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HomeMy WebLinkAboutMy Generationn MagazineTOWN L,6011% -- -- NOTE: All Payments must be cash or certified check - Date Received: ✓ Completed application ✓ 100 nonrefundable application fee W ✓ Certificate of insurance that evidences a public liability mount of $1,000,000 covering the town as an additional insured (one million dollars) per occurrence for the duration of the or still filming photography. .✓ Indemnification agr Bement stating the applicant agrees to assume all ree liability for and will indemnify and hold the town harmless s of and f of from any and all damages that occur to persons or property by said filming or still photography - 16 Forward hotography.16Forward completed application to Chief of police for approval or 36 disapproval an determination if Traffic Control Fee is required S Approved w Disapproved No Fee Required required Fee in the amount of $ 4 3 Forward certificate of insurance and indemnification agreement to Town Attorney fo approval , Approved Disapproved COLLECT FEES AS FOLLOWS: permit Fees (Prior to issuance of permit): apo ^ Film Fee - $100 per day of each day covered by the permit 6o — 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 maybe required b 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 C f of Police C 'ef Building Inspector Fire Marshal ,-,/Code Enforcement Officer ::�/,q/Superintendent of Highways 0 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. ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Raymond Jacobs, Superintendent of Highways From: Linda J. Cooper, Deputy Town Clerk Dated: June 7, 2001 Re: Film Permit No. 005 Cleanup Deposit Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 in accordance with §44A-5 of the Southold Town Code, please advise if the $250.00 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. Date ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P:O. Box 1179 ,Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 FILMING/STILL PHOTOGRAPHY Issued to: PERMIT MY GENERATION Date(s), Time(s), Locations(s) Monday, June 4, 2001 and Tuesday, June 5, 2001 8:00 A.M. to 8:00 P.M. Horton's Point na Lighthouse Road Beach, Southold Parker's Landing, Peconic New Suffolk Beach, New Suffolk Permit No. 005 Issue Date: May 31, 2001 Elizabeth A. Neville Southold Town Clerk (Town Seal) ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR. OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER o��s�FFO�kcoG Town Hall, 53095 Main Road P.O. Box 1179 H Southold, New York 11971 4 'F Fax (631) 765-6145 Telephone (631) 765-1800 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD June 13, 2001 Federal Express Joyce DeWitt My Generation 780 Third Ave, 41St Floor New York NY 10017 Dear Ms. DeWitt: Returned herewith are the two (2) Certified Checks in the amount of $250 each that were being held for cleanup fees as required by the Southold Town Code, Chapter 44A. An inspection of the permit sites was made and no cleanup was necessary. I hope. all went well with your shoot. If I can be of any assistance in the future, please do not hesitate to contact me. Very truly yours, Linda J. Cooper Deputy Town Clerk Enc. lie L 23 L0 2 140V 1:0 2 2000134 21:60 L6 10009V ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR. OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 FILMING/STILL PHOTOGRAPHY Issued to: PERMIT MY GENERATION Date(s), Time(s), Locations(s) Monday, June 4, 2001 and Tuesday, June 5, 2001 8:00 A.M. to 8:00 P.M. Horton's Point 6a Lighthouse Road Beach, Southold Parker's Landing, Peconic New Suffolk Beach, New Suffolk Permit No. 005 Issue Date: May 31, 2001 Elizabeth A. Neville Southold Town Clerk (Town Seal) ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER C4 Z OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Raymond Jacobs, Superintendent of Highways