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HomeMy WebLinkAboutMattituck Laurel Historical Society ELIZABETH A.NEVILLE,MMC �� G.f, Town Hall, 53095 Main Road TOWN CLERKp P.O.Box 1179 H 2 Southold,New York 11971 REGISTRAR.OF VITAL STATISTICS O Fax(631)765-6145 MARRIAGE OFFICERy Z► RECORDS MANAGEMENT OFFICER ��,( .�a� Telephone 765-1800 FREEDOM OF INFORMATION OFFICER www.southoldtldtownny.gov OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD May 28, 2014 Lauren Brigham Mattituck Laurel Historical Society PO Box 24 Mattituck, NY 11952 Dear Ms. Brigham: This office is in receipt of your application to hold a lawn sale on the Historical Society property. This event does not require Town approval as it is held on private property and requires no Police presents. An insurance policy naming the Town of Southold as additionally insured has been filed with this office. If you have any questions, please contact me at the Town Clerk's office at 631-765-1800. Good Luck with your event. Sincerely, &Ujv�L Lynda M Rudder Deputy Town Clerk enc O��gr�FFO(,�co ELIZABETH A.NEVILLE,MMC �� G,j, Town Hall,53095 Main Road TOWN CLERKP.O.Box 1179 CO2 Z Southold,New York 11971 REGISTRAR,OF VITAL STATISTICS p Fax(631)765-6145 MARRIAGE OFFICER A �aO! Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION FOR A PERMIT TO HOLD A SPECIAL EVENT Please provide ALL of the information requested below. Incomplete applications WILL NOT be reviewed. Date of Submission 1114 Name of Event l ti ko" —1�3A e Ix►W� �1 V r�1 ��C1�1 Name of Organization: Is this a Not-For-Profit Event?Yes/No 6 Contact's Name: Mailing Address: �� p�`[ (� �`' T I t O`'-- Contact's Phone Number: Contact's Email Address: ((l CLo Event Location and Site Diagram: e (Use additional paper if necessary)Event Date(s): 41 abt �`M�e 36A 6 \ 4-1 (Include set up anJ shutdown times and dates) Nature of Event:61u& t-LJ��� � �� (Please attach a detailed description to this application) Time Period(Hours)of Event: From 3-AM to Maximum Number of Expected Attendees: 15Z Specify any special requirements(i.e. road closure, police presence): ,mane, If a Tent or other temporary structure will be used please contact the Southold Town Building Department at 631-765-1802 Mailing Address to Send Event Permit to: ($ Fees: $250 for events with less than 1000 expected attendees $350 for events with 1000 or more expected attendees $250 or more Clean-up deposit NOTE: Additional deposit may be required(see attached regulations)and shall be made in an amount determined prior to issuance of the permit based upon the estimated direct costs attributable to additional police, highway and cleanup costs associated with the event. The deposit will be used to cover such costs and any unused monies will be returned to applicant. CERTIFICATE OF INSURANCE REQUIRED: Not less than $2,000,000 naming the Town of Southold as an additional insured. � 9� l9 -V V r\oy- 14he Additional information and requirements may be required as deemed necessary by the Town Board. Luz, :s-, < Print name of Authorized PersAn filling out ign Lure of Authori d erson Cg out application application *Upon the request by applicant,the Town Board may waive in whole or in part any of the application requirements. 2 Rudder, Lynda From: Rudder, Lynda Sent: Tuesday, May 20, 2014 10:02 AM To: Flatley, Martin; Kruszeski, Frank Cc: Blasko, Regina (rblasko@town.southold.ny.us) Subject: Special Events Attachments: antique_20140520083307.pdf, cubmobile_20140520082917.pdf, lawn sale_ 20140520083401.pdf Please review the three (3)attached special events and provide approval/disapproval and cost analysis. Please note the lawn sale is self-contained and does not require police support. 1 Rudder, Lynda From: Flatley, Martin Sent: Wednesday, May 21, 2014 12:24 PM To: Rudder, Lynda; Kruszeski, Frank Cc: Blasko, Regina Subject: RE: Special Events Hi Lyn, I have no objections to the Cubmobile Race being held, we do provide the group with barricades to close down their road for the race, but don't assign any resources to it. I also have no objections to the Mattituck-Laurel- Historical Society's Annual Lawn Sale being held, we do not assign any resources to this event either. With regards to the Antique Show in Cutchogue, I will need more specifics of when their event is actually taking place. Traditionally it's been a one-day event on Saturday and I assume that has not changed? If it is more than that, I will need to know, as our manpower for July 4th weekend will only support so many events, and we have several approved already. Please let me know Lyn, Thanks Martin Flatley Chief of Police Southold Town Police Department 41405 State Rt. 25 Peconic, N.Y. 11958 631-765-3115 -----Original Message----- From: Rudder, Lynda Sent:Tuesday, May 20, 201410:02 AM To: Flatley, Martin; Kruszeski, Frank Cc: Blasko, Regina Subject: Special Events Please review the three (3)attached special events and provide approval/disapproval and cost analysis. Please note the lawn sale is self-contained and does not require police support. 1 RECEIVED April 2014 MAY 1 2014 P , Southold Town Clerk Elizabeth Neville, Southold Town Clerk Main Road Southold, NY 11971 Subject: Permit Request for Annual Lawn Sale Dear Ms. Neville, We are requesting a permit for our Annual Lawn Sale on the 1.2 acre Mattituck- Laurel Historical Society grounds. The event will be held July 5, 2014 from 8am- 4pm. Raindate will be July 6, 2014. There is ample parking on site for our guests. A portable toilet will be provided for the day. Enclosed is a one million dollar certificate of liability insurance naming Southold Town as an additional insured. Lauren J Brigham Acting President cc: file Enclosures MATT102 OP ID: RK CERTIFICATE OF LIABILITY INSURANCE DAT�2M9/201 YY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endomement(s). PRODUCER CONTACT NeefusStype Agency,Inc. PHONE FAX 711 Union Avenue No E :631-722-3500 A No:631-722-3591 P.O.Box 2340 E-MaL Aquebogue,NY 11931-2340 ADDRESS: Jason R.Wahl INSURER(S)AFFORDING COVERAGE NAIC N INSURER A:Markel Insurance Co INSURED Mattituck-Laurel Historical INSURER 0: Society and Museums PO BOX 766 INSURER C: Mattituck,NY 11952 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP RLIMITS A X COMMERCIAL GENERAL LIABILrrY EACH OCCURRENCE $ 1,000,00 CLAIMS-MADE FKOCCUR X 8502SS373291-2 04/11/2014 04/11/2015 pREMISEs Eaoaxurence $ 100,00 MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 X POLICY F ECTT �LOC PRODUCTS-COMP/OP AGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIM T $ Ea accident ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY $ AUTOS AUTOS JU (Por aaideM) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per aWdeM $ $ UMBRELLA I" OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATIONPER OTH- AND EMPLOYERS'LIABILI Y YIN STATUTE ER ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory M NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under E.L.DISEASE-POLICY LIMIT $ DESCRIPTION n OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached H mora space Is required) The Town of Southold is listed as additional insured with respects to General Liability. Event: Lawn Sale on Saturday July 5th from Sam-4pm with Rain Date Sunday July 6th from 8am-4pm CERTIFICATE HOLDER CANCELLATION TOWNSOU SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. 53095 Route 25 Southold,NY 11971 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD