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Home My WebLink AboutRiverhead Kennel Club JUDITH T. TERRY TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER OFFICE OF IFHE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southotd, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1801 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 Riverhead Kennel Club Inc. to hold an AKC Licensed Dog Show at the Mattituck High School grounds on Saturday, July 13, 1991, from 7:00 A.M. to 5:00 P.M., provided they secure and file with the Town Clerk a Certificate of Liability Insurance for at least One Million Dollars naming the Town of Southold as an additional insured. Dated: July 12, 1991. cc: Police Chief Droskoski Southold Town Building Dept. SPORTSMEN'S INSURANCE PLAN PO BOX 79S CAPE VINCENT, NY 13618 Agency Code: 55-2240 Insured RIVERHEAD KENNEL CLUB, INC. 7 WOODLAND PARK ROAD BELLPORT NY 11713 MARY K. BAKER TREASURER This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policies below. COMPANIES AFFORDING COVERAGE Company Letter "A" HANOVER INSURANCE CO. Coversqss This is to certify that the policies of insurance listed below have been issued to the insured named above for the policy period indicated, notwithstanding 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. Limits shown may have been reduced by paid claims. Ltr "A" LIMITS TYPE OF INSURANCE General Aggregate $2000000.00 Each Occurrence $1000000.00 Prod.-Comp/Op Agg. $ incl. Pars. & Adv. Injury $ excl. Fire Damage $ excl. Medical Payments $ excl. x Commercial General Liability Claims Made x Occurrence POLICY # LHS3274601 EFFECTIVE DATE 06/26/91 EXPIRATION DATE 06/26/92 12:0! A.M. STANDARD TIME CERTIFICATE # HD6358 Automobile Liability XHired Autos ~Non-Owned Autos Combined Single Limits $ 1.000.000/2.000.000 LHS3274601 06/26/91 to 06/26/92 12:01 A.M. HD6358 Excess Liability ___Umbrells Form NIL ___Other Than Umbrella Form NIL Worker's Comp. & Employers' Liability NIL Description of Operations/Locations/Vehicles/Special Items Organized Club and/or Show activities. Certificate Holder Cancellation Town of Southold Mattituck High School Southold, ~. I., N. Y. AUTHORIZED REPRESENTATIVE Should any of the above described policies be cancelled before the expiration date thereof, the issuing company will endeavor to mail lO days written notice to the certificate holder named to the left, but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representatives. Riverhead Kennel Inc. POLICY NUMBER: LHS3274601 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED---MANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. HD6358 SCHEDULE 1. Designation of Premises (Part Leased to You): Athletic field & parking area 2. Name of Person or Organization (Additional Insured): Town of Southold Mattituck ~ligh School Southold 3. Additional Premium: No ¥o (If no entry appears above, the information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) WHO IS INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1. Any "occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or dem- olition operations performed by or on behalf of the person or organization shown in the Sched- ule. CG 20 11 11 85 Copyright, Insurance Services Office, Inc., 1984 [] Producer SPORTSMEN'S INSURANCE PLAN PO BOX 799 CAPE VINCENT, NY 13618 Agency Code: 55-2240 RIVERHEAD KENNEL CLUB, INC. 7 WOODLAND PARK ROAD BELLPORT NY il713 NARY K. BAKER TREASURER This certificate is issued as · matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policies below, ~OMPANI£S AFFORDXRO COVERAGE Company Letter SA' HANOVER INSURANCE CO. This is to certify that the policies of insurance listed bales have been issued to the insured named above for the policy period indicated, notwithstanding 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 a~forded by the policies described herein is subject to ell the terms, exclusions and conditions of such policies. ~imita_~ehown may hqve been reduced by ~aid Clsim~. Ltr "A" ~MITS TYP~ OF INSURANCE General Aggregate $2000000°00 Each Occurrence $1000000.00 Prod.