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Home My WebLink About2021 Neville, Elizabeth From: Neville, Elizabeth Sent: Wednesday,June 16, 202110:57 PM To: mpereira@grucci.com';Theodore Strauel (orientharborj4f@gmail.com) Subject: Emailing: Fireworks Permit#2021-4_2Q210616220836 Attachments: Fireworks Permit#2021-4_2021Q616220836.pdf Attached, please find theFireworksPermit#2021-4 and Town Board Resolution 2021-505 approving it. Elizabeth A. Neville Southold Town Clerk, Registrar of Vital Statistics Records Management Officer; FOIL Officer Marriage Officer PO Box 1179 Southold, NY 11971 Tel. 631765-1800, Ext. 228 Fax 631765=6145 Cell 631466-6064 Your message is ready to be sent with the following file or link attachments: Fireworks Permit#2021-4 20210616220836 Note:To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. a 1 RESQLUTION 2021-505 3 ADOPTED DOC ID: 17155 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2021-505 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JUNE 1$,2021: RESOLVED that the Town Board of the Town of Southold hereby approves the issuance of a Fireworks Permit by the Town Clerk to Grucci Fireworks on behalf of Orient Harbor July 4t Festivities,Inc. for a fireworks displaypn Saturday, July 3,2021 at 9:15 PM (Rain Date: Saturday,August 7,2021 at 0:151M) on a Barge off Orient Yacht Club,2110 Village Lane, Orient,New York upon payment of a single fee of$100.00 and subject to the applicant's compliance with any Executive Orders of the Governor and compliance with any conditions and requirements of the Town of Southold policy regarding the issuance of fireworks permits. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: James Dinizio Jr, Councilman SECONDER:Louisa P. Evans, Justice AYES: Nappa, Dinizio Jr, Doherty, Ghosio, Evans ABSENT: Scott A. Russell BUFFQ,C RESOLUTION 2021-505 ~o©o� �yM�f lad ADOPTED DOC ID: 17155 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2021-505 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JUNE 15, 2021: RESOLVED that the Town Board of the Town of Southold hereby approves the issuance of a Fireworks Permit by the Town Clerk to Grucci Fireworks on behalf of Orient Harbor July 4t Festivities,Inc. for a fireworks display on Saturday,July 3, 2021 at 9:15 PM (Rain Date: Saturday,August 7, 2021 at 9:15PM) on a Barge off Orient Yacht Club, 2110 Village Lane, Orient,New York upon payment of a single fee of$100.OQ and subject to the applicant's compliance with any Executive Orders of the Governor and compliance with any conditions and requirements of the Town of Southold policy regarding the issuance of fireworks permits. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: James Dinizio Jr, Councilman SECONDER:Louisa P. Evans, Justice AYES: Nappa, Dinizio Jr, Doherty, Ghosio, Evans ABSENT: Scott A. Russell ` RECEIVED MAY 1 8 2021 May 17,2021 Southold Town Clerk Elizabeth Neville, Town Clerk Town of Southold 53095 Route 25 Southold, NY 11971 Phone: 631-765-1800 Fax: 631-765-6145 Email: e.neville@town.southold.ny.us CC: lynda.rudder@town.southold.ny.us Dear Ms. Neville: Please find attached hereto for the Orient Harbor July 4th Festivities, Inc.fireworks display scheduled for July 3rd,2021 with a Rain Date of 421 at 9:15 PM the following: '7+h 1) Town of Southold Permit to Display Fireworks Application 2) Insurance Certificate 3) Site Plan 4) FAA Notification Letter 5) Chief Pyrotechnician's Data Form 6) Chief Pyrotechnician's NYS Certificate of Fitness 7) Pyrotechnic Product Count 8) U.S. Fish &Wildlife Notification 9) DEC Notification 10) Letter to Sponsor 11) FAA Approval Letter 12) Coast Guard Approval Letter Soon to Follow: 1) Check for$100.00 for Permit Fee Thank you for your help in this matter and if you should have any questions please call. Sincerely, Matthew Pereira Logistics Manager Fireworks by Grucci, Inc. Office#: (631) 286-0088 20 Pinehurst Drive Fax#: (631)286-9036 Bellport, NY 11713 E-mail: mpereira(cDgrucci.com THE FIRST FAMILY OF FIREWORKS 3 . ;A"11 INSTRUCTIONS FOR DISPLAY OF FIREWORKS 1. Name of body sponsoring fireworks display.-- 2. isplay.-2. The date and time of day at which the fireworks display is to be held. 3. The exact location planned for the fireworks display, including TAX MAP NUMBER. 4. The age, experience and physical characteristics of the persons who are to do the actual discharging of the fireworks. 5. The number and kind of fireworks to be discharged. 6. The manner and place of storage of such fireworks prior to the display. 7. A diagram of the grounds on which the display is to be held, showing the point at which the fireworks are to be discharged, the location of all buildings, highways and other lines of communication, the lines behind which the audience will be restrained and location of all nearby trees, telegraph or telephone lines or other overhead obstructions. 8. Such other information as the Southold Town Clerk may deem necessary to protect persons and property. Written permission of the property owner is required. 9. An indemnity insurance policy with liability coverage and indemnity protection of $1,000,000.00 per person for bodily injury; $1,000,000.00 per accident; $1,000,000.00 property damage. 10. The Town Clerk of the Town of Southold must have the insurance policy in her possession before the fireworks permit is issued. The named insured must read: TOWN OF SOUTHOLD. 11. Application for a fireworks pen-nit must be made at least five days in advance of the date of the fireworks display. (The above instructions are in accordance with the Penal Law, Article 405 - Licensing and other provisions relating to fireworks.) Orient Wharf Company RECEIVED 2110 Village Lane JUN 1 5 2021 Orient, NY 11957 Southold Town Clerk June 14,2021 Elizabeth Neville,Town Clerk Town of Southold 53095 Route 25 Southold,NY 11971 Re: Orient Harbor July 4th Festivities, Inc July 3rd Permit Ms.Neville, The Orient Wharf Company grants permission to Orient Harbor July 4th Festivities,Inc to utilize the property to conduct a fireworks show on July 3rd,2021 at 9:15PM with a rain date of August 7th, 2021 at 9:15PM. The wharf will be used as a barge loading and unloading site. Very truly yours, Peter R.McGreevy President ORIENT FiRE DEPARTMENT, INC. MM,, 23300"Main,Rp4d--,Qrient NY 1'195'x' . (631) 323=2445 • Fax323-9706 RECEIVED MAY 2 8 2021 May 26, 2021 Southold Town Clerk Dear Ms.Neville, I have reviewed the information for the Orient Harbor July 411 Festivities Inc. firework display planed for July 3rd, 2021 with a rain date of July IOth, 2021 at 9:15 pm and see no issues. The Orient FD has always been invited down to watch the process of loading the barge and have been impressed with how Grucci does such a good job safely executing such an inherently dangerous event. We will be on stand-by for the event and be in contact with the crew on the day of the event to ensure another successful event. Any other questions feel free to contact me. Thanks Richard Gillooly Chief of Department 201-563-9394 Neville, Elizabeth From: Matthew Pereira <mpereira@grucci.com> Sent: Wednesday,June 09, 20211:32 PM To: Neville, Elizabeth Cc: Rudder, Lynda;tstrauel@gmail.com Subject: Fireworks By Grucci-Orient Harbor July 4th Festivities-7-3-21 Attachments: 1 - Letter to Clerk's Office-Rain Date Revison - Orient Harbor- 2021-07-03.pdf Dear Ms. Neville: Please find this letter as our intent to reschedule the rain date of the Orient Harbor July 4th Festivities, Inc.fireworks display scheduled for July 3rd,2021. Now with a rain date of August Th 2021. Thank you for your help in this matter and if you should have any questions please call. Thank you, FIREWORKS aY Matt Pereira Logistics Manager Fireworks by Grucci,Inc. p:+1631.286.0088 ext.121 m:+1631.708.5704 a: 20 Pinehurst Drive Bellport,NY 11713 mwwwgrucci.com e:mpereira@grucci.com ATTENTION: This email came from an external source. Do not open attachments or click on links from unknown senders or unexpected emails. 1 Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 05/24/21 Receipt#: 281273 Quantity Transactions Reference Subtotal 1 Fireworks 7/3/21-OrtHrbr $100.00 Total Paid: $100.00 Notes: Payment Type Amount Paid By CK#23776 $100.00 Fireworks By Grucci, Inc. Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Orient Harbor, July 4th Festivities Po Box 653 Orient, NY 11957 Clerk ID: SABRINA Internal ID 7/3/21-OrtHrbr Neville, Elizabeth v From: Neville, Elizabeth Sent: Friday,June 11, 20211:32 PM To: Easton,James Subject: Emailing:Approval for Fireworks 0_20210611133418 Attachments: Approval for Fireworks 0_20210611133418.pdf James, I need your approval as Fire Marshal of the attached Fireworks Permit Application submitted by Grucci on behalf of the Orient Harbor July 4th Festivities Committee for display on July 3rd, Rain Date July 7th. Elizabeth A. Neville Southold Town Clerk, Registrar of Vital Statistics Records Management Officer; FOIL Officer Marriage Officer PO Box 1179 Southold, NY 11971 Tel. 631765-1800, Ext. 228 Fax 631765-6145 Cell 631466-6064 Your message is ready to be sent with the following file or link attachments: Approval for Fireworks 0_20210611133418 Note:To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. r i Neville, Elizabeth From: Easton,James Sent: Friday,June 11, 20214:12 PM To: Neville, Elizabeth Subject: RE: Emailing:Approval for Fireworks 0_20210611133418 After reviewing the application I have no objections to this event taking place. Thank you, James Easton Fire Marshal,Town of Southold JamesE@southoldtownny.gov (W) 631-765-1802 PRIVELEGED AND CONFIDENTIAL COMMUNICATION CONFIDENTIALITY NOTICE: This electronic mail transmission is intended only for the use of the individual or entity to which it is addressed and may contain confidential information belonging to the sender which is protected by privilege. If you are not the intended recipient,you are hereby notified that any disclosure, copying, distribution, or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error, please notify the sender immediately by e-mail and delete the original message. -----Original Message----- From: Neville, Elizabeth<E.Neville@town.southold.ny.us> Sent: Friday,June 11, 20211:32 PM To: Easton,James<jamese@southoldtownny.pov> Subject: Emailing:Approval for Fireworks 0_20210611133418 James, I need your approval as Fire Marshal of the attached Fireworks Permit Application submitted by Grucci on behalf of the Orient Harbor July 4th Festivities Committee for display on July 3rd, Rain Date July 7th. Elizabeth A. Neville Southold Town Clerk, Registrar of Vital Statistics Records Management Officer; FOIL Officer Marriage Officer PO Box 1179 Southold, NY 11971 Tel. 631765-1800, Ext. 228 Fax 631765-6145 Cell 631466-6064 Your message is ready to be sent with the following file or link attachments: Approval for Fireworks 0_20210611133418 Note:To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. 