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2023
O\aS �'C®G DENIS NONCARROW Town Hall,53095 Main Road TOWN CLERK ® � P.O.Box 1179 y Southold,New York 11971 REGISTRAR,OF VITAL STATISTICS 0 .� Fax(631)765-6145 MARRIAGE OFFICER '�' Q@ f Telep - RECORDS.MANAGEMENT OFFICER ��.( '�►� X' "' 1 FREEDOM OF INFORMATION OFFICER www south wail ERIV D OFFICE OF THE TOWN CLERK JUN - 1 2023 TOWN OF SOUTHOLD APPLICATION Clerk, PERMIT TO DISPLAY FIREWORKS r-muffl ��0wn.__ _ 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 r� ecif:eda, /DISPLAY IS TO BE SPONSORED BY Lra' (/ 6 ,2 PRINCIPAL OFFICE AT I c1 DATE & TIME OF DISPLAY av ° %I, EXACT LOCATION OF DISPLAY �j'yj 1e +°C �� , t rA���>,C��T fit[ /lead l SUFFOLK COUNTY TAX MAP NUMBER FOR SITE 1906— RAIN DATE & TIME urs aclId ✓� The following persons are to be in charge of the actual shooting of the fireworks: Name Age Experience Physical Condition V j'ri m a zz ez 6 S 1/0 tzlea-5 �mo/ (Additional names and information may be submitted on an attached sheet Number and type of fireworks is as follows: ii i / <34e nu m Le � O IaSS r ©, :Frvym 1 t`-0 J;/a ;V1 Alam Manner and place of stora a of fireworks prior to display: rucrYi� -e,c�a f 44te dyspfaavL 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 Proy)ertv Owner, mus be sub itt w h th�j Application. ewl)( cd f �aq�o�P . � ✓ 6 'y � Yl.l of Or anization FEE: $100:03 By Signature of Applicant Da of Application DENIS NONCARROW Town Hall,53095 Main Road TOWN CLERK o P.O.Box 1179 W Southold,New York 11971 REGISTRAR OF VITAL STATISTICS ro ® Fax(631)765-6145 MARRIAGE OFFICER '� �� a0 Telephone(631)765-1800 ,f RECORDS.MANAGEMENT OFFICER •� `j► -" wwwv.sop o tgv�nn�ggv. FREEDOM OF INFORMATION OFFICER t OFFICE OF THE TOWN CLER _ 1 2023 TOWN OF SOUTHOLD JUN APPLICATION , PERMIT TO DISPLAY FIREWO Shu"r6�^ -Fswn cp9; 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 firewor hereina er specifie I. .r. DISPLAY IS TO BE SPONSORED BY MV L A PRINCIPAL OFFICE AT DATE & TIME OF DISPLAY A6 EXACT LOCATION OF DISPLAY SUFFOLK COUNTY TAX MAP NUMBER FOR SITE RAIN DATE & TIME The following persons are to be in charge of the actual shooting of the fireworks: Name Age Experience Physical Condition / V Af? 47-) I r j44-< (Additional names and information may be submitted on an attached sheet Number andpe of fireworks is as follows: /lttrr� / d� 3'76 C Jess 'r�,���QCs he�fs fay 'ty rd Uri '4 Manner/ and place of storage of fireworks prior to display: �/uL�(2G� ,`� `✓/� G r Oce daV D -1'44E L�,_ (/Gr�S '-4 Q vac/ "&e ed 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,s�bmitted wit the Application. g �✓�r'!C �d1c ��-ad"�r�d � {fftJseCda re-en 1-4 F-,`r-e Por-�r►-z��f FEE: $100:00 of Orga ization By rJ:F—2 L Signature of Applicant 3/ d Date o Application c 1 Facility Shell and Rack Breakdown for Phenix Hook& Ladder Co. / Relief Hose Comp. #2 Event State: NY Event Date: Jul 5,2023 10:00 PM And July 8, 2023 Rain Date: Jul-6, 2023 10:00 PM And TBD Program Length: 10 Shell Total: 370 Per Event Rack Total: 41 Fire Type: Both Opening and Closing Shell and Rack Detail: 777�l.0 Op:enmg%Closing; ".^3Y,.Y > u'�.i•' "r."ryf .dri:•. •.e'b u •'•:ut.;•.'. ;`.! •i..:.,z:'.:A'".,; .. �"�'�"> A,e: ,.: .�.. . �, •. > .. ,�:-: ,.,.�., -Breakout`-:,: ,,.:�<:.,• :,��.���uw.. ,�.� � �;.�,:. 2.5 Inch100 10/90, 10 3 Inch 60 10/50 6 4 Inch 6 .0/6--, 7 5Inch 0 2 Inch Starblaster 2.5 1nch'S-Cake , 3 Inch S-Cake Body Detail: 2Inch 0 2.5 Inch 96 10 3 Inch 72- 8 4 Inch 36 6 5 Inch 0 6 Inch 0 8 Inch 2.5 Inch S-Cake 3.Inch S-Cake " 3 Inch S T C Cake 4 Inch S T-0 Cake" Cakes 10 77 Squibs 60 k a o / !. 77 44, tl � GREENPORT HOSE r: 400' RADIUS COMPANY 0 4" MAX SIZED a SHELLS 3 400' RADIUS rn m 171 MOORES LN GREENPORT, NY 11944 D f1 , r" NO ADMITTANCE ,,,p- low 4106 11 N _ 72 22 16 W J' -� �i - ' NEW YORK STAT' (S_, DRIVER LICENSE 10227 506 600 cuslp MAZZA VINCENT.0 51 TUDOR ST STATEN ISLAND NY 10308 h4 H�grA 5,_QEJ,�'�Fyns BRO .. OUB06/18/1960 06/1812026 NONE RNONE x D5131/2018 .......... ww - or " T tel. CW4 C RWICATE OF Co � f"" - - VINCENT C MAZZA LASS_ A ANY D&NA r THIS CARL M uS; 3E CAM4 wHEk US ti: PM's CERU ;Ao''27 NYC & NYS CERTIFICATKX6 PEQUIRED N tK • nra��� res r Federal Explosives License/Permit Bur Department of Justice (I8 U.S C. Chapter 40) Bureau of Alcohol,Tobacco,Firearms and Explosives aam®ttuaws�;t�a:�n�t 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 I.8,United States Code and the regulations issued thereunder,until the expiration date shown. THIS LICENSE IS NOT TRANSFERABLB':(fNDER-27._CE[t 555.53.._See"WARNINGS"and'NOTICES"on reverse. Direct ATF ATF-Chief FELC :license/Permit Correspondence To 244 Needy Road Nuiiiber','~ •> Martinsburg,WV 25405-9431 • ^' • • Chief FederaIE xplosives Licensing Cente (FELC) Expiration' Date May 1, 2024' Name STARFIRE CORPORATION Premises Address(Changes?Notify the FELGarleasi'10 da{,s.iTefore 566 THEATRE ROAD '' ,.f SAINT BENEDICT PA 15773= ' f x ,• ; Type of License or Permit 50-MANUFACTURER OF EXPLOSLVES Purchasing CertiSckion:S'faterite}it• Mailing`Addtess(Changes?`N"ofify the FELC of any changes.) /:'"'; The licensee or permittee named above shall usa.a"copy;ofithis license.m,peiiriit,t assist u;.: -. ", i„. Y .,,..,, transferor of explosives to verify the identity and the,Gceit`sed±status of the•licerisee'or•'°• ., ,;; y_.. . r fr' V:.;.',', permittee as provided by 27 CFR Part 555. The stRttahtre on eacli'eonv.mus["be Ott orisinal simature. Ataxed,scanned or e-mailed copy ofthe'lic ;se`on iewrth a si attire '"": "STARFIRE;CORPCJR, , f ON intended to be an original si atureisace able. Ttiesi .•dttireariiiSt•bethatoftheFedeitti PO B71 O 179" ; ! l .. .- Explosives Licensee(FEL)or a responsible person oftlto.FE_L°;KT certit '.thatthis is a true SAINT BENEDIGT Pio 15773- copy of a license or permit issued to the licensee or permittee nanied'aliove to engage ur the b ess or oration ecifred aboveunder Type of License.or F'emtrt; .,; ”t '" ?' "• j Licensee/Pe i e Responsible Per, n ignature Position/Title,'' Je 2-Z _/Z/3 inted Name Date ATF Form,5400:1415400.15 Part I Revised September 2011 Previous Edition is Obsolete STAN FIRE CORPORATIONZATHEATRE ROA0157n:8-PA•021•SG4E•02621'Mq 1.20MM-14ANUFACTUREROF EMONVES Federal Explosives License(FEL)Customer Service Information Federal Explosives Licensing Center(FELL) Toll-free Telephone Number: (877)283-3352 ATF Homepage:www.atf.gov 244 Needy Road Fax Number: (304)616-4401 Martinsburg,WV 25405-9431 E-mail: FELC@atfgov 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 Chiet Federal Explosives 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 fumish 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----------------------------1 I— I Federal Explosives License/Permit(FEL)Information Card I I I License/Permit Name:STARFIRE CORPORATION t I 1 I Business Name: 1 License/Permit Number:8-PA=021-50=4E-112627 1 I License/Permit Type:50-MANUFACTURER OF EXPLOSIVES I I I I - I Expiration: May 1,2024 j I I I Please --cte: Not Valid for the Sale or Other Disposition of Explosives. 1 1 Federal Explosives License/Permit U.S.Department of Justice (18 U.S.C. Chapter 40) Bureau of Alcohol,Tobacco,Firearms and Explosives nmt®ia5armtawntsrmcismwi In accordance with the provisions of Title XI,Organized Crime ControlAct of 1970,and the regulations issued thereunder(27 CFR Part 555),you may engage in the activity specified in this license or pemlit within the]imitations of Chapter 40t.Title 18,,United States Code and the regulations issued thereunder,until the expiration date shown. THIS LICENSE IS NOT TRANSFERABLE_UNDER 17,CFR.5 5:53—See"WARNINGS"and"NOTICES"on reverse. Direct ATF ATF-Chief,FELC - License/P'ermit" Correspondence To 244 Needy Road %8-PA-021.24-4E-1267' Martinsburg,WV 25405-941" Chief Federal Explosives h censing Cente (FELL) Expiration:' Date May 1 5 '2024 Name STARFIRE CORPORATION;4 '1.'7r:` Premises Address(Changes?Notify t]re ELJG,�at leustR10 days:beforethe move:) _..•_.- *, j; i; s 566 THEATRE ROAD SAINT BENEDICT,PA 157'3 Type of License or Permit 24-IMPORTER OF EXPLOIV,E$ t' t Purchasing Certification Siatemeht :,; '` Mailing Address(Changes? o rfy fire FELC of any changes.) „ t.'? ,..fit,,t r.•. � .' G{ The licensee or permittea named above shall usm ii4y" transferor of explosives to verify the identity and the licen'sed.itatus permittee as provided by 27 CFR Part 555. The sir?rtatur&�n eacli copy must be an or`ieiEial' y I ° siatrature. Afaxed,scanned ora mailed copy of the^lip'ie°�dr.permit:with a sigratiire Y; ='Sl ARFI RE.GO!4?QFRATION intended to be an original signature is acceptable. Thbsi ati�re mu4`.Vc hat.ofthe Fedeial' ° PO BOX y 1.79;';'•;r``;;' 4 Explosives Licensee(FEL)or a responsible person oftflaFEl✓�I*catify``tIiatthis.isatrue SAINT,BENED'ICT�f'A 15773- copy of a license or permit issuedto the licenseeor permittee named ubove.to engage"ii1'the busim or operations cified above ander"Type of Licence or.Peruiil" '/�,"� ' License e/Perm• esponsible Pers nature Positi6n/,Title Tinted Name - - Date- - - 'ATFFormi5406.1415400-15 Revised September 2011 - PreviousEdition isObsolete STARFIRECORPORIIT100575TREATAEROAD:15M:I•PA-0 -24,4E-12677:May1.202421dMPOnTEa0FF1(PLOMYES Federal Explosives license(FEL)Customer Service Information Federal Explosives Licensing Center(FELC) Toll-free Telephone Number: (977)283-3352. ATF Homepage:www.atf.gov 244 Needy Road Fax Number: (304)6164401 Martinsburg,WV 25405-9431 E-mail: FELCQatf.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 now location of the business or operations not less than 10 days prior to such removal with the Cbiet;Federal Explosives Licensing Center. The license or permit will be valid for the remainder of the term of the original license or permit. (The Chief,FELC,shall,if the licensee or peimd tee 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 ----------- I Federal Explosives License/Permit(FEL)Information Card II I License/PermitName:STARFIRE"=RPORATION I I Business Name: j License/Permit Number,8=RA`:021-244E-1 873 I License/Permit Type:24-1 ,OF.EXC'LOSiVES I I I , Expiration: May 1,2024 j I I I Please Note: Not Valid for the Sale or Other Disposition of Explosives. I -----------------.. ---------- ------ U.S.Department Eastern Service Center 1701 Columbia Ave. of Transportation Operations Support Group College Park,GA 30337 AJV-E2 FIREWORKS DISPLAY NOTIFICATION Company Name: STARFIRE CORPORATION Email Address of Person Submitting Request: Kimberly@starfirecorporation.com Cell Phone Number for On-Site Technician: Vin Mazza Cell#718.938.8616 Event Name: Phenix Hook and Ladder Jul 5 and 8, 2023 Jul 6, 2023 and TBD Display Date: Y Rain Date: y Display Start Time: Approximately 10:00pm Duration of Fireworks Display: Approximately 10 minutes Max Height of Fireworks: Approximately 400ft _ Address,City and State: 171 Moores Lane, Greenport, NY 11944 Latitude: 41.10999 (North) Longitude: -72.37139 (West) List the Closest Public Use Airport Within 5 Nautical Miles of the Display if the Fireworks Will Reach or Exceed 500 Ft. N/A Under 500'-No major airport within 5 miles Special Notes Please email your request to: 9-ATO-ESA-OSG-Fireworks@faa.sov_ GREENPORT UNION FREE SCHOOL DISTRICT 720 FRONT STREET GREENPORT,NEW YORK 11944 Request to Use Building and/or Grounds Date Submitted: Areas to be used (check all that apply): "Subject to availability when not in use by the school ❑ ❑ Classrooms ❑ Gyms Fields&Grounds ❑ Front Lobby Auditorium (Please Specify (Please Specify) (Please Specify, (Including Rooms) including Front Hallways) Driveway) ❑ Other Organization and Event Details Name of Organization: _6 t 1 Email: ... Address: Telephone: ;? - PP Pl `1 Event Supervisor: t Name of Event: 66 r-11 e J,9,t( Time of Use:Date: J 4 Y Time: Number of Participants Expected: `j Will the Event be Open to the Public: 7 / Is this a FOR PROFIT Organization: d Admission Charge Amount: � ��le Purpose of Admission Charge: ��/( Will refreshments be served?Give details: L� Specific 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 agrees 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 agree to defend,indemnify and hold harmless the District from and against any and all liability,loss,damages, claims,or actions(including costs and attorney's fees)for bodily injury and/or property damage,to the extent permissible by law,arising out of or in connection with the actual or proposed use of the District's propel "ties and/or s rvices by the user organization. Signature of Organization's Representative Date P-Jer �a-cr, s s-aa- a3 Print Name of Organization's Representative Date Appro ed Disapproved /Z i , �- , Signature of Superintendent Date Revised 7/31/18 CHIEF WAYDE MANWARING ' ' (631)477-9801 -STATION 1 18TASST.CHIEF ALAIN DEKERILLIS (631)477-8261 -STATION 2 2ND ASST.CHIEF CRAIG JOHNSON v (631)477-1943-CHIEFS OFFICE CHAPLAIN FRANK MUSTO ,�� (631)477-4012-FAX 311 THIRD STREET•P.O.BOX 58 ASST.CHAPLAIN CLAUDE KUMJIAN • GREENPORT,NY 11944 SECRETARY/TREASURER ALAIN DEKERILLIS ' Email:gfdfire@optonline.net DEPARTMENT SECRETARY JAMES KALIN _ www.greenportfd.org May 30, 2023 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 a fireworks display on Wednesday, July 5, 2023 in conjunction with their annual carnival. A rain date is scheduled on Saturday, July 8, 2023. The display will be at 10:00pm and will be shot from the athletic fields of Greenport Public School. Greenport Fire Department will be standing by on scene with two (2) fire engines, one (1) ambulance and any additional apparatus as needed. If you have any questions please feel free to contact any fire chief at the phone number above. Sincerely, lJames H. Kaljn Department Secretary Greenport Fire Departments Independent DaV Celebr, �. Greenport, NY i S t. +f:.1 •0 e - Y�iMa ^m. :f mow` OS Cl_ / !s Discharge Site 1 ' 0 = Max shell size 41, , . . • rr` ; 400' Fallout Area `*Exceeds NFPA 1123 70' / - N Latitude: - > 41 ° 6'12.62"N z Y Longitude i n �' 0' 100' 200' 300' 401 7202217.44 W 1 i �I. L a DATE(MM/DD/YYYY) AC o® CERTIFICATE OF LIABILITY INSURANCE 5/22/2023 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. PHONEIC 216-658-7100 ac No):216-658-7101 One Cleveland Center, Floor 30 E-MAIL 1375 East 9th Street ADDRESS: info@brittongailagher.com Cleveland OH 44114 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:JAMES RIVER INS CO t 12203 INSURED 3074 INSURER B:Arch S eClall Ins Co 21199 Starfire Corporation _ _ P__. �-�� 566 Theatre Road INSURER C:Everest Denali Insurance Compal 16044 St. Benedict PA 15773 INSURER D:NY State Fund-Liverpoo_t INSURER E:Axis Surplus Insurance Company 26620 INSURER F: COVERAGES CERTIFICATE NUMBER:754366179 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. INSRDDLTSITBR m — POLICY EFF POLICY EXP ^� LTR TYPE OF INSURANCE p POLICY NUMBER MM/DD/YYY MM/DD/YY LIMITS A X COMMERCIAL GENERAL LIABILITY 00126603-1 1/22/2023 1/22/2024 IEACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE I X J OCCUR [PREMISES(Ea occurrencJ_150,000 --- MED EXP(Any one person) $ _ PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL_AGGREGATE $3,000,000 X POLICY 11 JECT 17 LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ C AUTOMOBILE LIABILITY S18CA00272.221 1/22/2023 1/22/2024 COMBINED SINGLE LIMIT _ $ Ea acaidenD_w_ 000 000 _ X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED "_SCHEDULED I BODILY INJURY(Per accident) $ X AUTOS X AUTOS NON OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS --- E UMBRELLA LIAB I X P-001-000762543-01 1/2212023 1/22/2024 1 OCCUR EACH OCCURRENCE $4,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE` $4,000,000 DED RETENTION$ ( $ D WORKERS COMPENSATION ( 24616542(NY) 1/11/2023 I 1/11/2024 XSTATUTE ETH AND EMPLOYERS'LIABILITY — ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $Unlimited OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $Unlimited If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S Unlimited B Excess Liability#2 UXP1048011-00 1/22/2023 1/22/2024 Each Occ/Aggregate $5,000,000 Total Combined Excess $9,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement. Display dates: Juy 5&July 8,2023 Rain Date:TBD Location: 171 Moores Lane,Greenport,NY Additional insured: Town of Southold 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. 53095 Route 25 PO Box 1179 AUTHORIZED REPRESENTATIVE Southold NY 11971 I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD MIDD a`o CERTIFICATE OF LIABILITY INSURANCE DATE(M 4/za1202 YY1f) zoz3 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). CONTACT RODUCER NAME: 3ritton-Gallagher and Associates,Inc. '"",E,,En;216-658-7100 FA/1c No:216-658-7101 )ne Cleveland Center,Floor 30E-MAILc ° 375 East 9th Street SS: info britton alla her.com ;leveland OH 44114 INSURERS AFFORDING COVERAGE NAIC# INSURER A:JAMES RIVER INS CO 12203 ISURED 3074 INSURERS•Arch Speciality Ins Co 21199 Rarfire Corporation INSURER C:Everest Denali Insurance Company 16044 i66 Theatre Road A.Benedict PA 15773 INSURER D:NY State Fund-Liverpool INSURER E:AXIS Surplus Insurance Company 26620 INSURER F, :OVERAGES CERTIFICATE NUMBER:30284104 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. Sit ADDL UBR POLICY EFF POLICY EXP LIMITS TR TYPE OF INSURANCE I Sp POLICY NUMBED! MIDD (MMDNYYYI A X COMMERCIAL GENERAL LIABILITY 00126603-1 1/22212023 1/22/2024 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES Fa occurrence) $50,000 � MED EXP(Any one person) $ PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S3.000,000 X POLICY❑PRO--JECT �LOC PRODUCTS-COMP/OPAGG S2,0o0,000 S OTHER C AUTOMOBILE LIABILITY SIBCA00272-221 1/2212023 1/12/2024 COMBINED SINGLE LIMIT S Ea accident 1,000,000 BODILY INJURY(Per person) S X ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNEDPROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Peraccident S E UMBRELLA L.IAB X OCCUR P-001-00076254301 1/22/2023 112112024 EACH OCCURRENCE $4.000,000 X1 EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000 DED RETENTIONS S D WORKERS COMPENSATION 24616542(NY) 1/1112023 1/11/2024 Xi STEARTure—L. I ER AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNER(EXECUTIVE ❑ EL EACH ACCIDENT 5 UnlimitedOFFICER/MEMBEREXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $Unlimited If yes,RIPTION OF OPERATIONS below describe under E.L DISEASE-POLICY LIMIT 5 Unlimited DESC B Excess Liability#2 UXPI048011-00 1/2212023 1/22/2024 Each 0crJAggregate $5.000,000 Total Combined Excess $9,000,000 )ESCRIPTION OF OPERATIONS I LOCATIONS]VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement. Display Dates: 7/5/23 and 7/8/23 Rain Dates: TBD Location:171 Moores Lane,Greenport,NY Additional Insured: Greenport High School;Town of Southold;Village of Greenport;Greenport Fire Department;Blue Sky Amusements Standard Hose Company -ERTIFICATE 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. Greenport Union Free School District 720 Front Street AUTHORED REPRESENTATIVE Greenport NY 11944 __1/ ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD / l ® DATE(MM/DD/MY) AC00R o CERTIFICATE OF LIABILITY INSURANCE 06-01-2022 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(les)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 PHONE Ext1n A No):415-475-4304 DIVISION OF SPG INSURANCE SOLUTIONS, LLC ADDRESS: 1304 SOUTHPOINT BLVD.,#101INSURERS AFFORDING COVERAGE NAIC# PETALUMA CA,94954 INSURER A: Certain Underwriters at Lloyd's,London 15792 INSURED INSURER B: NYSIF Special FX Wizard Inc. INSURER c: 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 ADDLTYPE OF INSURANCE INM WVD SUER POLICY NUMBER MNWD�F MNWDnry P LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE S 5,000,000 DAMAGE TO RENTEff X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence S 50,000 X CLAIMS-MADE F�OCCUR MED EXP(Anyone person) S A X PY/22-0087 05/05/2022 05/05/2023 PERSONAL&ADV INJURY S T SURER(S)NAMED HER IN IS(A )NOT GENERAL AGGREGATE $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: LI E SED BY THE STATE OFNEW YOR NOT PRODUCTS-COMP/OP AGO S X POLICY PROT. LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT EVEN OF THE INSOLVENCY F THE SURER Ea accident ANY AUTO (S ,N T PROTECTED BY NEW YORK ST TE BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILYINJURY(Peraccident) $ AUTOSSEC ITY FUNDS. THE POLICY MAY N TBE HIRED SAUTOS NON-OWNED S J CT TO ALL OF THE RE ULATIO S OF Pe°aC�Id DAMAGE $ s UMBRELLA LIAB HOCCUR P RT INING TO POLICY FO S. EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S DED RETENTIONS $ WORKERS COMPENSATIONX WC STATU- OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 B OFFICER/MEMBER EXCLUDED? N/A 2513166-5 05/23/2022 05/23/2023 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 It yes,describe under 1,000,000 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) Phenix Hook&Ladder Co.#1; Relief Hose Co.#2,for permits only;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 Phenix Hook&Ladder Co.#1 Relief Hose Co.#2,for permits SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. Box 58 3rd Street ACCORDANCE WITH THE POLICY PROVISIONS. Greenport NY 11944 AUTHORIZED REPRESENTATIVE S, L� ©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): Phenix Hook&Ladder Co. #1 Relief Hose Co. #2, for permits only P.O. Box 58 3rd Street Greenport NY 11944 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. (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. PY AI 006 6-14 *- T F I -4 CORPORA 566 Theatre Rd.PO Box 179,St.Benedict,PA 15773/814-344.9200/800-806-4486/www.starfiirecorporation.com FIREWORKS DISPLAY CONTRACT Customer: Greenport FD Pli� tv�,c� Le Re-1 o-e`i Jd se Display Date/Time: July 5 & July 8, 2023 / 10:00 PM Display Site: 171 Moores Lane, Greenport, NY Company Contract No.: 2023-508 This Contract made by and between Starfire Corporation,whose address is 566 Theatre Rd. St. Benedict, PA(hereinafter"Company'); and Greenport FD a� Ea�a �)-. ) whose address is 3—. d. St. , Greenport, NY 11944 (hereinafter"Customer') (collectively the"Parties"and individually each a"Party") is made effective as of April 12, 2023. ("Effective Date") WHEREAS Company designs, produces, and conducts fireworks displays; and WHEREAS Customer wishes to engage Company for the design, production, and performance of a fireworks display on the terms and conditions set forth herein. NOW,THEREFORE, in consideration of the terms, conditions. and covenants set forth herein,the Parties hereby mutually agree as follows, each intending to be legally bound: 1. Fireworks Display: A. On the Display Date at-the Display Site, Company shall provide fireworks and related equipment referred to as the "Display." B. Start and Stop Times:The start times are best estimates depending upon location and other seasonable variables. Start and stop time may also be determined by the governmental authorities having jurisdiction over the display. The Company Pyrotechnician in Charge has the authority to delay or may at any time temporarily discontinue the discharge of fireworks for any reason. C. Company shall designate a pyrotechnician to be its"Pyrotechnician in Charge"who is trained to present the Display. D. Alternate Date: (if mutually agreed to by the Parties): TBD 2. Costs and Payments: Total 2 Display Pricing$ 15,000 A. Payment Due at Contract Signing $7,500 B. Payment Due at 30 Days Prior to Display Date $7,500 Please initial each page read Page 1 of 8 i *Seller reserves the right to require payment in full at time of contract execution. C. Additional Costs. Company reserves the right to invoice an equitable transportation surcharge in the event of any material increase in transportation costs(including the cost of fuel and third-party shipping costs), and additional permitting fees to Company after the Display Date. 3. Postponement/Rescheduling: Any request made by Customer for rescheduling/canceling shall be directed to HELPCDstarfirecorporation.com or by phone 800-806-4486. A. If the Display is postponed/rescheduled (1) by reason of inclement weather, (2) determination by the governmental authority having jurisdiction, (3) as the result of any unsafe condition in the sole discretion of Company, or(4)for any other reason beyond the control of Company, the Display shall be re-scheduled to the Alternate Date set forth above. If no Alternate Date is set or Alternate Date is Cancelled,the Customer has to reschedule within 6 months of the original Display Date. B. Postponement/Rescheduling Fee. In the eventt-a postpohement/rescheduling is necessary a postponement/rescheduling fee will be based on the table below. Description % Of Fireworks Additional Costs Display Price If notified before 12:01 AM on 10% Any 3rd Party Vendor Expenses Display date If notified after 12:01 AM on 15% Any 31d Party Vendor Expenses Display date Once Starfire arrives on site 1 20% Any 3rd Party Vendor Expenses C. It is understood and agreed that Company shall have no obligation to reschedule a display except as required by inclement weather or reasons beyond the control of Company and as specifically set forth in this Contract. 4. Customer Responsibilities: A. Customer is responsible for the payment of all governmental fees and taxes, including, but not limited to,sales, use, excise, license, permit, entertainment, or other fees,taxes or surcharges imposed or otherwise applied to the Display. Customer is responsible for any additional marine costs, barge rentals and movement of barges, and corresponding costs and fees; city permit/escort fees; County/State/PD/FD/FM fees; local,town permit fees, and any related costs or fees. Customer shall also be responsible for all costs associated with its Security and Safety obligation set forth in Article 5. B. Customer's Designated Agent: Customer shall designate a Customer's Agent("Agent')to whom all questions and inquiries shall be relayed. Agent shall be the only individual authorized to make decisions on behalf of Customer or to request rescheduling of the Display. Company shall have the right to rely upon and act in accordance with the directions and decisions made by Agent. Furthermore, Customer shall indemnify, defend, and hold Company harmless for any reasonable actions or inactions taken at the direction of Agent. CUSTOMER DESIGNATED AGENT: Pete Harris PHONE: 631-655-3683 C. Permits: It is the Customer's responsibility to contact Customer's State, City, County,Town, Borough, or Village Fire Marshal or other appropriate authority to file for and obtain all necessary Display permits. Company will prepare the paperwork for the permit application on Customer's behalf. Upon receipt of permit, Customer must send the permit to Company no later than 30 days prior to the Display Date. Failure to do so could be grounds for default. Please initial each page read Page 2 of 8 D. Additional Customer Responsibilities: I. Meeting the filing application deadline and paying all licensing and permit fees. ii. Obtaining local and state requirements for fireworks license for transportation and/or display. iii. Adherence to Fire Marshal's requirements for security of firework display trucks upon arrival, and the security of the fire zone before,during and after the Display. Any fees associated with security are sole responsibility of the Customer. iv. Notifying the FAA on the Display Date, according to the instructions in the FAA Letter of Approval,which will be forwarded to Customer prior to Display unless directed otherwise. V. Customer