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HomeMy WebLinkAboutLI Metro Lacrosse Foundaton ¶ Doroski, Bonnie From: Sakarellos, Elizabeth Sent: Friday, April 01, 2016 8:19 AM To: Doroski, Bonnie Subject: RE: Lacrosse Tournament Hi sorry I've been out sick. Vicki says she has to contact them. From: Doroski, Bonnie Sent: Wednesday, March 30, 2016 9:37 AM To: Sakarellos, Elizabeth Subject: Lacrosse Tournament Hi Liz, Just wondering if your office had any decision on that application? Thanks, Faovcie p. Dpi Deputy Town Clerk Southold Town Clerk's Office 53095 Main Road Southold, NY 11971 (631) 765-1800 office (631)765-6145 fax 1 03/2112016 12:18 6315938951 GREENPORTSCHOOL PAGE 02/04 ELIZABETH A.NEVILI..E,MMC �� , TOWN CLERK Town Hall,53095 Main Road - F.O.Box 1179 en tyr -e Southold,New York 11971 REGISTRAR OF VITAL STATISTICS to �+ Fax(631)765.6145 MARRIAGE OFFICER Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER Als �► FREEDOM OF INRMATION OFFICER ,, +'' www southoldtownnygav OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION FOR A PERMIT TO HOLD A SPECIAL EVENT Please rovide ALL of the information re crested below. Ircom fete a lications WILL NOT be reviewed. Date of Submission t3 1 , Name of Event a( 1,0r4 03 Ma, l 00.f not,1140 4 4 Name of Organization: Lon. try e" r ..Pb l Is this a Not-For-Profit Event, es/Non Yl Contact's Name: L t1L. J cue, 1 -- — Mailing Address: R,_(73 Wfa,t f t, • at-e Pi [aim( ,c " �. IrD3 Contact's Phone Number: 5 i — 1 - 0 Contact's Email Address: O/ •C,h 1 O Event Location and Site Diagram: y'ee * . t1 sc Yio o , Rel ds (Use additional paper if necessary-)` �'� Event Date(s): tom. 12 a v\/d... T— �f 01 tw► (Include set up and,shutdown times and dates) Nature of Event I -e Cs c Lon, hits,, C+ i©C9 it y4 !)- (Please attach a detailei description to this •,plication) Time Period(Hours)of Event: Fromo O� a_to s.(,`1d Q Maximum Number of Expected Attendees: 04m_ Maximum Specify any special requirements(i.e.road closure,police presence): • Revised $15115 03/21/2016 12:18 6315938951 GREENPORTSCHOOL PAGE 03/04 if a Tent or other temporary structure will be used please contact the Southold Town Building Department at 631-765-1802 Mailing I-� ' r erg alling Address to Send Event Permit to: I— , PJJce 'niw LL Fees: $250 for events with less than 1000 expected attendees $500 for events with 1000 or more expected attendees - $1,500.00 Bicycle and/or Running Special events $250 or more Clean-up deposit (Cannot be Waived) CERTIFICATE OF INSURANCE REQUIRED: Not less than$2,000,000 naming the Town of Southold as an additional insured. ***NOTE: PLEASE SEE ATTACHED REVISED ADOPTED TOWN POLICY*** Additional infotmation and requirements may be required as deemed necessary by the Town Board. e WO TL65, Print name of Authorized Person filling out out Signature of Authorized P -o filling out app iention application *Upon the request by applicant,the Town Board may waive in whole or in part any of the application requirements. Revised 8/5/15 2 03/21/2016 12:18 6315938951 GREENPORTSCHOOL PAGE 01/04 Greenport . ri Or .,,Froe..School District - 720,1ront$trot • C,reenpbrt, Neik•York• X19444599 Phbne•,631/4774'666 Rat 631/593.8951 • David Oaniberg Supertntendent FAX TRANSMITTAL SHEET DATE: c„ '.2.(J l ' TO: l Jl COMPANY: 1 C JC\ c 4c FAX# (.3\ —7(c)57-- ( . FROM: )�,, 11►� 1 r`- MESSAGE:,_ ', _, l ] .''.' _ • Si. I , 4 ' t .�� 4-4" Cl P\Le.8-4 .,O' r Q L to .L• -w 1 i'1n. • aJ1\\OC\ LYallInC 'Q r1)YQi_Tr)1.)1(2Cit L. lift dk .r.• atiolCAn (c5CA). RESPOND TO FAX# (631) 593-8954 TELEPHONE# (631) 477-1950 Ext. 423_)_ # OF PAGES LI (INCLUDING TRANSMITTAL SHEET)