1 Neville, Elizabeth From: Duffy, Bill Sent: Thursday, May 20, 202112:02 PM To: Neville, Elizabeth Subject: RE: Emailing: Fireworks Ap OrientHarbo_20210519160553 No objection William M. Duffy, Esq. Town Attorney Town of Southold Southold Town Annex 54375 Route 25 (Main Road) P.O. Box 1179 Southold, New York 11971-0959 Office: 631.765-1939 Fax: 631.765.6639 Email: billd@southoldtownny_gov -----Original Message----- From: Neville, Elizabeth<E.Neville@town.southold.nv.us> Sent:Wednesday, May 19, 20214:07 PM To: Burke,John<johnbu@southoldtownny.gov>; Duffy, Bill<billd@southoldtownny.gov>; Fisher, Robert <Robert.Fisher@town.southold.ny.us>; Flatley, Martin<mflatlev@town.southold.nv.us>; Hagan, Damon <damonh@southoldtownny.Rov>; Norklun, Stacey<Stacey.Norklun@town.southold.nv.us>;Spiro, Melissa <Melissa.Spiro@town.southold.ny.us>; Dinizio,James<lames.dinizio@town.southold.ny.us>; Doherty,Jill <fill.doherty@town.southold.ny.us>; Evans, Louisa <louisae@southoldtownny.eov>;Ghosio, Bob <bob.ghosio@town.southold.nv.us>; Nappa,Sarah<sarahn@southoldtownny.gov>; Russell, Scott <scottr@southoldtownny.gov> Subject: Emailing: Fireworks Ap OrientHarbo_20210519160553 Attached please find an application submitted by Grucci Fireworks on behalf of the Orient Harbor July 4th Festivities, Inc. for their Fireworks Display on July 3rd, rain date July 10th. Please review it and send me your comments and recommendations. Elizabeth A. Neville Southold Town Clerk, Registrar of Vital Statistics Records Management Officer; FOIL Officer Marriage Officer PO Box 1179 Southold, NY 11971 Tel. 631765-1800, Ext. 228 Fax 631765-6145 Cell 631466-6064 Your message is ready to be sent with the following file or link attachments: Fireworks Ap OrientHarbo_20210519160553 Note:To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. i Neville, Elizabeth From: Spiro, Melissa Sent: Thursday, May 20, 20212:14 PM To: Neville, Elizabeth; Burke,John; Duffy, Bill; Fisher, Robert; Flatley, Martin; Hagan, Damon; Norklun, Stacey; Dinizio,James; Doherty,Jill; Evans, Louisa; Ghosio, Bob; Nappa, Sarah; Russell, Scott Subject: RE: Emailing: Fireworks Ap OrientHarbo_20210519160553 This is not preserved land. Melissa S. -----Original Message----- From: Neville, Elizabeth Sent:Wednesday, May 19, 20214:07 PM To: Burke,John<iohnbu@southoldtownny.gov>; Duffy, Bill<billd@southoldtownny.gov>; Fisher, Robert <Robert.Fisher@town.southold.ny.us>; Flatley, Martin<mflatley@town.southold.ny.us>; Hagan, Damon <damonh@southoldtownny.gov>; Norklun, Stacey<Stacey.Norklun@town.southold.ny.us>;Spiro, Melissa <Melissa.Spiro@town.southold.ny.us>; Dinizio,James<iames.dinizio@town.southold.nv.us>; Doherty,Jill <rill.doherty@town.southold.nv.us>; Evans, Louisa <louisae@southoldtownny.gov>; Ghosio, Bob <bob.ghosio@town.southold.ny.us>; Nappa,Sarah<sarahn@southoldtownny.gov>; Russell, Scott <scottr@southoldtownny.sov> Subject: Emailing: Fireworks Ap OrientHarbo_20210519160553 Attached please find an application submitted by Grucci Fireworks on behalf of the Orient Harbor July 4th Festivities, Inc. for their Fireworks Display on July 3rd, rain date July 10th. Please review it and send me your comments and recommendations. Elizabeth A. Neville Southold Town Clerk, Registrar of Vital Statistics Records Management Officer; FOIL Officer Marriage Officer PO Box 1179 Southold, NY 11971 Tel. 631765-1800, Ext. 228 Fax 631765-6145 Cell 631466-6064 Your message is ready to be sent with the following file or link attachments: Fireworks Ap OrientHarbo_20210519160553 Note:To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. 1 Neville, Elizabeth From: Flatley, Martin Sent: Friday, May 21, 20219:15 AM To: Neville, Elizabeth; Burke,John; Duffy, Bill; Fisher, Robert, Hagan, Damon; Norklun, Stacey; Spiro, Melissa; Dinizio,James; Doherty,Jill; Evans, Louisa; Ghosio, Bob; Nappa, Sarah; Russell, Scott Cc: Blasko, Regina Subject: RE: Emailing: Fireworks Ap OrientHarbo_20210519160553 Attachments: Orient Harbor Fireworks21nosal.x1s I have no objections to this event being approved. My Cost Analysis is attached. d Martin Flatley. Chief of Police Town of Southold Police Department 41405 State Route 25 Peconic, N.Y. 11958 Tel: 631-765-3115 The information contained in this electronic message and any attachments to this message are intended for the exclusive use of the addressee(s) and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient,you are hereby notified that any review, retransmission, conversion to hard copy, copying, reproduction,circulation, publication, dissemination or other use of,or taking of any action, or omission to take action, in reliance upon this communication by persons or entities other than the intended recipient is strictly prohibited. If you have received this communication in error, please (i) notify us immediately by telephone at 631.765.2600, (ii) return the original message and all copies to us at the address above via the U.S. Postal Service, and (iii)delete the message and any material attached thereto from any computer, disk drive, diskette, or other storage device or media. -----Original Message----- From: Neville, Elizabeth<E.Neville@town.southold.nv.us> Sent: Wednesday, May 19, 20214:07 PM To: Burke,John<johnbu@southoldtownny.eov>; Duffy, Bill<billd@southoldtownny.g_ov>; Fisher, Robert <Robert.Fisher@town.southold.ny.us>; Flatley, Martin<mflatley@town.southold.ny.us>; Hagan, Damon <d'amonh@southoldtownny.gov>; Norklun,Stacey<Stacey.Norklun @town.southoId.nv.us>;Spiro, Melissa <Melissa.Spiro@town.southold.nv.us>; Dinizio,James<fames.dinizio@town.southold.nv.us>; Doherty,Jill <fill.doherty@town.southold.nv.us>; Evans, Louisa <louisae@southoldtownny.gov>; Ghosio, Bob <bob.Rhosio@town.southold.ny.us>; Nappa, Sarah<sarahn@southoldtownny.gov>; Russell, Scott <scottr@southoldtownnv.sov> Subject: Emailing: Fireworks Ap OrientHarbo_20210519160553 Attached please find an application submitted by Grucci Fireworks on behalf of the Orient Harbor July 4th Festivities, Inc. for their Fireworks Display on July 3rd, rain date July 10th. Please review it and send me your comments and recommendations. Elizabeth A. Neville Southold Town Clerk, Registrar of Vital Statistics Records Management Officer; FOIL Officer Marriage Officer PO Box 1179 Southold, NY 11971 Tel. 631765-1800, Ext. 228 Fax 631765-6145 Cell 631466-6064 1 Your message is ready to be sent with the following file or link attachments: Fireworks Ap OrientHarbo_20210519160553 Note:To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. r ' I I 2 -Aft r�- 1�R Zft 9t VT' -q- ROW ol "41 ilk "S 6 Arl_*WN 'w" -bi se lit hoot rftV05''zv';q'm D fj, Mk"WTIR, V4!,V.�q � ?1.N Edi IJ�RST�sD�FZI,' .(,• fS( Zit P `''S��K 4/(.t'("-,-. 0 ?r� r 1��i•aY�`�.•4� L'i•fYyr 0/"'j-�Jj'20Z'�I C� Av Lo aN K"X_eR S", j ft" R vfl LIK 1!l 2"'; Hndr`eif,z� dbi�oo �F 17'AA Q �Nlz z p YM, INW- pa YX� ',7 ' - 0 fS.Q UTM&DINY41:197 ii; aw' `PAPER R m no Tr'E MA L. l,"PA9 to 090EP<& 01JE,UbN;f+Fl0 FIG FIREWORKS BY GRUCCI, INC. 23776 VENDOR NO EAN001 NAME ELIZABETH A NEVILLE, MMC,TOWN CLERK CHECK DATE 5/19/2021 REFERENCE INVOICE DATE GROSS AMOUNT DISCOUNT TAKEN NET AMOUNT PAID 7593.ORIENT HARBOR 5/19/2021 10000 000 100.00 TOTAL > 10000 000 10000 vor ntv rmg, n"Aqm im "M 41 .j, 4 ®01%Foa( ELIZABETH A. NEVILLE, MMC ��® �� Town Hall,53095 Main Road TOWN CLERK ® P.O. Box 1179 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS %�5 Fax(631)765-6145 MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER Telephone(631)765-1800 FREEDOM OF INFORMATION OFFICER www.southoldtownny.gov OFFICE OF THE TOWNCLERK TOWN OF SOUTHOLD June 7, 2021 Theodore A. Strauel, President Orient Harbor July 4 Festivities, Inc. 3017 401h Avenue Long Island City, NY Dear Mr. Strauel, I am in receipt of your application package and check no. 1038 for the Fireworks show. However, Grucci Fireworks already paid the application fee with their check on May 24tH Therefore, I am returning your check herewith. I do still need the letter from the Orient Wharf Company. I expect the permit to be issued at the June 15th Town Board meeting. Please advise where you would like the permit mailed to or if someone would be coming to Town Hall for the permit. Yours truly, (L—�Pj�0. Elizabe h A. Neville SnuthnId Tnwn CIPrk ,T ' ;Yilii ;" y 4t �Cstivitlesil��(`.e°° 4 � ` �, �w � � x�t103 - 's,�, w-."t-t '' �Xt' OL) X= x �e<ik".3'"4� '° ,SY«`5`++'-`',- ", T; 4i•�j'�" a+ Enclosure 1 zlo; .; I 11 �• ', � l I ~ E Y r t ` ;jr, g �,', .'7' r ��^7,>•r ''-,�"�-. s,< �: =f „ 3 � `"xv.-.,n a:*r -;a'w Check no. 1038 �� m t a `n a. xa,,. `v „,fit:, s f,� e x; 44" " v"�..� -` „�ite�.Xt{ ..• 'afff>, ',z�, n 3tt ya�.�g:-;�',""r sxi<;�.-" ''a'..k'-,` 3._ °'3P` 3-`�¢�,' g�rrdr °; .4- ti. •4�4ty�(i' {.�`,'�,. Mt$ � x" , ":�� - �.^'S:.n,S+7�,,;i +�-- -•'','>` ^'�;.xk-r .»��'' ��.'a t, l,i: ^t�xtK, E' �'`ciS:eT�i" `-P&I 4»"" v_'a. �i't' -u«'• ... a tl..,ti,34'^ :. .`ik� a, .: ' S. `�.C'#`-.' �*-fF.v ` ��'Y��'`''.� ,'`-°3, � D�©C7 '�`•`,. �'.'�'�`,S=c;;'=t"~9tt"`.; '�'�"� �':s�,•��+'-v-�'�{;,,'�„�_�,,-'��4 OehH"sQ 141A;,M gan Chase;;N.A =�„ ..-._• -��.- i-.;. Z" �P � x;a,w�a�.. y ,�=--"k^"�`Y �'r�`" f�.� -t, by r,,�•'' -„�±� ;',`• T"'�'��"� ��<rr�, ,*^k�.�,�'" ate""" +, � ,�=c �„�� . - :;-...�:.. �.�;.. t.�:>;wa,.., .-..Aw,'' 't,.* :,.�;s ' '"'N";.�,:.:,.wS:`a,�;�_;.-z�a. `��+�szz:�^:,.~�``•:.� a` �� -w"=',a.. "'�=�” ^*'.>'.�^�:'� - -£Nti`��`y`3�;C='�•" -L"te,i.F:,d�.,�.i,<x¢��,p,,_ _- t �...�w« w�a..0 +7x ""h F-r;±;�x.',.,.