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CITY OF TYBEEISLAM
MERCHANDISESIDEWALK CAFE OR ,
RNUT
WAVES _#
WILLIAM NAVON
P.O.
BOX 2812
TYBEE ISLAND,
. 31328
BusinessLocation: 7 TYBRISA STREET
Certificate #: 253
Date Issued: 1/20/2022
A clear pedestrian path of u minimum of 4 fast must be maintained at all times. Compliance with
ADA provision is required at all times. A sidewalk element shall not be permanently attached to
the sidewalk. Sidewalk elements shall be stacked/set aside immediately upon ceasing daily-
operation and must be secured in such a manner as to prevent their use. Use of the right -of --way
may be temporarily suspended at the discretion of the city® Sate transactions shall riot occur on
sidewalks. s. All sales must occur in the building.
MERCHANDISE DISPLAY
HOURS OF OPERATION
Sunday : OA -- 1:00AA 1
Monday :40A--1:OOA
Tuesday :OOA I — 1:00AI 1
Wedrresdav :OOAA1— :OOA
Thursday ay :O A I — 1:00AM
Friday :OAI —1:OA
Saturday 8:00A — 1:00AM
This Permit and plans must be displayedin a conspicuous lac. in your business establishment.
The City of Tybee Island mustnotified f any change in status. This Permit is not transferable
and is subject to beingrevoked if abused. This Permit expires on 12/3112022
George Shaw
Planning Zoning
P.O. Box 2749.403 Butter Avenue - Tvbee tstand, Georgia,31:28-274
(912) 786-4573 - F (912) 786-5737
CITY OF TYBEE ISLAND
MERCHANDISESIDEWALK CAA OR
PERMIT APPLICATION
t' r7l
Business name i I,.wt1� ez d� � � W �
Street addressdt 8J1
Mailing address q t l x� 4 v'R, , 4 61
d r i, dr y
11 Email
Name of business owner: kx gear JN f"1 1° J 0 T` Mobile
M - Home
Phone numbers of owner: Business I
Email
Name of applicant if other than owner;+11 i l d ? l$ 1 t' �1 Mobile
Phone numbers of applicant: Business _ 4 -} _ 115 Home
Relationship of applicant to owner (same, employee, agent, etc) (j ter ; t2,,.AL f" A k Q
Mailing address of applicant m :. )x c,:- " l 1
.......Application is for: s
=s Sidewalk Cafe Merchandise Display
I . The length and width in feet of the public right-of-way to be used;
2. The number of tables and chairs to be provided at the Sidewalk Cafe:
3, Hours of operation of the Sidewalk Cafe or Merchandise Display:
Sunday: -u o i3 : until ( ;
Monday: until
Until ra
Tuesday: =
until
Wednesday: ;
Thursday: until
Friday: I until
Saturday:
b
Sidewalk elements of approved
ed means or dise displays must be change the layout without writtenly when authorization from the Planning and Zoning Manager.
business operations cease.
The applicant shall not replace the app
DOC NTS RE UIRED WITH APPLICATION
El Affidavit (must be notarized; see page 2)
Tj Indemnification Agreement (must be notarized, see page 3)
Certificate(s) of Insurance listing the City of Tybe Isla ndasidewalk ddea®and all itinal it ms to be placed on or within it (see page 4)
A Site Plan to scale with measuremen of the proposed
Photograph(s) of the sidewalk area ptional)
Date
Applicant's signature
Printed name t ,�� d° A rr r\ PJA -J t
HATE FEE APPROVE OR DENY BY $0.00
ROUTIPIG Sidewalk Use Fee
An application may regdve
City Marshal DIRECT
days or more to process.
DIRECT AN APPEAL OF PERMIT
DENIAL TO THE CITY MANAGER.
Planning & Zoning Manager
403 Butler Avenue, P.O. Box 2749, Tybee Island, Georgia 31328
(912) 472-5033 FAX (912) 786-9539
Lse aaf(q_,).cityoftybm or
72!14!2012
Page I of 6
AFFIDAVIT
. ..," . j rJ \J A r Yet
I d acting 5 1 - "� J i, °' e , in the capacity of Yom.
, owner, agent, employee, etc.
name
on behalf of the establishment known as i t " '`£ s i £' located at
bunness h.-
Tybee
ameT bee Island, Georgia, attest to the following.
