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Home My WebLink About1999~, , • ELIZABETH A. NEVII.L.E TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER '~~Og~f FOCI-~o~ ~ 1 o - y x W a i Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765..61145 Telephone (516) 765-1800 OFFICE OF THE TOWN CLERK TOWN OF 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 MATTI'TUCK LIONS CLUB a; FIREWORKS BY GIRONE 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 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 separated points as possible within the actual area of the display. (Town Seal) Elizab A. Neville, To n Clerk Town of Southold Suffolk County, New York June 15, 1999 Date 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 OFFICE OF THE TOWN CLERK TO WN OF SOUTHOLD ELIZABETH A. NF.VH.LE, TOWN CLERK P.O. BOX 1179 SOUTHOLU, NEW YORK 11971 RECEIVED .! i 1 1999 Southold Tnum Clerk ~ 5yFF0(,~~~~ ~ ,` o~• ~O~ 01 #~ y~ 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 Telephone (516) 765-1801 APPLICATION IS HEREBY MADE, pursuant to the provisions of Section 4050.00 of the Penal Law of the State of New York, for a permit to display fireworks as hereinafter specified: /~~ f ~~ / DISPLAY IS TO BE SPONSORED BY ~L'~SP~f~~/Bh_S L1GC6 PRINCIPAL OFFIC E AT 5~T/ s ~~ ~~~~ DATE OF DISPLAY /~ a~36e TIME OF DISPLAY ~.~ RAIN DATE & TIME ~,.,~ ~;~ ~.°S ~h~t The following persons are to be in charge of the actual shooting of the fireworks: Number and type of fireworks is as follows: Qc1 C~ C. The fireworks will be stored in a covered truck prior to shooting on the grounds. Attached hereto and made a part 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. Acme E,x~p'erience Ph sical Condition _.J'~ ~ca Date of Application ~i rn d 5~~~.s Pa, k.Ls I-~I ~ l . ~ ni ~""' C.en~~ ~ rass . .S. w:r~e. 3SO ~ ih oJ1 dx~w r'~ R~.~ Ja/ks 3Sa Ft ~"'~ ~ o Ft 3S~ Ff • '~v,~ '.: DATE ~MMIDD/YY) ~~~ TIFI :~~ ~wlA B~IL ~AVORd~- ~ +~~~~ ~tJ : : :. . ra _ ~~ : , : : 05/17/1999 :.:~ ~ ~~~~~ ;;' ~~~ :;:, vRODUCER (609)694-2222 FAX (609)694-2279 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE he Borelli Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Dutch Mill Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Malaga„ NJ 08328 COMPANIES AFFORDING COVERAGE CoMPANV T ravelersI ndemni ty Attn: Toni Albertson Ext: '0' INSORED _._... COMPANY Wausau Insurance Co. Vineland Fi reworks,Inc./Fireworks by Gi rone B 1640 E.Carden Road Vineland, Nl 08360 COMPANY C COMPANY D G THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCEL!STEDBELDW HAVE BFF.N ISSUED TO THE INSURED~NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, 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. LIMITS SHOWN MAV HAVE BEEN REDUCED BV PAID CLAIMS. CO rypE OF INSURANCE POLICY NUMBER LTR 'POLICY EFFECTIVE 'POLICY E%PIRATION' LIMITS DATE (MMIDOMQ DATE IMM/DDNY) I GENERAL LIABILITY :GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY ! PRODUCTS -COMP/OP AGG $ :CLAIMS MADE :OCCUR : PERSONAL 8 ADV INJURY $ OWNER'S 8 CONTRACTOR'S PROT : .EACH OCCURRENCE S i i FIRE DAMAGE (Any one (ire) $ MED EXP (Any one