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HomeMy WebLinkAboutPindar Vineyards 2018-5 RESOLUTION 2018-887 ADOPTED O DOC ID: 14538 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2018-887 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON OCTOBER 9,2018: RESOLVED that the Town Board of the Town of Southold hereby grants permission to Pindar Vineyards, LLC, 37645 Route 25, Peconic,New York to hold a Special Event as applied for in Application 2018-5 for one (1) event: Cutchogue Lions Fund Raiser on June 23, 2019 from 8:OOAM to 5:OOPM,provided they adhere to all conditions on the application and permit and to the Town of Southold Policy for Special Events., '2?� Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Jill Doherty, Councilwoman SECONDER:William P. Ruland, Councilman AYES: Dinizio Jr, Ruland, Doherty, Ghosio, Evans, Russell SPECIAL EVENTS PERMIT 2018-5 APPLICATION FOR A PERMIT TO HOLD A SPECIAL EVENT Please provide AIL of the information requested below,Incomplete applications WILL NOT be reviewed. Special Event Permit# 2018 – 5 Applicant(s)name: Cuthchogue Lions Club Date of Submission_9/17/2018 Name of Event Cutchogue Lions 49th Annual Fundraiser SCTM#'s 1000-Section 85 Block- 2 Lot(s) 14 Dates of Each Event: 6/23/2019 If Multiple Dates are requested,applicant must give all information for all dates. Nature of Event:—Fundraiser by running a car show and possible static display of a military helicopter_ (Please attach a detailed description of EACH event to this application) Time Period(Hours)of Event: From 08:00 to 17:00 Town Services requested: ( )Yes (x)No If yes,Describe Police Dept._Highway Dept. Describe Services Maximum Number of Persons Attending At One Time: 750 Number of cars expected-500— Is xpected500Is a Tent or other temporary structure being used?[ x]Yes[ ]No If yes provide size(s)_10 ft.X 10 ft. Will food be served?[x ]Yes [ ]No If yes provide number and name(s)of food vendor(s)_2,see attached Updated 8n12018 Suffolk County permit#(s) Will other vendors be on the premises during the event?[x ]Yes [ ]No If yes how many?_4 Describe Type of vendor(s)_Merchandise,Live Radio Broadcast by WLNG Property Owner(name/address): Pindar Damianos,Pindar Vineyards,37645 Main Road(Route 25),Peconic,NY 11958 Contact Person and Contact Tel.# Michael Kretschmann,President Cutchogue Lions Club,(631)872-9146 e-mail address kretschmannmrk@gmail.com Event Location:Street-Hamlet Address:_37645 Main Road(Route 25),Peconic,NY 11958 SCTM# 85-2-14 Mailing Address to Send Event Permit to:Pindar Vineyards,37645 Main Road(Route 25),Peconic,NY 11958 Have any of the development rights been sold to the Town of Southold[ ] Yes [x ]No and/or Suffolk County Agricultural Program? [ ]Yes [x ]No If yes to either or both_also indicate on the attached plan the boundaries of the reserved area u=which the event will akeIn ace. YOU MUST ATTACH A PARKING/]EVENT PAN TO THIS APPLICATION IF THF EXPECTED ATTENDANCE IS 300 OR MORE PEOPLE,YOU MUST ALSO ATTACH A TRAFFIC ON RO .PLAN(see next nage) A Par ing/_F,vent Plan may be a survey, site plan and/or aerial view( or example Google art of the subject proper INDICATE ON THE PLAN ALL of the fo lowing information: A parking/event plan showing: (1) The size of the property and its location in relation to abutting streets or highways. (2) The size and location of any existing building(s)or structure(s)that will be in operation during the course of the event and any proposed building,structure,or signs to be erected temporarily for the event. (3) The location of the stage or tents,if any. (4) The designated areas of use for spectators,exhibitors,vendors,employees and organizers. (5) Location of all entries and exits. (6) The location of all fire extinguishers and other fire safety equipment. (7) The location of all temporary utilities to be installed for the event,if any. (8) The layout of any parking area for automobiles and other vehicles and the means of ingress and egress for such parking areas. The parking spaces must allow for 300 sq.ft. per car. (9) A traffic control plan for vehicles entering and leaving the site for the proposed event. (10) Plan for the use of live outdoor music,loudspeakers and other sounds which will be used, if any,and the type and location of speakers and other audio equipment. (11) A description of emergency access and facilities related to the event. (12) Provisions to dispose of any garbage,trash,rubbish or other refuse. (13) Location and description of any additional lighting to be utilized in conjunction with the event. Updated 8/7/2018 (14) Location of sanitary facilities on site. Traffic Control Plan Events for three hundred(300)or more people also require submission and approval of a traffic control plan,acceptable to the Town of Southold,AND a qualified traffic controller must be provided Please attached a written description and/or notate on the parking event plan the following: 1)Who will be conducting traffic,2)Where they will be stationed on site,3)How they will direct the entrance, circulation,parking,and exiting of cars on site,and 4)Contact information for use by Southold Town Police. OWNER'S SICNAT[I E.: I am the Owner of the Property where this event is to be held and I agree to comply with the laws, rules,regulations,conditions,and requirements of the Code of the Town of Southold including but not limited to the conditions listed below,as well as all other applicable agency rules and regulations pertaining to the activities under this event Furthermore,I hereby swear or affirm that the information contained herein and attachments hereto are true and correct to the best of my knowledge, and agree to provide notice to the Town immediately should there be any material changes regarding to this application.. Furthermore,I hereby authorize Code Enforcement Personnel of the Town of Southold to enter the property during the hours of the permitted special event to make any and allinspections necessary in connection with this Special Event Pindar Damianos Print name of Owner Signature of wner Michael Kretschmann s Print name of Authorized Person/Representative si a Autho0 rized Person/Representative PERMISSION IS HEREBY GRANTED,SUBJECT TO THE FOLLOWING ONDITION : 1. By acceptance of this permit, applicant agrees to adequately supervise and direct all parking to be on the premises or at another site, and to provide parking assistants and any additional traffic controls necessary for this event. Parking is strictly prohibited on ANY Town,County or State Roads or Rights of W-aX- 2. Traffic control at events for three hundred(300)or more people shall be provided by a qualified traffic controller in accordance with the attached,approved traffic control plan. 3. One "on-premises" sign not larger than six (6) square feet in size may be displayed not longer than thirty (30) days before this event, and removed immediately after the event. Directional parking signs shall be adequately displayed. 4. Applicant indemnifies and holds harmless the Town of Southold from all claims, damages, expenses, suits and losses including but not limited to attorney's fees arising from activities under this permit. 5. Tent proposals must receive permit approval from the Southold Town Building Inspector before placement on the property and must meet all fire and safety codes. 6. This permit is valid only for the time, date, place and use specified above, and for the designated event. Each additional day will require a separate permit application, fee, and related documents for review,etc.at least 60 business days prior to the scheduled event. 