-Comp/Op Agg. $ Pare. & Adv. Injury $. excl. Fire Damage $ ~cl. Medical Payments $ excl. Commercial General Liability .~iaims Mede ~ Occurrence POLICY # LHS3274601 EFFECTIVE DATE 06/26/9! EXPIRATION DATE 06/26/92 12tO1 A.M. STANDARD TIME C£RTIFICATE # Automob~~ __~Hlred Autos ..,~Non-Owned Autos LHS3274601 06/26/9i to Combined Single Limits 06/26/92 12:0l A.N. __Umbrella Form NIL ~Other Than Umbrella Fgrm NIL Worker'~ Comp. & £mD,loYer~' Liability NIL ~scrio[loq Of Ooeratlons/b~cations/¥ehicleq/gpe~ial Items Organized Club and/or Show activities. ~ertificate Hoide~ Town of Southold Mattituck High School Southold, ~. I., N. Y. AUTHORIZED REPRESENTA~rIVE Cancellqtioq Should any of the above described policies be cancelled before the , . expiration date thereof~ the'iasuin~---~ company will endeavor to mail lO days written notice to the certificate holder named to the le~t, but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representatives. Riverhead Kennel ~, lnc,. POL3CY NUMBER: LHS3274601 MMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY, ADDITIONAL INSUREDmMANAGERS OR LESSORS OF PREMISES This endorsement modifies insurance provided unde~ the following: HD6358 COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE 1. Designation of Premises (Part Leased to You): Athlel~ic field & parking area 2, Name of Person or Organization (Additional Insured): Town of Southold Hatt:ituck High School Southold 3. Additional Premium: N.Y. (if no entry appears above, the information required to complete this endorsement will be shown in the Declara- tions as applicable to this endorsement.) WHO IS I NSU RED (Section II) is amended to include as an insured the person or organization shown in the Schedule but only with respect to liability arising out of the ownership, maintenance or use of that part of the premises leased to you and shown in the Schedule and subject to the following additional exclusions: This insurance does not apply to: 1, Any "occurrence" which takes place after you cease to be a tenant in that premises. 2. Structural alterations, new construction or dem- olition operations performed by or on behalf of the person or organization shown in the Sched- CG 20 11 11 85 .. Copyright, Insurance Services Office, Inc., 1984 SPORTSMEN'S ZNSURANCE PCAN TO~&X NUMBER~ ~]6-765-182~ Town of Southold SPORTSMEN'S ZNSURAN¢~ P~AN PO SOX 4~ C~AYTON~ NY 15624 /UDITH T. TERRY TOWN CLERK REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 FAX (516) 765-1823 TELEPHONE (516) 765-1801 SPECIAL PERMIT In accordance with Chapter 27, Section 27-I-B of the Code of the Town of Southold, a permit is hereby granted to the Riverhead Kennel Club Inc. to hold an AKC Licensed Dog Show at the Mattituck High School grounds on Saturday, July 14, 1990, from 7:00 A.M. to 5:00 P.M., provided they secure and file with the Town Clerk a Certificate of Insurance for at least One Million ,Dollars naming the Town of Southold as an additional insured. Dated: July 9, 1990. -Judith T. Ter/-y Southold Town ClerR cc: Police Chief Winters VICTOR LESSARD PRINCIPAL BUILDING INSPECTOR (516) 765-1802 FAX (516) 765-1823 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD July 9, 1990 To: From: Re: Judy Terry, Town Clerk Victor G. Lessard, Principal Building Inspector Riverhead Kennel Clttb Dog Show The Building Department is satisfied with the data submitted by your office, so you can continue with the permit process. I suggest that Anthony DeMaula notify this office when the tents have been erected so that an inspection can by made. JUDITH T. TERRY TOWN CLERK REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, $3095 Main Road P.O. Box 1179 Southold, New York 11971 FAX ($16) 765-1823 TELEPHONE ($16) 765-1801 July 9, 1990 To: Victor G. Lessard, Principal Building Inspector From: Judith Terry, Town Clerk~ Re: Riverhead Kennel Club Dog Show Attached is a request from Anthony DeMaula for a Special Permit to hold a Dog Show at Mattituck High School grounds on July 14, 1990. They plan to erect tents which will be set up on July 13th. Please advise if you have a problem if I issue a permit, whereas the event is this coming Saturday. Thank you. JUL-- I 8--9 8 T U E I 4 : sP Ol~ ~1-'$ ME Ng~'~ '1N iU N C E P . 