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HomeMy WebLinkAbout2022 DENIS NONCARROW �� ��� Town Hall,53095 Main Road TOWN CLERK ® a P.O.Box 1179 C Southold,New York 11971 REGISTRAR OF VITAL STATISTICS %95 Fax(631)765-6145 MARRIAGE OFFICER Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER ®1 �� www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE.TOWN CLERK. TOWN OF SOUTHOLD PERMIT 2022 PUBLIC DISPLAY OF FIREWORKS. I, Denis Noncarrow, Town Clerk of the Town of Southold, Suffolk County, New York, being an officer duly designated by the Town Board of the Town of Southold for this purpose, do hereby GRANT TO: GREENPORT FIRE DEPARTMENT PHENIX HOOK& LADDER COMPANY,THIRD STREET,GREENPORT A PERMIT FOR THE PUBLIC DISPLAY OF FIREWORKS by said organization in accordance with the provisions of Section 405.00 of the Penal Law of the State of New York at Sunday July 1st, 2022 @ 10:00 PM; Raindate:July 3'd, 2022) on the property of GREENPORT PUBLIC SCHOOL Athletic Field, located on the north side Front Street and east side Moores Lane,Greenport, New York. ON CONDITION THAT the bond (indemnity insurance) required shall continue in full force and effect in favor of the Town of Southold, and PROVIDED that the actual point at which the fireworks are to be fired shall be at least two hundred feet from the nearest building, public highway or railroad, or other means of travel, and at least fifty feel from the nearest above ground telephone or telegraph line, trees or other overhead obstruction; that the audience at such display shall be restrained behind lines at least one hundred and fifty feet from the point at which the fireworks are discharged and only persons in active charge of the display shall be allowed inside these lines; that all fireworks that fire a projectile shall be so set up that the projectile will go in the air as nearby as possible in a vertical direction, unless such fireworks are to be fired from the shore or a lake or other large body of water, then they'may be directed in such manner that the falling residue from the deflagration will fall in to such lake or body of water;that any fireworks that remain unfired after the display is conducted shall be immediately disposed of.in a way safe for the particular type of fireworks remaining; that no fireworks display shall be held during any wind storm in which the wind reaches a velocity of more than thirty miles per hour; that all persons in actual charge of firing the fireworks shall be over the age of eighteen years, competent and physically fit for the task,that there shall be at least.two such operators constantly on duty during the discharge and that at least two soda acid or other approved type fire extinguishers of at least two and one-half gallons capacity each shall be kept at such widely separated points as possible within the actual area of the display. This permit is subject to the applicants compliance with an xe utive Ordersxrssued bv the Governor and to applicants compliance with anV conditions and I re irements Af The Town of.Southold Policy regarding the issuance of fireworks permits. Denis Nonca row;Town Clerk Dated:June 8, 2022 THIS PERMIT IS NOT TRANSFERABLE RESOLUTION 2022-504 ADOPTED DOC ID: 1.8169 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2022-504 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JUNE 7, 2022: RESOLVED that the Town Board of the Town of Southold hereby approves the issuance of a' Fireworks Permit by the Town Clerk to the Greenport Fire Department Phoenix Hook & Ladder Company for a Fireworks display on Friday, July 1st, 2022 at 10:00PM . Rain Date, Saturday July 3rd, 2022 at 10:00PM at the Greenport Athletic Field, Greenport High School, located at 725 Front Street and east side of Moores Lane, Greenport, New York, upon single payment of $100.00 and subject to the applicant's 'compliance with any Executive Orders issued by the Governor and to applicants compliance with any conditions and all requirements of the Town of Southold Policy regarding the issuance of fireworks permits. Denis Noncarrow Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Sarah E. Nappa, Councilwoman SECONDER:Brian O. Mealy, Councilman AYES: Nappa, Doroski, Mealy, Doherty,Evans, Russell ' u May 30, 2022 `� TO: Denis Noncarrow,Town Clerk �i Town Hall Il ADDRESS: 53095 Main Rd PO Box 1179 Southold,New York 11971 RECEIVE® E-MAIL: denisn@southoldtownny.gov �i PHONE: 631-765-1800 FAX: 631-765-6145 J U N — 6 2022 FROM: Edward Rubio Dear Mr.Noncarrow, Southold Town Clerk Re: Greenport Independence Day Celebration— July 1, 2022 Rain Date:July 3, 2022-Approximately 10:00 PM We are honored to have been selected to provide this year's fireworks for the above mentioned event. Please find attached the following documents. 1) Town of Southold Permit Application 2) Check in the amount of$100.00 to cover the application fee 3) Copy of the display contract 4) Insurance Certificates 5) Site Plan 6) FAA Letter of No Objection 7) Approved Greenport High School property use application 8) Confirmation letter of apparatus standby from Greenport Fire Department If you should need any further information or have any questions please contact me. Thank you for your help and cooperation in the issuance of the corresponding permit as soon as possible. Sincerely, w i Edward Rubio Special FX Wizard, Inc. Cell #: 516-658-4486 Special FX Wizard,Inc. Office#:631-772-5157 PO Box 266 Cell#: 516-658-448 Mastic Beach,NY 11951 E-mail: Sales cLSpecialFXWizard.com ELIZABETH A.NEVILLE,RMC,CMC D Town Hall, 53695 Main.Road TOWN CLERK 3 P.O. Box 1179 REGISTRAR OF VITAL STATISTICS en:, Southold, New`dark 11971 1bIA1tRIAGE OFFICER O Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER1,f' tty'gg�� = Telephone(631)765-1800 FREEDOM OF INFORMATION OFFICERdUIG 1 1: southoldtown.northfork.net OFFICE OF THE T CLERK OWN 694&TOWN OF SOUTHOLD I /�� APPLICATION 1 V 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 PHe.y1 t k�Ad k�' "er (A 2 PRINCIPAL OFFICE AT ;)(-rd rerzf__ �;��rtL�7�; ll v %/CVY DATE & TIME OF DISPLAY 7• % -- tla—'2 .-',le: t C) Pm • t - ys i'.5's' EXACT LOCATION OF DISPLAY �Yt:e2v1.Pc3!1 .� r�;11._- r I,, l.. %f 2 • c FTd �►- 3s SUFFOLK COUNTY TAX MAP NUMBER FOR SITE- 445-� --7 -�5 RAIN DATE & TIME 7 The following persons are to be in charge of the actual shooting of the fireworks: Name Age Experience Physical Condition Sandra Fahey 51 over 11 years exrpllpnt Edward Rubio 53 over 33 years- Russ Goetz 63 over..28..y ears_- excellent (Additional names and information may be submitted on an attached sheet Number and type of fireworks is as follows: The display will be fires electrically-discharging up to..a max 4"_aerial shells,...3".aerial shells 2.5"aerial shells comets and mines. Quantity will not exceed 120-4"aerial shells, 300-.3" aerial-shells, 300-2.5"aerial shells and 30 MSB's (multi shoot boxs) Manner and place of storage of fireworks prior to display: in.U.N.Approved fiberboard boxes, in a DOT approved 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.Pronerty Owner, must be submitted with the Application. Name of Organization By Signature of Applicant Date of Application 1� Q� ELIZABETH A.NEVILLE,RMC, CMC d ®� Town Hall, 53095 Main;Road TOWN CLERK P.O. Box'1179 REGISTRAR OF VITAL STATISTICS Southold,New-Y rk"11971 MARRIAGE OFFICER �•, ��� Fax(631) 765-6145 RECORDS MANAGEMENT OFFICER 6� ,�,�,� Telephone(631)765-1800 FREEDOM OF INFORMATION OFFICER CQIV 1.Lt souEholdtown.nai tfifot-k.net 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 Pen l Law of the State of New York, for a permit to display fireworks as hereinafter specified: DISPLAY IS TO BE SPONSORED BY I,.�P_;l;k k "'erLa t J Me/.`is� cc i(.i. PRINCIPAL OFFICE AT _43 r:d S-kre e+ G rpgo ppi�-i-. All" 11 CI V i DATE & TIME OF DISPLAY EXACT LOCATION OF DISPLAY 0,:f-,�$v1,Perf 4i" l� r +crl I7T't9��T•`C -1- 3S SUFFOLK COUNTY TAX MAP NUMBER FOR SITE RAIN DATE & TIME -e The following persons are to be in charge of the actual shooting of the fireworks: Name Age Experience Physical Condition Sandra Fahey 51 over 11.years _excellent ... Edward_Rubio 53 ver 3 :rears_.. ...... excellent: ....: Russ Goetz 63 over-28-years. excellent (Additional names and information may be submitted on an attached sheet Number and type of fireworks is as follows: .The diSDIav will be fires electricall ...dischar in .0 _to:a..max 4'....aerial._shells_3.'.'._aerial shells 25'aerial shells comets and mines. Quantity will not exceed 120-4"aerial shells,_300-_3",aerial shells,300-2.5" aerial shells and 30 MSB's (multi shoot boxs) Manner and place of storage of fireworks prior to display: in U.N. Approved fiberboard boxes, in a_DOT approved 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. i'VOTICE: Written permission,with signature of the.Pronerty Owner, must be submitted with the Application. Name of Organization By Signature of Applicant Date of Application ELIZABETH A.NEVILLE,R.MC,CMC Town Hall,5305 Main Road TOWN CLERK P.O.Box 1179 REGISTRAR OF VITAL STATISTICS ch Southold,New York 11971 MARRIAGE OFFICER y4 Fax(631)?65-6145 RECORDS MANAGEMENT OFFICER Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER 'flt1t`ls' southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD INSTRUCTIONS.FOR DISPLAY. I+IREWORKS I. Name of body sponsoring fireworks display. 2. The date and time of day at which the fireworks display is to be held. Display must be concluded by 10:00 p.m. if held Sunday through Thursday, 11:00 p.m. if held Friday or Saturday, and there shall be no time restriction if held on July 4. 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 and a copy of a valid certificate of competency as a pyrotechnician for the individual supervising the.firing of the display 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. Detailed diagram showing location of fireworks discharge and minimum separation distances in accordance with the applicable requirements of Penal Law Section 405 (2). 8. Copy of the contract with fireworks display company. 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. Certificate of Insurance naming the Town of Southold as additional insured with coverage limits of $2,000,000.00 for public liability and $2,000,000.00 for 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 30.days in advance of the date of.the fireworks, displace 12. All applications for a fireworks permit shall be subject to an application fee in an amount of$100.00, g rmined by-the Town_Board to coverthe Town's together with a processing fee In an amount to be dete costs for monitoring and enforcing compliance with the Penal Law. (The above instructions are in accordance with the Penal Law.Article 405-Licensing and other provisions relating to fireworks.) ELIZABETH A.NEVILLE,RMC,CMC �. {d. Town Hall, 53&6 Main Road TOWN CLERK P.O.Box 1179 REGISTRAR OF VITAL STATISTICS v' Southold,New York 11971 MARRIAGE OFFICER Fax(631)'Z65-6145 RECORDS MANAGEMENT OFFICER �l Telephone(631) 765-1800 FREEDOM OF INFORMATION OFFICER southoldtown.northfork.net OFFICE OF TIRE TOWN CLERK TOWN OF SOUTHOLD INSTRUCTIONS FOR DISPLAY OT 1+IREWORKS 1. Name of body sponsoring fireworks display. 2. The date and time of day at which the fireworks display is to be held. Display must be concluded by 10:00 p.m. if held Sunday through Thursday, 1 I:00 p.m. if held Friday or Saturday, and there shall be no time restriction if held on July 4. 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 and a copy of a valid certificate of competency as a pyrotechnician for the individual supervising the firing of the display 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. Detailed diagram showing location of fireworks discharge and minimum separation distances in accordance with the applicable requirements of Penal Law Section 405 (2). 8. Copy of the contract with fireworks display company. 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. Certificate of Insurance naming the Town of Southold as additional insured with coverage limits of $2,000,000.00 for public liability and $2,000,000.00 for 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 30 days in advance of the date of the fireworks- . ......... display. I2. All applications for a fireworks permit shall be subject to an.appiication fee in an amount of$100.00, together with,a processing fee in an amount to be determined_by.the Town_.B.oard to cover the Town's costs for monitoring and enforcing compliance with the Penal Law. (The above instructions are in accordance with the Penal Law.Article 405-Licensing and other provisions relating to fireworks.) p -'jowi``m RESOLUTION 2010-474 i!y F di p ADOPTED DOC ID: 6016 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO.2010-474 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOA"ON JUNE 29,2010: RESOLVED that the Town Board of the Town of Southold hereby-2(10 ts.the follo"'n POLICY regarding the issuance:of fireworks:.nermits: l. The Town may grant a permit for the display of fireworks by municipalities, fair associations, amusement parks,persons or organizations of individuals. Penal T", Section 405.00(2). 2. An"organization of individuals"is a religious, civic,or comparable organization.'Op. Atty. Gen No.2007-3. 3. Fireworks permits shall indicate that the display must be concluded by 10:00 p.m.if held Sure ay-tThursday, 11:00 p.m. if held Friday or Saturday, and there shall be no time restriction if held on July 4. 4. No person shall engage in or allow the manufacture, assembly, storage or display of any fireworks or pyrotechnics display without first obtaining a permit issued by the Town Clerk. A completed application for display of fireworks must be received by the Town Clerk a minimum of 30 days prior to the date of display. The permit application for any fireworks or pyrotechnics display shall be accompanied by the following: �r (a) a copy of a valid certificate of competency as a pyrotechnician for the ridiviival supervising the firing of the display; (b) Certificate of Insurance naming the Town of Southold as additional lhsci-M with coverage limits of$2,000,000 for public liability and$2,000,000 for_property damage; (c) Detailed diagram showing location of fireworks discharge and minimum separation distances in accordance with the applicable requirements of Penal.Law Section 405(2); (d) A copy of the contract with fireworks display company; and (e) All applications shall require the approval of the Fire Chief of the District in which the display will take place and the Fire Marshal before beingpresen ted for approval by the Town Board. RESOLUTION 2010-474 ADOPTED DOC ID: 6016 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO.2010-474'7VAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOAR'ON JUNE 29,2010: RESOLVED that the Town Board of the Town of Southold herebya(!tOpis the fohowin POLICY regarding the issuance-of fireworks nerniits: 1. The Town may grant a permit for the display of fireworks by municipalities, fair associations, amusement parks,persons or organizations of individuals. Penal Iau� Section 405.00(2). 2. An 'organization of individuals is a religious,civic,or comparable organization.'Op. Atty. Gen No.2007-3. 3. Fireworks permits shall indicate that the display must be concluded by 10:00 p.m.if held Sunday-Thursday, 11:00 p.m. if held Friday or Saturday, and there shall be no time restriction if held on July 4. 4. No person shall engage in or allow the manufacture, assembly,storage or display Qf any fireworks or pyrotechnics display without first obtaining a permit issued by the"Toivn' Clerk. A completed application for display of fireworks must be received by the Town Clerk a minimum of 30 days prior to the date of display. The permit application for,any fireworks or pyrotechnics display shall be accompanied by the following: (a) a copy of a valid certificate of competency as a pyrotechnician for the,indvitua supervising the firing of the display; (b) Certificate of Insurance naming the Town of Southold as additional i issued-with coverage limits of$2,000,000 for public liability and$2,000,000 forpropety damage; (c) Detailed diagram showing location of fireworks discharge and minimum separation distances in accordance with the applicable requirements of Penal Law Section 405(2); (d) A copy of the contract with fireworks display company; and (e) All applications shall require the approval of the Fire Chief of the District in which the display will take place and the Fire Marshal before being pr+eseited-for approval by the Town Board. Resolution 2010-474 Board Meeting of June±9,2010 5. All applications for a fireworks permit shall be subject to an application fee in an"=ount of$100.00,together with a processing fee in an amount to be determined by the T.own Board to cover the Town's costs for monitoring and enforcing compliance with:thd Penal Law. Elizabeth A.Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Albert Krupski Jr., Councilman SECONDER:Vincent Orlando, Councilman AYES: Ruland, Orlando,Talbot, Krupski Jr.,Russell ABSENT: Louisa P. Evans Updated: 6/30/2010 10:43 AM by Lynda Rudder Page 2 Resolution 2010-474 Board Meeting of June 29,2010 5. All applications for a fireworks permit shall be subject to an application fee in an�at'nount of$100.00,together with a processing fee in an amount to be determined by the Town Board to cover the Town's costs for monitoring and enforcing compliance with hd Penal Law. Elizabeth A.Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Albert Krupski Jr., Councilman SECONDER:Vincent Orlando, Councilman AYES: Ruland, Orlando,Talbot, Krupski Jr.,Russell ABSENT: Louisa P. Evans Updated: 6/30/2010 10:43 AM by Lynda Rudder Page 2 Special FX Wizard Inc. PO Box 266 Mastic Beach, NY 11951 Office: 631-772-5157 Email: Sales@SpecialFXWizard.com x s3a DISPLAY GONTRACTr y i o f Sponsor: Phenix Hook&Ladder Co.#1 Greenport Fire Department G.F.D. Fax: 631-477-1943 G.F.D. E-mail:gfdfire@optonline.net Address: PO Box 58, 3rd St.,Greenport, NY 11944 Contact: Peter Harris Phone: 631-447-2407 Cell:631-655-3683 I.CONTRACT: Whereas both Special FX Wizard Inc., herein referred to as the "Vendor" and Phenix Hook& Ladder Co. #1, herein referred to as "Sponsor"agree that the Vendor shall pending receipt of all required permits,written property owner consent,signed contract and payment in full, produce and display special effects, close pyrotechnics and/or fireworks, herein referred to as the "Effects" as contracted below and as indicated on the attached site plan: Date Rain Date Time of Display Duration Type of Effects Contract Total July1 2022 .s; •:Ju/y3;.2022minutes Fireworks $ Initial here that the`above has been read:and confirmed for accuracy;- .r i II. PAYMENT SCHEDULE: Payment of the Total Display Contract for$ of which Phenix Hook&Ladder Co.#1 is responsible for$—. The Total Contract shall be paid by Sponsor as follows: • A payment for$ due upon the return of this endorsing contract, no later than May 31,2022. • Balance payment of$ is due no later than June 15,2022. • A fee of$100.00, plus 2%interest will be charged to any unpaid balance per month. • The deposit is non-refundable, please read the Postponement section for details. III. DISPLAY SITE: The Sponsor shall provide an appropriate display site that meets the requirements of all applicable NFPA codes,state regulations and local regulations: • This display site is located at Greenport High School,Athletic Fields, 720 Front St.,Greenport,NY 11944 see attached site plan for accuracy. • The display site must be approved by the Vendor and the authority having jurisdiction over the display IV.SERVICE AGREEMENT: The Contract Total cost above is quoted fob destination at site for the display and transportation of personnel,and equipment.Services that need to be provided and paid for by the sponsor are as follows: • Include crediting as"Fireworks display by Special FX Wizard"in any advertising including radio announcements,fliers, posters, banners, press release, event programs, etc.Artwork will be provided for such purposes. • Security upon arrival until departure of Display areas, Discharge Sites and Fallout Areas, including any fencing and/or crowd control. • Security of equipment that will remain set-up from July 15L to July 3rd. (NO FIREWORKS STORAGE) • Discharge area mowed/removal of all flammable debris to allow for a safe display. (See site plan) • Provide 2-way radio and/or cell phone communications to provide a "go" cue. • Site access, use and detailed clean-up. Office 631-772-5157 Sales@SpecialFXWizard.com www.SpecialFXWizard.com Special FX Wizard Inc. PO Box 266 Mastic Beach, NY 11951 Office: 631-772-5157 Email: Sales@SpecialFXWizard.com y, a DISPL, Y I�-T,-, T GCS n Sponsor:- Phenix Hook&Ladder Co.#1 Greenport Fire Department G.F.D. Fax: 631-477-1943 G.F.D. E-mail:gfdfire@optonline.net Address: PO Box 58, 3rd St.,Greenport, NY 11944 Contact: Peter Harris Phone:631-447-2407 Cell:631-655-3683 I.CONTRACT: Whereas both Special FX Wizard Inc., herein referred to as the "Vendor" and Phenix Hook& Ladder Co. #1, herein referred to as "Sponsor"agree that the Vendor shall pending receipt of all required permits,written property owner consent,signed contract and payment in full, produce and display special effects, close pyrotechnics and/or fireworks, herein referred to as the "Effects" as contracted below and as indicated on the attached site plan: Date Rain Date Time of Display Duration Type of Effects Contract Total July 1,2Q22 July 3,2022 9 30„PM. .a, ',. S rnin'utes Fireworks Initial hereahat;the above has, een read and confirmed for.accuracy II. PAYMENT SCHEDULE: Payment of the Total Display Contract for ,of which Phenix Hook& Ladder Co.#1 is responsible for,$_. The Total Contract shall be paid by Sponsor as follows: • A payment for$ due upon the return of this endorsing contract, no later than May 31,2022. • Balance payment of$ is due no later than June 15,2022. • A fee of$100.00, plus 2%interest will be charged to any unpaid balance per month. • The deposit is non-refundable, please read the Postponement section for details. III. DISPLAY SITE: The Sponsor shall provide an appropriate display site that meets the requirements of all applicable NFPA codes,state regulations and local regulations: • This display site is located at Greenport High School,Athletic Fields, 720 Front St.,Greenport,NY 11944 see attached site plan for accuracy. • The display site must be approved by the Vendor and the authority having jurisdiction over the display IV.SERVICE AGREEMENT: The Contract Total cost above is quoted fob destination at site for the display and transportation of personnel,and equipment.Services that need to be provided and paid for by the sponsor are as follows: • Include crediting as"Fireworks display by Special FX Wizard"in any advertising including radio announcements,fliers, posters, banners, press release, event programs, etc.Artwork will be provided for such purposes. • Security upon arrival until departure of Display areas, Discharge Sites and Fallout Areas, including any fencing and/or crowd control. • Security of equipment that will remain set-up from July 111 to July 3r,. (NO FIREWORKS STORAGE) • Discharge area mowed/removal of all flammable debris to allow for a safe display. (See site plan) • Provide 2-way radio and/or cell phone communications to provide a "go" cue. • Site access, use and detailed clean-up. Office 631-772-5157 Sales@SpecialFXWizard.com www.SpecialFXWizard.com • Section VI Local,State and Federal Permits and Regulations. V. POSTPONEMENT or CANECLLATION: In the event the fireworks performance is rescheduled for any reason including weather or wind conditions,Special FX Wizard will work with the client on a future date as postponement date in consideration for a 10%fee per day of the Fireworks Contract total plus all out-of-pocket expenses if cancelled on the date of the display. If the event is cancelled no later than 30 days prior to the display date,there will be no cancelation fee.The show can be rescheduled to a Later date,the deposit will be applied to the new date scheduled.These costs shall be paid by the sponsor upon demand. In any event,the sponsor shall be responsible for full agreement price and those related costs as stated above. In the event the display is set up and it is postponed to the following day,the display will not be broken down.Additionally,the sponsor shall provide security for the site until the crew arrives the next day to run the display. VI.LOCAL,STATE, FEDERAL PERMITS AND REGULATIONS The Vendor shall file for all necessary..permits, licensees and approvals applicable to this contract. However, the sponsor shall be responsible for the payment of all government fees, fire department and police fees,taxes, including but not limited to, sales, use, excise,entertainment,import charges and bonds for such permits,licensees and approvals forthe display and the activities undertaken pursuant to this contract from the appropriate federal, state, and local authorities.This contract is subject to all federal, state, and municipal laws and regulations now in force or which may be enacted before the completion of this contract. Should any municipal, state or federal law or ordinance be passed which prohibits or restricts the performance or operation of the display described herein, the same shall automatically restrict or limit the effects performances described herein accordingly. In the event the federal government or other regulatory authorities restricts or prohibits the use of any display effect as set forth herein,preventing the vendor from providing the display as described above,then in such event,the vendor shall substitute an effect of equivalent entertainment value,such substitution shall not constitute a reduction in the contract price. VII.GENERAL PROVISIONS: Neither the Sponsor nor Vendor shall be in default or liable for any type of damages under this Agreement for any Force Majeure event. A Force Majeure Event is any such unforeseen act or event this is beyond the reasonable control of a party that prevents the Sponsor or Vendor from performing and is not the fault of the Sponsor or Vendor;and in addition a Force Majeure Event is also defined as war,government intervention, un-navigable waters or waterways,strikes, inclement weather,fire,explosions,civil disturbance,act of God or the public enemy, military action,terrorist act,unforeseeable or unpreventable lack of materials or equipment. • Once the contract is signed and the display is then cancelled by the Sponsor for any reason,the Vendor shall be paid one hundred percent(100%)of the total contract price. • The Vendor shall not be responsible for any weather or atmospheric conditions that may interfere with the display or aesthetic quality of the effects. • This contract constitutes the entire contract between the parties relating to the subject matter hereof,and may not be changed,modified, renewed,or extended except by a written contract,signed by the party against whom enforcement of change, modification, renewal or extension is sought. • Special FX Wizard Inc.agrees to procure general liability insurance in the amount of five million dollars and to issue form attached hereto,evidencing such insurance and covering the persons and entities named therein as additional insureds against any claims arising out of the sole negligence of Special FX Wizard Inc.in excess of$2,500.00 per event. • This contract shall be interpreted in accordance with and the rights of the parties hereto and shall be determined by,the laws of the State of New York. • Any and all disputes,controversies,actions,claims,or proceedings arising under,out of,in connection,or relating to the terms of this contract,and amendment thereof, commenced by; between or against any of the parties to this contract shall be commenced and maintained solely in the courts of the State of New York, and by the signing of this contract all parties hereby submit to this same jurisdiction. • By signing this contract the Sponsor agrees to reimburse the Vendor for any and all costs including but not limited to administrative and attorney fees related to any and all disputes,controversies,actions,claims,and/or proceedings arising under,out of, in connection,or relating to the terms of this contract. The authorized representatives of the parties hereby agree to the aforementioned terms and conditions of this contract.To validate this contract,it must be endorsed and returned to the Special FX Wizard Inc.on or before May 31,2022. Peter Harris Date Edward Rubio III Date President/CEO Office 631-772-5157 Sa1es@Specia1FXWizard.com www.SpecialFXWizard.com • Section VI Local,State and Federal Permits and Regulations. V. POSTPONEMENT or CANECLLATION: In the event the fireworks performance is rescheduled for any reason including weather or wind conditions,Special FX Wizard will work with the client on a future date as postponement date in consideration for a 10%fee per day of the Fireworks Contract total plus all out-of-pocket expenses if cancelled on the date of the display. If the event is cancelled no later than 30 days prior to the display date,there will be no cancelation fee.The show can be rescheduled to a later date,the deposit will be applied to the new date scheduled.These costs shall be paid by the sponsor upon demand. In any event,the sponsor shall be responsible for full agreement price and those related costs as stated above. In the event the display is set up and it is postponed to the following day,the display will not be broken down.Additionally,the sponsor shall provide security for the site until the crew arrives the next day to run the display. VI. LOCAL,STATE, FEDERAL PERMITS AND REGULATIONS The Vendor shall file for all necessary permits, licensees and approvals applicable to this contract. However, the sponsor shall be responsible for the payment of all government fees, fire department and police fees,taxes, including but not limited to, sales, use, excise,entertainment,import charges and bonds for such permits,licensees and approvals for the display and the activities undertaken pursuant to this contract from the appropriate federal, state, and local authorities.This contract is subject to all federal, state, and municipal laws and regulations now in force or which may be enacted before the completion of this contract.Should any municipal, state or federal law or ordinance be passed which prohibits or restricts the performance or operation of the display described herein, the same shall automatically restrict or limit the effects performances described herein accordingly. In the event the federal government or other regulatory authorities restricts or prohibits the use of any display effect asset forth herein,preventing the vendor from providing the display as described above,then in such event,the vendor shall substitute an effect of equivalent entertainment value,such substitution shall not constitute a reduction in the contract price. VII.GENERAL PROVISIONS: Neither the Sponsor nor Vendor shall be in default or liable for any type of damages under this Agreement for any Force Majeure event. A Force Majeure Event is any such unforeseen act or event this is beyond the reasonable control of a party that prevents the Sponsor or Vendor from performing and is not the fault of the Sponsor or Vendor;and in addition a Force Majeure Event is also defined as war,government intervention, un-navigable waters or waterways,strikes,inclement weather,fire,explosions,civil disturbance,act of God or the public enemy, military action,terrorist act, unforeseeable or unpreventable lack of materials or equipment. • Once the contract is signed and the display is then cancelled by the Sponsor for any reason,the Vendor shall be paid one hundred percent(100%)of the total contract price. • The Vendor shall not be responsible for any weather or atmospheric conditions that may interfere with the display or aesthetic quality of the effects. • This contract constitutes the entire contract between the parties relating to the subject matter hereof,and may not be changed,modified, renewed,or extended except by a written contract,signed by the party against whom enforcement of change,modification, renewal or extension is sought. • Special FX Wizard Inc.agrees to procure general liability insurance in the amount of five million dollars and to issue form attached hereto,evidencing such insurance and covering the persons and entities named therein as additional insureds against any claims arising out of the sole negligence of Special FX Wizard Inc. in excess of$2,S00.00 per event. • This contract shall be interpreted in accordance with and the rights of the parties hereto and shall be determined by,the laws of the State of New York. • Any and all disputes,controversies, actions,claims,or proceedings arising under,out of,in connection,or relating to the terms of this contract,and amendment thereof,commenced by,between or against any of the parties to this contract shall be commenced and maintained solely in the courts of the State of New York, and by the signing of this contract all parties hereby submit to this same jurisdiction. • By signing this contract the Sponsor agrees to reimburse the Vendor for any and all costs including but not limited to administrative and attorney fees related to any and all disputes,controversies,actions,claims,and/or proceedings arising under,out of, in connection,or relating to the terms of this contract. The authorized representatives of the parties hereby agree to the aforementioned terms and conditions of this contract.To validate this contract,it must be endorsed and returned to the Special FX Wizard Inc.on or before May 31,2022. Peter Harris Date Edward Rubio III Date President/CEO Office 631-772-5157 Sa1es@Specia1FXWizard.com www.SpecialFXWizard.com DATE AC40R" CERTIFICATE OF LIABILITY INSURANCE FO6-01-2022(MM/DDNYYY) 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 NAME: PROFESSIONAL PROGRAM INSURANCE BROKERAGE a/c°No Ext:415-475-4300 FA No:415-475-4304 DIVISION OF SPG INSURANCE SOLUTIONS, LLC E-MAIL ADDRESS: 1304 SOUTHPOINT BLVD.,#101 INSURER(S)AFFORDING COVERAGE NAIC# PETALUMA CA,94954 INSURERA: Certain Underwriters at Lloyd's,London 15792 INSURED INSURER B: NYSIF Special FX Wizard Inc. INSURERC: P.O Box 266 INSURER D: Mastic Beach,NY 11951 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 LTR TYPE OF INSURANCE AINSR S POLICY POLICY NUMBER MMIDD MM DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 5,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED 50,000 PREMISES Ea occunence $ X CLAIMS-MADE OCCUR MED.EXP(Any one person) $ A X PY(22-0087 05/05/2022 05/05/2023 PERSONAL&ADV INJURY $ T E 11 4SURER(S)NAMED HEREIN IS(ARE)NOT GENERAL AGGREGATE $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ PRO- LI E SED BY THE STATE OF NEW YOR ,NOT X POLICY E LOG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT EVENT OF THE INSOLVENCY OF THE INSURER Ea accident ANY AUTO (S . i N T PROTECTED BY NEW YORK ST TE BODILY INJURY(Per person) $ ALL OWNED SCHEDULED I AUTOS AUTOS SE CU TY FUNDS. THE POLICY MAY NOT BE BODILY INJURY(Per accident) $ NON-OWNED, PROPERTY DAMAGE $ HIRED AUTOS AUTOS S B CT TO ALL OF THE REGULATIONS OF Per accident UMBRELLA LIAB OCCUR PI RT INING TO POLICY FORMS. EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X TORYTA U- OTR AND EMPLOYERS'LIABILITY B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A 2513 166-5 05/23/2022 05/23/2023 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 1.,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Greenport High School;Town of Southold;Village of Greenport;Greenport Fire Department,for permits only; Blue Sky Amusements;State of New York are Additional Insured as respects the Class B Aerial Fireworks display(s)on 07/01/2022(RD:07/03/2022)located at Greenport High School athletic fields,720 Front St., Greenport, NY 11944. This policy provides a two-year extended reporting period from the date of the display.30-day notice of cancellation applies. CERTIFICATE HOLDER CANCELLATION Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 53095 Main Rd. PO Box 1179 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Southold NY 11971 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD A� CERTIFICATE OF LIABILITY INSURANCE Fo,,-01-2022D/YYYY) 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 NAME: PROFESSIONAL PROGRAM INSURANCE BROKERAGE n/allo Ext:415-475-4300 A/C No:415-475 4304 E MAIL DIVISION OF SPG INSURANCE SOLUTIONS, LLC ADDRESS: 1304 SOUTHPOINT BLVD.,#101 INSURERS AFFORDING COVERAGE NAIC# PETALUMA CA,94954 INSURER A: Certain Underwriters at Lloyd's,London 15792 INSURED INSURER B: NYSIF Special FX Wizard Inc. INSURERC: P.O Box 266 INSURER D: Mastic Beach,NY 11951 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR IN WVO POLICY NUMBER MM/DDIYYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 5,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) ccurrence $ 50,000 X CLAIMS-MADE F—IOCCUR MED EXP(Any one person) $ A X PY/22-0087 05/05/2022 05/05/2023 PERSONAL&ADV INJURY $ T E 11 4SURER(S)NAMED HE IN IS(ARE)NOT GENERALAGGREGATE $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: LI E SED BY THE STATE OF NEW YOR NOT PRODUCTS-COMP/OP AGG $ X POLICY PRO LOC $ COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY EVENT OF THE INSOLVENCY 13F THE INSURER Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED (S ,NOT PROTECTED BY NEW ORK ST TE BODILY INJURY(Per accident) $ AUTOS AUTOS S CU TY FUNDS. THE POLICY MAY N T BE NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS S BJ CT TO ALL OF THE RE ULATIO S OF Per accident UMBRELLA LIAB OCCUR P1 R.T. INING TO POLICY FOR S. EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION YIN X WC STATU- OTH- AND EMPLOYERS'LIABILITY /� T LIMITS E B ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A 2513 166-5 05/23/2022 05/23/2023 (Mandatory in NH) EL DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Greenport High School;Town of Southold;Village of Greenport;Greenport Fire Department,for permits only; Blue Sky Amusements;State of New York are Additional Insured as respects the Class B Aerial Fireworks display(s)on 07/01/2022(RD:07/03/2022)located at Greenport High School athletic fields,720 Front St., Greenport,NY 11944. This policy provides a two-year extended reporting period from the date of the display.30-day notice of cancellation applies. CERTIFICATE HOLDER CANCELLATION Town of Southold SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 53095 Main Rd. PO Box 1179 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Southold NY 11971 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER: PY/22-0087 PYROTECHNIC LIABILITY THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. ADDITIONAL INSURED Underwriter's at Lloyd's,London: Referred to in this endorsement as either the"Insurer"or the"Underwriters" This endorsement modifies insurance provided under the following: SECTION III.PERSONS INSURED In consideration of the premium charged for the Policy, it is hereby understood and agreed that the following entity(ies)is an additional insured pursuant to Section III. e), but only as respects the specific Display or Special Effects listed on the attached Certificate of Insurance: Name of Person or Organization(Additional Insured): Town of Southold 53095 Main Rd. PO Box 1179 Southold NY 11971 Any coverage afforded to any above person or entity as an Additional Insured shall apply only with respect to Bodily Injury or Property Damage directly resulting from(1)the Named Insured's ongoing operations performed for such specific person and entity; or(2)acts or omissions of the Additional Insured in connection with their general supervisions of the Named Insured's ongoing operations. Coverage for such person or entity as an Additional Insured does not apply to: W Personal Injury and Advertising Injury Liability; (ii) Fire Legal Liability; (iii) Employee Benefits Liability; (iv) Bodily Injury or Property Damage which the person or entity is obligated to pay as damages by reason of the assumption of liability under a contract or agreement but this shall not apply to liability for damages the person or entity would have in the absence of the contract or agreement; (v) Property Damage to: (1)property owned,used or occupied by or rented to such person or entity; (2) property in the care custody,or control of such person or entity or over which such person or entity is for any purpose exercising physical control; or(3) any work,including materials,parts or equipment furnished in connection with such work,which is performed for the person or entity by or on behalf of the Named Insured. (vi) Products-Completed Operations Hazards; (vii) Any obligation assumed by the Additional Insured in any contract related to the Display or Special Effects listed in the attached Certificate of Insurance. (viii) Such other Claims,Accidents,offenses, damages and/or liabilities which may be excluded pursuant to Section V.Exclusions of the Policy. All other terms, exclusions and conditions of this Policy remain unchanged. PY AI 006 6-14 POLICY NUMBER: PY/22-0087 PYROTECHNIC LIABILITY THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. ADDITIONAL INSURED Underwriter's at Lloyd's,London: Referred to in this endorsement as either the"Insurer"or the"Underwriters" This endorsement modifies insurance provided under the following: SECTION III.PERSONS INSURED In consideration of the premium charged for the Policy, it is hereby understood and agreed that the following entity(ies)is an additional insured pursuant to Section III. e),but only as respects the specific Display or Special Effects listed on the attached Certificate of Insurance: Name of Person or Organization(Additional Insured): Town of Southold 53095 Main Rd. PO Box 1179 Southold NY 11971 Any coverage afforded to any above person or entity as an Additional Insured shall apply only with respect to Bodily Injury or Property Damage directly resulting from(1)the Named Insured's ongoing operations performed for such specific person and entity; or(2) acts or omissions of the Additional Insured in connection with their general supervisions of the Named Insured's ongoing operations. Coverage for such person or entity as an Additional Insured does not apply to: (i) Personal Injury and Advertising Injury Liability; (ii) Fire Legal Liability; (iii) Employee Benefits Liability; (iv) Bodily Injury or Property Damage which the person or entity is obligated to pay as damages by reason of the assumption of liability under a contract or agreement but this shall not apply to liability for damages the person or entity would have in the absence of the contract or agreement; (v) Property Damage to: (1)property owned,used or occupied by or rented to such person or entity; (2) property in the care custody, or control of such person or entity or over which such person or entity is for any purpose exercising physical control; or(3) any work,including materials,parts or equipment furnished in connection with such work,which is performed for the person or entity by or on behalf of the Named Insured. 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Longitude 72°22'17.4411W r � .,I 11 IO 2 i 0 4 i 0 3 All Information contained on this document is copyright material and the intellectual property of Special FX Wizard Inc.Reproduction and/or circulation without approval of Special FX Wizard Inc.is prohibited. Rev 5/17/22 1 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-NTMS (1-877-487-6867) at least 24 hours (but not more than 7 days) in advance to request a Notice to Air Missions (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-ATO-ESA-OSG-Fireworksnfaa.gov Sincerely, Matthew N.Cathcart Manager, Operations Support Group 1 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 pen-nit. 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-NTMS (1-877-487-6867) at least 24 hours (but not more than 7 days) in advance to request a Notice to Air Missions (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-ATO-ESA-OSG-Fireworks@faa.gov Sincerely, Matthew N. Cathcart Manager, Operations Support Group GREENPORT UNION FREE SCHOOL DISTRICT tO FRONT STREET G ORT NEW YORK 11944 Request to Use Building and/or Grounds . . .... ...=.� 4DsOd Sufi xtt u. Areas to be used (check all that apply): "Subject to availability when not in use by.the school Ciassrot>zns Qyms Ftelds uncls Front I ubbjr uditorium (please A Spt cafy, (1'lase S ect _F Y) (flea"se Specify,; {Including::. l oi3zns t; . hallr�tays �. �rtelttdta :Fronf Driveway) Other Orgaton and Event Details Name of Organization:. Addresse ' Telephone: r .......... Event Supervisor: Name of Event- um i V Nber of Participants Expected: 96 Will the Event be Open to the Public Is this a FOk PROFIT Organization: Admission Charge Amount: Purpose of Admission Charge: Will refreshments be served?Give details: ' � GREENPORT UNION FREE SCHOOL DISTRICT 720 FRONT STREET PI ENPOR'T"WEW YORK 11944 Request to Use Building and/or Grounds etiedJLc vj�..1 3 d Areas to be used(check all that apply) "Subject to availability when not in use by.the school CIassroe s Gyms Ftel s Gzr�unds> Frorat;i obby Auditorium (Please Spicify' (Please SpeeXfy) (Please S eci fyt {inclading . ,),. �ncla�liu�l;rout� T�allvtays). Driveway) Other $'gation and Event Details Name of Organization: tddtess Telephone. Ca� r�a `r': t1G� 22( ,SAS SIP�� Eyent Supervisor: n Name of Event: ly 1 S i •f?rs!;. wor 3'r"d Number of Participants Expected: OD — 9,60 Will the Event be Open to the Public. 9 7- Is this a FOR PROFIT Organization: / /Yd Admission Charge Amount: �, /v .... . Purpose of Admission Charge: Will refreshments be served?Give details: '„ � pe Ift Equipment and Services.Needed Number of Tables Needed: Where Placed: Number of Chairs Needed. Where Placed: Lighting(Auditorium): Sound(Auditorium): - Gymnasium Bleachers Needed: Other OW+5 AGREEMENT: The undersigned is over 21 years of age and has read this form andsattached regulations and agrees to comply with them.He/She agrees to be responsible to Greenport Union Free School District for,tlie;use and care of the facilities.He/She,oil behalf of the user organization does hereby covenant and agte£'to defend,indemnify and hold harmless the District from and against any and all liability,loss,darrta claims,or actions(including costs and attorney's fees)for bodily injury and/or property damage,tg.the extent permissible by law :arising out-of or in connection with the'actual or proposed use of the'Diitrict's pro .. cites•ati'10,,services by the user organization. Signature of Organ #tope's Represtatt'ire" _ Date Print Name of Organization's Representative Date Approved Disapproved Signature of upertr►tersdent Date ,/ Specift ,Equipment and Services Needed Number of Tables Needed. Where Placed: Number of Chairs Needed: Where Placed: Lighting(Auditorium): Sound(Auditorium): "Gymnasium Bleachers Needed: Other: AGREEMENT: The undersigned is over 21 years of age and has read this form and=attached regulations and 4$0 ,to comply with them.He/She agrees to be responsible to Greenport Union Free School District for the ,use and care of the facilities.He/She,on behalf of the user organization does hereby covenant and ague to defend,indemnify and hold harmless the District from and against any and all liability,loss,dSx Oos claims,or actions(including costs and attorney's fees)for bodily injury and/or property damage,t, the %extent permissible by law,arising out of or in connection with the actual or proposed use of the Diib ict'.s proCiltes• i' services by the user organization. (Signature of , hon',s lepreseritatie. Date 7 a .Print Name of Organzation's Representative Date Approved Disapproved Signature of uportntcndent Date CHIEF'WAYDE;MANwAR(NG (631):477 9801 -STAT OtJ 1 15TASST.CHIEF ALAIN DEKERILLIS (631)477-8261 -,STATION 2 21111ASST.CHIEF CRAIG JOHNSON (631)477-1943-CHIEFS OFFICE CHAPLAIN FRANK MUSTO � ' " (631)477.4012-FAX ' 311 THIRD,STF EET•P.O.BOX:88 ASST.CHAPLAIN CLAUDEKUh1JIgP1, ' GREENPORT,:NY 11944 SECRETARYITRErASURER ALAIN DEKERILLIS - Px <tMrr 4:g(dfireC optonl ni:net DEPARTMtNT SECRETARY JAMES KALIN € www;greenporifd.org June 1, 2022 To Whom it May Concern, The Phenix Hook & Ladder Co. # 1 and the Relief Hose Co.#2 of the Greenport Fire Department will be having fireworks displays on Friday,July 1, 2022 A rain date will be Sunday,July 3, 2022. The displays will be shot from the athletic fields of the Greenport Public School. Greenport Fire Department will be standing by with two (2)fire engines, one (1) ambulance and any additional apparatus as needed. If you have any questions please feel free to contaet:any fire chief at the phone number above. i cerely, ,,. JamesH.,Ka(n Secretary CHIEF W)U YDE,MANVVARINc (631)477-9801 --STA`I;IOW 15TASST.CHIEF ALAIN DEkERILLIS (631)4.7 J-8261 -.STATION 2 2N11ASST.CHIEF CRAIG J€)HRVSfSN (631)477-1943-CHIEFSOFFIGE kl}�PLAiN,:FRANK MUSTO (631)477-4012-FAX ASST.CH,A1?LAIN CI AtJC)E KUR1JiAiV 311 THIRDSTFiEET P.O.BOXil58 GREENPORT:NY 11944 SECRETARYJREASUR913 ALAIN DEKERILLIS Srna i g(zllire Ps niina;net DEPARTMEW'SECRETARY JAMES KALIN 1v yyc;g a 1pQrtfd.otg June 1, 2022 To Whom it May Concern, The Phenix Hook & Ladder Co. # 1 and the Relief Hose Co.#2 of the Greenport Fire Department will be having fireworks displays on Friday,July 1, 2022 A rain date will be Sunday,July 3, 2022. The displays will be shot from the athletic fields of the Greenport Public School. Greenport Fire Department will be standing by with two (2)fire engines, one (1) ambulance and any additional apparatus as needed. If you have any questions please feel free to'contaet`any fire chief at the phone number above. i ,cerely,. k .James N..,;Kaln Secretary ' �3910 1512 OREENPORT FIRE DEPARTMENT 1 1 P IENIX HOOK&LADDER CO. DATE y � � 212 KNAC'P PUACE i 'iEfKi6 11944 PAY d v r»d vd z JW� e H DOLLAR. 8 IMP JPM4 an;Ehase Bank,NA ewww.Chasecom _ MEMO 1����J�i�� ! E!��/ �� t _ _� _ nn+ s1:0 2 10000:21i: 13 10 139 3911015 12 Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 06/06/22 Receipt#: 300368 Quantity Transactions Reference Subtotal 1 Fireworks 7.1.2022 $100.00 Total Paid: .$100.00 Notes: Payment Type Amount Paid By CK#1512 $100.00 Department, Greenport Fire Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Department, Greenport Fire 212 Knapp Place Greenport, NY 11944 Clerk ID: DENISN Internal ID:7.1.2022 Noncarrow, Denis From: Flatley, Martin Sent: Monday,June 6, 2022 10:29 AM To: Noncarrow, Denis Subject: RE: Greenport Fire Department/Firework App. Looks good to.me, as long as they are licensed to perform displays. Also could you let Lyn know that the Triathlon people should not receive their deposit back as they left all of their.orange-painted markings all over the roads in the Bayview area. 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. From: Noncarrow, Denis<denisn@southoldtownny.gov> Sent:'Monday;June 6, 2022 9:50 AM To: Blasko, Regina<rblasko@town.southold.ny.us>; Doroski, Melanie<Melanie.Doroski@town.southold.ny.us>; Flatley, Martin <mflatley@town.southold.ny.us>; Norklun, Stacey<Stacey.Norklun@town.southold.ny.us>; Spiro, Melissa <Melissa.Spiro@town.southold.ny.us>; Doherty,Jill <jill.doherty@town.southold.ny.us>; Doroski, Greg <greg.doroski@town.southold.ny.us>; Louisa Evans<Ipevans06390@gmail.com>; Mealy, Brian <brian.mealy@town.southold.ny.us>; Nappa, Sarah.<Sarah.nappa@town.southold.ny.us>; Noncarrow, Denis <denisn@southoldtownny.gov>; Rudder, Lynda <lynda.rudder@town.southold.ny.us>; Russell,Scott <Scott.Russell @town.southold.ny.us>; Standish, Lauren <Lauren.Standish@town.southold.ny.us>;Tomaszewski, Michelle<michellet@town.southold.ny:us>; Burke,John <johnbu@southoldtownny.gov>; Hagan, Damon <damonh@southoldtownny.gov>; Mirabelli, Melissa <melissa.mirabelli@town.southold.ny.us> .Cc: Rudder, Lynda <lynda.rudder@town.southold.ny.us> Subject: Greenport Fire Department/Firework.App. Importance: High If you can please review ASAP.The old Firework company backed out. Thank you Denis Noncarrow Southold Town Clerk. Town of Southold, New York www.southoldtownny.gav denisn@southoldtownny.pov 1 631-765-1800 CONFIDENTIALITY NOTICE: This communication with its contents may contain confidential and/or legally privileged information. It is solely for the use of the intended recipient(s). Unauthorized interception, review, use or disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy Act. If you are not the intended recipient, please contact the sender and destroy all copies of the communication. • 2 . DENIS NONCARROW ®� �.�� Town Hall,53095 Main Road TOWN CLERK P.O.Box 1179 Cn Southold,New York 11971 REGISTRAR OF VITAL STATISTICS t5 Fax(631)765-6145 MARRIAGE OFFICER Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER ®•( '�� www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD PERMIT For PUBLIC DISPLAY'OF FIREWORKS I, DENIS NONCARROW, Town Clerk of the Town of Southold, Suffolk County,New York, being an officer duly designated by the Town Board of the Town of Southold for this purpose, do hereby GRANT TO: GREENPORT FIRE DEPARTMENT STAR HOUSE CO. , THIRD STREET, GREENPORT A PERMIT FOR THE PUBLIC DISPLAY OF FIREWORKS by said organization in accordance w th the provisions of Section 405.00 of the Penal Law of the State of New York at 10:00 p.m. on Saturday, . a # 4� 12�tRaindate: Sunda May 29 2022 on the property of GREENPORT PUBLIC SCHOOL Athletic Field north side Front Street and east side Moores Lane, Greenport , New York. ON CONDITION THAT the bond (indemnity insurance) required shall continue in full force and effect in favor of the Town of Southold,and PROVIDED that the actual point at which the fireworks are to be fired shall be at least two hundred feet from the nearest building, public highway or railroad, or other means of travel, and at least fifty feel from the nearest above ground telephone or telegraph line, trees or other overhead obstruction; that the audience at such display shall be restrained behind lines at least one hundred and fifty feet from the point at which the fireworks are discharged and only persons in active charge of the display shall be allowed inside these lines; that all fireworks that fire a projectile shall be so set up that the projectile will go in the air as nearby as possible in a vertical direction, unless such fireworks are to be fired from the shore or a lake or other large body of water, then they may be directed in such manner that the falling residue from the deflagration will fall in to such lake or body of water; that any fireworks that remain unfired after the display is conducted shall be immediately disposed of in a way safe for the particular type of fireworks remaining; that no fireworks display shall be held during any wind storm in which the wind reaches a velocity of more than thirty miles per hour; that all persons in actual charge of firing the fireworks shall be over the age of eighteen years, competent and physically`fit for the task, that there shall be at least two such operators constantly on duty during the discharge and that at least two soda acid or other approved pe fire extin ` *shers of at least two and one-half gallons capacity each shall be kept at such widely sep at po'nts as sible within the actual area of the display. Denis Noncarrow, Southold Town Clerk (Town Seal) Suffolk County,New York Date: March 29, 2022 THIS PERMIT IS NOT TRANSFERABLE Southold Town Board - Letter Board Meeting of March 29, 2022 RESOLUTION 2022-290 Item# 5.28 y3 '�°lam Yea ADOPTED DOC ID: 17925 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2022-290 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON MARCH 29,2022: RESOLVED that the Town Board of the Town of Southold hereby approves the issuance of a fireworks permit by the Town Clerk to Star Hose Company of the Greenport Fire Department for a fireworks display at 10:00 PM on Saturday May 28, 2022 (Rain Date of: Sunday May 29, 2022) at Greenport High School's Athletic Field located on the north side of Front Street and the east side of Moores Lane, Greenport,New York upon the payment of a single fee of$100 and subject to the applicant's compliance with the requirements of the Town's policy regarding the issuance of fireworks permits and subject to the approval of the Town Attorney. Denis Noncarrow Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Brian O. Mealy, Councilman SECONDER:Sarah E.Nappa, Councilwoman AYES: Nappa, Doroski, Mealy, Doherty, Evans Generated March 30, 2022 Page 42 RECEIVED VAR 17 2022 ELVABET111A.NEVILLE,MMC pyo l/ Zbwn XWjS lA T WA Clerk TOWN CLERK p P.O.Box 1179 cSouthold,New York 11971 REGISTRAR OF VITAL STATISTICS p Aftv Fax(631)765-6145 RECORDS OF MANAGEMENT OFFICER AGE OFFICERy�®j ,A`�4� Trlephone n.no 765-1800 e FREEDOM!OF INFORMATION OFFICER southoldtown.norEhfork.net >02140660c OFFICE OF THE TOWN CLERK FOR DEPOSIT ONLY TOWN OF SOUTHOLD DENIS NONCARROW APPLICATION SOUTHOLD TOWN CLMK PERMIT TO DISPLAY FIREWORKS 0500015466 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 tia R' s -Greenpo r De ac e t PRINCIPAL OFFICE AT P.�."F 7 ;G— e' rfe amort l .�a T, , €� �1'g'4 DATE&TIME OF DISPLAY 5/28/22 @ 10:00 pm EXACT LOCATION-OF DISPLAY Greenport High School Athletic Field SUFFOLK COUNTY TAX MAP NUMBER FOR SITE see attached map RAIN DATE&TIME 5/29/22 @ 10:00 pm The following persons are to be in charge of the actual shooting of the fireworks: Name Age Experience Physical Condition Richard Gomberg 59 15 yrs. Fit Edward Matuszak 67 20 yrs. Fit (Additional names and information may be submitted on an attached sheet Number and type of fireworks is as follows: 1.3G Fireworks: Opening: 5-3"Shells&64-1" Shells (1 Cake); Body: 20-2 1/2"Shells, 127-3"Shells, 5 - Multi Shot cakes 1"or less shells (243 total shots), Finale: 1 - Multi Shot Cake (64- 1" shells), 100-2 1/2" Shells, 70-3"Shells. Manner and place of storage of fireworks prior to display: Fireworks will be stored in a SWFF box truck and arrive 4 hours prior to display. Fireworks will be placed in there appropriate mortars for firing. 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. Santore's World Famous Fireworks LLC FES: $100 Name of Organization See policyvfor additional information Jeffrey Ward - Manager B,y Printed Name of Applicantignatur of Applicant e-mail address: Jward@santorefireworks.com 518 3/15/2022 Telephone Number ( ) 664-9994 Date of Application oFOL��o ELIZABETH A.NEVILLE,MMC may. �y Town Hall,53095 Main Road TOWN CLERK P.O.Box 1179 t� Southold,New York 11971 REGISTRAR OF VITAL STATISTICS • . Fax(631)765-6145 MARRIAGE OFFICER yaQ� Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD POLICY for the Issuance of Fireworks Permits 1. The Town may grant a permit for the display of fireworks by municipalities, fair associations,amusement parks, ep rsons or organizations of individuals. Penal Law Section 405.00(2). 2. An"organization of individuals"is a religious,civic,or comparable organization. Op. Atty. Gen No.2007-3. 3. Fireworks permits shall indicate that the display must be concluded by 10:00 p.m.if held Sunday-Thursday, 11:00 p.m.if held Friday or Saturday,and there shall be no time restriction if held on July 4. 4. No person shall engage in or allow the manufacture,assembly,storage or display of any fireworks or pyrotechnics display without first obtaining a permit issued by the Town Clerk. A completed application for display of fireworks must be received by the Town Clerk a minimum of 30 days prior to the date of display. The permit application for any fireworks or pyrotechnics display shall be accompanied by the following:- (a) ollowing:(a) a copy of a valid certificate of competency as a pyrotechnician for the individual supervising the firing of the display; (b) Certificate of Insurance naming the Town of Southold as additional insured with coverage limits of$2,000,000 for public liability and$2,000,000 for property damage; (c) Detailed diagram showing location of fireworks discharge and minimum separation distances in accordance with the applicable requirements of Penal Law Section 405(2); (d) A copy of the contract with fireworks display company; and (e) All applications shall require the approval of the Fire Chief of the District in which the display will take place and the Fire Marshal before being presented for approval by the Town Board. 5. All applications for a fireworks permit shall be subject to an application fee in an amount of$100.00,together with a processing fee in an amount to be determined by the Town Board to cover the Town's costs for monitoring and enforcing compliance with the Penal Law. (The above instructions are in accordance with the Penal Law,Article 405 -Licensing and other provisions relating to fireworks.) ,�- rC io GREENPORT FIRE DEPARTMENT GREENPORT, NEW YORK 300 ft radius , 3 inch max .: ` `AT "# ® amid vt ow LL (72 Aw �r s a r t STATE OF NEW YORK - DEPARTMENT OF LABOR PYROTECNNICIAN CERTINCATE CSE COMPETENCE RICHARD W GOMBERG CLASS: P NON PROXIMATE AUDIENCE ONLY THIS CARO MUST RE CARRIED WHEN USING PYRGT F*695 NYC & NYS CERTIFICATIONS REQUIRED IN NYC , STATE OF NEW YORK DEPARTMENT OF LABOR PYROTECHNICIAN CERTIFICATE OF COMPETENCE EDWARD MATUSZAK 3: CLASS: B NON PROXIMATE AUDIENCE ONLY THIS CARD MUST BE CARRIED WHEN USING PYROT CERT# P425 NYC & NYS CERTIFICATIONS REQUIRED IN NYC I�nitlt���tll �Itl�t/lilt i� UNITED STATES OF AfAERIicr xi DEPARTMENT OF TRANSPORTATION . FEDERAL AVIATION ADMINISTRATION IV NAME EDWARD MATUSZAK V ADDRESS 675 BOELSEN DR WESTBURY NY 11""90-5904 VI NATIONALITY USA SEX HEIGHT WEIGHT HAIR EYE IVa D.O.B. 5 DEC 1954 M 71 260 BROWN BLU IX HAS BEEN FOUND TO BE PROPERLY QUALIFIED TO EXERCISE THE PRIVILEGES OF II REMOTE PILOT 01 CERTIFICATE NUMBER 4081457 Y DATE OF ISSUE 26 DEC 2017 XN VM ACTING ADMINISTRATUR pF NEI{ STATE OF NEW YORK �;��„ AT DIVISION OF DEPARTMENT OF LABOR '' SAFETY AND HEALTH LICENSE TO DEAL IN OR MANUFACTURE EXPLOSIVES Expires: 12/31/2022 Santore's World Famous Fireworks, LLC 846 Stillwater Bridge Rd THIS LICENSE MUST BE Schaghticoke, NY 12154 POSTED IN YOUR PLACE OF BUSINESS August N. Santore, Jr. License No D-5796 is hereby licensed to deal in or manufacture explosives in compliance with the requirements of the Labor Law and Industrial Code Rules. Any change in the conditions under which this license is granted may cause it to be revoked. Eileen M. Franko,Acting Director FOR THE COMMISSIONER OF LABOR Every person selling, delivering or giving away any explosives must keep at the principal place of business within the state, a record of each transaction, including: 1) the NAME or TYPE and QUANTITY of explosives SOLD, DELIVERED or GIVEN. Note: No license is needed to purchase smokeless powder,or black powder in quantities not exceeding five pounds for use in firing antique firearms or artifacts or replicas thereof. However,dealers MUST post all such transactions on the"Dealer-Manufacturer Report of Explosives Transactions". 2) the DATE OF EACH SALE, DELIVERY or GIFT. 3) the NAME, LICENSE NUMBER, and BUSINESS ADDRESS of the purchaser, donee,or person to whom the explosives were delivered and the firm, if any, represented by such person. 4) the NAME,ADDREFS, and LICENSE NUMBER of the person TAKING THE EXPLOSIVES AWAY from the seller or donor. SH-862(5-98) Federal Explosives License/Permit U.S.Department of Justice Bureau of Alcohol,Tobacco,Firearms and Explosives (I8 U.S.C. Chapter 40) us�u�rarsaamen®awl In accordance with the provisions of Title XI,Organized Crime Control Act of 1970,and the regulations issued thereunder(27 CFR Part 555),you may engage in the activity specified in this license or permit within the limitations of Chapter 40,Title 18,United States Code and the regulations issued thereunder,until the expiration date shown. THIS LICENSE IS NOT TRANSFERABLE UNDER 27 CFR 555.53. See"WARNINGS"and'NOTICES"on reverse. Direct ATF ATF-Chief,FELC License,Permit Correspondence To 244 Needy Road Numberi Martinsburg,WV 25405-9431 C-01 080 Chief.Federal Explosives Licensing Cente (FELC) Expiration Date March 1 , 2024 Name SANTORES WORLD FAMOUS FIREWORKS LLC Premises Address(Changes? Notify the FELC at least 10 days before the move.) 846 STILLWATER BRIDGE ROAD SCHAGHTICOKE NY 12154- Type of License or Permit 20-MANUFACTURER OF EXPLOSIVES Purchasing Certification Statement Mailing Address(Changes? Notify the FELC of any changes.) The licensee or permittee named above shall use a copy of this license or permit to assist a transferor of explosives to verify the identity and the licensed status of the licensee or permittee as provided by 27 CFR Part 555. The signature on each copy must be an original signature. Afaxed,scanned or e-mailed copy of the license or permit with a signature SANTORES WORLD FAMOUS FIREWORKS LLC intended to bean original signature is acceptable. The signature must be that of the Federal 143 SUMMIT AVE Explosives Licensee(FEL)or a responsible person of the FEL. I certify,that this is a true BERKELEY HEIGHTS, NJ 07922- cop),of a license or permit issued to the licensee or permittee named above to engage in the business or operations specified above under"Type of License or Permit." 0,y/j Liciggseli PerriiittreResponsible Person Signature Position,Title ,TtLfrcy 7// I /2 L Printed Name Date An Form MW W-14 u 15 Part I Previous Edition is Obsolete SANW SWOWFAMU5FIREWO ULA"STILLWTERSROGERM0.Rlbli-IY•AJ49Niloa:snn1.M4A4WWXTUsEewexnoava Revised5epternber2011 Federal Explosives license(FEL)Customer Service Information Federal Explosives Licensing Center(FELC) Toll-free Telephone Number: (877)283-3352 ATF Homepage:www.atf.gov 244 Needy Road Fax Number: (304)6163401 Martinsburg,WV 25405-9431 E-mail: FELC(datf.gov Change of Address (27 CFR 555.54(a)(1)). Licensees or permittees may during the term of their current license or permit remove their business or operations to a new location at which they intend regularly to carry on such business or operations. The licensee or permittee is required to give notification of the new location of the business or operations not less than 10 days prior to such removal with the Chief;Federal F,xplosives Licensing Center. The license or permit will be valid for the remainder of the term of the original license or permit. (The Chief,FELL,shall,if the licensee or permittee is not qualified,refer the request for amended license or permit to the Director of Industry-Operations for denial in accordance with§555.54.) Right of Succession (27 CFR 555.59). (a)Certain persons other than the licensee or permittee may secure the right to carry on the same explosive materials business or operations at the same address shown on,and for the remainder of the term of,a current license or permit. Such persons are: (1)The surviving spouse or child,or executor,administrator,or other legal representative of a deceased licensee or permittee;and(2)A receiver or trustee in bankruptcy,or an assignee for benefit of creditors. (b)In order to secure the right provided by this section,the person or persons continuing the business or operations shall furnish the license or permit for for that business or operations for endorsement of such succession to the Chief,FELC,within 30 days from the date on which the successor begins to carry on the business or operations. (Continued on reverse side) Cut Here X Federal Explosives License/Permit(FEL)Information Card I LicenseiPermit Name:SANTORES WORLD FAMOUS FIREWORKS LLC I I I I I Business Name: I I I LicensePermit Number:6-NY-083-20-4C-01080 I I LicensevPermit Type:20-MANUFACTURER OF EXPLOSIVES Expiration: March 1,2024 II I Please Note: \of Valid for the Sale or Other Disposition of Explosives. I I I —----------——————————————————————— — A� CERTIFICATE ®F LIABILITY INSURANCE DA E(MMI022�n 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 NAME: Britton-Gallagher and Associates, Inc. PHONE FAx One Cleveland Center, Floor 30 A/c No ExtI:216-658-7100 AIC Nol:216-658-7101 1375 East 9th Street E-MAIL Cleveland OH 44114 INSURERS AFFORDING COVERAGE NAIC# INSURERA:Everest National Insurance Company 10120 INSURED 18341 INSURER B:AXIS Surplus Ins Company 26620 Santore's World Famous Fireworks LLC 846 Stillwater Bridge Road INSURER C: Schaghticoke NY 12154 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:217186740 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. ILTR TYPE OF INSURANCE AINSR JM DDL SUBR POLICY NUMBER MMIDDY EFF MMIDD EXP LIMITS A GENERAL LIABILITY Y Y S18ML00235-221 2/9/2022 2/9/2023 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGEPREMISESPREMISESSEa occurrence $500,000 CLAIMS-MADE �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 Y Y SIBCA00102-221 2/9/2022 2/9/2023 COMBINED SINGLE LIMIT Ea accident) cc dent $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident B UMBRELLA LIAB X OCCUR Y Y P-001-000074909.04 2/92022 2/9/2023 EACH OCCURRENCE $4,000,000 X EXCESS LIAR CLAIMS-MADE AGGREGATE $4,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN —IIQRY LIMITS FIR ANY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/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. Town of Southold,Suffolk County,and The Greenport Fire Department Star Hose Company No.3 are named as additional insureds,but only in respect of liability caused by the negligent acts or omissions of the named insured.Subrogation waived to the extent required by written contract. 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 53095 Main Rd. AUTHORIZED REPRESENTATIVE Southold NY 11971 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD i� NYSIF New York state Insurance Fund PO Box 66699,Albany,NY 12206 1 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ^AAA^A 472010297 SANTORE'S WORLD FAMOUS FIREWORKS LLC 143 SUMMIT AVE ❑AD BERKELEY HEIGHTS NJ 07922 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER SANTORE'S WORLD FAMOUS TOWN OF SOUTHOLD FIREWORKS LLC 53095 MAIN RD. 143 SUMMIT AVE SOUTHOLD NY 11971 BERKELEY HEIGHTS NJ 07922 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD DATE A2353 260-9 581792 02/07/2022 TO 02/07/2023 3/15/2022 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2353 260-9, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION. LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS:IIWWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER THE SOLE PROPRIETOR, PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STATrSU/RffE FUND DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:396422630 U-26.3 Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 03/17/22 Receipt#: 295270 Quantity Transactions Reference Subtotal 1 Fireworks 1 $100.00 Total Paid: $100.00 Notes: Payment Type Amount Paid By CK#000247 $100.00 Santore's, World Famous Fireworks Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Santore's, World Famous Fireworks Po Box 687 Stillwater, NY 12170 Clerk ID: DENISN Internal ID: 1 AC® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 01/15/2020 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 have ADDITIONAL INSURED provisions or 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 Donna Ackroyd —NAMEMcMann Price Agency,Inc. PHONE (631)477-1680FAX 631 477-8930 828 Front Street E MAILo Ext): AIC No: ( ) —ADDRESS: donna@mcmannprice.com PO Box 2065 INSURERS)AFFORDING COVERAGE NAIC# Greenport NY 11944-0876 INSURERA: Arch Insurance Company INSURED INSURER B: Village of Greenport Fire Department INSURER C: PO Box 58 INSURER D: INSURER E: Greenport NY 11944-0058 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2011502713 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 MAYBE 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 SLIBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/ (MM/DDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE ®OCCUR DAMAGE TO RENTETT_PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 A Y MEPK06726914 06/01/2019 06/01/2020 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATELIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000,000 POLICY EPRO- JECT F7LOC PRODUCTS-COMP/OP AGG $ 10,000,000 OTHER: I Liquor Liab.Cov.Part $ 3,000,000 AUTOMOBILE LIABILITY &GI%rBFNE&,SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per. er accident $ �/ $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE g 5,000,000 A EXCESS LIAB CLAIMS MADE MEUM06473414 06/01/2019 06/01/2020 AGGREGATE $ 5,000,000 DED I I RETENTION$ $ WORKERS COMPENSATIONPER 0TH- AND EMPLOYERS'LIABILITY Y/N STATUTE 1 1 ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACHACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes,describe under E.L.DISEASE-EA EMPLOYEE $ DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) _ With respect to Star Hose Carnival from May 21 to May 24,2020 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Town of Southold ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1179 AUTHORIZED REPRESENTATIVE Southold NY 11971 1988-2015 AC PORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD ACC? te C? ® 72/14/2022 (MMIDD/YYYY) ``�V�� 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 NAME: Britton-Gallagher and Associates, Inc. N P 1C e -658-7100 MC No:216-658-7101 One Cleveland Center, Floor 30 E t: 216 1375 East 9th Street A DRIESS, Cleveland OH 44114 INSURERS AFFORDING COVERAGE NAIC# INSURER A:Everest National Insurance Company 10120 INSURED 18341 INSURER B:AXIS Surplus Ins Company 26620 Santore's World Famous Fireworks LLC 846 Stillwater Bridge Road INSURER C: Schaghticoke NY 12154 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:860258582 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. IN5R TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM DDIIYYYY OLICY EFF MMIDDIYYYY OLICY EXP LIMITS LTR A GENERAL LIABILITY Y Y S18ML00235-221 2/9/2022 2/9/2023 EACH OCCURRENCE $1,000,000 X DAMAGETO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $500,000 CLAIMS-MADE �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 PEO LOC $ A AUTOMOBILE LIABILITY Y Y S18CA00102-221 2/9/2022 2/912023 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPER PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per accident NON B UMBRELLA LIAB XJ OCCUR Y Y P-001-000074909-04 2/9/2022 2/9/2023 EACH OCCURRENCE $4,000,000 X EXCESS LIAR CLAIMS-MADE AGGREGATE $4,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N O I ITS E ANY PROPRIETOR/PARTNER/EXECUTIVE❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 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 of Display: 5/28/22;Rain date:5/29/22. Location:Greenport H.S.,Greenport,NY Greenport Fire Department;Star Hose Company;Village of Greenport,Town of Southold;Suffolk County,Greenport UFSD are hereby named as additional insureds,but only in respect of liability caused by the negligent acts or omissions of the named insured. Subrogation waived to the extent required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Greenport Fire Department ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 345 Greenport NY 11944 AUTHORIZED REPRESENTATIVE USA ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Rudder, Lynda From: Noncarrow, Denis Sent: Friday, March 18, 2022 8:56 AM To: Rudder, Lynda Subject: FW: Fireworks application Denis Noncarrow Southold Town Clerk. Town of Southold, New York www.southoldtownny.pov denisn @south oldtownn y.go 631-765-1800 CONFIDENTIALITY NOTICE: This communication with its contents may contain confidential and/or legally privileged information. It is solely for the use of the intended recipient(s). Unauthorized interception, review, use or disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy Act. If you are not the intended recipient, please contact the sender and destroy all copies of the communication. From: Flatley, Martin Sent: Friday, March 18, 2022 8:54 AM To: Noncarrow, Denis<denisn@southoldtownny.gov> Subject: RE: Fireworks application Thanks Denis, I have no objections to this event taking place as in the past 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. From: Noncarrow, Denis<denisn southoldtownny.gov> Sent: Friday, March 18, 2022 8:49 AM To: Blasko, Regina <rblasko town.southold.ny.us>; Doroski, Melanie<Melanie Doroski@town.southold.nv.us>; Flatley, Martin <mflatley@town.southold.nv.us>; Norklun,Stacey<Stacev Norklun@town.southold.nv.us>; Spiro, Melissa <Melissa Spiro@town.southold.ny.us>;Town Att 1 Cc: Rudder, Lynda <lynda.rudder@town.southold.nv.us> Subject: Fireworks application Please see attached. Thank you Denis Noncarrow Southold Town Clerk. Town of Southold, New York www.southold townn y.qov denisn@southoldtownny.gov 631-765-1800 CONFIDENTIALITY NOTICE: This communication with its contents may contain confidential and/or legally privileged information. It is solely for the use of the intended recipient(s). Unauthorized interception, review, use or disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy Act. If you are not the intended recipient, please contact the sender and destroy all copies of the communication. 2