From: Linda J. Cooper, Deputy Town Clerk Dated: June 7, 2001 Re: Film Permit No. 005 Cleanup Deposit Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 In accordance with §44A-5 of the Southold Town Code, please advise if the $250.00 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. Signature Date POLICE DEPAMMENT TOWN Of (SOUTHOLD Telephone Emergency Dial 911 ufT71�111�1 TO: Linda Cooper, Deputy Town Clerk FROM: Chief Carlisle E. Cochran, Jr. DATE: May 30, 2001 RE: Application for Filming/Still Photography MY GENERATION MAGAZINE CARLISLE E. COCHRAN, JR. Chief of Police Pursuant to their prior approval, the change in date is acceptable together with the same conditions. The addition of Parker's Landing is approved with no police assistance, as long as they bear in mind that the boat ramp portion must remain open to the public. 41405 Route 25 • P.O. Box 911 • Peconic, N.Y. 11958 Administrative (631) 765-2600/2601 • Fax (631) 765-2715 POLICE DEPAPTMEW TOWN OF SOUT�IOLD CARLISLE E. COCHRAN, JR Chief of Police Telephone Emergency Dial 911 MEMORANDUM TO: LINDA COOPER, DEPUTY TOWN CLERK FROM: CHIEF CARLISLE E. COCHRAN, JR. G v DATE: MAY 17, 2001 RE: FILMING PERMIT - MY GENERATION MAGAZINE With reference to the above filming permit, the following information will have to be provided before approval is granted: 1. Where on Oregon Road the filming will take place. 2. Light House beach is OK as long as they do not block the entrance. Filming on New Suffolk beach is OK. 41405 Route 25 • P.O. Box 911 • Peconic, N.Y. 11958 Administrative (631) 765-2600/2601 • Fax (631) 765-2715 • ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR. OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER o�oSOFFot,��oG y� o - oy � !� OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 FILMING/STILL PHOTOGRAPHY Issued to: PERMIT MY GENERATION Date(s), Time(s), Locations(s) Monday, June 4, 2001 and Saturday, June 5, 2001 8:00 A.M. to 8:00 P.M. Horton's Point 6D, Lighthouse Road Beach, Southold Parker's Landing, Peconic New Suffolk Beach, New Suffolk Permit No. 005 Issue Date: May 31, 2001 Elizabeth A. Neville Southold Town Clerk (Town Seal) • ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR, OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD • Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 To: Southold Town Attorney's Office From: Linda J. Cooper Dated: 5/30/01 Re: Filming Permit In accordance with the Southold Town Code, Chapter 44A, Section 3, Subsection D, the Certificate of Insurance and Indemnification Agreement for _y Generation is attached hereto. Please review and advise whether these documents meet with your approval. Thank you. Approved as submitted Disapprove for the following reasons: 4� a Sgnat e e 3 O _ Date • ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER o��S�ffO�,�coG Cm y Z OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 FILMING PERMIT NO 005 OF 2001 PARKING PERMIT DATE: MONDAY, JUNE 49 2001 TUESDAY, JUNE 59 2001 TIME: 8:00 A.M. to 8:00 P.M. LOCATION: Beach at Lighthouse Road, Southold Parker's Landing, Peconic New Suffolk Beach, New Suffolk ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Chief Cochran, Southold Town Police Mike Verity, Senior Building Inspector Fire Marshal Ed Forrester, Code Enforcement Officer Raymond Jacobs, Superintendent of Highways From: Linda J. Cooper, Deputy Town Clerk Dated: May 30, 2001 Re: Filming Permit No. 005 • Town Hail, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 In accordance with Town Code 44A-9 you are being notified that a Film Permit was issued to My Generation magazine. See following page for a copy of the permit. 