HomeMy WebLinkAboutDocumentation_Regular_Tab 14_06/11/2015 EMAIL CLERK Print Form
VILLAGE CLERK'S OFFICE �,
AGENDA ITEM ROUTING SHEET �+' �
Meeting Date: Meeting Type: Regular Ordinance #:
Consent Agenda: No Resolution #:
June 11, 2015
Originating Department: Community Development
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SE 5-15: Application for a special event permit for a Health & Wellness event at Seacoast Bank located at 710
US Hwy 1 in Tequesta, Florida.
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Account #: Amount of this item:
Budgeted amount available: Amount remaining after item:
Budget transfer required: N/q Appropriate Fund Balance:
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SE 5-15: Application for a special event permit for a Health & Wellness event at Seacoast Bank located at 710
US Hwy 1 in Tequesta, Florida. The event is planned to take place on Saturday, June 20, 2015 between 9am
and 5pm. The projected number of attendees is 100-200 people. The event will have a live band, food vendors,
and mobile medical services such as the Big Red Blood Bus and Jupiter Medical Center's Wellness in Motion
bus. No alcohol will be served.
, � . -
Department Head '�i��! vl ����'iLc �� `" �
Legal (for legal sufficiency)
Finance Director or Representative , ,
Reviewed for Financial Sufficiency � ,��'��� '
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No Financial Impact �:' %�
v
Village Manager:
Submit for Council Discussion: �
Approve Item: �
Deny Item: 0
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Form Amended: 10/30/14
�`��"' VILLAGE OF TEQUESTA �_ •�
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COMMUNITY DEVELOPMENT DEPARTMENT PERMIT N0:_�
� � ;, Submittal Date: i� '1 " �
i ,_ ` ���:,, ;,� 345 Tequesta Dr. �epositAmount: � �
� :;�`` Tequesta, Florida 33469 �
�'�'` �, �,1 (561) 768-0450 Fax (561) 768-0698 � ' � �
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SPECIAL EVENT PERMIT APPLICATIORJ
Any Village resident, or any Village business holding a current Village business tax receipt pursuant to Chapter 70, Article II, is eligible
to apply for and obtain a special event permit pursuant to Sec. 78-561. Any such resident or business that desires to conduct any
type of special event within the Village must obtain a permit from the Village in order that the Viliage may adequately provide for
the potential impacts created by the proposed event. A maximum of four (4) such permits shall be allowed per address or per
business in any single calendar year.
"Special Event" is any outdoor activity, gathering or group of persons, vehicles or both, organized and having a common
purpose, upon public or private property, which is likely to inhibit the usual flow of vehicular or pedestrian traffic, which is
likely to create noise in excess of that typically associated with the areas upon which the vent is to occur, or which is likely
to preempt or restrict use of property typically accessible by the general public. Examples of special events include, but are
not limited to blocl< parties, parades, races or wall<s, grand opening events, charity fundraisers, and other similar events not
specifically permitted by the Village's zoning ordinance. Special Events that are sponsored by the village and held on village
property shall be exempt from the provisions of this section.
Written application must be submitted to the Village Community Development Department at least forty five (45) days prior to the
date for which the special event is proposed; which application shall contain the following information:
DATE OF SALE/EVENT: �-, � c � � / i-( , HOURS: FROM: `; � � � T0:
, �
TYPE OF EVENT: �� \�ti�-'�1 � I l� � I I����_ ,`;
LOCATION OF EVENT: � I �% �; '� t�� �,�� . ��: ���' l�_� �, . �.,� �� _; (�- � � C ;'>� I 1� i
�
PROPERTY OWNER: �<�c- c'� r; � t�c �_ 1;-- (Attach written consent of property owner of record.)
Print Name
CONTACT INFORMATION
SPONSOR or PERSON(S) RESPONSIBLE FOR EVENT: �� �� �,�'� � � � < � ��'�< �_ .- �� _
,: .
EMAIL: � �< i � �iI � -IP ,r����� �I��� �,�
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MAILING ADDRESS: � � I I ( '� i � � V �� ,_;, � , � -` , ��,� � PHONE NO.: =� ,�-=� �� �( -� L( 3 �_f �>
� � ��, '�"Z ��`�tl�`�� FAXNO.: ".<<�1 ��_��� �-� � ;l_���
PROJECTED NUMBER OF ATTENDEES: � i l'l! t' �'t t COUNCIL APPROVAL REQUIRED: ( )YES ( )NO
• Any proposed special event whose attendanc�e is contemplated to exceed 200 people in total shall require final approval by
the Village Council which, after considering the recommendations of the Community Development Director, the Police
Chief and the Village Manager, may approve the application, deny the application in whole or in part; or approve the
application with conditions.
