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HomeMy WebLinkAboutSchofield Films SO(/ryo ELIZABETH A.NEVILLTown Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 ' REGISTRAR OF VITAL STATISTICS Southold, New York 11971 MARRIAGE OFFICER • COQ Fax(631) 765-6145 RECORD MANAGEMENT OFFICER Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER �COU � southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD August 1, 2005 Michael Sibley Schofield Films 560 Broadway, Suite 204 New York, NY 10012 Dear Michael: Enclosed find your deposit in the amount of$750.00 for the clean up for three (3) days of filming. It was determined that no clean up by Town Departments was needed. Thank you for your cooperation. Very truly yours, -CA M &Q, -1 Lynda M Bohn Deputy Town Clerk enc pF SO�ly4 ELIZABETH A. NEVILLE �� lQ Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR,OF VITAL STATISTICS cn � Southold,New York 11971 MARRIAGE OFFICER �QyFax(631) 765-6145 RECORDS AGEMENT OFFICER Telephone(631) FREEDOM OF INFORMA ION OFFICER OI�CoU�{,� s utho dtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Peter Harris, Superintendent of Highways From: Lynda M. Bohn,Deputy Town Clerk Dated: July 27, 2005 Re: Film Permit No. 016 & 017 Cleanup Deposit In accordance with §44A-5 of the Southold Town Code,please advise if the $250.00 daily Cleanup deposit may be returned to the applicant; if not,please provide a statement setting forth the actual cost to the town of providing said cleanup service. Cleanup was not required at the location(s) identified on the permit. The deposit may be returned. Cleanup was required. Actual cost statement is attached. Please respond within five(5)business days Signature Date ��pF soUryo ELIZABETH A. NEVILLE Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS N ac Southold,New York 11971 MARRIAGE OFFICER �Q Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER ��� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER CQU ,� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Chief Cochran, Southold Town Police From: Lynda M Bohn, Deputy Town Clerk Dated: July 27, 2005 Re: Traffic Control Cost Statement Film Permit No. 016 & 017—Michael Sibley In accordance with Town Code §44-A paragraph D., a statement regarding the actual cost to the town of providing traffic control and police officers must be provided by the Chief of Police. Please provide this information to this office within five(5)business days. Thank you. 50(/ryo ELIZABETH A.NEVILLE Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR,OF VITAL STATISTICS CAR Southold, New York 11971 MARRIAGE OFFICER �Q� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER 0��. Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER em southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD FILMING/STILL PHOTOGRAPHY PERMIT Issued to: Schofield Films/Michael Sibley Location(s),Date(s),Time(s): Location: Pipes Neck Cove Beach, Greenport Dates: Monday,July 25,2005 12:00 p.m.—8:00 p.m. Tuesday,July 26,2005 7:00 a.m.—8:00 p.m. Permit No. 016 Issue Date: 7/22/05 f � Elizabeth A. Neville Southold Town Clerk (Town Seal) TOWN CLERK'S CHECKLIST FOR FILMING PERMIT NOTE: All payments must be cash or certified check Applicant: +�.{�C�,!Q J to(el Date Received: n I n l cxs ✓ 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$1,000,000 (one million dollars)per occurrence for the duration of the filming or still photography. ✓ Indemnification agreement stating the applicant agrees to assume all liability for and will indemnify and hold the town harmless of and free from any and all damages that occur to persons or property by reason of / said filming or still photography. Forward completed application to Chief of Police for approval or disapproval and determination if Traffic Control Fee is required Approved Disapproved No Fee Required Fee in the amount of$ required ✓ Forward certificate of insurance and indemnification agreement to Town Attorney fob 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. 