shall also be responsible for procuring hotel rooms within 10 miles of the show site if requested.The exact quantity of hotel rooms shall be conveyed by Company to Customer before the Display. E. Security and Safety Obligations as set forth more fully in Article 5. F. Coast Guard Permits(where necessary and required): If the Display is to occur on or near the water,the following may be required: (Requests for permits must be filed at least 135 days prior to the Display Date: i. Coast Guard Application and Permit to Handle Hazardous Materials. ii. Coast Guard Marine Event Permit. G. After Displgy:Following the Display,Customer shall be responsible for cleaning and policing of the Display Site and surrounding area.Customer shall provide trash removal of cardboard boxes, broken lumber, etc.Company is responsible for cleanup for immediate work area only. 5. Security and Safety: A. Company shall designate a pyrotechnician to be its"Pyrotechnician in Charge"who is trained to present the Display. B. Customer shall provide and maintain sufficient Security before,during and after the Display until the Pyrotechnician in Charge declares the area clear. "Security"shall include, but not be limited to, all security lines, police protection,snow fencing, rope lines, barricades or any other item deemed necessary by the local government or by Company. Security must be provided for the Display trucks,and to maintain a fire safety zone) at the staging area from the arrival of the trucks to the departure of the trucks,which may include the day prior to,or following day. C. Customer shall also provide and maintain an area clear of any temporary structures, cars and spectators with a minimum radius as specified by current edition of NFPA Code 1123, as a Fire Safety Zone("FSZ")during the entire period commencing from the time the fireworks are delivered to the site until the area is declared clear by the Pyrotechnician in Charge. The Parties agree that Company will cease all fireworks discharge due to any security breach of the FSZ. Company shall not be responsible for personal injury, or property damage occurring within the FSZ because of the Customer's failure to maintain the FSZ in accordance with the standards of current edition of NFPA 1123,which are only minimum standards of distances. Customer acknowledges and agrees that Company's responsibilities are limited to-the Display and that Company is relying on Customer to maintain the FSZ and to comply with all Federal, State, municipal and local laws, orders, regulations, and ordinances pertaining to the implementation of any and all security measures at the Display Site. Please initial each page read Page 3 of 8 D. Site Inspections:Any site inspections by or on behalf of Customer shall be in accordance with the current edition of NFPA 1123 and under the direct supervision of the Pyrotechnician in Charge. Inspections shall not in any way interfere with the safety,setup,or schedule of the preparation for and disassembly after the Display.The Pyrotechnician in Charge may, in his sole discretion, cancel any inspection that, in his opinion, may compromise the safety of the setup or the Display or the setup schedule. The Pyrotechnician in Charge may at any time temporarily discontinue the discharge of fireworks for any reason. 6. Force Majeure: Company shall be excused for the period of delay in the performance of any of its obligations hereunder and shall not be liable for failure to perform or considered in default hereunder,when prevented from so performing due to causes beyond its reasonable control including without limitation legal or regulatory restrictions, labor disputes of whatever nature, power loss, telecommunications failure, act of God, pandemics,or any other similar causes beyond its reasonable control. 7. Publicity: Customer shall give Company program credit as the sole-fireworks supplier and producer in all press releases, marketing literature, online advertising, or any other program announcements, printed or otherwise. 8. Government Regulations: This Contract and Company's obligations hereunder are subject to all applicable Federal, State,Municipal and local laws, rules,ordinances, regulations, and codes, now or hereinafter in effect,and to the conditions and limitations contained in the permits required to be obtained by Customer prior to the Display. In the event any Federal, State,municipal or local law, rule, regulation or ordinance shall be enacted which in any way prohibits, limits or restricts the sale, performance or operation of the Display or in the event Customer's permit in any way limits or restricts the sale,performance or operation of the Display, Company shall limit or restrict its performance or the Display so as to comply with such law, rule, regulation or ordinance or limitation or restriction of Customer permit. Customer acknowledges that any such limit or restriction placed on the performance or operation of the Display shall in no way result in or entitle Customer to a reduction or abatement in the full Display Price. 9 Late Fees: In the event Customer shall fail to pay any sum when due under the terms of this Contract, Customer shall pay,in addition to such amount due, an interest at the rate of 1.5% per month on the unpaid amount from the original due date. Customer shall also pay Company reasonable attorney fees and other costs in the event Company shall commence any proceeding or incur fees to compel Customer to pay any sums due hereunder or otherwise because of Customer's default of any of the terms and provisions herein contained. 10. Liquidated Damages: In the event Customer cancels the Display and does not reschedule per the Contract or otherwise defaults hereunder,Company shall be entitled to receive the entire Display Price and same shall be considered"liquidated damages"based upon an understanding between the Parties hereto that Company shall have suffered damages due to Customer's default.The damages suffered by Company because of Customer's default will be substantial,but incapable of determination with precision.It is, therefore,agreed by the Parties that the amount due Company is not a penalty,but rather a mutually beneficial and reasonable estimate of the damages suffered by Company. 11. Substitutions: Company shall have the right,at its discretion, to make minor modifications or substitute any fireworks it deems necessary provided same does not materially detract from the aesthetic value or overall quality of the Display.This includes, but is not limited to,shell sizes, quantities,types,and brand names. Any substitutions shall in no way result in or entitle Customer to a reduction or abatement of the full Display Price. 12. Governing Law and Dispute Resolution:This Contract shall be governed by and construed in accordance with the laws of the Commonwealth of Pennsylvania, excluding its conflict of law rules. All disputes, differences, or any other type of controversy arising out of or in relation to this Contract, Please initial each page read Page 4 of ll including as to the meaning or interpretation of any provision hereof, shall be resolved by arbitration in Cambria County, PA, pursuant to the commercial rules then obtaining of the American Arbitration Association. Only one(1)arbitrator shall be required, and the arbitrator may award attorneys'fees. The award of the arbitrator shall be final, and binding and judgment may be entered thereon in any court of competent jurisdiction.The arbitrator sitting in such controversy shall have no power to alter or modify any express provision of this Contract, nor to make any award which by its terms effects any such alteration or modification. Either Party may seek from the court of competent jurisdiction any provisional remedy in aid of arbitration, including, but not limited to, injunction, attachment,or replevin, pending the determination of any claim or controversy in arbitration. 13. Binding Effect: This Contract shall not be binding on Company until(1)executed by Customer and (2)Company is in receipt of the Down Payment required hereunder. 14. Bankruptcy: If Customer becomes bankrupt or insolvent,or if a petition in bankruptcy is filed by or against Customer or if a receiver is appointed for Customer,Company may refuse to perform under this Contract and may terminate this Contract without prejudice to the rights of Customer. if Customer has a material change in financial status as reasonably determined by Company,then Company may require Customer to deposit the balance of the Display Price in escrow or provide sufficient proof of its ability to pay the balance of the Display Price. 