IS ALCOHOL BEING SERVED? ( )YES (��.)NO
• The service of alcoholic beverages at any special event shall require the issuance of the appropriate state alcoholic
beverage permit, a copy of which must be provided to the village in conjunction with the special event permit application.
• The Village may require the use of physical barriers to define and contain the outdoor area within which alcoholic
beverages may be consumed and/or the use o� security or off-duty law enforcement personnel at the special event.
a It is the applicant's responsibility to monitor for and prevent excessive as well as underage consumption of alcoholic
beverages at all times.
Page 1 of 2
. By submitting a complete application, the applicant expressly agrees th�t it shall indemnify, defend and hold the Village
harmless from any and all damage to any real or personal property, and from any and all injury or death suffered by any
person directly or indirectly related to the consumption of alcoholic beverages in conjunction with the special event.
NON-PROFIT ENTERPRISES:
• The Village may issue non-profit permits to any person or arganization for the conduct or operation of occasiona) sales
and/or fundraising projects held by non-profit enterprises, either regu.larly or temporarily, when the applicant signs an
affidavit that the applicant operates without private profit, for a civic, public, charitable, youth, service, educational,
literary, fraternal, or religious purpose.
� A person making application under this section must comply with all rules and procedures for the granting of special event
permits as set forth in this section. All persons operating under a non-profit permit shall operate their non-profit enterprise
in compliance with this section and all other rules and regulations of the Viliage.
THE FOLLOWING ITEMS ARE REQUIRED TO BE SUBMITTED AT TIME OF APPLICATION:
� Proof of insurance in amounts acceptable to the Village for the type of event. The Village shall be named as an additional
insured on ail liability insurance.
• Expected traffic, fire-rescue, and utilities impact, if any, and proposed mitigation plans.
, Copy of all required state and county permits if event will be held on or utilize state and/or county-controlled property.
• A refunda�ile deposit is required if the event is held on any Village property.
• Site Plan required with each application accompanied with drawing indicating layout for event.
• All sale sites shall be left in a clean and ocderly manner upon completion of sale.
• Should the sale/event include the use of one or more tents, a$35.00 Fire Inspection Fee, due at time of application, and a
certificate of flame resistance is required for each tent. Inspection to be done on the first day of event.
7
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SIGNATURE OF APPLICANT: � �� �� " � '' ` � ' / DATE: `' / ��_.�
Print Name Signat r'e � � �
***��***�**�******�***�**:����*******�*******************�****�****�************�*****�*********
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RECOMMEND FOR APP VAL: ; � . !,'
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POLICE CHIEF: b,= � �aTE D�S G� � i,� �
t � �.
,��,�z�.�� DATE: �. .��`� �
FIRE CHIEF:
/
PARI<S/RECREAT N; DATE:
COMMUNITY �Y�V. ' DIRECTOR: ;\��J� �� / L�.��it/1 DATE: y� .�-c.) . ;
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APPROVED BY / �
,�.�_� � � ,,l
VILLAGE MANAGER: � __~ DATE: � � �
♦
����c�aSIBC��f'c ''� N US Hiqhsvay, Suite 1
�e.�uesta, FL 33469
Aphrodite bloulis 0 561 744 4340
VP S��io- ,��� �_; ,�1�„� �,, C 561 762 1446
���`�� T 800 706 9991
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Page ? of 2
/�,"! ��� �c.P,l� i ,� �,,� ,!!�s �iik.rui;��
SeacuastBank.com
� SeacoastBank
To: Village of Tequesta
Attn: Denise Pennell, Planner
From: Aphrodite Moulis, Vice President
Seacoast Bank
Re: Request for Special Event Permit
We are requesting a Special Event Permit for our upcoming event:
Date: Saturday, June 20 2015
Set up time: 9 am to 11 am
Event Time: 11 am — 3 pm
Break down time: 3pm — Spm
Location: Seacoast Bank
Tequesta Branch outside parking lot
710 N US Hwy 1
Tequesta, FL 33469
The event is to proinote health and wellness thru MyClinic (a non-profit organization
which is a free clinic for low income families), as well as promoting the Tequesta office
of Seacoast Bank.
