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Home My WebLink AboutMoving Mountains Productions AN TOWN CLERK'S CHECKLIST FOR FILMING PERMIT NOTE: All payments must be cash or certified check Applicant: 7M _ 721 4c, Date Received: /V 7 � Completed application $100 nonrefundable application fee Certificate of insurancethat evidences a public liability insurance policy covering the town as an additional insured in the amount of$1,000,000 (one million dollars)per occurrence for the duration of the filming or still photography. Indemnification agreement stating the applicant agrees to assume all liability for and will indemnify and hold the town harmless of and free from any and all damages that occur to persons or property by reason of said filming or still photography. Forward completed application to Chief of Police for approval or disapproval and determination if Traffic Control Fee is required t� Approved Disapproved ✓ No Fee Required Fee in the amount of$ 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): 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. _ AW 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. oF so ELIZABETH A. NEVILLE TOWN CLERKT"Wil Fiall, 53095 Main Road Afl P.O. Box 1179 CAI MARRIAGI-i Southold, New York 11971 MANA(,H M P,NT j,'I,,I 1?Ij Fax (631) 765-6145 A P'R F 101, Telephone (631) 765-1800 NIA'1'1()N T1 s()Lltholdtown.nortlifoi-k.ii(,t OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD March 21, 2007 CERTIFIED MAIL RETURN RECEIPT REQUESTED Moving Mountains Productions Inc. 444 East 82"d St, #6 New York NY 10028 Re: Southold Town Filming Permit No. 019 Dear Sir or Madam: Returned herewith is your check No. 3067 in the amount of$250.00 for the highway cleanup deposit as required by the Southold Town Code. An inspection of the permit site was made and no highway cleanup was necessary. I hope everything went well with the filming. If I can be of any assistance in the future, please do not hesitate to contact me. Very truly yours, 3067 MOVING MOUNTAINS PRODUCTIONS, INC. ti P.O. Box 638 GREENPORT. NY 11944 50-10631 '937 DATE— 214 PAY TO TH ORDER OFE lowlyl $ '250. _—.DOLLARS THE BANKOF NEW Y78 Main Slreel YORK G—p—.NY 003067u 1:02L4106371: 113690 L ? 913 24 71 ij 2/20/07 02 : 10PM EST —> Linda 6317656145 Pg 2/2 Moving Mountains Productions, Inc. 444 East 821 Street,#6 New York NY 10028 (212)-535-4993 February 20th, 2007 To: The Town of Southold, NY Hello. My name is Ema Jitsukawa and I'm contacting you from Moving Mountains Productions, a television production company based in New York. We are currently producing segments for a Japanese television series entitled "Astonishing News for Japans oldest private network, Nippon Television (NTV). It is a unique format show, featuring different astonishing stories from around the world with the reenactment of the stories each week, and is one of the top rated TV programs in Japan. One of our stories is about a man who picks up a young, lost hitchhiker and forms a meaningful bond with him during a road trip in the late 1970s. For our film shoot, we would like to do some filming on specific beaches within Southold. We will be filming simple scenes where the hitchhiker character and the driver character are talking. We would need the each beach location for about an hour(total of 2 hours in addition to travel time in between) on Friday, Feb. 23'd (if not on Thursday or Saturday, depending on the weather conditions). The areas in Southold we're interested in are the following: 1. Southold Town Beach (at the end of Sound Road in/near Greenport, by a cliff) beach from approximately 2,30 to 4,00pm 2. Southold Town Beach (on North Bayview Road by Goose Creek)from approximately 1:30 to 3*00pm 3. We would also like drive down a road with a camera inside the vehicle as well as film a car driving from the side of a road either on Sound Avenue, Cox Lane, Route 25 or its vicinity in Southold. This is a quick driving shot which will take about 20 minutes. This is a small video crew consisted of producer, director, cameraman, cameraman assistant, production manager and a few production assistants. As we discussed, we will send just 2 actors and 3 film crew to the film location site and the rest of us will stay behind inside a production vehicle somewhere near by, if we cannot get the film permit on time. Should you need additional information from us, please feel free to contact me. My telephone number is (646) 202-2911. We will promise to do our utmost to be respectful of your location site while filming. Thank you for your help. Sincerely yours, Ema Jitsukawa Location Manager Moving Mountains Productions, Inc. fjf S ELIZABETH A. NEVILLE Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER cou southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD FILMING/STILL PHOTOGRAPHY PERMIT Issued to: MOVING MOUNTAINS PRODUCTIONS,INC. Date(s), Time(s) and Location Saturday, February 24,2007 beween 9:00 AM and 5:00 I'M at Goose Creek Beach, Southold; Sound Road beach, Greenvort; and unknown side roads within Southold Town Permit No. 019 Issue Date: 2/23/2007 61j"40a.nwo�& Elizabeth A. Neville Southold Town Clerk (Town Seal) 2/20/07 02 : 10PM EST -> Linda 6317656145 Pg 1/2 Phone:6462022911 Fax:6462014420 Fox To: Linda From: Ema Jitsukawa Fax: 631-763-6145 Pages: 2 Re: Filming details (resend) Date: February 20, 2007 Hi Linda, I'm resending you our project information. Thank you for your help. Best regards, Ema r, x ELIZABETH A.NEVILLE Za`- Town Hall,53095 Main Road Cz TOWN CLERK :` P.O. Box 1179 REGISTRAR OF VITAL STATISTICS ,' Southold,New York 11971 MARRIAGE OFFICER y �� $��r.;r Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER µ ' Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD FAX TRANSMITTAL To: Chief Cochram From: Linda J. Cooper,Deputy Town Clerk Dated: February 20,2007 Re: Info for Filming Permit Number of Pages (including cover):2 If total transmittal is not received, please call 631-765-1800, Ext 210 COMMENTS: As we discussed. 2/20/07 03 : 23PM EST -> Linda 6317656145 Pg 2/4 INDEMNIFICATION AGREEMENT TOWN OF SOUTHOLD FILMING/STILL PHOTOGRAPHY PERMIT The Applicant shalt 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 rdming 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 to additional insured on any applicable policies. 5i ature Date l r r�R � '+,ru a1,J Printed name ry L-- Title Title J 2/20/07 03 : 20PM EST -> Linda 6317656145 Pg 2/4 I I APPLICATION FOR FILMING/STILL PHOTOGRAPHY PERMIT NO: Please Print or Type APPLICATION DATE: j Zr NAME OF APPLICANT: MAILING ADDRESS; q - `4 R d Jf 6 , ti .� Y'A�k , n/Y r u z F _ PHONE: BUSINESS: G ct-d ii HOME: S-/ 6 `ey -/d?:J NAME OF ORGANIZATION!COMPANY: M r v; h J MAILING ADDRESS; PHONE: E 4-d z y. , -may f FAX: DESCRIBE TYPE OF ACTIVITY(e.g. Motion Picture, Commercial, Television, Catalog, Magazine, etc.): 1-e. 6"4� DATE(S)AND TIME(S)OF PROPOSED FILMING/PHOTOGRAPHY; PROPOSED LOCATION(S) OF FILMING/PHOTOGRAPHY: (attach additional sheet, if necessary) ( S u f'cry -4f 1 N L1N►+t NAME OF PERSON IN CHARGE AT SITE: K !c o NUMBER OF PERSONS AT LOCATION (cast& crew included): NUMBER AND TYPE OF VECERES AT LOCATION: I is-,etsbn a NL. v� TYPE OF SPECIAL EQUIPMENT: ANY SPECIAL REQUIREMENTS: lgnature Return to: Southold Town Clerk Southold Town Hall 53095 Main Road IA4Z A �-� ^ S � ; Zti L P.O. Box 1179 cl Southold, NY 11971 20/02 '07 TUE 15:27 FAX 631 765 6145 SOUTHOLD TOWN CLERK 0001 �e*�c TX REPORT TRANSMISSION OK TX/RX NO 3272 CONNECTION TEL 97342315 CONNECTION ID PD Administ ST. TIME 20/02 15:26 USAGE T 00'50 PGS. SENT 2 RESULT OK ELIZABETH A.NEVILLE o4 Town Hall,53095 Main Road TOWN CLERK P.O. Box 1179 ` "' `� �` Southold,New York 1]971 REGISTRAR OF VITAL STATISTICS y X4"3 '. MARRIAGE OFFICER Fax(631) 765-6145 631 7651800 RECORDS MANAGEMENT OFFICER �•`' Telephone ) FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD FAX TRANSMITTAL To: Chief Cochram From: Linda J. Cooper,Deputy Town Clerk Dated: February 20,2007 Re: Info for Filming Permit Number of Pages (including cover):2 If total transmittal is not received, please call 631-765-1800, Ext 210 COMMENTS: As we discussed. 2/20/07 03: 23PM EST -> Linda 6317656145 Pg 1/4 Moving Mountains Productions,Inc. 444 East 8V Street.#6 New York,NY 10028 (212)-535-1993 February 20th.2007 To:The Town of Southold, NY Hello. My name is Ema Jitsukawa and I'm contacting you from Moving Mountains Productions, a television production company based In New York, We are currently producing segments for a Japanese television series entitled"Astonlshing News"for Japan's oldest private network, Nippon Television (NTV). It is a unique format show, featuring different astonishing stories from around the world with the reenactment of the stories each week,and is one of the top rated TV programa in Japan. One of our stories Is about a man who picks up a young, lost hitchhiker and forms a meaningful bond with him during a road trip in the late 1970s. i For our film shoot,we would like to do some filming on specific beaches within Southold.We will be filming simple scenes where the hitchhiker character and the driver character are talking.We would need the each beach location for about an hour(total of 2 hours in addition to travel time in between) on Friday, Feb. 23rd (f not on Thursday or Saturday,depending on the weather conditions), The areas in Southold we're interested in are the following: 1. Southold Town Beach (at the end of Sound Road in/near Greenport, by a cliff) beach from approximately 2;30 to 4:00pm 2. Southold Town Beach (on North Bayview Road by Goose