Fillable COVID-19: TEMPORARY OUTDOOR (Incorporated Village of Sag Harbor)

Fill Online, Printable, Fillable, Blank COVID-19: TEMPORARY OUTDOOR (Incorporated Village of Sag Harbor) Form

Use Fill to complete blank online INCORPORATED VILLAGE OF SAG HARBOR (NY) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

COVID-19: TEMPORARY OUTDOOR (Incorporated Village of Sag Harbor)

On average this form takes 8 minutes to complete

The COVID-19: TEMPORARY OUTDOOR (Incorporated Village of Sag Harbor) form is 4 pages long and contains:

  • 0 signatures
  • 19 check-boxes
  • 25 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Incorporated Village of Sag Harbor

BROWSE INCORPORATED VILLAGE OF SAG HARBOR (NY) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
1
Version 1 – June 3, 2020
Village of Sag Harbor
Building Department
Thomas Preiato
Senior Building Inspector
55 Main Street, Sag Harbor, NY 11963
(631) 725-0224
TPreiato@sagharborny.gov
COVID-19: TEMPORARY OUTDOOR
DINING APPLICATION
NO FEE IS REQUIRED
(This permit will become in effect once the
Governor allows restaurants to re-open and shall
expire on November 1, 2020)
Three (3) copies of this application shall be delivered to the attention of the Senior Building Inspector either by
mail, email (PDF) or hand delivered to 55 Main Street, Sag Harbor, NY 11963. Please contact Tom Preiato
at 631-461-1827 with any questions or problems.
NAME OF BUSINESS: ___________________________________________________________________
Street Address: __________________________________________________________________________
SCTM #: ________________________________________________________________________________
Does this business have a Certificate of Occupancy for restaurant/food service use? ____ Yes ____ No
If no, this application for Temporary Outdoor Dining does not apply. If yes:
a. How many seats are currently approved for this establishment? ___________________________________________
b. How many seats are currently approved for outside seating? _____________________________________________
c. To comply with Covid-19 requirements, how many seats are proposed: Inside? _______ Outside? ______ (total may
not exceed seats in a.)
APPLICANT/CONTRACT VENDEE/LESSEE
Name: ______________________________Firm Name: __________________________________________
Street Address: ___________________________________________________________________________
City: __________________________________________ State: __________ Zip Code: ________________
E-MAIL: _______________________________________________ Phone: __________________________
__________________________________________________________________
Signature of Applicant/Contract Vendee/Lessee
VILLAGE OF SAG HARBOR
COVID-19: TEMPORARY OUTDOOR DINING APPLICATION
2
Version 1 – June 3, 2020
OWNERS CONSENT
Be advised that I am the owner of record of the property referenced herein and consent to this application. As owner, hereby authorize
employees or agents of the Village of Sag Harbor, in conjunction with this application, to enter and inspect the project site. I
understand that this permit shall expire on November 1, 2020 and that the Village shall retain the right to revoke this permit at any
time if deemed necessary.
Name: _________________________________________________________________________________
Address: _______________________________________________________________________________
Phone: ___________________________ Email: _______________________________________________
Signature: __________________________________________ Date:_______________________________
__________________________________________________________________
Signature of Building Inspector upon Approval
I. REQUIRED ITEMS FOR TEMPORARY OUTDOOR DINING APPLICATION
☐ 1. Submit plan showing location of proposed outdoor seating. Plan can be hand-drawn on an existing survey,
site plan or aerial map from Google Maps/Earth, Bing, etc.
☐ 2. Illustrate location of outdoor seating tables and/or chairs, service/customers aisle and pathway from
business to outdoor seating area. COVID-19 seating must be spaced at least 6 feet between patrons (see
illustration below as example for proposed outdoor seating plan).
☐ 3. A site plan showing where the proposed outdoor seating is to be located and indicating the number of
seats
1
. Show location of hand sanitizing stations and plans to maintain safe distancing for take-out, wait
staff and restroom queuing. Provide details regarding locations of canopies and methods of securing same.
☐ 4. Submit narrative plan indicating how tables, chairs, plates, utensils will be sanitized.
☐ 5. Insurance certificate naming the Village as an additional insured of for use of public right of way (if use
of sidewalk is proposed).