� . �:o2•ViooOYo 2 4:i.iFS,.. Neville, Elizabeth From: Neville, Elizabeth Sent: Wednesday, May 26,,202111:25 AM To: 'richardgillooly@gmail.com' Subject: Orient Harbor July 4th Festivities,Inc. Foreworks Application Attachments: Fireworks Ap OrientHarbo_20210519160553.pdf; Laserfiche Documents.zip Importance: High - A Fireworks Permit application has been filed by Grucci Fireworks on behalf of the Orient Harbor July 4th Festivities, Inc. The attached application must be reviewed by the Chief of the Orient Fire Department who must then send a letter on the Orient FD letterhead to the Town Clerk's Office stating his approval and any comments/recommendations before the Town Board can adopt a resolution to issue the permit. The second (2"d) attachment is a sample copy of a past letter to assist you. Elizabeth A.Neville Southold Town Clerk,Registrar of Vital Statistics Records Management Officer;FOIL Officer Marriage Officer PO Box 1179 Southold,NY 11971 Tel.631765-1800,Ext.228 Fax 631765-6145 Cell 631466-6064 1 Neville, Elizabeth From: Neville, Elizabeth Sent: Wednesday, May 19,,20214:07 PM To: Burke,John; n-- ; Fisher, Robert;J4A , n; Hagan, Damon; Norklun, Stacey; Spiro, Melissa; Dinizio,James; Doherty,Jill; Evans, Louisa; Ghosio, Bob; Nappa, Sarah; Russell, Scott Subject: Emailing: Fireworks Ap OrientHarbo_20210519160553 Attachments: Fireworks Ap OrientHarbo_20210519160553.pdf Attached please find an application submitted by Grucci Fireworks on behalf of the Orient Harbor July 4th Festivities, Inc. for their Fireworks Display on July 3rd, rain date July 10th. Please review it and send me your comments and recommendations. Elizabeth A. Neville Southold Town Clerk, Registrar of Vital Statistics Records Management Officer; FOIL Officer Marriage Officer PO Box 1179 Southold, NY 11971 Tel. 631765-1800, Ext. 228 Fax 631765-6145 Cell 631466-6064 Your message is ready to be sent with the following file or link attachments: Fireworks Ap OrientHarbo_20210519160553 Note:To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. 1 Your message is ready to be sent with the following file or link attachments: Fireworks Ap OrientHarbo_20210519160553 Note:To protect against computer viruses, e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. z Neville, Elizabeth From: Flatley, Martin Sent: Friday, May 21, 20219:15 AM To: Neville, Elizabeth; Burke,John; Duffy, Bill; Fisher, Robert; Hagan, Damon; Norklun, Stacey; Spiro, Melissa; Dinizio,James; Doherty,Jill; Evans, Louisa;'Ghosio, Bob; Nappa, Sarah; Russell, Scott Cc: Blasko, Regina Subject: RE: Emailing: Fireworks Ap OrientHarbo_20210519160553 Attachments: Orient Harbor-Fireworks2lnosal.xls I have no objections to this event being approved. My Cost Analysis is attached. Ma t.in=Flatley, Chief of Police Town of Southold Police Department 41405 State Route 25 Peconic, N.Y. 11958 Tel: 631-765-3115 The information,contained in this electronic message and any attachments to this message are intended for the exclusive use of the addressee(s) and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient,you are hereby notified that any review, retransmission, conversion to hard copy, copying, reproduction, circulation, publication, dissemination or other use of, or taking of any action, or omission to take action, in reliance upon this communication by persons or entities other than the intended recipient is strictly prohibited. If you have received this communication in error, please (i) notify us immediately by telephone at 631.765.2600, (ii) return the original message and all copies to us at the address above via the U.S. Postal Service, and (iii) delete the message and any material attached thereto from any computer, disk drive, diskette, or other storage device or media. -----Original Message----- From: Neville, Elizabeth<E.Neville@town.southold.nv.us> Sent:Wednesday, May 19, 20214:07 PM To: Burke,John<iohnbu@southoldtownny.gov>; Duffy, Bill<billd@southoldtownny.eov>; Fisher, Robert <Robert.Fisher@town.southoId.ny.us>; Flatley, Martin<mflatley@town.southold.ny.us>; Hagan, Damon <damonh@southoldtownny.gov>; Norklun, Stacey<Stacey.Norklun @town.southold.ny.us>;Spiro, Melissa <Melissa.Spiro@town.southold.nv.us>; Dinizio,James<iames.dinizio@town.southold.nv.us>; Doherty,Jill <fill.doherty@town.southold.nv.us>; Evans, Louisa<louisae@southoldtownny.gov>; Ghosio, Bob <bob.ghosio@town.southold.ny.us>; Nappa,Sarah<sarahn@southoldtownny.sov>; Russell,Scott <scottr@southoldtownny.gov> Subject: Emailing: Fireworks Ap OrientHarbo_20210519160553 Attached please find an application submitted by Grucci Fireworks on behalf of the Orient Harbor July 4th Festivities, Inc. for their Fireworks Display on July 3rd, rain date July 10th. Please review it and send me your comments and recommendations. Elizabeth A. Neville Southold Town Clerk, Registrar of Vital Statistics Records Management Officer; FOIL Officer Marriage Officer PO Box 1179 Southold, NY 11971 Tel. 631765-1800, Ext. 228 Fax 631765-6145 Cell 631466-6064 1 Town of Southold Police Department Special Event Cost Analysis Event: Orient Harbor Fireworks Display Date(s): July 3, 2021 Location: Orient Harbor Reg Hours OT Hrs Hrly Wage Total r Comments PO Onufrak 2 $144.98 ec sp Tb`.z6 u�,�.'a- Reg Hours OT H113 rs Hrly Wage Total Comments rB yc"1e�Pat� °� = Marine° Marine 2� 3 $165.82 Marine 3 3 1 $154.39 Marine 4 3 $124.42 r•-:�e..=F, -. ._,, ,•-,.�5;• -� et*.' £.:-.-..-, ,.,�....,;mr�-gym*."':- —?,.»••- _:.-.` { �.� ��4-; Reg Hours OT Hrs Hrly Wage Total Comments TC Officer#1 2 $18.00 1 $36.00 TC Officer#2 2 $18.00 $36.00 TC Officer TC Officer TC Officer " +�'rn°c ��,� , u� went Costs _ ,, � - '.. ��, a ` PD Vehicles #of vehicles $/hr Total 3 $10.00 $60 $60.00 Command Van Marine Patrol Boats 1 $25/hr $75 $75.00 Total Department Cost for Event = $796.61 Prepared by Chief M. Flatley 6/8/2021 Page 1 ORIENT ORIENT HARBOR HARBOR JULY 4TH FESTIVITIES INC. P.O. Box 653 FIREWORKS ORIENT, N.Y. 1 1957 ' I RECEIVE[ June 3, 2021 J U N i 1 2021 Southold Town Clerk Elizabeth Neville, Town Clerk Town of Southold 53095 Route 25 Southold,NY 11971 Ms.Neville, Enclosed please find application package and check for a fireworks show over Orient Harbor this July 3rd. The only item not in the package is the permission letter from the Orient -Wharf Company, and this is expected to be delivered in a matter of days. Please call me at 914-523-9289 if you have any questions or concerns. Very truly yours, heodore rauel President Town of Southold Police Department Special Event Cost Analysis Event: Orient Harbor Fireworks Display Date(s): July 3, 2021 Location: Orient Harbor Patrol l�llt a i' n^f E ., G �.F ;a •;,a �xN. • �,,a -11741 c f o or `ventu r a. r ' . x.=r,x . _:.'},, _ =_,.,, v . .n,... ',a Mxra,..a_..z�_ •,-z..: :, .�" L,�"i=._x '.. ',..�.`. �:�` aw:,:�. _vim.' .,: '@w:..' :.;.. ,. Reg Hours OT Hrs Hrly Wage Total Comments Poli� ° ?fficers PO Onufrak 2 $144.98 s eC1al,Patrol q^ Reg Hours IOTHrs lHrlyl Total Comments PRO 1=1 IIM17i2E I vB`'%�yc ale Ratrol .- Marine 2 3 $165.82 Marine 3 3 $154.39 Marine 4 3 $124.42 „`„,.- -•;ter-�'-& �, ^--.^Garro �. ,• t c '' � '1` ':<#,...,-.°..�.- •-. k-kms^'^ w'..,_.M raffic°tC©ntrol � � b. , ^ ' � a . .- Reg Hours OT Firs I Hrly Wage Total Comments TC Officer#1 1 2 $18.00 $36.00 TC Officer#2 2 $1800 $36.00 TC Officer TC Officer TC Officer ��•--�:- _gym .�. �- .x ;�•.�.,T��F=_,�.,•„ , ,�„--a .t�•�~ �5=:~ �•,-� --�.».�-•Y-�q E UI# enam..:.LC ,sts � � a.;. .: xi.,.^ PD Vehicles #of vehicles $/hr Total 3 $1000 $60 $60.00 Command Van Marine Patrol Boats 1 $25/hr $75 $75.00 Total Department Cost for Event= $796.61 Prepared by Chief M. Flatley 6/8/2021 Page 1 o��gUFF01,��o ELIZABETH A. NEVILLE, MMC �� Gy Town Hall,53095 Main Road TOWN CLERK p P.O.Box 1179 60 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS Q Fax(631)765-6145 MARRIAGE OFFICEROl �a0t' Telephone(631)765-1800 RECORDS OF MANAGEMENT OFFICER southoldtown.northfork.net FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD 1T APPLICATION PERMIT TO DISPLAY FIREWORKS APPLICATION IS HEREBY MADE, pursuant to the provisions of Section 405.00 of the Penal Law of the State I f New York, for a permit to display fireworks as hereinafter specified: DISPLAY IS TO BE SPONSORED BY Orient HarborJuly4th Festivities, Inc PRINCIPAL OFFICE AT PO Box 653, Orient, NY 11957 DATE&TIME OF DISPLAY July 3,2021 Cc-)approx.9:15pm _ EXACT LOCATION OF DISPLAY Barge off orient Yacht Club-410 8.045'N; 72°18.671'W SUFFOLK COUNTY TAX MAP NUMBER FOR SITE 1000-24-2-28.1 RAIN DATE&TIl L, 021 @ apprnx A-15pn1 The following persons'are to be in charge of the actual shooting of the fireworks: Name Age Experience Physical Condition James Lipp 51 26 years Excellent (Additional names and information may be submitted on an attached sheet Number and type of fireworks is as follows: Grucci Grand Illuminations-4500 2Y2-3"- 1020 4"-325 5"-300 6"-275 8"-32 Total: Not to exceed 1952 Firework Shells and 4500 Illuminations Manner and place of storage of fireworks prior to display: In UN approved boxes in company vehicle. Attached hereto and made a part of hereof is a diagram of the grounds on which the display is to be held. Also attached is a certificate or policy of insurance coverage. hjOTICE: Written permission, with signature of the Property Owner, must be submitted with the Application. Orient Harbor July 4th Festi ''es Inc. FEE: $100 Name of Organizati n See policy for additional information. Byy�-- Si a e f Appficandt 2 Date of Application AOC R CERTIFICATE OF LIABILITY INSURANCEFDATE(MMIDD/YYYY) `•�� 4/13/2021 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 CONTACT Britton Gallagher 'PHONEFAX One Cleveland Center, Floor 30 A/c No 216-658-7100 AICNo:216-658-7101 1375 East 9th Street E-MAIL RSS : Cleveland OH 44114 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Everest National Insurance Company 10120 INSURED INSURER B:Continental Indemnitv Company Fireworks By Grucci Inc.and/or Pyrotechnique By Grucci, Inc.and/or Philny Effects, Inc. INSURER C:AXIS Surplus Ins Company 26620 20 Pinehurst Drive INSURER D: Bellport NY 11713 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1419090670 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ; ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCEImima POLICY NUMBER MMIDDIYYYY) (MMIDDIYYYYI LIMITS A GENERAL LIABILITY SISMLOOD93-211 2/17/2021 21172022 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence) $500,000 CLAIMS-MADE FKI OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $2,000,000 POLICY X PRO- LOC $ A AUTOMOBILE LIABILITY S18CA00044-211 2/172021 2/172022 COMBINED SINGLE LIMIT Ea accident $1,000=0 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Peraccident $ $ C UMBRELLA LIAB X OCCUR P-001-000082173-03 2117/2021 2/172022 EACH OCCURRENCE $4,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000 DED I I RETENTION$ $ B WORKERS COMPENSATION 82-474435-01-09(MASTER) 5272020 5/272021X WC STAT% 0 R- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT $1,000,000 OFFICERIMEMBER EXCLUDED? NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yyes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement. Date:July 3,2021;Rain Date:July 10,2021; Location:Orient Yacht Club,Orient,NY; Additional Insured:Orient Harbor July 4th Festivities,Inc,its Directors and Committee Members;Thomas E.Foster III;Nathalie&Theodore A.Strauel;Orient Yacht Club,its Officers and Board Members;Orient Wharf Company,and its Officers;Greenport Shipyard;Orient Fire Department;Town of Southold;State of New York;Crowley Marine;Costello Marine Construction; CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Southold Town Hall 53095 Main Road Southold NY 11971 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD (0r,K i L G''J- }' L `R�t ti '-t 1` ",...,"'r ,. �'..'