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HomeMy Public PortalAboutSEAGULLS.pdfCITY OF TYBEE ISLAND SIDEWALK PERMIT APPLICATION CAMERCHANDISE DIS Business name strut address Mailing address Phone numbers of owner: Business Name of applicant if other than owner: 1 Phone numbers of applicant: Business Relationship of applicant to owner (same. arrsplovee, agent, etc) ailing address of applicant Home Ott* Home Mobile Application is for: Sidewalk Cafe ErMerchandise Display 1. 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: 55'. (DO P til 1 a aD P Monday: until -__4 Tuesday: until Wednesday : until Thursday: until Friday: _— until Saturday: until Sidewalk elements of cafes and merchandise displays must be secured daily when normal business operations cease The appticaru shall not replace the approved itencr or change the layout without wrinen authorization from the Planning and Zoning Manager DOCUMENTS REQUIRED WITH APPLICATION O Affidavit (must be notarized, see page 2) O Indenuufication Areement (must be notarized: see page 3) O Certificate(s) of Insurance listing the City of Tybee Island as an additional insured (see page 4) O A Site Plan to scale with measurements of the proposed sidewalk area and all items to be placed on or within it (see page 4) • Photograph(s) of the sidewalk area (optional) Applicant's signature rl ll i Nad°11 Date l tzAo�3 Printed name ROPTR4G Cm, M,arrnal PIaanin, & Zomn; Manager Page 1 of 6 APPROVE OR DEAN' BY FO OFFICE USE ONLY axe Rectiv d new of Ptenemd Drees. Mum DATE 103 Buder Avenue, P 0. Box 2749, Tybee Island. Georgia 31328 1912) 472-5033 FAX (912) 786-9539 I Schaaf ii citvoftybee.©rg S,.:e amik use ra SD An applieatbn may require IC days or more to prom% DIRECT AN APPEAL OF PERIM DE. nAL TO THE CITY MANAGER. 12/14/201. AFFIDAVIT , acting m the capacity of OW flt r on behalf of the establishment known as J Q G � i-� r' -S located at 6.awar war cg 5 Tuft; sue. S4- Tybee Island, Georgia, anest to the followings �I have reviewed this application and all entries are correct and accurate to the best of my knowledge. ei/ There are no otnusions of fact. 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. c/ 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 ine last 12 months preceding the date of the application, 2L - 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 die 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 tithes during the term of the Sidewalk Cafe or Merchandise Display Permit �otanzee Signanue. Printed Name: t.)..2 -1\V• Q-*••• ci AJ 0 r STATE OF GEORGIA COUNTY OF CHATHAM The foregoing insnunent was aclmow,edged before me this I2 day. of Sias. , e ofN My Comrnission expires Pagr 2 of Date li?4.7.p 72 INDEMNIFICATION AGREEMENT (RELEASE AND HOLD HARMLESS AGREEMENT) This Indemnification. Release and Hold Harmless Agreement Li trade this dal of . ,20A3 by tVt \wuNkNowc l' ("APPLICANT') for the benefit of the City Tybee Island Georgia "CITY", R'titee 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 APPLICAN I. is the owner or lessee of the property located at ra' i� Island, Georgia; and WHEREAS, the APPLICANT has applied for a Sidewalk Cafe or Merchandise Display Permit for the temporary uusc of the sidev alt. area abutting the property described above pursuant to City Codes, ordinances, and policies and is required thereby to indemnify defend and hold and sane the CITY harmless for iu use of the public tight -of -way i hereinafter collectively. the "PROPERTY , and. WHEREAS, the APPLICANT is authorized to and has obtained all necessary approvals for this Agreement. NOW, THEREFORE, m consideration of the CITY allowing the APPLI(.ANT to use the public right-of-way for its Sideµali, raft. or Merchandise Display the APPLICANT agrees as follows.. 1 a . rybee !he above recitals are true and correct anc are incorporated heroin by reference. The APPLICANT agrees to indemnify and hold and save the CITY harmless from any and all damages, ,oss 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 Cafe or Merchandise Display Permit or the use of the PROPERTY by the APPLICANT or their family, officers agents, representative, guests, employees, uavittes, or persons contracting with either or any of them or occasioned by an act or omission.. neglect, or wrongdoing of the APPLICANT or their fmmily, officers, agents, representative, guests, employees, invitees, or persons contracting with either or any of therm APPLICANT will. at their own cost and expense, defend and protect the CITY against any and ail such suits, claims or demands which cnay be claimed to have arisen as a result or consequence of or tr. connection with the issuance of the Sidewalk Cafe or Merchandise Display Permit or the use of the PROPERTY by the APPLICAN7 or thew family, offcers, agenrs, 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 anti of them, Notwithstanding the foregoing this should