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Home My WebLink AboutDCR Productions - pF SO(/l�ol ELIZABETH A.NEVILLE,RMC,CMC ti O Town Hall,53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold,New York 11971 MARRIAGE OFFICER ► • �O� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICERTele hone (631) 765-1800 FREEDOM OF INFORMATION OFFICER COUNTI southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD February 4, 2009 CERTIFIED MAIL RETURN RECEIPT REQUESTED DCR Productions 120 W 25" St., Ste 5E New York NY 10001 Re: Southold Town Filming Permit No. 023 Dear Sir or Madam: Returned herewith is cashiers check No. 9793700244 in the amount of$750.00 for the highway cleanup deposit as required by the Southold Town Code. An inspection of the permit sites was made and no highway cleanup was necessary. Very truly yours, 4tz� k 4"� Linda J. Cooper Deputy Town Clerk ro In .. , M tr Co P ?ostage $ !�/ r3 Oertltied Fee J`H Qt O w C3 Retum Reclept Fee O Postmark y (Endorsement Required) �`� Here .� C3 Restdeted Delivery Fee r-3 (Endorsement Required) M Total Postage&Fees $ S 3 21 m C3 t o NOae pf-, uc T fieet S` Apt No.; - ��-------- or PO Box No. - -----------------------�s k Sf S City State ZlX4 x'y • • • DELIVERY SENDER: COMPLETE SECTION ■ Complete items 1,2,and 3.Also comp [3 Agent lete A sig"ature Item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse X ❑Addressee so that we oan return the card to you. B. Received by(Printed Name) C. Date of Delivery I ■ Attach this card to the back of the mailpiece, I or on the front if space permits. D. Is delivery address different from Item 17 ❑Yes - 1. Article Addressed to: If YES,enter delivery address below: ❑No J av w I - I N LiGt> yv 2K `a 3. So,We Type EJ Certified Mail ❑Express Mail I/ 000 / ❑Registered ❑Return Receipt for Merchandise Ii ❑Insured Mall ❑C.O.D. I , 4. Reshlcted Delivery?P tra Fee) ❑Yes 2. Article Number I (Transfer from servk;e laden 7 0 0 3 3110 0001 8 5 4 9 3584 I PS Form 3811,February 2004 DomesticReturn Receipt 102595-024A-1640 64 J l,, 282111107 NEW 01/08 8810004306 91/1 - f, Reintitter I,7E#I EILeY1 5 t IUIlE61F1TY DOLLARS aNi0CENTS TOW t J, ' �Af+) A8 BIkNiK�N,ll r i }kms' S Or 1 e t�resident Chose tBank,NA. t 1189*93700 24411' 1:04400003700. 75866 L43311' � d I ELIZABETH A.NEVILLE �QF SDUryOI Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER G Q Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER �liJ'couffN southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD FILMING/STILL PHOTOGRAPHY PERMIT Issued to: DCR Prod uctions/Hiddens Street Productions Date(s), Time(s) and Location Saturday, November 15, 2008 —Love Lane, Mattituck—6:00 AM— 8:30 AM Saturday, November 22, 2008 —Dam Pond - 6:00 AM to 6:00 PM Sunday, November 23, 2008 — Dam Pond—6:00 AM to 6:00 PM Permit No. 023 Issue Date: 10/13/08 Elizabeth A. Neville Southold Town Clerk (Town Sea]) TOWN CLERK'S CHECKLIST FOR FILMING PERMIT NOTE: All payments must be cash or certified check Applicant: D C/� ,pleo�C v c) Date Received: // — -7 - bS�' Completed application $100 nonrefundable application fee / Certificate of insurance that evidences a public liability insurance policy covering the town as an additional insured in the amount of$1,000,000 (one million dollars) per occurrence for the duration of the filming or still photography. Indemnification agreement stating the applicant agrees to assume all liability for and will indemnify and hold the town harmless of and free from any and all damages that occur to persons or property by reason of bo said filming or still photography. 7 Forward completed application to Chief of Police for approval or disapproval and determination if Traffic Control Fee is required 7�� ✓Approved Disapproved No Fee Required Fee in the amount of$ required Forward certificate of insurance and indemnification agreement to Town Attorney for approval Approved Disapproved COLLECT FEES AS FOLLOWS: Permit Fees (Prior to issuance of permit): -3Y) Film Fee - $100 per day of each day covered by the permit Cleanup deposit: Separate certified check for $250 for each day covered by the permit. Traffic control fee - $1000 for each day covered by the permit if required by the Chief of Police. NOTE: Additional funds may be required by Police if it is determined that $1000 per day fee will be expended prior to the termination of the permit period. Beach Parking fee - $10 per vehicle, per day between May 1 and September 30. ISSUED PERMIT Countersign application Issue permit with name of applicant, locations(s), date(s), and time(s) NOTIFICATION of ISSUED PERMIT Chief of Police Chief Building Inspector Fire Marshal Code Enforcement Officer Superintendent of Highways Superintendent of Parks and Recreation REQUEST FOR EXTENSION OF PERMIT Forward extension permit request to Chief of Police If granted, collect additional $100 per day filming fee Amend permit to indicate granted extension period COMPLETION OF PERMIT PERIOD Chief of Police to provide applicant with statement of cost for providing Traffic Control and police coverage. (Refund overpayment or collect for additional costs within 30 days of termination of permit) Superintendent of Highways inspections locations listed on permit and determine if cleanup efforts by town personnel is required. *If cleanup is required, Superintendent will provide Town Clerk with a statement of actual costs. (Refund overpayment or collect for additional costs within 30 days of termination of permit) *If not cleanup is required, Superintendent of Highways will notify Town Clerk and Town Clerk will remit the $250 certified check to applicant. Page 1 of 1 Cooper, Linda From: Cochran, Carlisle Sent: Wednesday, November 12, 2008 12:01 PM To: Cooper, Linda Cc: Garsik, Pat Subject: filming Permit I have reviewed the request for a filming permit and spoken to Dane C. Reilly of DRC Productions. I have no objection to the permit being issued and find that there is no need for Police involvement as the filming will not take place on any roadways. Carlisle E. Cochran Jr. Chief Southold Town Police PO Box 911 Peconic, NY 11958 1-lqs Phone 631-765-2600 Admin Phone 631-765-2671 Admin Fax 631-734-2315 Main Fax 63 1-765-2715 The inforl-nation contained in this c-nriail message is intended only for the personal and confidential use of the designated recipient named above. This message may be a Law Enforcement comzmulication that is security sensitive and confidential. If the reader of this message is not the intended recipient, you are hereby notified that you have received this message and any attached documents in error, that any review. dissemination, distribution, or copying of the message and documents is strictly prohibited. If you have received this message in error, please notify us by e-mail or telephone immediately and delete it and any accompanying documents. 