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) NO/TIFICATION of ISSUED PERMIT Chief of Police Chief Building Inspector Fire Marshal Code Enforcement Officer Superintendent of Highways V Superintendent of Parks and Recreation RE UEST FOR XTENSION OF PERMIT Forward ext\' npermit request to Chief of Police If granted, collect a 'tional $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. o��pF SO(/ryol ELIZABETH A.NEVILLE Q Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS N Southold, New York 11971 MARRIAGE OFFICER OQ Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER ���. � Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER e0UNTY, southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Chief Cochran, Southold Town Police From: Lynda M. Bohn, Deputy Town Clerk Dated: July 22, 2005 Re: REVSIED Filming Permit Transmitted herewith is the application of Schofield Films by Michael Sibley for a Filming Permit. In accordance with Section 44A.3 of the Town Code please review the application and advise of approval or disapproval of the application and whether a traffic control fee is required and the amount needed. They would like to extend the permit to include Monday, July 25, 2005 from 7:00 a.m. to 8: p.m.. I have spoken with Mike this morning, he really doesn't think they will make it out here on Monday but would like to get the permit just in case. Approve Disapprove Also, he will be bringing back another application for Wednesday, July 27, 2005 for a still photography shot which I will fax over for your approval when I get it. .,18/07 '05 MON 09:44 FAX 631 765 6145 SOUTHOLD TOWN CLERK Q003 TOWN OF SOUTHOLD APPLICATION FOR FILMING/STILL PHOTOGRAPHY ( PLZAS13 FRzNT OIL TYPE APPLICATION DATE: I ` zPERMIT NO: a NAMs OF APYLIGiNI: d ,{. M i �� S{� ,11 FiB MAILING ADDRS: 1-1v W� 1 e-r � 1 c4pj PHONE: HQaT S-S BOMB �c+ _ ► (wiS NAMH OF ORGANIZATION, COMPANY: V G k0F1 d Ic! MAILING anna�ss: �rm�wa H -r k �2 0 iy� / X PRONE a ( 00 vex�i*��r.�r•'""��i1'•`1Nr�FhWi/hr!*1r�t Rii srw:arrf t�fifrr.rwrJitr+••rt1+n��rf rrs r• DRSCBIDU TYPE OP ACTIVITY (e.g, Xotioa picture, Commercial, Televie3oa, Catalog, Magaz3ae, etc.) : ']'�ItJiSivn Comr*-o r Cid ( Por We- ( bofr;- p V�^'+� /-- ATL(SI 1M1ND TIKE(H1 01� p�LOPOSE7D b'IZDIING BHOTOG PA c ' ?ues�l �v / — �g2 f G � f � PROPOSED LQCA?Ii=(g) OP VYLKING/PHOTOGRAPHY: attar addat±onal sheet, if necessary. / YK Vic.eS N m 0r PERSW Za CSaROS AT ST=; t b MMME 2 OF PgRSONS AT LOCATION (t3!►s{T {� CILS4t IliCLLjDgD) _ N'LMSER AND TYPE or v.Us;YCLsa AT LOCATION:, 61W/fi to y Vwws t e a►� Sr— '10 C Q� TYPE OF SPECIAL RQUX13X S IT. ANY 9PEC3;A1+ XVQD'TR=LNTH F s� r+ature R rn to: 'Southold Town Clerk Southold Town Hall 53095 Main Road P. O. Box 1179 Southold, NY 11971 i@iVr r. m- =0 - 7/18/05 Lynda M. Bohn Town of Southold Via Facsimilie (631)765-6145(fax) Dear Lynda, I am writing you pursuant to our earlier phone conversations with regard to Schofield Films interest in filming in 2S/1• Greenport. Please consider this letter as part of our permit application. We are planning on filming on Private property within Town of Southold Jurisdiction in Greenport on Tuesday,July 26`h, 2005.Our rain date would be either Wed,7/27 or.Thurs.7/28.We would start our day filming at The Foti Residence,located at 1925 Pipes Neck Road.The earliest we would begin filming is 7 am,but it could be later. We will park our vehicles on Private Property and/or Park them legally on the side of Pipes Neck Road and purchase any necessary parking permits. We will not block public access or thru traffic. At some point in the day,for approx. 2—3 hours,we would like carry our camera and other equipment across the foot- bridge to film on the small barrier beach across from the residence at 1925 Pipes Neck Road.The scene we are filming would involve a couple rowing a boat in the shallow water off the beach,possibly beaching the boat and climbing out,and possibly tying the boat up to a dock. (Please note,there is no dock on this beach. If we did this shot,we would bring in a temporary Prop Dock, which we would remove immediately after filming.We may also rent a second boat to put the camera on to do a shot from the water. Once we have completed the work in this location(approx.mid-afternoon),we would move our trucks and equipment to the Delsman residence,4 Sandy Beach Point Road in Greenport.Once again,we would park our vehicles in some combination of Private Property&streets with proper permits. We would film at this property,on their private beach until approx.8 p.m. Once we have completed filming,we will load our equipment and return to NYC. We are planning on revisiting Greenport with the heads of all of our Technical Departments on Thursday,July 2151,2005. After this"Technical Scout",we will no much more about our specific parking plans,schedule,and the nature of our work on Pipes Neck Beach. I spoke with Chief Cochran on Friday about our general plan,but I did not know about the beach shot at that time.I will try to speak with him as soon as possible regarding that scene. Thank you so much for your time and attention to these matters. If you have any questions or concerns,please call me at any time on my cell phone at(917)846-7977. Sa Regards el Sibley Location Manager Schofield Films 560 Broadway, Suite 204 NYC 10012 tel.212.633.8700 fax.212.633.9850 18/07 '05 MON 09:45 FAX 631 765 6145 SOUTHOLD TOWN CLERK 0 004 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 sante at his own cost and expense. In addition, the Applicant will name the Town as an additional insured on any applicable policies. Signature Date Printed name L o c. *-rt N A-Aj R-6re Title MARSH USA INC. CERTIFICATE OF INSURANCE CERTIFICATE NUMBER PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO Marsh USA Inc. RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE 777 S. POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE Los Angeelesles,,CA 90017 St.24th Floor AFFORDED BY THE POLICIES HEREIN. C 213-346-5000 COMPANIES AFFORDING COVERAGE Attn:Sarah Yates COMPANY Auto—WPP/Grey—New York Fireman's Fund Insurance Company INSURED COMPANY Schofield Films B CHUBB 560 Broadway New York,NY 10012 COMPANY C COMPANY D COVERAGES This certificate supercedes and replaces any previouslyissued certificate for the policy period noted below. THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,CONDITIONS AND EXCLUSIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. T TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION LTR POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $2,000,000 A ®COMMERICAL GENERAL LIABILITY XXC80412613 2/1/05 2/1/06 PRODUCTS—COMP/OP AGG $1,000,000 ❑CLAIMS MADE ®OCCURRENCE PERSONAL&ADV INJURY $1,000,000 ❑OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $1,000,000 ®FOREIGN LIABILITY(INCLUDING AUTO) FIRE DAMAGE(Any one fire) $ 100,000 AUTOMOBILE LIABILITY IEX86947298 2/1/05 2/1/06 MED PAY(Any one person) $ 5,000 ❑ANY AUTO XXC80412613 2/1/05 2/1/06 COMBINED SINGLE LIMIT $1,000,000 ❑ALL OWNED AUTOS ❑ BODILY INJURY SCHEDULED AUTOS (Per person) $ ®HIRED AUTOS A MPT 07105092 2/1/05 2/1/06 (Per accidenILY t) EEquipment ®NON-OWNED AUTOS ®NON-OWNED/HIRED PHYSICAL DAMAGE Physical Damage c Limit GARAGE LIABILITY ❑ ANY AUTO AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ EXCESS LIABILITY AGGREGATE $ EACH OCCURRENCE UMBRELLA FORM $19,000,000 B79535897 2/1/05 2/1/06 AGGREGATE ®OTHER THAN UMBRELLA FORM $19,000,000 B WORKERS COMPENSATION AND $ EMPLOYERS'LIABILITY WC STATUTORYI WITS OTHER EL EACH ACCIDENT $ THE PROPRIETOR/ ❑INCL $ PARTNERS/EXECUTIVE EL DISEASE-POLICY LIMIT OFFICERS ARE ❑EXCL EL DISEASE-EACH EMPLOYEE $ OTHER:Errors and Omissions MSF 07002774 2/1/05 2/1/06 Limit$1,000,000 Ded:$25000 Props,Sets&Wardrobe Miscellaneous Equipment Limit$1,000,000 Ded:$1,500 A Third Party Property Damage MPT 07105092 2/1/05 2/1/06 Limit$2,000,000 Ded:$2,500 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESSPECIAL ITEMS(LIMITS MAY BE SUBJECT TO DEDUCTIBLE OR RETENTIONS) Limit$1,000,000 Ded:$2,500 Certificate Holder is included as Additional Insured and Loss Payee as their interest may appear as respects to production entitled:"Experience"Job#045- WB-034.With respect to other,coverage is Worldwide,in transit and All Risk. With respect to Automobile rentals, Non-Owned&Hired Auto Physical Damage limits are included in Miscellaneous Equipment. Deductible is 10%of loss;subject to$2,500 minimum and$7,500 max.(per occurrence)WPP. CERTIFICATE HOLDER CANCELLATION Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE 53095 Main Road THEREOF,THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL,'Lo DAYS WRITTEN NOTICE TO P.O. Box 1179 THE CERTIFICATE HOLDER NAMED HEREIN,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR Southold, NY 11971 LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE,ITS AGENTS OR REPRESENTATIVES. MARSH USA INC. BY: Jahn. Mamby MM1 9/99 VALID AS OF 03/02/2005 JUL- 20. 2005 2: 53PM N0. 617 P, 1 pf SOUS Town Hall,53095 IVlaixi Road ELIZABETH A.NEV AX P.O.Box 1179 TOWN CLERK Southold,New York 11971 REGISTRAR OF'VITAL STATISTICS Pax(631) 765-6145 MARRIAGE OFFICER Telephone (631) 765-1800 RECORDS MANAGEMENT OFFICER. southoldtown.northfork.net FREtDOM OF INFORMATION OFFICER C oUNv, OFFICE OF THE TOWN CLERK TOWI'T OF SOUTHOLD To: Southold Town Attorney's Office From: Lynda M Bohs� Dated: July 19, 2005 Re: Filming Permit In accordance with the Southold Town Code, Chapter 44A, Section 3, Subsection D,the Certificate of Insurance and Indemnification Agreement for a Filming Permit Application for Schofield Films by Michael Sibley are attached hereto. Please review and advise whether these documents meet with your approval. Thank you swo�c� r�d-Whit�hc�� _- Approved as submitted CCS'Q(AA Disapprove for the following reasons: Signator zf SO!/Tyo ELIZABETH A. NEVILLE ti0 lQ Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS N Southold, New York 11971 MARRIAGE OFFICER �p Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER ��'. Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER Comm, southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Captain Martin Flatley, Southold Town Police From: Lynda M. Bohn, Deputy Town Clerk/, 0 Dated: July 19, 2005 Re: Filming Permit Transmitted herewith is the application of Schofield Films by Michael Sibley for a Filming Permit. In accordance with Section 44A.3 of the Town Code please review the application and advise of approval or disapproval of the application and whether a traffic control fee is required and the amount needed. 0 P'. 91-Ab � ,o ��L20z o� ..18/07 '05 MON 09:44 FAX 631 765 6145 SOUTHOLD TOWN CLERK 16003 TOWN OF SO'UTHOLD APPLICATION FOR FILMING/STILL PHOTOGRAPHY PLEASE pazm OR TYPE APPLICATION DATE: ` `S ^^� PERb= NO: ag ��t,=cArri: oe -y M .MAILING ADDktFi9s: L' W i�-f &3 PHONE: evaz�ss Y�L 3 •� �O u0m NANO OF ORGANIZATION, COMPANY.- S G WF KL.TLXNG AXktMXSS: s(o o '�ct9 wa�I IL - 2 0%4 p$ s (d� (a33• cao FAR. _,12c70633- xxx�r:.rr..►•r.rr�.�..IN1�tWNiww-l./r�xwa6 xw:..rfs.irr.rr.�ww�••wwrwrxtrxe.*r 'D$50=0 MI( OP ACTIVITY (e.g. JSotlos► Pictiare, Commerclal, Televia3ct► Catalog, Magazine, etc.) e-41 5, e)MKP r Cid butr;A DATES) AXD'TI3E(8) O$ V90POSL'D 3'1La1iXG/vmoTOr.T(},, yt ' 'Tut Sol �vP "_ fC ``` PROPOSED LOCATIOW(S) Off+' li'TLMINA/PHOTOGRAPHY:jatttar�4_a4utional abeet, 3f ueceeeazy. GS D� G)k 1 ► �`� lIIA� OP PERSoa7 23Q CHARGE AT SITZ. & NQMBgYt OF Vmso s AT LOCATION (ahaT & CRSN INCLAngD) _ $MOOR AND TYPE OF VHRYCLUS AT LOCATION:, r�c.k; 2 w�a WSJ rvw l fi P to vav�s t � �►� S— � a '1c�,� . TYPE OF SPECIAL Ramv3m�'s; o, , 0 G ANY 3PEC3;AT+ XXQ=RWMWTB . r s� mature Return to: •Southold Town Clerk SbUthold Town Hall 53095 Main Road P. 0. Box 1179 Southold, NY 11971 Schof • 7/18/05 Lynda M.Bohn Town of Southold Via Facsimilie (631)765-6145(fax) Dear Lynda, I am writing you pursuant to our earlier phone conversations with regard to Schofield Films interest in filming in Greenport.Please consider this letter as part of our permit application. We are planning on filming on Private property within Town of Southold Jurisdiction in Greenport on Tuesday,July 26 , 2005.Our rain date would be either Wed,7/27 or.Thurs.7/28.We would start our day filming at The Fod Residence,located at 1925 Pipes Neck Road.The earliest we would begin filming is 7 am,but it could be later.We will park our vehicles on Private Property and/or Park them legally on the side of Pipes Neck Road and purchase any necessary parking permits.We will not block public access or thru traffic. At some point in the day,for approx. 2—3 hours,we would like carry our camera and other equipment across the foot- bridge to film on the small barrier beach across from the residence at 1925 Pipes Neck Road.The scene we are filming would involve a couple rowing a boat in the shallow water off the beach,possibly beaching the boat and climbing out,and possibly tying the boat up to a dock. (Please note,there is no dock on this beach.If we did this shot,we would bring in a temporary Prop Dock, which we would remove immediately after filming.We may also rent a second boat to put the camera on to do a shot from the water. Once we have completed the work in this location(approx.mid-afternoon),we would move our trucks and equipment to the Delsman residence,4 Sandy Beach Point Road in Greenport.Once again,we would park our vehicles in some combination of Private Property&streets with proper permits.We would film at this property,on their private beach until approx.8 p.m.Once we have completed filming,we will load our equipment and return to NYC. We are planning on revisiting Greenport with the heads of all of our Technical Departments on Thursday,July 21",2005. After this`"Technical Scout",we will no much more about our specific parking plans,schedule,and the nature of our work on Pipes Neck Beach.I spoke with Chief Cochran on Friday about our general plan,but I did not know about the beach shot at that time.I will try to speak with him as soon as possible regarding that scene. Thank you so much for your time and attention to these matters. If you have any questions or concerns,please call me at any time on my cell phone at(917)846-7977. Regards i ael Sibley Location Manager Schofield Films 560 Broadway, Suite 204 NYC 10012 tel.212.633.8700 fax.212.633.9850 18/07 '05 MON 09:45 FAX 631 765 6145 SOUTHOLD TOWN CLERK 004 INDEMNIFICATION AGREEMENT TOWN OF SOUTHOLD P'ILMMUSTILL 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. Signature Date Printed name G*-rt o ^ flelfiry A-U�'� <2CJy0�r f%.b J C, qS, Title MARSH USA INC. CERTIFICATE OF INSURANCE CERTIFICATE NUMBER PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO Marsh USA