0~; '" " C_g_ST_!_FAG_~ T g_ O_F eights upon the certificate holder. This certificate does not amend, extend or alter th~ coverage afforded by the policie~ listed below. COMPANY LEII'FR "A" HANOVE:~ _IN_':~_'~RANCE COMPANY _ COMPANY LE'II'ER "B" .............. Name end e:Jd; s~s of Insured: SPORTSMEN'S INSURANCE PLAN .zv...~^r~ ~z~*q,r,_ ouL, s. ~o. PO BOX 40 7 WOODLAND PARK ROAD CLAYTON, NY 1,3624 BEt. LPOR~ ( 31b)654-2068/FAX: ~ 315)654- 30'~'7 BELLPORT NY 11713 MARY K. BAKER TREASURER _Co. l'~/pe Of__I.osu_ranc_e ................... ~o~l!o_y _Num~be? .... OENERA.L Comprehens£ve Form Premls~a~Ope~at~on~ P~oducts/Completed OperatJon~ Hazard Contractual. Broad Form Property Damage Independent Contractor~ AUTOMOB i~ E_~_I~A B I___~: LT_Yj _ x_Btred ~X_Non-owned A CSL $1,(}00,000/2,000,1)00 BI/PD AGGREGATE LHS3274601 Certificate # HD4402 ~ol~__cy In_qgD%l~oo Dat~ 06/26/90 Polic__~x~lration pat~ 06/26/91 ~tmSts o~ Ltabill~z CSL BI/PD $1000000.00 AGGREGATE $2000000.~0 Policy Number LHS3274601 Certificate# HD4402 Policy Inception 06/26/90 Policy Expiration 06/26/91 5s~cript*on of -O'per~tl'o;~/-loca~On~}vehicles~ O,,~,,,,ized dc, g club activities. before the expiration date thereof, the t~sutng company will endeavor to mail ~O days wTltten notice to the below named certificate holder, but failure to mail s~.~ch notice sh~ll impose no obligation or liability of Shy kind upon th~_o_p_lZg~y~ _._ NAME AND ADDR£SS OF CER'I'IF'~C~I'~ Town of Sourbold Mattituck High School Long Is.land, N. ¥. NN3-C/INS MUI.,DER: Represen~tive DATE MAILED:07/10/90 --T U L-- i 0-- 9 8 T U E · Rivm;head Kennel Club, PODCY NUMBER: LBS3274601 COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED--MANAGERS OR LESSORS OF PREMISES SCHEDULE 1. D-~gn~!o-otPrm~,~,(P.,~fl~' ''''rJlOYo''~) ALhlet~C £ield & .0arkJ. n~, area 2. N ,':e v~u~'.~ ~r S',E~ ;zdt~m~:~J;' ,,/l~s,,~e,t) '[o~n of SouLhold ~attit~ck H~gh Schoo[ 3. Add,~or,,~lPrennum I,on8 Tsland, N. Y. 1 Arty "occurre;~ce' which ~akes prate after you (:ease Io be a ret'ant W, that [)rem,scs ule CG 2u Il !1 85 Csp/, :' ufa ~e Se,v,.esOff,ce Inc 1984 JUL--18--90 SPORTSMEN'S INSURANCE PLAN BUSINESS PHONE · (315) 654-2068 FAX # (315~ 654-3097 FACSIMILE COVER SHEET NUMSER OF PA~ES:~__~ .... INCLUDING COVER SHEET FROM: SPOk?'SMEk'S INSURANCE PLAN PO BOX 40 CLAYTON~ NY 13624 CERTIFICATE OF INSURANCE This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the policies listed below. COMPANIES AFFORDING COVERAGE COMPANY LETTER "A" HANOVER INSURANCE COMPANY COMPANY LETTER "B" Name and address of Agency: SPORTSMEN'S INSURANCE PLAN PO BOX 40 CLAYTON, NY 13624 (315)654-2068/FAX:(315)654-309? Name and address of Insured: 7 WOODLAND PARK ROAD BELLPORT BELLPORT NY 11713 MARY K. BAKER TREASURER Co. Type of Insurance GENERAL LIABILITY A x__Comprehensive Form x__Premises/Operations x__Products/Completed Operations Hazard x__Contractual Insurance __Broad Form Property Damage x__Independent Contractors Policy Number LHS32?4601 Certificate # HD4402 Policy Inception Date 06/26/90 Policy Expiration Date 06/26/91 Limits of Liability CSL BI/PD $1000000.00 AGGREGATE $2000000.00 AUTOMOBILE LIABILITY Hired X Non-owned CSL $1,000,000/2,000,000 BI/PD AGGREGATE Policy Number LHS3274601 Certificate# HD4402 Policy Inception 06/26/90 Policy Expiration 06/26/91 Description of Operations/locations/vehicles: Organized dog club activies. Cancellation: Should any of the above described policies be cancelled before the expiration date thereof, the issuing company will endeavor to mail 10 days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: Town of Southold Mattatuck High School Long Island, N. Y. HH3-C/INS DATE MAILED:06/19/90 ~thorized Representative