7. Adequate temporary sanitary facilities must be provided by applicant for this event and applicant agrees to remove the temporary facilities from the premises within 48 hours after the day of the event. Updated 8/7/2018 8. On-site food preparation is NOT permitted, although food may be catered subject to all Suffolk County Department of Health regulations. 9. NO activities associated with this event, including .h g b not limited to parking,ing] ss/es/eumss/acces tent(s)or tempo=structure(s)- or tempora y c ni a facilities- shall he conducted on Town of Southold Purchase of Develoment DevelopmentRights land. 10. NO activities associated with this event, including but not limited o parking, ingm/cure s/s /accesss, tent(s) or tc=Qmry structure(s), or tempumiy sanitaU facilities, shall be conducted on Suffolk County Purchase of Development Rights land without a permit issued by the Suffolk CounlyFarmland Committee. 11.Issuance of this permit does not authorize in any manner the occupancy of any building exceeding the legal limitations under the fire code or other codes which would prohibit such increased occupancy. 12. Access shall be provided for emergency vehicles, to all public assembly areas, all buildings,all work areas and any additional area where emergencies may occur. Two emergency-fire exits and exit paths from the building(s) on the property, to a public way or remote safe area, shall remain open and unobstructed at all times. 13. Owner assures full compliance with all fire,safety,building,and other Town laws. 14. Music,when outdoors,is required to stop at the time specified in the permit.Placement of the speakers must be in a location that affords the greatest protection from noise intrusion upon adjacent properties. 15. Owner will allow access to Code Enforcement Personnel of the Town of Southold during the hours of the special event to make any and all inspections necessary in connection with this Special Event. 16. ADDITIONAL CONDITIONS: ANY VIOLATIONS IN CONNECTION WITH THE CONDITIONS LISTED HEREIN WILL TERMINATE THIS PERMIT. APPROVED Town of Southold Resolution Number: Date Issued: Updated 8/7/2018 StO F8 RECEIVED SE? 21 2018 Southo"J Town Clerk TOWN OF SOUTHOLD Town Code Chapter 20 "Public Entertainment and Special Events" SPECIAL EVENT PERMIT INSTRUCTIONS AND APPLICATION FORM Applications for a Special Event Permit are subject to an inter-departmental coordinated review by the Southold Town Board,Town Attorney,Town Assessors,Land Preservation,Building,Planning,Zoning Board of Appeals and Police Departments,and the Suffolk County Planning Commission. Application fee: $150.00 per application. Up to six(6)multiple events of the same type, occurring over a period of three months,may be permitted on one(1)application for a fee of$150.00. However,specific details of each event must be included with this application. All applications must be submitted at least 60 business days before the event Applicants are encouraged to submit applications as early as possible. Anycompleted application that is not submitted 60 or more business days prior to the scheduled event may be rejected or subject to a late processing fee of$250.00 by the Office of the Town Clerk, unless a waiver is ob ain d, Requesting an expedited review must be submitted in writing to the Town Clerk.The Town Clerk will forward all applications to the Special Events Committee for processing. The Committee will obtain comments on all applications from relevant Town, County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. The Town reserves the right to request additional information from an applicant to address issues related to the health,safety,and welfare of the community. When is a Permit Required? All Special Events,per Southold Town Code Article I,Section 205-2(Definitions)must obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits. Any use of residential pmq=Zy for profit-such as a venue for weddings or other events is prohibited. This application is deemed complete once all the fo lowing requirements are submitted to the Town Clerk: Please indicate submi cion of the following by checking off the boxes and signong below, El A completed =1ication form signed by the owner and the event manager. Applications without property owner's signature/approval will be rejected. EEE; Is the application being submitted at least 60 days before the event[x ]Yes [ ]No If Yes,Fee of$-100.00 has been submitted ElIf No,Fee of$ has been submitted Updated 8/7/2018 The applicant/owner of the property where the special event is proposed to take place must provide a certificate of insurance not less than 2 million dollars naming the Town of Southold as an additional insured A ParkinaTaent Plan: consisting of a survey, site plan and/or aerial view of the subject property that includes the locations of on-site parking, sanitary facilities, and tents or other temporary structure(s). (See application form for details) ElEvents for three hundred (300) or more people require submission and approval of a traffic control plan acceptable to the Town of Southold AND a qualified traffic controller must be provided at the event.(See application form for details) Signature of Property Owner on the application authorizing Code Enforcement Personnel of the Town of Southold to enter the subject premises during the hours of the event to ensure compliance with any and all special event permit conditions. My signature below affirms that I have submitted all the information required above in connection with my application. 11171 D ed I natu�' Activities associated with outdoor public events are strictly prohibited from taking place on land preserved through the sale of development rights to the Town of Southold, and can only take place on land preserved through the sale of development rights to the County of Suffolk with a permit issued by the Suffolk County Farmland Committee. If food is to be served, it must be catered and prepared off-site by food vendors who hold a permit to operate issued by the Suffolk County Bureau of Public Health Food Protection Unit Updated 012018 Town of Southold P O Box 1179. Southold, NY 11`971 * * * RECEIPT * * * Date: 10/04/18 Receipt#: 248834 Quantity Transactions Reference Subtotal 1 Event Fee 2018-5b $5000 Total Paid: $5000 Notes: Cutchogue Lions Club 49th Annual Fundraiser Payment Type Amount Paid By CK#1261 $5000 Paul Schineller Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Pindar, Vineyards 37645 Main Rd Peconic, NY 11958 Clerk ID: SABRINA Internal ID•2018-5b Town of Southold P O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 09/21/18 Receipt#: 248575 Quantity Transactions Reference Subtotal 1 Event Fee 2018-5 $100.00 Total Paid: $100.00 Notes: Cutchogue Lions 49th Annual Fundraiser @ Pindar Vineyards Payment Type Amount Paid By CK#242 $100.00 Michael Kretschmann Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Pindar, Vineyards 37645 Main Rd Peconic, NY 11958 Clerk ID: SABRINA Internal ID-2018-5 Contact Info: - = Michael Kretschmann + Presid to ue Lions , 4 g . Ce11 872-9146 w . - F { Pindar Vineyaru �+ n . 