1-1 ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER o�oSUEFo�,��o� N Z OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD RECEIPT $100.00 Application Fee - Permit No. 005 $200.00 Daily fee — June 4 and June 5, 2001 $500.00 Cleanup Deposit $ 40.00 Parking Permits (2 Vehicles, 2 Days) Film Permit No. 005 - W GENERATION Received by • Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER o�OS�fFO�,�cOG co y� y Z oyi • OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD • Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 To: Chief Cochran, Southold Town Police From: Linda J. Cooper Dated: 5/30/01 Re: Filming Permit Transmitted herewith is the application of My Generation Magazine 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. NOTE: Original dates and locations have changed (rain date). ANOTHER NOTE: New Suffolk Beach has been added to the list of locations. I have been promised this will be the last amendment. 05/30/2001 12:00 FAX 12128268877 MY GENERATION 2001/001 May 30, 2001 To: Linda Cooper. From: Jessie DeWitt Re: additional area Please add New Suffolk Beach to the areas where we'd like to shoot on June 41h and S`". Thank you. rL:!wrE3;:ic:Ct;`'z{`:::i::.:::is....::;.::::::.;»:<•::::::::............... OF INFORMATION i::;:.:;::.:;.;::;:;;:::;•:>;.»:;•:;;.>:;:.:::::::::::::::::::.................. THIS CgRTIFICATE IS ISSUED AS A MATTER ...................... 212 682-7500 Producer ONLY AND CONFER -S NO RIQITS UPON THE CERTIFICATE HOLDER- Producer NORTHEAST THIS CERTIFICATE DOES NOT AMEND, EXZ�ID OR A'� THE 90 PARK AVENUE COVERAGE AFFORDED BY THE POLICIES BELOW - NEW YORK, NY 10016 CC�MpANlES AFFORDING CJO�7FZACE company Hartford Insurance Company AARPC01-TOM d Company Company AARP ICompany 601 E Street N.W. nr 20 D �yv�+ ........ :...<...:::..... ::::: ED NAMED ABOVE CY THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW FOR THE POLI ............. HAVE BEEN ISSUED TO THE IN UME CT OR ER DOC INDICATED. NOTYITTHSIANDINNG O MAY HIS PERTAIN. TERM OINSURANCEIAFFORDED ON OF YBYOTHEAPOLICIES HDESCRIBED NHEREIN IST WITH SSUBJECT TOPECT TO IALL CH TTHE CERTIFICATE BE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHppLI Y HAVE BEOLI REDUCED BY PAID CLAIMS. CY EFFECTIVE EXPIRATION LIMITS CO TYPE OF INSURANCE LTR LIABA72nmeer's rcial General iabims MadeOccur & Cont Protective MOBILE LIABILITY y Auto 1 Owned Autos heduled Autos red Autos n -Owned Autos GARAGE LIABILITY 7Anv Auto EXCESS LIABILITY Umbrella Form Other Than Umbrella Form WORmRs - COMPENSATION AND EMPLOYERS' - LIABILITY TnherP-/Rxeccutive qI - POLICY NUMBER OCSEJ54907 1/01/01101/01/02 e Fi ;ombined Single Limit 3odily Injury (per person) 3odily Injury (per accident) Property Damage Auto Only - Ea AccidE Other Than Auto Only Each Accidi Statutory Limi EL Each Accident EL Disease -Polis DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS 3095 RE. P.O eBoxa1179,FSouthhold, NYa11971. oJuneu4handd5,52001,Main Road, Town of Southhold included as additional insured. own Of Southhold Suffolk County ew York, Town Hall TT: Linda Cooper 3095 Main Road outhhold, NY 11971 ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE .ION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL _DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TD THE BUT FAILURE TO NAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION r77.iTY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE- ve • ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR, OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 To: Southold Town Attorney's Office From: Linda J. Cooper Dated: 5/30/01 Re: Filming Permit In accordance with the Southold Town Code, Chapter 44A, Section 3, Subsection D, the Certificate of Insurance and Indemnification Agreement for My Generation is attached hereto. Please review and advise whether these documents meet with your approval. Thank you. Approved as submitted Disapprove for the following reasons: Signature Date 05/24/2001 TAU 11:25 FAX 05/23/01 16:25 FAb 212 W" orte ACoitDSA NORTB'SAs'I' .90 PKRZ A'PEMZ SM YORX, NY 10016 m wm A Street N.W. nvv�W tin • 7512W 'Z= %$ AS ]! rffi =• t OV moo'0= mv coms 00 Ain m zee � �,rpl0�.M= CMRWZWjgZ=es 1W r ri1�. >tO> Mb as �f -MM MM Ifs Boz=r�a91�- W, ` Hartford Insuraaae C=.