Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
2024
g�gFFO(, RESOLUTION 2024-481 ADOPTED DOC ID: 20297 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2024-481 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JUNE 4,2024: RESOLVED that the Town Board of the Town of Southold hereby approves the issuance of a Fireworks Permit by the Town Clerk to Santore's Fireworks on behalf of the Peconic Bay Vineyards (Crossroads Wine LLC), for a fireworks display on Saturday, July 6th, 2024 at 9:15 PM(Rain Date: Sunday, July, 7th at 9:15PM) at 31320 Main Road, Cutchogue, New York upon payment of a single fee of$100.00 and subject to the applicant's compliance with any conditions and 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:Greg Doroski, Councilman AYES: Doroski, Mealy, Smith, Krupski Jr, Doherty ABSENT: Louisa P. Evans Franke, Diana, I From: Franke, Diana Sent: Tuesday, May 21, 2024 3:23 PM To: Lillian McCullough; Blasko, Regina; DeChance, Paul; Flatley, Martin; Grattan, Steven; McCullough, Lillian; McGivney,Julie; Norklun, Stacey; Squicciarini,James;.Stype, John; Visser III, Fredric Cc: Noncarrow, Denis; Sabrina Born (sabrina.born@town.southold.ny.us) Subject: Fireworks Application: Peconic Bay Vineyards (Crossroads Vine LLC) Attachments: Peconic Bay V.pdf Good Afternoon, Attached, please find an application for a fireworks permit for Peco.nic_BayVineyards-(.Crossroads Wirie L'LC),submitted on 05/15/2024. Please review and send me your comments and/or recommendations. Thank you so much, �1117711' Account Clerk Southold Town Clerk's Office (631)765-1800 Ext 1228 i Franke, Diana From: Flatley, Martin Sent: Wednesday, May 22, 2024 2:03 PM To: Franke, Diana; Lillian McCullough; Blasko, Regina; DeChance, Paul; Grattan, Steven; McCullough, Lillian; McGivney, Julie; Norklun, Stacey; Squicciarini, James; Stype,John; Visser III, Fredric Cc: Noncarrow, Denis; Born, Sabrina Subject: RE: Fireworks Application: Peconic Bay Vineyards (Crossroads Vine LLC) i I have no objections to application 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:Tuesday, May 21, 2024 3:23 PM 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>; Grattan,Steven <sgrattan@southoldtownny.gov>; McCullough, Lillian<lillianm@southoldtownny.gov>; McGivney,Julie <juliem@southoldtownny.gov>; Norklun, Stacey<Stacey.Norklun@town.southold.ny.us>; Squicciarini,James <jacks@southoldtownny.gov>; Stype,John <johnst@southoldtownny.gov>;Visser III, Fredric <fredv@southoldtownny.gov> Cc: Noncarrow, Denis<denisn@southoldtownny.gov>; Born, Sabrina <sabrina.born @town.southold.ny.us> Subject: Fireworks Application: Peconic Bay Vineyards(Crossroads Vine LLC) Good Afternoon, Attached, please find an application for a fireworks permit for Peconic Bay Vineyards (Crossroads Wine LLC), submitted on 05/15/2024. Please review and send me your comments and/or recommendations. Thank you so much, 1 Franke, Diana From: Visser III, Fredric Sent: Wednesday, May 22, 2024 8:21 AM To: Franke, Diana Subject: RE: Fireworks Application: Peconic Bay Vineyards (Crossroads Vine LLC) Good morning I have no po position, I am going to request the "shooters" NYS license I will reply with the copy as I get it. Thank you! i 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 FIRE MARSHAL 0 SOUTy�� FIAF 1 AAA RN NY From: Franke, Diana <dianaf@town.southold.ny.us> Sent:Tuesday, May 21, 2024 3:23 PM To: Lillian McCullough <1 ilia nm@southoldtownny.gov>; Blasko, Regina <rblasko@town.southold.ny.us>; DeChance, Paul <pauld@southoldtownny.gov>; Flatley, Martin <mflatley@town.southold.ny.us>; Grattan, Steven <sgrattan@southoldtownny.gov>; McCullough, Lillian <I!llianm@southoldtownny.gov>; McGivney,Julie <juliem@southoldtownny.gov>; Norklun, Stacey<Stacey.Norklun@town.southold.ny.us>; Squicciarini,James <jacks@southoldtownny.gov>; Stype,John <johnst@southoldtownny.gov>;Visser III, Fredric <fredv@southoldtownny.gov> Cc: Noncarrow, Denis<denisn@southoldtownny.gov>; Born, Sabrina <sabrina.born @town.southold.ny.us> Subject: Fireworks Application: Peconic Bay Vineyards (Crossroads Vine LLC) Good Afternoon, Attached, please find an application for a fireworks permit for Peconic Bay Vineyards (Crossroads Wine LLC), submitted on 05/15/2024. Please review and send me your comments and/or recommendations. Thank you so much, Franke, Diana From: Franke, Diana Sent: Wednesday, May 22, 2024 8:25 AM To: McCullough Lillia_ Subject: FW: Fireworks Application: Peconic Bay Vineyards (Crossroads Vine LLC) Attachments: Peconic Bay V.pdf I From: Franke, Diana Sent:Tuesday, May 21, 2024 3:23 PM -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>; Grattan, Steven <sgrattan@southoldtownny.gov>; McCullough, Lillian<lillianm@southoldtownny.gov>; McGivney,Julie <juliem@southoldtownny.gov>; Norklun,Stacey<Stacey.Norklun@town.southold.ny.us>; Squicciarini,James. <jacks@southoldtownny.gov>; Stype,John <johnst@southoldtownny.gov>;Visser III, Fredric <fredv@southoldtownny.gov> Cc: Noncarrow, Denis<denisn@southoldtownny.gov>; Sabrina Born (sabrina.born@town.southold.ny.us) <sabrina.born@town.southold.ny.us> Subject: Fireworks Application: Peconic Bay Vineyards(Crossroads Vine LLC) Good Afternoon, Attached, please find an application for a fireworks permit for Peconic Bay Vineyards (Crossroads Wine LLC), submitted on 05/15/2024. Please review and send me your comments and/or recommendations. Thank you so much, Account Clerk Southold Town Clerk's Office (631)765-1800 Ext 1228 1 FIRE MARSHAL OF SOUTy�� FIRE 1 J( Al �0. AAA MABSNa� X1 From: Franke, Diana <dianaf@town.southold.nv.us> Sent:Tuesday, May 21, 2024 3:23 PM To: Lillian McCullough <lilianm@southoldtownny.gov>; Blasko, Regina <rblasko@town.southold.ny.us>; DeChance, Paul <pauld@southoldtownny.gov>; Flatley, Martin <mflatlev@town.southold.nv.us>; Grattan,Steven <sgrattan@southoldtownny.gov>; McCullough, Lillian<lillianm@southoldtownny.gov>; McGivney,Julie <juliem@southoldtownny.gov>; Norklun, Stacey<Stacey.Norklun@town.southold.ny.us>; Squicciarini,James <iacks@southoldtownny.�ov>; Stype,John <iohnst@southoldtownny.gov>;Visser III, Fredric <fredv@southoldtownny.gov> Cc: Noncarrow, Denis<denisn@southoldtownny.gov>; Born, Sabrina <sa bring.born @town.southold.ny.us> Subject: Fireworks Application: Peconic Bay Vineyards (Crossroads Vine LLC) Good Afternoon, Attached, please find an application for a fireworks permit for Peconic Bay Vineyards (Crossroads Wine LLC), submitted on 05/15/2024. Please review and send me your comments and/or recommendations. Thank you so much, AC711ma771�6 Account Clerk Southold Town Clerk's Office (631)765-1800 Ext 1228 2 ayItoo- r4�. ,;`u,'� � IZ. stir`�'.t�'. :�E4.;1���'n�•i:.�4�f,tV3�,y:�:4M.,�',+� u�a<Y°..; ppi.y CfDTTFlCATl OM =I: t'Ndbt;ksaATS ,ftR° 'tiJa.Ba'" �d'P;uYRI i7i;w—k''Pa}d,Yyy�rapa ,iy ' •'xx� °�beb.�re"''xr�a'� P.1:.�.".�ama�r,+,r�ewr�w..a.,.,.��7, s� »w•,;<n�;- ... maw;� �'� \� .. DENIS NONCARROW �� * Town Hall,53095 Main Road TOWNCLERK P.O.Box 1179 z Southold,New York 11971 REGISTRAR OF VITAL STATISTICS mot: Fax(631)765-6145 MARRIAGE OFFICER '°�� �� r Telephone (631)765-1800 RECORDS MANAGEMENT OFFICER �� ��' www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER RECEIVED OFFICE OF THE TOWN CLERK 'v. � TOWN OF SOUTHOLD MAY APPLI ATTON PERMIT TO DISPLAY FIREWORKS Southold Town Clerk APPLICATION IS HEREBY MADE, pursuant to the provisions of Section 405.00 of the Pena! Law of the State of New York, for a permit to display fireworks as hereinafter specified: DISPLAY IS TO BE SPONSORED BY: Peconic Bay Vineyards (Crossroads Wine LLQ.................. PRINCIPAL OFFICE AT 31320 Main Rd Cutchogue NY 11935................................................................. DATE &TIME OF DISPLAY 7/6/2024 9:15pm EXACT LOCATION OF DISPLAY 31320 Main Rd. Cutchogue NY 11935 SUFFOLK COUNTY TAX MAP NUMBER FOR SITE RAIN DATE & TIME 7/07/2024 9:15pm............................................................................................... The following persons are to he in charge of the actual shooting of the fireworks: Name Age Experience Physical Condition Robert Mardorf 56yrs. 20+ Active /Fit (Additional names and information may be submitted on an attached sheet Number and type of fireworks is as follows: 150-2.5" shells,192-3"shells,102-4"shells 8-1.3G Cakes Manner and place of storage of fireworks prior to display: Delivery of product in secured SNUFF Truck on day of Displaay------------------------------------------------------------------ kttached hereto and made a part of hereof is a diagram of the grounds on which the display is to he held. klso attached is a certificate or policy of insurance coverage. 40TICE: Written permission, 'With signature of the Property Owner, must be submitted with the "`• Application. J Santore's World Famous Fireworks LLC FEE: $200. 00 Name of Organization 7MAa_.0(.''2odka rgdoxlca. __ Signature of Applicant �' r vn. MP M. ;MAX 4W "% j .# ,. av �" K mk'�-F` •�°� 6y .. Ir ?..z� .' +. .'- .. AS SANI r Y 5 x Yx'k Y' FIREWORKS Peconic Bay Vineyards Red circle- Fallout"Lone 300 feet(max.'"steel'; Blue square=Launch location Yellow rectangle-Spectators All measuremems meet or exceed NFPA Il d3 �` Kin'•Kul en• � �Coffee�t '�'.A � •t;:,�1. �' "�. - • �� t • pr NailtSalen� ai �'.� t ...`". N�f� �L F6rtr�`!ib ♦ �,�Pe..onic a �rrrerlarrti a, 5,,.-• r• r(r � TF1CKer Eleatic'' w e t >. '- �• ° n� � �•,� 'w .r `�. � � � T°i..�:,.,Downey B Pamth,..., « ++ ! .�i 4YP Peconic Bay Vineyards Audience qr XL IL K DisplayD. 7/06/24 Rain D. Launch Site • • 00 i • DisplayMax Size Shell = 4" FalloutU = • w/400'Radius = Launch Site • -'s World Famous Fireworks, •1: 872-0624 I , I , i • i I ' � SH-862( WE ARE YOUR ® ®.II. Expires: Expires: 1/31/2025 i DIVISION OF SAFETY HEALTH THIS LICENSE MUST BE LICENSE AND CERTIFICATE UNIT 4To�'Aa'ircE It)e artment Of Labor POSTED IN YOUR PLACE OF abor BUSINESS I STATE OFFICE CAMPUS,BLDG, 1 t ALBANY,NY 12226 License No. D_6796 f LICENSE TO DEAL IN OR MANUFACTURE EXPLOSIVES Santore's World Famous.Fireworks, LLC 846 Stillwater Bridge Rd Schaghticoke, NY 12164 } August N. Santore, Jr. Is hereby licensed to deal in or manufacture explosives In compliance with the requirements of the Labor Law and Industrial. Code Rules.Any change in the conditions under which this license Is granted may cause it to be revoked. Every person selling,delivering or giving away any explosives must keep at the principal place of business within the state, a record of each transaction,including: 1) the NAME or TYPE and QUANTITY of explosives SOLD,DELIVERED or GIVEN.Note:No license is needed to purchase smokeless powder,or black powder and quantity is not exceeding five pounds for use in firing antique firearms or artifacts or replicas thereof.However,dealers MUST post all such transactions on the"Dealer- Manufacturer Report of Explosives Transactions".. 2) the DATE OF EACH SALE,DELIVERY or GIFT. ' ,3) the NAME,LICENSE NUMBER,and BUSINESS ADDRESS of the purchaser,donee,or person to whom the explosives were delivered and the firm,if any,represented by such person. } 4) the NAME,ADDRESS,and LICENSE NUMBER of the person TAKING THE EXPLOSIVES AWAY f from the seller or donor. I i Amy Phillips,Director FOR THE COMMISSIONER OF LABOR SH-862(5-98) 1 i i I I ' f U.S.Department of Justice Federal Explosives LieensedPelrmit Bureau of'Albobol,Tobacco,Firearms and Explosives (IS U.S.C Chapter 40) rebhhumurme�tuhtaat�tn�nhAn 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 cngaga in the activity speciSed in this license or permit within the limitations of Chapter 40,Tide 18,United States Code and the regiAalions issued thereunder,until the motion date shown T13lS LICENSE IS NO TRANSFERABLE UNDER 7 Z,5.5.53. Soo'WARNINGS"and'NOTICES"on reverse. Direct A1F ATF-Chief FFLC LicensaFermit Correspondence To 244 Needy Road Number 08 081 Maardnsburg,W V 25405-943I Chief.Federal Explosives L'censing Ce (FELC) Expiration Date March 1 , 2024 Name SANTORES WORLD FAMOUS FIREWORKS LLC Premises Addre s(Chnnges2 NotifytheFE=ax least 10darWarethemove.) 846 STILLWATER BRIDGE ROAD. SCHAGHTICOKE,NY 12154- Type ofLicense or Permit E3-IMPORTER OF EXPLOSIVES Purchasing Certiseetion Statameut Mailing Address(Changes?Notify the FaC ofany changes.) 'the licmna or peimitree mated above shaII use a copy afthis,litxase ar permit to assist a tratufaw•of�ptosives io vsify the ideriity andthe lica�ed.status afthe Eicetsee ar pmiinee ns pr(rtided by 27 tom$Part SSS. The siieratare an euch copy awns.be as orisinal si ure A faxed,seamed or o-mailed copy othee license rir permit with a sigtatwe SANT0RES WORLD FAMOUS FIREWORKS LLC intendedtobounarisWulaignatumisaeoemri 143 SUMMIT AVr= ExplosivesUemr.mML)orarespow%leperswdlheFEL Iar*thethis.isatrue BERKELEY HEIGHTS, NJ 07922- copy of a lio mse or permit ismedto the licensee or penmitleawrned•oboveto-mgage im the business ar operations specified above nnder'Type of Lkxm or Permit." LicenseeJPennittee Responsible Person Signature Positiom?itle Printed Name Date AZFFam'54M.14i5400.tsPan I Pre%QUsEdhiwrisgbscide RcvisedSgtmtbu2D11 Federal F.sploshres Uceose(FEL)Custouaer Service Thbirination Federal Explosives Licensing Cantor(FELC) Toll-flee Telephone Number: (877)283.3352 ATF Homag age:www.at£gav 244 Needy Road FoxNirmbsr: (304)616-1401 Martinsburg,WV 25405-9431 E-mail. FELCAat£gov Change of Address (27 CFR 555.5d(a)(I)). Ueenaees or perm6tet s may dutittg the term oftheir current license or permit remove thair business or operations to n new location at which they intend regalmiy to carry on such business or op nt iens. The licensee or permittee is required to give notification ofthe new locatioa ofthe business or operafim mat:Ims than 10 days prior to such rmm-al vdth the ChK Fcdm-9 Explosim Licensing Ceuter. The Iioo=or permit will be valid for the remainder ofthe term ofllre original lic eau or petmlt. (!The ChM;FELL,shall,ff the Ccensee or ptrrmittee isnot quvWmd,reft the rcquest for mneudtd llemm or pentut to the Dirrctvr of bduMy Operadm for dads]hit acordam rrldt§555.5t) Right of Succession (27 CFR 555.591. (a)Certain persons other titan the licensee or pemtittee may secure the r*U to catty on the same explosive materials bush=or operations at the same address shown on,and for the remainder ofthe term of,a current license or permit. Such persons are: (1)The surviving spouse or child,or exerwor,administrator,or tither legal rive ofa daces d,li ensce orpermittee,and(3)A receiver or trustee at ban1kruptcy,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 to 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 catry on the business or operations (Contimwd on rew nw side) Cut Here X Federal Explosives LfcenseJPerridt(FEL)Information Card l License-Termit Name:SANTORES WORLD FAMOUS FIREWORKS LLC t i I l I 1 Business Name: I 1 t License/Pervrit Number_"V-N3-ZWC-01091 1 t License'Permit Type 234MPORTER OF EXPLOSIVES E t t , Expiration: March 1,2024 r t l Pleasehote: Not ValidfortheWeor Other DispositimofRNplosives.--------------------------------- � t I SH-862(3/22) WE ARS Expires. 1/31/2025 DIVISION,OF-SAFETY HEALTH YOUR D�' THIS LICENSE MUST BE LICENSE AND CERTIFICATE UNIT loeffrrent POSTED.IN YOUR PLACE OF STATE OFFICE CAMPUS,BLDG.1 BUSINESS ALBANY,NY 12226 License No. D_5796 LICENSE TO DEAL IN QR MiaNILIFACTURE EXPLOSIVES Sen,tore's World Famous Fireworks, LLC, 846 Stillwater Bridge'Rd Schaghticoke, NY-12154 August N. Santore,'Jr.