person) $ AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT $ X ANV AUTO _.. - 5,000,000 ALL OWNED AUTOS ~. BODILY INJURY $ SCHEWLEO AUTOS ! (Per person) A 68LHT172 D4946-98 ;03/31/1999 .03/31/2000 - --- HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS i ; (Per acciden0 ----- ----- -- ~ :PROPERTY DAMAGE $ GARAGE LIABILITY '. AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY' __ _.... _..... ___.. __..: ' EACH ACCIDENT: $ j . ... ... __. _. _. _..... .. _. _.. ' AGGREGATE $ E%CESS LIABILITY ', '., !EACH OCCURRENCE $ UMBRELLA FORM '. (AGGREGATE $ OTHER THAN UMBRELLA FORM ' '. $ WORKERS COMPENSATION AND i TORY LIMITS' X i ER .EMPLOYERS' LIABILITY i ~ ' - B ELEACHACCIDENT $ 500, 000 THE PROPRIETOR/ 1110-03-027178 :04/01/1999 04/01/2000 "'~'~- ---- -- -- PARTNERSIEXECUTIVE ' INCL EL DISEASE-POLICY LIMIT $ $00,000 (OFFICERS ARE '. EXCLi EL DISEASE EA EMPLOYEE $ 500,000 OTHER DESCRIPTON OF OPERATIONSILOCATIONSNEHICLES/SPECIAL ITEMB ispl ay Date: lone 19, 1999 ain Date: TBD CERT,iFICATE NOLDER :: •: '. CikNCEL T1.';... t :' SHOULD ANV OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE E%PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ~-DAYS WRITTEN NOTCE TO THE CERTIFICATE NOLOER NAMED TO THE LEFT, Matti tUCk Lions Club L i ) N t & S BUT FAILURE TD MPIL SUCH N T E Q 1 O~ LIGATON OR LIABILITY ~ 7 M p e s . ew on ons ~ .I~,scL {{ ~ ~ 212 Knapp Place OF ANY KIND UPON THE COMPANY,i 5~ EN1 O R R ENTATIVES. G reenport Long Isla, NY 11944 AUTHORIZED REPR ENT, IVE ~/'~ff ~~ //T} ~ /J / ]j ACORU 29.9 ~9 (96} f a3A00.R6 CORPORIMTION 3968 r1 ACnRD~ ~~~ ~ I DATE pAAV0DnY/ R ~ ~ ~., p~;F~ :e,~. ~e , 1)5/21/99 a .r , r ,,, .I`°; PRGwr.E-R THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT:.; UPpN THE CERTIFICATE 13rown & Hu$raphrey Surplus Lines HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 41?0 Montgomery St. Suite 500 ALTER THE COVERAGE AFFORDC-D BV THE POLICIES BELOW. SaD Francisco, l:A 94104 ___ COMPANIES AFFORUINa COVF.NAGE COMPANY A Underwriters, Lloyds & ChiA Re - _ ---_- -- INSURED _- _ - _.- -- -- OMPANY __ ___. __.-_ _... _.. __ _ -. - Fireworks Ily Girone B 6 0 Garden Road - Vineland, N.J 08360 coMPANY ~ _ _ _ _-- - - COMPANY VS D ~ ~b881P a ~ ' `~ a; ~,., axM ,,1 y,f a.. t `G. .• %`;, s3 ¢' +~:95y. r ..'. 1'1115 IS TO CERT!° :' THAT 1"HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED AP,OVE FOR T HE POLICY PERIOD INDICATED, NOTWITHSTANDING ANV REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER UOQII•flENT WITH HEu ECT TO WHICH T; IIS CERTIFICATE MAY BE ISSUED OR MAV PERTAIN, 7HE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAV HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER LTR POLICY EFFECTIVE POLICY EXPIRATION LIMITS DATE (MM/DD/YY) DATE (MM/DD/YY) A GEN ERAL LIABILITY 299/0515 05/31/99 OS/3l/00 GENERALAF~REGAfE ~ $ Z,000,OOO X COMMERCIAL GENERALLIARILITV PRODUCTS-COMP/OPAGG I $ 2 000 OOO L L r CI AIMS MADE L X~ OCCUR _ Pf RRt NAL 3 MJ/ N.,URV { I $ I,000,QOO OWNEN58 CONl1.ACtORB PROT EACH OCCURRENCE 1 I $ 1,000,IIOO. FIRE CAMAE'F (An a mnl _ -___ $ SO,000 _._- __... __ ._ ~ -_. _..._.