Creek)from approximately 1:30 to 3:OOpm 3. We would also like drive down a road with a camera inside the vehicle as well as film a moving vehicle from the side of a road either on Sound Avenue, Cox lane, Route 25 or its vicinity in Southold.This is a quick driving shot which will take about 15-20 minutes. This is a small video crew consisted of producer,director, cameraman, cameraman assistant, production manager and a few production assistants.As we discussed, we will send just 2 actors and 3 film crew to the film location site and the rest of us will stay behind inside a production vehicle somewhere near by, If we cannot get the film permit on time. Should you need additional Information from us, please feel free to contact me. My telephone number is(646)202-2911. We will promise to do our utmost to be respectful of your location site while filming, Thank you for your help. Sincerely yours, Erna Jitsukawa Location ager Moving Mountains Productions, Inc. 2/20/07 03 : 20PM EST -> Linda 6317656145 Pg 3/4 Moving Mountains Productions, Inc. 444 but 82h1 Street,#6 New York,NY 10028 (212)-535-4993 February 201'.2007 To: The Town of Southold, NY Hello. My name is Ema Jitsukawa and I'm contacting you from Moving Mountains Productions, a television production company based In New York, We are currently producing segments for a Japanese television series entitled"Astonishing News"for Japan's oldest private network, Nippon Television (NN. It is a unique format show, featuring different astonishing stories from around the world with the reenactment of the stories each week, and Is one of the top rated TV programs In Japan. One of our stories Is about a man who picks up a young, lost hitchhiker and forms a meaningful bond with him during a road trip in the late 1970s. For our film shoot, we would like to do some filming on specific beaches within Southold.We will be filming simple scenes where the hitchhiker character and the driver character are talking,We would need the each beach location for about an hour(total of 2 hours in addition to travel time in between) on Friday, Feb. 23'd (f not on Thursday or Saturday,depending on the weather conditions), The areas in Southold we're interested in are the following: 1. Southold Town Beach (at the end of Sound Road in/near Greenport, by a cliff) beach from approximately 2;30 to 4:00pm 2. Southold Town Beach (on North Bayview Road by Goose Creek)from approximately 1:30 to 3:00pm 3. We would also like drive down a road with a camera inside the vehicle as well as film a moving vehicle from the side of a road elther on Sound Avenue, Cox Lane, Route 25 or its vicinity in Southold.This is a quick driving shot which will take about 15-20 minutes. This is a small video crew consisted of producer,director, cameraman, cameraman assistant, production manager and a few production assistants.As we discussed, we will send just 2 actors and 3 film crew to the film location site and the rest of us will stay behind Inside a production vehicle somewhere near by, If we cannot get the film permit on time, Should you need additional Information from us, please feel free to contact me. My telephone number Is (646)202.2911, We will promise to do our utmost to be respectful of your location site while filming, Thank you for your help. Sincerely yours, 2!-- I&A-L-.- 2/20/07 03 : 20PM EST —> Linda 6317656145 Pg 1/4 Phone:6462022911 Fax:6462014420 To: Linda From: Ems Jitsukawa Fax: 631-765-6145 Pages: 4 Re: Film Permit Application Date: February 20, 2007 Please review. I will follow up with you shortly by email. Thank you for your help. Best regards, Ema 2/20/07 01 : 46PM EST —> Linda 6317656145 Pg 1/2 Phone:6462022911 Fax:6462014420 FWc, To: Linda From: Ema Jltsukawa Fax: 631-765-6145 Pages: 2 Re: Filming In Southold Date: February 20, 2007 Linda, Thank you for talking to me. I'd like to go ahead and apply for the permit, but here's the description of our project. Thank you for your help. Best regards, Ema Jitsukawa s Town Of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT Date: 02/24/07 Receipt#: 3066 Transaction(s): Reference Subtotal 1 1 Application Fee- Non-Refund 019 $1.00.00 1 1 Daily Filming Permit 019a $100.00 Check#: 3066 Total Paid: $200.00 K Name: Moving, Mountains Productions Inc P O Box 638 Greenport, NY 11944 Internal ID:019 Clerk ID: ' LINDAC 2/20/07 01 : 46PM EST —> Linda 6317656145 Pg 2/2 Moving Mountains Productions, Inc. 444 East 821d Street,#6 New York, NY 10028 (212)-535-4993 February 20th, 2007 To: The Town of Southold, NY Hello. My name is Ema Jitsukawa and I'm contacting you from Moving Mountains Productions, a television production company based in New York. We are currently producing segments for a Japanese television series entitled "Astonishing News"for Japan's oldest private