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Home My WebLink About2003 ELIZABETH A. NEVII.LE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRiaGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER o~gUFFO(~co o~ ~~ ti x W • °s~,ol ~ ~ao~ OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD PERMTT For PUBLIC DISPLAY OF FIREWORKS Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631)765-6145 Telephone (631) 765-1800 southoldtown.northfork.net 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: by said organization in accordance with the provisions of Section 405.00 of the Penal Law of the State of New York at 9:00 a.m. on Saturday, August 16. 2003 RainDate: Sunday. August 17. 2003 on the property of Belvedere Procerty Management LLC at Robins Island. New Suffolk, New York 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 neazest 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 poim at which the fireworks are 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 lazge 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 particulaz 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 dischazge and that at least two soda acid 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. /n~ _5.~~ ` Elizabeth A.Neville, Southold wn Clerk Suffolk County, New York (Town Seal) Date: August 14, 2003 THLS PERMIT IS NOT TRANSFERABLE l/ S y w~Y/l ~e , r iS~~~c~ Cc.C j ~i~r-e Cr-e ~0 0~ c~ ~~~ ~~i~. L~oSer ~ 1 Ct ~C~-4-~.~ W 1 ~ ~ ~ ~ ~I s t Tt' . ~~-e / K~ ::~JS ~o~~ . RECEIVED AL^v ` 6 2003 Sonlhold Town Clerk z <6 0> T p ~'N ~0 <62> _ . ~6~ _ -,78~ SUFFOLK N /~ ~5~91 - <fi 4> ~ ~ <7.4> .3> "~~(7.BE - - ~ Yin N <fi.5> ~ <~ <eas> - .. Ee ai {s.ai - a s> - Eloai - <6.93 <9.0> ~ .4 u.o>.,, DEPtiTfi AF 11/ <lik3>' -tO~4.6> - K7J>.~ -. c='L8( ~ ~~ A/ T p)•irin IfATt QF 30U <9s> . <5.6> ~ ~ ~ (l2.6 • (12.6} ~ " .. . ~ n- i ~lE~1i ~+9 . 11, <6.7> f''" <e u, : '~~. DATE OF 34l G9.0> - d (10.4} }9.4} , 1 <1] 4> " (7.81 DATlT1[ - 2I.1 u.0> <5.5> - ~ .fa.4} ~~ '~~ v N }10.4) ~ (E.4( N ~5 4j V ~ ~,' w ~ _ o / ~ - ~ ~,N~~~ AN.Y ~ALTERATfON OR ADDITION. TO THIS SURVEY !5 A VIOLATION 0£ SECTION ]209 OF THE MEW YORK STATE EDUCATION LAW. EXCEPT A5 P£R SEG7fON 7209-5(7g01ViS10N 2• ALC C£RT1FfCA710N5 Q HEREON ARE VALID FP1R THfS-MAP AND CQPlES THEREOF ONLY 1F SA}D MAP OR 'COPIE'S BEAR THE (f,tPRES5E0 SEAL OF THE SURVEYOR - WHOSE SICNAJUR6 APPEARS HEREON. - POI,IC~ D~Pt1RTM~NT TOWN Off' SOUTtIOLD Telephone Emergency Dial 911 MEMORANDUM CARLISLE E. COCHRAN, JR. Chief of Police RECEIVED JUL ? ~ 20Ci8 TO: Elizabeth A. Neville, Town Clerk FROM: Chief Carlisle E. Cochran, Jr. Gv Southold Town Clertt DATE: July 28, 2003 RE: Request for Special Pennit -Fireworks Display Belvedere Property Management LLC on Robins Island Saturday, August 16 -rain date Sunday, August 17 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 Route 25 • P.O. Box 911 Peconic, N.Y. 11958 Administrative (631) 765-2600/2601 • Fax (631) 765-2715 ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER ~~gUFFO~,~c~ o~O Gyp N Z W • oy~01 ~ ~a~~ OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork.net To: Chief Carlisle E. Cochran, Jr, j~ From: Town Clerk Eiizabeth A. Neville`'l,~l/ Re: Request for permission to hold a Fireworks Display by the Belvedere Property Management LLC on Robins Island on Satwday, August 16, 