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PIRATE FEST 1OF2.pdf
City of Tybee Island • Community Development Dept. Inspection Report 403 Butler Ave. • P.O. Box 2749 • Tybee Island, GA 31328 Phone 912.472 -5032 Fax 912.786.9539 Permit No. /j Owner's Name Gen. Contractor Contact Information Project Address Scope of Work Inspector INTERNATIONAL CODE COUNCIL MEMBER Date Requested Date Needed Subcontractor /// Date of Inspection Inspection Pass El Fail ❑ Fee Inspection Pass ❑ Fail ❑ Fee Inspection Pass ❑ Fail ❑ Fee Inspection Pass ❑ Fail ❑ Fee DATE ISSUED: 10 -10 -2013 WORK DESCRIPTION WORK LOCATION OWNER NAME ADDRESS CITY, ST, ZIP PHONE NUMBER CONTRACTOR NAME ADDRESS CITY STATE ZIP FLOOD ZONE BUILDING VALUATION SQUARE FOOTAGE OCCUPANCY TYPE TOTAL FEES CHARGED PROPERTY IDENTIFICATION # CITY OF TYBEE ISLAND BUILDING PERMIT TENTS /STAGES /BOUNCY HOUSES 16TH ST PARKING LOT SEABAR, LLC PO Box 1970 Tybee Island GA 31328 SEABAR, LLC PO Box 1970 Tybee Island GA 31328 P $ 900.00 NONE - CITY PROPERTY PROJECT VALUATION $ 1.00 PERMIT #: 130635 Iee_w vedG.4- to•24 -13 TOTAL BALANCE DUE: $ 900.00 It is understood that if this permit is granted the builder will at all times comply with the zoning, subdivision, flood control, building, fire, soil and sedimentation, wetlands, marshlands protection and shore protection ordinances and codes whether local, state or federal, including all environmental laws and regulations when applicable, subsequent owners should be informed that any alterations to the property must be approved by the issuance of another building permit. Permit holder agrees to hold the City of Tybee Island harmless on any construction covered by this permit. This permit must be posted in a conspicuous location in the front of building and protected from the weather. If this permit is not posted work will be stopped. The building contractor will replace curb paving and gutter broken during construction. This permit will be voided unless work has begun within six months of the date of issuance. Signature of Building Inspector or Authorized Agent: P. 0. Box 2749 - 403 Butler Avenue, Tybee Island, Georgia 31328 (912) 786 -4573 - FAX (912) 786 -9539 www.cityoftybee.org Date(s) of Event: Contact Person(s): Date Erected: CITY OF TYBEE ISLAND TENT /CANOPY APPROVAL /REQUIREMENTS Telephone: (912) 472 -5030 • Fax: (912) 786 -9539 Pirate Fest 10/11/2013 to 10/13/2013 Location of Event: 16th Street Parking Lot Jenny Orr Richard Adams 10/07/2013 Phone: 912- 786 -6109 Phone: 912- 224 -5111 Date Down: 10/15/2013 DNR Permit required: Yes Received On 9/23/2013 Contractor Registration: Yes Received TENTS 1- 50'x150' • Occupancy = 925 • Per Provider and provider's engineer, tent will be secured to ground by concrete blocks. Tent will be secured with one (1) 2,000 pound block at each staking station. Total number of blocks 24. • Must have a minimum of four (4) exits with each exit a minimum of 120 inches in width • Each exit must be marked and have emergency lights. • Each exit must remain open and shall not be obstructed. • No smoking permitted within the tent. Approved "No Smoking" signs posted. • Required number of approved fire extinguishers: six (6) - 3A4OBC with current inspection tag. Fire extinguishers must be visible and readily available for use within 75 feet of travel distance for total event site. • Pathway illumination shall be provided in compliance with the provisions of the IBC and IFC and subject to the field approval of the Fire Inspector. 1- 40'x60' • Occupancy = 50 plus petting zoo • 7 tables with chairs are allowed • Per Provider and provider's engineer, tent will be secured to ground by concrete blocks. Tent will be secured with one (1) 2,000 pound block at each staking station. Total number of blocks 6. • Must have a minimum of two (2) exits with each exit a minimum of 120 inches in width • Each exit must be marked and have emergency lights. • Each exit must remain open and shall not be obstructed. • Dry hay is extreme fire hazard — keep hay damp. • No smoking permitted within the tent. Approved "No Smoking" signs posted. Post additional "No Smoking" signs for this tent. • Required number of approved fire extinguishers: two (2) - 3A4OBC with current inspection tag. Fire extinguishers must be visible and readily available for use within 75 feet of travel distance for total event site. • Pathway illumination shall be provided in compliance with the provisions of the IBC and IFC and subject to the field approval of the Fire Inspector. 3- 15'x15' • Per Provider and provider's engineer, each tent will be secured to ground by concrete blocks. Tent will be secured with one (1) 600 pound block at each staking station. Total number of blocks 6. • Required number of approved fire extinguishers: one (1) - 3A4OBC with current inspection tag. Fire extinguishers must be visible and readily available for use within 75 feet of travel distance for total event site. • No smoking permitted within the tent. Approved "No Smoking" signs posted. 2- 10'x50' • Per Provider and provider's engineer, each tent will be secured to ground by concrete blocks. Tent will be secured with one (1) 600 pound block at each staking station. Total number of blocks 6. • Required number of approved fire extinguishers: one (1) - 3A4OBC with current inspection tag. Fire extinguishers must be visible and readily available for use within 75 feet of travel distance for total event site. • No smoking permitted within the tent. Approved "No Smoking" signs posted. Tent Provider: Savannah Special Events by Ranco Tent Erected by: Savannah Special Events by Ranco Address: 1200 West Bay Street, Savannah, GA Emergency phone number: 912 - 657 -0358 Wind resistance: 45 MPH On -site tent expert/Person of Responsibility: Emergency phone number: Robert Eichorn 912 - 657 -0358 Flame retardant certificate - Date of last treatment, name of chemical used in treatment, name of firm or individual treating fabric and testing agency and standard use. Labeling and /or other certification may be acceptable to the fire code official. OTHER STRUCTURES 18' x 31' Metal screen enclosure (see COOKING section) 30' x 24' Stage with 2 (two) 4' x 8' sound wings 34' x 15' Stage 1 -15' x 30' Bouncy house • Per Provider and provider's engineer, bouncy house will be secured to ground by concrete blocks. Bouncy house will be secured with one (1) 600 pound blocks at each staking station. Total number of blocks 2. 2 — 15' x 20' Bouncy house • Per Provider and provider's engineer, bouncy houses will be secured to ground by concrete blocks. Bouncy houses will be secured with one (1) 600 pound blocks at each staking station. Total number of blocks 2. 35' x 52' Ferris wheel — Current certificates will be displayed on equipment. 30' x 30' Carousel — Current certificates will be displayed on equipment. Build -a- Bar — trailer mounted COOKING 18' x 31' metal screen enclosure • 2 (two) exits • Required number of approved fire extinguishers: two (2) - 3A4OBC with current inspection tag AND two (2) Class K extinguishers with current inspection tag. Note: Fire extinguishers must be visible and readily available for use within 75 feet of travel distance for total event site. • Flammable or combustible liquids must be located outside of structure. Note: Storage, use, or handling of flammable liquids or gases shall be prohibited at the site unless specifically approved and inspected by the Fire Marshal. • LP gas tank must be secured in place to prevent tipping with a minimum three foot clearance around tank. • Any LP tank larger than 20 lbs. shall be ten (10) feet from tent and have the proper size gas line secured. • Metal trash can with lid required. ELECTRICAL Only a state licensed electrical contractor may apply for this permit and request the inspections which MUST be completed before the event is opened to the public. Electrical Permit - Required for any electrical installations or wiring including, but not limited to, any lighting and power supply to the general area, electric motors and /or lights or any electrical installations relating to stages, stands, general lighting, emergency lighting, exit signs, concession stands or tents. Application received 9/23/13 Protective mats - Protective mats or other approved means shall be placed over electrical cables on walkways. Wiring and Lighting - All wiring and lighting shall be free from damage. All electrical connections, switches, and fuses shall be in approved enclosures and secured in place to prevent a tripping or safety hazard. Ramp and secure all electrical cables and /or electrical wiring. Generators • Shall be located on a level area and secured in place. • Generators shall be arranged and isolated from the occupants / general public in a safe manner. • The exhaust shall be directed away from combustible material(s), people, and /or animals. • Generator fuel shall be stored in an approved container and located at a safe distance from the generator. • Generators shall be at least 20 feet from any structure or canopy and not accessible to the public. Power Sources - Provide 2 power sources with 1 being for emergency use. OTHER REQUIREMENTS Site plan — Received revised plan 10/01/2013 Emergency access • No parked vehicles permitted within twenty (20) feet of tent. • For tents that have more than one exit, there shall be an unobstructed fire break passageway of not Tess than twelve (12) feet in width and free from guy ropes or other obstructions shall be maintained on all sides of tent. • Provide one (1) 3A4OBC fire extinguisher for every seventy -five (75) feet of travel distance on fairway. • For every 50 feet of side -by -side tents, provide a minimum 5 foot wide emergency access walkway. Comprehensive general liability - Hosting organization, permit holder, or host establishment Liability insurance - Tent provider Received 05/28/2013 Hold Harmless Agreement - Hosting organization, permit holder, or host establishment Received 05/28/2013 Trash and Debris: Keep ground area and thirty (30) foot perimeter clear of trash and debris. Emergency Plan — Tybee Island Police and Fire Departments will be briefed by Event Organizer. Crowd Control Managers: Provide a minimum of 6 crowd control managers with 1 serving point of contact. Point of contact information to be provided to City Manager, Fire Chief, Officer Warren "Hodad" Millikan, and Police Chief High Winds: see 2013 Pirate Fest Severe Weather Action Plan Comments: • Brief event staff • Safety inspection required no later than 9:00 AM on 10/11/2013 • Electrical inspection required no later than 9:00 AM on 10/11/2013 • Fireworks display to be monitored by credentialed fire professional with adequate fire protection onsite City Official Signature: Approval Date: City Official Printed Name: Dianne K. Otto City of Tybee Island Community Development Department Occupant Load Limit MAXIMUM LEGAL OCCUPANT LOAD 50 PERSONS Minimum number of approved independent exits for this occupancy is 2 with 120 -inch minimum width each 40' x 60' October 10, 2013 This sign must be displayed in a clearly visible and conspicuous place, near the main exit of the business. It shall be unlawful to remove or deface this sign. Ray Hord Building Inspector City of Tybee Island, Georgia /a, 0/3 Date City of Tybee Island Community Development Department Occupant Load Limit MAXIMUM LEGAL OCCUPANT LOAD 925 PERSONS Minimum number of approved independent exits for this occupancy is 4 with 120 -inch minimum width each 50' x 150' October 10, 2013 This sign must be displayed in a clearly visible and conspicuous place, near the main exit of the business. It shall be unlawful to remove or deface this sign. Ray Hord Building Inspector City of Tybee Island, Georgia /d /v/3 Date STATE OF GEORGIA COUNTY OF CHATHAM HOLD HARMLESS / INDEMNIFICATION AGREEMENT THIS AGREEMENT is made the t (i day of \v Lk C G 4CA Q YY\ S (hereinafter referred to as "Owner ") ,20 \3 ,by W ITN ESSETH Owner hereby agrees to protect, defend, indemnify and hold harmless the City of Tybee Island, Georgia (a political subdivision of the State of Georgia), its Mayor and Council, officers, agents, and employees (hereinafter referred to as "City ") from and against any and all liability, damages, claims, suits, liens, and judgments of whatever nature, including any claims for contribution and /or indemnification for injuries to any person or persons, or damage to the property or other rights of any person or persons, caused in any manner pertaining to the location of privately constructed or any other privately owned structures and plants, which protrudes into the right -a -way of any City street. The undersigned further recognizes and agrees that this license does not confer upon the undersigned any rights, title, estate, or interest in said licensed premises; nor does this license agreement confer upon the undersigned a license coupled with an interest or easement. This license merely gives the undersigned a revocable privilege, it being expressly understood and agreed that, regardless of any improvements or investments made, expense and harm incurred or encountered by the undersigned, this agreement shall be subject to revocation, cancellation or termination, this license shall be null and void. IN WITNESS THEREOF, Owner has hereunto set its h written. and ,affixed its seal on the day and year first above -lam Owner Address r-.7 �� X tv. RECEIVED 2013 PIRATE FEST SEVERE WEATHER ACTION PLAN