network, Nippon Television (NTV). It is a unique format show, featuring different astonishing stories from around the world with the reenactment of the stories each week, and is one of the top rated TV programs in Japan. One of our stories is about a man who picks up a young, lost hitchhiker and forms a meaningful bond with him during a road trip in the late 1970s. For our film shoot, we would like to do some filming on specific beaches within Southold. We will be filming simple scenes where the hitchhiker character and the driver character are talking. We would need the each beach location for about an hour and (total of 2 hours in addition to travel time in between) on Friday, Feb. 23`d (if not on Thursday or Saturday, depending on the weather conditions). The area in Southold we're interested in are the following: 1. Southold Town Beach (at the end of Sound Road in/near Greenport, by a cliff) beach from approximately 2:30 to 4:OOpm 2. Southold Town Beach (on North Bayview Road by Goose Creek)from approximately 1:30 to 3,00pm This is a small video crew consisted of producer, director, cameraman, cameraman assistant, production manager and a few production assistants.We will send just 2 actors and 3 film crew to the film location site and the rest of us will stay behind inside a production vehicle somewhere near by, if we cannot get permit on time. Should you need additional information from us, please feel free to contact me. My telephone number is (646)202-2911. We will promise to do our utmost to be respectful of your location site while filming. Thank you for your help. Sincerely yours, Ema Jitsukawa Location Manager Moving Mountains Productions, Inc. ' DATE(MMIDDIYYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE 02121/2007 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Film Em onium (NY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P � HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 274 Madison Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. New York City, NY 10016 Phone No. 800 371-2555 Fax No. 888 229-6247 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: EFM-Empire Fire and Marine Insurance Company. Moving Mountains Productions, Inc. INSURER B: FFC-Fireman's Fund Insurance Company 444 E.82nd Street, #6E INSURER C: MCC-Maryland Casualt Company New York, NY 10028 INSURER D: P" "° 516 449-1689 Fax No. INSURER E: 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' TYPE OF INSURANCE POLICY NUMBER POLICDATEY EFFECTIVEYt_ POLICDATEY EXPIRATION LIMITS EACH OCCURRENCE $ 3,000,000 GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY PREMISES(Fa occur.., c rance $ 100,000 CLAIMS MADE a OCCUR F10106318 02/18/2007 02/18/2008 MED EXP(Anyone parson) $ 5 000 EFM PERSONAL 8 ADV INJURY It 3000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS.COMPIOP AGG $ 3,000,000 POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea eoddent) ALL OWNED AUTOS BODILY INJURY f SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE"' S Excluded (Peracddenq M"Aww. Excluded GARAGE LIABILT Y AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGO EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE f OCCUR FICLAIMS MADE AGGREGATE f $ DEDUCTIBLE f RETENTION W.R C 9TATT. OTH- FR EMPLOYERS'LIABIKERS LTyIONAND In Process-003271 02/18/2007 02/18/2008 E.L.EACH ACCIDENT f 1,000,000 MCC ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? Yes Proof of Workers E.L.DISEASE-EA EMPLOYEE $ 1000,000 8 deacriM undePROVISIONS Compensation Insurance only. E•L.DISEASE-POLICY LIMIT $ 1,000,000 SPECIAL PROVISIONS below OTHER COVWW DWOMibM EF Miscellaneous Rented Equipment F1010631B 02/18/2007 02/18/2008 $ 250,000 1,500 EF Third Party Property Damage F1010631B 02/18/2007 02/18/2006 $ 500,000 2,500 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Coverage Location: United Slates&Canada Certificate Halder is named as an Additional Insured as their interests may appear. All coverages expire at 12:01 a.m.Standard Time. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Southold Southold Town Hall DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN 53095 Main Road P O Box 1179 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO 90 SHALL Southold, NY 11971 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Phone Na. 631-765-180 Fax No. 631-765-180 ACORD 25(2001108) 101505-170755-129150 C ACORD CORPORATION 1988 02/24/2007 Town Of Southold Page: 1 Daily Cash Report February 24,2007-February 24,2007 USER ID: LINDAC Date Cash Category Fee Description Name ID# Misc Rcpt# ri Amount 02/24/07 Filming() Application Whav- ing, Mountains 019 019 3066 1 100.00 Non-Refund Productions Inc Daily Filming Permit Moving, Mountains 019a 019a 3066 1 100.00 Productions Inc Total for: 02/24/2007 $200.00 Report Total: $200.00