%Pariy Ampany wany C nr Q 004 0 zslxs za za C>snTYE�c 1YlAT 'i'RS M}.TrTQc of I019DAARCB �.lSi'9D MOM 3MVH z teBGSD To MM rlvadAeb NAIL aa]yv8 FOlt 1803 POLICY THIS is T d='rTrY6IVAT lli ANY RFQfliRSN�IQi, T8[!1f OR CAl4Aixjam Of Wy OOIaWM= OR. OTwm Doeoff= WSTU SS9PSCT To MCK TBIs cEaTTpIcnTB DW = %so= OR PAY VBRTAE21• TM nUMAM APFwDEP ez 168 @oIa1CIBS DF1s$Y peD ffitH17f T9 ;.'OASnaT TO ALL TfiR Ex5mTOWSAND19RTTt OF 3MM Ox,7CCIB T'TM9 OM HA L+II 29PRermnow-atm LBE= %TM op To= Ref1cf MOM TyA7'8Ummmu C LME== r�n�cisl r3onsral LLab JOCSEJ$4!?07 Q1/01/O1 01/01/08 bareo ai-& A3�+OmjllrY s 7Claama runt moeour mmor l s & C rl[ i'catnatjvr, fay Auk* All own*4 Autca scheduled Atlaoa ]fired Autoe lIbm-owned Autos ArW AunO �Offtumxxu 110m1 other Th.in`ombzella Vo= Mmvvzo. MMOMEMMIM mm meq. Z.t 53;L= P��n sa '07=e-uYSVa 0li1cc7['S azz: 8�ca7. Qj3mK Comb -1 aingle Liiair. (per aCCidetritl 4vuper1:y DOMAM; kE: gy Generation Pashippn� $$.soot at Town of Sou in cld 53095 MaRoad, P.O_ Box 1179, SouChhCl3, NY 11971. June a and 9, 2001. rown of Southholdt incl1xC ect .10 additional i-=0 red. own of Southhold Suffolk Co=ty isw York, Toren Hall rT: Llnda Coo�ar 3095 Ma. r. Roa3 outhhol , NY 11971 MX or MM Man VRSCP== 70=C3s; MR CMDK3== >aEPMa MM MgMZCW, — Z=== CCf22a r 1f ML MUWLVM Tec M33;- vacII I su zOr To mm messol:om mxmm In"m To %" m FLMME TO POLI SUCH1sDiICB MOIL . m *MAGWIC1{t GMAK OP An =w commm. as bma''s Olt xm*m- TOO Z NOI,Lv2 aNaD AN LL889Z8ZTZT XV3 9Z : ST TOOZ/6Z/5o 05/15/2001 17:31 FAX 12128268877 MY GENERATION 1.X.& .,{y IUJ u14J ,JUU1nULV t Lijp INDEMNIFICATION AGREEMENT TOWN OF SOUTHOLD FILMING/STILL PHOTOGRAPHY PERMIT The Applicant shall indeomify and hold barmless 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 connection wkh the performance of filming or still photography by the Applicant, his employees or agents or any subeoixtractor and in case of any such action brought sigain.st the Town, the applicant shall imm6diately take charge of and defend the same at his ovm cost and expense. In addition, the Applicant will name the Town as am additional insured on any applicable policies. S� Date W. /tEIVA Printed, name Title 2004 10004 ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR. OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER O�Oco S�FFO�,�cOG H Z oy� • o�� OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Chief Cochran, Southold Town Police From: Linda J. Cooper Dated: 5/30/01 Re: Filming Permit Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 Transmitted herewith is the application of My Generation Magazine 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. NOTE: Original dates and locations have changed (rain date). To: Linda Cooper From.: Jessie DeWitt Re: My Generation photo shoot We'd like permission to shoot on June 4' and/or 5', 2001 at the following areas: Horton's Point Lighthouse Beach Parker's Landing As Y wrote before, we're planning to make pictures of sweaters against a natural background. At the most, nine people will be on the shoot. There are no models, no hair and make-up. Thank you for all your help. Z00 Z NOIVSHMa0 AN LL889Z9ZTZT XVd LZ:ST TOOZ/6Z/90 •Town Of Southold P.O Box 1179 Southold, NY 11971 ***RECEIPT*** Date: 05/30/01 • Receipt#: 177121 Transaction(s): Subtotal 2 Daily Filming Permit $200.00 Cash#: 177121 Total Paid: $200.00 Name: My, Generation 780 Third Ave., 4th FI New York, NY 10017 Clerk ID: LINDAC Internal ID: 32689 •Town Of Southold • P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * Date: 05/30/01 Receipt#: 9999 Transaction(s): Subtotal 4 Beach Permits $40.00 Check#: 999 Total Paid: $40.00 Name: My, Generation 780 Third Ave., 4th FI New York, NY 10017 Clerk ID: LINDAC Internal ID: 32690 17T r, •:'tin lases. 