Inc. RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE 777 S.Figueroa St.24`"Floor POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES HEREIN. Los Angeles,CA 90017 213-346-5000 COMPANIES AFFORDING COVERAGE Attn:Sarah Yates COMPANY Auto-WPP/Grey-New York A Fireman's Fund Insurance Company INSURED COMPANY Schofield Films B CHUBB 560 Broadway New York,NY 10012 COMPANY C COMPANY D COVERAGES This certificate suDercedes and replaces any previouslyissued certificate for the policy period noted below. THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,CONDITIONS AND EXCLUSIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. T TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION LTR POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $2 000 000 A ®COMMERICAL GENERAL LIABILITY XXC80412613 2/1/05 2/1/06 PRODUCTS-COMP/OP AGG $1,000,000 ❑CLAIMS MADE ®OCCURRENCE PERSONAL 8 ADV INJURY $1,000,000 ❑OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $1,000,000 ®FOREIGN LIABILITY(INCLUDING AUTO) FIRE DAMAGE(Any one fire) $ 700,000 AUTOMOBILE LIABILITY IEX86947298 2/1/05 211/06 MED PAY(Any one person) $ 5,000 ❑ANY AUTO XXC80412613 2/1/05 2/1/06 COMBINED SINGLE LIMIT $1,000,000 ❑ALL OWNED AUTOS BODILY INJURY ❑SCHEDULED AUTOS (Per person) $ ®HIRED AUTOS A MPT 07105092 2/1/05 2/1/06 (PeraLcY�n;RY ®NON-OWNED AUTOS $ ®NON-OWNED/HIRED PHYSICAL DAMAGE Physical Damage $Ind.In Misc Equipment Limit GARAGE UABIUTY ANY AUTO❑ AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ EXCESS LIABILITY AGGREGATE $ ®UMBRELLA FORM EACH OCCURRENCE $19,000.000 B 79535897 2/1/05 2/1/06 AGGREGATE .®OTHER THAN UMBRELLA FORM $19,000,000 B WORKERS COMPENSATION AND $ EMPLOYERS'LIABILITY WC STATUTORY ❑ OTHER EL EACH ACCIDENT $ THE PROPRIETOR/ [I]INCL $ PARTNERS/EXECUTIVE EL DISEASE-POLICY LIMIT OFFICERS ARE ❑EXCL EL DISEASE-EACH EMPLOYEE $ OTHER:Errors and Omissions MSF 07002774 2/1/05 2/1/06 Limit$1,000,000 Props,Sets&Wardrobe Ded:$25000 Miscellaneous Equipment Limit$1,000,000 Ded:$1,500 A Third Party Property Damage MPT 07105092 2/1/05 2/1/06 Limit$2,000,000 Ded:$2,500 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLEWSPECIAL ITEMS(LIMBS MAY BE SUBJECTTO DEDUCTIBLE OR RETENTIONS) Limit$1,000,000 Ded:$2,500 Certificate Holder is included as Additional Insured and Loss Payee as their interest may appear as respects to production entitled:"Experience"Job#045- WB-034.With respect to other,coverage is Worldwide,in transit and All Risk. With respect to Automobile rentals,Non-Owned&Hired Auto Physical Damage limits are included in Miscellaneous Equipment. Deductible is 10%of loss;subject to$2,500 minimum and$7,500 max.(per occurrence)WPP. CERTIFICATE HOLDER CANCELLATION Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE 53095 Main Road THEREOF,THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL W DAYS WRITTEN NOTICE TO P.O. Box 1179 THE CERTIFICATE HOLDER NAMED HEREIN,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR Southold, NY 11971 LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE,ITS AGENTS OR REPRESENTATIVES. MARSH USA INC. BY: Joh'v ffan'tby Mill 9/59 VAUD AS OF 03/02/2005 SOF so ELIZABETH A.NEVILLE ��� �lQ Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS N Southold, New York 11971 MARRIAGE OFFICER �Q Fax (631) 765-6145 RECORDS MANAGEMENT OFFICER ��yp Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER C�U111�,P southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Chief Cochran, Southold Town Police Mike Verity, Building Department Bob Fishers, Fire Marshal Ed Forrester, Code Enforcement Officer Peter Harris, Superintendent of Highways James McMahon, Dept of Public Works From: Lynda M Bohn, Deputy Town Clerk Dated: July 21, 2005 Re: Filming Permit No. 016 In accordance with Town Code 44A-9 you are being notified that a Film Permit was issued to Michael Sibley on behalf of Schofield Films. See following pages for a copy of the permit and application. Bohn, Lynda From: Flatley, Martin Sent: Thursday, July 21, 2005 9:31 AM To: Bohn, Lynda Subject: Filming Permit Hi Lynda, I spoke to Michael Sibley two days ago and will meet with him today regarding the shoot he has planned. Therefore, I approve of issuing him this permit as he has been working with us as to its implementation. 1 *pF SO!