2003 (Rain Date: Sunday, August 17, 2003 Date: July24, 2003 Please review the attached request for the above, and respond in writing, with your recommendations. Thank you. ELIZABETH A. NEVII.I.E TOWN CY.ERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER o~ y~ N 2 W~~O' !11 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516)765-1823 Telephone (516) 765-1800 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION for PERMIT TO DISPLAY FIREWORKS 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 I PRINCIPAL OFFII DATE OF DISPLA TIME OF DISPLA' RAIN DATE & TI The following persons are to be in charge of the actual shooting of the fireworks: Age Experience Physical Condition ~ / ~ ~aJ~rc 1 ~ / ~ ~~~rS Number and type of fireworks is as, follows: The fireworks will 6e 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. U,'n~ ~i ~,S~~~y .s ~f ~ ~~S _ ~~C 07/24/200a 12:91 FA% 856 697 9557 VINELAND FIREWORKS CO. f~j002/005 0'712412003 eg:21 FgflgLLON RSSOCIATES ~ 16566979557 ~•~ D01 ~R . I~CA~ Q~'.: ~uR~~~+ . , . ISSUE DATE J1~ 24, 2003 o.~..nncb 17a9 C6R71PICATL nl L9dUBD ABA MATTER OFINPOSSYA ONLY AmI CON ___ ....,........c.~.ma wnrn~TiliS CLH7IF[fAT1SaOCB NOT AMENa Brown and IlamphreY Surplus Lines lnturanee Brokers Farallon AssooiateBlasprao~ Brokers 4DD Montgomery 9teect Spito 500 San Fraaeieca, CA 9410A B88 39I-1053 INE4JREa Vineland FitT;wcrka Ca, Inc, 1d40 Garden Road Vineland, N.I 08360 t1VSUAERB AFPORpI]VG trp'VEBAG& 7N611RE9 A: rNnrtneR a: AwYe fOR Wile ve~oo ~ r~ ~ M~iIY nL :e:~ .~n.cWili~ .ire tewuilZOaB w eaf lp .acL m W ML 0'81111 rvrr or LisuBancc oBNBnAL LuBiuTr CLAIMS 41ADE A •OTONOBILe WANLfrr Q ANY A1R'O ~ ~ i ~ p vr u O li1YeD AUtt1S p Norwmvca Aums A WOBKBeS COMPENSATION AND B'MPWYEYB' LIABIU7Y apeefAl ErilCl 6CFM IBNf15 uMrrs WAY t1ESCBIYfJON Or UI'CIN PUrvyya,a.w uaw,on,..w.-~.....•~.••.•_.-_.____ __ _.._ _. q Darryl Volinakl, Operatinee Manager 2) Tom of Southold 3) Cpunty of Snllolk are Addifioaal Iran a aE rea a fireworks display on Augast 16, 1003 (Rain Date: Aagtiat 17, 2003) at Robim Island -Southold, IVY. L'lR1Ur1L:w i c nuaruan epy~ 41,n. pF ~ A110V6 nr6CNSBp POLIOtBB Belvedere Property Managempat, LLC TMBBBOn.'rmttsaunvc coslrAPnvnu.enmravo 212 Knapp Place cBanLrcwTR troLUSa NAMED TO ms LB , avr l Green rt Lang Island, NY 1194A aOLICATrol1 OR 41A61 WTYOB ANY N pa AUI'NOel26 REPRrecNTA'nVE ~ A e,Jp1 aR ppmpww~ w,. r,v.a AOM118r [LMA7N LLeAL LLBLL p B,ieOtpe(B) A8816TAMt8i aR UaW'8 FAILUPL M 1'OLLOW NPP voucv,l6Lleee I pn+'cM DMGCW030004 ~ 07/0813003 I D71D8/]A0/ DMGLW030004 ~ 07108lZ003 107/0812004 sucw Ei.t~eux:mw A. N~.II,LE TOWN CLEHR REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICE OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 63096 Main Road P.O. Box 1179 Southold, New York 11971 Fax (616)766-1823 Telephone (516) 765-1800 INSTRUCTIONS FOR DISPLAY OF FIREWORKS 1. Name of body sponsoring fireworks display. 2. Tha date and time of day at which the flreworks display is to be held. 3. The exact location planned for the flreworks display. 4. The age, experience and physical characteristics 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 $7,000,000.00 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 the 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 - Licensfng and other provisions relating to fireworks.)