Purpose: The 2013Pirate Fest Inclement Weather Action Plan serves to outline necessary steps in the event of weather threatening the safety of event attendees, volunteers, city workers, and employees. The severe weather pre -plan includes, at a minimum, the following points that are addressed in more detail below: • A chain of command that identifies the individual (s) who have the authority to remove individuals from the field or a given activity. • A designated weather watcher. This is someone who actively watches for signs of threatening weather and informs those who are in charge of removing individuals from the field. • Means to monitor local weather forecasts and /or severe weather warnings. • Specific criteria for cancellation. suspension, and resumption of activities. • Recommended weather safety strategies. • A list of safe areas for people to find shelter from the dangerous weather. A. Definitions • SEABAR: South End Association of Bars and Restaurants • SEM: SEABAR Special Event Manager • Main Tent: 50ft x 150ft tent on the north end of event area, housing the entertainment stage • Full Event: any event area blocked to the public for purposes of the 2013 Tybee Island Pirate Fest. • Safety Team: SEABAR Special Event Manager. Pirate Fest Site Manager. Police Chief. Fire Chief, and City Manager B. Chain of Command To prevent any confusion on the day of the event, SEABAR Special Events Manager will establish and review a chain of command, as well lightning, wind, and severe weather policies and procedures as part of pre - planning activities. The Special Events Manager will also review the established chain of command on the day of the event with all on -site volunteers and staff when inclement weather is a possibility. (See Figure I) C. Weather Watcher The designated weather watcher will have the duty to be aware of approaching s orms and to watch for signs of dangerous weather. In the event of dangerous weather inthe area. it is the weather watcher's responsibility to inform the event manager of the potential danger associated with the incoming weather and make recommendations regarding suspension of event activities. 1 The weather watcher will b. ,.ovided with the tools necessary to ac. ately and consistently monitor the weather. The person(s) assigned to this position will be held to a strict no- alcohol policy during assigned shifts. D. Monitoring Local Weather The weather watcher may util¢e television radar reports, internet radar reports, and /or radio /telephone communications with the Tybee Island Police Department (TIPD) to monitor weather events. Monitoring is to be done before, during, and after suspension of the event. The weather watcher will also watch the skies for flashes of lightning and listen for their accompanying thunderclap. E. Criteria for Suspension and Resumption of Activity Once signs of dangerous weather have been demonstrated to the designated on -site weather watcher, he /she will relay this information using the established chain of command. The following are criteria for suspension and resumption of event areas: Prior to Event Opening Tybee Island Prate Fest is a rain or shine event. All reasonable efforts will be made to open the event to the public. Event cancellation will only occur in the event of a catastrophic weather event. These events include tornado, hurricane, flooding, and fire. SEABAR and the designated safety team will make cancellation recommendations no later than 24 hours prior to gate opening. During Event Activity Wind Sustained Wind Speed 0 -25 mph No Action 25 -35 mph Weather Watcher Alert SEM 35 mph Safety Team on Watch 45 mph Main Tent evacuated 55 mph Activities Suspended Severe Weather Lightning No Lightning Indicated No Action Lightning within 35 miles Weather Watcher Alert SEM Lightning within 20 miles Safety Team on Watch Lightning within 4 miles Main Tent evacuated Severe Thunderstorm No Thunderstorm No Action Thunderstorm Detected within 35 miles Weather Watcher Alert SEM Severe Thunderstorm Watch Safety Team on Watch 2 Severe Thunderstorm Warning Full event notification Tornado No Storm Indicated No Action Thunderstorms Detected within 35 miles Weather Watcher alert SEM Tornado Watch Safety Team on watch Tornado Warning Full event notification F. Zone Safety Action Plan • Zone l • Components: Main tent, event stage, back stage, and VIP area • Primary Contact: Site Manager • On Watch: The Site Manager is to notify tenting specialists, electrical staff, theatrical staff, and security volunteers to prepare for evacuation. • Evacuation: Security volunteers will make announcements of evacuation. A security officer will be placed at each exit to safely guide visitors out of the tented area. 1. Should evacuation occur during the concerts (Friday and Saturday evenings), a designated volunteer will make an announcement from the stage. All concerts will be halted and evacuation instructions will be given from the stage. • Zone 2 • Components: beer trailer, Pirate Pub, food tents • Primary Contact: TBD • On Watch: Zone 2 Capitan will notify all food vendors, bartenders, beer truck operators, and entertainers to prepare for a possible evacuation. • Evacuation: vendors will be asked to cease serving and guests will be notified via Zone 2 Capitan to leave the area through designated exit. Zone 3 • Components: vendors spaces (1 -13 and 30 -41) and restrooms (1 -12) • Primary Contact: TBD • On Watch: Zone 3 Capitan will notify all vendors to prepare for a possible evacuation. • Evacuation: vendors will be asked to cease selling and evacuate tents. Zone 3 Capitan will make an announcement via ( ? ? ?) and lead patrons to designated exit. • Zone 4 • Components: entrance gate • Primary Contact: TBD • On Watch: Zone 4 Capitan will alert gate volunteers and box office staff to prepare for a possible evacuation. • Evacuation: box office will be asked to cease selling tickets and to instruct any visitors to move to a safety- designated area. • Zone 5 • Components: vendors spaces (15 -29 and 43 -57) and restrooms (13 -20) • Primary Contact: TBD • On Watch: Zone 3 Capitan will notify all vendors to prepare for a possible evacuation. • Evacuation: vendors will be asked to cease selling and evacuate tents. Zone 3 Capitan will make an announcement via ( ? ? ?) and lead patrons to designated exit. • Zone 6 • Components: children's tent, small stage • Primary Contact: TBD • On Watch: Zone 6 Capitan will alert vendors and entertainers to prepare for a possible evacuation. 3 " E v a c u a t i o n : S e c u r i t y v o l u n t e e r s w i l l m a k e a n n o u n c e m e n t s o f e v a c u a t i o n . A s e c u r i t y o f f i c e r w i l l b e p l a c e d a t e a c h e x i t t o g u i d e v i s i t o r s o u t o f t h e t e n t e d a r e a . G . S a f e A r e a s " T y b e e G y m 2 0 4 5 t h S t r e e t " O c e a n P l a z a 1 4 0 1 S t r a n d A v e n u e H . C o m m u n i c a t i o n E q u i p m e n t " M a i n s t a g e s o u n d e q u i p m e n t " ( 2 ) B u l l h o r n s 4 Weather Watcher SEABAR SPECIAL - SEABAR Events Manager Representative Pirate Fest Site Manager — Ranco Tent Reps. — Technical Crews Zone 1 Captain Zone 2 Captain Zone 3 Captain Zone 4 Captain Zone 5 Captain Zone 6 Captain Volunteers — Food Vendors Beer Truck - Pirate Pub Visitors Vendors Midway; Visitors Gate Volunteers _ SCAD Box Office Vendors Volunteers Fnf rtriinPm Entering Visitors Little Matey's Cove Visitors Officer Warren "Hodad" Milikan Po{ice Chief 9 Fire Chief - PF Task Force - jSEABAR SEC 2013 Tybee Island Pirate Fest Chain of Command 2013 PIRATEFEST QTY SIZE STRUCTURE FEE 1 50 X 150 tent 100 1 40 X 60 tent 100 3 15 X 15 tent 100 2 10 X 50 tent 200 1 18 X 31 cooking tent 100 1 30 x 24 stage 100 1 34 X 15 stage 100 3 varies bouncy house 100 1 35 x 52 ferris wheel 0 1 30 x 30 carousel 0 1 trailer mounted build -a -bar 0 13 900 "-C. GEORGIA COASTAL RESOURCES DIVISION MARK WILLIAMS A.G.'SPUD' WOODWARD COMMISSIONER DIRECTOR SEP 2 3 ,2013 Richard Adams 18 Horse Pen Point Tybee Island, Georgia 31328 Re: Letter of Permission (LOP), Pirate Fest 2013, Activities within the State's Jurisdiction, South Beach Parking Lot at 16" Street and Strand, City of Tybee Island, Chatham County, Georgia. Dear Mr. Adams: This letter is in response to your request, dated September 20, 2013 to sponsor Pirate Fest 2013 in the South Beach Parking Lot at 16th Street and Strand Avenue, Tybee Island, Georgia. Pirate Fest 2013 is scheduled for Thursday, October 10, 2013 through Sunday October 13, 2013. The temporary project will begin no sooner than 15 day after the date on this letter and be completed October 15, 2013. As proposed, your request includes the placement of sixty -three (63) 10' x 10' vendor tents, one (1) 100' X 50' tent and one (1) 40' x 60 tent. The project also proposes the temporary placement of two stages, 21 portable toilets, a ferns wheel and a carousel on the existing, paved parking area as depicted in the plans. Additionally, the request includes the closure of the 17th Street public crossover to the general public during the event for security purposes. All activities proposed in association with Pirate Fest 2013 will occur within the confines of the paved parking area, landward of the sand dunes. The tents, stages, toilets and amusement rides will be set up October 7, 2013 and removed no later than October 15, 2013. No impacts to the sand sharing system are proposed and access to the beach is available to the public at existing crossovers along the strand. The Department authorizes the temporary installation of the proposed amenities as depicted in the attached location map provided all Best Management Practices (BMPs) will be used to prevent any additional impacts at the site and to protect jurisdictional shore areas. This Letter of Permission is not meant to exempt the above referenced activity from future environmental laws. No equipment, materials or debris may be placed, disposed of, or stored in jurisdictional areas. Any incidental impacts associated with this project must be rectified by fully restoring areas to their pre - construction topographic and vegetative states. ONE CONSERVATION WAY I BRUNSWICK. GEORGIA 31520-8686 912.264.7218 1 FAX 912.262.3143 1 WWW.COASTALGADN R.ORG This LOP is valid for the above referenced project. Any change in the use, location, dimensions, or configuration of the approved project, without prior notification and approval from this office could result on the revocation of this permission and in the required removal of the materials and related structures. This project must comply with all other Federal, State, and local statutes, ordinances and regulations. If you have any further questions or concerns in regard to this or any other projects please feel free to contact Deb Barreiro at 912.266.3695. Sincerely, A.G. "Spud" Woodward Director Coastal Resources Division Enclosures: Project Description, Location Map cc: Chantel Morton Box 2749 403 Butler Avenue Tybee Island, Georgia 31328 File # LOP20130166 TYBEE SEABAR September 18, 2013 Re: Georgia Department of Natural Resources Applicet Island Pirate Fest To whom it may concern: n 2013 1 bee Please find out request for the Tybee Island Pirate Fest nciosed. This Is the eighth year of the event and we anticipate no changes to the previous layout. Should you have any questions, please feel free to contact me at your convenience. Thank -you for your consideration. Richard Adams Event Manager 912 - 224-5111 activeone28@gmail.com 00/E0 39Vd ECEIVED EP 2 0 2013 DNR /HMP s3or 213)Or Z9E9h8LEb8 00:0t EtOZ /OZ /60 Event Name: Event Dates: Event Location: Event Description: TYBEE SEABAR Tau_ ISI p -PIRMTE. , ' ST October 11th - 1 3th, 2013 South Beach Parking Tybee Island, Georgia Pirate Fest is a pirate themed event bring visitors to Tybee Island during shoulder season. The event include crafts, entertainers, food, children's Parade and various contests. Set Up Start Date: Monday, October 7th, 2013 Breakdown End Date: Tuesday, October 15th, 2013 Event Manager: Tent Company: Tent Size: Attachments: 08/Z8 39 d Richard Adams 912 - 2245111 Savannah Special Events / Ranco Tents (1) 50 x100 feet (63) 10 X 10 feet (3) 15X15 feet event layout s3or a3xor structure tent pole tent pole tent lesigned to he live music, activities, a - ,ECEIVED ;EP 2 A 2013 G DNR / '1P _. .._ i Z8E908LEti8 80:0t ETBZ /BZ/68 Googlc earth nutter. i000 '400 MIA Nance ■ 01941 Otlddh+tMlM.+dundao Womntton tooth ■ Pood*Moto ■ Mmlundlw W,don ■ Yuongllnl LIIM Flom Pub CoMM4lu loch; ■ Ilntroomt . RECEIVED SEP 2 0 2013 CA DNR / HMP ACOROP CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 10/04/2013 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). PRODUCER Tybee Island Insurance Agency P 0 Box 774 Tybee Island,Ga 31328 INSURED Tybee Seabar Inc P O Box 1970 Tybee Island,Ga 31328 CONTACT NAME: Carrie Traeger PHONE ._tALC. No. Esti: 912 -786 -5541 E -MAIL ADDRESS: traegetCQbellsouth.net... INSURER(S) AFFORDING COVERAGE FX (AA A C. No): 9_12Z86 -87-07 INSURER A: Scottsdale Insurance Co NAIC If INSURER B INSURER C : INSURER D INSURER E : INSURER F : rtfftrvirrl . iC - -I3 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. 