/ryp ELIZABETH A. NEVILLE h0 lQ Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS N Southold, New York 11971 MARRIAGE OFFICER �Q� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER ip, l� Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER C��111,,� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Captain Martin Flatley, Southold Town Police From: Lynda M. Bohn,Deputy Town Cler+-O Dated: July 19, 2005 Re: Filming Permit Transmitted herewith is the application of Schofield Films by Michael Sibley for a Filming Permit. In accordance with Section 44A.3 of the Town Code please review the application and advise of approval or disapproval of the application and whether a traffic control fee is required and the amount needed. pF SO�ryo ELIZABETH A.NEVILLE �� lQ Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR,OF VITAL STATISTICS G Southold, New York 11971 MARRIAGE OFFICER �► ap Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER I�CUU ,� southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Southold Town Attorney's Office From: Lynda M Bok4Aj5 Dated: July 19, 2005 Re: Filming Permit In accordance with the Southold Town Code, Chapter 44A, Section 3, Subsection D,the Certificate of Insurance and Indemnification Agreement for a Filming Permit Application for Schofield Films by Michael Sibley are attached hereto. Please review and advise whether these documents meet with your approval. Thank you. Approved as submitted Disapprove for the following reasons: Signature 18/07 '05 MON 14:54 FAX. 631 765 6145 SOUTHOLD TOWN CLERK 01001 o,*pF SOUF�oI ELIZABETH A.NEVILLE Town Hall,53095 Main Road TOWN CLERK P.O.Box 1179 REGISTk Att OF VITAL STATISTICS CAR Southold, New York 11971 MARRIAGE OFFICER , ® O� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICERTelephone(631) 765-1800 =44EDOM OF INFOIIMATION OFFICER CQV�(,� Boutltoldtown.norih.rork..n.et OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD F A X To: Michael Sibley Schofield Films From: Lynda M Bohn Re: Filming fees Date: July 18,2005 Pages: 1 including cover I have reviewed your application and letter. It all seems fine. The next thing would be to get me the original application,iiusurance and indemnification form along with the fees, which would be as follows: These must be separate checks: $100.00 certified check for the filming permit for each day of filming (which in this case would be one day) $250.00 certified check,this would be the clean-up deposit fee which will be returned after a site inspection by our Highway Dept. after filming The only other fee would be for parking. In our Town Code, Pipes Neck Road from the Terminus north for 300 feet requires a parking permit. You have two (2) choices: 1. If you know how many vehicles will be parked on the road I can issue permits when I issue the filming permit at$10.00 per vehicle for that day. Of course,I will need to know how many vehicles to issue the permits for and would also need the check for that amount prior to issuing them. 2. The other choice would be to stop at one of the"bait &tackle" stores on the way out. They would be$12.00 each vehicle and the plate numbers for each vehicle would have to be placed on the permit. I can provide these if necessary. I o,\OF SO�ryol. ELIZABETH A.NEVILLE Q Town Hall, 53095 Main Road TOWN CLERK P.O. Box 1179 REGISTRAR OF VITAL STATISTICS N Southold, New York 11971 MARRIAGE OFFICER Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER 0 Telephone (631) 765-1800 FREEDOM OF INFORMATION OFFICER I�COU�Y,� southoldtown. rthfork.net C OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD F A X To: Michael Sibley Schofield Films From: Lynda M Bohn Re: Filming fees Date: July 18, 2005 Pages: 1 including cover I have reviewed your application and letter. It all seems fine. The next thing would be to get me the original application, insurance and indemnification form along with the fees, which would be as follows: These must be separate checks: $100.00 certified check for the filming permit for each day of filming (which in this case would be one day) $250.00 certified check, this would be the clean-up deposit fee which will be returned after a site inspection by our Highway Dept. after filming The only other fee would be for parking. In our Town Code, Pipes Neck Road from the Terminus north for 300 feet requires a parking permit. You have two (2) choices: 1. If you know how many vehicles will be parked on the road I can issue permits when I issue the filming permit at$10.00 per vehicle for that day. Of course, I will need to know how many vehicles to issue the permits for and would also need the check for that amount prior to issuing them. 2. The other choice would be to stop at one of the"bait& tackle" stores on the way out. They would be $12.00 each vehicle and the plate numbers for each vehicle would have to be placed on the permit. I can provide these if necessary. 