not be construed so as to require the applicant or anyone else to indemnify the CITY for clair7.: arising frorn the sole negligence of the CITY its agents. employees, or officers The APPLICANT does hereby rernse, release; satisfy. quit claim, and forever discharge the CITY from any and ail actions. suits claims or demands Mat they ever had, now has, or may have in the future against the CITY as a result of the granting of the Sidewalk Cafe/Merchandise Display Permit or because of the use of the PROPERTY by the APPLICANT or their family officers, agents. representatives, guests, employees, invitees, 3r aersons contracting with either or any of them a The APPLICANT will maintain liability or other insurance as required by City codes, ordinances, and polities which shall name the CITY as an additional insured and for which the CITY will be oven a current certificate. Said liability or other insurance shall provide coverage for any suit or claim arising from the issuance of tilt. Sidewalk Cafe or Merchandise rD:splay Permit or the use attic PROPERTY by the APPLICANT 5 The terms of this Indemnification Agreement shall be binding upon and iri.rre to the benefit of the parries and their heirs, legal representatives, successors and assigns 'Notarized signature !"- Printed name ti ` G.. -.. Q .a t n'7 Date STATE OF GEORGIA COUNTY OF CHATHAM The foregoing msnument was acknowledged before me this 12 day of bit \ ti 6.,h. I\3Cs.J er- who is persa VtA !tbFo• N° �.f V f� S�rr L ci '�iss.••• d'c�'�i 5iga ure of 1lotasy P,r4 lie .' c 4 G �t� %�iggCn s, r{ My Commission expires 1 t S i - 02 m• Page 3 ?i 6 2 % 'Q25 try: O : •0 %, "y Vi •COW.V"` l *�. —rrtotoiA .1,11uQt .20,P3 bas produced identification, 12144012 • ILJ • — ` - - 1.1 s. Gri fir 411i 4 ,3T. Wm. (5 0 p•ri Psi% 12. 46,44 cL7ors AGENCY CUSTOMER ID: NAVOENT-01 LOC #: AC D� ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Chatham Insurance Partners, LLC POUCY NUMBER CARRIER NAMED INSURED Funky Fish, Inc. Insurance Department P.O. Box 2497 Tybee Island GA 31328 NAIC CODE EFFECTIVE DATE: ADDMONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Davis 222, LLC -10 17th Place, Tybee Island, GA 31328 1402 6th Avenue, LLC - 1402 6th Ave, Tybee Island, GA 31328 Southeast Marketing (USA), LLC -103 Lewis Ave, Tybee Island, GA 31328 5th Avenue Rental, LLC -1305 5th Ave, Tybee Island, GA 31328 ACORD 101 (2008(01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACc Re CERTIFICATE OF LIABILITY INSURANCE DATE112/2023rn 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 WANED, 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 Chatham Insurance Partners, LLC 2502 Habersham St. Savannah GA 31401 License*: 202416 NAMECONTACT Jacquelyn Tucker PHONE FAX , NQ Exu: 912-650-2808 IA/C. No): ADPORESs: Iacquelynlachathaminsurance.com INSURER(S) AFFORDING COVERAGE HAIC INSURER A : CINCINNATI INSURANCE COMPANY 10677 INSURED NAVOENT-01 Funky Fish, Inc. Insurance Department P.O. Box 2497 Tybee Island GA 31328 INSURER B : Nutmeg Insurance Company 39608 INSURER C : INSURER 0 : INSURER E : /NSURER F : COVERAGES CERTIFICATE NUMBER: 116845954 • 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 D SUBR _WELL POLICY NUMBER POUCY EFF MMFQD/YYYY1 POLICY EXP IMM/OD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY Y ENP 0398909 I 9/1/2022 9/1/2023 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 500,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY 51,000,000 GEN'L AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG 5 2,000,000 S A AUTOMOBILE X — X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS X SCHEDULED AUTOS NON -OWNED AUTOS ENP 0398909 9/1/2022 911/2023 COMBINED SINGLE LIMIT (Ea axpent) $ 1 000.000 BODILY INJURY (Per person) $ BODILY INJURY(Per accident) $ PROPERTY DAMAGE (Per accident) $ UMBRELLA UAB EXCESS LIAR _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes. describe under DESCRIPTION OF OPERATIONS below N / A 20WECAH4OZB 8123/2022 8/23/2023 X PER OTH- STATUTE ER E.L. EACH ACCIDENT 5500,000 E.L. DISEASE - EA EMPLOYEE S 500,000 E.L. DISEASE - POLICY LIMIT 5 500,000 DESCRIPTION OF OPERATIONS! LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more apace is required) RE: Short Term Rental Dwellings City of Tybee Island is listed as Additional Insured as required by written contract with respect to the following locations: Funky Fish, Inc. - 23 Tybrisa St, Tybee Island, GA 31328 Silver Waves Inc. - 27 Tybrisa Ave, Tybee Island, GA 31328 Funky Fish, Inc. - 211 Butler Ave, Tybee Island, GA 31328 Funky Fish, Inc. -1415 Butler Ave, Tybee Island, GA 31328 104 18th Street, LLC -104 18th St, Tybee Island, GA 31328 15 15th Street, LLC -15 15th St, Tybee Island, GA 31328 See Attached... ANCELLATION City of Tybee Island P.O. Box 2749 Tybee Island GA 31328-2749 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2014101) O 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD