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HomeMy WebLinkAbout1995JUDITH T. TERRY TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town HaH, 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 In accordance with Chapter 27, Section 27-1-B of the code of the Town of Southold, a permit is hereby granted to the Cutchogue Lions Club to hold their annual Antique Auto Show on the East Cutchogue School grounds, Main Road, Cutchogue, N.Y., on Sunday, July 9, 1995, from 8:30 A.M. to 4:30 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: June 1, 1995. Southold Town Clerk Certificate on file. cc: Supt. of Highways Jacobs Police Chief Droskoski Building Department (tents) May 31, 1995 Ms. Judith Terry Southold Town Clerk Main Road P. O. Box 1179 Southold, N. Y. 11971 RECEIVED MAY 3 11995 Seulbold To, Clerb Re: Cutchogue Lions Club Antique Auto Show July 9, 1995 Dear Judy: On behalf of the Cutchogue Lions Club, I wish to apply for a permit for the Lion's Antique Auto Show on July 9, 1995. The sho, will be held on the grounds of the East Cutchogue School, Main Road, Cutchogue, N. Y. The school grounds will be open to the public around 8:30 a.m.. The Show will start at 12:00 p.m. and it end around 4:30 p.m. The Club's current president is David Robinson, and the Vice President is John Kujawski. I have enclosed a diagram of the field layout. We ill have three tents on the property -- two very small tents for sun protection by the gates, and one tent for the Food Committee. I am also enclosing herewith a copy of the Certificate of In- surance listing the Town of Southold as Certificate Holder and Additional Insured. If you have any questions, please give me a call. Sincerely, East End Insurance Services Main Street, P. O. Box 1406 Southold, N. Y. 11971 MAy~-30-1995 13:47 T.J. ADAMS ASSOC. TO 15167653846 P.02 UUTC~0GU~, NY 11935 ,,,,,c~ ~vros Owned Atttomo~lle$ Not Covered IN~UR~D, RUT ONLy ~DITtONAL CITTCHOuUE LION9 CLUB AND NOT OUT OF ~ SOL~ N~CLiO~CE O~ SAZD ~DITON~ IN~I~ED. ~ RESPECTS I.~LI~ ~I~IN~ ~R~ O~ THE U~ OF T~TR ~R~Zg~ ~y , ~ I'O~N OF ~OUTHOLD 5309~ ~AIN ROAD g.o. EOX 1179 9OI1T'~OLO, gy 11971 TOTAL P.02 PRODUCER I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND I CONFERS NO RIGH'r8 UPON ~-IE CERTIFICATE HOLDER. THIS CERTIfiCATE TJ. Adams & Assoc. Inc. DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. 2021 Spring Road Oak Brook, IL 60521 COMPANIES AFFORDING COVERAGE (708)572-1550 COMPANY (708)$74-3278 FAX L~TTEa A Royal Insurance Company of America CUTCHOGUE LIONS CLUB ~-~ C I~SURED P.O. BOX 715 CUTCHOGUE, NY 11935 ~=m~ D THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER~OD INDICATED, NOTINITHSTANDING ANY REC~JIREMENT, 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, GENERAL UABJUTY GENERAL AGGREGATE $ 2,000,000 X COMMERCLaL GENERAL LIABILITY PRODUCTE-COMP~JP AGG. $ 2,000,000 A I CLaiMS ~[~ OCCUR. ~ 600094 09/01/94 09/01/95 PERSONAL & ADV. INJURY $ 1,000,000 OWNER'S & CONTRACTOR~ pRO] EACH OCCURRENCE $ 1,000,000 FIRE OAMAGE (Afly oeo fke)$ 1,000,000 MED. EXPENSE (Any o~e pe~ S 1,000 AUTOMOBILE UABIUTY COMBINED m.C~E s Included A~V ^u~o UM~T In Above A SCHEDUt~D ~UTOS PIW 600094 09/01/94 09/01/95 X HIRED numa Owned Automobiles sorely INJURY S X ~O~OWN~O^UmS NotCovered Not Covered ~c~TE & ~..~ L~..~.~.>.,~.~.~.~.~..~.~..~.i~ o~ ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ~ Not Covered ~ACH ~CC~OENT ~LO~S' uAatur,, DmE~SE_~C~ EM~.O~ $ ESCRIPTION OF OI~RATIONSa. OCATIONSN EHICL ES~S pEClAL ITEaS PROVISIONS OF THE POLICY AP?LY TO THE ~NTIQUE AUTO SHO~ SPONSORED BY THE CUTCHOGUE LIONS CLUB JULY 9, 1995 AND [NCLUDES THE [~TEREST OF THE TO~ OF SOUTHOLD AS AN ADDITIONAL I~SURED, BUT ONLY AS RESPECTS LIABILITY ARTSTNG OUT OF TEE USE 0P THETR ?REMTSES BY TEE CUTCHOGUE LIONS CLUB A~D ~OT OUT DE THE SOLE NEGLIGENCE OY SAXD ADDTTO~AL [~SURED. ~~ .................. :... TO!~q OF SOUTHOLD 53095 I~IN ROAD P.O. BOX 1179 SOUTHOLD, NY 11971