COLD SPRING HARBOR FIRE DISTRICT Use of District Facilities Policy Any (1) not-for-profit or eleemosynary organization, or (2)

Member of the Cold Spring Harbor Volunteer Fire Department, Inc., or (3) Commissioner of the Cold Spring Harbor Fire District, or (4) resident of the Cold Spring Harbor Fire District (any of the foregoing, an Applicant) may apply to the Board to use the facilities of the District upon the following terms and conditions: 1. In the case of a Member of the Cold Spring Harbor Volunteer Fire Department, Inc., such application shall first be subject to the approval of the Department prior to submission to the Board of Fire Commissioners. 2. All applications, in a form approved by or acceptable to the Board, shall be submitted in advance for approval by the Board of Fire Commissioners, and shall include payment of any applicable fees and deposits. 3. Prior to such requested use, each Applicant shall deliver to the Board, for review and approval, a Certificate of Insurance naming the District as Additional Insured, in the minimum indemnity amount of $1,000,000, and, if applicable, including appropriate coverage for Liquor Liability, for each such use. 4. Any serving of any alcoholic beverages during such use shall be in accordance with the Alcohol Policy of the Board of Fire Commissioners. The Board of Fire Commissioners reserves the right to prohibit the serving, provision and/or consumption of alcohol on District premises at any time in its sole discretion. 5. Immediately after such use the Applicant shall restore the facilities to the condition in which they were found prior to such use. In the event the facility used is not restored to the condition in which it was found, Applicant shall pay the sum of $50.00 to the Cold Spring Harbor Fire District for cleaning services. 6. Use by Cold Spring Harbor Fire District residents, Commissioners and by Members of the Cold Spring Harbor Volunteer Fire Department, Inc. shall be restricted to direct personal use and shall not be used for profit or other financial gain or benefit. 7. The Board of Fire Commissioners reserves the right in its sole discretion to impose any fee, additional fee(s) and any deposits as it sees fit for compensation to the District with regard to exceptional use/abuse of facilities. 8. Use of the facilities is subject to compliance with the Use of District Facilities Rules as promulgated by the Board of Fire Commissioners.

By Order of the Board of Fire Commissioners

COLD SPRING HARBOR FIRE DISTRICT USE OF DISTRICT FACILITIES RULES

Purpose: In accordance with New York State Town Law, Art. 11 176, the Fire Districts facilities are to be available for the social and recreational use of the firemen and residents of the district. Additionally, the District Facilities are a community asset and the Board of Fire Commissioners wish to encourage their use by the community when not in use for official Fire District and Fire Department business. No smoking nor use of nicotine products, e-tobacco or herbal cigarettes is permitted inside the Fire District buildings. Smoking outside Fire District buildings is only permitted in designated areas and smokers shall extinguish and discard their butts in proper receptacles. The person/organization with permission to use the room/area is responsible for the conduct of the persons attending such function/event and responsible and liable for any damage to the facilities or property of the Fire District. No one under the age of 21 shall be permitted to use the facilities without supervision. Children shall be supervised at all times. Illegal activities, improper use or violation of any safety requirements will warrant immediate expulsion from the Fire District premises. Any fireman found to be in violation of the Rules shall be subject to disciplinary action by the Board of Fire Commissioners, including possible termination of membership. Use of the facilities does not infer any right of privacy and any use is subject to attendance and or observation by Fire District officials or personnel at any time. Events involving the sale, advertisement or promotion of commercial products or services or the solicitation of future sale of commercial products or provision of commercial services, are prohibited. Fundraising by non-profit groups shall be permitted on a case-by-case basis. No alteration of the physical structure is permitted. No permanent affixation to the walls may be made of any kind. Any furniture moved shall be returned to its original configuration. No storage of any items before or after the function/event is permitted. Access to exits must be clear and fire exits unlocked from the inside at all times. All applicable fees and insurance certificates must be delivered to the District Office prior to the date of the event. No event may utilize any Fire House/District telephone number for information or any other purposes. Fire House staff will not accept any calls, relay messages or page persons attending any event except in the case of an extreme emergency. No announcement of an event may describe any connection with the Fire District that would be construed as affiliation or sponsorship. Use of the meeting room does not imply any endorsement of the event or event organizers by the Fire District. All use is subject to the sole discretion of the Board of Fire Commissioners. The Board of Fire Commissioners reserves the right to cancel use of its facilities for any particular event at any time with no liability. If in an emergency situation (i.e., snowstorm, hurricane) the facility to be used is declared closed by the Board of Fire Commissioners, all scheduled events will be automatically cancelled without liability to the Board of Fire Commissioners and the Fire District. Actions of the Board of Fire Commissioners may be taken through a designated representative. The Board of Fire Commissioners reserves the right, in its sole discretion, to waive any provision contained herein, modify or revoke any permission for use previously granted, and to amend or cancel any of these provisions at any time subject to applicable law.

Application for Use of District Facilities

Cold Spring Harbor Fire District 2 Main Street, Cold Spring Harbor, New York 11724

Name of Applicant: __________________________________________ Date of Application _____________ Member of CSH Fire Dept

Resident of CSH Fire District

If an Organization, Contacts Name: __________________________________________________________ Tel. # of Applicant: (____) _________________ Applicants address: ______________________________________________email: _____________________ Facility Request: ___ Meeting Room ___ Other or additional space(s)__________________________________ Day and Date of Event: ______________________________ Total Number of people expected:____________ Purpose of Event: ____________________________________________________________________________ Description of Event: _________________________________________________________________________ Time of Event: _______________to ________________ (Include set-up and clean-up time) Furniture Requirements: ______________________________________________________________________ Refreshments Planned: ________________________________________________________________________ Additional Contact Person in Case of Emergency: ______________________________Tel: (___ ) ___________

I agree to abide by and adhere to the Use of District Facilities Rules and all policies, rules and regulations of the Cold Spring Harbor Fire District pertaining to use of and presence upon district facilities and property.

As official representative of the organization, I am fully authorized to pledge the applicant organization to these
rules, including the fee(s) required and to the complete assumption of all responsibility in connection therewith. I agree to be personally responsible for the adherence of the organization and its invitees to the Rules. Signature of the undersigned below is evidence of agreement to hold harmless and fully indemnify the Cold Spring Harbor Fire District, its Board of Fire Commissioners and its employees for, from and against any and all liability, action, cause of action, claim, damage or loss arising from or resulting out of use of the facilities and property, including any and all fees, costs and expenses of any kind whatsoever related thereto (including, without limitation, reasonable attorneys fees). ____________________________________ __________________________________________ ________________ Signature Print Name Date If on behalf of an organization, Title of Organization: _______________________________________

Application to be signed and submitted to the District Office. Please include proof of residency. -----------------------------------------------------------------------------------------------------------------------------------------------Approval of CSH Fire Dept for a members use: _____________________________________ Signature of Dept President/Secretary ________________________________ Signature of Chief