Montclair Townhouse Condo
Receivj.d: 2/27/09 :;,: I I r-M, \.....,.~,---
FEs-2'r-2~ \31:42P FROM:TOWN CLERK
(845)298-1478
TO: 4622272
P.2
Town Clerk
Office: 845.297.5771 '" Fax: 845.297.4558
www.townofwappinger.us
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TOWN OF WAPPINGER
P.O. BOX 324 - 20 MIDDLEBUSH ROAD
W APPINGERS FALLS. NY 1 2590
Agreeme t For The Use Of The Town Hall Facilities For Meetings
,4rJ /106m &,v'T
?'is--- Lj~)-- J~ 70
Phone No.
This will confirm the arrangements being requested for your groups' use of the Wappinger Town Hall
Facilities, as noted below:
( )/ Senior Citizens Room
('1 Large Meeting Room
() Other: Specify:
The group is npt ex~cted to exceed JrS' persons .-J- 9
Date(s): LJ"d-,.. d d, 7' OM" h "'< r 1 'i I ZO I' Time: b :trI/)(n UJ .' 3 Olt??
It should be understood that groups using the Buildings' Facilities for evening meetings must select
dates when Town Meetings are normally scheduled (i.e., Justice Court, Planning Board, etc.) Special
requests will be considered upon their own merit, and arrangements can be made for access to, and
closing, the building at the close of your meeting.
You and your Organization hereby agree to adhere to the rules set forth on the attached page by
signature of an authorized member of your Organization or group.
The Town of Wappinger reserves the right to suspend tempor21rlly this agreement should the Town
have need of the facility for Its own purposes. Advance notice will be given as soon as possible on
such occasions.
The Town Clerk should be informed promptly of any schedule change or cancellation of your group
activities. Arrangements for access to specific area to be used should be made with the Town Clerk
at the time this form Is submitted.
No application shall be considered approved until it has been submitted to the Town Clerk for review
and clearance.
Terms of this agreement must be strictly adhered to by the contr21cting group as any disregard or
abuse of the rules for use of the facilities will result in termination of use by the offending group, and
they will not be granted reinstatement.
TOW04S,TC.1l!F (4.03 Rev) I of3
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Receiv~d: 2/27/09 5:12PM; (~40'<!l:lC- \""0
FEB-2."-2009 131: 42P FROM: TOWN CLERK
,
(845)298-1478
TO: 4622272
P.3
Town of Wappinger Town Clerk
Agreement for the use of the Town Hall Facilities for Meetings
Approved:
I have read and understand the rules and regulations for the use of the Facilities in the Town of
Wappinger Town Hall, and will comply with these requirements.
Sign~~ .
For:_. _ ~
(Name of Group or Organization)
Dated: ?vr'- II
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Date:
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Sent By:_Town & Country Property Mgmt;
"',.ce~v.d: 1 01 3/11 : g:47AN1;
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Page 3/3
Fro.:Donn Gerell I : Assoe Insurance
9142713598
10/03/2011 08:27
1434 P.003/003
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Additiaul c:overage!S and Factors
Line of Bus;"" eov.rages for
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_New York State Insurance Fund
Workers' Compensation & Disability Benefits Specialists Since 1914
199 CHURCH STREET, NEW YORK, N.Y. 10007-1100
Phone: (888) 997-3863
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
^ ^ ^ ^ ^ ^ 222838233
MONTCLAIR TOWNHOUSES CONDO ASSOC
% TOWN & COUNTRY PROPERTY MGMT
3 NEPTUNE ROAD-SUITE A19A
POUGHKEEPSIE NY 12601
POLICYHOLDER
MONTCLAIR TOWNHOUSES CONDO ASSOC
% TOWN & COUNTRY PROPERTY MGMT
3 NEPTUNE ROAD-SUITE A19A
POUGHKEEPSIE NY 12601
CERTIFICATE HOLDER
TOWN OF WAPPINGER FALLS
20 MIDDLEBUSH ROAD
WAPPINGER FALLS NY 12590
[POLICY NUMBER~'CERTIFICATE NUMBER
L.._ G 1217 706':'~_.---.L~660495_~___
DATE l
8/10/20~__1
PERIOD COVERED BY THIS CERTIFICATE
03/29/2011 TO 03/29/2012
THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE
FUND UNDER POLICY NO. 1217 706-9 UNTIL 03/29/2012, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER
FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL
OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW.
IF SAID POLICY IS CANCELLED, OR CHANGED PRIOR TO 03/29/2012 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE,
10 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE.
NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. THE NEW
YORK STATE INSURANCE FUND DOES NOT ASSUME ANY LIABILITY IN THE EVENT OF FAILURE TO GIVE SUCH NOTICE.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE
COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER
THE COVERAGE AFFORDED BY THE POLICY.
ell (J) Ii - [}6 f~_ h-) G loiucr
JnPJJ.tO (:0.).'1- ".J \~(, h
7J a I A. - DIRECTOR,INSURANCE FUND UNDERWRITING
This certificate can be validated on our web site at https:/Iwww.nysif.com/certlcertval.asp or by calling (888) 875-5790
VALIDATION NUMBER: 1000237414
NEW YORK STATE INSURANCE FUND
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TOWN &COUNTRY
PROPERTY MANAGEMENT
August 10, 2011
Mr. Christopher Masterson
T own Clerk - Town of Wappinger
20 Middlebush Road
Wappingers Falls, NY 12590
Re: Montclair Townhouse Condominium
Annual Homeowners' Meeting - October 19,2011
Dear Mr. Masterson,
Enclosed please find the following pertaining to the reservation of the large meeting room at the
Town of Wappinger Town Hall on Wednesday, October 19th, 2011, 6:00pm to 9:30pm for the
Montclair Annual Homeowners' meeting:
. Signed Agreement for the use of the Town Hall facilities
. Certificate of Insurance noting the Town of Wappinger as an Additional Insured
. Check No. 2360 of Montclair Townhouse Condo payable to the Town of Wappinger in the
amount of $100.00
Thank you for your assistance in this matter.
'"
Ips
Enclosures
3 Neptune Road, Suite AI9A, Poughkeepsie. NY 12601 tel. 845.462.2270 fax 845.462.2272
e-mail cownandcountrypropertymgmt@att.ner
Duman Group Managers
ABO Safety Group Manager
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ASSOCIATED BUILDERS AND OWNERS
OF GREATER NEW YORK, INC.
August 10, 2011
Town of Wappinger Falls
20 Middlebush Road
Wappinger Falls, NY 12590
Re: Certificate of Insurance
Policy # 1217 706-9
Montclair Townhouses Condo Assoc
Dear Sir/Madam:
As requested, please see the enclosed Certificate of Workers' Compensation
Insurance for the above referenced policy.
Thank you for your time and assistance.
Since.. rely,. \
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Mat ewJ.Duman
Matt@durnangroup.com
Phone# 212-768-9191
Fax#516-678-7081
Enc:
MJD: dp
ABO Safety Group #561 Office Locations:
80 Maiden Lane, Suite 1503, New York, New York 10038 . 212-768-9191 . Fax 212-385-1442
15 Front Street, P. O. Box 390, Rockvi lie Centre, New York 11571 . 516-764-4000 . Fax 516-678-7081
Town of Wappinger
20 Middlebush Rd
Wappingers Falls, NY 12590
(845) 297-5771
RECEIPT
#44546
08/24/2011
Management, Montclair Townhouse
Ck # 2360
Received $ 100.00 for Building Use Fee, on 08/24/2011. Thank you for stopping by the Town
Clerk's office.
As always, it is our pleasure to serve you.
John C. Masterson
Town Clerk