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. ILTR TYPE OF INSURANCE SR SUBR POLICY NUMBER (MM /DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY 1 CLAIMS -MADE I . I OCCUR X CPS1841442 10/11/2013 10/13/2013 EACH OCCURRENCE $ 2,000,000 DAMAGE TO REN FED PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES POLICY JECT PER. -I LOC PRODUCTS - COMP/OP AGG 5 2.000,000 S AUTOMOBILE _ LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS F I COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) 5 PROPERTY DAMAGE (Per accident) $ $ __ UMBRELLA LIAR EXCESS LIAB - OCCUR CLAIMS -MADE r' j' EACH OCCURRENCE $ AGGREGATE $ DED RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICE/MEMBER EXCLUDED'/ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y J N N / A WC STATU- I- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ E L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT $ Liquor Liability T I ^ Each Common Cause $1,000,000 Aggregate 51.000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Pirates Fest festival and parade. Festival located at Strand Ave Parking Lot, Tybee Island, Ga. 31328 Certificate Holder is named Additional insured as respects Pirates Fest held October 11,2013 to October 13, 2013(subject to policy terms and conditions) CERTIFICATE HOLDER CANCELLATION City of Tybee Island 401 Butler Ave Tybee Island, Ga. 31328 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Carrie Traeger ACORD 25 (2010/05) ©1988 -2010 ACORD CORPORAT 1-rights reserved. The ACORD name and logo are registered marks of ACORD UNIT SPECS: • Overall Dimensions of tractor and trailer: approx. 62' long x 8'6" wide • Length of trailer (bar and trailer box): 51' • Width of BAB (open): 24' • Length of BAB only: 43' • Weight: 22,000 lbs SITE PLAN: • Standard Site Plan (hard surface): 43'x 24' (bar only) • Site Plan (grass): 55' x 24' (if ground is too soft trailer box will not be detached) • Ideal footprint: 53' x 34' • Approximate set -up is 6 hours • Ideal footprint: 53' x 34' S POWER: • BAB requires (2) standard 110 plug -ins *BAB does have a generator if power is not available PRODUCT: • BAB has (1) draught tower with (2) handles, unit has coil system and wholesaler will need to provide line cleaning, keg tubs and ice • BAB unit has (7) package product compartments to ice down product, total of approx. 35 cases can be iced at any one BRANDING: • The branding of the large Build a Bar is determined by the brand team. AD units will have branding specific to the event cf< TV 0 0 TV 10 G. O O O BUILD—A—BAR WHOLESALER RESPONSIBILITIES: • Provide (2) laborers for set -up and teardown • Provide a rental car or wholesaler vehicle to crew member for use while in market • Merchandise the bar to meet brand and event theme • Arrange concessionaire of vendor to sell product • Provide all needed permits and local approvals • Provide (2) ambassadors to support the build -A -Bar when utilized for VIP or consumer sampling • Provide overnight security if needed • Provide a level site 30' x 45'. This should be the most highly visible placement available to foot traffic • Add desired support items to enhance the experience • Focused management involvement • Designate a person to support promotional efforts • Local advertising and media placement • Produce event signs on sign- making equipment • Provide a detailed schedule to include: show dates, hours of operation, set -up /tear -down dates and time • Provide trash removal service • Be available at all times for contact from the Build -A -Bar crew chief • Provide 2 people for 2 hours each to assist with set -up and cleaning Yv, J S2. rv1Q r► dies 3'�°""` CERTIFICATE OF INSURANCE MST" mow= MD T1l Palal. sacs= leeernatiarl Special Events and Remesrion Aaocistioa, Inc. Inc.. A Risk Retention Purchasing Group qliftd under toe Risk Remotion Act of 1906; Federal L aw 97-4 5. P(). Roc 463 Sandy, OJT 84091-0469 80(011 -1493 �+(' TIlIS CBRTIPICATE IS ISSUED All A MATTER OF INFORMATION ONLY� AND CONFERS NO IIiMT$ UPON ME CERTIFICATE wont ?! CERTIFICATE OF INSURANCE DOES NOT AFFIRMATIVELY OR NEOATN /WEND, END, EXTEND, OR ALTER THE COVERAGE AFFORDED MY THE INSURANCE POUCIES BELOW. MUMS AFFORDING COIiiRAG* INIUM Magic Midway/Rands, Roach ' 4(149 Highway 84 East MMUIER /t NOTICE: illI.sl m a lm lla Inlad r oat Ni de Evros Goad MMlwea a, POW iael a mstobara dMa MMlrutafsrua Riede icoarea are MUM* C: Remotion AnneraMan, Inc. a Rnt Rete don lrradeagi Chou 'adtarieed weer are Riek utlurlet O, Reeennan Add 19 Fedora law al-46. .•y•.. _ l 1.udowici , GA 31316 »�O1S SHOWN Alm a Oetata 1Maesrerlas M Urge, Wade J UVfiCT AS Olf POLICY Psc 'Tray COVERAGES The Mime d Laurens Mead beim hula hem lead to Be inure in ahem W8. polay B1laled. llaaerlartanp astyrmaerne s, rem or =Mon of arty contact a oMtcr document *eh roped b which Me ostak ae may M name a mg paean. the Mumma albino Who pr/cles desabd twain ■ *ul ad In el the I rune. arkroiea aid co ditier of such paid. Awoke Linde Moon may bra Man reduced by paid daft. PtM.R7 POLtctaAMlRTroN TWO OfaNNAINS F ---_- • I..._,.' AL/ Mrs. ..j Lien '1t CaNANNILIJAININ 4_ Claims Made (ye Exclude Products i'V Euulude Complalsd Operations LAP0324- 13040001 4/13/2013 4113/201 1100,000 PerPerekn 51,000,000 Per Acknlent 52,000,000 Polio Aka ..--; CalIMIgiddAliaLIBIAlk Any Auto M Owned Aube Scheduled Autos Hired Autos Non-Owrred Auks Drive Away -.T. rifi.MMAKAMILIANNE GILLS- O.T.R.P.D. D O.C. CAIRO On Hook Employee Dishonssly Wrongful Repossession Claims Node Etches Products Wale Complid Ope bone _ °` l I I LMfMTION OFOOVNM011MO ADOMO AL MUMS Liability, Coverage is only provided to the Additional hound with neapeet to Accidents odentine covered under the Policy/Coverage Contract where the hawed is found diraah Rabic and not wbete the Addition& Insured is found independently negligent of the Insured. October 1 Oth -13th, 2013 apatantrl OP OPINIFOOSNLOCATIONbill AOOM Irf INOOSMINIMITOMCIIL P110■1110lt Coverage is limited to only insured gaieties or operations on the Participant Mamba Dodaratan Califiab a as may be separately atdaecd. (E_cehtdes Inland Moline Liability). Amusement - Centre - Rides - Mechanical - Scheduled Equipment Only.. Amusement - Scheduled Canes! Rides. .. rt, CERTIFICATE HOLDER ;."r 1 ADDITIONAL N$JRE J' .i [LOSE PAYEE Tybee- SEABAR LLC Tybee Island, Georgia f8E1dK-014WOCT2Ma &OuLO ANY OF THE ABOVE DESCRIBED POLICIES BE CNC:EII/20 BEORE THE DAYS DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO IMO a DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAIEO TO THE LEFT. BUT FAILURE TO 00 SO Mika IMPOSE NO OBLIGATION OR LNBEJTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESEP4TATNES. AMOROSO tlIROMMrTATO M OP nil vid Eft oosyso r 'y�.T`Xa �r.ir'.'"r. . CERTIFICATE OF INSURANCE • osrz `�I inl national Special Events and Recreation Aseociatioa, Mc. Inc., A Risk Retention Micheline Group Qualified tinder Ile Risk Rogation Act of 1946; Fadetat tear 97-43. P.O. Box 469 Sandy, UT 84091.4)469 800.321 -1493 mis CtRTtlLCATP MUM A3 A MATTER OF TONOIL -Y AID CONFERS NO R10MTi UPON 7NE CERTIFICATE !10!lfER. 1R4� AFFIRMATIVELY OF INSURANCE DOES NOT AFFIRMATLY OR NEGATIVELY AEIFND, EXTEND, OR h>i .TER THE COVERAGE AFFORDED EY THE INSURANCE POLICES MAW_ III AFFORDING COV RAGI 111111MeD Magic Midway/Randy Wadi 4849 Highway 84 East MI MO A. NOTICE: Cesar is team parrided es ped S18 MUNI WPM a4M/1ER 8 Poior iiMwd li mateMSis GI* Pie MaNl lips -40 Writ and MVIaIR O: a /UM Roarron'Ptedaak1 Group` autlrrieed order the Rik ROAM rt Ralenion Arid 1lw: Federal Isar 87-46. ,.mr•r. I.odovrici . GA 31316 _ LIMITS SHOWN ARE 711066 IN > cTAe orrob POLICY ev TPYf CANNA tlatswrt+are at LJept s IOWA. (COVERAGES , The p o e m s of instants l d babe Haug Moen issued In the rimed misdate/allele poky Wiellist Meseltallaing enyimplement, w n or wddon dr,caisd or ether doamot ath target te vthish this anl'Oeate mg es wader and eosin, the Imusnee selwded by 8. pares dseuibad herein I eyed to el the lama, eidteinti and oondlion e of such poetise. Apprpste Bair Mown ma Imo Men newsier pad eteina. MAY IPPECTIVO O OP NeUMICE P0tLT* t 111101tt0wr 'MTN MO 11) mare cili•. glairtekilimida Claims Made k Exclude Products id Exclude Competed Opsrailats LAP032413010001 4/1312013 d/13R011 ' 3100.000 Per Person 11,000,000 Per Abadan 12,000,000 Po/icy �bG^^? 1 ST Domersioldulallatax Any Auto All Oared NIIOS Scheduled Autos Hired Autos No -Ownsd Autos Olive Away ;.- 21MEEMEErallEEKLEISESE G.KLL O.T.R.P.D. DD.C. C990 On Hook Employee Dishonesty Wrtxgful Repossession Cisme tide Baud. Produces Exclude Cum ieled Opontlare _ , Clain* Mad. I 1,NIATInn OP eMORaa& POOAOVIn01ML sMNw Liability Coverage is only provided to the Additional hewed with retract b Accidents otherwise covered under the PalicvlCoveiaye Convict wham (fie Insured is found ditooly Babb and not what the Additional howled is rand iodependetly negligee of the Insured. October 10th - 13Th, 2013 OssaMPnwaOPOPetllTMMLOG MOOD wQa011 yJRfCJICP110l1sONS Commie is limited to only blared activities or aprrWLome or the Pa tieipget Mgubg Desiention Oenigma or ea may be separately endorsed. (Excludes inli d Marine I.iabilitvt Amo email - Camila/ - Rid Mrcbaocal - Scheduled Equipment Only.. Amusement - Scheduled Carnival Rides. c ! CERTIFJPJUE HOLDER 1;14 ADDIToNAL INSURE =-; I LOSS PAYEE City of Tybee Island Tybee Island, Georgie 1 MW 414 tO0C1T006 SHOULD ANY OF THE ABOVE DEscRISED POLICIES BE CANCEI(ED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MM 0 DAYS WHITEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAMLURH TO DO SO SHALL WPM 110 OBLIGATION OR UPOILIIY OF N4Y 10140 UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Airneetom Iar essorretres OP T!lTYACtli/ie grow , :. • '' { N4 • ' ".•Ar".-r?,'- , lMe ' ■I t 1 A I N1 1 114 11 Mil it 1 1 1 ok 1 1ri ttp 11N141,41•1114 1/4,,1 ,%It 11O* 1 . 1 , . 111 t(storoo O V Alvo r 1111- INl it tlloA 11 �AN1►1V111tivtt4 tA1 111 11,41 "II► Ii lobo r11Nlith'1 N %li +it.tioo li 111 III it I 1111• IR Wl t 1AI 1NM Motoi1a1N 11,rrti it 4 hNvv+two' Stomp 1aimlisi11 lossipt1 t twla Itthimitt% O1l11 **to 1110 414 Id! p1�M11i ►1 1 I oil yawn 1.101141 • • 11 IV 1 111 N I Al 1` tl lt, tw milt; ,;I A11 I111t 1tt11 t11■ 11I41;t1 Certification is hereby made that. The articles described on this Certificate have been treated with a flame 'Ma'am)! approved chemical and that the application of said chemical was done in conformance with California Fire Marshal Code. All fabric has been tested and passes NFPA 701-99, CPAI 84, ULC 109. III011U1 Sena 11 SI7S0,31 (6) Descript'oi •f Item certified: ANCHOR STRUCTURE MID 1SMXSM .102 FERRARI WHITE 81 OCKOUT Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life of The Fabric FERRARI TEN' IU•S, LA TOUR-131 I -P; V, r K&NCE Signed t ( Nome of ApcpKator of Flame Resistant Flush ANCHOR INDUSTRIES INC rabar '' ac11131offmmas -w 7mlf virrirac rasrarnasnalra Z1;,l,N.7:alri a a )ia67dc R7 IMPORTANT DOCUME f Certificate CertifiCate of q'(ame insistance ta«. a ISSUED BY 07rl64 We** rNCHQR Tper, , SSW �! 10201513 EVAINSV1LLE.INDIANA 47726 MANUFACTURERS OF THE FINISHED TENT PRODUCTS DESCRIBED HEREIN es to ratty that the rnater:aka ci*scrit,e: err- *f fla^,e retardant and ware suppled td RANCO TENT RENTAL 1200 W BAY STREET SAVANNAH, GA 31415 Certification is hereby made that The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code All fabric has been tested and passes NFPA 701 -04, ULC 109 S.rial i 8125035 (2) De.c ripson of Item oer fled R STRUCTURE MID MOM FERRARI WHITE SLOCKOuT Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric sir Signed ANCHOR INDUSTRJES INC P444 02 IMPORTANT DOCUMF Certificate of Eta= r .t ISSUED SY fNCHOR EVANSVILLE. MOIAJA -':S MANUFACTURERS OF THE FINISHED TENT PRO '3 'Tr* as we car* ON the frlifteriati Oescrtied are inriereriti Item y . , �►.� w ..z. :-mow► ism 2Naris RANCO TENT RENTAL 1200 W BAY STREET SAVANNAH, GA 31415 Certiircabon rs hereby made that The artwcies described on this Certificate have been treed +wilt a fiar.e---vardartt a svr_r cherrtical and Willi the application of said cherncal was done in cookrnartat watt :alliarna =sat C ode. Al fabric has been tested and pies NFPA let-Cis ,A.Z: IN Sys s 8125432 t2) Ossavon of ton ANCHOR STRUC1VRE 191 1702 FERRARI BLOO( Iv' . Flame Retardant Process Used Will Not Be Washing And Is Effective For The Life Of Facr c _ AO0k'alior d Haan Rehr' z Sired 110O40111 /wR31."37Z! 1rC TENT fritiernyntionai hotbitiewilutoteipteg rites h vv; 441t. t 7.1t4 opt %10.80*, 0-10*1esik ,4.1101: *1114 3 /11$ -V41:0114 14,11 k lob) 4$114111011 vloCrret Ale 431141" 410111110.4 RaN144.Citte*P11.11141)r ipinmenkumma... zial!PL sit fa.. • 41... 0_'112 2013 09:18 40• 35818 GA DEPT OF LABOF C5 C-E 0? 1,- GEORGIA INSURANCE DEPARTMENT 2 Martin Luther King, Jr. Dr., 920 West Tower, Atlanta, GA 30334 404 - 679 -0687 www.oci.ga.gov PERMIT RECEIVED TO OPERATE AMUSEMENT AND CARNIVAL RIDES Has Been Issued by the Safety Inspections Division COMPANY NAME MAGIC MIDWAY ADDRESS 4849 HWY 84 E LUDOWICI, GA 31) -Za; • OWNER/OPERATOR RANDY ROACH DATE ISSUED February 12. 2013 EXPIRES December 31, 2013 Permit No AC13 -0036 CHI NGINE THIS PERMIT MUST BE DISPLAYED )WNERIt 16295 -1 tide Name Manufacturer Jur. # - Serial # Insp. Date Insp. Init. OOP-O -PLANE 'ARATROOPER rILT-A -WHIRL SCRAMBLER )CT0PUs AERRY GO ROUND) 'EMPEST 'on OF 'UN :ANOE EYERLY 03884 6056 HRUBETZ 01276 - 568U -615 SELLNER 04542 - 951705.52 \ ELI BRIDGE ) 12160 - AR2148 EVERLY 13290 • 1082 SAN ANTONIO 05156. 