07/18/2005 13; 29 FAX [a 001 Schof iold Films T0: � � COMPANY: � td TEL: FROM:M;G ham, 10 DATE: '91 o 5,,,_., RE: PAGES: s--. Pages including cover MESSAGE: v v I ' Z w r l I C-v 560 Broadway, Room 204 NYC 10012 tel.212.633.8700 fax.212.633.9850 07/18/2005 13:30 FAX Q003 JL5/UI 'us MUN u9:44 FAX 631 765 6145 SOUTHOLD TOWN CLERIK 0 003 TOWN OF SO'UTHOLD APPLICATION FOR FILMING/STILL PHOTOGRAPHY r ( PLZA213 FAIM OR TYPE APPLICATION LATS! ` l , PZMaT No s Val NAm of Avv =carr: � - _ M i G IA aaa►rLxHa xDn9s 1 V .W c1e.f �� .5�:- > FROM. Im8mmE9s zit 3 -g o0 HOWm NAIOi OF ORGANIZATION, CODA".. MAILING A7aDseZSSi ��0 ���� / NY . kiv BHCNIS ( a 3 3 (� FAR. ..w�3rarr■rr�.►rrt+�`MNt1��V4i��**i tewi��.=..■tyf�4fr■.r•A RA+��yw�w■rr�yr��rs D$3CATll� S"7CpB of► ACTIVITY (Q.g, XCtioa Victumo, Cemmerci.al, TeleViHJCA, Catalog, magaZIne, etc_) % 'Te Ic/i5;an C e)mrka r cLa Fer Wctl6utt-;A DATE(S) A='TINS(6) OP CROPO$!1D b'SL7IIDTG/BHOSOGItAP}17(t ' PROPOSED LOCATZOU(N) OP PII&=0/BH0TOORAPHY% attga A40,t±onal sheet, if ueceeeary. KPAO OF VERNON ZR CESROM AT SITZ.rNUhollp' OF BpRSqVS AT LOCATION (CAST & CR8ti4 INCLUDED) S'MMZR AM TYPIC or V=tCLVgj AT SIOCATSOlT:, r✓Lk ri //-Io 2 (M,d �'�•—'�"S� w/fi p !e vahs t L a►/ TTFS OF BPSCIAL amrY rmm=- ANY SPEC_' A4 »iQ »i4121'PB t s1 aatura Return to: 'Southold Town Clerk SAt-Ithold Town Hall 53095 Main Road P. O. Box 1179 Southold, NY 11971 07/18/2005 13: 30 FAX 191004 18/07 - '05 MON 00:45 FAX 631 765 6145 SOUTHOLD TOWN CLERK (�004 INDEMNIFICATION AGREEMENT TOWN OF SOUTHOLD FILMTNC/STI L PHOTOGRAPHY PERMIT The Applicant shall indemnify and hold harmless the Town from and against all suits, claims,demands or ar-tions 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 intmediately take charge of and defend the sank at his own cost and expense. In addition,the Applicant will name the Town as an additional insured on any applicable policies. Signature Date Printed name Lo G/t''T c O rt'/Ll A'GC I Tttic <�, C fyO lal n-b � 07/18/2005 13:30 FAX Z005 MARSH USA,INC. CERTIFICATE-OF INSURANCE;, , CERTIFICATE NUMBER PRODUCER THIS CERTIFICATE 16 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO Marsh USA Inc. RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE 777 S.Figueroa St.24"Floor POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE Los Angeles,CA 90017 AFFORDED BY THE POLICIES HEREIN. 213.346-5000 COMPANIES AFFORDING COVERAGE Attn:Sarah Yates COMPANY Auto-WPP/Gra -New York A Fireman's Fund Insurance Company INSURED COMPANY Schofield Films B CHUBS 560 Broadway New York,NY 10012 COMPANY C COMPANY D COVERAGES ` rhls certificate su"'ercedes and re laces anV,previously'itsued'certltli ate for tFle ollcy period noted below. THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS,CONDITIONS AND EXCLUSIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. c0 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE(MMND/YY) DATE(MIA/DD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $2,000,000 A ®OOMMERICAL GENERAL LIABILITY XXC80412613 2/1/05 2/1/06 PRODUCTS-COMP/OP AGG $1,000,000 ❑CLAIMS MADE ®OCCURRENCE PERSONAL 6 AN INJURY $7,000,000 ❑OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $1,000,000 ®FOREIGN LIABILITY(INCLUDING AUTO) FIRE DAMAGE(Any one fire) $ 100,000 AUTOMOBILE LIABILITY IEX86947298 2/1/05 2/1/06 MED PAY(Any one person) $ 5,000 ❑ANY AUTO XXCO0412613 2/1/05 2/1/06 COMBINED SINGLE LIMIT $1,000,000 ❑ALL OWNED AUTOS El SCHEDULED AUTOS BODILY INJURY ( Person) $ ® HIRED AUTOS BODILY INJURY A MPT 07105092 2/1/05 2/1/06 (Per accident) $ ®NON-OWNED AUTOS ®NON-OWNED/HIRED PHYSICAL DAMAGE Physical Damage $Incl.In Misc Equipment Limil GARAGE LIABILITY ❑ ANY AUTO AUTO ONLY-EA ACCIDENT $ FJ OTHER THAN AUTO ONLY: EACH ACCIDENT $ EXCESS LIABILITY AGGREGATE $ EACH OCCURRENCE UMBRELLA FORM $19,000,000 6 79535897 2/1/05 2/1/06 AGGREGATE ®OTHER THAN UMBRELLA FORM $19,000,000 B WORKERS COMPENSATION AND $ EMPLOYERS'LIABILITY ❑ WC STATUTORY OTHER EL EACH ACCIDENT $ THE PROPRIETOR/ ❑INCL PARTNERSEXECUTIVE EL DISEASE-POLICY LIMIT $ OFFICERS ARE ❑EXCL EL DISEASE-EACH EMPLOYEE $ OTHER:Errors and Omissions MSF 07002774 2/1/05 2/1/06 Limit$-1,000,000 Props,Sets&Wardrobe Dad:$25000 Miscellaneous Equipment Lina$1,000,000 Dad:$1,500 A Third Party Property Damage MPT 07105092 2/1/05 2/1/06 Limit$2,000,000 Dad:$2,500 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLEWSPECIAL ITEMS(LIMITS MAY BE SUBJECT TO DEDUCTIBLE OR RETENTIONS) Limit$1,000,060 Dad;$2,50D Certificate Holder is included as Additional Insured and Loss Payee as their interest may appear as respects to production entitled:"Experience"Job#045- WB-034.With respect to other,coverage is Worldwide,in transit and All Rlsk. With respect to Automobile rentals,Non-Owned&Hired Auto Physical Damage limits are included in Miscellaneous Equipment. Deductible is 10%of loss:subject to$2,500 minimum and$7,500 max(per occurrence)WPP. CERTIFICATE