We are making arrangements to have the following in attendance:
• B1g Red Blood Bus (36 feet long, 10 feet wide and 12.5 tall)
• Jupiter Medical Center's Wellness in Motion Bus (30 feet long, 8 feet wide and 8 tall)
• RJ's BBQ
• MyClinic information table
• Healthier Jupiter information table
• Modern Juice Tent (8 x 10)
• Our Sister's Place, hot dog stand
• Annie's Ice tent (8 x 10)
• Seacoast Bank Tent for Spin the Wheel and marketing items (lo x 10)
• Seacoast bank Tent for selling waier and enter to win basket (lo x 10)
• A live band (doctors from Jupiter Medical Center will be playing)
• Beads by Joy teni/table (8 x �o)
Searo..,stEanf�.,r_i
FDIC �tuar t, FL 3d994
� Seacoas�Bank
Page 2 of 2 Seacoast Bank - Special Permit request
Tequesta's Mayor to make an appearance.
We would also like to have:
4 Seacoast Bank Feather Flags on the perimeter of our property along US Hwy #1. (photo
attached).
1 BBQ Feather Flag from RJ's BBQ. (1/4 of the size of above)
We have included the following with this letter of request:
• Special Event Permit Application
• Certificate of Liability Insurance
• Google map overhead view of bank and parking lot, including placement of
Vehicles and tents.
• Photograph of Seacoast Feather Flag
The traffic pattern for the County Line plaza will not be blocked. The plaza road which
goes froin Village Blvd. north to the main plaza entrance will still be open to the public.
The Seacoast Bank parking lot and bank drive thnl will be blocked for vehicle traffic to
allow for the event and walking patrons only. Please note that the Seacoast Bank branch
is closed on Saturdays.
The landlord for the County Line Plaza has been informed of the event and is informing
all the businesses in the plaza. She has approved the overflow parking into the rest of the
plaza parking areas. Note fi•om Trisha, attached.
Thank you for your review and consideration.
�1 _ �,�°',��
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Aphrodite Moulis
Seacoast Bank
Vice President
Senior Market Manager
_�e3co;stBank.cum �
•�.,,��,�.
fDIC 5'ua t, FL 34974
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Event: Seacoast Bank Health & Wellness Event
Location: 710 N US Highway 1, Tequesta — County Line Plaza outparcel
Date & Time: Saturday, June 20, 2015 from 9:am to S:OOpm •
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� 1 � DATE (MMlDDlYYYY)
��� ° CERT'IFICATE OF LIA�tlLITY ItVSURANCE 5/il/2015
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RiGHTS UPON THE CERT3fICATE HOLDER. THIS
CEi2TIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT COPISTITUTE 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).
PRODUCER NAMEACT KE11.12 Starling
RICK CARROLL INSURANCE AGENCY PHONE .(772) 334-3181 FAX (772)339-7742
A/C No :
2160 NE Dixie Highway AD R�E :kstarling@rickcarroll.com
PO BOX H77 INSURER S AFFORDING COVERAGE NAIC #
Jensen Beach FL 34958-0877 iNSURERA:American Guarantee and Liab 6247
INSURE� INSURER B :
Seacoast Banking Corp of Florida, Inc.etal INSURERC:
Commercial Business Finance Corp INSURERD:
815 Colorado Ave INSURERE:
Stuart FL 34994 INSURERF:
COVERAGES CERT(FICATE NUMBER:CL REVISION NUMBER:
THIS lS TQ CERTIFY THAT THE POL(GfES 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 INSUR,4NCE 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 A DL SUBR POLICY EFF POLICY EXP LIMITS
LTR TYPE OF 1NSURANCE POLICY NUMBER MM/�D/YYYY MM DDIYYW
GENERAL LIABILITY - EACH OCCURRENCE $ 1� OOO � OOO
DAMAGETO RENTED 1 OOO OOO
X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ r r
A CIAIMS-MADE � OCCUR X P0654862219 7/1 f 2014 /1/2015 MED EXP (Any one person) $ 10 � 000
PERSONAL &ADV INJURY $ 1� OOO � OOO
GENER4LAGGREGATE $ 2 � 000, 000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2� OOO � OOO
X POLICY PRO- LOC $
AUTOMOBILE LIABILITY E� aBCtleD SINGLE LIMIT 1 000 O00
