HomeMy WebLinkAboutThe Arts In Southold Town, IncJUDITH T. TERRY
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 (516) 765-1823
Telephone (516) 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.B of the Code of the Town of Southold, to The Arts in Southold
Town, Inc. to present a ~Festival of the Arts" at the Southold Historical
Society, NYS Route 25 and Maple Lane, Southold, N.Y., on Saturday,
August 16, 1997, from 11:00 a.m. to ~1:00 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: July 23, 1997.
Judith T. Terry (/
Southold Town Clerk
Certificate of Insurance on file.
cc: Chief of Police Conway
Dir. of Code Enl. Forrester (tent)
DIRECTORS
Neboysha K Brashich
Margaret It. Brown
Carole G. Donlin
John Flynn
Marilyn Flynn
Evelyn H. Lucas
John B. Ru$ch
ill
P.O. Box 612 · Cutchogue, L.I., N.Y. 11935
RECEIVED
JUL 2 ~ 1997
~--
ONE
TOWN,
MANY TALENTS
~RTI~ICAT~ O~ INSUR~N¢~
gePetrls & Kramer Agency o[
Suffolk, Inc.
P.O. Box 14~6 Main Street
Southold, NY
11971
P~0~1516-765- 3811
.............................................
The ~rts in Soutbold Town Inc
ltt, Margaret Brown
PO Box 612
Cut chogue, NY
11935
~7/16/97
I'H/~ CI~R'I'IF£CRTJ~ lB i~BUJ~D R~ R N. RI'I'Iq~ OJ~ IN~'URM. RI'ION ORbY AND CUl41q{b{~
NO RIGHTS UPON THE CERTIFICATH HOLDHR. THIH CERTIFICATE DONS NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIRR BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY LETTERA Worcester Insurance Company
COMPANY LETTER B
COMPANY LHTTHR C
' iiEi4i 4i' ' .........................................................
COMPANY LETTER E
COVERAGES <
THIS IH T0 CERTIFY THAT POLICIRE OF INSURANCE LISTED BHLOW HAVE BEEN IRBUED TO THE INRURED NAMHD ABOVE FOR THE POLICY
PERIOD INDICATED. NOTWITHSTANDING ANY REOHIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO
WHICH THIN CERTIFICATE MAY BE IBBUED OR MAY PERTAIN, THE INHDRANCE AFFORDHD BY THE POLIClEH DESCRIBED HHREIN IS HUBJHCT TO
ALL TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH POLICIES. LIMITH SHOWN MAY HAVE BNNN RRDUCND BY PAID CLAIMB.
TYPH OF INSURANCE POLICY NUMBER POLICY EFF POLICY NIP
DATH DATE
GENERAL LIABILITY
IX] COMMERCIAL GEE LIABILITY
[ I [ ] CLAIMS MADE }(] OCC.
[ ] OWNER'H & CONTRACTORH
PROTECTIVE
[]
AUTOMOBILE LIAB
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRHD AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
RXCRSS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS' COMP
AND
EMPLOYERS' LIAB
3L812164 .~126196 L~126197
ALL LIMITS IN THOUHANDH
GENERAL AGGREGATE 1{~{
PRODS-COMP/OPE AGG.
PHRH. & ADVG. INSURY 58~
BACH OCCURRHRCB 588
FIRE DAMAGE
(ANY ONE FIRE} 58
MEDICAL EXPENSE
(ANY ONE PERSON} 5
CHL
BODILY IN3URY
{PER PERSON}
BODILY IN3URY
(PER ACCIDENT}
PROPERTY
I EACHOCC ( AGGREGATE
HTATUTORY
EACH ACC
DISEASE-POLICY LIMIT
DISEASE-EACH EMPLOYEE
OTHgR
DBHCRIPYION OF OPERATIONBtLOCATIONE/VHHICLEE/HPECIAL ITEMS
FOR ARTH FESTIVAL BEING HELD AT EOUTHOLD HIHTORICAL HOCIEYY 8/16/97
MAIN ROAD, 80UTHOLD
CERTIFICATE HOLDER: TOWN OF SOUTHOLD
CERTIFICATE HOLDER < ............................... > CANCELLATION <
= SHOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TEE EX-
TOWN OF SOUTHOLD
ATT~ TOWN CLNRK
MAIN ROAD
SOUTHOLD, NY
11971
RCORD 25-8
PlRATION DATE THEREOF, THE ISSUING COMPANY WILL HNDHAVOR TO MAIL 15
DAYH WRITTEN NOTICE TO THE CERTIFICATE HOLDER MAMHD TO THE LHFT, BUT
FAILURE TO MAIL HUCH NOTICE SHALL IMPOSE MO OBLIGATION OR LIABILITY OF
ANY KIND UPON THE COMPANY, ITS AGHNTH OR RHPRHBEHTATIVNH.
........................ ..........