1 4Y,", jp F y`+ } n of n: 'v FOOD VENDORS PROVIDING CATERING AT CUTCHOGUE LIONS 49th ANNUAL FUNDRAISER NAME ADDRESS PHONE NUMBER Crazy Creations 663 Wading River Rd, Manorville, NY 11949 (631) 566-2354 Nice Buns P.O. Box 1617 Southold, New York 11971 (516) 457-8049 CUTCHOGUE LIONS 4911 ANNUAL FUNDRAISER @ PINDAR VINEYARDS — June 23, 2019 PARKING & EVENT PLAN Contact Info: Michael Kretschmann President, Cutchogue Lions Club Cell # (631) 872-9146 L z SHOW AREA 165,000 sq. ft. 165,000/300 sq. ft. _ 550 Cars Maximum • SHOW PARKING 165,000 sq. ft. „ 165,000/300 sq. ft. _ 550 Cars Maximum ' LION Tents 10 X 10 Ft Tents VENDOR AREA Z Helicopter LZ 150 ft. Diameter CUTCHOGUE LIONS 4911 ANNUAL FUNDRAISER @ PINDAR VINEYARDS — June 23, 2019 PARKING & EVENT PLAN Contact Info: Michael Kretschmann President, Cutchogue Lions Club Cell # (631) 872-9146 Notes 1. For the event only the Pindar bathrooms as noted on the plan will be utilized. All other Pindar structures will not be utilized. 2. Pindar will run their facilities on their normal Sunday operational schedule. 3. Location of Exits and Entrances noted on provided Traffic Control Plan 4. On the Pindar Site traffic shall be controlled by Cutchogue Lions. The Club president will be the contact for all issues. 5. For traffic control Cutchogue Lions will be stationed at: • Point where entering vehicles on the site will be divided between Show/Vendor parking access and the visitor parking field • Points where exit & entrance paths cross 6. Emergency access will be via the access roads on site. 7. Trash barrels and a dumpster will be provided for the event. 8. A fire extinguisher shall be located at one of the Lion Ticket Booths in the Show Area and one by the Helicopter LZ. 9. No Temporary Lighting is required for the event. 10. No temporary utilities will be required for the event. .AcaR& CERTIFICATE OF LIABILITY INSURANCEFDATEiMMIDDIYYYY) 09/15/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED.the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: John Adams DSP Insurance PHONN.Ext): 1-800-316-6705 arc,No): 847-934-6186 1900 E. Golf Road, Suite 650 EMAIL lionsciubs ADOREss: Co3dspins.com Schaumburg, IL 60173 INSURER($)AFFORDING COVERAGE NA►C M INSURER A. ACE American Insurance Company 22667 INSURED INSURER B Lions Club of Cutchogue INSURER C. Cutchogue New York INSURER D. INSURER E. i INSURER F. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS To CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWiTHSTAND1Nl.� ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR 07HER DOCUMENT WITH RESPECT TO YVHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO A,L. THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS LTR TYPE OF INSURANCE11611 POLICY NUMBER POLICY—EFF POLICY EXP LIMITS A GENERAL LIABILITY EACH OCCURRENCE S 1,000,E X COMMERCIALGENERALLABILITY HDOG71094972 09/01/2018109/01/2019 PREhtisFs,E,occurrenc , _$ 1.000,000 CLAIIAS—MADE L—^J OCCUR1 h1ED_EXP t one per ort 5 5.000 q— X AM.Per Named Insured I PERSONAL s ACV INJURY S 1.000,000 Is$2,000,000 i GENERAL AGGREGATE _ $ 1_0,0_00,000 GEWL AGGREGATE LIMIT APPLIES PER f PRODUCTS-COMP,'OP AGG S 2,000,000 X POLICY PRO LOC, I I $ A AUTOMOBILE LIABILITY E�`N ISINGLE Uh11r S1,000,000 ANY AUTO j ISAH25159226 09/01/2018 09/01/2019 BODILY INJURY(Per person) S ALL OVMED SICHEDULED I — — AUTOS AUTOS BODILY INJURY{Per accdent) S HIRED AUTOS AU ON-OWNED I ; P e entl DAMA(�E M 5 f fl $ UMBRELLA LIAB OCCUR � � j EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED 1 RETENTION$ ! S WORKERS COMPENSATION YIN 41C STATU- pTH• AND EMPLOYERS"LIABILITY ANY PROPRETORPARTNEWEXECUTNE(__jN NIA EL EACH ACCtDENT({i OFF CER-MEMBER EXCLUDED �y $�^�T (Mandatory in NH) I E L.DISEASE EA EfAPLOYEEqJS It v,es,descrd*tlfMl�f DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LRAIT 1 S II I DESCRIPTION OF OPERATIONS I LOCATIONS F VEHICLES (Attach ACORD 101.Additional Remarks Schedule if more space is required) Provisions of the policy apply to the named insureds participation in the following activity during the policy period shown above.Cutchogue Lions Club 49th Annual Fundraiser Town of Southold New York is included as an Additional Insured(s),but only with respect to General Liability arising out of the issuance of permit(s)to the Insured shown above and not out of the sole negligence of said additional insured. PROVISIONS OF THE POLICY DO NOT APPLY TO THE SALE OR SERVING OF ALCOHOLIC BEVERAGES CERTIFICATE HOLDER CANCELLATION Pindar Vineyards SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 37645 Main Road(Route 25) THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Peconic New York 11958 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTAIIVE (E)1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD ^ PINDAVIN ACC)R ® DATE(MMYY) O CERTIFICATE OF LIABILITY INSURANCE g/ig/20182pig THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTNAME: Visnla Marcic E,,): 917.260.2168 (FAX M. AICNo): 855-840-5144 USI Insurance Services National,Inc. ADDRESS: BSU.NYC@wellsfargo.com 261 Madison Ave INSURERS AFFORDING COVERAGE NAIC# New York,NY 10016 INSURERA: Great Northern Insurance Company 20303 INSURED INSURER B: Federal Insurance Company 20281 Pindar Vineyards LLC INSURER C c/o Pindar Vineyards LLC INSURER D 591 Bicycle Path,Suite A INSURER E: Port Jefferson Stat NY 11776 INSURER F; COVERAGES CERTIFICATE NUMBER: 13420973 REVISION NUMBER: See below THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 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. IF POLICY EXP LTR TYPE OF INSURANCE INSD JM ADDL SUER POLICY NUMBER MPOLICY I DNYVY MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACXGSH $ 1,000,000 A 3593-14-60 5/31/2018 5/31/2019 H OC INIII CLAIMS MADE OCCUR PREMISES Ea occurrence $ 1,000,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY 1 PRO- 1 FX]LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY 73560257 5/31/2018 5/31/2019 COMBINED SINGLE LIMIT $ 1,000,000 Ea accident) X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ x HIRED x NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident) $ x Comp$500 x Coll$500 1 $ B x UMBRELLALIABOCCUR 7987-46-74 05/31/2018 05/31/2019 EACH OCCURRENCE $ 10,000,000 x EXCESS LIAR CLAIMS-MADE AGGREGATE $ 10,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICERIMEMBEREXCLUDEDI NIA (Mandatory in NHI E.L.DISEASE-EA EMPLOYEE $ If es,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) EVIDENCE OF INSURANCE. CERTIFICATE HOLDER CANCELLATION Duck Walk Vineyards SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Jason's Vineyard,RHX Corp. HE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN y p ACCORDANCE WITH THE POLICY PROVISIONS. 59-A Bicycle Path Port Jefferson Station,NY 11776 AUTHORIZED REPRESENTATIVE 9e-4a, The ACORD name and logo are registered marks of ACORD @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) RESOLUTION 2018-767 ADOPTED DOC ID: 14418 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2018-767 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON AUGUST 28,2018: RESOLVED that the Town Board of the Town of Southold hereby sets the fees for Special Events as follows, effective immediately: $150.00 Application Fee $250.00 Late Processing Fee ?� Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: James Dinizio Jr, Councilman SECONDER:Jill Doherty, Councilwoman AYES: Dinizio Jr, Doherty, Ghosio, Evans, Russell ABSENT: William P. Ruland Neville, Elizabeth From: Neville, Elizabeth Sent: Friday, September 21, 2018 3:07 PM To: Noncarrow, Denis; Silleck, Mary Cc: Born, Sabrina; Doroski, Bonnie; Rudder, Lynda; Smith, Jennifer Subject: Emailing: SE CutLions 620180921145630 Attachments: SE CutLions 6_20180921145630.pdf Attached, please find a Special Events Application submitted by Cutchogue Lions Club for Event to be held at Pindar Vineyards on June 23, 2019. Elizabeth A. Neville, MMC Southold Town Clerk, Registrar of Vital Statistics Records Management Officer; FOIL Officer Marriage Officer PO Box 1179 Southold, NY 11971 Tel. 631765-1800, Ext. 228 Fax 631765-6145 Cell 631466-6064 Your message is ready to be sent with the following file or link attachments: SE CutLions 620180921145630 Note:To protect against computer viruses,e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. 