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HomeMy WebLinkAbout0138Revised per TB 7101 WINERY PERiT TO HOLD AN Dat~ of Event: ~~ Address to Send Event P ~enn~t~' t?~ __? ~ ' ~ t~ ~. ' Nature ofEven~ O _~ . C ~ -' ' ' Is a Tent being used? ~)Q Yo~ ] No (Location F41m attached). to the conditions listed below, as weg as ag o4her aPld~_r-=h~ agency ndes_and regulations pedaining to t~e acOvities under this evenL ~.~-~ ~ ~_~ ~ w,.o ow. (signature) PERMISSION IS HEREBY GRANTED, SUBJECT TO THE FOLLOWING CONDITIONS: /'1. By acceptance of 1his permit, Al~iicant agrees to adequately supewise and direct ag paddng to be ~ this site, and Applicant agnms to ixovide additional b-affic r.~mtrols necessary for this evmtt. ,~2. One 'on-premises' sign not largiw Ora. six (6) square feet in size may be ~spla~ed not longer Ihan thirty (30) days f~fore this .~.t, and removed immediately after th~ eve~ Directional ~ ~ shall ix, adequately diSl~ay~l. ./3. ~a~)licant indemnifi~s and holds han111e~s the Town of Southold horn all claims, damagos, exiXillS.~ Certificate of Liability naming the Town of Southold as an additional insured in h ammmt of ~ Million ($1,000,000.00) Do#ms b he~ flk~d by Applicant, and said Ceftil~a:-~ must remain in M force and effect during this entk~ evenL ~//4. Tent proposals must receive pdor wdtten alqN~val from the Southold Town Building Inspector her(m) placement on the PrOlo~ty and must meet aN lire and safety code~ ®venL Each additional day will require a sepa,-a;., permit application, fee. and related 4octmtents for review, etc. at least 45 days la,or to this event. agrees to remove the temporary fac~Tdies h~xn the premises w#hin 48 hours of the day of ~ ~ ~//7. No on-site food prep~al;~t is pennitled, a#ho~gh food may be ca;~md subject to all health regulations. /'8. Events for three hundred (3QO) or more pe~ple require submission and aplwoval of a traffic co~bui plan, acceptable to the Town. H~nerv Event Permit. continued:. Page 2 - Winery Event Permit ~/~0. Issuance of ~ls pmmit does not autltmize in any manner occupancy of tim principal building exceeding the legal limitations tmde~ the fire code, or other codes which would prolt~4 sug# imm~ased occupancy. ~/~1. Two fire exits shall remain ~ and unobatxucted at all times to building(s) mt t~e I~- c,~2. Music, when outdoors, ls requked to stop at lO:OO p.m. No loud music or bend mualc of~r lO:O0 p.m. When disc jockeys are used, the decibel levels will be monitored to ensure ~ levels. O~ganizers of the eve~s wi# be required to use an approved dim:jockey recommended by the winery or have their o~m disc jockey algn a contract agrealng to the above. If I~ey do no~ Itmtor PRODUCER I THIS CERTIFICATE IS ISSUED AS A MATTER OF IN~=ORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Brisotti & $ilkworth, Znc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 8400 Main Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. O. Box 1448 Mattituck, NY 11952 INSURERS AFFORDING COVERAGE NAIC# COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR%DD'[ POliCY EFFECTIVE I POECYEXPIRATION LTR NSRE TYPE OFINSURANCE POLICY NUMBER DAIE(MM/DD/YYII DATEiMMIDDF~YI LIMITS A GENERAL LrABILITY 358*6203 03/14/2005 103/14/2006 EACH OCCURRENCE I $ 1000000  DAMAGE TO RENTED COMMERCIAL GENERAL LIABILrTY ] PREMISES (Ee 0ccurence) $ 1000000 I CLAIMSMADE [] OCCUR MEDEXP{An¥oneperson) ~ 10000 X PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS- COMP/DP AGG $ 1000000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) -- ALL OWNED AUTOS BODiLy iNJURY $ SCHEDULED AUTOS (Per person} HIRED AUTOS -- BODILY INJURY NON-OWNED AUTO S (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY. EA ACCIDENT  ANYAUTO OTHERTHAN EAACC AUTO ONLY: AGG EXCESS/UMERELLA LIABILITY EACH OCCURRENCE $ ~ OCCUR ~1 CLAIMS MADE AGGREGATE $ -- WORKERS COMPENSATIONAND I TORYLIMITS I r°E~ Certificate holder is named aa additional insured with respects tO general liability. CERTIFICATE HOLDER CANCELLATION Town of Southold P.O. Box 1179 $outhold, NY 11971 ~IIOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION LATE THEREOF, THE ISSUING INSURER W~LL ENDEAVOR TO MAIL 1.~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTAT~ ACORD 25 {2001/08) © ACORD CORPO RATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certiiicate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAI',qER The Certificate of Insurance on the reverse side of tlis form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) 1570 50-791/2t4 ~os~. ~^u~ w,.~.¥, ,.c. ~_~ ~ 4108 MERRICK RD. ~ O-,~ ~ MASSAPEQUA, NY 11758 DA~_ ~ North Fork Ban ZBA TO TOWN CLERK CHECK TRANSMITTAL SHEET (Filing of Application and Check for Processing) DATE: 4~22~05 ZBA # NAME CHECK # AMOUNT TC DATE STAMP RECEIVED WP-13~ Joseph Paul Winery 1570 $50. APR 2 8 2005 $outhold Town TOTAL $5o. Thank you. Date: 04/29/05 Town Of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Receipt'8: 1570 Transaction(s): 1 1 Public Events Reference WP-137 Subtotal $50.0O Check#: 1570 Total Paid: $50.00 Name: Joseph, Paul Winerylnc 4108 Merrick Road Massapequa, NY 11758 Clerk ID: BONNIED Internal ID: WP-137 r ~"'I~II'I~A TION$ ROAD LANES ,RD. ) (C. R. 48) NOTE' THERE ARE NO STORM DRAINS ~FITHIN ;~ 50' RADIUS OF THE WELL & THERE ,~LL ~E NO C.P. WITHIN A 150' RABIES OF ~ELL. ,, THERE AR~ NO ~ELLS WITHIN ,A 150' RADIUS OF CESsPOOlS. RMIT QUI,RED C METAL BUILDING EXISTING ~AGTE S,)¢~ ~bt TO REMAIN /oqm with Er. 4.5' /srge 9revel PARKING STORAG£ L. /ND, R£'I'A IL ..¢AL£$ Test Boring CRITERIA KEY MAP ~q. fL/*tOGO s'r;, 'ft./500 sq, fl, 1200 EMPL OzYE£~' PRO VIDE DRA:INGE CRITERIA ROOF 7083 sq. fl. CONTEtUR' LINES ARE TOTAL AREA= ~4.95~ LOT ~,VgRA~ v LA.SCAPE = I~ CIO - 94-0// ' G~OU~D ~A T.~ ~A~WZ-~k~ ZO~[ 'V,V, ~ ' . 14.955 ocres 300, = ¢NDUSTR/AL '- ' ' , 4~04 ~; . ,.-~'~'.~: ~s T OFFICE 200 ~ ~ ~¢~ SEPTIC TA~ ' lEO0 gal Septic ~ Tan~ provided LEACH/NE POOLS