• Is hereby'lleensed to deal in or manufacture explosives in compliance with the requirements'of the Labor Law and Industrial Code Rules.Any change in the conditions'und6r.which this license•is granted may cause it to be revoked. Every•persori selling,,delivering or giving away anyezplosives must keep at the principal place of business within the state, a record of each transaction,including: , 1) the NAME or TYPE and QUANTITY of explosives SOLD,DELIVERED or GIVEN.Note:No license`is needed to purchase smokeless powder,or"black powder and quantity is not exceeding five pounds fqr use in firing antique' firearms or artifacts or replicas thereof.However,deals es MUST post:all such transactions on the"Dealer- Manufacturer Report of Ezplosives.Transactions`. . 2) the DATE OF EACH SALE,DELIVERY or GIFT. 3) the NAME,LICENSE'NUMBER,and BUSINESS ADDRESS of the purchaser,donee,onpOson to whom the explosives were'delivered and the Grm,"if any;represented by such person. .4) the NAME,ADDRESS,and LICENSE NUMBER of the person TAKING THE EXPLOSIVES AWAY from the seller or donor. 4 - Amy Phillips,Director FOR'THE CONIMISSIONER OF LABOR SH-862(5-98) U.S.Department of Justice Federal Explosives License/Permit Bureau of Alcohol,Tobacco,Firearms and Explosives (I8 U.S.C Chapter 40) nnaimammai m9mutsmcncu In accordance«nth the provisions of Title Xi,Organized Crime Control Act of 1970,and the regulations issued thereunder(27 CPR Part 555),you may engage in the activity specified in this license or permit within the limitations of Chapter 40,Title IS,United States Code and the regulations issued thereunder,until the expiration date shown, ruts I.if'FNIRP IS NOT TR A N.,Z i RA RLr•t IWD_ F.12 27 CFR 4:47:�%43. See ttilrAPNTii ICS°..,d IWOTICES"on r=.• rev. Direct ATF ATF-Chic£,FRLC V License/Pennit Correspondence To 244 Needy Road Number j a 1 Martinsburg,WV 25405-9431 i Chief.Federal Explosives Licensing Cente (FELC) Expiration- Date March 1, Name SANTORES WORLD FAMOUS FIREWORKS LLC Premises Address(Changes?Notify the FELC at leasi 10 days before the more.) 846 STILLWATER BRIDGE ROAD , SCHAGHTICOKE, NY 12154- Type of License or Permit _ 20-MANUFACTURER OF EXPLOSIVES Purchasing Certification Statement Mailing Address(Changes? Notify the FELC ofany changes.) The licensee or peminee named above shall use a copy ofthis'license or permit to assist a transferor of explosivesto verify the identity and the licensed status ofthe licens`ea or - permittce as providedby 27 CFR Part 553. The sienattire on ead,coav must be nrrorieinal SANTORES WORLD'FAMOUS FIREWORKS LLC signature. A faxed,scanned or e-mailed copy ofthe license er permit ivith a signature kitended to be an original signature is acceptable. The signature must 6e that ofthe Federal 143 SUMMIT AVE Explosives Licensee(Ff:L)ora responsible person oftlicFEL IccniRthat•thisisatnte BERKELEY HEIGHTS, NJ 07922- copy of a license or permit issued to the licensee or pemminec named-abov a to engage in the-- business or operations specified above under"Type of Lic-ase or Permit. LicenseePermittee Responsible Person Sionature Position/Title Printed Name Date ATF Form 5 00,1Q;5tU0.15 Part I Previeu,Edition isObsolete LLC2S041WATtHImGrGM¢Ay.y9i•tp1ZD+GPC79fYtteLM4M'W%WA91U=OFMID,5B Revised SeTtmtber20)1 Federal Explosives License(FEL)Customer Senice Information Federal Explosives Licensing Center(FELC) Toll-free Telephone Number: (877)283-3352 ATF Iiomepage:www.atf gov 244 Needy Road Fax Number: (304)616-I401 Martinsburg,WV 25405-9431 F-mail: FELCe-.atf gov Change ol'Address (27 CIR 555.54(a)(1)). Licensees or permittees may during the term of their current license or permit remove their business or operations to a pen-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 that 10 days prior to such removal with the ChieZ Federal Explosives Licensing.Center. The license or permit will be valid for the remainder of the term of the original license or permit. (Tire Chief,FELC,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 mmith§555.54.) Right of Succession (27CF-R 555.59). (a)Certain persons other than the licensee or permittcc 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 tlic tern of,a current license or pennit. Such persons are: (I)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 ofsuch succession to the Chief II:LC,within 30 days from the date on which the successor begins to carry on the business or operations. (Continued oar reverse side) Cut Herr— t Federal Explosives License/Permit(FEL)Information Card I I Liccnse•Permit Frame:SANTORES WORLD FAMOUS FIREWORKS LLC 1 I I 1 1 t Business Name. I I I j Licensm/Permit Number:6-NY-083-20-4C-01080 I I I LieensePermit Typc:20-MANUFACTURER OF EXPLOSIVES t I - I Expiration: March 1,2024 I - I I I I Iplease Note: Not Valid for the Sale or Otter Disposition of Explosives. I M."RVITIMEY1,OF-IUSTICE �•r yr7rf II mu aAbAT Tthw,%,� A a M, Emil im,airs Explo'h C' Fchruatti,25.2024 SANUORES WORLD FANUAIS MIUMORKS I LC 90ko9o:MIUSNIC, 1.13SU1 NHTAVL-. 5400 BE:RKELEY 11F,3(.i1-ITS.NJ 07t)-12 File Number. 6-NY-01080 I.,R IMITKA- 1:1Su Dwr Sir Waru: This letter receipt W-yuur iiindy application W rcliew your Faleral c.\pIo,h,cs The BUI-Call of Alcohol.Tobj"o.Firearms and Explo,ive5 iATFI is not able tea prose,.,yourapplication prior tea[lie e\11irition I lawk:vcr.t"E:0 ra I III m--;yoll 1c,Qom hme eel, rrlitin,miner yom vix vren I ficenst:'perm ituntil such sm 5 In m§55�,'mi-,ittier.