HomeMy WebLinkAboutSouthold Mothers Club ELIZABETH A. NEVILLE
TOWN CLERK
REGISTI~R 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
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
SPECIAL PERMIT
A Special Permit is hereby granted in accordance with chapter 27, Section
27,1 8 of the code of the Town of Southo]d, to the Southold Mothers Club,
Inc., Southold, New York, tO hold their "Children's Festival", at the
5outho]d High School on sunday, November 5, 2000 from 7:00 a.m. to 8:00
p.m., provided they file with the Town Clerk a one Million Dollar
Certificate of Liability Insurance naming the Town of Southold as an
additional insured.
Dated: october 26, 2000
Southold Town Clerk
Police Chief Cochran
Superintendent of Highways Jacobs
Building Department
OCT 2 0 2000
~,~nola Iown Clerk
;,~oouc~.~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
ROY
H,
REEVE
-~,-~,,,.~r~.~,~..:~, INC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO BOX 54 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
13400 MAIN ROAD COMPANIES AFFORDING COVERAGE
MATTITUCK N.Y. 11952 COMPLY
A C G U
SOUTHOLD MOTHERS CLUB INC. B
P.O. BOX 1133 c
CUTCHOGUE NY 11935 co.P~v
i D
Q..E~U~U~TV UNASSIGNED 9/19/00 9/19/01 QENE".,~A~"E~A~ $2, 000, 000
X COMMERCIAL GENERAL LIABILITY PRODUCT8 - COMP~)P AS~ $2,000, 000
I OU,,MS M~E ~ OCCU, PERSONN. & ADV INJURY $1, 000,000
: 3WNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $1, 0_00, 000
~ ~.E DAMAQE (~ ~ .,,) $ 10 o ,~0_9~
,~AUTO MED EXP (Ar, y one I~son}$ 5. 0 0 0
~ j ALL OWNED AUTOS BODILY INJURY
CERTIFICATE HOLDER IS I,ISTED AS ~DDITIONAL INSURED EFFECTIVE 10/10/00
TOWN OF SOUTHOLD E:~m~ DA~ THEREOF, ~HE 18~UlN(I COMPANY WILL ENDEAVOR TO MAIL
MAIN RD POB 1179 10 DAYS WRD'[~N NO%'ICE TO ]HE CERT1F~A~ HOt.~ER NAMED TO I~IE LEFT,
SOUTHOLD NY 119 71 BUT F,'a. UB~ TO .*". S,C. NO'.~ B.,~U. ~"O~£ "O O.C~^~,O. OR ~