140.1954 WATKINS 07601 - 6611-M1 12 HAMPTON 04818 -18159 VENTURE 04778 -14074 GfD - 337-SF / DOL -4241 SCI Construction Materials Non Destructive Geotechnical Environmental Acct. No: MA048 Report Date: 04/12/2013 Project: 2013 Ride Inspections - St. George, SC Location: SOIL CONSULTANTS, INC. ENGINEERS AND GEOLOGISTS SINCE 1951 P.O. Drawer 698 • CHARLESTON, SC 29402 • (843) 723-4539 • Fax (843) 723 -3648 www.soilconsultantsinc.com Project No: 131196 Client: REPORT: MAGIC MIDWAY Date Sampled: 04/1112013 Sampled By: Mole, Gale By Order Of: Client Order Number: Magnetic Particle Exam LAB NO: 27672 -1 Test Method: See Below TEST RESULTS Report No 27672 -1 -2 Page 1 of 1 Inspection Performed: Annual Inspection of an Eli Bridge Ferris Wheel S/N 716 -41: Magnetic Particle Inspection of ride's Journal Bolts Plan /Dwg No: Date Examined: Surface Condition: Acceptance Std: Exam Std: NDT Procedure No: SC# 3853 04/11/2013 Clean State Requirement ASTM E709 SCI -MT -300 Item No: N/A Type of Matt: CFE Heat No: N/A Date Received: 04/11/13 Temp of Mat!: Ambient Heat Treat: N/A Amperage: Fixed Particles Color: Yellow Method: Dry / Visible, DC Prod Spacing: As needed, N/A Equipment: Magnaflux Y8 DC Yoke Part No: Journal Bolts Type of Work: New PC# or SM# All 24 Journal Bolts Result Accept Total Length Examined: 100% No Items Accepted: 24 No Items Rejected: 0 Defect Remarks No rejectable defects found Remarks: This inspection covers only area of ride listed. Examiner: Gale F. Mole, Level III Orig: MAGIC MIDWAY (LUDOWICI, GA) Attn: MR. RANDY ROACH (1 -cc copy) Respectfully Submitted, SOIL CONSULTANTS, INC. � Gale .Mole, NDT Manager,Le el III THIS REPORT APPLIES ONLY TO THE STANDARDS OR PROCEDURES INDICATED AND TO THE SAMPLE(S) TESTED AND /OR OBSERVED AND ARE NOT NECESSARILY INDICATIVE OF THE QUALITIES OF APPARENTLY IDENTICAL OR SIMILAR PRODUCTS OR PROCEDURES, NOR DO THEY REPRESENT AN ONGOING QUALITY ASSURANCE PROGRAM UNLESS SO NOTED. THESE REPORTS ARE FOR THE EXCLUSIVE USE OF THE ADDRESSED CLIENT AND ARE NOT TO BE REPRODUCED VNTHOUT WRITTEN PERMISSION. SHOW NAME LOCAT ION OWNER LESSEE. MANUFACTURES: I ` {' SOUTH CAROLINA DEPARTMENT OF LABOR LICENSING & REGULATION P.O. Boa 11329 Columba, S.C. 29211 -1329 803/734 -9711 FAX (803) 737 -9119 AMUSEMENT NT DEVICE INSPECTION ` '��V�" "y DATE: 1f. (L <ItiGi c4 CODE: (S) Satisfactory (U) Unsatisfactory LOCATION AND INSTALLATION 1 Veswl inspection arourd4rtade 06t f< inspsdbn of Welty. shoring. braces, anchoring, level 100 W11 7/ 4407 IOC 2 visual tepecibn d storms. ramps. c< entrances and Batts to( lilt passage 3 Visual iroped& d lend% rating, burr pinch points. 7/44(V/# Cis 774450 /l, STRUCTURAL INTEGRITY 4 Vaual aepedbn d clevirs structure for abnormal wear. correct grade of taster pica 714407 //l K K 5 visual cheek d alignment of sheaves c data for abnormal wear mealpsnert cperatbn 714400 /N 6 Vlual Inspection d motors, dilutes a and test al brakes and stops 714100 Visual check d ma Stefano' al rydaul systems 7144071 TUB AND VEHICLE INTEGRITY 6 Inspect latches. hinges and backups, covers and passenger restrains for pro operarbn 7144001//A ELF CTRICAL SAFETY 9 Al electrical equipment and deVcas W inatatohzed access 714050 / C 1 p nepedbn d Cochlea' eptprt•ra4 wtln systems and lighting attachments 7144W 11/ /1 714450 /N 774 11 Pram voltage on dark Mss Inca sysu 12 Secure attachment 01 *gtllrg b We ar lghis. 714450E OPE FAT ION 13 Proper ride speed (II P M.) 714107 14 Proper operation d rids by attendants, complete operating eyrie. 714407 /1 15 Inspect al automatic and manual sates! andWM 11commurecafbnegzpmen1 71440011/0• E 16 Proper type and size of Are eainguihe 714150115 E 11 Smoke detector on dam Mss 77445 13 STATE ID#: RIDE NAM SERIAL #: m � - 7 PERMIT #: t3 (X) Does no apply (R) Corrected Relnspection totor*WAGNAL - OWNER CANARY - OFFICE PINK - INSPECTOR J 16 Check owners tea shalt 714100/ 19 Chack opanbrs are eeonthe 's training program 7141CV N PAPER WORK AND LOGS 20 Check monickers ceotldlt (owners cMddet) 71-MV/ 21 Check dilly malntennoo ardor preopen*p checklist 71- {K1)1/1 22 Check manual 714600 /// 23 Check NOT reconl 7/4300 N/ 24 Check pfyskul data ors*" 714107 25 CMCk operational INN 714300 l VIOLATION EX PLANAT ION, 2E40 .09 Initial Accident Complaint Re -insp. \* -e- In spector PERMR EXPIRES DECEMBER 31ST Of THE YEAR ISSUED 2 ID# RE V 4:96 SCDLLA/LM7106 S U X R i hazards, )ryes, swab, platforms '14407 III ICJdee guard and la awrecl assent.% s vid %pe d ides bees a rd proper srlao6 raped � "< 1 " -,— L _.—. -_ -- c system and at c sddng, seat per oPndMbn and POW against g fusing, wring Ix 6n 714450 /0 r.1 guaml over X —.2( nclud(rg we (2) f eQuWmml needed r present ONE < // �� ^I` totor*WAGNAL - OWNER CANARY - OFFICE PINK - INSPECTOR J 16 Check owners tea shalt 714100/ 19 Chack opanbrs are eeonthe 's training program 7141CV N PAPER WORK AND LOGS 20 Check monickers ceotldlt (owners cMddet) 71-MV/ 21 Check dilly malntennoo ardor preopen*p checklist 71- {K1)1/1 22 Check manual 714600 /// 23 Check NOT reconl 7/4300 N/ 24 Check pfyskul data ors*" 714107 25 CMCk operational INN 714300 l VIOLATION EX PLANAT ION, 2E40 .09 Initial Accident Complaint Re -insp. \* -e- In spector PERMR EXPIRES DECEMBER 31ST Of THE YEAR ISSUED 2 ID# RE V 4:96 SCDLLA/LM7106 i nay Are Called Better Built For A Reason! r2FTTER UILT BUILDINGS 6'ce5s TOMER SERVICE AND BEST PRICES! 6� /275 6�i~l LINE AT 1111 �. r,, r. . J �r.t. _1 �.,r. �r.I.1J � 5707 Ogeechee Road BRYCE WILKERSON Savannah, GA 31405 912- 234 -3348 EG U LAR STYLE ,2S-(3 -R hor4Ma.n5 BOXED EAVE STYLE VERTICALTROOF STYLE $795.00 $1095.00 18'x21'x$'6' 2 1/2" 14 Gauge -29 Gauge Roofing tLL BUILDINGS -4 Corner Braces NCLUDE: ■ - Center Braces Regular Style, Standard Height 4E' 6' 18'x21'x6' 12x21 $595 18 x 21 $695 20x21 $995 22x21 $1195 24x21 $1295 12x26 $895 12x31 $1095 12x36 $1295 12 x 41 $1495 18x26 $995 20 x 26 $1195 22 x 26 $1495 24 x 26 $1595 18 x 31 $1195 20 x 31 $1495 22 x 31 $1795 24x31 $1995 18x36 $1395 18x41 $1695 20 x 36 $1795 20 x 41 $2095 22x36 $2095 22 x 41 $2495 24x36 $2295 24 x 41 $269 INCLUDED IN PRICE (Jr��►r�J� J1_ f.;11JJJ_5iJ -1 '- JJ�rJJ1_I; Boxed Eave Style, Standard Height 6' 12x21 $695 18x21 $795 20x21 $1095 22x21 $1295 24x21 $1495 12x26 18x26 20x26 22x26 24x26 $995 $1095 $1295 $1595 $1895 12x31 18x31 20x31 22x31 24x31 $1195 $1395 $1595 $1895 $2195 12x36 18x36 20x36 22x36 24x36 $1395 $1595 $1895 $2195 $2595 12x41 18x41 20x41 22x41 24x41 $1695 $1895 $2295 $2695 $3095 18'x21'x6' 2 1/2" 14 Gauge -12 GA. 2 1/4" Framing 20 Year ALSO Limited Rust Through Warranty AVAILABLE - Certified Buildings 130mph -30psf - Certified Buildings 26'- 40' Wide Vertical Roof Style, Standard Height 6' SE PRICE IS FOR TOP ONLY o FRAME IS 1 FT SHORTER THAN ROOF LENGTH WISE s FR PLEASE NOTE THAT COLORS MAY VARY DUE TO PRINTING PROCESS 12x21 18x21 20x21 22x21 24x2" I $995 $1095 $1295 $1595 $169. 12x26 18x26 20x26 22x26 24x26 $1395 $1495 $1695 $1995 $2095 12x31 18x31 20x31 22x31 24x31 $1695 $1795 $1995 $2395 $2595 12x36 18x36 20x36 22x36 24x36 $1995 $2095 $2395 $2795 $2995 12x41 18x41 20x41 22x41 24x41 $2295 $2495 $2695 $3295 $3495 E INSTALLATION ON YOUR LEVEL LAN GARAGE DOORS NOW AVAILABLE IN: 1 1. Red Black Burgundy Clay E. Brown E. Green P. Beige P. Gray Q. Gray S. Stone S. Blue Tan White Dianne Otto From: Chantel Morton Sent: Tuesday, June 25, 2013 7:37 AM To: Dianne Otto Cc: Diane Schleicher Subject: RE: revised Tybee Island Pirate Fest event app follow up Attachments: revised site plan 6- 24.pdf; Beach Derby site 6- 24- 13.pdf Good Morning Dianne. Richard Adams and 1 spoke yesterday afternoon / evening. Please see responses from those conversations in red below. Attached is a larger version of the site plan with additional details he provided. The application was requested to be on this Wednesday's City Council meeting agenda. Therefore, I have already had to turn in the application agenda request to Jan, and will be sending her follow up documentation. Will you please let me know if you have anything further prior to providing your signature on the department head page so that I may include that with the follow up to Jan as soon as possible? Thank you. Chantel Chantel R. Morton Better Hometown Program Coordinator Click here for more information about the program. P. 0. Box 2749 Tybee Island, GA 31328 P: 912/472 -5071 C: 912/844 -9771 F: 912/786 -9539 Become a "FB fan "... 3132 Pheoutelt am* " Tybee Island... your nostalgic paradise to live, do business and visit year- round" =Sign up for our BHT E- Newsletter E/SafeSubscribe=r1 <5: g- r--4--A cter I. C0-2- s' l3 11: S e p From: Dianne Otto Sent: Monday, June 24, 2013 7:08 AM To: Chantel Morton Subject: FW: revised Tybee Island Pirate Fest event app follow up Chantel, The attached Site Plan is too blurry so I used the one in your office. With that, the application and the attachments I made a summary below. Please let me know if there are any errors. How many bouncy houses? There will be two bouncy houses (15'x 30 and 15'x 20'). How are they anchored? They will be anchored with concrete blocks. Please discuss with Ray Hord ASAP. Ray confirmed a permit application will need to be submitted by the organizer. 1 relayed this information to Richard. A previous proposal for an outside bouncy house was no -go. 1 Narrative page — B. Site Plan: lists Ft Tents (3) 15'x15'. Site Plan drawing li 10' x 10' Food Vendor Booth as orange squares. Are there orange squares on the Site Plan? Orange squares were depicted on the site plan emailed 6/20, as well as on the attachment on this email. The food tents will be 15'x 15'. Are Food Vendor Booth and Food Tents describing the same thing? Yes. Are they cooking tents? As of right now they are cooking tents. It will be finalized once the meeting that Sharon is arranging with the Health Department, Fire Marshall, et al has happened. Where on they? ? What are distances between them and everything else around them? There will be 10'x 10' spacing around them. On Site Plan legend, what does "General" mean and where is it located? General was a typo. It should have been generator which is depicted on the attachment with this email. Little Matey's stage is 34' x 15'. Tent is 34' x 15'? This stage has a cover on it (not an actual tent) similar to what was used for Mardi Gras. 40' lighting truss over entrance The truss will be at the entrance to the children's area as noted in Supplement B. Site Plan of the application. "X" marks the spot on the attachment with this email. Main stage is 24' x 20' w /4' x 8' sound wings. Tent is 50' x 150'. Confirmed as noted in application. What will the distance be from the 150' x 50' tent to the technical equipment trucks parked behind the main stage? Vehicles will be parked in the emergency lane as noted within the application. SHINE float parked in Strand loading zone after parade. Not shown on Site Plan? The Shrine float will be parked in the loading zone on Strand between Spanky's and Fannies only after the parade as discussed at the 6/13 meeting with the organizer. Where is the pirate ship parked? The pirate ship will be parked in the roundabout as discussed at the 6/13 meeting with the organizer. Shade Zone tent is 40' x 60'. Confirmed as noted in application. One green room tent 15' x 15'. Not shown on Site Plan? The green room tent is to the left of the stage. It is noted on the attachment with this email. Carousel. Ferris wheel. Confirmed as noted in application. A Site Plan is needed for Tybee Beach Derby. [Pirate Fest application will not be approved due to two events on one application.] Attached is a map of the area with obstacles as noted in the application listed. A Site Plan is needed for the encampment on the beach. Two tents? What are the sizes? There will be one (1)10'x 10' tent used for the encampment. Richard will submit details to DNR with the request for a letter of permission as applicable for the event. He wishes to obtain City Council approval for the event prior to submitting the request for a LOP. What size is the Ticket Entry tent? Not shown on Site Plan? The tents are 10'x 10' and will be at the main entrance. Fireworks. Correct. They are currently working to secure a sponsor /donor. Is Exotic Petting Zoo in a tent? If yes, what size? Not shown on Site Plan? The petting zoo will be covered with the depicted 40' x 60' tent. 2 Thanks, Dianne K. Otto, CFM City of Tybee Island Planning & Zoning Manager phone 912.472.5031 fax 912.786.9539 From: Chantel Morton Sent: Thursday, June 20, 2013 1:28 PM To: #Dept Heads Cc: Parking Subject: revised Tybee Island Pirate Fest event app follow up Hello All — Attached is the revised special event application and site plan for the Tybee Island Pirate Fest. Please review and let me know of any questions / concerns you may have in order to sign. The application is in my office on the table by the back door for you to sign when ready. Once all signatures are provided, I will submit the request for council consideration. Thank you. Chantel Chantel R. Morton Better Hometown Program Coordinator Click here for more information about the program. P. 0. Box 2749 Tybee Island, GA 31328 P: 912/472 -5071 C: 912/844 -9771 F: 912/786 -9539 Become a "FB fan"... 