(it ns C-%phained i fcl I lotto.,"vi I I S.Te a&Lour Hemse Items anti[WC Complete Won an your ranual- Sinct:We have not 401'.1pleted IsommIg ymw a"li"Ami.ym stay s"ply a cqyy of this Itawr to odwr your Jimribunvr'.1,61-the nest AN 11100111S for Mild We MITIOCIe=On m ymm rentaml. if that uccum in le" Ilum six monbsi m. evidence of yt,ur lien ed panhwd status If n-c hmv not completed pro"asirig you application Aw nmood "Ahim As nionk, of the d"lu-of this letter. we will.'end youallotli'21.lcltci,which ivill aisv he maHd for As mondis(or until we complat;action on your r:ne%tal. if tha oce-tirs in less than AN nwaflvo. flii, is ofcovjr-se coniingcrif upon your rernaininu calitled lu comilloc (Teration,under your cun-ent hcen--e permit. Please diri!cr qve;tions w cmicm,mprehyAN loner tv bus n Ma=41644M, Marna I loward Ctfiei',Federal F.kplosivi�,Licensing Center well addrcN;. •%;-w <ri t Caw U.S.Department Eastern Service Center 1701 Columbia Ave. of Transportation Operations Support Group College Park,GA30337 AJV-E2 FIREWORKS DISPLAY NOTIFICATION Company Name: Santore's World Famous Fireworks 4LC Email Address of Person Submitting Request: terisa D-santorefireworks.com Cell Phone Number for On-Site Technician: Robert Mardorf 516-369-2107 Event Name: Peconic Bay Vineyards(Crossroads Wine ) Display Date: 7/06/2024 Rain Date: 7/07/2024 Display Start Time: approx 9 : 1 5 p m Duration of Fireworks Display: 10-12 minutes Max Height of Fireworks: 300' feet Address,City and State: 31320Main rd. Cutchoaue NY 11935 Latitude: 41.017995N 72.487640W (North) Longitude: (West) List the Closest Public Use Airport Within 5 Nautical Miles of the Display if the Fireworks Will Reach or Exceed 500 Ft. Special Notes—Display will NOT exceed 300' Please email your request to: 9-ATO-ESA-OSG-Fireworks@faa.eov Air Traffic Organization 1701 Columbia Avenue Eastern Service Center College Park,GA 30337 U.S. Department of Transportation Federal Aviation Administration Dear Fireworks Proponent: Thank you for informing us of your proposed fireworks display. Although there are currently no federal regulations specific to fireworks displays,the Federal Aviation Administration(FAA)has been tasked with regulating the safe and efficient use of the navigable airspace (49 U.S.C.§ 40103). In recognition of this role in promoting aviation safety, many jurisdictions require notice to the FAA as a condition of approval of a fireworks permit. We acknowledge your notification and have no objection to the fireworks display, provided it is conducted in a manner that does not create a hazard to other persons or their property. To enhance the safety of your event,we recommend the following actions: • Fireworks staff should remain vigilant to ensure that no aircraft are in the area prior to beginning the fireworks display. • If your event is within 5 miles of a public use airport, or if the display will exceed 500 feet Above Ground Level (AGL), contact Leidos Flight Service at 1-877-4-US-NTMS (1-877-487-6867) at least 24 hours (but not more than 7 days)in advance to request a Notice to Air Missions (NOTAM). You will need to provide the following information: o Name and address of the person filing the NOTAM o Date, time(s), and event location(City, State, and location in reference to the airport) o Maximum altitude of the display This letter should not be construed as superseding or invalidating any existing rules or regulations promulgated by any other federal, state, county, or municipal government which may be required for this display. If you have any questions regarding this information,please contact our office at(404) 305- 5570 or 9-ATO-ESA-OSG-Fireworks(a,faa.gov Sincerely, Wr C � Matthew N. Cathcart Manager, Operations Support Group NYSIF New York state Insurance Fund PO Box 66699,Albany,NY 12206 nysif.com CERTIFICATE OF WORKERS' COMPENSATION INSURANCE 4E. . .� AAAAAA 472010297 SANTORE'S WORLD FAMOUS FIREWORKS LLC143 SUMMIT AVE . BERKELEY HEIGHTS NJ 07922 SCAN TO VALIDATE AND SUBSCRIBE POLICYHOLDER CERTIFICATE HOLDER SANTORE'S WORLD FAMOUS TOWN OF SOUTHOLD FIREWORKS LLC 53095 MAIN RD. 143 SUMMIT AVE SOUTHOLD NY 11971 BERKELEY HEIGHTS NJ 07922 POLICY NUMBER CERTIFICATE NUMBER POLICY PERIOD ' DATE A2353 260-9 440758 02/07/2024 TO 02/07/2025 3/6/2024 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 2353 260-9, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF YOU WISH TO RECEIVE NOTIFICATIONS REGARDING SAID POLICY,INCLUDING ANY NOTIFICATION OF CANCELLATIONS, OR TO VALIDATE THIS CERTIFICATE,VISIT OUR WEBSITE AT HTTPS://WWW.NYSIF.COM/CERT/CERTVAL.ASP.THE NEW YORK STATE INSURANCE FUND IS NOT LIABLE IN THE EVENT OF FAILURE TO GIVE SUCH NOTIFICATIONS. THIS POLICY DOES NOT COVER THE SOLE PROPRIETOR,PARTNERS AND/OR MEMBERS OF A LIMITED LIABILITY COMPANY. THE POLICY INCLUDES A WAIVER OF SUBROGATION ENDORSEMENT UNDER WHICH NYSIF AGREES TO WAIVE ITS RIGHT OF SUBROGATION TO BRING AN ACTION AGAINST THE CERTIFICATE HOLDER TO RECOVER AMOUNTS WE PAID IN WORKERS'COMPENSATION AND/OR MEDICAL BENEFITS TO OR ON BEHALF OF AN EMPLOYEE OF OUR INSURED IN THE EVENT THAT, PRIOR TO THE DATE OF THE ACCIDENT, THE CERTIFICATE HOLDER HAS ENTERED INTO A WRITTEN CONTRACT WITH OUR INSURED THAT REQUIRES THAT SUCH RIGHT OF SUBROGATION BE WAIVED. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. NEW YORK STAT SUR NCE FUND T �V DIRECTOR,INSURANCE FUND UNDERWRITING VALIDATION NUMBER:542576776 U-26.3 (MMIDDIYY A� CERTIFICATE ®F LIABILITY INSURANCE DAT3/M/2024 YY) 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: Acrisure, LLC dba Britton Gallagher&Associates PHONE FAx One Cleveland Center, Floor 30 c No Ext:216-658-7100 A/c No:216-658-7101 1375 East 9th Street ADDRESS: Cleveland OH 44114 INSURER(S)AFFORDING COVERAGE NAIC 4 INsuRERA:Everest National Insurance Company 10120 INSURED 18341 INSURER B:AXIS Surplus Ins Company 26620 Santore's World Famous Fireworks LLC 846 Stillwater Bridge Road INSURERC: Schaghticoke NY 12154 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:979735877 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMBS LTR INSR Vivo POLICY NUMBER MM/DD MMIDD A GENERAL LIABILITY Y Y S18ML00235-241 2/9/2024 2/9/2025 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $500,000 CLAIMS-MADE rx]OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $1,000.000 GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 17 POLICY X PRO- LOG $ A AUTOMOBILE LIABILITY Y Y S18CA00102-241 2/9/2024 2/9/2025 COMBINED SINGLE LIMIT Ea accident_ $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per aocldenl $ B UMBRELLALIAB X OCCUR Y Y P-001-000074909-06 2/912024 2/9/2025 EACH OCCURRENCE $4,000,900 X EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY T RY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE� N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement. Town of Southold,Suffolk County,and The Peconic Bay Vineyards(Crossroads Wine,LLC) 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 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Southold 53095 Main Rd. AUTHORIZED REPRESENTATIVE Southold NY 11971 -�f ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD U.S. Federal Explosives License/Permit Bureauu ofAlfAlcoh Department of Justice (I8 U.S.C Chapter 40)ol,Tobacco,Firearms and Explosives 1 ntmrmmarate�auuaatwamtta'.:¢aui 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 vdthin the limitations of Chapter 40,Title 18,United States Code and the regulations issued thereunder,until file aniratiou date shown. €d S f.It'F.i9�F IC 1LTE7T� 18�15 1?�12ART 'i1UY &Y2'�7 C.£+`F:'56�.u^. Soa'RV,�iP�27II�TC5"fltd'TtOTICLS^on ovoro, Direct ATF ATF-Chief FELC " Licensei'emiit_m Correspondence To 244 Need)•Road _ Nurnber : Martinsburg,WV 25405-9431 Chief.Federal Explosives Licensing Cent (FELC) Expiration DateMarch 1. 21024 Name SANTORES WORLD FAMOUS FIREWORKS LLC Premises Address(Changes?Notify the FLLC at'(east 10 days before the move.) - 846 STILLWATER SRID.GE'RO AD• , SCHAGHTICOKE, NY 12154 Type of License or Permit ; 20-MANUFACTURER OF EXPLOSIVES Purchasing Certification Statement Mailing Addce§s,(Changes'? Notify the FELC of on)'changes.) The licensee or pemunee named above shall use_a copy.ofthis,license or-pennit to assist a- u-ansferor of...,plosives to verify the identity and the lies used"us of the licensee or - permatecasprovidedby27CFR Part 555. The simattue.cn"each copy mus(t+e`atiorisntu( si tature. A fax SAIVTORES,WORLD FAMOUS FIREWORKS LLC ed sunned ore-mailed copy of the liceiise'crperma Keith'a signature '"" intcndedtobean original signature isacceptable. The si,flahtrzmtistbe that ofliteFedetal 143 SUMMIT AVE; Explosives Licensee(FL•L)or a responsible person of the FEL."I c ni V that this is,a true B ERKEL`EY HEIGHTS, NJ 07922- copy of a license or permit issued to the liceusee or permitted named-aboti:e to engage-in the. business or operations speed above undcar"Type of License or Pcrmii: ; LicenstmPermittee Responsible Person Signature Position/Title Printed Nime Date ATF Form 540o.1•t.'i1UA.13 hart 1 Previous Edition is Obsolete sL.nmtswcuorMW.fmtmemauucauatQuexre x�wm.nzvr,.mr.ca.m+cates;ts,,,cet,traxo-suxwurcea urnreas�es Revised Septembcr 2011 Federal Explosives license(FEL)Customer Service Information Federal Explosives Licensing Center(FELC) Toll-free Telephone Number: (877)283-3352 ATF Homepage:a%vw.atf gov 244 Needy Road - Far Number. (304)616-4401 Martinsburg,WV 25405-9431 E-mail: FELL^atfgov Change o€Address (27 CIR 555.5 F(a)(I)). Licensees or permittees may during the term oftheir 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 permitted is required to give notification of the new location of the business or operations not less than 10 days prior to such removal with the Chief Federal F..,plosives 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 pennittee is not qualified,refer the request for amended license or permit to the Director of Industry Operations for denial in accordance frith§555.54.) Right o€Succession (27 CfR 555.59). (a)Certain persons other than the licensee or permitted;may secure the right to carryon the same explosive materials busincss•or operations at the same address shown on,and for the remainder of the term of,a current license or,pennit. Such persons are: (1)The surviving spouse or child,or cxeculor,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 condnuing 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 front the date on which the successor begins to carry on the business or operations. (Continued on reverse side) Cut Here X t----------------------------------1 t Federal Explosives License/Permit(FEL)Information Card r I I License`PermitName.SANTORES WORLD FAMOUS FIREWORKS LLC 1 t t 1 t Business Name: t r I I I t Licensc)Peanit Number:SNY-063-204C-01080 1 I 1 License,Permit Typc:20-MANUFACTURER OF EXPLOSIVES 1 I Expiration: March 1,2024 t t I I I Please Vote: Not Valid for the Sale or Other Disposition of Explosives.