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Home My WebLink AboutSvoboda, Mark �. 970 Peconic Lane Ken Reeves '' ;'ti:, P.O.Box 267 Recreation Supervisor, `' t'' Peconic NY 11958 Town of Southold '' 631.765.5182 Ken.Reeves@town:southold:ny.us TOWN OF SOUTHOLD RECREATION DEPARTMENT APPLICATION FOR WEDDING CEREMONY ON SOUTHOLD TOWN BEACHES PLEASE PRINT LEGIBLY APPLICATIONS DUE AT LEAST THREE(3)MONTHS BEFORE EVENT Today's Date: 10/2,6) /3 Applicant's Name: :91'mlonda Address: .2j951 0 to Home Phone: Business Phone: Cell Phone: f mail address: Name o rid roomlSpouse#1, �r?4 1"Y ,lid's r Name of Bride/(!�Ppouse#2• fy)(M a syaboda Beach Requested: Mwals (Town Beach,Gull Pond, ,Keenny's, Cabe's,New.Suffolk,Goose Creek,etc.) Number of Guests:_ Number of vehicles: Day and date of use: �I Length of ceremony: From: A.NL _P.M. To: A.M. LJSL P.M. Number of temporary parking permits requested: 3 0 Please allow ample time to set up and clean beach after use. Town beaches are closed from dusk until dawn. Is the bride/groom/spouse a resident of the To of Sou Id? DYES O Applicant's Signature: ew FEES: Residents: Free of Charge Non-Residents: $50(under 50 participants) $75(over 50 participants) Refundable cleanup deposit of$250 required for all applicants. Please note: Fees must be paid once application is approved. Checks made payable to TOWN OF SOUTHOLD. Please submit separate checks. TOWN OF SOUTHOLD 2013 INDEMNITY AGREEMENT STATE OF NEW YORK ) )ss.: COUNTY OF SUFFOLK ) This Agreement is made this 3fl day of 10 G� , 2013 between the Town of Southold(hereinafter"Town")and t'Y1AP--le Sdor�aizA (hereinafter"Applicant"). In consideration of issuance by the Town's Recreation Department of an approval to utilize a Town Beach, the Applicant voluntarily agrees to indemnify and hold the Town and its officers, employees, and agents harmless from and against any and all losses, liabilities, damages, or costs sustained by any person for personal injury, death, or property damage arising out of,or as a consequence to the use of the Town property. The undersigned further agrees to indemnify and hold harmless the Town and its officers, employees, and agents from and against any and all losses, liabilities, damages, or costs which may be imposed upon, incurred by or asserted against the Town by reason of any act of omission of the undersigned, which result in damage or injury of any kind to any person or any property and which arises out of or is any way connected with the event permitted by this approval. APPLICANT: By: Sworn to before me mLe�this SD day of ,20!,3.; ADAM J HALPERN Notary Public,SUft of NOW Work No.01MAtI2707ao QualMed In KkVe County Notary Public Commission Expires October 22,2016 :lfi�i�i�:�;l�l;Ci�i�i��li�iri�i�:l�S'��i�i��:l�l�li��'e"i�.E�'li��i��fi��il�'l�li��✓�i'li''�i'i�i��f�i�i�� !-/�1�1-l-lls�l��l��l��!-�11�r�l-l-rt��/tit/!��!-�/t��1-�l•�l-ll-��s��!/11-�1-I FOR OFFICE USE ONLY FACILITY IS: REQUEST IS: AVAILABLE I Vf APPROVED { } NO V BLE { } DENIED { } Recreation Department Supervisor CERTIFICATE OF INSURANCE REQUIRED? `i Y LA'S LINO Application fee of 0$50 0$75 received on: Date Check Number Deposit of$250 received on: Date Check Number 4�OgUFfO(,�-�o ELIZABETH A. NEVILLE,MMC �� G,y Town Hall, 53095 Main Road TOWN CLERK o P.O.Box 1179 co 2 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS p `� Fax(631)765-6145 MARRIAGE OFFICER 'f �a0� Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD April 7, 2014 Mark Svoboda 205 Amity St Brooklyn NY 11201 RE: Beach Parking Permits for 9/13/2014 Wedding Dear Mr. Svoboda: Enclosed herewith are 30 permits for your wedding guests to park at Kenney's Beach, Southold on September 13,2014 for your wedding ceremony. Please have your guests place the permit on the vehicle's dashboard, passenger side. Failure to display the permits could result in the vehicles being issued