. l'=a..v rd 'l - --`'-- --- •_• -�'i r,"'a r 6. 7 I`�°( � r?"'i �s-- '"� >.� �,'�' �'',�73'.''"'x" � E HN ��: N CERT OF COQ ��a.� _ ..il LIPP JAMES B .� CLASS : 6 NON PROXIMATECE ONLY THIS CARD MUST BE CARRIED i j WHEN S I G YRS . ! r { r May 12,2021 Theodore Strauel Orient Harbor July 4th Festivities, Inc. 680 Croton Lake Road Bedford Corners, NY 10549 Cell: 914-523-9289/Email:tstrauel(Dgmail.com Dear Mr. Strauel: Please find attached hereto for the Orient Harbor July 4th Festivities, Inc.fireworks display scheduled for July 3rd,2021 with a Rain Date of Julyh,2021 at 9:15 PM the following: Wh 1) Letter to Town of Southold Clerk's Office 2) Town of Southold Permit to Display Fireworks Application 3) Insurance Certificate 4) Site Plan 5) FAA Notification Letter 6) Chief Pyrotechnician's Data Form 7) Chief Pyrotechnician's NYS Certificate of Fitness 8) Pyrotechnic Product Count 9) U.S. Fish &Wildlife Notification 10) DEC Notification Soon to Follow: 1) FAA Notification Approval 2) U'S Coast Guard Permit(Filled on-line) Please sign the enclosed application and forward to the Town of Southold along check for$100 made out to the Town of Southold with written permission from the Orient Yacht Club's property owner to: Elizabeth Neville,Town Clerk Town of Southold 53095 Route 25 Southold, NY 11971 Thank you for your help in this matter and if you should have any questions please call. Sincerely, Matthew Pereira Logistics Manager Fireworks by Grucci, Inc. Office#: (631) 286-0088 20 Pinehurst Drive Fax#: (631)286-9036 Bellport, NY 11713 E-mail- mpereira(c)grucci corn THE FIRST FAMILY OF FIREWORKS FAA/Air Traffic Organization 1701 Columbia Avenue Eastern Service Center College Park,GA 30337 U.S.Deportment of Tronsportatlon Federal Aviation Administration Dear Firewbrks,P'roponent: Th6nk you'for informing us of y6ur',proposed fireworks display. Although there are currently no federal regulations specific to fireworks displays,the Federal Aviation,Administration,(FAA)has been tasked,with regulating the safe and efficient use of the navigable airspace (49 U.S.0.'§ 40103.). in recognition of this role in promoting aviation safety,,m "any.jurisdictions;require notice to the FAA as'a condition of approval of a Fireworks permit. 'We acknowledge yourpotMcation and have,no,objection to the fireworks display,provided itis conducted,in:a°manner that does not-create a hazard to other persons,,or their;property: To,enhanc`e the.'safety of your event, we recommend the following actions: + Fireworks;staff should remain vigilant to ensure that no aircraft are'in the,,area prior to beghining the fireworks display. If your event is within.5 miles,of a public-use airport,or if the display will exceed.5,00 feet-Above Ground Level (AGL),contact L'eidos Flight Service at 1-877-4-US-NTMS (1=877.-487-686'7) at least 24 hours'(but not more than 72 hours) in advance to-request a Notice to,Airman(NOTAM). You will need to provide the.following,information: o Name and address.of the person filing the NOTAM o Date,time(s), and event location(City, State, and location in•refererice to the aimport) o Maximum altitude of the display This lettor should not be construed as superseding or invalidating any existing rules or regulations,promulgated by any other federal, state,county, or municipal government which may be required for this display. If you have.any questions regarding this information,please contact our office at(404)305- 5570 or 9-ATO-ESA-OSG-Fireworkslffaa.l?ov. Sincerely; K___ Ryan W. Almasy Manager, Operations Support Group Eastern Service Center, Air Traffic Organization May 12,2021 TO: Andria McMaugh COMPANY: Senior Wildlife Biologist 50 Circle Road SUNY Stony Brook Stony Brook, NY 11790 PHONE: 631-444-0308 FAX: 631-444-0272 EMAIL: amcmaugh(a.dec.ny.gov Dear Mr. Hamilton: Below please find display information for a coming contracted fireworks display with our site plan for this event attached. EVENT: Orient Harbor July 4th Festivities, Inc. LOCATION: Barge off Orient Yacht Club 2110 Village Lane, Orient, NY LATITUDE: 410 08.045'N LONGITUDE: 72°18.571 W DATE: July 3rd, 2021 RAIN DATE: July W,2021 7A TIME: Approx.9:15 PM DURATION: 14- 15 Minutes We would appreciate your assistance in getting a notice out to the Coast Guard ASAP with copy to us of your agency having no objections to this site being used. Thank you for your help and cooperation in this matter. Sincerely, Matthew Pereira Logistics Manager Fireworks by Grucci, Inc. Office#: (631)286-0088 20 Pinehurst Drive Fax#: (631)286-9036 Bellport, NY 11713 E-mail mpereira(.grucci.com THE FIRST FAMILY OF FIREWORKS May 12,2021 TO: Mr. Steve Papa COMPANY: U.S. Fish &Wildlife Service E-MAIL: stevepapa(aOws.gov PHONE: 631-776-1404 x 201 FAX: 631-776-1405 Dear Mr. Papa: Attached please find site map for the fireworks display noted below: EVENT: Orient Harbor July 4th Festivities, Inc. LOCATION: Barge off Orient Yacht Club 2110 Village Lane, Orient, NY LATITUDE: 41°08.045'N LONGITUDE: 72°18.571 W DATE: July 3rd, 2021 RAIN DATE: July 10th, 2021 TIME: Approx. 9:15 PM DURATION: 14- 15 Minutes We would appreciate your assistance in getting a notice out to the Coast Guard with copy to us of your agency having no objections to this site being used. Thank you for your help and cooperation in this matter. Sincerely, Matthew Pereira Logistics Manager Fireworks by Grucci, Inc Office# (631)286-0088 20 Pinehurst Drive Fax#: (631)286-9036 Bellport, NY 11713 E-mail: mpereira(cDgrucci.com THE FIRST FAMILY OF FIREWORKS U.S. Department oYE Commander 120 Woodward Avenue Homeland SecuritUnited States Coast Guard New Haven,CT 06512 Sector Long Island Sound Phone (203)468-4565 United States Fax (203)468-4423 Coast Guard 5216/P129-21 April 29,2021 Orient Yacht Club Attn:Mrs.Leslie M.Fernandez 20 Pinehurst Drive Bellport,NY 11713 Mr.Fernandez: Thank you for submitting your Marine Event Application for the Orient Yacht Club Fireworks Display to be held on July 3,2021 with a Rain Date of July 10,2021 in Orient Harbor,NY. After reviewing your application,we have determined that your event does not introduce extra or unusual hazards that would jeopardize the safety of human life on the navigable waters of the United States,and therefore will not require any additional regulatory action. It is your responsibility to contact this office if there are any charges to the event,including the number of participants and/or expected spectators,location, or any other significant change that may necessitate reconsideration as to whether a permit is required As the event sponsor,you are reminded that safety is paramount;you are responsible for the overall safety of the event, including monitoring and appropriately responding to changing weather conditions as well as cancellation of the event should conditions warrant. You are also responsible for participant accountability and appropriate event communication to participants for updates,safety, and cancellations.It is your responsibility to be aware of and ensure local and state health guidelines are followed during your event. Nothing in this determination is intended to restrict the Coast Guard's ability to take action authorized under the Ports and Waterways Safety Act,the Magnuson Act,or other authorities to ensure the safety of vessels and waterfront facilities,and the protection of the navigable waters and the resources therein. Such actions could include promulgation of Regulated Navigation Areas or Limited Access Areas,broadcasting safety notices or other actions taken under the authorities granted to the United States Coast Guard. Coast Guard review and recognition of this event in no way implies that the event is without risk or deemed completely safe,nor does it imply that the Coast Guard has"approved"the event.As the event sponsor,you are reminded that you are responsible for the overall safety of the event and must comply with all existing Federal, State,and local laws that may require additional permits.You should take appropriate action to ensure compliance with all such requirements prior to holding your event. It is recommended that sponsors of fireworks events that will be launched within 3/4 of a mile of beaches and any event that will attract shore side spectators where Piping Plover shore birds may nest consult with the local U.S.Fish and Wildlife Service Field Office(Shirley,NY—631- 286-0485)regarding compliance with Section 9 of the Endangered Species Act and the New York State Department of Environmental Conservation Office(Mr.Kevin Jennings,631-444-0308)regarding equivalent State environmental laws. I sincerely appreciate your proactive effort in bringing this event to our attention. Because of the dynamic nature of the waterway,boating,and maritime activities,the Coast Guard carefully considers the totality of the risks associated with each event on a case-by-case basis when determining whether a permit is needed.Please contact MST2 Mark Paget at(203)468-4583 if you have any questions or if the event is cancelled for any reason. Sincerely, Jennifer L. Sheehy Lieutenant,U.S.Coast Guard