11/12/2008 SOF SO(/ry ELIZABETH A.NEVILLE �� 1 Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER G Q Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER �li�'couffm� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Chief Cochran, Southold Town Police From: Linda J. Cooper, Deputy Town Clerk Dated: November 7, 2008 Re: Filming Permit Transmitted herewith is the application of Dane C. Reilly of DCR Productions for a Student TV Pilot filming permit. In accordance with Section 139.0 of the Town Code please review the application and advice of approval or disapproval of the application and whether a traffic control fee is required and the amount needed. APPLICATION FOR FILMING/STILL PHOTOGRAPHY PERMIT NO: Pleave Print or Type APPLICATION DATE: I I ALA NAME OF APPLICANT: n 'RP-11e.4 MAILING ADDRESS: 1Za su L' Sr- PHONE: BUSINESS: alto. S63: - LL35 _HOME,: NAME OF ORGANIZATION/COMPANY: bd �� cbr..s ��-I� -•s MAILING ADDRESS: I Zp W 254 5lr,_xf SA, 'Sr L — PHONE: 41 •5 6J•q��S FAX: DESCRIBE TYPE 11 YPE OF ACTIVITY (e.g. Motion Picture, Commercial, Television. Catalog, Magazine, etc.): +Ud 9J: _N � ._� - DATE(S) AND TIME(S) OF11PROPOSED FILMING/PHOTOGRAPHY: f Love LF.m c CCNoJ 1 I5;6 9)WACI -60A4 hasm ,� Li'Md '-3 600,4'-`Oct`., PROPOSEDD LOCATION(S) OF FILMING�/PHOTOGRAPHY: (attach additional sheet, if necessary) —Lyn � o C dr -WA..r Love NAME OF PERSON 1N CHARGE AT SITE: _ C. 1�pA _ �x �21" NUMBER OF PERSONS AT LOCATION (cast&crew included): 2-5 NUMBER AND TYPE OF VECHILES AT LOCATION: TYPE OF SPECIAL EQUIPMENT: 3 5kj. ANY SPECIAL REQUIREMENTS: SIA iL_3Z Sign a Return to: Southold Town Clerk Southold Town Hall 53095 Maid Road P.O. Box 1179 Southold,NY 11971 Z0 39bd 60Z0 S,OANIN X3Q3d 09ST-GZG-ZTZ EZ:6T 800Z/90/TT 'INDEMNIFICATION AGREEMENT TOWN OF SOUTHOLD FILMING/STILL PHOTOGRAPHY PERMIT The Applicant shall indemnify and hold harmless the"Town from and against all suits, claims, demands or actions for any damage and/or injury sustained or alleged to be sustained by any party or parties in connection with the performance of filming or still photography by the Applicant, his employees or agents or any subcontractor and in case of any such action brought against the Town,the applicant shall immediately take charge of and defend the same at his own cost and expense. In addition,the Applicant will name the Town as an additional insured on any applicable policies. r Signature Date Printed name Title 60 39Vd 60Z0 S,OANIA X3Q33 095T-6Z6-ZTZ EZ:6T 800Z/90/TT LAMM TTNA LL Vf LIABILITY INSURAN E 11/oa/2oo8 aooucEr, (212)947-6488 FAX (212)947-6489 THIS C""RTIFICATE 18 ISSUED AS A MATTER OF INFORMATION 'aylor A Taylor Ltd. ONLY AND CONFER$NO RIGHTS UPON THE CLR`rtr-7CATE 10 Park AVenue HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR i wd Floor ALTER THE COVER GE AFFORDER BY TIME POLICIES BELOW, dew York, NY 10016 Contact - K. Engl and INSURERS AFFORDING COVERAGE NAIC s ;UReD Hidden St. Pro uct ons, LLC INSURERA: Praetorian XnSuranCe Co. 150 Spring Street INSURER B: New York, NY 10012 McURER C; FINSURER