1 A Special Events Committee �--• Application Summary and Recommendation Application name: b,)/nS Address: l/1dQr" i� 1 n�iylC4rdS Application number: Date of Event: 9 �� 3 / 19 Time: �� M Date Received by Town Clerk: Date Received by Committee: 12- 1 Nature of Event (S): l�n�{ �- Committee Comments Received by: Denis Noncarow Melissa Spiro L-1 Leslie Weisman Melissa Kangas Chief Flatley Andrew Amakawa eather Lanza d/ Robert Fisher Mike Verity Claire Glew Kevin Webster Committee Recommendation's: IV Approve as applied Approve with Additional conditions: Hold Public Hearing Deny --� i Dated: l� S -2 0� f Denis Noncarrow Committee Chairperson Silleck, Mary From: Leslie Weisman Forward Sent: Friday, October 05, 2018 12:52 PM To: Noncarrow, Denis; Flatley, Martin Cc: Silleck, Mary Subject: RE: Pindar Lions club fundraiser I have noissue with them holding this event although in future they need to be more specific about the size of the parking area.And I'm not sure why they need to display a helicopter at a car show????? But there is nothing in the code to say they can't do that as Ing as the transport is safe Leslie -----Original Message----- From: Noncarrow, Denis [mailto:denisn@southoldtownny.gov] Sent: Friday, October 05, 2018 10:05 AM To: Flatley, Martin; Leslie Weisman Forward Cc: Silleck, Mary Subject: Pindar Lions club fundraiser Hi If you would take a look at the Lions club car show permit app as we have to get it on today.They need to ask the Army if they could get the Black Hawk for the event. Thank you Denis Noncarrow Denis Noncarrow Government Liaison Officer Town of Southold (631)765-5806 1 Silleck, Mary From: Noncarrow, Denis Sent: Thursday, October 04, 2018 3:01 PM To: Silleck, Mary; Duffy, Bill, Flatley, Martin; Lanza, Heather;Verity, Mike;Weisman, Leslie Subject: RE. Cutchogue Lions at Pindar Approved. I think it should be approved but with 2 Porta pottys added to the venue. From:Silleck, Mary Sent:Thursday,October 04, 2018 2:02 PM To: Duffy, Bill<billd@southoldtownny.gov>; Flatley, Martin <mflatley@town.southold.ny.us>; Lanza, Heather <heather.lanza@town.southold.ny.us>; Noncarrow, Denis<denisn@southoldtownny.gov>;Verity, Mike <Mike.Veritv@town.southold.ny.us>; Weisman, Leslie<lesliew town.southold.ny.us> Subject:Cutchogue Lions at Pindar All, here are the questions that were raised by committee members regarding the Car Show at Pindar. Denis contacted the owner and responses are below. Please advise if this event should be approved or denied at next Town Board meeting 10/9/18. Heather is away but as discussed all we need is a majority vote. Thank you Mary ---------------------------------------------------------------------------------------------------------------------------------------------------------------- Michael Kretschmann, President Cutchogue Lions. 631-872-9146 And here were the concerns: 1. Need to get the proper fee.. $150.00 All good. he is dropping off$50.00 2. If Pindar is open, how many bathrooms do they have? I'm surprised no additional bathrooms are being provided for this many people. Using Pindars bathrooms. Has worked fine. 3. Also,why is there a helicopter landing zone on the plan? Helicopter landing zone given the very loud noise created by helicopters. How will a helicopter be involved? Is it landing and taking off multiple times? How many times?Where will it be flying?The Army maybe loaning them a Blackhawk for display 4. I don't believe they wrote anywhere in their application what exactly they'll be doing all day. Might be good to have them describe the event in a narrative for those of us who don't know. It is the yearly car show. More info can be given if needed. 1 0 Silleck, Mary From: Verity, Mike Sent: Friday, October 05, 2018 8:30 AM To: Noncarrow, Denis; Silleck, Mary; Duffy, Bill; Flatley, Martin; Lanza, Heather,Weisman, Leslie Subject: RE: Cutchogue Lions at Pindar OK to approve. From: Noncarrow, Denis Sent:Thursday, October 04, 2018 3:01 PM To:Silleck, Mary<marys@town.southold.ny.us>; Duffy, Bill<billd@southoldtownny.gov>; Flatley, Martin <mflatlev@town.southold.ny.us>; Lanza, Heather<heather.lanza@town.southold.ny.us>;Verity, Mike <Mike.Verity@town.southold.ny.us>;Weisman, Leslie <lesliew@town.southold.ny.us> Subject: RE: Cutchogue Lions at Pindar Approved. I think it should be approved but with 2 Porta pottys added to the venue. From:Silleck, Mary Sent:Thursday, October 04, 2018 2:02 PM To: Duffy, Bill <billd@southoldtownny.gov>; Flatley, Martin<mflatley@town.southold.nv.us>; Lanza, Heather <heather.lanza@town.southold.ny.us>; Noncarrow, Denis<denisn@southoldtownny.Bov>;Verity, Mike <Mike.Verity@town.southold.ny.us>; Weisman, Leslie<lesliew@town.southold.ny.us> Subject:Cutchogue Lions at Pindar All, here are the questions that were raised by committee members regarding the Car Show at Pindar. Denis contacted the owner and responses are below. Please advise if this event should be approved or denied at next Town Board meeting 10/9/18. Heather is away but as discussed all we need is a majority vote. Thank you Mary ---------------------------------------------------------------------------------------------------------------------------------------------------------------- Michael Kretschmann, President Cutchogue Lions. 631-872-9146 And here were the concerns: 1. Need to get the proper fee.. $150.00 All good. he is dropping off$50.00 2. If Pindar is open, how many bathrooms do they have? I'm surprised no additional bathrooms are being provided for this many people. Using Pindars bathrooms. Has worked fine. 3. Also,why is there a helicopter landing zone on the plan? 1 Silleck, Mary From: Leslie Weisman Forward Sent: Friday, October 05, 2018 12:52 PM To: Noncarrow, Denis; Flatley, Martin Cc: Silleck, Mary Subject: RE: Pindar Lions club fundraiser I have noissue with them holding this event although in future they need to be more specific about the size of the parking area.And I'm not sure why they need to display a helicopter at a car show????? But there is nothing in the code to say they can't do that as Ing as the transport is safe Leslie -----Original Message----- From: Noncarrow, Denis [mailto:denisn@southoldtownny.gov] Sent: Friday, October 05, 201810:05 AM To: Flatley, Martin; Leslie Weisman Forward Cc: Silleck, Mary Subject: Pindar Lions club fundraiser Hi If you would take a look at the Lions club car show permit app as we have to get it on today.They need to ask the Army if they could get the Black Hawk for the event. Thank you Denis Noncarrow Denis Noncarrow Government Liaison Officer Town of Southold (631)765-5806 1 Silleck, Mary From: Fisher, Robert Sent: Tuesday, September 25, 2018 11:29 AM To: Silleck, Mary;Andrew Amakawa (andrew.amakawa@suffolkcountyny.gov); Duffy, Bill; Flatley, Martin; Glew, Claire; Lanza, Heather; Lauretta Fischer (Iauretta.Fischer@suffolkcountyny.gov); Leslie Weisman Forward; Melissa Kangas; Noncarrow, Denis; Spiro, Melissa;Verity, Mike;Webster, Kevin Cc: Weisman, Leslie Subject: RE: Cutchogue Lions 49th Annual Fundraiser Mary I have no problem with this event taking place as applied for. Bob Robert Fisher Fire Marshal, Town of Southold robert.fisher@town.southold.ny.us (W) 631-765-1802 - (C) 631-786-9180 