HomeMy WebLinkAbout1998
ELIZABETH A. NEVII.L.E
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
PERMIT
for
PUBLIC DISPLAY OF FIREWORKS
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516)765-1823
Telephone (516) 765-1800
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
CRANT TO MATTITUCK LIONS CLUB E FIREWORKS BY GIRONE
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 June 20 1998 BETWEEN 9:30 P.M. AND 10:00 P.M. on the
property of Walter Gatz south side of Sound Avenue east of Cox Neck Road,
Mattituck, New York, the 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 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 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.
----- ----- - ------- - ----
Elizabe~e~e, own Clerk
Town of Southold
Suffolk County, New York
June 15, 1998
Date
(TOWN SEAL)
THIS PERMIT IS NOT TRANSFERABLE
J
JUDITH T. TERRY
Southold Town Clerk
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Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 71971
Telephone
(516) 765-1801
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
INSTRUCTIONS FOR DISPLAY OF FIREWORKS
1. 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.
4. The age, experience and physical characterics 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 obstructions.
8. Such other information as the Southold Town Clerk may deem necessary
to protect persons and property.
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; $1,000,000.00 property damage.
10. The Town Clerk of the Town of Southold must have the insurance policy
in her possession before fireworks permit is issued. The named insured
must read: TOWN OF SOUTHOLD.
11. Application for a fireworks permit must be made at least five days in
advance of the date of the fireworks display.
(The above instructions are in accordance with the Penal Law, Article 405 -
Licensing and other provisions relating to fireworks.)
~ g~EFO(,(~~0~
~ ~
JUDITH T. TERRY O~y~,~ ~
Southold Town Clerk ~1 ~ ~1a~
OFFICE OF THE TOWN CLERK
R~I~D TOWN OF SOUTHOLD
MAY ~ 1998 APPLICATION
Southold Town Clerk for
PERMIT TO DISPLAY FIREWORKS
Town Hall, 53095 Main
P. O. Box 1179
Southold, New York
Telephone
(516) 765-1801
APPLICATION IS HEREBY MADE, pursuant to the provisions of Section 4050.00
of the Penal Law of the State of New York, for a permit to display fireworks as
hereinafter specified:
DISPLAY IS TO BE SPONSORED BY ~~~ f(,(('~ L.idd15' ~/({~
PRINCIPAL OFFICE AT
Road
11971
/N, ~:
D~13G0
_~
DATE OF DISPLAY ~J;ah~_~, ~ ycj~
TIME OF DISPLAY /,~.3d f /~
RAIN DATE & TIME ~j~e
The following persons are to be in charge of the actual shooting of the fireworks:
Name Age
~~, t7ai~ cl. /YQTn,s
~~ / ~~~_ ~
Experience
as Y~rs
(7~~'CcrS _.
'7 /ears
Phy/s~ical /Condition
(.~aDdJ
~UAd
The fireworks will be stored in a covered truck prior to shooting on the grounds.
Attached hereto and made a part hereof is a diagram of the grounds on which `
the display is to be held. Also attached is a certificate or policy of insurance coverage.
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Number and type of fireworks is as follows:
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Bore'li Agency, Inc.
tch Mill Road
laga „ N] 08328
Antoinette Alber*.son
Vi~_land Fireworks, Inc.
1630 E.Garden Road
Vi Tel and, N] 08360
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RTIFY T~IA'Y'PHEPOL CIF5 (`'F IN~U~t'N^=.'. FP B~`L6V~'~AVE BEF , I$r l tc "
INOICA DLO NOTNITHETANDmG ANY RE4JIREMENT EFQJ CR Ct NO T'nN OF AN e
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GERTIFI(l~TE IeIAY BF.SS'JED OR MAV PERTAIN, THE INSUPANCE 1FrORDED BV T" .
'a P ) i .:) l t _
EXCLUS!ON3 ANC CONDITIONS OF SUCH `~OLICIE3. LIN11T5 SHOVJr1 MAV /
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L~ `Y'Pf?OF INSURANCE j POLICI
POLICY NUMBEq I F4D'rl ~.. y)', r Rf.is ,n.
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GENERA. uABIUTY~
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8 rNePRDVRIETOR~ ~°INCL:1119-a:-02!178
PARTNER i~EXECL r'vk
OFFlCEgE ARE. ' EXCL.
