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HomeMy WebLinkAboutSouthold Town Republicans JUDITH T. TERRY TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER 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 27.1.B of the Code of the Town of Southold, a permit is hereby granted to the Southold Town Republican Club, Inc. to hold their Second Annual Barbeque Pig Roast at Santa's Christmas Tree Farm, Main Road, Cutchogue, New York, on Saturday, July 17, 1993, from il:00 P.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 (certificate has been filed). Dated: July 9, 1993. Southold Town Clerk cc: Police Chief Droskoski Building Dept. (tents) July 9,1993 Town Clerk Judith T. Terry Southold Town Hall Southold, New York, 11971 Dear Judy, On Behalf of the Southold Town Republican Club, I would like to apply for a permit for our second annual Barbeque Pig Roast. The roast will be held at SaNTA,s Christmas Tree Farm, on the Main Road in Cutchogue, New York, on Saturday July 17th, from 4p.m.-Sp.m. We will have two tents, one being 100 feet long and a~bther smaller one~ E~closed p!e&se, find a small drawing depictbng a layout of the farm and ten~ area, and also enclosed ~leasei~ind a proof of insurance from our insurance agent. Any questions, please contact me. Thank you. Sincerely yours Mrs. Sibby Penny Chairperson of event PRODUCER McMann Price Agency Inc. 828 Front Street, PO Box 2065 Greenport, NY 11944 516-477-1680 INSURED 7-6-93bc THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS HO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Southold Town Republican Committee and Southold Town Republican Club PO Box 1641 Southold, NY 11971 COMPANIES AFFORDING COVERAGE COMPANY LE'i-FER aUtica Mutual Insurance Company COMPANY LETTER a COMPANY LETTER C COMPANY LETTER D COMPANY LETTER E 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 SY PAID CLAIMS. POLICY EFFECTIVE POLICY EXPIRATION CO TYPE OF INSURANCE POLICY NUMBER LIMITS LTR DATE (MM/DDIYY) DATE (MMIDDIYY) GENERAL LIABILITY A x COMMERCIAL GENERAL LIABILITY CG1322335 CLAIMS MADE X OCCUR. OWNER'S & CONTRACTOR'S PROT. 3-22-93 3-22-94 GENERAL AGGREGATE S 1,000,000 PRODUCT$-COMPIOP AGG. $ excluded RSSSONAL &AOV. ,.~URY $ excluded EACH OCCURRENCE $ 1~ 000,000 FIRE DAMAGE (Any o.e fire) $ 50,000 MED. EX~S~ (~y ~ p~o.) $ 5.000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LJABILITY UM6RELLA FORM COMBINED SINGLE LIMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) PROPERTY DAMAGE EACH OCCURRENCE AGGREGATE OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY STATUTORY LIMITS EACH ACCIDENT $ DISEASE--POLICY LIMIT $ DISEASE--EACH EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS Certificateholder is named as additional insured for pig roast 7-17-93, at Santa's Christmas Tree Farm, MaSh Road, Cutchogue, I~ 11935 CERTIFICATE HOLDER Town of Southold 53095 Main Rd, PO Box 1179 Southold, NY 11971 ACORD 258 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ~ 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. ©ACORD CORPORATION 1990 JUDITH 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 27-1-B. of the Code of the Town of Southold, a permit is hereby granted to the $outhold Town Republicans to hold a "Get-Together With Republican Candidates" on Sunday, October 25, 1989, from 2:00 P.M. to 5:00 P.M., on the premises of Leander Glover Jr., Cox Lane, Cutchogue, provided they secure and file with the Town Clerk a Certificate of Insurance for at least One (1) Million Dollars liability insurance covering the Town of Southold as an additional insured. Dated: October 25, 1989. Judith T. Terry~/ Southold Town Clerk cc: Police Chief Winters Building Department RECEIVEO OCT,2 5 1989 Elizabeth M. Visser 405 Saltatre Way Mattituck, NY 11592 Town of Southold Main Road Southold, NY Attn: Mrs. Judith Terry, Dear Mrs. Terry: The Southold Town Republicans Republican Candidates" on Oct. Town Clerk will hold a "Get-Together With 29, 1989, on the premises of J. Glover, Very truly yours, Elizabeth Visser, Organizer can be reached at 298-9363. Cox Neck Lane, Cutchogue. The general public is invited. Refreshments will be served at no charge (non-alcoholic beverages) and there wi]] be live musical entertainment. Please issue a permit for the event. Insurance coverage in the amount of $1 million has been arranged. ~RODUCER McMann Price Agency, Inc. P.O. Drawer E Greenport, NY 11944 10/26/89 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS COMPANIES AFFORDING COVERAGE Y2229 COME^NY LETTERA CODE SUB-CODE COMPANY LETrER a INSURED Southold Town Republican Corrmittee COMPANYC LE"CFER Southold Town Republican Club Main Road COMPANY D LETTER Southold, NY 11971 Utica Mutual Insurance Company COMPANY E LETTER 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 HERE~N IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POMCY EXPIRATION DATE (MM/RD/YY) DATE (MM/DD/YY) ALL LIMITS IN THOUSANDS GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY C~,MS MABE X OCCUR. CG605573 OWNER'S & CONTRACTOR'S PROT. AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON*OWNED AUTOS GARAGE LIABILITY EXCESS LIABILITY OTHER 03/22/89 03/22/90 OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY GENERAL AGGREGATE $ 1 ~ 000 PRORUCTS-COMP/OPS AGGREGATE *none PERSONAL & ADVERTISING INJURY *none EACH OCCURRENCE $1 ~ 000 FIRE DAMAGE (Any one fire) $ 50 MEDICAL EXPENSE (Any one person) $ 5 COMBINED SINGLE $ LIMIT BODILY INJURY $ (Per person) BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ EACH AGGREGATE OCCURRENCE $ $ STATUTORY $ (EACH ACCIDENT) $ (DISEASE--POLICY LIMIT) $ (DISEASE--EACH EMPLOYEE DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIRESTRICTIONSISPECIAL ITEMS "Get-Together With Republican Candidates" on the premises of J. Clover, Cox Neck Lane, Cutchogr NY on the afternoon of October 29, 1989. only. cERTIRCAI'E ~0ER Town of Southold Main Road Southold, NY 11971 Certificate Holder is additional insured for this eve CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 15 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR AUTHORIzEDLIABILITY~~OFREpANY IND UPONE THE COMPANY, ITS AGENTS OR REPRESENTATIVES.