PRIVILEGED AND CONFIDENTIAL COMMUNICA TION CONFIDENTIALITYNOTICE' This electronic mail transmission Is intended only for the use of the individual or entity to which it is addressed and may contain confidential information belonging to the sender which is protected by privilege. If you are not the intended recipient,you ore hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error,please notify the sender immediately by e-mail and delete the original message. From:Silleck, Mary Sent:Tuesday, September 25, 2018 9:07 AM To:Andrew Amakawa (andrew.amakawa@suffolkcountyny.gov)<andrew.amakawa@suffolkcountyny.gov>; Duffy, Bill <billd@southoldtownny.gov>; Fisher, Robert<Robert.Fisher@town.southoId.ny.us>; Flatley, Martin <mflatley@town.southold.ny.us>; Glew, Claire<Claire.Glew@town.southold.ny.us>; Lanza, Heather <heather.lanza@town.southold.ny.us>; Lauretta Fischer(Iauretta.Fischer@suffolkcountyny.gov) <Iauretta.Fischer@suffolkcountyny.gov>; Leslie Weisman Forward<lesliekweisman@gmail.com>; Melissa Kangas <Melissa.Kangas@suffolkcountyny.gov>; Noncarrow, Denis<denisn@southoldtownny.gov>;Spiro, Melissa <Melissa.Spiro@town.southold.ny.us>;Verity, Mike<Mike.Verity@town.southold.nv.us>; Webster, Kevin <kevin.webster@town.southold.ny.us> Cc:Weisman, Leslie<lesliew@town.southold.ny.us> Subject: Cutchogue Lions 49th Annual Fundraiser Attached for your review is a Special Event Application for June 23,2019 Please hit reply all when responding. Thank you, 1 Silleck, Mary From: Lanza, Heather Sent: Tuesday, September 25, 2018 9:40 AM To: Silleck, Mary; Duffy, Bill; Flatley, Martin; Noncarrow, Denis;Verity, Mike;Weisman, Leslie Subject: RE. Cutchogue Lions 49th Annual Fundraiser Forgive me for not having attended the previous 48 of these, but I couldn't tell what sort of fundraiser this is. Is it a car show? I had to guess since I don't believe they wrote anywhere in their application what exactly they'll be doing all day. Might be good to have them describe the event in a narrative for those of us who don't know. From:Silleck, Mary Sent:Tuesday,September 25, 2018 9:06 AM To: Duffy, Bill<billd@southoldtownny.gov>; Flatley, Martin <mflatley@town.southold.ny.us>; Lanza, Heather <heather.lanza@town.southoId.ny.us>; Noncarrow, Denis<denisn@southoldtownny.Bov>;Verity, Mike <Mike.Verity@town.southold.ny.us>;Weisman, Leslie<lesliew@town.southold.ny.us> Subject: RE: Cutchogue Lions 49th Annual Fundraiser Sorry here It is From: Silleck, Mary Sent: Tuesday, September 25, 2018 9:05 AM To: Duffy, Bill; Flatley, Martin; Lanza, Heather; Noncarrow, Denis; Verity, Mike; Weisman, Leslie Subject: Cutchogue Lions 49th Annual Fundraiser Attached for your review is a Special Event Application for June 23,2019 Please hit reply all when responding. Thank you, Wary Stick Secretary to the Town Attorney Town of Southold Southold Town Hall Annex 54375 Route 25 (Main Road) P.O. Box 1179 Southold,New York 11971 Office: (631) 765-1939 Fax: (631) 765-6639 1 Silleck, Mary From: Spiro, Melissa Sent: Tuesday, September 25, 2018 10:27 AM To: Silleck, Mary;Andrew Amakawa (and rew.amakawa@suffolkcountyny.gov); Duffy, Bill; Fisher, Robert; Flatley, Martin; Glew, Claire; Lanza, Heather; Lauretta Fischer (Iauretta.Fischer@suffolkcountyny.gov); Leslie Weisman Forward; Melissa Kangas; Noncarrow, Denis;Verity, Mike;Webster, Kevin Cc: Weisman, Leslie Subject: RE:Cutchogue Lions 49th Annual Fundraiser This is not Town preserved property. Melissa Spiro From:Silleck, Mary Sent:Tuesday,September 25, 2018 9:07 AM To:Andrew Amakawa (andrew.amakawa@suffolkcountyny.gov)<andrew.amakawa@suffolkcountyny.gov>; Duffy, Bill <billd@southoldtownny.gov>; Fisher, Robert<Robert.Fisher@town.southold.nv.us>; Flatley, Martin <mflatley@town.southold.ny.us>; Glew, Claire<Claire.Glew@town.southold.ny.us>; Lanza, Heather <heather.lanza@town.southold.nv.us>; Lauretta Fischer(Iauretta.Fischer@suffolkcountyny.gov) <Iauretta.Fischer@suffolkcountyny.gov>; Leslie Weisman Forward<lesliekweisman@gmail.com>; Melissa Kangas <Melissa.Kangas@suffolkcountyny.gov>; Noncarrow, Denis<denisn@southoldtownny.gov>;Spiro, Melissa <Melissa.Spiro@town.southold.ny.us>;Verity, Mike<Mike.Verity@town.southold.ny.us>; Webster, Kevin <kevin.webster@town.southold.nv.us> Cc:Weisman, Leslie<lesliew@town.southold.nv.us> Subject:Cutchogue Lions 49th Annual Fundraiser Attached for your review is a Special Event Application for June 23,2019 Please hit reply all when responding. Thank you, Wary Siffeck Secretary to the Town Attorney Town of Southold Southold Town Hall Annex 54375 Route 25 (Main Road) P.O. Box 1179 Southold,New York 11971 Office: (631) 765-1939 Fax: (631) 765-6639 i Silleck, Mary From: Flatley, Martin Sent: Tuesday, September 25, 2018 9:18 AM To: Silleck, Mary; Duffy, Bill; Lanza, Heather, Noncarrow, Denis; Verity, Mike;Weisman, Leslie Subject: RE: Cutchogue Lions 49th Annual Fundraiser I have no objections to this event being approved Martin Flatley,Chief of Police Southold Town Police Department 41405 State Route 25 Peconic, New York 11958 631-765-3115 From:Silleck, Mary Sent:Tuesday, September 25, 2018 9:06 AM To: Duffy, Bill<billd@southoldtownny.Pov>; Flatley, Martin<mflatley@town.southold.ny.us>; Lanza, Heather <heather.lanza@town.southold.nv.us>; Noncarrow, Denis<denisn@southoldtownny.gov>;Verity, Mike <Mike.Verity@town.southold.ny.us>;Weisman, Leslie<lesliew@town.southold.ny.us> Subject: RE: Cutchogue Lions 49th Annual Fundraiser Sorry here It is From: Silleck, Mary Sent: Tuesday, September 25, 2018 9:05 AM To: Duffy, Bill; Flatley, Martin; Lanza, Heather; Noncarrow, Denis; Verity, Mike; Weisman, Leslie Subject: Cutchogue Lions 49th Annual Fundraiser Attached for your review is a Special Event Application for June 23,2019 Please hit reply all when responding. Thank you, Wary Sideck Secretary to the Town Attorney Town of Southold Southold Town Hall Annex 54375 Route 25 (Main Road) P.O. Box 1179 Southold,New York 11971 Office: (631) 765-1939 Fax: (631) 765-6639 1 Silleck, Mary From: Kangas, Melissa <Melissa.Kangas@suffolkcountyny.gov> Sent: Tuesday, September 25, 2018 9:46 AM To: Silleck, Mary;Amakawa,Andrew; Duffy, Bill; Fisher, Robert; Flatley, Martin; Glew, Claire; Lanza, Heather; Fischer, Lauretta; Leslie Weisman Forward; Noncarrow, Denis; Spiro, Melissa;Verity, Mike;Webster, Kevin Cc: Weisman, Leslie Subject: RE: Cutchogue Lions 49th Annual Fundraiser We do not have objections to the special event at Pindar Vineyards, as long as the adjacent County PDR (SCTM # 1000- 85-2-11.3) property is not being used for parking, improvements and activities associated with this event. Thank you, Melissa xangas Planning Aide Suffolk County Dept. of Economic Development&Planning Division of Planning&Environment 100 Veterans Memorial Highway,2nd Floor Hauppauge,NY 11788 631-853-4910 Tel 631-853-4044 Fax p r a c t i c e G R E E N Save a tree.Read,don't print.emails CONFI DENTIALI TY NOTI CE: This electronic mail transmission is intended solely for the use of the individual/entity to whom it is addressed and may contain confidential information belonging to the sender If you are not the intended recipient,you are hereby noted that any disclosure,copying, distribution,or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error,please notify the sender immediately by e-mail and delete the original message. From: Silleck, Mary [mailto:ma[vs(a)town.southold.ny.us] Sent: Tuesday, September 25, 2018 9:07 AM To: Amakawa, Andrew; Duffy, Bill; Fisher, Robert; Martin Flatley; Glew, Claire; Lanza, Heather; Fischer, Lauretta; Leslie Weisman