31328 40101104Nr.ww..awrwwye "Tybee Island... your nostalgic paradise to live, do business and visit year- round" 6111Sign up for our BHT E- Newsletter Privacy by I/ SafeSubscribe ��1 u m A - ( 1 ) l a 4 M I l ' ! U S C o a s t G o o d S I M i o n T y b w ` j �� ; ) F e e t P u l a s k i U s e r * , Y o n a n i M ( 4 1 2 ) 7 8 f - 5 7 5 7 e . * * w o o U s , P a g e 1 o f 1 S t a r t L i n e - N o r t h e a c h ( J e t t y ) 4 4 ( 9 1 2 ) 7 s e s l o t f 1 x O b s t a c l e 1 - G u l l i c k S t r e e t L e w i s e a r l s o w O b s t a c l e 2 - E n t r a n c e t o F t . S c r e e n O b s t a c l e 4 - C e n t e r S t r e e t ( M a r l i n M o n r o e ' s ) 1 ( r , + O b s t a c l e 3 - 3 r d S t r e e t ( D e s o t o ) 1 ' ' O b s t a c l e 5 - 7 t h S t r e e t = O b s t a c l e 6 - 9 t h S t r e e t 1 Y r �� Y " F i n i s h L i n e - S o u t h B e a c h ( P i e r O b s t a c l e 7 - 1 1 t h S t r e e t O b s t a c l e 8 - 1 4 t h S t r e e t O b s t a c l e 9 - 1 6 t h S t r e e t P . . O b s t a c l e 1 2 - 1 6 t h S t r e e t ( F i n i s h L i n e ) O b s t a c l e 1 0 - 1 7 t h S t r e e t ( F a n n i e s ) O b s t a c l e 1 1 - 1 8 t h S t r e e t ( J e t t y ) 6 V " t % r e ' , 3 0 ( P . M C P k , g o l 1 : 9 ) P i g ( CITY OF TYBEE ISLAND TENT /CANOPY PERMIT APPLICATION Telephone: (912) 472 -5030 • Fax: (912) 786 -9539 t Applicant's Name: i c wn 00 9Arti 5 Applicant's Telephone: q,' i 2 -2 Z -S 1 Applicant's Address: 24 doest PE,. > ?G t N 1 /1-Ye•-ge Date(s) of Event: IOC( 1 i 12. ! Type of Event: r 1 Number of Tents /Canopies: 2, Size 16 ' x t6' Number of Exits ` per tent Number of Tents /Canopies: Size ' x Number of Exits per tent Number of Tents /Canopies: Size ' x ' Number of Exits per tent Number of Tents /Canopies: Size ' x ' Number of Exits per tent Name and address of Tent Provider fi/a C, 0 ."-Te id •' 7--pTent Site Location(s) Ste A "JD X12 V< t 00-• L Q'-T Date Erected 0 CT 1 Qf 1 3 Date Down: 0 c T 15 .r G O 1 3 Will electrical power be provided? Yes iL No jg.,_ Will cooking be done inside the tent(s)? Yes No I have received and r_ad a c y f the be: n, Tent and Canopy Policy. Applicant Signature ' j nr : Date S E. P ( 2 20 1-3 f,n, 5 Applicant Printed Name y C 'p, AR 0 ADA Approvals: Signature Date Planning & Zoning Manager Building Official City Manager Attachments to Permit Application ✓ Site Plan ✓ Provide a seating /table arrangement floor plan ✓ Certificate of Liability insurance ✓ Tent provider's Liability insurance ✓ Emergency Plan ✓ Hold Harmless Agreement ✓ Flame Retardant Certificate ✓ Information on staking method to be used ✓ A letter by the Tent Contractor (stating size(s) of the tent /canopy, date(s) of event, date to be installed and removed, and that the tent /canopy will be dismantled if the wind speed exceeds the tent capacity.) ✓ Wind resistance data to be provided by tent manufacturer or engineer ✓ Name, address, phone number, license number, emergency phone number of tent contractor CITY OF TYBEE ISLAND TENT /CANOPY PERMIT APPLICATION Telephone: (912) 472 -5030 • Fax: (912) 786 -9539 Applicant's Name: ! MAYOR Jason Buelterman CITY COUNCIL Wanda Doyle. Mayor Pro Tem Barry Brown Jan Fox Bill Garbett Tom Groover :. Paul Wolff CITY OF TYBEE ISLAND CITY Ur tui6GE. REC : U3374277 Dia e.S;c3ycher.3:11 r+f OFEE:c H TFfCLERK OF COUNCIL - CM Janet LeViner FIF TE rE5TCITY ATTORNEY Evert .Edwardt -M. Hughes _? TEKIEREI: :: 5U:11! i LAtH APPLIED: 5(1.71- CHANGE: O,CO SPECIAL EVENTS APPLICATION The Cityof Tybee'Islarid recognizes that special events play a significant role in the life of the community. Special events enhance the community by providing recreation, cultural and educational opportunities to residents and tourists and they attribute to the economic health of the community. It is our goal to assist event organizers in planning safe and successful events that have a minimal impact in the areas surrounding the event. By keeping the public's best interest in mind, persons or organizations wishing to host a special event upon public property or private property requiring City Services, special permitting and / or vendors must first be granted approval from the City Council and / or the City Manager. The Special Event application shall be completed with all requested information completed and submitted for consideration at least sixty (60) days prior to event. Events with 75 or more people upon public property or private property requiring City Services, special permitting and / or vendor permits that are not for the non - profit organizer of the 'event require approval from the City of Tybee Island. No more than one event per day will be permitted due to limited infrastructure and city resources. In order to ensure a smooth review.process for permission to have a Special Event, the applicant will receive direction from applicable City Departments, City Manager and Better Hometown Program Coordinator. Prior to the application being submitted for City Council consideration (if applicable), all concerns and details must be addressed, confirmed by the organizer and accepted by designated City Staff of impacted Departments. Note: Applicant must meet with the Better Hometown Program Coordinator or his /her designee at time of submitting application. Additional meetings may be required. .nn Q .a 5i tiI i3. Tbday's Date:- v l Ay 9 O / .01"3 • Application Fee Submitted: A non -refundable Special Event application fee of $50 is required at time of application submittal for processing and consideration. Checks or money orders should be made payable to the City of Tybee Island. 1. SECTION 1: EVENT INFORMATION I. Name of Event: 7 hP� �S141r1Cr�,t, i�tf D��'+�S a t d1 � 2. Date and time of event: Ob�� t " , J t /0,0) 3 �• Setup: Date/Time period Cil dLU- ,, (J( 1C CAcO )e 71 ) t3 .. Breakdown: Date/Time period 1Lk'Qr5 > / [ ,-%D `Oe'C `5 i o2D \ 3 3. Location(s): - .10T(-) Pat' kin L5 arc' InecdnoS€3 -- . A site plan of the event area drawn to scale and depicting all event structures is required at time of application submittal. A Letter of Permission (LOP) from Georgia Department of Natural Resources ( http : / /coastalgadnr.ore/sendemail) is required for events with beach usage and / or within the Shore Protection jurisdiction (i.e. beach side parking lot areas, etc.). The LOP•is due no later than two (2) weeks prior to the event. f 4. Organization: a P1 ��L& f` -,t'1! A 415CCVCA ILN1 c 3C2.S QdilA i'e51ch -u-rc o Commercial? r Non- profit / Tax Exempt? (Non Profit Status / GA Tax Exempt Certificate must be attached. ',. _. 5. Phone number and / or website for public event information trOCIt E.SfeSA • p n C� J "1 -22'4-5 n, 6. Organizer / Applicant: C �--11� n* (�' /«R --\r\ r6 A aa.kry\ ccc Address: \ -3 T C'0.` ek_ State: City: A■j C /k Contact Phone: "1, ` t O t{) - 1O, Email: A C2 t C(le, Iii( (1J i(1'iQ 1 \'C-o n Organizer / Applkont listed above must be in attendance and readily available for the duration f fa event. P.O. Box 2749 - 403 Butler Avenue, Tybee Island, Georgia 31328 -2749 (912) 472 -5071- FAX (912) 786 -9539 www.cityoftybee.org SECTION 2: ANT DETAILS Y 1 1. Is this event... Open to the public (❑ Private Invitation only 2. Describe the event and its goals: Yi coAe, �1 eAt e +5 * (c. c) rokryi ` -9u.r ■' rv-■ 0.vck I n ex e ck se \ i 4 -Ixi-: 9 n c u c 'irte SVIOUICtoaliEWAVIN 3. Estimated number of people to attend and what this is based on: Dine —800 >I D l Q /47_ 4. Is there an admission fee for attendees? ❑ No 12'Yes - Fee will be: .. 9 ( i ' c- ea, . A preliminary budget is due with application. (refer to Section 7: Financial) S. Have you ever done this event before? If yes, list dates and locations: ye.e d" i flwit- , 6. Describe parking arrangements during event in detail: fi Please attach a drawing of parking plan. Organizer may be required to run a shuttle If a parking lot is closed for the event. �^ /� 7. list event sponsors and marketing plan: 'f^ 1111/1_ &�- J�PVLSOF' — S i-t an loi+4kAA S c)ons>ses llyeAl 1Ou5ir1eeSe S -C�n r'lbt„t>dr� 8. List any additional contact person(s) and their phone numbers involved in the planning of this event. �r iOnaca Adams ono--0,,zy - t‘1 .9. What plans exist for clean up and recycling? (Disposal of grease, trash, etc.) .)e-A1 %C . 03111 IN'QNi& 'rra51n) g ck. `t-�e cs- i-;o41 ocA .s,'D c ktVje, revti-erk cser"...)ev. cti 10. Please list any entertainment, bands, emcees or onsite promoters attending this event. Describe sound equipment: Qt'I ke55; oelcd J(U V 1cea u�►�\ be i,..yf-ccCoR 01/4.1..4.:c -e.q 116"e' 1. Please list your previous special event and /or hosting organization's experience in producing events. Gc\-'- ractnvvNe+1v 2. Please list two (2) references excluding City Officials and Staff: a. Name: e1ie Ve.,1 l G.M r [pj� Address: ?f�.�Ox �1�� bee St•) CA Phone: ` 1 ‘r)- I } r7 46 p/ r (4,'" rj b. Name: C ' C-k Gi(��'1(n Address : bt- ��J�fL 1q Ty \oee--IS, • 1 n Ck Phone: (b 1p "n"g ri t4 Page 2 of 8 Cio, Council Approved: February 14, 2013 SECTION 4: OTHER REQUESTS (Check the boxes below and provide additional information if applicable.) 1. 1 Vendors (Organizer must submit all Vendor Applications with payment no later than two [2) weeks prior to event. Chatham County Health Department must be contacted for approval of food vendors in accordance with their regulations.) 2. Department of Public Works (DPW) Request(s) (DPW approval required; staffing /equipment fees may apply) DPW Item Amount rjeded Total hours needed Traffic Cones Barricades Traffic Barrels Trash cans as' , Recycling containers 5 Port-a -lets Sweeper Vac Truck Fire ant treatment Dump Truck Back -hoe List other services that are requested. Costs will be determined. 5EM3X.e. C e' q0 .e5* S ' i 5 (gickrc e `! ne '1415 r;�t �W1a�5 Qcrk Cizorn to/ c _- \D1(3. PInts wnlbeprt aalec 3. 13/Street Closures (Tybee Island Police Department (TIPD] approval required.) a. List requested streets: 'jIP- Qi'1-wC f vyve v * 4. Ll Special parking / parking pass request(s) (Parking Service Division approval required.) a. Please describe: See.. D�4r+Q_Sr% rvser k 5. 'Commercial truck parking a. Please describe: 5P_A'aAZ `c-v tii Phu:Qmev '�TvC�y QC��K��"' �/ E� b J1/►av�S��►� 6. CJ' Police Detail (TIPD approval required; staffing /equipment fees may apply) r� a. Please describe:3G P r % A " t - \ W: r2 octaIVIDro.1 icer' pt- recon. .-eAdO (If off duty police officers are hired, organizer is responsible for contracting directly with the individual(s) and paying fees direct as agreed upon.) 7. Si Alcoholic Beverages (License Application should be submitted to the Administrative Assistant to the City Manager. Approval is required by City then State.) 8. D Fire Detail /Inspection (staffing /equipment fees may apply) a. Please describe: (If off duty fire department staff / volunteers are hired, organizer is responsible for contracting directly with the individual(s) and paying fees direct as agreed upon.) 9. 0 Fireworks (TIFD, Chatham County and U. S. Coast Guard approval required. Special application due to USCG of least 135 days prior.) 10. Cd"Additional Security a. Please describe: See 0 t4 mer1i–' 11. GiPetting Zoo a. Please describe: e `k- Page 3 of 8 City Council Approved. February 14, 2013 SECTION 4: OTHER REQUESTS (CON'T.) (Check the boxes below and provide additional information iif applicable.) 12, ilParade /Procession (T1PD approval required; staffing /equipment fees may apply) a. List requested parade staging area and route: See. CA-A-0.0-3A rV , Qv. (' Parades are required to start on Saturdays no later than 3:00pm with the exception of the Beach Bum Parade. Participants must adhere to safety guidelines.) 13. Amusement Rides (insurance from providing company is required no later than two 12) weeks prior to event.) 14. d Temporary Structure (i.e. tents, booths, stage, etc.) a. Please describe: r ce 'rerf1C5 D. ' *Lj te_ (Permits for tents larger than 10' x 1(Y; stages, booths and the like are required through the Planning & Zoning Deportment. Completed application with required documentation must be submitted no later than thirty [30] days prior to the event. Structures are not permitted without approval from the Planning & Zoning Deportment. Fees apply.) 15. I! Electrical needs (fees may apply) a. Please describe: SEA .13AV— \ 'cs eY\4- c\ Gse'n'e f'czko r5 16. ❑ Filming (Permit application should be filed with Facilities Coordinator. Approval is required.) 17. EW Banner Permits (Permit application should be filed with Facilities Coordinator. Approval is required.) 