HOLDER CANCELLATION Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION GATE 53095 Main Road THEREOF,THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL 29 DAYS WRITTEN NOTICE TO P.O. BOX 1179 THE CERTIFICATE HOLDER NAMED HEREIN,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR Southold, NY 11971 LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE.ITS AGENTS OR REPRESENTATIVES. MARSH USA INC. BY: y� ,j�'_•_ �fiarrrtlry MM1 9159 VALID A5 07/18/2005 13:29 FAX 1A.002 g� Schof • 7/18/05 Lynda M.Bohn Town of Southold Via Facsimilie (631)765-6145(fax) Dear Lynda, I am writing you pursuant to our earlier phone conversations with regard to Schofield Films interest in filming in Greenport.Please consider this letter as part of our permit application. We are planning on filming on Private property within Town of Southold Jurisdiction in Greenport on Tuesday,July 26', 2005.Our rain date would be either Wed,7/27 or.Thurs.7/28.We would start our day filming at The Foti Residence,located at 1925 Pipes Neck Road.The earliest we would begin filming is 7 am,but it could be later.We will park our vehicles on Private Property and/or Park them legally on the side of Pipes Neck Road and purchase any necessary parking permits.We will not block public access or thru traffic. At some point in the day,for approx.2—3 hours,we would like carry our camera and other equipment across the foot- bridge to film on the small barrier beach across from the residence at 1925 Pipes Neck Road.The scene we are filming would involve a couple rowing a boat in the shallow water off the beach,possibly beaching the boat and climbing out,and possibly tying the boat up to a dock. (Please note,there is no dock on this beach. If we did this shot,we would bring in a temporary Prop Dock, which we would remove immediately after filming.We may also rent a second boat to put the camera on to do a shot from the water. Once we have completed the work in this location(approx.mid-afternoon),we would move our trucks and equipment to the Delsman residence,4 Sandy Beach Point Road in Greenport.Once again,we would park our vehicles in some combination of Private Property&streets with proper permits.We would film at this property,on their private beach until approx.8 p.m.Once we have completed filming,we will load our equipment and return to NYC. We are planning on revisiting Greenport with the heads of all of our Technical Departments on Thursday,July 21".2005. After this`Technical Scout",we will no much more about our specific parking plans,schedule,and the nature of our work on Pipes Neck Beach.I spoke with Chief Cochran on Friday about our general plan,but I did not know about the beach shot at that time. I will try to speak with him as soon as possible regarding that scene. Thank you so much for your time and attention to these matters.If you have any questions or concerns,please call me at any time on my cell phone at(917)846-7977. Regards 7Z-ael Sibley Location Manager Schofield Films 560 Broadway, Suite 204 NYC 10012 tel.212.633.8700 fax.212.633.9850 NOTICE COUNTY OF SUFFOLK C —SCH N"t Dlatrkt Liro H--- UNLESS DRAWN OTHERWISE, ALL PROPERTIES Red Property Tax Service Agen •5°N°M pkirkt lira —" ARE WITHIN THE FOLLOWING DISTRICTS: .—- Wetme 0101kt LN,e --_R—- SCHOOL ,0 S SEWER rWJO -- MAINTENANCE,ALTERATION,SALE OR City center Riverheodl N Y 11901 2 Fks Oltttkt uro F HYDRANT DISTRIBUTION OF ANY PORTION OF THE b 1—VIwkt Um -W—- Matarkd0airkt Llro —HST FIREWATER SU SUFFOLK COUNTY TAX MAP IS PROHIBITED SCALE IN FEET: LIGHT 4Wy Np 0200 4H -7�� LI�t OMtrkt LNx —-L—__ ladgxs 01 trkt U"---A—- PARK 70 REFUSE WITHOUT WRITTEN PERMISSION OF THE �8�g®� purr gaMkt lN+ —''P--- Wmter4fer gairkt U. —WN—- AMBULANCE WASTEWATER REAL PROPERTY TAX SERVICE AGENCY. SEE SEC.NO.045 r O � 3 MATCH LINE , +L 7 FOR PCL.NO. GO 1.111AIc1 SEE SEC.NO. N 3 045-05-004 47X ti M ? 4 iP 5 e'``� d +,2 7.8le A1c1 ryr 11.44(c) 6 11.3A 9 2 13.0A10 TOWN OF I 'rv, n+� y SOUTNao 17 \� 47 (UNERWATER 18.11AIC1 3 , x LAN& � COBE 'Ift / 4 /, 4 •, / /3.2A(c). , 2.5A(c) I } r TOWN OF ",• n „a 3fy ys- d SOUTHOLD 2.5A 15.1 11AAfel KFRw�N �+p T 14.1 c/ a /•,/' / ��>• "„ _ 5.8A1d _ 1B r s v ;s .1 TOWN OF SOUTHOLD EK CRE (UNDERWATER LAND) a• PIPES el ° �o e / / a :F ,f /• 44.1 �m T.7A n �' 104 rs tsw J +i1g ' J °r� VSt G % �/ t P� 4'- Z j,.t „e pU n° +♦.�. �''`' �;f9 .,a a ,/fig/S/?6'e $Il�RE, 9 ?0?t . ff ff 12.6 O J cq, 'a ' J $/.+�', 98.OAIU 1!' ��a ' ,'4.'7 J 4 ��Jr i ,y 4 b� � ri�, • p66 e ♦yrr >s 'W'� 1 ' Uz � '� ^•�P y '4 8 a 9 :m .. ,fJS 2,44 0 °z r 40 $ 12.8 9 +ro FOR PCL.N0. A SEE SEC.NO. e a I' �^ x OST-OS-03a.3 F }qP MATCH z �-- 6 SEE SEC.NO.057 SEE SEC.NO.057 4 °• (so') nr cl)ccni v rl