Forward; Kangas, Melissa; Noncarrow, Denis; Spiro, Melissa; Verity, Mike; Webster, Kevin Cc: Weisman, Leslie Subject: Cutchogue Lions 49th Annual Fundraiser Attached for your review is a Special Event Application for June 23,2019 Please hit reply all when responding. Thank you, Silleck, Mary From: Silleck, Mary Sent: Tuesday, September 25, 2018 9:06 AM To: Duffy, Bill, Flatley, Martin; Lanza, Heather; Noncarrow, Denis;Verity, Mike;Weisman, Leslie Subject: RE: Cutchogue Lions 49th Annual Fundraiser Attachments: SE Cutchogue Lions 6.2019.pdf Sorry here It is From: Silleck, Mary Sent: Tuesday, September 25, 2018 9:05 AM To: Duffy, Bill; Flatley, Martin; Lanza, Heather; Noncarrow, Denis; Verity, Mike; Weisman, Leslie Subject: Cutchogue Lions 49th Annual Fundraiser Attached for your review is a Special Event Application for June 23,2019 Please hit reply all when responding. Thank you, Wary SitTeck Secretary to the Town Attorney Town of Southold Southold Town Hall Annex 54375 Route 25 (Main Road) P.O. Box 1179 Southold,New York 11971 Office: (631) 765-1939 Fax: (631) 765-6639 i Silleck, Mary From: Silleck, Mary Sent: Tuesday, September 2S, 2018 9.07 AM To: Andrew Amakawa (andrew.amakawa@suffolkcountyny.gov); Duffy, Bill; Fisher, Robert; Flatley, Martin; Glew, Claire, Lanza, Heather; Lauretta Fischer (lauretta.Fischer@suffolkcountyny.gov); Leslie Weisman Forward; Melissa Kangas; Noncarrow, Denis; Spiro, Melissa;Verity, Mike;Webster, Kevin Cc: Weisman, Leslie Subject: Cutchogue Lions 49th Annual Fundraiser Attachments: SE Cutchogue Lions 6.2019.pdf Attached for your review is a Special Event Application for June 23,2019 Please hit reply all when responding. Thank you, Wary A%ck Secretary to the Town Attorney Town of Southold Southold Town Hall Annex 54375 Route 25 (Main Road) P.O. Box 1179 Southold,New York 11971 Office: (631) 765-1939 Fax: (631) 765-6639 1 RECEIVED SEP 2 1 2018 Soufho!d Town Clerh TOWN OF SOUTHOLD Town Code Chapter 205"Public Entertainment and Special Events" SPECIAL EVENT PERMIT INSTRUCTIONS AND APPLICATION FORM Applications for a Special Event Permit are subject to an inter-departmental coordinated review by the Southold Town Board,Town Attorney,Town Assessors,Land Preservation,Building,Planning,Zoning Board of Appeals and Police Departments,and the Suffolk County Planning Commission. Application fee: $150.00 per application. Up to six(6)multiple events of the same type,occurring over a period of three months,may be permitted on one(1)application for a fee of$150.00. However,specific details of each event must be included with this application. All applications must be submitted at least 60 business days before the event. Applicants are encouraged to submit applications as early as possible. Any wMieled application that is not submitted 6i or more bus*ness days prior to the scheduled event may be rejected or subJect to a late processing fee of$250.00 by the Office of the Town Clerk unless a waiver. obtained. Requesting an expedited review must be submitted in writing to the Town Clerk.The Town Clerk will forward all applications to the Special Events Committee for processing. The Committee will obtain comments on all applications from relevant Town, County and/or State agencies and will forward completed applications to the Town Board with a recommendation as to whether to grant or deny the application. The Town reserves the right to request additional information from an applicant to address issues related to the health,safety,and welfare of the community. When is a Permit Ittguired? All Special Events,per Southold Town Code Article 1,Section 205-2(Definitions)must obtain a permit. Occasional events on private residential properties hosted by the owner thereof that are by invitation such as family gatherings, weddings, graduations, parties or not-for-profit fundraisers do not require permits. A"use of residential=,p=for pmfit-such as a venue fQr weddipgs,or other events is prohibited This application is deemed complete once all the following requirements are submitted to the Town Clerk:- Please indicate submission of the following by checking off the boxes and signing below. 0 A completed application form signed by the owner and the event manager. Applications without property owner's signature/approval will be rejected. EEE: Is the application being submitted at least 60 days before the event[x ]Yes No El If Yes,Fee of$-100.00 has been submitted I If No,Fee of$ has been submitted Updated 8/7/2018 The applicantlowner of the property where the special event is proposed to take place must provide a certificate of insurance not less than 2 million dollars naming the Town of Southold as an addi anal insured A ParkingJEvent Plan:consisting of a survey,site plan and/or aerial view of the subject property that includes the locations of on-site parking, sanitary facilities, and tents or other temporary structure(s). (See application form for details) Events for three hundred(300) or more people require submission and approval of a traffic control plan acceptable to the Town of Southold AND a qualified traffic controller must be provided at the event.(See application form for details) Signature of Property Owner on the application authorizing Code Enforcement Personnel of the Town of Southold to enter the subject premises during the hours of the event to ensure compliance with any and all special event permit conditions. My signature below affirms that I have submitted all the information required above in connection with my application. 171 fY -_ . Ddtedtatu p} Activities associated with outdoor public events are strictly prohibited from taking place on land preserved through the sale of development rights to the Town of Southold, and can only take place on land preserved through the sale of development rights to the County of Suffolk with a permit issued by the Suffolk County Farmland Committee. If food is to be served, it must be catered and prepared off-site by food vendors who hold a permit to operate issued by the Suffolk County Bureau of Public Health Food Protection Unit Updated 8/7/2018 Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 09/21/18 Receipt#: 248575 Quantity Transactions Reference Subtotal 1 Event Fee 2018-5 $100.00 Total Paid: $100.00 Notes: Cutchogue Lions 49th Annual Fundraiser @ Pindar Vineyards Payment Type Amount Paid By CK#242 $100.00 Michael Kretschmann Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Pindar, Vineyards 37645 Main Rd Peconic, NY 11958 Clerk ID: SABRINA Internal ID-2018-5 APPLICATION FOR A PERMIT TO HOLD A SPECIAL EVENT Please provide ALI,of the information requested belon incomplete applications WILL NOT be reviewed. Special Event Permit# Applicant(s)name: Cuthehogue Lions Club Date of Submission_9/17/2018 Name of Event Cutchogue Lions 49tb Annual Fundraiser SCTM#'s 1000-Section-85—Block--2 Lot(s) 14 Dates of Each Event: 6/23i2019 If Multiple Dates are requested,applicant must give all information for all dates. Nature of Event:—Fundraiser by running a car show and possible static display of a military helicopter_ (Please attach a detailed description of EACH event to this application) Time Period(Hours)of Event: From 08:00 to 17:00 Town Services requested: ( )Yes (x)No If yes,Describe Police Dept._Highway Dept. Describe Services Maximum Number of Persons Attending At One Time: 750 Number of cars expected-500— Is xpected500Is a Tent or other temporary structure being used?[ x]Yes[ ]No If yes provide size(s)_I 0 ft.X 10 R. Will food be served?