18. d City Facility requests require separate forms and approval through the Facilities Coordinator. a. The Walter W. Parker Pier and Pavilion is managed by Chatham County Parks & Recreation. Reservations for use of this facility must go through their office. A non - refundable Special Events application fee is required at time of application submittal. The application will not be processed without the application fee of $50.00. Checks should be made payable to the City of Tybee Island. If the applying organization is tax exempt, a GA Tax Exempt Certificate must be submitted with the application. Insurance, as indicated below, is required at least two (2) weeks prior to the Event. Failure to provide insurance will result in the cancellation of event. The application will go through the review process again if substantial changes are made or additional needs are requested. Additional application fees will result with additional meetings. %le Alat4tVil 1(9 mrl-e RJ04c,t4or tidcz Page 4 oj8 City Council Approved: Februar' 14, 2013 PRIVATE PROPERTY PUBLIC PROPERTY PRIVATE Organizer is responsible to obtain necessary insurance as deemed appropriate by the property owner. , Signed Indemnification Agreement required. INVITATION OPEN TO Signed Indemnification Agreement required. Organizer Is responsible to obtain necessary insurance as deemed appropriate by property owner. • If use of the Walter W. Parker Pier and Pavilion is part of the event, a $1 million certificate of insurance, with Chatham County Parks & Recreation listed as an additional insured and certificate holder is required. Signed Indemnification Agreement required and a $1 million certificate of insurance, with the City of Tybee Island listed as additional insured and certificate holder. If use of the Walter W. Parker Pier and Pavilion is part of the event, a $1 million certificate of insurance, with Chatham County Parks & Recreation listed as an additional insured and certificate holder is required. THE PUBLIC The application will go through the review process again if substantial changes are made or additional needs are requested. Additional application fees will result with additional meetings. %le Alat4tVil 1(9 mrl-e RJ04c,t4or tidcz Page 4 oj8 City Council Approved: Februar' 14, 2013 AgWi--iltA6:,0- H -(� to . (Do !r SECTION 6: INDEMIFICATION AGREEMENT AND ACCEPTANCE TO ADHERE TO APPLICATION REQUIREMENTS I, individually and as the Agent representing the Event Organization, do hereby agree to indemnify and hold harmless the City of Tybee island, Georgia, its officers, agents, employees and contractors from and against any and all loss, damage, claim, demand, liability or expense by reason of any damage or injury to property or person which may be claimed to have arisen as a result of or in connection with the occupancy or use of listed event premises during the time period of said event. Such obligation to indemnify and hold harmless shall continue notwithstanding any negligence or comparative negligence on the part of the City relating to such Toss or damage, except for loss or damage arising from the sole negligence or willful misconduct or gross negligence of the city, and shall include all costs, expenses and liabilities incurred by the City in connection with any such claim, suit, action or cause of action, including the investigation thereof and the defense of any action or proceeding brought thereon and any other judgment or decree which may be entered in any such action or proceeding or as a result thereof. These provisions shall survive the expiration or earlier term • of the use of p ises. Nothing in this Agreement shall be construed to affect in any way the City's rights, privileges, an. immu•it'es a for 'orgia Statutes and /or the Constitution of the State of Georgia. Organizer / Applicant's Signature: Date: MM 2 -t H- 260 INTERNAL USE BELOW. Staff signatures for City Departments listed below indicate the event application has been reviewed and department needs are accepted as requested. All signatures are required prior to application being submitted for City Council consideration. City Manager and / or Designee Planning & Zoning Manager and / or Designee Finance Director and / or Designee Water & S,weiI�ertment Supervisor and / or Designee Chief of Police and / or Designee Campground Manager and / or Designee Chief of Fire Department and / or Designee Department of Public Works Director and / or Designee COMMENTS: DATE APPROVED BY CITY COUNCIL: ADMINISTRATIVE APPROVAL !as aaplitable): Better Hometown Coordinator: Date: City Manager: Date: • pR even - -S Page 5 of 8 City Council Approved: February 14, 2013 Affidavit Verifying Status for City Public Benefit Application By executing this affidavit under oath, as an applicant for a City of Tybee Island, Georgia, Business License or Occupation Tax Certificate, Alcohol License, Taxi Permit; Contract, or other public benefit as referenced in O.C.G.A. Section 50 -36 -1, I am stating the following with respect to my application of a City of Tybee Island: • Business License or Occupational Tax Certificate, • Alcohol License. • Taxi Permit, • Contract (circle all that apply) • Other public benefit for v E (printed name of natural person applying on behalf of individual, business, corporation, partnership, or other private entity). 1) 1 am a United States citizen. OR 2) I am a legal permanent resident 18 years of age or older or 1 am an otherwise qualified alien or non - immigrant under the Federal Immigration and Nationality Act, 18 years of age or older and lawfully present in the United States. * In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall b- •uilty of a violation of Code Section 16 -10 -20 of the Official Code of Georgia. SUBSCRIBED AND SW • • N BEFORE ME ON TH THE DAY I+F , 20 Notary Public /76 • at ' . f Applicant Notary Puuic;iam Count, GA My Commission Expires: MY Commission Expires Oct. 10, 2015 5E1 L Date Printed Name * Alien Registration Number for Non - citizens Note: O.C.G.A. § 50- 36- 1(e)(2) requires that aliens under the federal Immigration and Nationality Act, Title 8 U.S.C., as amended, provide their alien registration number. Because legal permanent residents are included in the federal definition of "alien", legal permanent residents must also provide their alien registration number. Qualified aliens that do not have an alien registration number may supply another identifying number below: Michael S. Moody Attorney at Law P.O. BOX 1009, 701 U.S. Highway 80 Tybee Island, Georgia 31328 michaelmoodylaw@aol.com Telephone Facsimile (912) 472 -4285 (912) 472 -4016 May 28t 2013 TO: City of Tybee Island FROM: Michael Moody, Attorney DATE: 05/28/2013 RE: South End Association Bar & Restaurant, "S.E.A.B.A.R." TO WHOM THIS MAY CONCERN: Please be advised that this office has been retained to prepare the necessary documents to incorporate South End Association Bar & Restaurant as a not for profit 501(c)(3) corporation. The reservation of the name process is already underway, as well as the submission of the SS-4 form to the Internal Revenue Service for a not for profit status determination. Until the articles of incorporation are approved and the seal is given, representatives of "S.E.B.AR." should be considered as operating under the Georgia Charitable Solicitations Act, pursuant to O.C.G.A. §43- 17 -3(g). Please do not hesitate to email or call me with any questions you might have. Thank you, Michael Moody G.B.N. 517731 L.ocA' EVENT EWPSR MC't 2004 South Pacific Tybee Pier Production and Stage Manager 2005 Alice in Wonderland Tybee Gym Production and Stage Manager Best Little Whorehouse in Texas Tybee Pier Production and Stage Manager 2010 Wizard of Oz Tybee Gym Production and Stage Manager 2009, 2010, 2011, 2012, 2013 Tybee Wine Festival Tybee Light Station Site and Staging Manager 2009, 2010 Tybee Arts Festival Strand parking lot Site Manager 2006, 2007, 2008, 2009, 2010, 2011, 2012 Tybee Pirate Fest Strand Parking Lot Site and Staging Manager 2009, 2010, 2011 Tybee Island Mardi Gras Strand Avenue Parking Lot Site and Staging Manager 2011, 2012, 2013 Polar Bear Plunge South Beach Site and Stage Manager Numerous other smaller events on this great little piece of paradise. xoot viii . 4'),e `e / v-i' s1 (< ./{ •% 2013 Tybee Island Pirate Fest Special Event Application Supplement A. Additional Information A -1 dates and times • Friday 10/11/13, Festival hours 5pm -11pm • Saturday 10/12/13, Festival hours loam -llpm Tybee Beach Derby 8am -1pm ySunday 10/13/13, Pirate Church service loam • Sunday 10/13/13, festival hoursbam -4pm A -2 parking arrangements • SEABAR requests use of Tybrisa and Strand parking lots • SEABAR requests use of North Beach parking lot for parade set -up for the following hours: Saturday 10/12/13 llam -4pm. As in years past. • SEABAR will operate a shuttle from areas around the island to the festival site throughout the weekend • SEABAR requests that digital parking signs be used to direct festival goers to available parking areas. A -3 street closures • SEABAR requests the closure of the parade route from2:45pm-Spm or until the end of the parade • SEABAR requests partial closure of the 16th street roundabout A-4 special parking/ parking pass request • SEABAR requests full day parking passes for crew vehicles for the following dates: (10TMonday, October 7th, (10) Tuesday, October 8th — Friday, 10/11/13, (10) Friday, 10/11/13 — (6) Tuesdayl0 /15/13 • SEABAR requests to pre - purchase 3 day parking passes for festival vendors to be distributed in vendor packages. Estimated 50 needed. A -5 fees 41( k-tUq'f-J 't/tcv-4-- JO V41-fQ Ov\_ " S E A B A R r e q u e s t s t o b e r e l e a s e d f r o m t h e f o l l o w i n g f e e s : B u i l d i n g a n d z o n i n g , p e r m i t f e e s , p a r k i n g f e e s l i s t e d i n A - 4 , p a r k i n g l o t u s a g e f e e s , D P W , T y b e e P o l i c e s t a n d a r d p a r a d e B . S i t e p l a n " I n a d d i t i o n t o t h e i l l u s t r a t i o n p r o v i d e d , S E A B A R r e q u e s t s t o h a v e r o v i n g p e r f o r m e r s u t i l i z e T y b r i s a S t r e e t a n d t h e S t r a n d �% P r o p o s e d P i r a t e F e s t L a y o u t I n v e n t o r y " M a i n s t a g e 2 4 ' x 2 0 ' p o r t a b l e w i t h 4 ' x 8 ' s o u n d w i n g s " B u d w e i s e r t r a i l e r 5 0 ' x 1 2 ' " 4 P o r t a b l e b a r w i t h a w n i n g i d i t 4 0 ' L i g h t i n g t r u s s a t e n t e r a n c e o f c h i l d r e n s a r e a , a s i n 2 0 1 0 " M a i n s t a g e t e n t 5 0 ' x 1 5 0 ' " V e n d o r t e n t s ( 4 9 ) 1 0 ' x 1 0 ' " G a t e t e n t s ( 3 ) 1 0 ' x 1 0 ' " B l a c k b e a r d ' s p i r a t e s h i p 2 2 ' x 1 5 ' " 4 P e r m i s s i o n t o p a r k S H I N E f l o a t i n S t r a n d l o a d i n g a r e a a f t e r P a r a d e - " F o o d t e n t s ( 3 ) 1 5 ' x 1 5 ' " B e e r t e n t s ( 2 ) 1 0 ' x 1 0 ' " K i d ' s c o v e r e d s t a g e 3 4 ' x 1 5 ' " - i W e m a y u s e o n e 3 s t a l l R o y a l r e s t r o o m , 2 2 ' x 9 ' " P o r t a b l e r e s t r o o m s ( 2 0 ) 4 ' x 4 ' ( 4 ) A D A a p p r o v e d 4 ' x 6 ' . f& S h a d e Z o n e 4 0 ' x 6 0 ' " G r e e n r o o m t e n t 1 5 ' x 1 5 ' f& D r e s s i n g r o o m s 1 0 ' x 1 0 ' f& D u m p s t e r 8 ' x 2 0 ' f& F e r r i s W h e e l 3 5 ' x 5 2 ' f& I c e w a g o n 9 ' x 1 2 ' 4 ♦ Carousel 30'x 30' C. Non - profit status D. Parade information • Pirate Victory Parade • Saturday 10/12/13 line -up begins at 12:30pm, parade will start at 3:OOpm • Line -up at North Beach lot for vehicles and Memorial Park for walkers • Route will be the same as previous years • South on Meddin drive, left on VanHorne, left onto rt street onto Butler, left on Tybrisa, right onto Strand Avenue. Ends at 17th . Floats will exit route onto 18th street. E. Tybee Beach Derby F. Anticipated Permits Pirate Encampment The pirate encampment is being conducted through a local theater group. The encampment will include two tents representing historic pirate life, and other pirate related activities. SEABAR will request appropriate beach permits following application approval. SEABAR will hire overnight security to guard valuable props with permission from the city. This member will not sleep on site. The encampment will use sand specific staking. Anticipated Permits In addition to this application, SEABAR anticipated needing to pursue permits for: Food tents Encampment tents Main stage tents Amusement rides Main stage Children's stage Ticket Entry tent Green room tent Electrical Parking use in roundabout for loading and unloading and other parking as needed. PiraJz ship. SEABAR request permission to remove parking stops at exit point on Strand side of main tent, and beach side of main tent also the stops in Ferris Wheel foot print. Fireworks at end of Pier, Saturday 8:45 pm, looking for sponsor. Exotic petting zoo, in Little Matey's Cove. Ferris Wheel , carousel horses and bouncy houses in Children's area. Request emergency parking area at base of pavilion for staging vehicles. Tybee Beach Derby The SEABAR will contract an independent organizer to facilitate the Tybee Beach Derby as part of Tybee Island Pirate Fest. All required permitting and additional requests of the city will be facilitated through this organizer. Proceeds from the derby will benefit local non[profit organizations. Date and Time: Saturday 10/12/13, Setup 7am — 9am, Breakdown 12pm — 2pm Location: Beach area from North Beach to pier, Staging at North Beach n ��ti� V� Description: 5K Beach obstacle course \\NN Estimated Attendance Goal 2,000 Admission: spectators free, participants $49.99 (includes race and entry fee to Pirate Fest) Clean -up: Each obstacle will be manned by a volunteer clean -up crew The first wave of 200 participants will leave from North beach jetties at 9:30am and be followed by a 200 person wave every 15 minutes. The final wave will take off at 11:OOam and should cross the finish line at the pier by 12:OOpm. Obstacles will be off beach area by 1:OOpm. Obstacle Descriptions: 1) Captain Jack Sparrow's High Knee Extravaganza Runners will high knee through inflated inner tubes staked in the sand to resemble tires. 2) Jacob's Ladder Runners must crawl under net draped on posts 2 feet above sand. 3) Jolly Roger Runners jump over hurdles. 4) Scalleywag Runners bust through noodles buried upright in the sand blocking view to other side and find hidden treasure. 5) Captain Hook's Rope Climb Runners climb over a 4 foot net set at a 45 degree angle. 6) Man of War Dizzy Spell Runners spin around with their head on a baseball bat 5 times. 7) Blackbeard's Secret Runners crawl through 3x3 foot tubes. 8) The Black Pearl Runners must "avoid" being attacked by pirates waiting for them. 9) Neptune Runners must zig -zag through network of cones. 