Board of Elections2010-01-19 JCM
FOR INTERNAL USE ONLY
Received by: Christine Fulton ,~},
Jessica Fulton D
Date Received: ~a / ~~ / O} ~'"
Serial #:
Application ^ $100.00 "^ Cert. of LI
^ Notified Recreation (date:_,~
Town of Wappinger
Agreement for the Use of the Town
Hall Facilities for Meetings
Agreement for the Use of the Town Hall Facilities for Meetings
! ~ is.-F- ~ h u r, +~„~~ n ~ r cl o-~' ~ I e ~ -tin ~ S
Name of Organization or Group
rnhn"~°~si~,n r~ Erg ~ l~cught a FrC,nc.e s KnC~~i~
Name of person representing the Organization or Group
Address
Phone No.
This will confirm the arrangements being requested for your groups' use of the Wappinger Town Hall Facilities, as
noted below:
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Senior Citizens Room
Large Meeting Room
Other: Specify:
The group is not expected to exceed ersons
Date(s): ~ ~.-~! ~ ~ a ~~C ~.~ r ~ I i ~ ~ ~ l~ II iT Time: ~! ~ a N ~ I ~. 9' C~ - a b (~ a - I ('• 3 Da.w, ~O = D U ~o w
11 }~ O2 - S: i 5 fpm -- io~.oo pm
It should be understood that groups using the Buildings' Facilities for evening meetings must select dates when
Town Meetings are normally scheduled (i.e., 3ustice 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 temporarily 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 youz group activities.
Arrangements fox 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.
I
2010-01-19 JCM
Terms of the agreement must be strictly adhered to by the contracting group as any disregazd or abuse of the rules
for use of the facilities wiIl result in termination of use by the offending group, and they will not be granted
reinstatement.
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 ese requirements.
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Signed:
For: _ ~ u-F C~~ne S S ~uVl~'`i ~oQ ~"G~ O~ ~ ~ CC '1-i D t~ S
(Name of Crroup or Organization)
Date: ~31.~~z-- -
Approved:
Tvwn Clerk
Date:
COPY
2012-90
Resolution Authorizing Use of Town Hall Meeting Room as Poll Site
At a regular meeting of the Town Board of the Town of Wappinger, Dutchess County,
New York, held at Town Hall, 20 Middlebush Road, Wappingers Falls, New York, on February
13, 2012.
The meeting was called to order by Barbara Gutzler, Supervisor, and upon roll being
called, the following were present:
PRESENT: Supervisor
Councilmembers
ABSENT:
Barbara Gutzler
William H. Beale
Vincent F. Bettina
Michael Kuzmicz
Ismay Czarniecki
The following Resolution was introduced by Councilman Beale and seconded by
Councilman Kuzmicz.
WHEREAS, the Dutchess County Board of Elections has requested the use of the Town
Hall meeting room for use as a poll site for the presidential, federal and state primary elections as
well as the general election scheduled for calendar year 2012; and
WHEREAS, the Town Board is willing to authorize use of the main meeting room in the
Town Hall building upon the terms hereinafter set forth.
NOW, THEREFORE, BE IT RESOLVED, AS FOLLOWS:
1. The recitations above set forth are incorporated in this Resolution as if fully set
forth and adopted herein.
2. The Town Board hereby authorizes the Dutchess County Board of Elections to
use the main meeting room in the Town Hall building located at 20 Middlebush
Road, Wappingers Falls, New York for the following federal and state primary
elections as well as the general election:
Election
Presidential Primary
Federal Primary
State Primary
General Election
Date Time
Tuesday, Apri124, 2012 11:30 AM to 10:00 PM
Tuesday, June 26, 2012 11:30 AM to 10:00 PM
To be announced after date is scheduled.
Tuesday, November 6, 2012 5:15 AM to 10:00 PM
3. The Town Board hereby authorizes the Dutchess County Board of Elections to
use the main meeting room in the Town Hall for use as a poll site for the
presidential, federal and state primary elections as well as the general election
scheduled for calendar year 2012 on the express condition that the Town of
Wappinger is named as a certificate holder under the Dutchess County Board of
Elections' general liability policy with said coverage to be in the minimum of
$1,000,000 per occurrence; said certificate of insurance to be in form acceptable
to the Town's Insurance Consultant and Attorney to the Town.
4. The designation of the Town of Wappinger main meeting room as a poll site is
authorized pursuant to New York State Election Law § 4-104 and the Town
Board hereby waives any fees or costs associated with the use of the main
meeting room as a poll site.
5. The Town Clerk and/or the Town Supervisor is hereby authorized to complete
and sign the 2012 Poll Site Agreement, Contact Information and Poll Site
Questionnaire on behalf of the Town of Wappinger, copies of which are affixed
hereto.
6. The Town Board acknowledges that the main meeting room will be used as a poll
site for three separate election districts and agrees to provide one (1) table and
four (4) chairs for each of the aforementioned districts.