15. Signatures:This Contract may be executed by each of the Parties on separate counterparts, each of which,when so executed,shall be deemed an original, but all of which shall constitute but one and the same instrument. Execution and delivery of a counterpart of this Contract(i)by portable document format("PDF")copy bearing the PDF signature of a duly authorized officer of either Party hereto,whether delivered by facsimile, e-mail, or physical delivery service("PDF Signature"), or(ii) by electronic signature of a duly authorized officer of any Party hereto,pursuant to electronic signature procedures Company may establish from time to time. ("Electronic Signature"),shall be equally as effective as delivery of a manually executed counterpart of this Contract and shall constitute a-valid and binding execution and delivery of this Contract by such Party. The Parties agree that(a)each PDF Signature and/or Electronic Signature of such party will be enforceable to the same extent as a manual signature, whether in court or otherwise and(b)such party will not raise any defenses or regulatory or statutory claims attempting to invalidate the enforceability of its PDF Signature or Electronic Signature. 16. Limitation of Liability: IN NO EVENT SHALL COMPANY'S AGGREGATE LIABILITY ARISING OUT OF OR RELATED TO THIS CONTRACT,WHETHER BASED IN CONTRACT, TORT(INCLUDING NEGLIGENCE)OR OTHERWISE, EXCEED THE DISPLAY PRICE PAID TO COMPANY BY CUSTOMER. IN NO EVENT SHALL COMPANY BE LIABLE TO CUSTOMER OR ANY THIRD PARTY FOR ANY LOSS OF REVENUE OR PROFIT OR FOR ANY CONSEQUENTIAL, INDIRECT, INCIDENTAL, SPECIAL, EXEMPLARY,OR PUNITIVE DAMAGES WHETHER ARISING OUT OF OR RELATED TO BREACH OF CONTRACT,TORT(INCLUDING NEGLIGENCE)OR OTHERWISE, REGARDLESS,OF WHETHER SUCH DAMAGES WERE FORESEEABLE AND WHETHER OR NOT COMPANY HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. No action may be brought for any alleged breach of contract more than one(1)year after display date. 17. Insurance and Indemnity: Company agrees to procure general liability insurance. Any additional insurance that is required that incurs a cost,will be Customer's responsibility. Customer shall indemnify and hold Company harmless for all claims,actions, and suits made against Company for personal injury or property damage arising from or relating to the failure of Customer,or its agents, employees, or contractors to adhere to or perform its obligations under this Contract. Customer shall list below the additional insured, as they should appear on the insurance certificate. All individuals/entities listed on the certificate will be deemed an additional insured per this contract. Please initial each page read Page.5 of li 18. General Provisions: A. This Contract and addendums constitute 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 both Parties. Customer acknowledges and agrees that Company has not made any representations or warranties except those specifically set forth in this Contract. Should any clause, section,or part of this Contract be held or declared to be void or illegal for any reason,all other clauses,sections, or parts of this Contract which can be affected without such illegal clause,section,or part shall nevertheless continue in full force and effect. B. It is specifically understood to read that Company shall not be responsible in any way if any third-party service with which Company has contracted for service fails to perform and the display cannot proceed as planned. C. This Contract, and the rights and obligations of the Parties hereunder, shall be binding and inure to the benefit of their respective successors, assigns, heirs, executors,administrators, and legal representatives. Company may assign any or all its rights and obligations under this Contract or subcontract or delegate any or all its obligations hereunder. Customer may not assign any of its rights and obligations under this Contract without the prior written consent of Company. The authorized representatives of Parties hereby agree to the terms and conditions of this Contract as of the Effective Date. / ��1�.vl i VL ��t� 03 •�1 CUSTOMER: Greenport FD R-e_U 2f Printed Name: P�.2r qaLI;s Authorized Representative Title: Uee�t LfiiG'i�'r�✓i Signature: I P2-&L, Date: a� COMPANY: STARFIRE CORPORATION Printed Name: Audrey Jean Terrizzi Authorized Representative Title: President Signature: A ' Ju Date: �� 2-?�a o-X 3 Please initial each page read Page 6 of 8 DISPLAY DATES: 7/5 AND 7/8123 ,-' T R_F1R -t RPOR ATION 566 Theater Rd. P.O. Box 179 St. Benedict, PA 15773 Phone: 800-806-4486 Fax 814-344-9222 INVOICE DATE: 4/3/23 Customer Name: Greenport FD O'heddA t HLi Company Address: 510 Flint Street, Greenport, NY 11944 COMMENTS OR SPECIAL INSTRUCTIONS: Fireworks Display Payment UNIT PRICE TOTAL 1 Fireworks Display Payment Due at Contract Signing $7,500 $7,500 50%Down Payment 7/5/23 Display Date 50%Down Payment 7/8/23 Display Date SUBTOTAL $7,500 TOTAL DUE $7,500 Payments can be submitted electronically via check, Bank Wire or by Credit card.There is a 3.5%fee on all credit card transactions. Please contact us(814)344-9200 for payment processing ACH or Wire Remittance Information: CNB Bank 1808 Bigler Avenue P.O. Box 579 Northern Cambria, PA 15714 Bank Account Number. 6136162 Bank Routing Number: 031306278 If paying by check please make all checks payable to STARFIRE CORPORATION If you have any other questions, please contact Starfire Corporation 800-806-4486. THANK YOU FOR YOUR BUSINESS! Please initial each page read Page 7 of 8 i DISPLAY DATES: 7/5 AND 7/8/23 TARFI -1;. CORPORATION 566 Theater Rd. P.O. Box 179 St. Benedict, PA 15773 Phone:800-806-4486 Fax: 814-344-9222 INVOICE DATE: 6/4/23 Customer Name: Greenport FD Star Hose Company Address: 511 Flint Street, Greenport, NY 11944 COMMENTS OR SPECIAL INSTRUCTIONS: Fireworks Display Payment UNIT PRICE TOTAL 1 Payment Due 30 Days Prior to Display Date $7,500 $7,500 50%Balance Due 7/5/23 Display Date 50%Balance Due 7/8/23 Display Date SUBTOTAL $7,500 TOTAL DUE $7,500 Payments can be submitted electronically via check, Bank Wire or by Credit card.There is a 3.5%fee on all credit card transactions. Please contact us(814)3444200 for payment processing ACH or Wire Remittance Information: CNB Bank 1808 Bigler Avenue P.O. Box 579 Northern Cambria, PA 15714 Bank Account Number. 6136162 Bank Routing Number: 031306278 If paying by check please make all checks payable to STARFIRE CORPORATION If you have any other questions, please contact Starfire Corporation 800-806-4486. THANK YOU FOR YOUR BUSINESSI Please initial each page read Page 8 of 8 Franke, Diana From: Flatley, Martin Sent: Thursday,June 1, 2023 12:18 PM To: Franke, Diana; Lillian McCullough; Blasko, Regina; DeChance, Paul; Ginas,James; McCullough, Lillian; McGivney,Julie; Mirabelli, Melissa; Norklun, Stacey; Squicciarini, James;Visser III, Fredric Cc: Born, Sabrina; Noncarrow, Denis Subject: RE: Special Event: Greenport Fire Department I have no objections to these events being approved 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: Franke, Diana <dianaf@town.southold.ny.us> Sent:Thursday,June 1, 2023 10:38 AM To: Lillian McCullough<lilianm@southoldtownny.gov>; Blasko, Regina <rblasko@town.southold.ny.us>; DeChance, Paul <pauld@southoldtownny.gov>; Flatley, Martin <mflatley@town.southold.ny.us>; Ginas,James <jginas@town.southold.ny.us>; McCullough, Lillian <lillianm@southoldtownny.gov>; McGivney,Julie <juliem@southoldtownny.gov>; Mirabelli, Melissa <melissa.mirabelli@town.southold.ny.us>; Norklun, Stacey <Stacey.Norklun@town.southold.ny.us>; Squicciarini,James<jacks@southoldtownny.gov>;Visser III, Fredric <fredv@southoldtownny.gov> Cc: Born, Sabrina <sabrina.born@town.southold.ny.us>; Noncarrow, Denis<denisn@southoldtownny.gov> Subject:Special Event: Greenport Fire Department Importance: High Good Morning, Please see attached the Application for a Special Event Permit from Greenport Fire Department received on 06/01/2023 Thank you, 1 , 111 CgFran r Account Clerk Southold Town Clerk's Office (631)765-1800 Ext 1228 � 2 Franke, Diana From: Visser III, Fredric Sent: Thursday,June 1, 2023 12:54 PM To: Franke, Diana, Subject: RE: Special Event: Greenport Fire Department Hello, I am trying to get ahold of the applicant, I need licenses of the firework company,the licenses of the persons firing the fireworks, as well a show script with a more detailed number and types of fire works. Thank you, Fredric Visser, Fire Marshal Town of Southold Phone: (631)765-1802 Web: https:Hsoutholdtownny.gov/1736/Fire-Marshal Email: Fredv@southoldtownny.gov PO Box 1179 f 54375 Main Road Southold, NY. 11971 From: Franke, Diana<dianaf@town.southold.ny.us> Sent:Thursday,June 1, 2023 10:38 AM To: Lillian McCullough <lilianm@southoldtownny.gov>; Blasko, Regina <rblasko@town.southold.ny.us>; DeChance, Paul <pauld@southoldtownny.gov>; Flatley, Martin <mflatley@town.southold.ny.us>; Ginas,James <jginas@town.southold.ny.us>; McCullough, Lillian <lillianm@southoldtownny.gov>; McGivney,Julie <juliem@southoldtownny.gov>; Mirabelli, Melissa <melissa.mirabelli@town.southold.ny.us>; Norklun, Stacey <Stacey.Norklun@town.southold.ny.us>;Squicciarini,James<jacks@southoldtownny.gov>;Visser III, Fredric <fredv@southoldtownny.gov> Cc: Born, Sabrina <sabrina.born@town.southold.ny.us>; Noncarrow, Denis<denisn@southoldtownny.gov> Subject:Special Event: Greenport Fire Department Importance: High Good Morning, Please see attached the Application for a Special Event Permit from Greenport Fire Department received on 06/01/2023 Thank you, " V'a Account Clerk Southold Town Clerk's Office (631)765-1800 Ext 1228 1 Franke, Diana From: Franke, Diana Sent: Thursday,June 1, 2023 10:38 AM To: Lillian McCullough; Blasko, Regina; DeChance, Paul; Flatley, Martin; Ginas,James; McCullough, Lillian; McGivney, Julie; Mirabelli, Melissa; Norklun, Stacey; Squicciarini, James;Visser III, Fredric Cc: Sabrina Born (sabrina.born@town.southold.ny.us); Noncarrow, Denis Subject: Special Event: Greenport Fire Department Attachments: Spec Event July 5 Appl.pdf, Spec Event July 8 Appl.pdf, Spc Evnt July 5&8 Attachments.pdf Importance: High Good Morning, Please see attached the Application for a Special Event Permit from Greenport Fire Department received on 06/01/2023 Thank you, liana p�rartke Account Clerk Southold Town Clerk's Office (631)765-1800 Ext 1228 1 Born, Sabrina From: Noncarrow, Denis Sent: Tuesday, June 6, 2023 12:41 PM To: Born, Sabrina; Mudd,Jennifer Subject: FW: PHENIX HOOK & LADDER/Greenport Fireworks Attachments: GFD FW.pdf Denis Noncarrow Southold Town Clerk. Town of Southold, New York www.southoldtownny.gov 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. From:Visser III, Fredric Sent:Tuesday,June 6, 2023 12:39 PM To: Noncarrow, Denis<denisn@southoldtownny.gov> Subject: RE: PHENIX HOOK& LADDER/Greenport Fireworks More info,good to go. Fredric Visser, Fire Marshal Town of Southold Phone: (631)765-1802 Web: https://southoldtownny.gov/1736/Fire-Marshal Email: Fredv@southoldtownny.gov PO Box 1179 54375 Main Road Southold, NY. 11971 From: Noncarrow, Denis<denisn southoldt\ownny.gov> Sent:Tuesday,June 6, 2023 12:23 PM To:Visser III, Fredric<fredv@southoldtownny.gov> Subject: RE: PHENIX HOOK& LADDER/Greenport Fireworks Thank you Fred Denis Noncarrow Southold Town Clerk. Town of Southold, New York www.southoldtownny.gov 1 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. r From:Visser III, Fredric Sent:Tuesday,June 6,,2023 12:22 PM To: Noncarrow, Denis<denisn@southoldtownny.gov> Subject: RE: PHENIX HOOK& LADDER/Greenport Fireworks Yes, I approve. Fredric Visser;- Fire Marshal Town of Southold Phone: (631)765-1802 Web: https:/Isouth6ldtownny.gov/1736/Fire-Marshal Email: Fredv@southoldtownny.Rov PO Box 1179 54375 Main Road Southold, NY. 11971 From: Noncarrow, Denis<denisn southoldtownny.gov> Sent:Tuesday,June 6, 2023 12:21 PM To:Visser III, Fredric<fredv@southoldtownny.gov> Cc: Born, Sabrina <sabrina.born@town.southold.nv.us>; Mudd,Jennifer<iennifer.mudd town.southold.nv.us> Subject: RE: PHENIX HOOK& LADDER/Greenport Fireworks So are you approving this or not yet Denis Noncarrow Southold Town Clerk. Town of Southold, New York www.southoldtownny.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. From:Visser III, Fredric Sent:Tuesday,June 6, 2023 12:17 PM To: Noncarrow, Denis<denisn@southoldtownny.gov> Subject: FW: PHENIX HOOK& LADDER/Greenport Fireworks 2 Attached is the shooters license, and a site plan, I requested a copy of the company's license as well. I'll continue to work on it but I don't want to hang up this application. Fredric Visser, Fire Marshal Town of Southold Phone: (631)765-1802 Web: https://southoldtownny.gov/1736/Fire-Marshal Email: Fredv@southoldtownny.gov PO Box 1179 54375 Main Road Southold, NY. 11971 From: Charlie Rappa ZOHO email set up <charlie@starfirecorporatio n.com> Sent:Tuesday,June 6, 2023 11:08 AM To:Visser III, Fredric<fredv@southoldtownny.gov> Cc: Kimberly Montani <kimberly@starfirecorporation.com> Subject: [SPAM] - PHENIX HOOK& LADDER/Greenport Fireworks Hello Fred Thanks for taking my call today. Based on our conversation, please find the information you requested. Kim who is cc'd here heads up Starfire Corp permitting department and can provide you with any additional information you may need. Each program will consist of approximately; 2.5" shells= 200 3" shells= 150 4" =50 10-15 Barrage/cakes/units= 1000—2000 shots approximate. Thanks and look forward to working with you and your team. Charlie Rappa Starfire Corporation 631-624-4976 C Confidentiality Notice:This message is intended exclusively for the individual or entity to which it is addressed.This communication may contain information that is proprietary, privileged,confidential or otherwise legally exempt from disclosure. If you are not the named addressee,you are not authorized to read, print, retain, copy or disseminate this message or any part of it. If you have received this message in error, please notify the sender immediately either by phone(631-624-4976) or reply to this e-mail and delete all copies of this message. ATTENTION:This email came from an external source. Do not open attachments or click ori links from unknown senders or unexpected emails. 3 'u:.l-` a. ,vi:c,..,.,.,.;:'"'Fs.:'.:.._..�a.'x':'.::,:.a>a�tk.'•'.z.�.;ai":.`,::aa::v...i::a' - .i$cual:'1"iS?:F'A:..�'..:'w,'��w�«`::r.:.`" `"�'^'�"�'+ ':£:m:ev^�u�.`.'."s3.....<:...(.".0 GREENPORT FIRE DEPARTMENT F,o-391 1559 PHENIX HOOK&LADDER CO. �^1 212 KNAPP PLACE � T� GREENPORT,,,rY 11944 IPf"1°O'Pf, OIl8Il�1 1�G�1� CHASEij JPMorgan Chase Bank;N.A. www.Chase.com _ 1:0 2 10000 2 0: 1 3 10 1 39 39ii' 1 5 59 Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 06/01/23 Receipt#: 311127 Quantity Transactions Reference Subtotal 1 Fireworks GFD1 $100.00 1 Fireworks GFD2 $100.00 Total Paid: $200.00 Notes: Payment Type Amount Paid By CK#1559 $200.00 Greenport, Fire Department Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Greenport, Fire Department Po Box 58 Greenport, NY 11944 Clerk ID: DIANAF Internal ID:GFD2 DENIS NONCARROW �� Gy� Town Hall,53095 Main Road TOWN CLERKp - P.O.Box 1179 ti Z Southold,New York 11971 REGISTRAR,OF VITAL STATISTICS p Fax(631)765-6145 MARRIAGE OFFICER Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER ��l `1►a www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD PERMIT 2023 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 PHENIX HOOK AND LADDER CO. 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 on Wednesday, July 5"2023 at 10:00 pm with a Rain Date of Thursday, July 6t" 2023 at 10:00pm. The location will be at the Greenport Athletic Field , Greenport High School at 725 Front Street and East Side of 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 feet 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 into 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 last 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, and subject to any Executive Orders issued by the Governor and to the applicant's compliance with the requirements of the Town's policy regarding the issuance of fireworks permits. Applicant to Notify FAA 24 Hours before event. ------- ------------------------------------------------------- (Town Seal) Denis Noncarrow, Southold Town Clerk Town of Southold,New York Dated: June. 6",2023 THIS PERMIT IS NOT TRANSFERABLE Southold Town Board - Letter Board Meeting of June 6, 2023 sarur RESOLUTION 2023-541 Item# 5.35 y�0`pa� ADOPTED DOC ID: 19241 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2023-541 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JUNE 6,2023: 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 Phenix'-Hook & Ladder Co. #1/Releif Hose Co. #2 & Starfire Corp. for a Fireworks display on Wednesday, July 5th, 2023 at 10:00 P.M. / Rain Date, Thursday, July 6th, 2023 at 10:00 P.M. The fireworks display will be at the Greenport Athletic Field, Greenport High School, located at 725 Front Street and east side of Moores Lane, Greenport, New York, upon payment of $100.00 and subject to the applicant's compliance with any conditions and all requirements of the Town of Southold Policy regarding the issuance of fireworks permits. L ;��LIJ Denis Noncarrow Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Brian O. Mealy, Councilman SECONDER:Sarah E. Nappa, Councilwoman AYES: Nappa, Doroski, Mealy, Doherty, Evans, Russell Generated June 7, 2023 Page 55 Southold Town Board - Letter Board Meeting of June 6, 2023 RESOLUTION 2023-542 Item# 5.36 +4�a ADOPTED DOC ID: 19242 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2023-542 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JUNE 6, 2023: 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 Phenix Hook & Ladder Co. #1/Releif Hose Co. #2 & Starfire Corp. for a Fireworks display on Saturday, July 8th, 2023, at 10:00 P.M. The fireworks display will be at the Greenport Athletic Field, Greenport High School, located at 725 Front Street and east side of Moores Lane, Greenport,New York, upon payment of$100.00 and subject to the applicant's 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 Generated June 7, 2023 Page 56 - DENIS NONCARROW =� G.f� Town Hall,53095 Main Road TOWN CLERK p - P.O.Box 1179 C Z Southold,New York 11971 REGISTRAR OF VITAL STATISTICS Q Fax(631)765-6145 MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER �0,� � Telephone 765-1800 FREEDOM OF INFORMATION OFFICER www.southoldtldtownny.gov OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD PERMIT 2023 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 PHENIX HOOK AND LADDER CO. 