1180 L 23 LO 259911' 1:0 2 200084 21:60 L6 L0009w, DRAWER'S SIGNATURE DRAWER'S SIGNATURE 11300 17 7 12 111' 1: 1 11,0000 191: 00 1 6 4 100 L L 30111 Ampunt o [ Tlhe Cha l attan:Bank [ 8uf1alo; IJ: 2 m � Ml1 LU M co—As Pi ,., c'_ mp..... 17T r, •:'tin lases. 1180 L 23 LO 259911' 1:0 2 200084 21:60 L6 L0009w, DRAWER'S SIGNATURE DRAWER'S SIGNATURE 11300 17 7 12 111' 1: 1 11,0000 191: 00 1 6 4 100 L L 30111 E ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Jessie DeWitt From: Linda Cooper, Deputy Town Clerk Dated: May 23, 2001 Re: Filming Permit • Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 I am going to need amended information from you for the Filming Permit. Please send verification of the change of dates and locations. I left a voice mail for you concerning the following info. The contact for the Suffolk County Parks is Judy Gordon, Assistant Deputy Commissioner at 631-854-4949. She would be able to help you with the Cedar Beach and Goldsmith Inlet locations. The Parker Landing area is under the Town of Southold's jurisdiction so it would be part of our permit. I checked with our insurance carrier and the Certificate of Insurance must show Town of Southold as Additional Insured. According to him, having the Town of Southold as Certificate Holder just proves you have insurance. Naming the Town of Southold as Additional Insured covers the Town for the liability insurance if something should happen during your shoot. I've included a couple of examples. Look forward to hearing from you soon. • 0 POLICE DEPAMMENT TOWN OF (SOUTHOLD Telephone Emergency Dial 911 MEMORANDUM TO: LINDA COOPER, DEPUTY TOWN CLERK FROM: CHIEF CARLISLE E. COCHRAN, JR. G v DATE: MAY 17, 2001 RE: FILMING PERMIT - MY GENERATION MAGAZINE CARLISLE E. COCHRAN, JR. Chief of Police With reference to the above filming permit, the following information will have to be provided before approval is granted: 1. Where on Oregon Road the filming will take place. 2. Light House beach is OK as long as they do not block the entrance. Filming on New Suffolk beach is OK. 41405 Route 25 • P.O. Box 911 • Peconic, N.Y. 11958 Administrative (631) 765-2600/2601 9 Fax (631) 765-2715 Date Producer 212 ) 682-7500 THIS CERTIFICATE IS ISSUED AS A MATTER OF INPORNATION ACORDIA NORTHEAST ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE 90 PARK AVENUE COVBRAGE AFFORDED BY THE POLICIES BELOW. NEW YORK, NY 10 016 TTRYlTTT1 V 1 !W l[ 71 TfT Company Hartford Insurance Company A Company AARPCOI-TOM B Company (AARP 601 E Street N.W. Company THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY 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. POLICY POLICY CO EFFECTIVE EXPIRATION TYPE OF INSURANCE POLICY NUMBER ----- LIMITS LTR QENMLXL LIABILITY A Commercial Generaliab 10CSEJ54907 Claims Made Occur Owner's & Cont Protective ALTIOMOBILE LIABILITY Any Auto All Owned Autos Scheduled Autos Hired Autos Non -Owned Autos GARAGE LIABILITY Any Auto 1/01/01 101/01/02 Products - YY Each Occurrence $ Fire Damage (anv 1 fire) s i_ n n n_ n n n Combined Single Limit Bodily Injury (per person) Bodily Injury (per accident) Property Damage Auto Only - Ea Accide Other Than Auto Onlv DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS E: My Generation Fashion Shoot at Town of Southold, 53095 Main Road, P.O. Box 1179, Southold, NY 11971, May 23 and 24, 2001. own Of Southold Suffolk County ew York TT: Linda Cooper own Hall 3095 Main Road outhold, NY 11971 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE M(PIPATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEfT, BUT FAILURE TO MAIL SUCH NOTICE SHALL II+80SE NO OBLIGATION OR 1LIABILITY OF ANY KIND UPON THE COMPANY, ITS AMCENTS OR REPRE- Aut?b7AzAd Re(oresentative (ESS LIABILITY Each Uccurrence $ Umbrella Form I A re ate $ Other Than