;, street address
o I have reviewed this application and all entries are correct and accurate to the best of my knowledge.
o There are no omissions of fact.
o There are no items located on the sidewalk where the Sidewalk Cafe or Merchandise Display is proposed that would prohibit the
Planning and Zoning Manager from issuing a Sidewalk Cafe or Merchandise Display Permit.
o No violation(s) of Georgia Law, Federal Law, Local Ordinance, or any Rule or Regulation of the State Revenue Commissioner,
or any Rule or Regulation of the City of Tybee Island or Chatham County have been adjudicated against this business within the
last 12 months preceding the date of the application, or,
o The following violation(s) of Georgia Law, Federal Law, Local Ordinance, or Rule or Regulation of the State Revenue
Commissioner, or Rule or Regulation of the City of Tybee Island or Chatham County have been adjudicated against this
business within the 12 months preceding the date of the application:
o I have read the South End Policies and Procedures and will abide by said South End Policies and Procedures at all times during
the term of the Sidewalk Cafe or Merchandise Display Permit.
Notarized Signature:
Date:
_4�2a'_
Printed Name:
STATE OF GEORGIA
COUNTY OF C14ATHAM
The foregoing instrume t f acknowledged before me this day oft 2® 4 b y
(- who is personally known to me or who ation. "
rS&Z
HA o n®
°�®
w OTS �`®
�'�
® ,r
M -
Signature of Not P lic ` t I
' e. 202®
®®��®��w
y Commission expires: 0�4 ,
Ott X, Cad 1211412012
Page 2of6 111tH!",
INDEMNIFICATION AGREEMENT
� I
This Indemnification, Release and Hold Harmless Agreement is made this day of 20 by
t_ -L i Nrl-, i e , r' ("APPLICANT") for the benefit of the City Tybee Island, 'Georgia ("CITY"). When
referred to herein, the CITY means the Planning and Zoning Manager, the municipality, its City Council, and each member thereof,
and its officers, employees, advisory board members and representatives.
WHEREAS, the APPLICANT is the owner or lessee of the property located at i ." "'y "�tI Tybee
Island, Georgia; and,
WHEREAS, the APPLICANT has applied for a Sidewalk Cafe or Merchandise Display Permit for the temporary use of the sidewalk
area abutting the property described above pursuant to City Codes, ordinances, and policies and is required thereby to indemnify,
defend and hold and save the CITY harmless for its use of the public right-of-way (hereinafter collectively the "PROPERTY"); and,
VMEREAS, the APPLICANT is authorized to and has obtained all necessary approvals for this Agreement,
NOW, THEREFORE, in consideration of the CITY allowing the APPLICANT to use the public right-of-way for its Sidewalk Cafe
or Merchandise Display the APPLICANT agrees as follows:
1. The above recitals are true, and correct and are incorporated herein by reference,
1 The APPLICANT agrees to indemnify and hold and save the CITY harmless from any and all damages, loss or liability occurring
by reason of any injury of any person or property which may occur as a result or consequence of the issuance of the Sidewalk
Cafd or Merchandise Display Permit or the use of the PROPERTY by the APPLICANT or their family, officers, agents,
,representative, guests, employees, invitees, or persons contracting with either or any of them or occasioned by an act or omission,
neglect, or wrongdoing of the APPLICANT or their family, officers, agents, representative, guests, employees, invitees, or
persons contracting with either or any of them. APPLICANT will, at their own cost and expense, defend and protect the CITY
against any and all such suits, claims or demands which may be claimed to have arisen as a result or consequence of or in
connection with the issuance of the Sidewalk Cafd or Merchandise Display Permit or the use of the PROPERTY by the
APPLICANT or their family, officers, agents, representative, guests, employees, invitees, or persons contracting with either or
any of them or occasioned by an act or omission, neglect, or wrongdoing of the APPLICANT or their family, officers, agents,
representative, guests, employees, invitees, or persons contracting with either or any of them. Notwithstanding the foregoing, this
should not be construed so as to require the applicant or anyone else to indemnify the CITY for claims arising from the sole
negligence of the CITY, its agents, employees, or officers.
3. The APPLICANT does hereby remise, release, satisfy, quit claim, and forever discharge the CITY from any and all actions, suits,
claims or demands that they ever had, now has, or may have in the future against the CITY as a result of the granting of the
Sidewalk Cafd/Merchandise Display Permit or because of the use of the PROPERTY by the APPLICANT or their family,
officers, agents, representatives, guests, employees, invitees, or persons contracting with either or any of them.
4; The APPLICANT will maintain liability or other insurance as required by City codes, ordinances, and policies which shall name
the CITY as an additional insured and for which the CITY will be given a current certificate. Said liability or other insurance
shall provide coverage for any suit or claim arising from the issuance of the Sidewalk Cafd or Merchandise Display Permit or the
use of the PROPERTY by the APPLICANT.
5. The terms of this Indemnification A eement shall be binding upon and inure to the benefit of the parties and their heirs, legal
representatives, successors and as ' S.
Notarized signature: :,-__ lr/_�_Ok2_
Printed name: �,, (LA ,-i t lliT°ot
Date:
STATE OF GEORGIA
COUNTY OF CHATHAM
The for oing instrument was acknowledged before me this day of 1202- , by
i who is personally known to me or who has produce identification.
lt� l ttt
cj issi6
Signature of Not Pub ®°oo
My Commission expires: "•
® M;
co® 12/14/2012
Page 3 of 6 ®•��
Ui ' • .`
sa
ACC>RL)l` CERTIFICATE OF LIABILITY INSURANCE DATE (MM/aamvvp
1/13/2022
THIS CERTIFICATE IS ISSUED ASA 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), ATH RID
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the olicy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies 11kay require an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
Chatham Insurance Partners, LLC PHONe Jacquet n Tucker FAX
2502 Flabersham St. A/C No Ext): 912-650-2808 AA/C,—No),
E-MAIL ac uel n chathaminsurance-corn
Savannah GA 31401 AopaEss:) g - —
INSURER(s) AFFORDING COVERAGE NAIL #
_ L_i_cense#:202416 INSURERA: CINCINNATI INSURANCE COMPANY 10677
INSURED NAVOENT-01 INSURER B:
Silver Waves, Inc.
Funky Fish, Inc. INSURER C:
Insurance Department... INSURER D:
P.Q. Box 2497 INSURER E :
Tybee Island GA 31328
INSURER F
COVERAGES CERTIFICATE NUMBER: 250390394 REVISION NUMB
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
ADDL
SUBR
POLICY NUMBER
J POLICY EFF
MMMRffl YY
POLICY EXP
M LgR
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
Y
406 1st Street Tybee Island, GA 31328
ENP 0398909
9/1/2021
9/1/2022
EACH OCCURRENCE
$1,000,000
DAMAGE TO RENTED
._
_
CLAIMS -MADE OCCUR
PREMISES Ea occurrence)$
500,000
MED EXP (Any one person)
$ 5,000
PERSONAL &ADV INJURY
$1,000,000
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
GEN'L
PRO- ❑ LOC
POLICY I JO-
PRODUCTS - COMP/OP AGG
$ 2,000,000
OTHER
$
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
(Ea accident)_
$
BODILY INJURY (Per person)
$
ANY AUTO
ALL OWNED SGHEDULED
AUTOS AUTOS
----
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
NON -OWNED
HIRED AUTOS - AUTOS
$
UMBRELLA LIAB OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB CLAIMS -MADE
DEQ RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY ,r I N
PER OTH-
STATUTE ER
_
ANY PROPRIETOR/PARTNERFEXECUTIVE
E . EACH ACCIDENT
$
OFFICERIMEMBER EXCLUDED? ❑
NIA
----------
E.L. DISEASE - EA EMPLOYEE$
(Mandatory in NH)
If yes, describe under---
DESGRIPTION OF OPERATIONS below
E.L DISEASE -POLICY LIMIT
$
DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached it more space is required)
Aloha Gifts
25 Tybrisa Tybee Island, GA 31328
American Beachwear
17 Tybrisa Tybee Island, GA 31328
Waves
704 1 st Street Tybee Island, GA 31328
Island Style
502 1 st Street Tybee Island, GA 31328 W
Waves
27 Tybrisa Tybee Island, GA 31328
High Tide
406 1st Street Tybee Island, GA 31328
City of Tybee Island
401 Butler Avenue
Tybee Island GA 31328
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,DELIVERED
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORVED REPRESENTATIVE
® 1988-2014 ACORD CORPORATION, All rights reserved.
ACORD 2 (2014/01) The ACORD name and logo are registered marks of ACORD