� X ANYAUTO BODILYINJURY(Perperson) $ 1 000 000
A ALLOWNED SCHEDULED p0654862219 /1/2014 /1/2015 BODILYINJURY(Peraccident) $
AUTOS AUTOS
PROPERTY DAMAGE
X HIRED AUTOS X q�TOSWNED Pe� accident �
Medical a ments $ 1 000
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2O � OOO � OOO
A EXCESS LIAB CLAIMS-MADE AGGREGA7E $ 2O � OOO � OOO
DED RETENTION UC53464$409 /1/2014 /1/2015 $
WORKERS COMPENSATION WC STATU- OE H-
AND EMPLOYERS' LIABIIITY
ANY PROPRIETOR/PARTNERlEXECUTIVE � E.L. EACH ACCIDENT $
OFFICER/MEMBEREXCLUDED? N�A
(Mandatory in NH) E.L. DISEASE - EA EMPLOYE $
If yes, describe under �
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
DESGRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 701, Additiortal Remarks Schedule, if more space is required)
THIS CERTIFICATE IS FOR PROOF OF INSURANCE ONLY. CERTIFSCATE HOLDER IS NAMED ADDITIONAL INSURED FOR
GENERAI� LIABILITY PER CONTRACT FOR EVENT ON JUNE 20, 2015.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ASOVE DESCRIBED POLICIES 6E CANCE�LED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH 7HE POLICY PROVISIONS.
Village of Tequesta
345 Tequesta Drive
Tequesta, FL 33469 AUTHORIZEDREPRESENTA7IVE
Keith Carroll/KAS .��GC� G�,a�:��
ACORD 25 (2010/05) O 1988-2010 ACORD CORPORATION. All rights reserved.
' INS025 (zo�oo5).0� The ACORD name and logo are registered marks of ACORD
Aphrodite Moulis
From: tnorene@tamwestrlty.com
Sent: Monday, May 18, 2015 11:56 AM
To: Aphrodite Moulis
Subject: Re: June 20th event
Dear Villiage of Tequesta (Denise Pennell)
Please be notified that Countyline Plaza Managements has given permission and is aware that
Seacoast Bank is hoasting an event on June 20, 2015 and we are Ok with allowing the overflow �
parking to go into the Countyline Plaza parking area.
If you need anything else you can contact me at the number below.
Thank you,
Trish Naya Norene
Executiv.e Director for Tamwest Realty, Inc. �°
(561) 747-7033
On Mon, 18 May 2015 13:58:35 +0000, Aphrodite Moulis <Aphrodite.Moulis(a�seacoastbank.coin> wrote:
Hi Trish,
I've been by the Village of Tequesta and have been working with Denise Pennell in regard to our upcoming
event.
She indicated that you do not need to sign the application form, but I do need a signed scanned email from you
that states that you are aware we are having the event and are ok with allowing the overflow parking to go into
the coun±y line plaza parking area to our north/northwest.
Is that something you can supply to me this week so I can include it in my packet for the permit application??
Many thanks!
1
Aph
..�..
�.
������:������
Aphrodite Moulis � Vice President/ Senior Market Manager � NMLS #646909
710 N US Highway 1 Tequesta, FL 33469 �
Aphrodite Moulis(a�SeacoastBank.com � C: 561.762.1446 � O: 561.744.4340 ( F: 561.744.4330
IMPORTANT NOTICE Please be advised that e-mail is not a secure form of communication and should not be
used to communicate personal information. Seacoast Bank will never send an e-mail message requesting
confidential information, such as account numbers, passwords, social security numbers, or Personal
Identification Numbers (PINs). E-mail should not be considered a reliable means of conducting business
transactions. Any financial transaction instruction or inquiry should be made by calling our telephone banking
center at 800-706-9991 or visiting your local Seacoast National Bank office. This e-mail and the attachments
may contain legally privileged confidential information. It is intended solely for the use of the addressee. If you
are not the intended recipient, any reading, dissemination, copying, or other use of this message or its
. attachments is prohibited. If you have received this message in error, please notify the sender immediately and
delete this inessage and all copies.
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