----------------------------------- I I DEPARTMENT ot:-ifus,ricE SANTORL.S WORLD FAN401,13S FJRJ:W01?,KS LLC .901 090:MFPS"Mc 143 call:; ,0 Wr Ax 5400 NJ 07922 File Nbutber:6-NY-01080 MUDGE ROAD NCHAGRiTICOU.NY 1 lit Dew A NIAMA: This letter ackno%xlcdgcs recciliz of ytiur tiowly applicaiion to ronciv your Federal cxpik?5ive-,tier pe jlerlllit. The 13ure."111 ofAIC0110I.Tobacco.Fire irxns rind (ATF)k n,able to ru'O.Cus's yoll)-application Prior 14)file expiruliou 1-1 oweven Fedcrol Laval You to com illue opeto 1.1lader yolit'Cit frent I iCcn,,C:perlai L until Silch t i lav conlphcle-;proccs.,ing�,,mj r-it YJA ic.1 I ion.IS.5 USK§55R,T hi S I t:t uir.or I.,c.%1)I;j illed bckv,r,a follow-up let ter,w i I I Since Nke hav,�not compknv-d procesMng your applicatioll.you Illoy upply 1 cop, of this Icucr your distribtliors.for tilt! next six 111onth,for until lvv conjAcleaclioll on Your rent:%val. it'llua occurs ill (1144:1 ',iN Illonth"')as c%,idcnf;c of your IicSmm:d,pvmhwd swulc IT it h—am comMewd rrmassing 31—TOWnion Aw0 within A w"M of the due of As Jefier,%ve AR send yu another!of= which will also be vad Rw A mowhs Ow umd"v comMaze adAn on youl it'that oaCuv, ill k�,�N III-an .*ix 111011filsi. This is of Course cbIllinvent 11pon your E--'nl;!ijjjljg CatilICLI lji Malj�alC OperI4.4)JI,j undei yot4-ciiry at ficense pevaiii. please divvcr(tuestiorls 01-converas reprdiae.this letter to Susan CL)rk-,304-616-4404, Sincerely. CX Nlarna Howird Fedewl.J.',xiAosives Licctl;,ing Ctmier AIT lvcb oddre�,. v,g,�v Air Traffic Organization 1701 Columbia Avenue Eastern Service Center College Park,GA 30337 U.S, Department of Transportation Federal Aviation Administration Dear Fireworks Proponent: Thank you for informing us of your proposed fireworks display. Although there are currently no federal regulations specific to fireworks displays,the Federal Aviation Administration(FAA) has been tasked with regulating the safe and efficient use of the navigable airspace(49 U.S.C.§ 40103). In recognition of this role in promoting aviation-safety, many jurisdictions require notice to the FAA as a condition of approval of a fireworks permit. We acknowledge your notification and have no objection to the fireworks display, provided it is conducted in a manner that does not create a hazard to other persons or their property. To enhance the safety of your event,we recommend the following actions: • Fireworks staff should remain vigilant to ensure that no aircraft are in the area prior to beginning the fireworks display. • If your event is within 5 miles of a public use airport,`or if the display will exceed 500 feet Above Ground Level (AGL), contact Leidos Flight Service at 1-877-4-US-NTMS (1-877-487-6867)at least 24 hours (but not more than 7 days) in advance to request a Notice to Air Missions (NOTAM). You will need to provide the following information: o Name and address of the person filing the NOTAM o Date,time(s), and event location(City, State, and location in reference to the airport) o Maximum altitude of the display This letter should not be construed as superseding or invalidating any existing rules or regulations promulgated by any other federal, state, county, or municipal government which may be required for this display. If you have any questions regarding this information, please contact our office at(404)305- 5570 or 9-ATO-ESA-OSG-Fireworkskfaa.gov Sincerely, Matthew N. Cathcart Manager, Operations Support Group i few 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: Santore's World Famous Fireworks 4LC Email Address of Person Submitting Request: terisaOsantorefireworks.com Cell Phone Number for On-Site Technician: Robert Mardorf 516-369-21.07 Event Name: Peconic Bay Vineyards(Crossroads Wine ) Display Date: 7/06/2024 Rain Date: 7/07/2024 Display Start Time: approx 9 : 1 5 p m Duration of Fireworks Display: 10-12 minutes Max Height of Fireworks: 300' feet Address,City and State: 31320Main rd. Cutchoaue NY 11935 41.017995N 72.487640W Latitude: (North) Longitude: (West) List the Closest Public Use Airport Within 5 Nautical Miles of the Display if the Fireworks Will Reach or Exceed 500 Ft. Special Notes—Display will NOT exceed 300' Please email your request to: 9-ATO-ESA-OSG-FireworksCoDfaa.eov ACC>Ri CERTIFICATE OF LIABILITY INSURANCE DATE(M 024�) 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: Acrisure, LLC dba Britton Gallagher&Associates PHONE FAX One Cleveland Center, Floor 30 AIc No Ext:216-658-7100 vc,No:216-658-7101 E-MA1375 East 9th