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 on Saturday,July 8",2023 The location will be at the Greenport Athletic Field,Greenport High School at 725 Front Street and East Side of 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 feet 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 into 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 last two soda acid or other approved type fire extinguishers of at least two and one-half gallons capfeahall be kept;at such widely separated points as possible within the actual area of the display, and subject to any Executive Orders issued by the and the applicant's compliance with the requirements of the Town's policy he i e of fireworks permits. Applicant to Notify FAA 24 Hours before eve (Town Seal) - D is Noncarrow, Southold To Clerk Town of Southold,New York Dated: June. 6u',2023 THIS PERMIT IS NOT TRANSFERABLE Southold Town Board - Letter Board Meeting of April 25, 2023 RESOLUTION 2023-395 Item# 5.13 oyMO` a� ADOPTED DOC ID: 19094 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2023-395 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON APRIL 25,2023: 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 Star Hose Co. & SS Amusements for a Fireworks display on Saturday, May 27th, 2023 at 09:30 P.M: Rain Date, Sunday, May 28th, 2023 at 09:30 P.M. 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 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: Brian O. Mealy, Councilman SECONDER:Jill Doherty, Councilwoman AYES: Nappa, Doroski, Mealy, Doherty, Evans, Russell Generated April 26, 2023 Page 21 1 o��s11FF0t�►�oG _ ELIZABETH A.NEVILLE,MMC �� Town Hall,53095 Main Road TOWN CLERK p P.O.Box 1179 r/s = Southold,New York 11971 REGISTRAR OF VITAL STATISTICS p Fax(631)765-6145 MARRIAGE OFFICER 'y� p� Telephone(631)765-1800 RECORDS OF MANAGEMENT OFFICER Ol `1►a southoldtown.northfork net FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION PERMIT TO DISPLAY FIREWORKS APPLICATION IS HEREBY MADE, pursuant to the,provisions of Section 405.00 of the Penal Law of the State of New York,for a permit to display fireworks as hereinafter specified: DISPLAY IS TO BE SPONSORED BY Star Hose CO/GreenportFire dept.&SS Amusements PRINCIPAL OFFICE AT Po Box 345 Greenport NY 11944 DATE&TIME OF.DISPLAY 5/27/2023 9:30pm EXACT LOCATION-OF DISPLAY Greenport highschool athletic field SUFFOLK COUNTY TAX MAP NUMBER FOR SITE RAIN DATE&TIME 5/28/2023 9:30pm The following persons are to be in charge of the actual shooting of the fireworks: Name Age Experience Physical Condition Edward Matuscak 69 20+ good (Additional names and information may be submitted on an attached sheet Number and type of fireworks is as follows: 1.3G:2 1/2"- 3" =432 ,4"= 102 Manner and 'place of storage of fireworks prior to display: Secured on a Santore's Transport ,.until setup for display 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. / ge L 6,1 FEE: $1 OG Name of Organization See policy fox addition information e e By rinteName pp scant� � r ignature of Applicant e-mail address: e�artGfeefl�t�;y�tz{L,e Telephone Number 63[ Date of Ap lication © _ -DATE(&MUDDlYYYY) ,4C40R® CERTIFICATE OF LIABILITY INSURANCE 3/2912023 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(les)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). CONTACT PRODUCER NAME: -- ------ Britton-Gailagher'and Associates,Inc. PHONE One Cleveland Center,Floor 30 IA/c No all,216-658-7100__ 1 FAAic•No ):216-656-7101 E AIL 1375 East 9th Street ADDREss: Cleveland OH 44114 INSURER(S)AFFORDING COVERAGE MAIC 0 _ INSURER A:Everest National Insurance Company. 1_10120 INsuRED -- T�'t INSURER B:Axis Surplus Ins Company I 26620 Santore's World Famous Fireworks LLC i INSURERC: 846 Stillwater Bridge Road —. -- Schaghticoke NY 12154 INSURER O: �-- { INSURER E: -- INSURER F: ' COVERAGES CERTIFICATE NUMBER:1539607684 - \ 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. QSSR, 'AaDR! POLICY EFF POLICY EXP i LIMITS LTR: TYPE OF INSURANCE { i ; POLICY NUMBER MIM)ONYV {IMM/DD(YYYY i A j GENERAL LIABILITY Y t Y SISP.:LOO235-231 I 2S'2023 i 2.31202- {EACH OCCURRENCE j S t.000.000 _- 1 ] + I�Atv9.4--�0 RT�CD X i COMMERCIAL GENERAL LIABILITY i 1 I 1 i PREMISES(Ea occunemel `S 500.000 i t.4�0 L EtP(Any ane ptr>on) Is CLAIMS-AtP.O� `� OCCUR PERSONAL S ADV INJURY !S 1.000,000 'i GENERAL AGGREGATE I S 2,000.060 1 I I 1 { f I ('PRODUCTS•COt3P30P ACG S 2.000.000 ,GEN'L AGGREGATE LIMIT APPLIES PER: l r �i 1 —� I POLICY i n Pao- 1 y LCA .j 1 + { Y I Y 313CA00102-231 ver=3 21012024 'COhIBINEU SINGLE LIMIT ! A i AUTOMOBILE LIAEILITf i j L i 1{Eaaai®enU 1 S i 0D0.000 1 X {ANY Au+G { III 1 BOOIt'f UiJURY{Perpus:=n) S ALL O'JJNED a -;SCHEDULED ! i ! I I BODILY INJURY(Per acadec) S AUTOS AUTOS ( t f ,,PROPERTY DAMAGE ' X } x+ivON-0i'dNED ( + i } I I t?era- ceidznil _.t��. l HIRED AUTOS AUTOS 1 { { 15 B UMBRELLA UAB {X ,OCCUR I I -0000744D9 05 ��20 II i Y Y P-0OT EACH OCCURRENCE S4,000=0 1' EXCESSLIAR } j CLAIMSlMDEf I Ili I AGGREGATE ,54.000,060 i DED i i F.ETEN T lON S {{ I 1 IO.C STATU- 1 OTH•1, I WORKERS COMPENSATION YIN n StdtTc 1 AND EMPLOYERS'UABIUMY ! H I a {ANY PROPRiETOP✓PARTNEP✓'ExECUT1VE ED N I A i 1 i j^EL EACH E.A.ACCIDENT 4 S- 1 OF FtcEPJhlEt.tBER EXCLUDED? i E..L-DISEASE- &A.-LOYEP S I(Mandatory In NH) I,yes,describe vrdet { j {E.L DISEASE-POLICY LtF.SST 1 S 1 ESCRIP T ION OF OPERATIONS beta'.v { I S i q 1 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if morn space Is required) Additional Insured,extension of coverage is provided by above referenced General Liability policy where required by written agreement. Tu,vn 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- Group Code:12154 r 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 1 •� Southold NY 11971 i r i G 1988-2010 ACORD CORPORATION. Alt rights reserved. ACORD 26(2010105) The ACORD name and logo are registered marks of'ACORD ® CERTIFICATE /� pyo LIABILITY (MSUDDlYYY1) A ® CERTIFICATE OF LIABIL.I t I INSURANCE 3/29/2023 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 INSURERS), 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). CONTAC PRODUCER NAME_ ---.--- Britton-Gallagher and Associates,Inc. PHONE 216 658-7100 I c.Not:216-658-7101 One Cleveland Center,Floor 30 A c"yE n — E-MAIL 1375 East 9th Street ADDRESS: — Cleveland OH44114 INSURER(5)AFFORDING COVERAGE NAIC9 INSURER A:Everest National Insurance Company I 10120 INSURED 18341 INSURER 9:Axis Surplus Ins Company 26620 Sentore's World Famous Fireworks LLC INSURER C: } 846 Stillwater Bridge Road l Schaghticoke NY 12154 INSURERD: 'I INSURER E: I INSURER F: COVERAGES CERTIFICATE NUMBER:403617647 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 TERAS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 1 --�Abbt;sye[? --- {{ POLICY EFF POLICY FxP I LIMITS LTR TYPE OF INSURANCE f POLICY NUMBER 1 MhtlDD h9iNDl7lYYYY A (GENERAL LIABILITY Y i Y SIVALO-3235-231 I 2192023 i 2'4J2024 i EACH C.CURRUICE !.$1.000.000 I DArA�c TO RchTED 5500.000 X CO`IMERCIAL GENERAL LIABILITY i 1 j PRE USES(to occurrence) I } CLAItdS-1,9ADE I�OCCUR i 1 MED EXP(Any one person) is FEP.SOFJAL&ADV INJURY S 1.000,000 _. GENERAL AGGREGATE ,Szooa 00 _ 171'L AGGREGATE LIMIT APPLIES PER: I ;PRODUCTS-COMPIOP AGG i$2,000.000 '- POLICY X PRO- LOC. 1 1 I I I S A AUTOM081LE LIABILITY I Y I Y SIBCA00102-231 J92023 + 2A/2024 1(EaLo COMBINED LIMIT 1 S 1.000.00 j I I EODILY INJURY(Per person) 1a X i ANY AUTO i- I 1 , ALL OWNED t i SCHEDULED i i BODILY INJURY 1Per accident) S AUTOS 1NON-OWNEDI S PROPERTY DAA'IAGE 1 S X t HIRED AUTOS X AUTOS \ i ((( Per acadent) 1 1 i 1 I I A �5 8 UMBRELLA LIAS i X OCCURI Y Y i P-001.000074905.05 j 2!92023 2 12024 f EACH 00 OCCURRENCE 54.0 .020 X (EXCESS LIA8 CLARASAIADE 1 1 j}( AGGREGATE 154000.000 1 DED RETEty i(ONS I 1 1 1 I i 5 WORKERS COMPENSATION t 9 {, QVC STATU- �OTH-I 5 AND EMPLOYERS'LIABILITY YIN I 1 l—S�+ARY IJi1TS t !ANY PROPRIETORPARTNERIEXECUnVE E.L.EACH ACCIDENT i s f OFFICER1RiEMSER EXCLUDED? ❑lN1A1 } j(Mandatory In NH) i 3f { 1 EL DISEASE-EA EMPLOYEE _ Iflfyess.descnbeunder DESCRIPTIORIPTIC74OF OPERATIONS belga• i I i I iE1.DISEASE-POLICY LIMA(IS 1 DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if marospace is required) Additional Insured extension of Coverage is provided by above referenced General Liability policy where required by written agreement. Date of Display: 5127123;Rain date:5/28123. 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%vaived 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(2010105) The ACORD name and logo are registered marks of ACORD launch coordinates-41.103635 North - 72.371713 West LL a SANT ' -WURID/ARIM S- r1laMORKS Red Circle=300' Fallout Zone (maximum shell size-3") Blue=Launch Location Yellow=spe taytor area j All Measurements me t"or exceed NFPA1123_ STATE OF NEW YORK - DEPARTMENT T OE LABOR RTECHNICICER-19FICTE OF COMPETENCE EDWARD MATUSZA 4 • w CLASS. � . NON PROXIMATE AUDIENCE ONLY HIS CARD MUST DE CARRIED WHEN uSING PYR T NYC NYS CERTIFICATIONS REQUIRED IN NYC W ELIZABETH A.NEVILLE,MMC a.