The foregoing was put to a vote which resulted as follows:
BARBARA GUTZLER, SUPERVISOR Voting: AYE
WILLIAM H. BEALE, COUNCILMAN Voting: AYE
VINCENT F. BETTINA, COUNCILMAN Voting: AYE
ISMAY CZARNIECKI, COUNCILWOMAN Voting: ABSENT
MICHAEL KUZMICZ, COUNCILMAN Voting: AYE
Dated: Wappingers Falls, New York
2/13/2012
The Resolution is hereby duly declared adopted.
,~
HRISTINE FULTON, TOWN CLERK
~~
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Dutchess County Board of Elections (~ ~
47 Cannon Street ~'' ~ ~~
Poughkeepsie, NY 12601
(845) 486-2473
2012 Poll Site Agreement
Please read the following information in its entirety and sign the agreement below authorizing the use of
your facility as a poll site for the 2012 elections. Please return it to us along with the Contact
Information Sheet in the enclosed envelope.
1. Delivery of the machines will require a signature on the "Voting System Transportation
Manifest" confirming that the machines were delivered and received by the poll site in order to
maintain the chain of custody. You can expect the delivery of the machines the Thursday or
Friday prior to the election date and pick up 1-2 days after the election. You will be notified
of the delivery date when it is determined.
2. Entrance through accessibility ramps must be allowed for delivery of the machines.
3. Poll site must be opened at the designated time to allow for set up of the machines and the
appropriate equipment.
4. It is important that the attached contact sheet indicates the name and phone number of someone
that can be reached before and after your operating hours.
5. Adequate heat, light and access to an electrical outlet must be provided for each Election
District. In some instances, two or more outlets may be required. Adequate light must be
provided in the parking lot.
6. Adequate space -the voting system requires space to accommodate the voting machine(s) as
well as the voting booths. Please have voting area clear of extra furnishings prior to the arrival
of inspectors.
7. Adequate number of tables and chairs for inspectors and the public must be provided; one table
and four chairs are required for each election district in your building.
Poll Site Name: Town of Wappinger Town Hall
Poll Site Address: 20 Middlebush Rd., Wappingers Falls
Number of Election Districts at PoIl Site: 3
Presidential Primary: Apri124, 2012 Hours: 11:15 a.m. to 10:00 p.m.
Federal Primary: June 26, 2012 Hours: 11:15 a.m. to 10:00 p.m.
State Primary : To be Announced Hours: 11:15 a.m. to 10:00 p.m.
General Election: November 6, 2012 Hours: 5:15 a.m. to 10:00 p.m.
Authorization:
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Contact Information
For your convenience as well as that of the Board of Elections, it is essential that we have reliable
contact information. This is how we notify you of machine deliveries and guarantee that your facility is
accessible for these deliveries. On Election Day, it is how we ensure that poll workers and voters have
access to the poll site at the designated time before the polls open.
Please provide all contact information as follows:
Person to Contact During Business Hours:
Name: ~~ C1tt,~1 !~ L~-Phone: o~~ ~ - a 7 ~~ email: ~L117_~-`r~ TDI,t~~ ~~ 11~1A(-~~,~"'~
Cell: ~ `~zJ ~ ~-It-I • `I~ ~3~
Person to Contact Before or After Business Hours:
Name~~r.~~`~ZPhone:
email: l~C~~.l,~ ~ ~ 1 ~ ~ ~ `I~IgFp+~Y.~ t.Y ~ U S .
Cell: ~~ ~~~ ~~~~
Also, please be sure to provide an email address for anyone else that you wish to receive
communications. This should be an address which is checked daily in the weeks leading up to an
election. This will allow the Board to notify all poll sites of any important information that may anise.
Email address: C ~1.11.~CO~ ~~ (~jltxl C3PC ~~ - u5
Poll Site Name: Town of Wappinger Town Hall
Poll Site Address: 20 Middlebush Rd., Wappingers Falls
Number of Election Districts at Poll Site: 3
POLL SITE QUESTIONNAIRE
1. Please indicate your normal business hours so that we may acconunodate you when
delivering voting machines and other supplies. if you require extra advance notice
regarding delivery of machines, please contact our office.
2. Please give the full name/street address of the poll site if different from the address
listed below:
3. Please identify the entrance to the building which the voters will use:
Front,", Left side of building", Right side', Rear 0; other
4. Please identify the location, or the name of the room, where the voting will take place:
non va-~ ~(1 1'Yl ~ t.-~ ~G ~ 1~f~c~
5. Access is on (circle one):
A) Street level B) Step(s) up or down C) Ramp
Number of steps
6. Please state any additional information you think we should have:
Poll Site Name: Town of Wappinger Town Hall
Poll Site Address: 20 Middlebush Rd., Wappingers Falls
Number of Election Districts at Poll Site: 3