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HomeMy WebLinkAbout2002ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OP' SOUTHOLD PERMIT for PUBLIC DISPLAY OF FIREWORKS I, ELIZABETH A. NEVILLE, 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 MATTITUCK LIONS CLUB & VINELAND FIREWORKS INC. 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 Saturdav~June,l5t 2002, at 10:00 p,m. on property of Town of Southold and County of York, the time and place set 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 aze 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 aze discharged and only persons in active chazge 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 least two sodaacid or other approved type fire extinguishers of at least two and one-half gallons capacity each shall be kept at such widely sepazated points as possible within the actual area of the display. c _~~_ • ~ ~ ~~ Elizabe~lle, T~~k G~~ ~ __ Town of Southold (TOWN SEAL) Suffolk County, New York ELIZABETH A. NEVII.LE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER ~o~Ou --~ cod oy o 2 - W • OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION for PERMIT TO DISPLAY FIREWORKS Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fex (616) 765-1823 Telephone (516)765-1800 RECEIVED YAY 3 1 2002 Sootkold Town Clerk 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 PRINCIPAL OFFICE AT DATE OF DISPLAY .~it-- TIME OF DISPLAY RAIN DATE & TIM The following persons are to be in charge of the actual shooting of the fireworks: Name Age Experience Physical Condition ~2 a9 t/G~~-S ~ i ~ ~~.~ s ash Number and type of fireworks is as follows: ~~G, SAS,-~~~d<'iiPC - -3 S-d ~~r~^~~c mane ~ti~`~~Ze YDY tM d/..9 ,n~~ir ~1 ~~.i~n~ .~ ~i~s,o OYV~ The fireworks will be stored in a covered truck prior to shooting on the grounds. 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. ~el~~~~e ne of Organiz Lion By Signature of pplicant (JO,~ Date f Application 1 C RL~, CERTIFICATE OF LIABILITY INSURANCE os/osi2o z PROD CER (415) 391-1013 FAX '(41$) 391-45 Farpl lon Assoc Ins Brokers 40 Montgomery Street 14 THIS CERTIFICATE IS ISSUED AS A MATTER OP INFORMA OHOLDE~R, THISNCERTIFICATE DOES NOT AMEN EX ND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. su se 500 Sd Francisco, CA 94104 INSURERS AFFORDING COVERAGE Ixsu,D Vine an TreWOr s CO• INSURERA Royal Sur us Llnes Ins. Co. 1640 Garden Road INSURER B' Sorer NA Vineland, N] 08380 INBURERC AISLIC INSURER D: INSURER 8 COVERAGES TN POLICIES OF INSURANCE LEiTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE POR THE POLICY PERIOD INDICATED. NOTWITHSTANDING AN RECKIIREMENi, TERM OR CONDITKNJ OP ANY CONTRACT OR OTHER DOCUMENT WRH RESPECT TO WHICH THIS CERTIFICATE MAY 8E ISSUED OR THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, E7(CLUSIONS AND CONDITIONS OF SUCH MA PERTAIN , p0 qES. AGGREGATE LMTS SHOWN MqY HAVE BEEN REDUCED BY PAID CLAape. IN TYPE OF INSURANCE POLICY NUMBER PD IDY LIMITS ENCRAL LMBILITr 3064 05/31/2002 05/31/2003 EACH OCCURRENCE S 1,000 0 CDMMERCML GENERAL LIABILRY FIRE OHMAGE (Anyone pro) f SD Q cL,gIMe MADE OCCUR MED EXP (Anyone person) 9 nOn A ~ PERSONAL a ADV IwuRV f 1, 000, GENERAL AGGREGATE f 2,000. ENL AGGREGATE LIMB APPLIES PER: PRODUCTS-COMPpP A00 f 2,000, POLICY jR LOC r aMOBILeuABILm X12290-2002 04/20/2002 04/20/2003 COMBINED SINGLEUMR ANYAUrD ~`""'~ f 1,000,0 ALL OWNEG avros BODILY INJURY f SCHEDULED AUTOS (per person) B HIRED AUTOS BODILY INJURY f NON•OWNED AUroe p~erewaenq PROPERTY DAMAGE S (Per accident' ARAOE LIABILITY AUTO ONLY•EA ACpOENT 3 ANY AUTO OTHERTNAN EA ACC S AUTO ONLY: AGG f CESS UABILI7Y EACH OCCURRENCE f 4000 00 OCCUR ~ CLAIMS MADE AGGREGATE S 4,000, C E1398108F40 OS/31/Z002 05/31/2003 s OEIXICTIBLE f I RETT7I(ION 9 S RS cDMPENSAYION AND TORY LIMITS DT DYERS' LIABILRY E,L. EACH ACCIDENT y 6.L DFgEASB • EA EMPL f E.L DISEASE-POLICY LIMB f flTfER WTIOd OF ERATJDNSA.CCPTIRNw~n ESR~CCI. K)N AJDED BY ISP ML PROYLAIDNS ttltuc~t Llons Cluo z] ~ewls ~, t~~vton ~S~ona s3~ '~iwn of Southold 4) Mattituek Firs ep rtment are Additional Insureds as Respects a