parking tickets. I have also included the receipt for the Beach Wedding permit and the Clean-up deposit. I'll keep my fingers crossed that you have beautiful weather for you special day. Very truly yours, Linda J. Cooper Deputy Town Clerk Enclosures Cooper, Linda From: Cooper, Linda Sent: Tuesday, April 08, 2014 12:08 PM To: Flatley, Martin Cc: Kruszeski, Frank; Blasko, Regina (rblasko@town.southold.ny.us) Subject: Beach Wedding Parking Permits Attachments: beach wedding_20140408105417.pdf Attached is a copy of beach parking permits which will be used in September at Kenney's Beach. I know it's a long way off and normally I don't send out the parking permits until 3-4 weeks before the wedding but the bride wanted to make sure she has the permits way, way, way ahead of time. Thanks. e2"/ /', Deputy Town Clerk Town of Southold 631-765-1800 76 w4d tl:e Wt 4W fou mwr OW 44eae you caps. i SOUTHOLD TOWN BEACH PARKING PERMIT for Svoboda/Kallus Wedding This permit allows entrance and parking at: Kenney's Beach Saturday, September 13, 2014 7:00 PM — 7:30 PM Elizabeth A. Neville Southold Town Clerk (seal) Display permit on vehicle's dashboard, passenger side * * * RECEIPT * Date: 04/04/14 Receipt#: 166882 Quantity Transactions Reference Subtotal 1 Guarantee Bid Deposits 9/13/14 Wedding $250.00 Total Paid: $250.00 Notes: Payment Type Amount Paid By CK#458 $250.00 Svoboda, Mark J. Name: Svoboda, Mark J. 2417 41 st St., Apt 3f Astoria, NY 11103 Clerk ID: LINDAC Internal ID: 9/13/14 Wedding * * * RECEIPT * * * Date: 04/04/14 Receipt#: 166873 Quantity Transactions Reference Subtotal 1 Beach Wedding 9/13/14 KB $50.00 Total Paid: $50.00 Notes: Payment Type Amount Paid By CK#458 $50.00 Svobada, Mark J. Name: Svobada, Mark J. 2417 41st St., Apt 3f Astoria, NY 11103 Clerk ID: LINDAC Internal ID:9/13/14 KB Southold Town Board - Letter Board Meeting of October 21, 2014 RESOLUTION 2014-835 Item # 5.12 ADOPTED DOC ID: 10172 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2014-835 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON OCTOBER 21, 2014: WHEREAS Mark Svoboda supplied the Town of Southold with a Clean-up Deposit fee in the amount of$250.00 for his Beach Wedding at Southold Town Beach and WHEREAS the Southold Town Recreation Director Ken Reeves has informed the Town Clerk's office that this fee may be refunded, now therefore be it RESOLVED that Town Board of the Town of Southold hereby authorizes a refund be issued in the amount of$250.00 to Mark J. Svoboda, 2417 41" Street, Apt 3F, Astoria, New York 11103. 61- Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Robert Ghosio, Councilman SECONDER:Louisa P. Evans, Justice AYES: Ghosio, Dinizio Jr, Ruland, Doherty, Evans, Russell Generated October 23, 2014 Page 19 Vendor No. Check No. Townof Southold, New York - Payment Voucher Vendor Name Vendor Address Entered by Ma_yie, Svo bodes ' -� ----- Arr., - --- - __Y e1 __ udtt Dace Vendor Telephone Number r a35- 5,10 y Town Clerk . O_Q_ Vendor Contact Invoice Invoice Invoice Net Purchase Order Number Date Total Discount ;Amount Claimed Number Description of Goods or Services fiieheial:I edge�Ftind:and AccoubtNitrribdr:: C %.V ¢posit !a500" w $. 4. y . Total Payee Certification Department Certification The undersigned(Claimant)(Acting on behalf of the above named claimant) I hereby certify that the materials above specified have been received by me does hereby certify that the foregoing claim is true and correct,that no part has in good condition without substitution,the services properly been paid,except as therein stated,that the balance therein stated is actually performed and that the quantities thereof have been verified with the exceptions due and owing,and that taxes from which the Town is exempt are excluded. or discrepancies noted,an pa ent is approved. Signatu>leJL le Si ure Company Name Date 10 1 aK Titl M41C Date a