Umbrella Form WORKERS' CUMPENSATION AND IStatutory Limid the EMPLOYERS' LIABILITY EL Each Accident $.... The Proprietor/ Incl EL Disease-PolicyLimit $ Partners/Executive I] H DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS E: My Generation Fashion Shoot at Town of Southold, 53095 Main Road, P.O. Box 1179, Southold, NY 11971, May 23 and 24, 2001. own Of Southold Suffolk County ew York TT: Linda Cooper own Hall 3095 Main Road outhold, NY 11971 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE M(PIPATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEfT, BUT FAILURE TO MAIL SUCH NOTICE SHALL II+80SE NO OBLIGATION OR 1LIABILITY OF ANY KIND UPON THE COMPANY, ITS AMCENTS OR REPRE- Aut?b7AzAd Re(oresentative 05/21/2001 10:15 FAX 12128268877 • MY GENERATION • 5121 2-0°I Cool .GENERATION 780 3RD AVENUE 41ST FLOOR NEW YORK, NY 10017 (646) 521-2501 FAX! (212) 826-IR77 N S 05/21/2001 10:15 FAX 12128268877 uaitSiLUUi 17::1j k(PLK �� V� � 1!11826887 , MY GENERATION IR1 002 MY GENERATION • " Z002 AuuinuLY t l,C;ltt► 00l� lQJ DO 4 INDEMNIFICATION AGREEMENT TOWN OF SOUTHOLD FTGMING/STILL P1-IOTOGRAPHy ppXt ,ff The Applicant shall mde=1j* and hold h -armless the Towyn from and against sl1 gulfs, claims, demands or actions for any damage and/or injury susujaed or alleged Cabe 9us�ed by aay party or parties, iu-colMeation.wM'the performauce of filrRiuX or SUR photograplAy by the Appliean4 his exVloyees or agenft or any Subcoptractor and in case of any such actios,, brought Aggin6t the Town, the applicant shall imm.6djaWy take charge of and defend the szMa at hU owa, cost znd expense. In addition, I*e Applicant WW name the Town as on iWitional iWured on any applicable policies - Date Printed narne TWO THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY 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. POLICY POLICY CO TYPE OF INSURANCE POLICY NUMBER EFFECTIVE EXPIRATION LTR DATE DATE LIMITS tN3RAL YJ ILITY General Aggregate A Commercial General�iab 10CSEJ54907 01/01/01 01/01/02 Products -Com Ops A $ Claims Made Occur Personal & Adv In'u $00 Owner's & Cont Protective Each Occurrence S l n n n n n n DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS E: My Generation Fashion Shoot at Town of Southold, 53095 Main Road, P.O. Box 1179, Southold, NY 11971, May 22 and 23, 2001. own Of Southold Suffolk County ew York TT: Linda Cooper own Hall 3095 Main Road Southold, NY 11971 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELL13D BEFORE THE RATION DATE TBSREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Q_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE- Ud ,Representative Med Ex (an one person) AUTOPfOBILE LIABILITY Any Auto All Owned Autos Scheduled Autos Hired Autos Non -Owned Autos Combined Single Limit $ Bodily Injury (per person) $ Bodily Injury (per accident) $ Property Damage GARAGE LIABILITY JAny Auto Auto Only - Ea Accident $ Other Than Auto only Each Accident $ Aggreqate EXCESS LIABILITY Umbrella Form Other Than Umbrella Form Each Occurrence $ Aggregate WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY The Proprietor/ Partners/Executive Incl Officers are: Excl OTS r Statuto Limi the >:: EL Each Accident $ EL Disease -Policy Limit $ EL Disease -Ea Em to ee DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS E: My Generation Fashion Shoot at Town of Southold, 53095 Main Road, P.O. Box 1179, Southold, NY 11971, May 22 and 23, 2001. own Of Southold Suffolk County ew York TT: Linda Cooper own Hall 3095 Main Road Southold, NY 11971 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELL13D BEFORE THE RATION DATE TBSREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Q_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE- Ud ,Representative ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER O�OS�FfO(,�coG o� y� H Z 15 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Chief Cochran, Southold Town Police From: Linda J. Cooper Dated: 5/16/01 Re: Filming Permit Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 Transmitted herewith is the application of My Generation Magazine 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. •Town Of Southold P.O Box 1179 Southold, NY 11971 ***RECEIPT*** Date: 05/16/01 Receipt#: 0 Transaction(s): Subtotal 1 Application Fee - Non -Refund $100.00 Total Paid: $100.00 Name: My, Generation 780 Third Ave., 4th FI New York, NY 10017 Clerk ID: LINDAC Internal ID: 32156 15/05 '01 TUE 12:43 FAX 516 765 6145 SOUTHOLD CLERK TOWN OF SOUTHOLD APPLICATION FOR FILMING/STILL PHOTOGRAPHY PLEASE PRINT OR TRPS APPLICATION DATE: 7061 PERMIT NO: G �� NAME OF ]?r,=CANT: IS ' �ck KAILINQ ADDRESS; PHONEp BusTmaS6 - ^a - Jb WOM3 Nam OF ORGANIZATION, CajMjU y; (� MA -Minn ADDRVts, /W lA A A PHONE (vti lo- - i a FAR.T-f /�0/�v��0 wrrir •y �������'.,��iVllRwiiwk6S�•arrtwr**..4r.�Fd,F"R "Ras- -i . 55 -DZgC1S9E %"Xj'E OF ACTIVITY (4. t b�otion L�icture, Commcrc3al, Telerri Rion, Catalog, kSagazine t3tc .) : 71k 1� N Dl9rFs; DAT") AND I'IM'V (H) OF PROPOSZD FILMIXG/PHOTOGRAPH'k': v UN I / --!q� I/ -ao ( -- PROPOSSb LgC,ATZON m OF rILMIHG/PHOroRAPHY; attach additioa41 abeet, if neceeeary. NAMg Or PERSON IN CWMQE AT 9TT19, C Y `f T Ak, cxz Setm( A7U'M'3R OF PRRSONS AT LOCATION (CAST & CREW zHCLuDgn): ' • I U xoIM11R AND TYPE+ or �AiCLES AT LOCATION; V Cck— � TYPA OF SBBCIAI., RQUZPMSW'r• ANY SPECI;" "4DIR]DEENT6, signature Return to- Southold Town Clerk Southold Town Hall 53095 Main Road P. 0. Box 1179 Southold, NY 11971 • To: Linda Cooper Re: locations of photography for My Generation shoot From; Jessica De Witt • After a brief talk with Carla Engler, who will be on the shoot, the locations that fall under the Southold township where we would like to photograph are as follows; 1) area of Oregon road in Cutchogue 2) horton's point Lighthouse Beach 3) New Suffolk Beach 05/15/2001 15:46 FAX 12128268877 MY GENERATION Z001 • M110GENERATION 780 Third Ave. 4tst floor, New York, N.Y. too r7 FAX COVER SHEET To: Cd° I76--fL Fax: b9 ( . 165-6('t5 • I M D\2 (f \j F --o S �- �'- � es'� From: kvA A H-1 M C r->,-Z� -r� ,�`(b Sz-t �c,z2 Fax: g'2 -(..P -?-1 Re: Tet M �q Number of Pages (including this one): 3 p Message: F� C'- M L' (' �'- C ( Z) • o u t' (Z -0 w' N vel l LA, E SENT TDOPT C L 6 F1 (Z, 6vKNI9--(a-T WILAVE-P- . ?L/; N(7� 1 �1QJ nnN o(% rt 11 kPoc2 2513 . 05/15/2001 15:46 FAX 12128268877 MY GENERATION Z002 15/05_'01 TUE 12:43 FAX 516 765 6f SOUTHOLD CLERK • L1oat TOWN OF SOUTHOLD APPLICATION FOR FILMING/STILL PHOTOGRAPHY C h, 8L$ASE �'RTr1? O& xYss APPLICATTaR DATE: 5 �w) 1 pgp r� �pp� Rhma of r.P$LTCX=; IS \ `� - dr .. MAILZNG AL1Df"sj f $mm OF OR.GAt ZZ&T10N, COMpagy; Q a� MA-TL=c PHO", i� �- Sal - :)-sof) T -- y �-6 - � a- +frtii--->s•---* f.dVe �F iii.rtii.>4 R -r A..4->-♦w>itt�wi�»���»�w,rr� D$5CRIhZ %-Xp" Op AC7T1V1 TY (0,l3, 2Rpt10A Pidcure, COmmcrcial, TeleV113jan, Catalog, kiagazine etc .) x aAx� cs) ANp TXM (1g) o$ jpAQP0gjVD rXLUS=/VUOT0GP-h11 t'k'; 213 7- 00 I PROPOS= LOCl1TT01! (S) 08 Vjirmtv(;/Pi30vro�gApt�ty: attach add�tlQza�,l ahep�, i nCceeaary. % I -n , h- TlAitlffi or P$RT>Qbf IN CIi8R6$ AT 3ZTga NL1hm$R Oil PRRRSOla6 AT LOCATION (CAS? a CRM =NCLIMI D) : U rrQt~a►�t x►oi TICE+� OP S*FiFYGLSIa Apt LOCATSaNq I v C TYPO OF OVECIAL zquzp,t KQiy- MM 2231=;Az )WQt7xx=Km rrgj< y\0 Itik signature Return to, Southold Town Clerk S©uthold Town Hall 53095 Main Road P. O. Sox 1179 Southold, NX 11971 05%15/2001 15:46 FAX 12128268877 MY GENERATION i To: Linda Cooper Re: locations of photography for My Generation shoot From, Jessica De Witt 2003 i After a brief talk with Carla Engler, who will be on the shoot, the locations that fall under the Southold township where we would like to photograph are as :follows; X) area of Oregon road in Cutchogue 