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Splay CE.te: June 20, 1998
in Date; None
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Mat:ituck Lions Club
Lei,; ]. Newton & Sons
212 Knapp P1aCe
Grelanport, L,I., NY 1194u
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h 'S UPON THE CERTIFICATE
t l)ES NOT AMEND, EXTEND pR
Oi~DED 8Y THE POLICIES BELOW.
F I~ORDIN[: COyERA6E
unity _ _
to LO...... ._.. _.._..~
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,JVE FOR THL' P0~ aY F~RIOC
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$U SJ ECT TO ALL TNc TER595.
LIMrTE
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PER^'CAMAGE §
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LW 4CCICENT _~„ a' ~~
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TEASE • PO! ICY ualT ' 3 700, OQO
>EASE-EAcMr~PYEP..3 ___10~Opa
iOI: LIES eE CANCELLED 9EFPgE THE
OOmPANY WILL ENPEAVDR TO MAIL
::RiIFlGATE HCLCaR NAMEC r0 THE LEFT,
~.. I~M IP~OuS~E. N/O OBL.ItG~ATIGN OR LIAgIL.lT1'
•E~V~4 eFB.FEP~~9ly~TATIVES.
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CERTIFICP~TE OF 1!~!` l,Ifi?A,~I'C E:
Date ,~tpr ~'8, 1898
BROWN AND Y-IUMPI~IIZEY fiNC.
4~)0 MONTOOMHRS'
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' : ~ stc-,ice a
i ,h s sp n :tiec n~sterofinformatialoa~~yy
t'Fieateholder. Thecertif
5T, Si
1I
H 500
5AN FRANCISCO, (:A 94104 10? , r c t r.:
;~o'J,ti~is'~c i ,. 1,+. Ott , I tc a
:;,~. ~ the average affordedb
JIBED ^J' f=;1~'It .= ,4t h ~'?L?lNG CD1iE'RAG,
Fireworks By Gir~ne °:c ~r ;,;~>• , ~+'J ^ : r!E~ , .~ 'onal Reonsurar.~ca
1640 Garden Rotld .E rs r r. ,?c:'.:7 7'~ ,=; ~?: ;rpation
Vineland, NJ 08:h0
';ors oa" ~ J'?cJ:;~ ~irr,t „' at G/oyd's. London.
.e~trr 5 lU ,) ~ T+r^ipatiOn
.'his is tr, ecrtify that the }~licies stad below have teert sued !o the meufcd i~ur ! ..C~~. r t, , }::. 1 ~..tdicated. Notwistutandmg sny
equirem:nt, ~:erm, ur condition of end co^trsct_nr_ether dce.umert with respect : ,.w r:c r tt.: :: t t x ~.r.: :: ,~. i or say, peaain,.the insurance
f[prdCd_ ~ thepcticiea described he •ei~ s sub , et m all urm ~, eaclcsions and c~r,C~.'on c uc4, to c e _„ _ . _ _
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I Fo!ICy 3'ol;c~ ~;cu n„' Limits fn $1000's
0
Ltr~ Insuance _, N' mbyer ~ ~ L~tt+e e i 15x~ ae~ r! _ ,~ Each
^cid®nt Hggregate
General Llabll;ty i 1 ~
~
I Claims Made Form I
~:(Prenvses
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A a Contractual Liability I t:~nt
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& ;C Products!Completcd F38J4207/000~ 05%~ 1/98 ; C~5 ;"s1 ' 3
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Cover does net a ° 3odtly. P
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fidditionallnsur~ds with ,~especr to the shave o'is:>li,y -any __.____._
1) Mattituck Lions Club
2) Town of Southho4d ~,
?) Mattituck Fire Department
4; Lewis J• Newton & Sons it
~) Green Pastures %-arm/Walter Gafz ~ ~,a~,~r:;,,„=t,, ~
.;~ ~/pNµ
~ '~twuEd a. Y rf Nu: a':~t pe ,+olioies be canceled before'.
t h~o r~ti}sia~a t4,~: data !t i~rr ~..f, the issuing compan9 will~,'~,
i rua.Il 30 :1, }; writt::r: u:et:e to the certificate holdor
r~arwte d tc Cite. left:.
Autrr+:tr'~zt,y Represe.nr:~tr"ve: -
;, ^,
Mattituck Lions Glub/L®wis J, Newton & Sor7s
212 Knapp Place
Clreenpart, Long Island, New York 11 `?44
~ ~ .~
~nx rv, ,.e..ot~,,, ~~73:utive
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