__. MFUE%f IA~rt T ron) $ ~OOO L ALIT JMOUII_E LIC.:IILI rv ~ i_ __ - __ OIdRIMF,U LINE I_I Ih11'C $ __ANYAI/l0 I j - - ... _... _~ ALL OWNED AUTOS ~ ROUICI INJURY i SCHEDULED AUTOS Per ocr;on I 1 $ ~ HIRED AUTOS BODILY INJURV ~ NON-OWNED AUTOS (Per nrr,Iflenl) $ PROPERIIDAMAGE $ GARAGE LIADILITY gUTOONLV Fl ACCIUFIJi $ ANY AUiO -- OTHER TFIAN NRO~IIJI Y' ~~~~- ~~ _ -- - D\n ~ luar.- _ - a - - - _ __ __. ACGR ~AT£ $ E%LESS LIABILITY EAt H D7GURRCNCC $ -.___ _ __ _ _ UMRRELI.A f-OR1 AGGRFSATE _ _ - .$.. __ OTHER THAR UMBRELLA FORM - I g WORKERS COMPENSATIOPI ANO _-. rV/C 5'iATU TTH TOF1Y LIMITS CR : : EMPLOYERS' LIABILITY - _ . _.... .. . .. EL EACH ACfa L'[NT $ 1HE PROPRIETOR/ INCL PARTNERSIEXECUTIVC -- EL UISEASE FOLIC\'LIMIT -. $ OFFICERS ARE EXCL EL DISEASE _EA EMFLOVEE OTHER y__ --- ------~-~- 1 -- DE:'~CRIPTION OF OPF.RATIONSILOCATIONSIVEHICLES/SPECIAL ITEMS -- 1) Mattituck Lions Clab, 2) Lewis J. Newton & Sons, 3) Town of Southold, 4) 111attiturk Fire Department, and 5) Green Pastures Farm\Walter Gatz are Additional Insureds as Respects a Fireworks Display on June 19, 1999 or lOGt~ d RI~~ f$ ,~'1'~~ ° ~' f gy . 1 liL 4 T. . a d ro r..... "'i SHOULD ANV OF THE ASOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Mattituck Lions Club EXPIRAnON PATE THEREOF, THE ISSUING COMPANY 'HILL ENDEAVOR TO MAIL Atfn: Pete Barris pp ~ ZLE Knapp Place 4- DAYS WRITTEN NOTICE TO THE CER11FifpTE NULOF.Fl NAMF_p TO THE LEFT, (:reenport l.omg Island BUi FAILURE TO: AIL SUCH NOTICE SRAO. I".IPO°E NO ORLIGAnON Ofl LIABILRY /~ ~ r New YO[k 11914 OF ANV i IN PON THE WMPAPIY tR: ~ GFt !S O{i EPRESENTATIVE$ _ J ~ ~ I pUTNORIZED RE ENTA E I /r / 9i/ V /,`~f {/ j / l ,~ , ~ a e ~~ 1kii#t ~ # ^ x a~ ~ ~ / ~ ~ Flti 4t5Rt'~~~ ~ f' y ~. ~ ~ ~ e„ e r ~r~ , be~ . ~. ~ ~„ .,1~ ~ . , , ,• Sent by:NEW YORK NIF55 U.S. Department of Transporfaibn Federal Aviation Administrolion May 18, 1999 Mrs. Rose Girone Fireworks by Girone 1640 Garden Road Vineland, NJ 08360 Dear Mrs. Girone: Ma~9-99 07:08an _ ___ _fron 4717 609 697 9557 Page 2i 2 New Vork Automated International 150 Artival Avenue Flight SenrirP Station Ronkonkoma, NY 11779-7303 Our office has no objections to the proposed fireworks display scheduled for the Mattituck Strawaberry Fest, Green Pastures Road, Gteenport, NY. The time of the display will be approximately 9:00 p.m. on June 19, 1999 fora 20 to 22 minute duration, with a raindate of June 20, 1999. It should be noted that no shell shall exceed 600 feet and the following conditions must also be met. I. Contact the Supervisor of the New York TRACON at (516) 683-2984 at least two hours prior to your display to negotiate any altitude limitations or time frame restrictions, if they are required. 2. Contact the New York Automated International Flight Service Station at (516) 471- 7394 at least six hours prior to the scheduled detonation of the fireworks display to effect the issuance of a Notice to Airmen Advisory (NOTAM). This letter disposes of the Federa! Aviation Administration's interest in this matter, but 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. Sin'ceDrel~y, Ronald X. Ruggeri Manager, New Yotk AIFSS