Fireworks Display on June 14, 2002 at at Truck strawberry Festival grounds, Mattituck, NY, CERTIFICATE HOLDER I I ADpITIDNgL INSURED; INSURER LETTER CANCELLATION SNOlILO ANY DF THE ASDVE DESCRIBED POLICIES BB CANCBLLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY Y/ILL ENDEAVOR 7O MAIL 30 DgYS VlRI7TEN NOTICE TO TKE CERTIFICATE HOLDER NAMED TO TKE LEFT, MatL7tuCk L70nS CI Mb/LIWiS ]. NeWtOn & SOaS ~TFAILURE Ta MA1L SUCR NOTICE SHALL IMPOSE NO OBLIGATION OR LMBILRT 212 Knapp place CP ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENIATNEG ereenportLongIsl and, NY 11944 AUTHDRI~DREPRESENTATNE ICCORD `[$x-(7/97) Z'd . ®ACORD cORPORAnoN 19ae; S~JOM321I~ QNtil3NIA Wd£V:TO Z0. LT 1,CW ACORD CERTIFICATE OF LIABILITY INSURANCE n, DATE IMM/DDIYY) 05/06/2002 PRODUCER (856)694-2222 FAX (856)694-2279 the eo relli Agency, Inc. Dutch Mill Road ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Malaga„ NI 08328 INSURERS AFFORDING COVERAGE INSURED yi nel and Fireworks Co., Inc. INSURERA: Liberty Mutual Insurance Co. 1640 E. Garden Road INSURER B: Vineland, NJ 08360 INSURERO INSURER D INSURER E: I:UVtKAl9t5 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REDUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. AGGREGATE LIMITS SHOWN MAV HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE POLICY NUMBER DATE (MM/DDIYY) DATE (MM/DD/W) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any one tire) S CLAIMS MADE ^ OCCUR MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ POLICY PRO LOC JECT AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANV AUTO (Ea accitlaM) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-0WNED AUTOS (Per accitlent) PROPERTY DAMAGE $ (Per accitlen0 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANV AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE S OCCUR ^ CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ vroRKER3 coMPENSAnoN ANO C7-335-301113-012 04/01/2002 04/01/2003 TORY LIMITS ER EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 500,000 A EL. DISEASE-EA EMPLOYE $ $00, DDD E. L. DISEASE-POLICY LIMIT $ SQO,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIE%CLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS i spl ay date; June 15, 2002 ain date; To be determined CtK I IHIUA I t KULUtK ~ ~ ADDITIONAL INSURED; INSURER LETTER CANIaLLA I IVN Matti tuck Lions Club Leis J. Newton & Sons 212 Knapp Place Greenport Long Is., NY 11944 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATON DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10- DAY$,)QIWi,TE.N.NOT~Fi lO,TM§,CgF~$FIG/,T~Q~'DER NAMED TO THE LEFT, OF ANY KIND SHALL OR LIABILITY s ............ .... .. . __; . ~: ® ~ ~ ® ' , ~ . ~ fij ~ : : ® R ® . ~~ . ~ i i . ~i~~~: is .. ::.. A - ~ .. ® .......~~ :: ~: 'ft~'' .. a~ ~~J~y~:J~~~:. I is :." T ® ' ::::.. . : ... ... ~, ®.: B ~ ® ~. 6 tJ5 i:NE 55 .:A ND. ... .. ~:::. i i :®:::®:. ` {{~~~~11 I'ST:AEE:. 'AR'EA ~:: ... i iiQN~PRQFfiT.. i ... .. ... i .:.. B~: BfRR3 SALES s- a~ooa Cam. Ea[ODA:S:: ,2©~Q ST~~~~.~ ~: t F~S~I~AI. POIaICI+a DI'aPt1I~TM1'aNT TOWN OF c~OUTIIOhD Telephone Emergency Dial 911 MEMORANDUM TO: Elizabeth A. Neville, Town Clerk FROM: Chief Carlisle E. Cochran, Jr. !~ C'/ DATE: June 3, 2002 CARLISLE E. COCHRAN, JR. Chief of Police RE: Request for Special Permit -Fireworks Display at Mattituck Lions Club Sys .. #`'="~u~ 15, 2002 I have reviewed the above request for a special permit. I have no objection to the approval of this permit. cc: Lt. Martin Flatley 41405 Roure 25 • P.O. Bos 911 Peconic, N.Y. 11958 Administra[ive (631) 765-2600/2601 • Fax (631) 765-2715 :r ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER ~~O~~gOFFO(~co G o s~ N Z Oy ~ O~'~ ~~l Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Chief of Police Carlisle E. Cochran, 7 From: Town Clerk Elizabeth A. Neville Re: Fireworks Display at Strawberry Festival June 15, 2002 Mattituck Lions Club Date: May 31, 2002 Transmitted is request for fireworks permit at Strawberry Festival by Mattituck Lions Club.. Please review and advise of your recommendations. Thank you.