Chief, Waterways Management Division Copy: CG Station New London NY DEC U.S. Fish and Wildlife Services(Long Island) May 12,2021 Asper the document N.F.P.A. 1123-2018 Code for Fireworks Display and the Town of Southold regulations, the following information is provided. Sponsor/Client Name: Orient Harbor July 4th Festivities, Inc. Location and Date of Fireworks Display: Barge,off Orient Yacht Club 2110 Village Lane,Orient, NY 11957 July 31d,2021 —Rain Date July 10th,2021 @ Approximately 9:15 PM Chief Pyrotechnician: Health: Age: Years Experience: James Lipp Excellent 53 28 Product: Not to Exceed 1952 Firework Shells and 4500 Illuminations 1.3G &1.4G explosives, UN0335, Maximum Aerial Shell Diameter=8 inches. Storage will be at secured safety zone in D.O.T. approved fiberboard containers#UN-4G and stored in company vehicle approved for this purpose. Fireworks by Grucci complies with all requirements of the NFPA 1123 and The Town of Southold. The above information is submitted and verified by: Matthew Pereira Logistics Manager Fireworks by Grucci, Inc. Office#: (631)286-0088 20 Pinehurst Drive Fax#: (631)286-9036 Bellport,NY 11713 E-mail:mpereira@grucci.com THE FIRST FAMILY OF FIREWORKS tri IRMTI mal c 1011 ON �x,z 7 .1 4 zz z,3 WN AT .......... "VI J. �00 000, Caw U.S.Department of Eastern Service Center 1701 Columbia Ave. Transportation Operations Support Group College Park,GA 30337 Group A V-E2 FIREWORKS DISPLAY NOTIFICATION Company Name: Fireworks by Grucci,Inc. Email Address of Person Submitting Request: mpereira@grucci.com Initials: MP Cell phone Number for On-Site Technician: 631-286-0088 Event Name: Orient Independence Day Celebration Display Date: July 3.2021 Rain Date: July 10,2021 Display Start Time: 9:15pm Zulu;0115 Duration of Fireworks Display:0130 Max Height of Fireworks: Not To Exceed ABG of.2 Nautical Mile(1200' Height) Address,City and State: Barge of Orient Yacht Club,Orient, NY Latitude: 410 8.045' N (North) Longitude: 720 18.571'W (West) Display Radius: Not To Exceed .33 Nautical Miles (2000' Radius) List the closet public use airports within 5 nautical Miles of the Display if the Fireworks will reach or exceed 500 ft.: (1) Rose Field(2)Westmoreland Distance: (1)2 mi(2)4.4 mi Direction:(1)SW(2) N from Airport to Fireworks Display location Special Notes: Please email your request to: 9-ATO-ESA-OSG-Fireworks@faa.gov Fax to Flight Data at: 1-571-223-1593 Phone: 1-877-487-6867 Fax 24-48 Hours prior May 12, 2021 i 1 DISPLAY: Orient Harbor July 4th Festivities, Inc. Re: July 3rd, 2021 Fireworks Displays/Rain Date:July 10th, 2021 SHELL SIZE NOT TO EXCEED 8" SHELL SIZE: QUANTITY IN PCS. Grucci Grand Illuminations- 4500 2%-3" - 1020 4" - 325 5" - 300 6" - 275 8" - 32 10" - NIA 12" - N/A 24" - N/A Grucci Grand Illuminations= Gerbs, Mines, SPX, Comets, Roman Candles Water Falls, Strobe Pots Storage will be at secured safety zone in D.O.T. approved fiberboard containers#UN-4G, and stored in company vehicle approved for this purpose. Total: Not to exceed 1952 Firework Shells and 4500 Illuminations Type: Fireworks UN0335(Display Fireworks)(Explosive 1.3G) Fireworks UN0336(Special Effects)(Explosive 1 AG) Thank You, Matthew Pereira Logistics Manager Fireworks by Grucci, Inc. Office#: (631)286-0088 20 Pinehurst Drive Fax#: (631)286-9036 Bellport, NY 11713 E-mail: mpereira@grucci.com THE FIRST FAMILY OF FIREWORKS May 12,2021 TO: Mr.Steve Papa COMPANY: U.S. Fish &Wildlife Service E-MAIL: stevepapana.fws.gov PHONE: 631-776-1404 x 201 FAX: 631.776.1405 Dear Mr. Papa: Attached please find site map for the fireworks display noted below: EVENT: Orient Harbor July 4th Festivities, Inc. LOCATION: Barge off Orient Yacht Club 2110 Village Lane,Orient, NY LATITUDE: 410 08.045'N LONGITUDE: 72°18.571 W DATE: July 3"t,2021 RAIN DATE: July 10th,2021 TIME: Approx.9:15 PM DURATION: 14-15 Minutes We would appreciate your assistance in getting a notice out to the Coast Guard with copy to us of your agency having no objections to this site being used. Thank you for your help and cooperation in this matter. Sincerely, Matthew Pereira Logistics Manager Fireworks by Grucci, Inc. Office#: (631)286-0088 20 Pinehurst Drive Fax#: (631)286-9036 Bellport, NY 11713 E-mail: mpereira@grucci.com THE FIRST FAMILY OF FIREWORKS May 12,2021 TO: Andria McMaugh COMPANY: Senior Wildlife Biologist 50 Circle Road SUNY Stony Brook Stony Brook, NY 11790 PHONE: 631-444-0308 FAX: 631-444-0272 EMAIL: amcmaugh ,dec.ny.gov Dear Mr. Hamilton: Below please find display information for a coming contracted fireworks display with our site plan for this event attached. EVENT: Orient Harbor July 4th Festivities, Inc. LOCATION: Barge off Orient Yacht Club 2110 Village Lane,Orient, NY LATITUDE: 410 08.045'N LONGITUDE: 72°18.571 W DATE: July 3rd,2021 RAIN DATE: July 10th,2021 TIME: Approx.9:15 PM DURATION: 14.15 Minutes We would appreciate your assistance in getting a notice out to the Coast Guard ASAP with copy to us of your agency having no objections to this site being used. Thank you for your help and cooperation in this matter. Sincerely, Matthew Pereira Logistics Manager Fireworks by Grucci, Inc. Office#: (631)286-0088 20 Pinehurst Drive Fax#: (631)286-9036 Bellport, NY 11713 E-mail: mpereira@grucci.com THE FIRST FAMILY OF FIREWORKS FAA/Air Traffic Organization 1701 Columbia Avenue Eastern Service Center College Park,GA 30337 U.S. Department of Transportation Federal Aviation Administration Dear Fireworks Proponent: 'Thank_you-for informing us of your proposed fireworks display. Although there are currently no federal regulations specific-to fireworks displays;the Federal Aviation Administration(FAA)has been tasked with regulating the safe and efficient use of the navigable airspace(49 U.S.C.§ 40103). In recognition-of this role in promoting,aviation safety,many jurisdictions require notice to the'FAA as a condition of approval of a fireworks permit. -We acknowledge your notification and have no objection to the fireworks display provided it is conducted-in'a manner that-does not create a hazard to other persons, or their property. To enhance the safety of your'event, we_recommend the following actions: + Fireworks staff should remain-vigilant to ensure that no aircraft are in the area prior to beginning the fireworks display. If your event is within.5 miles of a public-use airport, or if the display will exceed 500 feet:Above Ground Level (AGL),contact Leidos Flight Service-at 1-877-4-US-NT-MS (1-877-487-6867) at least 24 hours-(but_not more than 72 hours) in,advance to request a Notice to Airman(NOTAM). You will need to provide the following information: o Name and address of the person filing the NOTAM a -Date,time(s), and event location(City, State, and location in reference to the airport) o Maximum altitude of the display This letter should not be construed as-superseding or invalidating any existing rules or regulations promulgated by any otherTederal, state, county,or municipal,government which may be required for this"display. If you have any questions regarding this information, pleas&contact our office-at(404) 305- 5570 or 9-ATO-ESA-OSG-Fireworksl'�jfaa.eov. Sincerely, Ryan W. Almasy Manager,Operations Support Group Eastern Service Center,Air Traffic Organization U.S.Department of Commander 120 Woodward Avenue Homeland Security United States Coast Guard New Haven,CT 06512 Sector Long Island Sound Phone:(203)468-4565 United States Fax:(203)468-4423 Coast Guard 5216/P129-21 April 29,2021 Orient Yacht Club Attn:Mrs.Leslie M.Fernandez 20 Pinehurst Drive Bellport,NY 11713 Mr.Fernandez: Thank you for submitting your Marine Event Application for the Orient Yacht Club Fireworks Display to be held on July 3,2021 with a Rain Date of July 10,2021 in Orient Harbor,NY. After reviewing your application,we have determined that your event does not introduce extra or unusual hazards that would jeopardize the safety of human life on the navigable waters of the United States,and therefore will not require any additional regulatory action. It is your responsibility to contact this office if there are any changes to the event,including the number ofparticipams and/or expected spectators,location,or any other significant change that may necessitate reconsideration as to whether a permit is required As the event sponsor,you are reminded that safety is paramount;you are responsible for the overall safety of the event,including monitoring and appropriately responding to changing weather conditions as well as cancellation of the event should conditions warrant. You are also responsible for participant accountability and appropriate event communication to participants for updates,safety,and cancellations It is your responsibility to be aware of and ensure local and state health guidelines are followed during your event. Nothing in this determination is intended to restrict the Coast Guard's ability to take action authorized under the Ports and Waterways Safety Act,the Magnuson Act,or other authorities to ensure the safety of vessels and waterfront facilities,and the protection of the navigable waters and the resources therein. Such actions could include promulgation of Regulated Navigation Areas or Limited Access Areas,broadcasting safety notices or other actions taken under the authorities granted to the United States Coast Guard. Coast Guard review and recognition of this event in no way implies that the event is without risk or deemed completely safe,nor does it imply that the Coast Guard has"approved"the event.As the event sponsor,you are reminded that you are responsible for the overall safety of the event and must comply with all existing Federal, State,and local laws that may require additional permits.You should take appropriate action to ensure compliance with all such requirements prior to holding your event. It is recommended that sponsors of fireworks events that will be launched within%of a mile of beaches and any event that will attract shore side spectators where Piping Plover shore birds may nest consult with the local U.S.Fish and Wildlife Service Field Office(Shirley,NY—631- ' 286-0485)regarding compliance with Section 9 of the Endangered Species Act and the New York State Department of Environmental Conservation Office(Mr.Kevin Jennings,631-444-0308)regarding equivalent State environmental laws. I sincerely appreciate your proactive effort in bringing this event to our attention.Because of the dynamic nature of the waterway,boating,and maritime activities,the Coast Guard carefully considers the totality of the risks associated with each event on a case-by-case basis when determining whether a permit is needed.Please contact MST2 Mark Paget at(203)468-4583 if you have any questions or if the event is cancelled for any reason. Sincerely, Jennifer L.Sheehy Lieutenant,U.S.Coast Guard Chief,Waterways Management Division Copy: CG Station New London NY DEC U.S.Fish and Wildlife Services(Long Island) INSTRUCTIONS FOR DISPLAY OF FIREWORK L Name of body sponsoring fireworks display. 