[x ]Yes [ ]No If yes provide number and name(s)of food vendor(s) 2,see attached, Updated 8/7/2018 Suffolk County permit#(s) _ Will other vendors be on the premises during the event?[x ]Yes [ ]No If yes how many? 4 Describe Type of vendor(s)_Merchandise,Live Radio Broadcast by WLNG Property Owner(name/address): Pindar Damianos,Pindar Vineyards,37645 Main Road(Route 25),Peconic,NY 11958 Contact Person and Contact Tel.#_Michael Kretschmann,President Cutchogue Lions Club,(631)872-9146 e-mail address krCtschmannmrk@gmail.com F,vent Location:Street-Hamlet Address: 37645 Main Road(Route 25),Peconic,NY 11958 SSIM# 85-2-14 Mailing Address to Send Event Permit to:Pindar Vineyards,37645 Main Road(Route 25),Peconic,NY 11958 Have any of the development rights been sold to the Town of Southold[ ]Yes [x ]No and/or Suffolk County Agricultural Program? [ ]Yes [x ]No if yes to either or both €alSS?_indicate on the attachedlan n th?boundaries of the resemed area upon which the evert will take place. YOU MUST ATTAC14 A PARKLN. G/E,VENT PLAN TO THIS APPLICATION If THE EXPECTED ATTENDANCE IS 300 OR MORE PEOPl.FµYOU MUST ALSO ATTACH A TRAP,FI!C CONTROL PIAN(see next pn 1 A ParldaglEvent Plan may be a survey,site plan and/or aerial view (for,cxample Goftgle Earth)of the su 'ectpraperty,IYDICA,TE-ON THE PLAN ALL of the fQJ1Q ,ing inforrnatlan: A parking/event plan showing: (1) The size of the property and its location in relation to abutting streets or highways. (2) The size and location of any existing building(s)or structure(s)that will be in operation during the course of the event and any proposed building,structure,or signs to be erected temporarily for the event. (3) The location of the stage or tents,if any (4) The designated areas of use for spectators,exhibitors,vendors,employees and organizers. (5) Location of all entries and exits. (6) The location of all fire extinguishers and other fire safety equipment. (7) The location of all temporary utilities to be installed for the event,if any. (8) The layout of any parking area for automobiles and other vehicles and the means of ingress and egress for such parking areas. The parking spaces must allow for 300 sq.ft. per car. (9) A traffic control plan for vehicles entering and leaving the site for the proposed event. (10) Plan for the use of live outdoor music,loudspeakers and other sounds which will be used, if any,and the type and location of speakers and other audio equipment. (11) A description of emergency access and facilities related to the event. (12) Provisions to dispose of any garbage,trash,rubbish or other refuse. (13) Location and description of any additional lighting to be utilized in conjunction with the event. Updated 8/7/2018 (14) Location of sanitary facilities on site. Traffic Control Plan Events for three hundred(300)or more people also require submission and approval of a traffic control plan,acceptable to the Town of Southold,AND aqualified traffic contrShcer must be Vwyided.Please attached a written description and/or notate on the parking event plan the following: 1)Who will be conducting traffic,2)Where they will be stationed on site,3)How they will direct the entrance, circulation,parking,and exiting of cars on site,and 4)Contact information for use by Southold Town Police fU''R' ,NATURE": I am the Owner of the Property where this event is to be held and I agree to comply with the laws, rules,regulations,conditions,and requirements of the Code of the Town of Southold,including but not limited to the conditions listed below,as well as all other applicable agency rules and regulations pertaining to the activities under this event Furthermore,I hereby swear or affirm that the information contained herein and attachments hereto are true and correct to the best of my knowledge, and agree to provide notice to the Town immediately should there be any material changes regarding to this application.. Furthermore,I hereby authorize Code Enforcement Personnel of the Town of Southold to enter the property during the hours of the permitted special event to make any and all inspections necessary in connection with this Special Event Pindar Damianos JJ Print name of Owner Signature of QNvner 6 Michael Kretschmann r Print name of Authorized Person/RepresentativeSigna a uthorized Person/Representative PERMISSION IS HFRFBY GRANTED,SUBJECT TO THE FOLLOWING CONDMONS: 1. By acceptance of this permit,applicant agrees to adequately supervise and direct all parking to be on the premises or at another site, and to provide parking assistants and any additional traffic controls necessary for this event.Parking is strictly prohibited on ANY Town County or State Roads or Rights o WaXL 2. Traffic control at events for three hundred(300)or more people shall be provided by a qualified traffic controller in accordance with the attached,approved traffic control plan. 3. One "on-premises" sign not larger than six(6) square feet in size may be displayed not longer than thirty (30) days before this event, and removed immediately after the event. Directional parking signs shall be adequately displayed. 4. Applicant indemnifies and holds harmless the Town of Southold from all claims, damages,expenses, suits and losses including but not limited to attorney's fees arising from activities under this permit. 5. Tent proposals must receive permit approval from the Southold Town Building Inspector before placement on the property and must meet all fire and safety codes. 6. This permit is valid only for the time, date, place and use specified above, and for the designated event. Each additional day will require a separate permit application, fee, and related documents for review,etc.at least 60 business days,priQr to the scheduled eyent. 7. Adequate temporary sanitary facilities must be provided by applicant for this event and applicant agrees to remove the temporary facilities from the premises within 48 hours after the day of the event. Updated 8/7/2018 8. On-site food preparation is NOT permitted, although food may be catered subject to all Suffolk County Department of Health regulations. 9. NO activities associated with this vent including but not limited toan rking, ingressfe=ss/access tent(a)or temporaly%tructure(s)_or temparacy sanitary facilities shall be conducted on Town of Southold Purchase of Devt<)o12r ent Rights land. 10. NO activities associated with this event. including, but not limited to narking ingress/egress/access. tent(s) or temLCystructure(s) or teary sanitary facilities all be conducted on Suffolk County Purchase of Development Rights land without a Mrmit issued b the Suffolk County Farmland Committee, 11.Issuance of this permit does not authorize in any manner the occupancy of any building exceeding the legal limitations under the fire code or other codes which would prohibit such increased occupancy. 12. Access shall be provided for emergency vehicles,to all public assembly areas,all buildings,all work areas and any additional area where emergencies may occur. Two emergency-fire exits and exit paths from the building(s) on the property, to a public way or remote safe area, shall remain open and unobstructed at all times. 13. Owner assures full compliance with all fire,safety,building,and other Town laws. 14. Music,when outdoors,is required to stop at the time specified in the permit.Placement of the speakers must be in a location that affords the greatest protection from noise intrusion upon adjacent properties. 15. Owner will allow access to Code Enforcement Personnel of the Town of Southold during the hours of the special event to make any and all inspections necessary in connection with this Special Event. 