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HomeMy Public PortalAboutFANNIES.pdfCITY OF TYBEE ISLAND SIDEWALK CAFE OR MERCHANDISE DISPLAY PERMIT APPLICATION Business name F•iKrii eS Dm i-i44 Bea Street address (c ( 3 i 7 Mailing address D6. aoX 39, g' Towner: (l, (,4 3(3Z't Name of business 3— N NI0 Z_ Email fa pi n ;e4 °}i,°Ai, e Q . 0 , (gyp V's Phone numbers of owner: Business oo7_--12,6 4101 Home Mobile GI ii fII mo'+ 5 4 Z7 Name of applicant if other than owner: Email Phone numbers of applicant: Business Home Mobile Relationship of applicant to owner (same, employee, a< t, etc) Mailing address of applicant 7 Application is for: I Sidewalk Cafe 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: 11 A -v s until 1 -e Monday: until Tuesday: until Wednesday: until Thursday: until Friday: 11_ AAA until .&rP%. Saturday: 1 I X7`^ until 1 2 .►V' V Merchandise Display �c FOR OFFICE U.SE ON£Y Date Received New or Renewal License ,Vumt,er Sidewalk elements of cafes and merchandise displays must be secured daily when normal business operations cease. The applicant shall not replace the approved items or change the layout without written authorization from the Planning and Zoning Manager. DOCUMENTS REQUIRED WITH APPLICATION O Affidavit (must be notarized; see page 2) O Indemnification Agreement (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) O Photograph(s) of the sidewalk area (optional) Applicant's signature �4, (/ N Wiz-.- (Z- ©IZI2._ Printed name Date 312''4I23 ROUTING APPROVE OR DENY BY DATE FEE City Marshal Sidewalk Use Fee $0.00 An application nwny requue 30 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 Lschaaf@cityoftybee.org Page 1 of 6 12/14/2012 AFFIDAVIT I, "aC W.11 r 1 , acting in the capacity of ®W P•4 5 ?- name owner, agent, employee, etc. on behalf of the establishment known as F ' M CS �4 1 'r G÷i business name 1 (it S'n2 C� , Tybee Island, Georgia, attest to the following: street address located at e" I have reviewed this application and all entries are correct and accurate to the best of my knowledge. of There are no omissions of fact. aV 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 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: X / Date: Printed Name: 312-4123 STA 1h OF GEORGIA COUNTY OF CHATHAM The foregoing instrument was acknowledged before me this eR Li day o , `/fr_____ , by ►2. e of Notary Pu My Commission expires: Page 2 of 6 who is personally known to me or who has produced identification. Sharon S. Shaver Wttary-PubticTeisatham County, GA Commission Expires December 4, 202:- 12/14/2012 INDEMNIFICATION AGREEMENT (RELEASE AND HOLD HARMLESS AGREEMENT) This Indemnification, Release and Hold Harmless Agreement is made this 29 day of , 20 23 , by — i')"'h i 2_-- c ("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 1 (o (3 <;' Y2. , 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, WHEREAS, 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, 2. 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 Cafe 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 Cafe 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 Cafe/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 Cafe or Merchandise Display Permit or the use of the PROPERTY by the APPLICANT. 5. The terms of this Indemnification Agreement shall be binding upon and inure to the benefit of the parties and their heirs, legal representatives, s - -ssors d assi Notarized signature: Printed name: l(-217/1-- (2- ai2d_ Date: STATE OF GEORGIA COUNTY OF CIIA`IIIAM The foregoing instrument w was acknowledged before me this Si ure of Notary My Commission expires: Page 3 of 6 4_,day of M (3 H , 2a3 , by who is personally known to me or who has produced identification. Sharan S. Shaver Netaey Public, Chatham County, GA My Commission Expires December 4, 2023 12/14/2012 /// ACS CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 03/27/2023 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 Inc P 0 Box 774 Tybee Island, Ga 31328 INSURED Orriginal Restaurant DBA Fannies on The Beach PO Box 39 Tybee Island Ga 313278 CONTACT • NAME: Carne Traeger 1 FAX No): 912-786-8707 PHONE O,EStl:_912-788-5541 X ADDRESS: traegerc©bell,Eauth net INSURERS) AFFORDING COVERAGE INSURER A : Scottsdale INSURER B : INSURER C : INSURER D : INSURER E INSURER F : NAIC X REVISION NUMBER: THIS IS TO CERTIFY THAT INDICATED. NOTWITHSTANDING CERTIFICATE MAY BE ISSUED EXCLUSIONS AND CONDITIONS INSR LTR ' TYPE OF INSURANCE THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ANY REQUIREMENT, TERM OR CONDITION OF ANY OR MAY PERTAIN, THE INSURANCE AFFORDED BY OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED ISSUED 70 CONTRACT THE POLICIES BY POLICY EFF (MMIDOIYYYY) THE INSURED NAMED ABOVE FOR THE POLICY PERIOD OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, PAID CLAIMS. POLICY EXP i IMM/ODIYYYY) ' LIMITS ADDL INSR SUBR; WVD , POLICY NUMBER GENERAL LIABILITY EACH OCCURRENCE $1,000 000 YDRENTEO 1 X COMMERCIAL GENERAL LIABILITY :DAMAGE PREMISES (Ea occurrence $ 100,000 I X CLAIMS -MADE OCCUR MED EXP (Any one person) S 5,000 A i CPS7595028 06/04/2022 06/04/2023 PERSONAL 8 AOV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S 2,000,000 I X i POLICY I 1 PRO- I LOC S AUTOMOBILE LIABILITY E COMBINED SINGLE LIMIT S 1 ANY AUTO i BODILY INJURY (Per person)- I S I ALL OWNED SCHEDULED 1 BODILY INJURY (Per accident) i S AUTOS AUTOS 1.PROPERTY DAMAGE NON -OWNED , S ' HIRED AUTOS AUTOS , (Per accident) IS , I UMBRELLA LIAB I Ii 1 OCCUR ' �' OCCURRENCE_ $ EXCESS LIAB r CLAIrAS-MADE 1 _EACH i AGGREGATE $ i _.. { - DED �COMPENSATIONN $ S WORKERS WC STATU- I I OTH-' I TORY AND EMPLOYERS' LIABILITY Y / N t LIMITS..f._ _ _. ONYFF CE/MEMBER EACH IDENT , EXCLUDED/EXECUTIVE OFFICE/MEMBEREXCLUDED? $7 NIA' E L DLS____ If yes, describe under j S DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT I DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H more apace is required) Coverage on 3 Story Restaurant known as Fannies on The Beach located at 1613 Strand Ave Tybee Island Ga 31328.This also covers the tables located on the sidewalk in front of the restaurant and has the City of Tybee Listed as additional insured for the tables. CERTIFICATE HOLDER City of Tybee Island CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEL„LEP BFFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHO RIZEpREPRES ENTATIVE Carrie Traeger/Tybee Island Insurance Agency Q 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD Clear All