D: INSURER E: THE POLICIES OF 1NSURANC15 LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDIN ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OYHER DOCUMENT WITH AFSPECT 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.AGQWEGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, DD' TYPE OF INSURANCE POLICY NW6Sq POLICY EFFECTIVE POLICY EXPINATION �g almew LIMILmr P0030CP001039-00 04/14/2008 04/14/2009 EACH OCCURRENCE s 1.000.01 X COMMERCIAL GENNERAL UASIUTY DAMAGE TO RENTED i 100.00A CLAIMS MADE 1.::..-I OCCUR MSD EXP(Ai,y ono perBon) 3 1100 PMSONAL i ADV MVJURY $ 1��00.0001 GENERAL AGGREGATE $ 2 000 OD GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS.COMPIOP AGG S 7 000 00 X POLICY JCS LOC AUTOMMLE LAY P0030CP001039-00 04/14/2008 04/14/2009 COMBMSD SMQLE LIMIT 5 ANY auTo (Ra�""1) 1 000 00 ALL OWNED AUTOS GODLY WURY i (Por W80n) A SCHEDULED AUTOS X HIRED AUTOS BOPLY INJURY (Por swident) Ix NON.OWNEO AUTOS Auto P.D. : XNCL. IN MISC EQUIP PROPERTY DAMAGE � D :10% LOSS/$2,Soo MIN/ $7,500 MAX (Per ecddent) QANAGE AUTO ONLY-EA AOdDehIT i ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AC+a S EXCESM1111BpeLLA LUIBILTIY EACH OCCURRENCE 6 OCCUR CLAIMS MADE AmOREGATE Z i DEDUCTIBLE S RETENTION S WORK411e CONPeNSAT1ON AND P003OWC000481-00 04/14/2008 04/14/2009 X `" IlTATU OTK EMPLOYERS'LIARNM e,L EACH ACCIDENT d 1, 010001 OO A ANY PROPRIETORIpARTNeAIEXECUTIVE E,l DISEASE-FA EMPLOYE i 1 OOO 00 OPFlc.ERIMEMBER EXCLUDED Wye&ds�aibe unserE.L DISEASE-POLICY LIMIT 16 110001000 SPEGUaL PROV1810NS Edow 50 Y 0003001000388-00 04/14/2004 04/14/2009 $750,000 LIMIT/S2, 0 DED EQUIPMENT A ROPE/9QTS/WARDROBE $150,000 Ll11T/52,500 DED RDPTY PROP DMG 51,000x000 111N17/52,500 DED DESGRpnwW OF OPegAnoN6/LOCATIONS/VEMCLgS/EXCLUSIONS MMED BY ENDOPSgMBNT/9PECM L PROVISIONS Certificate Holder is 'included as Additional Insured as respects to the General Liability and the negligence of the Named Insured. SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE E71PIR AMN DATE THEREOF,THE 6SUw0 MSURER WILL ENDEAVOR TO MAIL Town of Southold, New York _19 DAYS WWrMN NOTICE To THE CERTIFICATE HOLDER NAMED TO THE LEFT'. Attn: Town Clerk's Office BUT FAILURE To MAIL SUCH NOTICE.SHALL MWOSE NO OBLIGATION OR LIABI M 53095 Route Z5 P.O. Box 17.79 OF ANY KIND UPON THE WSURER.RS AGENTS OR RePPMN!YNTIYE9. Southold, NY 11971 AUTHORIZED REPRfiBENTATIvF µ``;A` Kath En land KATHY C IM►ACORD CORPORATION 1988 ACORN 25(200108) VO 39Vd E0ZO S.ONNIN X3Q33 0992-6Z6-ZTZ EZ:6T 800Z/90/TT 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). 0 SUBIaOGATiON 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 endotsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this 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) 90 39bd EOZ0 S,OANIA X3Q33 099T-6Z6-Z1Z i EZ:6T 800Z/90/1T Fbcfk KInkOSer, OFax Cover Sheet Office and Prim center Date _. I.� � Number of pages (including covor page) To: From Name w Name A. Company Company Telephone _ /) Telephone Fax 4 Comments ea' � f U 711NI9 0�3i6r1gl0 0�i71r11IIN1 7111111111111111111111111111111 00776 2 7 90363110147611118 711119036s��iri��1i100721�i��1101lllls Fax•Local Send Fax•Domestle Sand DOMESTIC Send eddl Pages 9 FOX•Inlernetlonal Sentl fedelckinkmcwl isoo.aORK&L0W. j.3= G 2M i.r[x xhiFJa Duk..nd F,I iS.rvla.x,li-.AN rbl..m..ra.e.Naym,wrrim rnu 4w.,4r Ia mft LnypItlO I.DY TZie6 TO 39Vd COZ0 S,0ANIA X3Q3d 09ST—GZG—ZTZ CZ:6T 800Z/90/TT 282111107 NEW 01/08 8810004306 HOLD-DOCUMENrUPc.TTO.THE UOMT M VIEW.TRUE WATERMARKr z,- -:-:. _HOLD DOCIIMEWT UP.M TMM M T TO WIRV TAM WATERMARK CHAS E 9793700244 Date 11/14/2008 440 Remitter DANE C. REILEY Pay: SEVEN HUNDRED FIFTY DOLLARS AND 00 CENTS _ $ ***********,.750.00 *** Pay e The SOUTHOLD TOWN CLERK OrdOf Draws. JPMORGAN CHASE BANK,N.A. "it iA Senior dice President &"JPMorgan Chase Bank,NA 8 m66uuss,OH n'9793700244ii' 1:0440000171: 75866143311' Town Of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 11/19/08 Receipt#: 30679 Transaction(s): Reference Subtotal 1 1 Application Fee - Non-Refund 023 $100.00 3 3 Daily Filming Permit 023a $300.00 Check#: 9793700243 Total Paid: $400.00 Name: DCR, Productions 120 W 25th St, Ste 5 E New York, NY 10001 Clerk ID: LINDAC Internal ID:023 Town Of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 11/19/08 Receipt#: 30679 Transaction(s): Reference Subtotal 1 1 Application Fee - Non-Refund 023 $100.00 3 3 Daily Filming Permit 023a $300.00 Check#: 9793700243 Total Paid: $400.00 Name: DCR, Productions 120 W 25th St, Ste 5 E New York, NY 10001 Clerk ID: LINDAC Internal ID:023 Film Permit+for Student Film "The Absence" (Shoot Date: Sunday, Nov. 7th) Page 1 of 2 Cooper, Linda From: Cochran, Carlisle Sent: Tuesday, December 02, 2008 3:40 PM To: Cooper, Linda Subject: RE: Film Permit for Student Film "The Absence" (Shoot Date: Sunday, Nov. 7th) They can do what ever they want on NOVEMBER 7th How ever if they would like to film on DECEMBER 7th there is no need for any police involvement. Chief From: Cooper, Linda Sent: Tuesday, December 02, 2008 2:41 PM To: Cochran, Carlisle Cc: Garsik, Pat Subject: FW: Film Permit for Student Film "The Absence" (Shoot Date: Sunday, Nov. 7th) Hi Chief, I have received a request from Dane Reiley (DCR Productions) to have an additional day's shoot. The information is below. Please let me know if it would be okay with you to extend his permit by one day. Thank you, Linda J. Cooper Deputy Town Clerk Town of Southold 631-765-1800 Life mar not he the park-we hoped,for,but as long as we're here,we might as well dance! From: Dane Reiley [mailto:dane.reiley@gmail.com] Sent: Tuesday, December 02, 2008 2:18 PM To: Cooper, Linda Subject: Film Permit for Student Film "The Absence" (Shoot Date: Sunday, Nov. 7th) Hello Linda, The Student Film, The Absence, would like to add an additional shooting day to our permit with the Town of Southold. Location: Dam Pond Reserve Date: Sunday, November 7th Time: 6am - 6pm The production team would consist of 15 crew members and 2 cast members. We are simply re-shooting a scene that was lost due to camera malfunction. As you are currently holding $750 in production funds, in the form of three (3) days clean up deposits, I was hoping that the appropriate amount of those withheld funds could be applied as our $100 filming fee and $250 clean up deposit. It has been a pleasure working with your office, thanks for all your help. I look forward to hearing from you. Best, 12/5/2008 Film PermitJor Stwdent Film "The Absence" (Shoot Date: Sunday, Nov. 7th) Page 2 of 2 Dane C. Reiley Creative Producer c: (480) 567-4335 Dane.Reiley@gmaiI.com 12/5/2008