10) Ahoy Matey Runners must go up and over a 4 foot wall. 11) Walk the Plank Runners must balance their way across a post above the ground. 12) Pirate Booty Finish Line Finish the race by crawling into the gates of Pirate Fest to retrieve Your booty. nfe•d (Pilo) 2013 PIRATES FEST BUDGET INCOME Alcohol /Beer Sales 20,000 Coca Cola Sales 2,500.00 Merchandise/ T -Shirts 10,000.00 Parade Entry Fees 1,000.00 Sponsorships 50,000.00 Ticket Sales 65,000.00 Event Booth 12,000.00 TOTAL INCOME 160,500.00 COST OF GOODS SOLD Cost of Alcohol /Beer T- Shirts /Hats /misc. TOTAL OF COST OF GOODS SOLD 8,000.00 6,000.00 14,000.00 GROSS PROFIT 146,500.00 EXPENSES Advertising /Marketing 5,000.00 Childrens Events Entertainment 6,000.00 Petting Zoo 2,000.00 Decorations 500.00 Prizes and Giveaways 500.00 TOTAL CHILDRENS EVENTS 9,000.00 Parade Setup and Decorations 1,000.00 Give -away Merchandise 1,000.00 TOTAL PARADE 2,000.00 Entertainment Cost 30,000.00 Administrative Costs Printing/Postage 600 Posters /Banners /Badges 800 Insurance 2,000.00 Licenses & Permits 600 Sales Tax 6,000.00 Bank or Creditcard Fees 1,500.00 City Services 5,000.00 Office Supplies 1,000.00 TOTAL ADMINISTRATIVE 17,500.00 Site Preparation Restrooms 2,000.00 Sound 5,000.00 Lighting 3,000.00 Chairs &Tables 1,000.00 Generators /Cables 10,000.00 Tents 25,000.00 Stage 4,000.00 Fence /Post/Ties 1,000.00 Video /Projector 2,000.00 Site Materials 4,000.00 Decorations 1,500.00 Equipment Rental 500 Labor - Casual 2,000.00 TOTAL SITE PREPARATION 61,000.00 Misc. Event Cost Security 2,000.00 Golf Carts 500.00 Labor For The Event 5,000.00 Van /Food /Rooms 1,200.00 Sponsor/Tent 1,000.00 Prize Money 500.00 Radio Rental 800.00 Trolley 1,000.00 Storage 1,000.00 Ice 800.00 Contingency 8,000.00 TOTAL MISC. EXP. 21,800.00 TOTAL EXPENSES 146,300.00 SURPLUS /DEFICIT 200 93 20i 2 6-ixdrJ- MAYOR Jason Buelterman CITY COUNCIL Wanda Doyle. Mayor Pro Tem Barry Brown v-134_3 r C i e� Jan Fox Bill Garbett �; 1 „ �1a„ Tom Groover Groover .. `1'C. Paul Wolff P \ 0 n , 11 II...ed _co c 4., CITY OF TYBEE ISLAND V•At • SPECIAL EVENTS APPLICATION The City.of Tybee'Island recognizes that special events play a significant role in the life of t the community by providing recreation, cultural and educational opportunities to resi economic health of the community. It is our goal to assist event organizers in plann minimal impact in the areas surrounding the event. By keeping the public's best interest i to host a special event upon public property or private property requiring City Services, spe be granted approval from the City Council and / or the City Manager. The Special Event appli requested information completed and submitted for c sideration at least sixty (60) days pri people upon public property or private property requir the non - profit organizer of the event require approval fr permitted due to limited infrastructure and city resources. T; or TCC ; i C(T t :la•% % 4GER REC #: r13374277 Diane; Sp a cher:_ ,1 _ 'h: t1i ' 25,00 Tv CL RR OF COUNCIL Janet LeViner OF'ER: lin RFFu: r'IFATE t_ST CITY ATTORNEY .. , EVer-it Feri,i ..,: - Irdward =M. Hughes - TENDFR ' "�'t Fi • 511.0G- MAKE: sa unity. p and tourists and they and successful events t ind, persons or organiz I permitting and / or v tion shall be compl to event. Events r vendor per one eve ess fo 100 events enhance ribute to the t have a ions wishing dors must first d with all th 75 or more s that are not for er day will be rmission to have a er Hometown Program concerns and details must be City Services, special permitting and the City of Tybee Island. No more th order to ensure a smooth review pr Special Event, the applicant will receive direction from appli Coordinator. Prior to the application being submitted for Cit addressed, confirmed by th nizer ccepted by design ble City Departments, City Manager ouncil consideration (if applicable), ed City Staff of impacted Departments. Note: Applicant must Additional meetings m Tbday's Dat * A non - refundable Checks or money or ordinator or his /her desi ee at time of submitting application. —0 al 51a1r.5. tion Fee Submi ecial Event application fee of rs should be made payable to 1. Name of Even 2. Date and time o Setup: • Breakdow event: 3. Location(s): o A site plan of th awn to scale an submittal. • SE time of ap land. cation submitta processing and consideration. N 1: EVENT I • ATION kobe ate/Time period Date/Time period i eAcOber r?, X013 &An goer 5, X013 In •. L ci- picting all event struc • -s is required at time of application nt are • 1 •: _t / • A Letter of Permission (LOP) from Georgia - partment of Natural Resources ( htto : / /coastalgadnr.ore/sendemail) is required for events with beach usag d / or within the Shore Protection jurisdiction (i.e. beach side parking lot areas, etc.). The LOP is no later than two (2) weeks prior to the event. L � "rte 4. Organization: )OL��}'V1 R-ro. A '>'j(�C 1m-k - ion & ZS ava es�4u.( ❑ Commercial? sz Non- profit / Tax Exempt? (Non Profit Status / GA Tax Exempt Certificate must be attached.;, _. 5. Phone number and / or website for public event information: t ('0.'i e gsTeS� - c cn -221-1.-- 5 111 6. Organizer/ Applicant: C )_\e /IN (' /(�' /R>, '{�i(N(,\,i`c - ,A aO rr Address: t (0 ` `) STCan eiv A 1)e. . City:lpe�s�aY1d State: C`lik (� Q L l_1 `► Contact Phone: "1 \ l O ` LAO Email: A GT l l)e One.,; ( tt,G(MY\ Organizer /Applicant listed above must be in attendance and readily available for the duration f event. P.O. Box 2749 — 403 Butler Avenue, Tybee Island, Georgia 31328 -2749 (912) 472 -5071 — FAX (912) 786 -9539 www.cityoftybee.org SECTION 2: EVENT DETAILS 1. Is this event... 27 Open to the public (�❑ Private Invitation only 2. Describe the event and its goals: t ccA >- \ -et e..42‘5_+ 5 k c y rc v k'QJ *ow- ■ S(11\ a.M 1 n�c -eca5e \r; 5 i A- cti--;&ln 6u,r„cl e s 3. Estimated number of people to attend and what this is based on: /1D&C — ,coO /0ot Q 4. Is there an admission fee for attendees? ❑ No E Yes - Fee will be: tU. C l _Q,k1k1f'e■ 'C -ee- A preliminary budget is due with application. (refer to Section 7: Financial) S. Have you ever done this event before? If yes, list dates and locations: SeC - c ' i nQv' k- AN 6. Describe parking arrangements during event in detail: 5r✓'e C�.�L° �YYIe i[1`� Please attach a drawing of parking plan. Organizer may be required to run a shuttle if a parking lot is closed for the event. 7. List event sponsors and marketing plan: 190MAR-L-S()c0 n5or -- JE.>4 l "K 8. List any additional contact person(s) and their phone numbers involved in the planning of this event. i&laccV Aodarv5 9. What plans exist for clean up and recycling? (Disposal of grease, trash, etc.) , e 141sAR L&.3 1 \ pr 6kilde ; r ot. to eNe■ n a, Q ev. L.).von; n ' ,,e ces +; eivcoc t nol.S. �u,mo4-ef �w;111� eevti-e� t`ew�ove v C44". e.. 42. - 10. Please list any entertainment, bands, emcees or onsite promoters attending this event. Describe sound equipment: 4r e-95ior0.i _pCi9'J Oe2.5 tZ■ \\ \Oe- l.A.`Yeck' c OLOcU O QQu` '" 1. Please list your previous special event and /or hosting organization's experience in producing events. She CLA- ;- acln.e�k 2. Please list two (2) references excluding City Officials and Staff: a. Name: j 0e (2,e -1 I G.'c Address: Phone: b. Name: �I � cAn \-k arn1zv Address : 'at��nOX611(- 'y \ems =5I.2 Phone: ! b " n►O itQ5 �h�e�,.� CA Page 2 of 8 City Council Approved: February 14, 2013 1. SECTION 4: OTHER REQUESTS (Check the boxes below and provide additional information if applicable.) Vendors (Organizer must submit all Vendor Applications with payment no later than two [2] weeks prior to 11 p event. Chatham County Health Department must be contacted for approval of food vendors in accordance with their regulations.) 2. 2' Department of Public Works (DPW) Request(s) (DPW approval required, staffing /equipment fees may opal DPW Item Amount needed Total hours needed Traffic Cones Barricades Traffic Barrels Trash cans r1 O9 Recycling containers oc 5- Port-a -lets Sweeper Vac Truck Fire ant treatment Dump Truck Back -hoe List other services that are requested. Costs will be determined. 5E A.Z14e t` ecbt.te5i S ` V D 1i Chcnc ne 1c kr,35 rti 7Cic 5 lark C crn to / c\ — 1O/13. P65 to ;llbe.pc-oo:citE 3. liStreet Closures (Tybee Island Police Department (TIPD) approval required.) a. List requested streets: 'f-e_.2 GA'}'- c.e'Myyte vrk- 4. El Special parking / parking pass request(s) (Parking Service Division approval required.) a. Please describe: 5 C *0cjA r erk 5. 1Commercial truck parking a. Please describe: 5eASAZ C'et4'2.5 ' 5 `�-V1 'vec�nA∎Co.` P�au.;paner.`t 11- v,C.(65 pac' K 4je-1, b !!pp rv�a n S }ale 6. ICY Police Detail (TIPD approval required; staffing /equipment fees may apply) a. Please describe:56- fr%A'� U.st ]\ \/\.I €_ ocktilirIcAncLI Acer5 pec- Seto... *end (If off duty police officers are hired, organizer is responsible for contracting directly with the individual[s] and paying fees direct as agreed upon.) 7. ® Alcoholic Beverages (License Application should be submitted to the Administrative Assistont to the City Manager. Approval is required by City then State.) 8. ❑ Fire Detail /Inspection (staffing /equipment fees may apply) a. Please describe: (If off duty fire department staff / volunteers are hired, organizer is responsible for contracting directly with the individual(s) and paying fees direct as agreed upon.) 9. ❑ Fireworks (TIFD, Chatham County and U. 5. Coast Guard approval required. Special application due to USCG at least 135 days prior.) 10. VAdditional Security a. Please describe: Se -GClnme,ni' 11. VPetting Zoo a. Please describe: e.Kc ■ C_ 'Q.+A-'■ An --zoo Page 3 1)1'8 City Council Approved: February 14, 2013 SECTION 4: OTHER REQUESTS (CON'T.) (Check the boxes below and provide additional information if applicable.) 12. t"Parade /Procession (TIPD approval required; staffing /equipment fees may apply) a. List requested parade staging area and route: See. Gi44ca .-k tvi ertt (* Parades are required to start on Saturdays no later than 3:OOpm with the exception of the Beach Bum Parade. Participants must adhere to safety guidelines.) 13. Amusement Rides (Insurance from providing company is required no later than two 12j weeks prior to event.) 14. Temporary Structure (i.e. tents, booths, stage, etc.) a. Please describe: cv.C,* C - eok-5 ava S4c e_ (Permits for tents larger than 10' x 10, stages, booths and the like are required through the Planning & Zoning Department. Completed application with required documentation must be submitted no later than thirty (30) days prior to the event. Structures are not permitted without approval from the Planning & Zoning Department. Fees apply.) 15. IY Electrical needs (fees may apply) a. Please describe: SE.-.M3 AV- 'u \ (, e nerwvo(`5 16. ❑ Filming (Permit application should be filed with Facilities Coordinator. Approval is required.) 17. a/Banner Permits (Permit application should be filed with Facilities Coordinator. Approval is required.) 18. 1A City Facility requests require separate forms and approval through the Facilities Coordinator. a. The Walter W. Parker Pier and Pavilion is managed by Chatham County Parks & Recreation. Reservations for use of this facility must go through their office. SECTION 5: ADDITIONAL REQUIREMENTS A non - refundable Special Events application fee is required at time of application submittal. The application will not be processed without the application fee of $50.00. Checks should be made payable to the City of Tybee Island. If the applying organization is tax exempt, a GA Tax Exempt Certificate must be submitted with the application. Insurance, as indicated below, is required at least two (2) weeks prior to the Event. Failure to provide insurance will result in the cancellation of event. The application will go through the review process again if substantial changes are made or additional needs are requested. Additional application fees will result with additional meetings. (4o 10 euwa Adct/r,a� Page 4 of 8 City Council Approved: February 14, 2013 PRIVATE PROPERTY PUBLIC PROPERTY PRIVATE Organizer is responsible to obtain necessary insurance as.deemed appropriate by the property owner. Signed Indemnification Agreement required. INVITATION OPEN TO Signed Indemnification Agreement required. Organizer is responsible to obtain necessary insurance as deemed appropriate by property owner. * If use of the Walter W. Parker Pier and Pavilion is part of the event, a $1 million certificate of insurance, with Chatham County Parks & Recreation listed as an additional insured and certificate holder is required. Signed Indemnification Agreement required and a $1 million certificate of insurance, with the City of Tybee Island listed as additional insured and * certificate holder. If use of the Walter W. Parker Pier and Pavilion is part of the event, a $1 million certificate of insurance, with Chatham County Parks & Recreation listed as an additional insured and certificate holder is required. THE PUBLIC The application will go through the review process again if substantial changes are made or additional needs are requested. Additional application fees will result with additional meetings. (4o 10 euwa Adct/r,a� Page 4 of 8 City Council Approved: February 14, 2013 SECTION 6: INDEMIFICATION AGREEMENT AND ACCEPTANCE TO ADHERE TO APPUCATION REQUIREMENTS I, individually and as the Agent representing the Event Organization, do hereby agree to indemnify and hold harmless the City of Tybee