Street ADDRESS: Cleveland OH 44114 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Everest National Insurance Company 10120 INSURED 18341 INSURER B:Axis Surplus Ins Company 26620 Santore's World Famous Fireworks LLC 846 Stillwater Bridge Road INSURER C: Schaghticoke NY 12154 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:979735877 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 y CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL S BR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMIDD/YYYY MMIDDM'W A GENERAL LIABILITY Y Y S18ML00235-241 2/9/2024 2/9/2025 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO TED PREMISES(Ea occurrence $500,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS- $2,000,000 POLICY X P CO- LOC $ MBINED A AUTOMOBILE LIABILITY Y Y S18CA00102-241 2/9/2024 2/9/2025 COINGLE LIMIT Ea accldeM S $1 000 000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS O X HIREDAUTOS X AUTOS NON-OWNED PPeraEcRdTmDAMAGE $ B UMBRELLA LIAB X OCCUR Y Y P-001-000074909-06 2/9/2024 2/9/2025 EACH OCCURRENCE $4,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- I JOTH- AND EMPLOYERS'LIABILITY YIN ORY LIM I S I ER ANY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement. Town of Southold,Suffolk County,and The Peconic Bay Vineyards(Crossroads Wine,LLC) 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 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Town of Southold 53095 Main Rd. AUTHORIZED REPRESENTATIVE Southold NY 11971 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Town of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 05/21/24 Receipt#: 327912 Quantity Transactions Reference Subtotal 1 Fireworks 07/06/24 $100.00 Total Paid: $100.00 Notes: Payment Type Amount Paid By CK#1125 $100.00 Peconic, Bay Vineyards Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Peconic, Bay Vineyards 31320 Main Road Cutchogue, NY 11935 Clerk ID: DIANAF Internal ID:07/06/24 Noncarrow, Denis From: Flatley, Martin Sent: Wednesday, May 22, 2024 2:03 PM To: Franke, Diana; Lillian McCullough; Blasko, Regina; DeChance, Paul; Grattan, Steven; McCullough, Lillian; McGivney, Julie; Norklun, Stacey; Squicciarini,James; Stype,John; Visser III, Fredric Cc: Noncarrow, Denis; Born, Sabrina Subject: RE: Fireworks Application: Peconic Bay Vineyards (Crossroads Vine LLC) I have no objections to application 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, (fi)return the original message and all copies to us at the address above via the U.S. Postal Service, and(N)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:Tuesday, May 21, 2024 3:23 PM 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>; Grattan,Steven <sgrattan@southoldtownny.gov>; McCullough, Lillian<lillianm@southoldtownny.gov>; McGivney,Julie <juliem@southoldtownny.gov>; Norklun,Stacey<Stacey.Norklun@town.southold.ny.us>; Squicciarini,James <jacks@southoldtownny.gov>;Stype,John<johnst@southoldtownny.gov>;Visser III, Fredric <fredv@southoldtownny.gov> Cc: Noncarrow, Denis<denisn@southoldtownny.gov>; Born,Sabrina <sabrina.born @town.southold.ny.us> Subject: Fireworks Application: Peconic Bay Vineyards(Crossroads Vine LLC) Good Afternoon, Attached, please find an application for a fireworks permit for Peconic Bay Vineyards(Crossroads Wine LLC),submitted on 05/15/2024. Please review and send me your comments and/or recommendations. Thank you so much, 1 Account Clerk Southold Town Clerk's Office (631)765-1800 Ext 1228 2 DENIS NONCARROW �� Gy� Town Hall,53095 Main Road TOWN CLERK p - P.O.Box 1179 y Z Southold,New York 11971 REGISTRAR OF VITAL STATISTICS O Fax(631)765-6145 MARRIAGE OFFICER Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER �O! '1►a www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD PERMIT for PUBLIC DISPLAY OF FIREWORKS I, Denis Noncarrow, Town Clerk of the Town of Southold, Suffolk County, New York, being an officer duly designated by the Town Board of the Town of Southold for this purpose, do hereby GRANT TO: Peconic Bay Vineyards LLC. 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, on Saturday, July 61h 2024 at 9 :15pm. Rain date is Sunday, July 7th• 2024. Exact Location is 31320 Main Road, Cutchogue New York, time and place set forth in the application therefore, 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 a 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 into 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 a 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 concluded 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 . which the wind reaches a velocity of more than thirty miles per hour; that all persons in actual charge of ri g the fireworks shall be over the age of eighteen years, competent and physically fit for the task, that ere shall be at le st two such operators constantly on duty during the discharge and that at least two soda cid othe ppro ed type fire extinguishers of at least two and one-half gallons capacity each shall be kept su h i sep ted points as possible within the actual area of the display. nis Noncarrow, Town qlerk Town of Southold Suffolk County,New York (TOWN SEAL) Date: June 5, 2024 THIS PERMIT IS NOT TRANSFERABLE