☐ 6. A copy of signed affirmation form acknowledging that you have read and understand your obligation to
operate in accordance with the State reopening guidance (see Page 4 of this application for a link to the
NY State website and form).
1
The total number of temporary outdoor dining seating shall not exceed 50% of the total permitted bar/restaurant occupancy approved
by the Fire Marshal or as indicated on the certificate of occupancy.
VILLAGE OF SAG HARBOR
COVID-19: TEMPORARY OUTDOOR DINING APPLICATION
3
Version 1 – June 3, 2020
II. ITEMS TO BE CONSIDERED IN REVIEW OF TEMPORARY OUTDOOR DINING
APPLICATIONS
☐ 1. COVID-19 outdoor seating must meet Fire Code standards, including points of egress, access
to fire extinguishers, and tent and awning ratings, if applicable. Seating shall not block
entrances, exits, fire lanes, hydrants, sprinkler connection points, drive aisles, back-up areas,
pedestrian or handicapped access.
☐ 2. COVID-19 social distancing accommodation areas, shall not be within 250 feet of a single-
family residences and shall only be utilized between the hours of 8:00 AM and 12:00 AM.
For areas within 500’ of single family homes, evening hours shall be reduced through 10
PM.
☐ 3. COVID-19 outdoor seating areas must be maintained and free of trash and other debris and
trash receptacles provided.
☐ 4. Restaurants with must comply with all New York State Liquor Authority permits, approvals
and any applicable laws to serve alcohol in the COVID-19 Outdoor Accommodation Area.
Nothing herein shall permit outdoor bars.
☐ 5. Outdoor loudspeakers, exterior live entertainment or dancing shall not be permitted without
approval of a Music/Entertainment permit
2
. No generators are permitted.
☐ 6. If a tent is to be used, a Tent Permit application is required.
☐ 7. Seating must not reduce sidewalk widths to less than 36”. For applications utilizing off street
parking lot areas, seating must not occupy or block handicap/ADA parking stalls or access
aisles and may not block ADA accessible routes.
☐ 8. Removal of existing natural areas or required buffers is not permitted. No proposals for
permanent structures or any construction that requires a Building Permit will be approved as
part of this temporary measure.
☐ 9. Outdoor use areas must not block fire access lanes.
2
Per Chapter 122 of Village Code.
VILLAGE OF SAG HARBOR
COVID-19: TEMPORARY OUTDOOR DINING APPLICATION
4
Version 1 – June 3, 2020
III. SUFFOLK COUNTY AND NEW YORK STATE REQUIREMENTS
☐ NY FORWARD SAFETY PLAN. Each business or entity, including those that have been designated as
essential under Empire State Development's Essential Business Guidance, must develop a written Safety
Plan outlining how its workplace will prevent the spread of COVID-19. Information is available at the
following website:
www.governor.ny.gov/sites/governor.ny.gov/files/atoms/files/NYS_BusinessReopeningSafetyPlanTemplate.pdf
A business may fill out the template to fulfill the requirement or may develop its own Safety Plan. This
plan does not need to be submitted to a state agency for approval but must be retained on the premises of
the business and must made available to the New York State Department of Health (DOH) or local health
or safety authorities in the event of an inspection.
Business owners should refer to the State’s industry-specific guidance for more information on how to
safely operate. For a list of regions and sectors that are authorized to re-open, as well as detailed guidance
for each sector, please visit: forward.ny.gov. If your industry is not included in the posted guidance but
your businesses has been operating as essential, please refer to ESD's Essential Business Guidance and
adhere to the guidelines within this Safety Plan. Please continue to regularly check the New York
Forward site for guidance that is applicable to your business or certain parts of your business functions.
Use the link below to access the form to affirm that you have read and understand your obligation to
operate in accordance with the State’s guidance: https://forms.ny.gov/s3/ny-forward-affirmation.
A copy of this affirmation must be submitted with the Temporary Outdoor Dining Application
☐ COVID-19 OUTDOOR SEATING IN FOOD ESTABLISHMENT. All outdoor seating in food
establishments must comply with the May 20, 2020 Suffolk County Department of Health Services
Guidance Memorandum (copy attached).
VILLAGE OF SAG HARBOR
COVID-19: TEMPORARY OUTDOOR DINING APPLICATION
5
Version 1 – June 3, 2020
COUNTY OF SUFFOLK
STEVEN BELLONE
SUFFOLK COUNTY EXECUTIVE
DEPARTMENT OF HEALTH SERVICES GREGSON H. PIGOTT, MD, MPH
Commissioner
May 20, 2020
GUIDANCE MEMORANDUM
OUTDOOR SEATING IN FOOD ESTABLISHMENTS
The Department of Health Services regulates the number of dining seats in food establishments, the