�. f% Town Hall,53095 Main Road TOWN CLERK � %! P.O.Box 1179 ria Southold,New York 11971 .REGISTRAR OF VITAL STATISTICS %11P-1 Fax(631)765-6145 MARRIAGE OFFICER �� ®�' Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER 7.1 -www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF TIS 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, erp sons 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) 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.) m ,> GREENPORT UNION-FREE SCHOOL DISTRICT 720 FRONT STREET .. GREENPORT;.NEW YORK 11944 Request to 'Use Building"and/or Grounds Date Submitted.: �) Areas to be used (check:all that.apply):_ . Sub ect to availability when not.in use.b the school.. * �. �, y ❑ ❑ Classrooms p Gyms Fields&Grounds p Front Lobby Auditorium (Please Specify (Please.Specify): Please Specify, (Including Rooms) T including Front Hallways). .Driveway) ❑ Other Organization and Event Details Name of Organization; A Email: 66-11) TO Address:; . ._ Telephone: 7rce oc' rv� 1f �l Event Supervisor: /n� f h act, 1. . " Nol Name of Event: r. Time of Use:Date: Time: I� �vZ3 Se �� Number of Participants Expected: � ��a:N@ L : a� . . 'T'1'rc livCy r/� Will the Event be Open to the Public: N f ��- Is this a FOR PROFIT Organization: too Admission Charge Amount: t� I q.0 Purpose of Admission Charge: d Will refreshments be served?Give details`. N Specific 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 agrees 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.agree.to defend;indemnify and:hold harmless the District from and against any and all liability; loss;damages; claims,or actions(including costs.and attorney's fees)for bodily injury and/or property damage;to the extent permissible bylaw,arising out of or in connection with the actual or proposed use of the District's: property, fa ilitie and/or services y th . ser rganization: atur f Or anizat 0. Re esentatiye Da e y Print.Name of Orga ization's Representative . Da Approved Disapproved Signature o Su erintendent Date Revised 7/31/18; _�-;_..,- ._<� •ate-. n a _ 1 r a i 0`1�9,0.2 0005-`` �5 9�9 0rh`t: = 2 0 `�05 At On J x Ny e O , v c• . e' ,n - e`,tt 'SdY 1 1VQa - M. —17 -I cl / 99.0 ,'.4ti6.1 l AN`.1kJOdN33Fl�. •G131H8Z3' ,_ — ��.j='. __ `�F.-X09�Od F` AH O3tlflDd9 _ _ t n � J.NVv dW0q-3S0H 8b'1S: xt:.. t . t it , - _- ;lrv3wlada3a; V Y _ �i Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 04/12/23 Receipt#: 309366 Quantity Transactions Reference Subtotal 1 Fireworks 5.27.23 $100.00 Total Paid: $100.00 Notes: J Payment Type Amount Paid By CK#1049 $100.00 Star, Hose Company Co#3 Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Star, Hose Company Co#3 Greenport Fire Department Po Box 345 240 6th Ave Clerk ID: DIANAF Internal ID:5.27.23 Franke, Diana From: Flatley, Martin Sent: Thursday,April 13, 2023 9:44 PM To: Franke, Diana Subject: RE: Fireworks Appl: Star Hose CO/Greenport Fire Dept. 05/27/2023 1 have no objections to this application bring approved Chief Martin Flatley, Town of Southold Police --------Original message-------- From: "Franke, Diana" <dianaf@town.southold.ny.us> Date:4/13/23 10:34 AM (GMT-05:00) To: "Flatley, Martin" <mflatley@town.southold.ny.us>, "Ginas,James" <jginas@town.southold.ny.us>, "Spiro, Melissa" <Melissa.Spiro@town.southold.ny.us>, "Verity, Mike"<Mike.Verity@town.southold.ny.us>, "Visser III, Fredric" <fredv@southoldtownny.gov>, "DeChance, Paul" <pauld@southoldtownny.gov>, "Mirabelli, Melissa" <melissa.mirabelli@town.southold.ny.us> Cc: "Born,Sabrina" <sabrina.born@town.southold.ny.us>, "Mudd,Jennifer" <jennifer.mudd@town.southold.ny.us>, "Noncarrow, Denis" <denisn@southoldtownny.gov>, "Norklun,Stacey" <Stacey.Norklun@town.southo Id.ny.us> Subject: Fireworks Appl: Star Hose CO/Greenport Fire Dept.05/27/2023 1 Good Mornig, Attached, please find an application for a fireworks permit for May 27, 2023, submitted by Star Hose CO/Greenport Fire Dept. &SS Amusements. Please review and send me your comments and/or recommendations. Thank you, Account Clerk Southold Town Clerk's Office (631)765-1800 Ext 1228 1 Franke, Diana From: Franke, Diana Sent: Thursday,April 13, 2023 11:06 AM To: Blasko, Regina Subject: FW: Fireworks Appl: Star Hose CO/Greenport Fire Dept. 05/27/2023 Attachments: Fireworks App] Star Hose CO.pdf Importance: High From: Franke, Diana Sent:Thursday,April 13, 2023 11:01 AM To: 'lillianm@southoldtownny.gov'<lillianm@southoldtownny.gov> Subject: FW: Fireworks Appl: Star Hose CO/Greenport Fire Dept.05/27/2023 Importance: High From: Franke, Diana Sent:Thursday,April 13, 2023 10:35 AM To: Flatley, Martin<mflatley@town.southold.nv.us>; Ginas,James<iginas@town.southold.ny.us>; Spiro, Melissa <Melissa.Spiro@town.southoId.ny.us>; 'Town Att';Verity, Mike<Mike.Verity@town.southold.nv.us>;Visser III, Fredric <fredv@southoldtownny.gov>; DeChance, Paul <pauld@southoldtownny.goy>; Mirabelli, Melissa <melissa.mirabelli@town.southold.nv.us> Cc: Born, Sabrina <sabring.born @town.southold.ny.us>; Mudd,Jennifer<iennifer.mudd@town.southold.nv.us>; Noncarrow, Denis<denisn@southoldtownny.gov>; Norklun,Stacey<Stacey.Norkiun@town.southold.ny.us> Subject: Fireworks Appl: Star Hose CO/Greenport Fire Dept.05/27/2023 Importance: High Good Mornig, Attached, please find an application for a fireworks permit for May 27, 2023, submitted by Star Hose CO/Greenport Fire Dept. &SS Amusements. Please review and send me your comments and/or recommendations. Thank you, Account Clerk Southold Town Clerk's Office (631)765-1800 Ext 1228 1 p l ELIZABETH A.NEVILLE,MMC � Town Hall,53095 Main Road TOWN'CLERK P.O.Box 1179 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS ® .� Fax(631)765-6145 MARRIAGE OFFICER �'� ®�' Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER ®.` ' '� www.soutlioldtownny.gov FREEDOM OF INFORMATION OFFICER RECEIVED OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APR 12 2023 Southoid'Town Clerk INSTRUCTIONS YOR DISPLAY OF FIREWORKS L Name of body sponsoring fireworks display. 2. The date and time of day at which the fireworks display is to be held.. 3. The exact location planned for the fireworks display,including TAX MAP NUMBER. 4. The age,experience and physical characteristics of the persons who are to do the actual discharging of the fireworks. 5. The number and kind of fireworks to be discharged. 6. The manner and place of storage of such fireworks prior to the display. 7. A diagram of the grounds on which the display is to be held,showing the point at which the fireworks are to be discharged, the location of all buildings, highways'and other lines of communication, the lines behind which the audience will be restrained and location of all nearby trees, telegraph or telephone lines or other overhead obstruction's. 8. Such other information as the Southold Town Clerk may deem necessary to protect persons and property. Written permission of-the property owner is required. 9. An indemnity insurance policy with liability coverage and indemnity protection of$1,000,000.00 per person for bodily injury; $1,000,000.00 per accident; $1,000,000.00 property damage. 10, The Town Clerk of the Town of Southold must have the insurance policy in her possession before the. fireworks permit is issued. The named insured must read:TOWN OF SOUTHOLD.< Thirty (30)Town of Southold POLICY 11. Application for a fireworks permit must be made at least fdays in advance of the date of the fireworks displaX (The above instructions are in accordance with the Penal Law, Article 405 - Licensing and other provisions relating to fireworks.) DENIS NONCARROW =� G.f� Town Hall,53095 Main Road TOWN CLERK p - P.O.Box 1179 CA Z Southold,New York 11971 REGISTRAR OF VITAL STATISTICS S Fax(631)765-6145 MARRIAGE OFFICER 'y RECORDS MANAGEMENT OFFICER ��,( .� Telephone 765-1800 FREEDOM OF INFORMATION OFFICER www.southoldtldtownny.gov 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 with the provisions of Section 405.00 of the Penal Law of the State of New York at 9:30 p.m. on Saturday,May 27,2023; Raindate: Sunday, May 28,2023 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 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. ----------------------------------------------------- Denis Noncarrow, Southold Town Clerk (Town Seal) Suffolk County,New York Date: April 25th, 2023 THIS PERMIT IS NOT TRANSFERABLE Norklun, Stacey From: Noncarrow, Denis Sent: Wednesday, May 3, 2023 7:49 AM To: Norklun, Stacey Subject: FW: [SPAM] - Greenport FD/Star Hose Hi Stacey I think you have this file for the Star Hose fire works. Thank you! Denis Noncarrow Southold Town Clerk. Town of Southold, New York www.southoldtownny.gov 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. -----Original Message----- From:Terisa at SANTORE [mailto:terisa@santorefireworks.com] Sent:Tuesday, May 2, 2023 10:06 AM To: Noncarrow, Denis<denisn@southoldtownny.gov> Subject: [SPAM] -Greenport FD/Star Hose Good Morning, I hope this message finds you well. It is my understanding, we are approved for the Fireworks display 5/27/2023. Our technician will meet Fred(fire marshall at 4:45 ) On the eve of the display. I have also forwarded the supporting insurance docs/show to the FD . Thank you ! Please reach out if you need anything further. All the best, ATTENTION:This email came from an external source. Do not open attachments or click on links from unknown senders or unexpected emails. i