2. The date and time of day at which the fireworks display is to be held. 3. The exact location planned for the fireworks display, including TAX MAP NUMBER. 4. The age, experience and physical characteristics of the persons who are to do the actual discharging of the fireworks. 5. The number and kind of fireworks to be discharged. 6. The manner and place of storage of such fireworks prior to the display. 7. A diagram of the grounds on which the display is to be held, showing the point at which the fireworks are to be discharged, the location of all buildings, highways and other lines of communication, the lines behind which the audience will be restrained and location of all nearby trees, telegraph or telephone lines or other overhead obstructions. 8. Such other information as the Southold Town Clerk may deem necessary to protect persons and property. Written permission of the property owner is required. b 9. An indemnity insurance policy with liability coverage and indemnity protection of $1;000,000.00 per person for bodily injury; $1,000,000.00 per accident; $1,000,000.00 property damage. 10. The Town Clerk of the Town of Southold must have the insurance policy in her possession before the } fireworks permit is issued. The named insured must read:TOWN OF SOUTHOLD. 11. Application for a fireworks permit must be made at least five days in advance of the date of the fireworks display. (The above instructions are in accordance with the Penal Law, Article 405 - Licensing and other provisions relating to fireworks.) Iy4 o��gllfflJLq-�o ELIZABETH A. NEVILLE, MMC �� r/y Town Hall,53095 Main Road TOWN CLERK q P.O.Box 1179 y Southold,New York 11971 REGISTRAR OF VITAL STATISTICS Q Fax(631)765-6145 MARRIAGE OFFICERy�0d �� Telephone(631)765-1800 RECORDS OF MANAGEMENT OFFICER southoldtown.northfork.net FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION PERMIT TO DISPLAY FIREWORKS APPLICATION IS HEREBY MADE, pursuant to the provisions of Section 405.00 of the Penal Law of the State of New York, for a permit to display fireworks as hereinafter specified: DISPLAY IS TO BE SPONSORED BY OrientHarborJuly4th Festivities, Inc PRINCIPAL OFFICE AT PO Box 653, Orient, NY 11957 DATE&TIME OF DISPLAY July 3,2021(ci)-approx.9:15pm EXACT LOCATION OF DISPLAY Barge off Onent Yacht Club-41°8.045'N; 72°18.571'W SUFFOLK COUNTY TAX MAP NUMBER FOR SITE 1000-24-2-28.1 RAIN DATE&TIME July 1p,9091annr� n�FL The following persons are to be in charge of the actual shooting of the fireworks: Name Age Experience Physical Condition James Lipp 51 26 years Excellent (Additional names and information may be submitted on an attached sheet Number and type of fireworks is as follows: Grucci Grand Illuminations-4500 2Y2-3"- 1020 4"-325 5"-300 6"-275 8"-32 Total: Not to exceed 1952 Firework Shells and 4500 Illuminations Manner and place of storage of fireworks prior to display: In UN approved boxes in company vehicle. Attached hereto and made a part of hereof is a diagram of the grounds on which the display is to be held. Also attached is a certificate or policy of insurance coverage. NOTICE: Written permission, with signature of the Property Owner, must be submitted with the Application. Orient Harbor July 4th Festivities, Inc. FEE: $100 Name of Organization See policy for additional information. By Signature of Applicant Date of Application June 9, 2021 Elizabeth Neville, Town Clerk Town of Southold 53095 Route 25 Southold, NY 11971 Phone: 631-765-1800 Fax: 631-765-6145 Email: e.neville@town.southold.ny.us CC: lynda.rudder@town.southold.ny.us Dear Ms. Neville: th Please find this letter as our intent to reschedule the rain date of the Orient Harbor July 4 rdth Festivities, Inc.fireworks display scheduledfor July 3, 2021. Now with a rain date of August 7 2021. Thank you for your help in this matter and if you should have any questions please call. Sincerely, Matthew Pereira Logistics Manager Cell # 631-708-5704 Fireworks by Grucci, Inc. Office #: (631) 286-0088 20 Pinehurst Drive Fax #: (631) 286-9036 Bellport, NY 11713 E-mail: mpereira@grucci.com THE FIRST FAMILY OF FIREWORKS RECEIVED 'Y 1 8 2021 May 17,202101 , Southold ler Elizabeth Neville, Town Clerk Town of Southold 53095 Route 25 Southold, NY 11971 Phone: 631-765-1800 Fax: 631-765-6145 Email: e.neville@town.southold.ny.us CC: lynda.rudder@town.southold.ny.us Dear Ms. Neville: Please find attached hereto for the Orient Harbor July 4th Festivities, Inc.fireworks display scheduled for July 3rd, 2021 with a Rain Date of July 10th, 2021 at 9:15 PM the following: 1) Town of Southold Permit to Display Fireworks Application 2) Insurance Certificate 3) Site Plan 4) FAA Notification Letter 5) Chief Pyrotechnician's Data Form 6) Chief Pyrotechnician's NYS Certificate of Fitness 7) Pyrotechnic Product Count 8) U.S. Fish &Wildlife Notification 9) DEC Notification 10) Letter to Sponsor 11) FAA Approval Letter 12) Coast Guard Approval Letter Soon to Follow: 1) Check for$100.00 for Permit Fee Thank you for your help in this matter and if you should have any questions please call. Sincerely, Matthew Pereira Logistics Manager Fireworks by Grucci, Inc. Office#: (631) 286-0088 20 Pinehurst Drive Fax#: (631) 286-9036 Bellport, NY 11713 E-mail: m,ere!r _,grucci.com FIRSTTHE IFIREWORKS INSTRUCTIONS FA S 1. Name of body sponsoring fireworks display. I The date and time of day at which the fireworks display is to be held. 3. The exact location planned for the fireworks display, including TAX MAP NUMBER. 4. The age, experience and physical characteristics of the persons who are to do the actual discharging of the fireworks. 5.. The number and kind of fireworks to be discharged. 6. The manner and place of storage of such fireworks prior to the display. T A diagram of the grounds on which the display is to be held, showing the point at which the fireworks are to be discharged, the location of all buildings; highways and other lines of communication, the lines behind which the audience will be restrained and location of all nearby trees, telegraph or telephone lines or other overhead obstructions. 8. Such other information as the Southold Town Clerk may deem necessary to protect persons and property. Written permission of the property owner is required. 9. An indemnity insurance policy witli liability coverage and indemnity protection of $1,000,000.00 per person for bodily injury; $1,000,000.00 per accident; $1,000,000.00 property damage. 10. The Town Clerk of the Town of Southold must have the insurance policy in her possession bel' re the fireworks permit is issued. The named insured must read: TOWN OF SOUTOLD. 11. Application for a fireworks permit must be made��,ta least live days, in advance of the date of the Ilreworks dis�1, (The above instructions are in accordance with the Penal Law, Article 405 - Licensing and other provisions relating to fireworks.) ELIZABETH A. NEVILLE, MMC Town Hall, 53095 Main Road TOWN CLERK P.O.Box 1179 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS Fax (631)765-6145 MARRIAGE OFFICER Telephone(631)765-1800 RECORDS OF MANAGEMENT OFFICER southol dtown.northfork.net FREEDOM OF INFORMATION OFFICER ' OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION PERMIT TO DISPLAY FIREWORKS APPLICATION IS HEREBY MADE, pursuant to the provisions of Section 405.00 of the Penal Law of the State of New York, for a permit to display fireworks as hereinafter specified: DISPLAY IS TO BE SPONSORED BY OrientHarborJuly4thFestivities, Inc PO Box 653, Orient, PRINCIPAL OFFICE AT NY 11957 DATE&TIME OF DISPLAY July 3 2021(a)ap rox.9:15 m ............. EXACT LOCATION OF DISPLAY Barge off Orient Yacht Club—41'8.045' N; 72°18.571'W SUFFOLK COUNTY TAX MAP NUMBER FOR SITE 1000-24-2-28.1 IN DATE&TIME July.10, 02 g approx.9:1Spm - The following persons are to be in charge of the actual shooting ol�`�the lig reworks: Name Age Experience Physical Condition James Lipp 51 26 years Excellent (Additional names and information may be submitted on an attached sheet Number and type of fireworks is as follows: Grucci Grand Illuminations -4500 2'/z- 3"- 1020 4"- 325 5"- 300 6"-275 8"-32 Total: Not to exceed 1952 Firework Shells and 4500 Illuminations Manner and place of storage of fireworks prior to display: In UN approved boxes in company,vehicle. Attached hereto and made a part of hereof is a diagram of the grounds on which the display is to be held. Also attached is a certificate or policy of insurance coverage. NOTICE: Written permission. with signature of the Property Owner, must be submitted with the Application. Orient Harbor July 4th_Festivities Inc.. FEE: $100 Name of Organization See policy for additional information.. By..,_.....__......__.....__.....__..... ..................... Signature of Applicant Date of Application DATE4/13/2021DWYY)' CERTIFICATE OF LIABILITY INSURANCE 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 CONTACT Britton Gallagher PHONE FAX One Cleveland Center, Floor 30 INP,No.E. 216-658-7100 1vc,,N,o,) 216-658 7101 1375 East 9th Street EMAIL m.. ACtDRE.SS'. Cleveland OH 44114 .I.NSURER(S)AFFORDING COVERAGE NAIC# ...... wsURERA:Everest National Insurance Company 10120 INSURED INSURER B Continental Indemnity,Company Fireworks By Grucci Inc. and/or Pyrotechnique - By Grucci, Inc. and/or Philny Effects, Inc. INSURER c Axis Surplus Ins Company, 2„6620 20 Pinehurst Drive INSURERDt Bellport NY 11713 INSURER E INSURER F t. COVERAGES CERTIFICATE NUMBER: 1673834962 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BE.:LOW HAVE BEEN ISSUED TO THE INSUM.'D N __.. .. AMED ABOVE FOR"1"i-IE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, T.'RM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PFRT/AM, THf! INSURANCE AFFORDED BY 11-NE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TI IE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMI ES SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. oNSR"„ .,wAtOLSL sudR ®.,, m _ LTR TYPE OF INSURANCE Iald S. " POLICY NUMBER MPll 7i�[SIC[7Y MMfDO YYif'k"... - ........LIMITS._.............. .. A GENERAL LIABILITY .rIOMI-0009:3-211 2197/20.21 211712022 °°1,fiida(1 Utirl _ k.l4CI d OC.t UP�rdl NCwf ,,,,, X COMI1111RCIAI GrIVl".RAL LIl461LI"EY fh'?,t Cu41 C'a 4h.