maximum allowable number of which is indicated on a facility’s operating permit. Approved indoor
seating may be temporarily relocated outside of the establishment without requiring a new application or
review of plans, provided the total number of seats indicated on the permit is not increased. The following
conditions must also be met:
No food preparation is permitted in exterior dining areas.
The facility does not undergo substantial remodeling, or make significant structural changes such
as adding building square footage or modifications that affect external water supply/wastewater
management infrastructure.
Relocation of dining seats must be compliant with all state and local codes.
Relocated exterior seating is subject to all COVID-19 recovery/reopening requirements, such as
social distancing and capacity reductions that are issued by the New York State Department of
Health or by executive order issued by the Governor.
For further information, please contact Christopher Sortino, Chief of the Bureau of Public Health
Protection, at (631) 852-5999.
BUREAU OF PUBLIC HEALTH PROTECTION
360 Yaphank Avenue, Suite 2A, Yaphank, NY 11980 (631) 852-
5999 | FAX (631) 852-5871
VILLAGE OF SAG HARBOR
ADDENDUM TO THE
COVID-19: TEMPORARY OUTDOOR DINING APPLICATION
1
June 5, 2020
ADDITIONAL GUIDANCE IN PREPARATION OF THE TEMPORARY OUTDOOR DINING APPLICATION
This additional guidance sheet to the Temporary Outdoor Dining Application has been prepared based upon
questions received since the application was released, and to incorporate the requirements for outdoor dining
contained in the NYS Guidance Memorandum issued on June 3, 2020 and Guidance from the State Liquor
Authority (SLA). We are here to help. Thank you for your patience.
New York State has authorized the “expansion of premises” for restaurants holding liquor licenses (see
sla.ny.gov/new-york-state-liquor-authority-guidance-outdoor-expansion-licensed-premises-response-covid-19).
The provisions allow a licensee to use contiguous outdoor space for the duration that the guidance remains in
effect (currently through July 3, 2020). Certain requirements apply and notice with an updated drawing to the
SLA must be submitted within 5 days. For those approvals that involve use of an area owned by others, submission
must include a letter from the municipality or other entity indicating authorization of outdoor use of the premises.
The outdoor seating Plan must contain enough detail to illustrate how the proposed tables, seats, access and
other details will comply with the NYS Guidance. If a base map is not to be used, the map must provide details
such as the building outline, location of entrances/exits, interior details as needed, dimensions of outdoor area
and access path to the outdoor seating area. Use labels and symbols as needed for clarity.
Plan must note the scale of the drawing & include critical measurements to demonstrate that all tables with seats
will be separated by at least six feet in all directions from any other tables, seats, patrons, or pedestrian
thoroughfares or corridors. This includes any doorways and frequently used routes (to serving stations, kitchen,
restrooms).
Where safe distancing is not feasible between tables (and thoroughfares), physical barriers may be used. The
physical barriers must be at least five feet in height and must not block emergency and/or fire exits.
The issuance of a temporary approval will follow an inspection of the actual layout of tables/chairs in place or, if
furniture is not available at the time, the applicant may illustrate the table/seating using tape. (Note that this
does not apply for new proposals for sidewalk dining).
The temporary outdoor seating will be subject to inspections throughout the season and may occur at any time
when the restaurant is serving.
Bar seating where authorized, may occur provided a distance of at least six feet between parties can be maintained
and staff may keep a distance of at least six feet from one another and customers when possible.
Restaurants may plan for larger parties with moveable tables, as long as the six feet distance in all directions is
maintains (with a maximum of 10 individuals per table).
Applications which are complete and contain detailed plans which clearly demonstrate conformance with the
State Guidance will help us to help you through this application process. The Village Planner and Building
Department will expedite review of applications to the extent possible to allow restaurants that can safely
accommodate outdoor dining as soon as possible.
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

COVID-19: TEMPORARY OUTDOOR (Incorporated Village of Sag Harbor)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 16 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document