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ELIZABETH A.NEVILLE,MMC � 4�� Town Hall,53095 Main Road
TOWN CLERK P.O.Box 1.1.79
Southold,New York 11971
REGISTRAR OF VITAL STATISTICS Fax(631)765-61.45
MARRIAGE OFFICER � Telephone(631)765-1800
RECORDS MANAGEMENT OFFICER .� `� www.southoldtownny.gov
FREEDOM OF INFORMATION OFFICER
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
APPLICATION FOR FILMING/STILL PHOTOGRAPHY
PERMIT NO;
Please Pant or Type
APPLICATION DATE; Monday, August 21st, 2017
NAME OF APPLICANT: Joe Mullaney-Assistant Location Manager
MAILING ADDRESS: 10 Java St, Brooklyn, NY 11222
PHONE: BUSINESS: 646-863-7544 HOME: (m) 631-365-9383
NAME OF ORGANIZATION/COMPANY: Crash for Gold Productions, LLC
MAILING ADDRESS: 10 Java St, Brooklyn, NY 11222
PHONE: 646-863-7544 FAX; 646-863-7539
DESCRIBE TYPE OF ACTIVI'T`Y (e.g. Motion Pict-are, Commercial, Television, Catalog, Magazine, etc.):
Television- HBO_`...`Crashinq" Season 2 _ _
DATE(S) AND TIME(S) OF PROPOSED FILMING/PHOTOGRAPHY:
Tuesday, August 29ft 2017 Approx. 2PM-8:30PM__
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PROPOSED LOCATION(S) OF FILMING/PHOTOGRAPHY: (attach additional sheet; if necessary)
Depot Ln btw County Rd 48 & Oregon Rd and Oregon Rd btw Depot Ln &Alvahs Lane
NAME OF PERSON IN CHARGE AT SITE: Joe Mullaney-Assistant Location Manager _
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NUMBER OF PERSONS AT LOCATION (cast & crew included): Approx. 40
(3)15 pass vans,(1)24 foot box truck,(3)picture cars i
NUMBER. AND TYPE OF VECI-IILES AT LOCATION:(1)restroom trailer,(1)generator van(1)3 room camper,(1)flatbed
TYPE OF SPECIAL EQUIPMENT: Camera_on._tri.pod. episodic TV cameraz grip & electric package I
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ANY SPECIAL REQUIREMENT'S: REQUEST(2) police officers w/RMP's during filming for intermittent traffic
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control in the above mentioned locations during the duration of the shoot. Camera on tripo�ciri streef a� on
Yt_o.uktL-r Camera-mOunted to rar_on I1ctess tray & hood_.r_vtount. ___...............Signature Return to: Southold Town Clerk
Southold Town Hall
53095 Main Road
P.O, Box 1179
Southold, NY 11471
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