�WKA ��1�(Ir�r oara,E1 S 5[117 L1C"!f3 _ ...........� MED EXP JM .... ..... c I ranws I�AraE� ( X�ral::Cana :.._�'!a+�.,., � PERSONAL&ADV INJURY 1,000,QCICI GE .... .. .,. ........ ,..m GENERAL AGGREGATE 1 S,,I30t700,D GEN'L AGGREGATE LIMIT dMl r4 LpL P E:::I't: PRODUCTS-COMP/OP AGG S 2,DDr1 Ca0t1 .X i�p_ C. .,. f'OP...ICY P��'=' �U nn � y' A AUTOMOBILE LIABILITY I€dCA00044-211 _ 2/17/2021 2/17/2022 ILRVhaED Ca C'LL LdMI I' COC ANY AUTO ®'tc ISu3nSi 5 hCYC1rY OL10 X BODILY INJURY(Per pa+i,on) S _ 'ALL OWNED SCHEDULED BODILY INJURY Per accident S AUTOS AUTO ( ) X r IIREID AUTOS IX NON-OViPIVLI) _ PPh y tE CRT/ �.�. .... .64a.1u¢:1S S ' { t,�rY utldeYG�,q,,, (' UMBRELLA LIAB X OCCURI'001 000(P.)217l-07 2/17/2021 2/171'20;22 EACH OCCURRENCE `a A,00ra 000 X EXCESS LIAB CLAIMS-MADE .... e,,,.., AGu IdLC'ACE � 100C100tb .......................................... �F-7FD �..�RE4 Elflrr()(7 tia .... B WORKERSAND C6MPiNSATION �. 82,474435-01-09 MPA, .•. ,- 'X,.�.��T dT' �I ... .��.... ...... WORKERS CO (MAS F2 aLW CS)1FI RS'LIABILITY Y/N I f hP27(2CY20 at27l26P29 ANY PROMIf:TOR/PAIR I NEIat4 7GLid:,UTIVk. �""" �,L.. I Ar,r I ACCII YI.IVT S 1 t.tC1Lr 00'D 0FFCFP'414Et,rkpER EXCLUDED? � �NIA .. iMandatory in NH] r I.. DISEASE E-LA EMI LOYI I S 1 01]J oilN If yes describe uAdef � ...... DF.,SC,l,tl'TIdR,=OF OPERA NON0t.Aow ........ E C-iGl t,�.a�i,.-F:1OLICY P...IMI C• ,1.00G"d,O00 �. 1 IONS(VEHICLES Attach ACORD 101,Additional Remarks Schedule,if more .... _ ... DESCRIPTION OF OPERATIONS/LOCATIONS ( re space is required) Additional In used extension of coverage i�, provided by above referenced General Liability policy where required by written agreement. Dale'.,July 3 2021 Rain Date tiny 10„20'x1; Location.Orient Yacht Cltah Qr-tenl,NY, Additional Insured(S):Orle,nt Harb'o'r July 4th FeFfivities Inc,as,Directors and"wonarnittee Members;Thomas E.Foster III;Nathalie&TheodoreA.Strauel;Orient Yacht Club,its Officers and Board Members,Orient VVIi art C on-1pany,and Its Officers;Greenport Shipyard;Orient Fire Department;Town of Southold;State of New York;Crowley Marine;Costello Marine C:onsirLamorro CERTIFICATE HOLDER CANCELLATION _ _. ..... ........ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orient Harbor July 4th Festivities, Inc.. ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 653 AUTHORIZED REPRESENTATIVE Orient NY 111957 . V 1988-2010 ACORD CORPORATION All ..... rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 00 DATE(MM/DD/YYYY) C. CERTIFICATE OF LIABILITY INSURANCE 4/13/2021 _. __. 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 CONTACT NAh9E.:.. Britton Gallagher PHONE FAX One Cleveland Center, Floor 30 (xc'Na bXxtt 216 658 7100 (awc„Not 216-658 7101 E•MA1L .... ........._. 1375 East 9th Street ADDRC +: ( Cleveland OH 44114 INSURER(S)AFFORDING,COVERAGE NAIC# INSURER A:Everest National Insurance Company 1.0.120 — —._ INSURED INSURER 13Continental IndemnityCom Fireworks By Grucci Inc. and/or Pyrotechnique — p .an Y By Grucci, Inc. and/or Philny Effects, Inc. INSURER C.Axis Surplus Ins Company 26620 20 Pinehurst Drive INSURER Bellport NY 11713 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER:1419090670 REVISION NUMBER: ..................... THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. , -- INSR .._....._....... ......... ............ I,4r5P7,�5L1HR ..,,. POLICY EFF POLICY"EXP I LTR TYPE OF INSURANCE �, POLICY NUMBER,. MM/DDlY Y M DDIYYYY f LIMITS A GENERAL LIABILITY ..... SIOML0009:3-211 2/17/20.21 2/17(2022 ( s EACH OCCURRENCE S 1 000,000 X C OMMERCIAL,GENERAL LIABILITY 7 r I FlCrhull5� (Lie a r�urra�uvcp! S500,000 f CLAIMS MADE ( X C)C4..UFx i I MED EXP(Any one person} S i PERS(JNPoI..A ADV INJURY 5 td�00 000 i..GENERAL AGGREGATE...... $2000,000 GEN'L AGGREGATE LIMIT.—L—_PFR ''.�.. PRODUCTS-COMP/OP,AGG S 2,000,000 PRO POI ICY X I JEC"I LOC i S A AUTOMOBILE LIABILITY ! j SIBCA00044-211 I 2/1712021 2/17/2022 COMF.R4E0 SINGLE LIUUq _. . (Ea aG6 en). s i quo c)Dn I ALL,OWNED SCHEDULED I j&0I)IL..Y IN.1'URY(Per accid n 5 ... X ANY AUTO BODILY INJURY(Per person) d�ilty S AUTOS AUTOS � e ,,.,. . _ ,., f NONOWNEDY HROPFRTY t7AMAUE S X.. HIREDAUYOS X i .,.,.. ` AUTOS ((,,.Er accident)_„ 1 C UMBRELLA LIAB X f"-OQII-CJJCIOE$21 t'0-f):i 2M7(2021 2(1'7f2022 EACH OCCURRENCE 54 000 600 OCCUR 1 X EXCESS LIAB AGGREGATE 54 000 000 H WORKERS COMPENSATION• ..�._.�_"CY N 82-474435-01-09(MASTER) 5/27/2020.. 5127/2021 I}(.. ..TA. � 1 CC I LILP, Ur) �- WC STPoTU 1 OTH I TORY.OMITS R AND EMPLOYERS'LIABILITY M1' { ... , ANY PROPRIETOR/PARTNERtEXECUTIVE I E.L EACH ACCI DENY a 1 000 000 OFFICFRtME111aFR EXCLUDE/ N J A ---. 1 _... (Mandatory in NH) '—" E I.. DIS I P,s E:. A C:IWI4'I.,OYI F. 5 1 000 000 .... If yes describe under DESCRIPTION OF OPERATIONS below I E I. DISEASE POLICY ILIMI C S1 000 000 � 1 I DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101 Addition......... ._ ww ....... nal Remarks Schedule,if more space is required) Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement. Date:July 3,2021;Rain Date:July 10,2021; Location:Orient Yacht Club,Orient, NY; Additional Irisured:Orient Harbor.July 4th Festivities,Inc,its Directors and Conorlltteed Members;Thomas E.Foster III,Nathalie&Theodore A.Strauel;Orient'Yacht Club,its Officers and Board Members;s;Orient Wharf E.:rTrr many,and its Officers;Greenport Shipyard;Orient Fires. Department;Town of Southold; State of New York;Crowley Marine;Costello Marine Construction; ................................ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Southold Town Hall 53095 Main Road AUTHORIZED REPRESENTATIVE Southold NY 11971 ..... ........ O 1988-2010 ACORD CORPORATION. All rights reserved c ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD I� �-- Mn _ r� `alnl%1 C7 _ •U N W 00 N 7 � O a N f� O N U)„& — C O 0CDLL N � Y_ > N N _N U Z -C rte-+ O Ch of of f Q L.L to N (0 bo C CO 2 (n -O N E J O O .- LL d x C) 0 U 0 E o J o _ U(6 0 0 0 0 0N O mf r' x � W N �` u W o cj� CL a m 0 C o-lw: O U C I (O C O U 9 Q Lo I � U C M1•� VB CE I MWASM � W U. O O m CX (6 sm i i V � I p 1 I� F CD C) c rte, Q 0 U LO O � ti E U 0 O c L c O a O c IIIII +; R,,V 4 V IN JP �,,d�' C 111 fl �; p ',O LO J ux N o O L e`x. U.S.Department of Eastern Service Center 1701 Columbia Ave. Transportation Operations Support Group College Park,GA 30337 Group AJV-E2 FIREWORKS DISPLAY NOTIFICATION Company Name: Fireworks by Grucci, Inc. Email Address of Person Submitting Request: rnpereira@grucci.corn Initials: MP Ce 631-286-0088 pone Number or On-Site Technician: �. �.._... _„� Event Name: Orient Independence Da Cee ration Display Date: Jul ,m3,,2021 Rain Date: July 10 2021 __- Display Start Time: 9:15pm wwwwww_ Zulu: 0115 Duration of Fireworks Display:,0130 Max Height of Fireworks: Not To Exceed ABG of .2 Nautical Mile (1200' Height Address,City and State: Barge of Orient Yacht Club, Orient, NY ....... Latitude: 41°8.045' N (North) Longitude: 72° 18.571'W ('West) ti I Display Radius: Not To Exceed .33 Nautical mm Miles (2000' Radius List the closet public use airports within 5 nautical Miles of the Display if the Fireworks will reach or exceed 500 ft.: (1) Rose Field (2) Westmoreland Distance: 1 2 rn 2L4.4 mi Direction: (1)SW(2) N from Airport to Fireworks Display location Special Notes: Please email your request to: 9-ATO-ESA-OSG-Fireworl<s@faa.gov Fax to Flight Data at: 1-571-223-1593 priorPhone: 1-877-487-6867 Fax 24-48 Hours May 12, 2021 As per the document N.F.P.A. 1123-2018 Code for Fireworks Display and the Town of Southold regulations, the following information is provided. Sponsor/Client Name: Orient Harbor July 4th Festivities, Inc. Location and Date of Fireworks Display: Barge off Orient Yacht Club 2110 Village Lane, Orient, NY 11957 July 3rd, 2021 —Rain Date July 10th,2021 @ Approximately 9:15 PM Chief Pyrotechnician: Health. Age: Years Experience: James Lipp Excellent 53 28 Product: Not to Exceed 1952 Firework Shells and 4500 Illuminations 1.3G & IIAG explosives, UN0335, Maximum Aerial Shell Diameter= 8 inches. Storage will be at secured safety zone in D.O.T. approved fiberboard containers#UN-4G and stored in company vehicle approved for this purpose. Fireworks by Grucci complies with all requirements of the NFPA 1123 and The Town of Southold. The above information is submitted and verified by: Matthew Pereira Logistics Manager Fireworks by Grucci, Inc. Office#: (631) 286-0088 20 Pinehurst Drive Fax#: (631) 286-9036 Bellport, NY 11713 E-mail: ��.ew�eir � �'�ct:i a7or THE FIRST FAMILY OF FIREWORKS / /r ! IfV� // 1,r�i� ' r� r a/�✓�/, r ///%� rr//�0 ;law // ,:,' /irG/i �/ ilo;a, / �j �r „� r,1r /jriic'r,✓r%%/' G�i/j' ��/i i �i l�//%i✓ �/`% ,"„ r l oiON1,11, ISOL r 11�o rr/„r r / ji ra I U/ ,, r , May 12, 2021 40 DISPLAY: Orient Harbor July 4th Festivities, Inc. Re: July 3rd, 2021 Fireworks Displays/Rain Date: July 10th, 2021 SHELL SIZE NOT TO EXCEED 8" SHELL SIZE: tUANTITY' IN PCS. Grucci Grand Illuminations- 4500 2'Yz-3" - 1020 4" - 325 5" - 300 6" - 275 8" - 32 10" - N/A 12" - N/A 24" - N/A Grucci Grand Illuminations = Gerbs, Mines, SPX, Comets, Roman Candles Water Falls, Strobe Pots Storage will be at secured safety zone in D.O.T. approved fiberboard containers#UN-4G, and stored in company vehicle approved for this purpose. Total: Not to exceed 1952 Firework Shells and 4500 Illuminations Type: Fireworks UN0335(Display Fireworks) (Explosive 1.3G) Fireworks UN0336 (Special Effects) (Explosive 1.4G) Thank You, Matthew Pereira Logistics Manager Fireworks by Grucci, Inc. Office : (631)286-0088 20 Pinehurst Drive Fax#: (631) 286-9036 Bellport, NY 11713 E-mail:Tpereirg@grrgcwc„i,com THE FIRST FAMILY OF FIREWORKS May 12,2021 °" , TO: Mr. Steve Papa COMPANY: U.S. Fish &Wildlife Service E-MAIL: stevepapa@fws.gov PHONE: 631-776-1404 x 201 FAX: 631-776-1405 Dear Mr. Papa: Attached please find site map for the fireworks display noted below: EVENT: Orient Harbor July 4th Festivities, Inc. LOCATION: Barge off Orient Yacht Club 2110 Village Lane, Orient, NY LATITUDE: 410 08.045' N LONGITUDE: 720 18.571 W DATE: July 3rd, 2021 RAIN DATE: July 10th, 2021 TIME: Approx. 