island, Georgia, its officers, agents, employees and contractors from and against any and all loss, damage, claim, demand, liability or expense by reason of any damage or injury to property or person which may be claimed to have arisen as a result of or in connection with the occupancy or use of listed event premises during the time period of said event. Such obligation to indemnify and hold harmless shall continue notwithstanding any negligence or comparative negligence on the part of the City relating to such loss or damage, except for loss or damage arising from the sole negligence or willful misconduct or gross negligence of the city, and shall include all costs, expenses and liabilities incurred by the City in connection with any such claim, suit, action or cause of action, including the investigation thereof and the defense of any action or proceeding brought thereon and any other judgment or decree which may be entered in any such action or proceeding or as a result thereof. These provisions shall survive the expiration or earlier term • . . of the use of p ises. Nothing in this Agreement shall be construed to affect in any way the City's rights, privileges, an. immu ' it es a for 1 orgia Statutes and /or the Constitution of the State of Georgia. Organizer / Applicant's Signature: Date: 1 l-A 2 ?I tk 2 Gt3 INTERNAL USE BELOW. Staff signatures for City Departments listed below indicate the event application has been reviewed and department needs are accepted as requested. All signatures are required prior to application being submitted for City Council consideration. City Manager and / or Designee Planning & Zoning Manager and / or Designee Finance Director and / or Designee Water & S9wey Pew ment Supervisor and / or Designee Chief of Police and / or Designee Campground Manager and / or Designee Chief of Fire Department and / or Designee Department of Public Works Director and / or Designee COMMENTS: DATE APPROVED BY CITY COUNCIL: ADMINISTRATIVE APPROVAL (as applicable): Better Hometown Coordinator: Date: City Manager: Date: Page 5 of 8 City Council Approved: February 14, 2013 Pirate Fast Layout -'12 w • :nr suart- Staging Zit hetghl 'r Staging) 111 height W Staging en height WII Generator P Os. Imp ter 5.6'X s5–p daft x 1211- Troller !Rear and Coca Cc!o) 1511 ' 1511- Fcad Tents c,'x164 -TEN"f WI 10 ft;: 1011'.rnndor /HospItolll y/Gala Tents Repko PirctB Shia I Poftohte Restroams —7"ry Drape Performance space /no platforms or sta tilvJ Refreshments w "tables arr]nrt .moo• IPIA f111M= (�� R9411 iv • O.A. • Affidavit Verifying Status for City Public Benefit Application By executing this affidavit under oath, as an applicant for a City of Tybee Island, Georgia, Business License or Occupation Tax Certificate, Alcohol License, Taxi Permit, Contract, or other public benefit as referenced in O.C.G.A. Section 50 -36 -1, 1 am stating the following with respect to my application of a City of Tybee Island: • Business License or Occupational Tax Certificate, • Alcohol License, • Taxi Permit. • Contract • Other public benefit (circle all that apply) for C1 E tJ ER. on behalf of individual, business, corporation, partnership, or other private entity). (printed name of natural person applying 1) � I am a United States citizen. OR 2) I am a legal permanent resident 18 years of age or older or I am an otherwise qualified alien or non - immigrant under the Federal Immigration and Nationality Act, 18 years of age or older and lawfully present in the United States. * In making the above representation under oath, 1 understand that any person who knowingly and willfully makes a false, fictitious, or fraudulent statement or representation in an affidavit shall b/• uilty of a violation of Code Section 16 -10 -20 of the Official Code of Georgia. SUBSCRIBED AND SW THE 3-4- DAY �F Notary Public N BEFORE ME ON THI� 20 Notary P ' c, v71' , GA My Commission Expires: MY Commission Expires Oct. 10, 2015 f Applicant J-2 '7 -15 5a-it-BA iZ, Date Printed Name * Alien Registration Number for Non - citizens Note: O.C.G.A. § 50- 36- 1(e)(2) requires that aliens under the federal Immigration and Nationality Act, Title 8 U.S.C., as amended, provide their alien registration number. Because legal permanent residents are included in the federal definition of "alien", legal permanent residents must also provide their alien registration number. Qualified aliens that do not have an alien registration number may supply another identifying number below: Michael S. Moody Attorney at Law P.O. BOX 1009, 701 U.S. Highway 80 Tybee Island, Georgia 31328 michaelmoodylaw@aol.com Telephone Facsimile (912) 472 -4285 (912) 472 -4016 May 28th 2013 TO: City of Tybee Island FROM: Michael Moody, Attorney DATE: 05/28/2013 RE: South End Association Bar & Restaurant, "S.E.A.B.A.R." TO WHOM THIS MAY CONCERN: Please be advised that this office has been retained to prepare the necessary documents to incorporate South End Association Bar & Restaurant as a not for profit 501(cX3) corporation. The reservation of the name process is already underway, as well as the submission of the SS-4 form to the Internal Revenue Service for a not for profit status determination. Until the articles of incorporation are approved and the seal is given, representatives of "S.E.B.AR." should be considered as operating under the Georgia Charitable Solicitations Act, pursuant to O.C.G.A. §43- 17 -3(g). Please do not hesitate to email or call me with any questions you might have. Thank you, Michael Moody G.B.N. 517731 LOCAL EVENT E'tPSR tEtiC� 2004 South Pacific Tybee Pier Production and Stage Manager 2005 Alice in Wonderland Tybee Gym Production and Stage Manager Best Little Whorehouse in Texas Tybee Pier Production and Stage Manager 2010 Wizard of Oz Tybee Gym Production and Stage Manager 2009, 2010, 2011, 2012, 2013 Tybee Wine Festival Tybee Light Station Site and Staging Manager 2009, 2010 Tybee Arts Festival Strand parking lot Site Manager 2006, 2007, 2008, 2009, 2010, 2011, 2012 Tybee Pirate Fest Strand Parking Lot Site and Staging Manager 2009, 2010, 2011 Tybee Island Mardi Gras Strand Avenue Parking Lot Site and Staging Manager 2011, 2012, 2013 Polar Bear Plunge South Beach Site and Stage Manager Numerous other smaller events on this great little piece of paradise. - W 1L/ ,__) 2013 Tybee Island Pirate Fest Special Event Application Supplement A. Additional Information A -1 dates and times • Friday 10/11/13, Festival hours 5pm -11pm • Saturday 10/12/13, Festival hours 10am -11pm Tybee Beach Derby 8am -lpm • Sunday 10/13/13, festival hours llam -4pm A -2 parking arrangements • SEABAR requests use of Tybrisa and Strand parking lots • SEABAR requests use of North Beach parking lot for parade set -up for the following hours: Saturday 10/12/13 11am-4pm • SEABAR will operate a shuttle from areas around the island to the festival site throughout the weekend • SEABAR requests that digital parking signs be used to direct festival goers to availabie parking areas. A -3 street closures • SEABAR requests the closure of the parade route from2:45pm-Spm or until the end of the parade • SEABAR requests partial closure of the 16th street roundabout A-4 special parking/ parking pass request • SEABAR requests full day parking passes for crew vehicles for the following dates: (10) Tuesday, October 8th — Friday, 10/11/13, (10) Friday, 10 /11/13 — Sunday 10/13/13, (6) Sunday 10/13/13 — Tuesdayl0/15/13 • SEABAR requests to pre - purchase 3 day parking passes for festival vendors to be distributed in vendor packages. Estimated 30 needed. A -5 fees " S E A B A R r e q u e s t s t o b e r e l e a s e d f r o m t h e f o l l o w i n g f e e s : B u i l d i n g a n d z o n i n g , p e r m i t f e e s , p a r k i n g f e e s l i s t e d i n A - 4 , p a r k i n g l o t u s a g e f e e s , D P W , T y b e e P o l i c e s t a n d a r d p a r a d e B . S i t e p l a n " I n a d d i t i o n t o t h e i l l u s t r a t i o n p r o v i d e d , S E A B A R r e q u e s t s t o h a v e r o v i n g p e r f o r m e r s u t i l i z e T y b r i s a S t r e e t a n d t h e S t r a n d " P r o p o s e d P i r a t e F e s t L a y o u t I n v e n t o r y " M a i n s t a g e 2 4 ' x 2 0 ' p o r t a b l e w i t h 4 ' x 8 ' s o u n d w i n g s " B u d w e i s e r t r a i l e r 5 0 ' x 1 2 ' " M a i n s t a g e t e n t 5 0 ' x 1 5 0 ' " V e n d o r t e n t s ( 4 9 ) 1 0 ' x 1 0 ' " G a t e t e n t s ( 3 ) 1 0 ' x 1 0 ' " B l a c k b e a r d ' s p i r a t e s h i p 2 2 ' x 1 5 ' " F o o d t e n t s ( 3 ) 1 5 ' x 1 5 ' " B e e r t e n t s ( 2 ) 1 0 ' x 1 0 ' " K i d ' s s t a g e 3 4 ' x 1 5 ' " P o r t a b l e r e s t r o o m s ( 2 0 ) 4 ' x 4 ' ( 4 ) A D A a p p r o v e d 4 ' x 6 ' f& S h a d e Z o n e 4 0 ' x 6 0 ' f& G r e e n r o o m t e n t 1 5 ' x 1 5 ' f& D r e s s i n g r o o m s 1 0 ' x 1 0 ' " D u m p s t e r 8 ' x 2 0 ' C . N o n - p r o f i t s t a t u s D . P a r a d e i n f o r m a t i o n " P i r a t e V i c t o r y P a r a d e " S a t u r d a y 1 0 / 1 2 / 1 3 l i n e - u p b e g i n s a t 1 2 : 3 0 p m , p a r a d e w i l l s t a r t a t 3 : O O p m " L i n e - u p a t N o r t h B e a c h l o t f o r v e h i c l e s a n d M e m o r i a l P a r k f o r w a l k e r s " R o u t e w i l l b e t h e s a m e a s p r e v i o u s y e a r s " S o u t h o n M e d d i n d r i v e , l e f t o n V a n H o r n e , l e f t o n t o 1 s t s t r e e t o n t o B u t l e r , l e f t o n T y b r i s a , r i g h t o n t o S t r a n d A v e n u e . E n d s a t 1 7 t h . F l o a t s w i l l e x i t r o u t e o n t o 1 8 t h s t r e e t . E . T y b e e B e a c h D e r b y F . A n t i c i p a t e d P e r m i t s P i r a t e E n c a m p m e n t T h e p i r a t e e n c a m p m e n t i s b e i n g c o n d u c t e d t h r o u g h a l o c a l t h e a t e r g r o u p . T h e e n c a m p m e n t w i l l i n c l u d e t w o t e n t s r e p r e s e n t i n g h i s t o r i c p i r a t e l i f e , a n d o t h e r p i r a t e r e l a t e d a c t i v i t i e s . S E A B A R w i l l r e q u e s t a p p r o p r i a t e b e a c h p e r m i t s f o l l o w i n g a p p l i c a t i o n a p p r o v a l . S E A B A R w i l l h i r e o v e r n i g h t s e c u r i t y t o g u a r d v a l u a b l e p r o p s w i t h p e r m i s s i o n f r o m t h e c i t y . T h i s m e m b e r w i l l n o t s l e e p o n s i t e . T h e e n c a m p m e n t w i l l u s e s a n d s p e c i f i c s t a k i n g . Anticipated Permits In addition to this application, SEABAR anticipated needing to pursue permits for: Food tents Encampment tents Main stage tents Amusement rides Mainstage Children's stage Ticket Entry tent Green room tent Electrical Parking use in roundabout for loading and unloading and other parking as needed. SEABAR request permission to remove parking stops at exit point on Strand side of main tent, and beach side of main tent. Exotic petting zoo in Little Matey's Cove. Ferris Wheel, carousel horses and bouncy houses in Children's area. Request emergency parking area at base of pavilion for staging vehicles. Tybee Beach Derby The SEABAR will contract an independent organizer to facilitate the Tybee Beach Derby as part of Tybee Island Pirate Fest. All required permitting and additional requests of the city will be facilitated through this organizer. Proceeds from the derby will benefit local non[profit organizations. Date and Time: Saturday 10/12/13, Setup lam — 9am, Breakdown 12pm — 2pm Location: Beach area from North Beach to pier, Staging at North Beach Description: 5K Beach obstacle course Estimated Attendance Goal 2,000 Admission: spectators free, participants $49.99 (includes race and entry fee to Pirate Fest) Clean -up: Each obstacle will be manned by a volunteer clean -up crew The first wave of 200 participants will leave from North beach jetties at 9:30am and be followed by a 200 person wave every 15 minutes. The final wave will take off at 11:OOam and should cross the finish line at the pier by 12:OOpm. Obstacles will be off beach area by 1:OOpm. Obstacle Descriptions: 1) Captain Jack Sparrow's High Knee Extravaganza Runners will high knee through inflated inner tubes staked in the sand to resemble tires. 2) Jacob's Ladder Runners must crawl under net draped on posts 2 feet above sand. 3) Jolly Roger Runners jump over hurdles. 4) Scalleywag Runners bust through noodles buried upright in the sand blocking view to other side and find hidden treasure. 5) Cap't Hook's Rope Climb Runners climb over a 4 foot net set at a 45 degree angle. 6) Man of War Dizzy Spell Runners spin around with their head on a baseball bat 5 times. 7) Blackbeard's Secret Runners crawl through 3x3 foot tubes. 8) The Black Pearl Runners must "avoid" being attacked by pirates waiting for them. 9) Neptune Runners must zig -zag through network of cones. 10) Ahoy Matey Runners must go up and over a 4 foot wall. 11) Walk the Plank Runners must balance their way across a post above the ground. 12) Pirate Booty Finish Line Finish the race by crawling into the gates of Pirate Fest to retrieve Your booty. -4"-o PAP KING LE T c,• - 7,171J1'1' itF.F uvt :TUESDAY OCTOBER 8T" — 7AM OCTOBER 9T" — 7AM BLUE ZONE: OPEN UNTIL THURSDAY 7AM PINK 7"4:: LUNCH CROWD 8TH,9TH,10TH IF l I l � Ix a TA7LSOQCONTENTS ' 10', 10 Wndor Bo a Rand Tib• with 10 cmrn Bw Top Alb No Ch,is Sm.» FrA-nd VW] Mir: roan Rowans T:�be .TsiancI Pirate . est Site Plan EXOTIC PETTING ZOC FERRIS WHEEL CAROUSEL IBEER TRAILER LITTLE MATEY'S COVERED STAGE BOUNCY HOUSES