16. ADDITIONAL CONDITIONS: ANY VIOLATIONS IN CONNECTION WITH THE CONDITIONS LISTED HEREIN WILL TERMINATE THIS PERMIT. APPROVED Town of Southold Resolution Number: Date Issued: Updated 8/7/2018 CUTCHOGUE LIONS 4911 ANNUAL FUNDRAISER @ PINDAR VINEYARDS — June 23, 2019 TRAFFIC CONTROL PLAN I ' � Illdl GIi1 y�^ P � FOOD VENDORS PROVIDING CATERING AT CUTCHOGUE LIONS 49th ANNUAL FUNDRAISER NAME ADDRESS PHONE NUMBER Crazy Creations 663 Wading River Rd, Manorville, NY 11949 (631) 566-2354 Nice Buns P.O. Box 1617 Southold, New York 11971 (516) 457-8049 CUTCHOGUE LIONS 4911 ANNUAL FUNDRAISER @ PINDAR VINEYARDS — June 23, 2019 PARKING & EVENT PLAN Contact Info: Michael Kretschmann President, Cutchogue Lions Club Cell # (631) 872-9146 L z SHOW AREA 165,000 sq.ft. 165,000/300 sq. ft. _ 550 Cars Maximum r i SHOW PARKING 165,000 sq. ft. 165,000/300 sq. ft. _ 550 Cars Maximum LION Tents a • 10 X 10 Ft Tents r VENDOR AREA Z Helicopter LZ 150 ft. Diameter CUTCHOGUE LIONS 49" ANNUAL. FUNDRAISER @ PINDAR VINEYARDS — June 23" 2019 PARKING & EVENT PLAN Contact Info: Michael Kretschmann President, Cutchogue Lions Club Cell #(631) 872-9146 Notes 1. For the event only the Pindar bathrooms as noted on the plan will be utilized. All other Pindar structures will not be utilized. 2. Pindar will run their facilities on their normal Sunday operational schedule. 3. Location of Exits and Entrances noted on provided Traffic Control Plan 4. On the Pindar Site traffic shall be controlled by Cutchogue Lions.The Club president will be the contact for all issues. 5. For traffic control Cutchogue Lions will be stationed at: Point where entering vehicles on the site will be divided between Show/Vendor parking access and the visitor parking field • Points where exit & entrance paths cross 6. Emergency access will be via the access roads on site. 7. Trash barrels and a dumpster will be provided for the event. 8. A fire extinguisher shall be located at one of the Lion Ticket Booths in the Show Area and one by the Helicopter LZ. 9. No Temporary Lighting is required for the event. 10. No temporary utilities will be required for the event. AC� �►..r' CERTIFICATE OF LIABILITY INSURANCE GI 3M}A.06iYYYY} 49/1512478 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCERIFN Ac s 'rFANE. John Adams DSP insurance LA iii' C=ti 1.800-316.6705 in x NM 847-934-6186 T'MAP lionsclubs@dspins.com 1900 E. Golf Road, Suite 650 AI.I,F,r Schaumburg, IL 60173 _ __ INSURER(S)AFFORDING COVERAGE NAICN INSURER A. ACE American Insurance Company 22667 INSURED RtSURCRP �-µ. .Fµ_. ._. _....._. _.___.......-_. ...____ _,., _.,........__..._._ C Lions Club of Cutchogue --RJ___SURCR ` " - Cutchogue New York INSURER D INSURER E. INSIIRFR F. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: -911qI'; TC, F�t'[T-, --IAT T,J _riJ' fL'�c- iFttil;:lf.`�,.[: iti'E-: i� -;A' rNi!'CA TEE ri; ..iiTmi!I -AND114r,AN, -F'.,., ,c 'N[,f7 r,N ANY '.RA"- ,-I� r,r" €t,!FN- T;- R;<,t'F " ",H, L'[ f.SAY GL 31 !L� t,Ay PrLri 4!'v 'ti- IN, +ti' r. ps.t., > (E­1 "f 'tit F'E ii :L Cif <1U-[i Hi'F ;.X: tf. t AN( , ,i`IEII"I+ly` t E" i,'I# i Eik'r r-AiiE :F>~tI:`t iit'E.i rAi[ INSR iL+4,J POLICY EFF fNVOCY EXP LTR! TYPE CG INSURANCE i{ n VOL ICY NUM8ER dMM`DDIYYYYi IMMrnt1/YYYY1. LIMITS A .GENERAL LIABILITY i ^:.r.��,,�i;ngEN�:c s 1 000 000 g X i.;' `a,€L: . .A!_ ;e.vEN:. _H[7I-Y HDOG71094972 09/01/2018 09/01/2019E-.; �",41<„c c`, ;� ,.€,„N 1,000,000 5,000 1XI ,=Aqg.Per Named Insured r. s L' r.�;Ll 000 000 1 is 52,000,000 5 10.000,0 0 <,Erdtkc:cR i LII'IT:c:,;Es> a< .3r• t, , fp., 00,000 = 5 /.'F•'.L� tt' L.r'", E 1,000,000 _ A AUTOMOBILE LIABILITY L r� ,,�r _ q ISAH25159226 09101/2018.09/0112019'-x: eIN',;Rv,Per:,,r-1-wC< '1��f:.`'%h,t i ,sT'«FII Y i .•L., i< UMBRELLA LIAR ` L A t EXCESS LIAR DEO i v kF I Eta`. V 5 -S �WORKERS rOMPENSAN(t N :ANDEMPiOYERSI€APhilY YIN AN',f�kl:l'Ri f i;'2'rARTNI-I;'E'Kr ,N,A (Mar satorf in 4H'I EL U1 E,L.'.iF'CCYE.J S DESCRIPTION OF OPERATIONS;LOCATIONS I VEHICLES (A¢ach 4CORD 107,Additional Renwdc Schedule if mo,v spare is requit r.dt Provisions of the policy apply to the named insureds participation in the following activity during the policy period shown above.Cutchogue Lions Club 49th Annual Fundraiser Town of Southold New York is included as an Additional Insured(s),but only with respect to General Liability arising out of the issuance of permit(s)to the Insured shown above and not out of the sole negligence of said additional insured. PROVISIONS OF THE POLICY DO NOT APPLY TO THE SALE OR SERVING OF ALCOHOLIC BEVERAGES CERTIFICATE HOLDER CANCELLATION Pirutar Vineyards SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 37645 Main Road(Route 25) THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Peconic New York 11958 ACCORDANCE WITH THE POLICY PROVISIONS. AtrTfit}F2tZE L)FILPRESEfdTATIVE /,'['�f,,�''�) I tif%1988-2010 ACORD CORPORATION All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD PINDAVIN DATE( YYYY) CERTIFICATE OF LIABILITY INSURANCE 9/16/2018/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement, A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT ViSR a MBrCIC PRODUCER NAME:_--- J Y, PHONE o,Ext}:_917.260.2168 '�AC,No);855-840-5144 USI Insurance Services National,Inc. ss_ BSU.NYG@we[lsfargo.cam 261 Madison Ave _ INS URER(S)AFFORDINGCOVERAGE } NAICfI New York,NY 10016 INSURER A: Great Northern Insurance Company 20303 INSURED INSURER B: Federal Insurance Company 20281 Pindar Vineyards LLC INsuRERc: c/o Pindar Vineyards LLC INSURER D 591 Bicycle Path,Suite A INSURER E. Port Jefferson Stat NY 11776 INSURER F. COVERAGES CERTIFICATE NUMBER: 13420973 REVISION NUMBER: See below THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 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. _ INSR ADOL SUBR' - POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE j I POLICY NUMBER MM7DDlYYX ,VDDlYYYY A X COMMERCIAL GENERAL LIABILITY i 3593-14-60 5/31/2018 + 5/31/2019 EACH OCCURRENCE I S _ 1,000,000 t --�'-.m - 1AD0,000 CLAIMSMADE �OCCUR I DAmAGCRTEOj S PR8Mi5 (Ie,cu:cutrence} MED EXP(Any one person) S — 1n.nm PERSONAL d ACV INJURY .S ^1,000,000 i E i'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE :S 2,000.000 POLICY❑JEC�" E LOC PRODUCTS-COMP/OP AGG .S 2,000,00:1 j OTHER I ^WSM B AUTOMOBILE LIABILITY I 73560257 5/31/2018 5/31/2019 COMBSINGLE LIMIT i s 1,000,000 X .ANY AUTO I BODILY INJURY(Per Person) I$ OWNED SCHEDULED BODILY INJURY(Per accident)I S AUTOS ONLY AUTOS X AHIREDUTOS ONLY I X I AUTOS ONNON-OWNLY I £ fPW accttcl DAMAGE S x j Camp$500 `'Call$500 5 B X UMBRELLA LIAR [XJ OCCUR 1 s 7987-46-74 05/31/2018 05/31/20191 EACHOCCURRENCE Is 10,000.000 EXCESS LIAR CLAIMS-{BADE. AGGREGATE ,$ 10,000,000 DED RETENTION,S i WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y I N i 1 .STPTUTE s i ER , ANYPROPRIETORIPARTNERIEXECUTIVE ° 3 ".E L.EACH ACCIDENT !s OFFICERIMEMBEREXCLUDEO? N!A (Mandatory in NH I -_DISEASE-FA EMPLOYEE;s H yes.describe under DESCRIPTION OF OPERATIONS below _�DISEASE-POLICY LIMIT S l ' l DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD`101,Additional Remarks Schedule,may be attached if more space is required) EVIDENCE OF INSURANCE. CERTIFICATE HOLDER CANCELLATION Duck Walk Vineyards SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Jason's Vineyard,RHX Corp. ACCORDANCE WITH THE POLICY PROVISIONS. 59-A Bicycle Path Port Jefferson Station,NY 11776 AUTHORIZED REPRESENTATIVE ge- , The ACORD name and logo are registered marks of ACORD ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103)