HomeMy WebLinkAbout1996
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JUDITH T. TERRY ~~"
Southold Town Clerk 0~~.( ~i ~~~
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
Telephone
(516) 765-1801
I, JUDITH T. TERRY, Town Clerk of the Town of Southold, Suffolk County,
New York, being an officer duly desighated by the Town Board of the Town of
Southold for this purpose; do here
GRANT TO Mattituck Lions Club S Silver Dollar Shows
A PERMIT FOR THE PUBLIC DISPLAY OF FIREWORKS by said organization in accord-
ande with
+ the provisions of Section 405.00 of the Penal Law of the State of New York,
June
ON 14, 1996 and June 15, 1996, between 9:30 P.M. arid 10:00 P.M., at the
Mattituck High School, Main Road, Mattituck, N.Y. (no rain date applied for)
the time and place set forth in the application therefor.
Fireworks Display by: 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 po)rit 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 inactive 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 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 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.
dith T. Terry, Town erk
Town of Southold
(TOWN SEAL) Suffolk County, New York
Ma 14 1996
ate
THIS PERMIT IS NOT TRANSFERRABLE
•
05-14-1996 14:34 6942279 BGRELLI AGENCY INC. P. Dl
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M~ TMi ClRTIFK:ATE R IiBUED Ai A MATTER OF INFORMATION
he BDrel l i Agency, InC. ONLY AND CONFERS NO RIaNTi UPON THE CERTIFICATE
HOLDER. 7H{i ClRTIFICAT! DDlB NOT AMlND, lXTEND OR
DUTCH MILL ROAD d ROUTE 40 ALTlR THE COYERAOE AFFORDED BY THE POLICIE8 BELOW.
MALAGA, NEW ]ERSEY 08328 COMPANIESAFFORWNOCOVERAOE
Aetna`Cesuhlty"~i"'5urety Co
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caMPANY
Attn: Antoinette Albertson Ext: A
iw~ue~o Vineland Fireworks/Fireworks by Gi rone , • ~e,~,~;: Weus'du "In'surnli'ce Co.
1311 E,Garden Road L..
Vineland, N] 08360 c~MP""'~
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THI816 TO ClRriIY THAT THE POLICIES DF INSURANCE LISTED BELOW HAVE BEEN 188UE0 TO THE INSURED NAMED ABOVE FOR THE POUCY PCRIOD
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CERTIFICAT! MAYBE ISSUED OR MAY PMYIUN, TH! INSURANCE ARORDlC OV THE POLIGTlB DCaCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
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SNWLD ANY OF THE ABOri DNCRICCD -OLIOICB BC OANOELLGD aGFORG THG
DIFlRAnON DATC TNlRBOP, THS IMUINO rAMPAMY MILL lNDCAVOR TO MML
MATTITUCK LIONS CLUB/SILVER DOLLARS 10 DAVSwRmeNHOTloerornxarnnNDAnlHxaaHAMeoroTHCLCrT,
PETE HARRI5 euT rAlLUxe To MuL sueH Nonce MALL IMPOiE NO oBLwAnON eR Lwam
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GREENPORT,LI„ NY 11944 AuTNORDSOearReu AT
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PRDDOCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFCATE HOLDER
THIS CERTIFICATE
Williatn Dukes and COm anV
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DOES NOT AMEND, EJREND OR ALTER THE COVERAGE AFFORDED BV THE
400 MODLgOmery Street POLICIE BELOW.
Suite S00 COMPANIES AFFORpING COVERAGE
San Francisco, CA 94104 --_.. _ _ _._ _ -._.
A Lexington Insurance Co
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INSVREO LETTER
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1640 Garden Road - ~ ---
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THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TD THE INSURED NAMED 4@OVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANV REOUIREMENi, TERM OR CONDITION OF ANY CONTRACT OR DTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE A. FORDED BY THE POLICIES DESCRIBED HEREIN IS BUBJEGT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY NAVE BEEN REDUCED BY PAID CLAIMS.
CC ~ TypE OF INSVRANCE PduCY NUMBER
LTR ~ POLICY EFFECTIVE ,'POLICY EXPIRATXIN ~~
I GATE (MMrpp,/YV) DATE (MM'DDf+V)
QENERAL LIABN.ffY
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GE$CRB+TION OF OPERATION&'LOCATIDNSNEXICLESlSPECIAL rtEMS
I IMattituck Lious Cluh, 2)Town o[ Southold, 3)Mattituck Fire Department,
4)Mattituck Cutchogu high School, 5)Silver Dollar Shows are Additional
Insureds as Respechl a Fireworks Display on June 14,1996, R/D June 15,
_ _ :3 $... i, a,~ s~A&° {$4 " rcn f ' „ ~. x ' ~ i.' ~ ~e ',., ut'°;HI4.,wP'~r `$ ..d..>n n ~~:a...' ~~•
^• SHOULD ANV OF THE ABOVE DESCRIBED POLICIES 6E CANC4LLEO BEFORE THE
Matti[uck Lions Club/ ;~` EXPIRATION DATE THEREOF, THE ISSUING CDMPANY WILL ENDEAVC9 TO
Silver Aollar Shows "~~ MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE
212 I{napp Place ;'~' LEFT, BUT FAILURE t0 MAIL SUCH NOTICE SHAD IMPOSE NO OBLIGATION OR
Mattltuck, New Xork l LIABILITY OF ANY KIND UPON THE OMPANV. ITS AGENTS OR R€PRESENTATIVES,
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JUDITH T. TERRY
Southold Town Clerk
APPLICATION
for
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OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
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:
LL~ ~
DISPLAY IS TO BE SPONSORED BY iI'Qt.c/U~ ~~ /J/ l n~u'U~_.~P
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PRINCIPAL OFFICE AT
DATE OF DISPLAI
TIME OF DISPLAY
Road
11971
RAIN DATE & TIME lll~~'
The following persons are to be in charge of the actual shooting of the fireworks:
Name
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~//./, La~~d~~
~7/i'6~~~P/ ~rr,'S
AcZe Experience Physical Condition
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S- y4vs" ~XCe~~.~T
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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Date o 'Application
Number and type of fireworks is as follows:
~~R~rNa2)c5 ~17~ ~~'~~
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