2) horton's point Lighthouse Beach 3) New Suffolk Beach ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD FAX TRANSMITTAL To: Jessie De Witt From: Linda Cooper, Deputy Town Clerk Dated: May 15, 2001 Number of Pages (including cover): If total transmittal is not received, please call 765-1800. COMMENTS: Jessie, I received your faxed application. We do not accept credit cards. Certified checks, money orders, or cash. There are a couple of problems with the locations. Nassau Point Causeway is not owned by the Town of Southold, the town cannot give permission for anything other that town -owned property. Contact the Cutchogue-New Suffolk Park District (Jeff Smith 631-734-5224 or Georgeanna Fogarty 631-734-5866); it would have to give permission (town permit not required). "Woodsy area" is too vague; the Chief of Police will need to know where you are going to be shooting. Application also needs the time listed. You can be quite general, but you must give some time. Also would you fax me a telephone number where I may reach you. Thanks. 05/15/2001 14:54 FAX 12128268877 MY GENERATION lao01 .GENERATIOP 780 M AVENUE -F,\ 41ST FLOOR NEW YORK, NY 10017 (646)521-2601 FAX (212) 826.977 mss, �ts5�� 05/15/2001 14:54 FAX 12128268877 MY GENERATION - -� avutauLJ1 L;Lob K TOWN OF SO'UTHOLD APPLICATTON FOR FILjgjWG/STILL PROTOGRAPH'Y sscAss Plz�,rr osz nss 1PD7-IC4TZQN BATS: 5 7661 << t{ pRRNS'f Sol 2T g of 82,2cAmr:— dr SAIL=lp0 AIIDA�IS9: ��(l (��C ' NsAZ� OF 031GANI4,ATZON. � J►tiY: PHONE, I\-- %'47('- 8a -I -I ...;.............. DESCRXM Z"MI OV A=n,-YTTy x4agazi3e fate.) ; Li" Mvtioa 1?iCtuze, Catnmcra;al. TeleviaioA, Catalog. S` bd1tL (9) ALTD TIME (H) Or PUPOSVD 2-3 zc)o kROFOsmp LOCATrO7t(S) OF V-xLmr'G' ti Z4rl;>-rnl = attach addltio+a�l 4$eet, if peG�4sa�y, rI oxr � so�cr zx CIQRAX AZ' s=ue!, �` Aor J `( ��BR OA P�S01Q8 AT LOCATSOl1 iC�iS82 & CREW ZZTMI ED) , 10 Nfl�SR TYPE 02' Y,SFICLSS TYDZI OF SFSCTbj,- SQ1h.PM9Wx: I V Ally SPECS,A,z'4'9 s 1 \.� ► �'l Sxgnatu=e , Return to: Southold Town Clerk S©iathold Town Hall 53095 Main Road P. 0. Box 1779 Southold, NY 17971 z0O1 0 i 05/15/2001 14:55 FAX 12128268877 MY GENERATION 10003 • • To: Linda Cooper Re: locations of photography for My Generation shoot From: Jessica DeWitt After a brief talk with Carla Engler, who will be on the shoot, the locations that fall under the Southold township where we would like to photograph are as follows: 1) area of Oregon road in Cutchogue 2) Morton's Point Lighthouse Beach 3) New Suffolk beach 4) Nassau Point Causeway 5) 'Woodsy areas ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD FAX TRANSMITTAL To: Jessie DeWitt 212-826-8877 From: Linda Cooper, Deputy Town Clerk Dated: May 15, 2001 Number of Pages (including cover): 8 If total transmittal is not received, please call 765-1800. COMMENTS: Info, application and other related materials for Filming Permit in Southold Town. Please do not hesitate to contact me if you have any questions or need assistance. 15/05 '01 TUE 11:52 FAX 516 765 6145 SOUTHOLD CLERK TRANSMISSION OK TX/RX NO CONNECTION TEL CONNECTION ID ST. TIME USAGE T PGS. SENT RESULT ELIZABETH A. NEVTLLE TOWN CLERK REGISTRAR OF VITAL. STATISTICS MARRIAGE OCFICER k2CORDS MANAGEMENT OFFICER FREEDOM OF INFORMA,rioN OFFICER * TX REPORTx 2518 12128268877 MY GENERATION 15/05 11:49 02'55 9 OK z 001 Town Hall, 53095 Main Road P_O. Box 1179 Southold, New York 11971 Fax(631)765-6145 Telephone (631) 765-1800 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD FAX TRANSMITTAL To: Jessie DeWitt 212-826-88.77 From: Linda Cooper, Deputy Town Clerk Dated: May 15, 2001 Number of Pages (including cover): 8 If total transmittal is not received, please call 765-1800. COMMENTS: Info, application and other related materials for Filming Permit in Southold Town. Please do not hesitate to contact me if you have any questions or need assistance.