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC i $ AUTO ONLY: AGO I $$ EACH OCCURRENCE AGGREGATE I AGGREGATE 5,000.000 UNLIMITED DEDUCTIBLE J$ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLESiEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISION Certificate holder is named as Additional Insured only as respects the use of premise/facilities for the 5K Race on 5-10-03 CERTIFICATE HOLDER ~ Town of Southoid i PO Box 1179 i Southold, NY 11971 ~ ADDITIONAL INSURED; INSURER LETFER; CANCELLATION SHOULD ANY OF THE ~OVE DES~IBED POHCIES BE CANCELLED BEFORE THE l EXPIRATION DATE THEREOF, THE iSSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRIer EN NOTICE TO TH E C ERTiF ICATE HOLDER NAMED TO THE LEFt, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITy OF ANy KiND UPON THE INSURER, ITS AGENTS OR P. EPR ESENTATIVES