9:15 PM DURATION: 14- 15 Minutes We would appreciate your assistance in getting a notice out to the Coast Guard with copy to us of your agency having no objections to this site being used. Thank you for your help and cooperation in this matter. Sincerely, Matthew Pereira Logistics Manager Fireworks by Grucci, Inc. Office : (631)286-0088 20 Pinehurst Drive Fax : (631)286-9036 Bellport, NY 11713 E-mail: nipereira@),qPuccA c0111 THE FIRST FAMILY OF FIREWORKS May 12,2021 - TO: Andria McMaugh COMPANY: Senior Wildlife Biologist 50 Circle Road SUNY Stony Brook Stony Brook, NY 11790 PHONE: 631-444-0308 FAX: 631-444-0272 EMAIL: amcmauwdec.ny ov Dear Mr. Hamilton: Below please find display information for a coming contracted fireworks display with our site plan for this event attached. EVENT: Orient Harbor July 4th Festivities, Inc. LOCATION: Barge off Orient Yacht Club 2110 Village Lane, Orient, NY LATITUDE: 41°08.045'N LONGITUDE: 720 18.571 W DATE: July 3rd, 2021 RAIN DATE: July 10th, 2021 TIME: Approx.9:15 PM DURATION: 14- 15 Minutes We would appreciate your assistance in getting a notice out to the Coast Guard ASAP with copy to us of your agency having no objections to this site being used. Thank you for your help and cooperation in this matter. Sincerely, Matthew Pereira Logistics Manager Fireworks by Grucci, Inc. Office#: (631) 286-0088 20 Pinehurst Drive Fax : (631) 286-9036 Bellport, NY 11713 E-mail: rnL,)e6La(a rr cci,com THE FIRST FAMILY OF FIREWORKS May 12,2021 Theodore Strauel Orient Harbor July 4th Festivities, Inc 680 Croton Lake Road Bedford Corners, NY 10549 Cell: 914-523-9289 I Email: tslrauel gmaf.corn Dear Mr. Strauel: Please find attached hereto for the Orient Harbor July 4th Festivities, Inc.fireworks display scheduled for July 3rd, 2021 with a Rain Date of July 10th, 2021 at 9:15 PM the following: 1) Letter to Town of Southold Clerk's Office 2) Town of Southold Permit to Display Fireworks Application 3) Insurance Certificate 4) Site Plan 5) FAA Notification Letter 6) Chief Pyrotechnician's Data Form 7) Chief Pyrotechnician's NYS Certificate of Fitness 8) Pyrotechnic Product Count 9) U.S. Fish &Wildlife Notification 10) DEC Notification Soon to Follow: 1) FAA Notification Approval 2) US Coast Guard Permit(Filled on-line) Please sign the enclosed application and forward to the Town of Southold along check for$100 made out to the Town of Southold with written permission from the Orient Yacht Club's property owner to: Elizabeth Neville, Town Clerk Town of Southold 53095 Route 25 Southold, NY 11971 Thank you for your help in this matter and if you should have any questions please call, Sincerely, mo Matthew Pereira Logistics Manager Fireworks by Grucci, Inc. Office#: (631)286-0088 20 Pinehurst Drive Fax#: (631)286-9036 Bellport, NY 11713 E-mail: f1j�rjLgiCd,1qr(.,,,orq THE FIRST FAMILY OF FIREWORKS FAA/Air Traffic Organization 1701 Columbia Avenue few Eastern Service Center College Park,GA 30337 07 S. Deportment f-ftraru poriallon F der it ,Aviation Admini iration Dear Fireworks Proponent: Thank you for informing us of your proposed fireworks display, Although there are currently no federal regulations specific to fireworks displays,the Federal Aviation Administration(FAA)has been tasked with regulating the safe and efficient use of the navigable airspace (49 U.S.C.§ 40103). In recognition of this role in promoting aviation safety,many jurisdictions require notice to the FAA as a condition of approval of a fireworks permit. We acknowledge your notification and have no objection to the fireworks display provided it is conducted in a manner that does not create a hazard to other persons, or their property. To enhance the safety of your event, we recommend the following actions: Fireworks staff should remain vigilant to ensure that no aircraft are in the area prior to beginning the fireworks display. + If your event is within 5 fniles of a public use airport, or if the display will exceed 500 feet Above Ground Level (AGL),contact Leidos Flight Service at 1-877'-4-US-N'TMS (1-$77-487-6867) at least 24 hours (but not more than 72 hours) in advance to request a Notice to Airman(NOTAM). You will need to provide the following information: o Name and address of the person filing the NOTAM o Date, time(s), and event location (City, State, and location in reference to the airport) o Maximum altitude of the display This letter should not be construed as superseding or invalidating any existing rules or regulations promulgated by any other federal, state, county, or municipal government which may be required for this display. If you have any questions regarding this information,please contact our office at(404) 305- 5570 or 9 T O E A-OSG 1 ireworks('ci.)fiti.1;�(.)v. Sincerely, ft--- Ryan W. Almasy Manager, Operations Support Group Eastern Service Center, Air Traffic Organization U.S. Department of Commander 120 Woodward Avenue Homeland SecurityUnited States Coast Guard New Haven,CT 06512 Sector Long Island Sound Phone:(203)468-4565 United States Fax:(203)468-4423 Coast Guard Aff 5216/P 129-21 April 29, 2021 Orient Yacht Club Attn: Mrs. Leslie M. Fernandez 20 Pinehurst Drive Bellport,NY 11713 Mr. Fernandez: Thank you for submitting your Marine Event Application for the Orient Yacht Club Fireworks Display to be held on July 3,2021 with a Rain Date of July 10,2021 in Orient Harbor,NY. After reviewing your application,we have determined that your event does not introduce extra or unusual hazards that would jeopardize the safety of human life on the navigable waters of the United States, and therefore will not require any additional regulatory action. It is your responsibility to contact this office if there are any changes to the event, including the number of participants and/or expected spectators, location, or any other significant change that may necessitate reconsideration as to whether a permit is required.As the event sponsor,you are reminded that safety is paramount;you are responsible for the overall safety of the event, including monitoring and appropriately responding to changing weather conditions as well as cancellation of the event should conditions warrant. You are also responsible for participant accountability and appropriate event communication to participants for updates,safety, and cancellations. It is your responsibility to be aware of and ensure local and state health guidelines are followed during your event. Nothing in this determination is intended to restrict the Coast Guard's ability to take action authorized under the Ports and Waterways Safety Act,the Magnuson Act, or other authorities to ensure the safety of vessels and waterfront facilities,and the protection of the navigable waters and the resources therein. Such actions could include promulgation of Regulated Navigation Areas or Limited Access Areas, broadcasting safety notices or other actions taken under the authorities granted to the United States Coast Guard. Coast Guard review and recognition of this event in no way implies that the event is without risk or deemed completely safe,nor does it Imply that the Coast Guard has"approved"the event.As the event sponsor,you are reminded that you are responsible for the overall safety of the event and must comply with all existing Federal, State, and local laws that may require additional permits. You should take appropriate action to ensure compliance with all such requirements prior to holding your event. It is recommended that sponsors of fireworks events that will be launched within 3/4 of a mile of beaches and any event that will attract shore side spectators where Piping Plover shore birds may nest consult with the local U.S. Fish and Wildlife Service Field Office(Shirley,NY—631- 286-0485)regarding compliance with Section 9 of the Endangered Species Act and the New York State Department of Environmental Conservation Office(Mr. Kevin Jennings, 631-444-0308) regarding equivalent State environmental laws. I sincerely appreciate your proactive effort in bringing this event to our attention. Because of the dynamic nature of the waterway,boating, and maritime activities,the Coast Guard carefully considers the totality of the risks associated with each event on a case-by-case basis when determining whether a permit is needed, Please contact MST2 Mark Paget at(203)468-4583 if you have any questions or if the event is cancelled for any reason. Sincerely, Jennifer L. Sheehy Lieutenant, [J.S. Coast Guard Chief, Waterways Management Division Copy: CG Station New London NY DEC U.S. Fish and Wildlife Services(Long Island) Neville, Elizabeth From: Matthew Pereira <mpereira@grucci.com> Sent: Monday, May 17, 20214:29 PM To: Neville, Elizabeth Cc: Rudder, Lynda; Corey Grucci; Leslie Fernandez; Lorrie Colichio Subject: Fireworks By Grucci-Orient Independence Day Celebration-7-3-21 Attachments: 00 - Packet to Clerk's Office - Orient Harbor- 2021-07-03.pdf Dear Ms. Neville Please find attached hereto for the Orient Harbor July 4th Festivities, Inc. fireworks display scheduled for July 3rd, 2021 with a Rain Date of July 10th, 2021 at 9:15 PM the following: 1) Town of Southold Permit to Display Fireworks Application 2) Insurance Certificate 3) Site Plan 4) FAA Notification Letter 5) Chief Pyrotechnician's Data Form 6) Chief Pyrotechnician's NYS Certificate of Fitness 7) Pyrotechnic Product Count 8) U.S. Fish & Wildlife Notification 9) DEC Notification 10) Letter to Sponsor 11) FAA Approval Letter 12) Coast Guard Approval Letter Soon to Follow: 1) Check for $100.00 for Permit Fee Thank you for your help in this matter and if you should have any questions please call. Thank you, FIREWORK BY Matt Pereira Logistics Manager Fireworks by Grucci,Inc. 5 p:+1631.286.0088 ext.121 m:+1 631.708.5704 a: 20 Pinehurst Drive Bellport, NY 11713 mwww.grucci.com e:mpereira@grucci.com i ATTENTION: This email came from an external source. Do not open attachments or click on links from unknown senders or unexpected emails. 2