HomeMy WebLinkAbout1953TO~P7 0P` :30tt.1'HO22~
T, RAI~'8 Y. f30t3J'1i. T Clerk ar the Tcreq, or scutho2d,
Stttf'olk Gc~ttntT. F3+~1 1~'1C. be#ug '~ ~dttiser Ault' fleaigaated
by t2xe Tte~t $a~ard ct the ~ 4t 80u-1sh~lll rear the pM-i
130 ICY' ~~73'C h 'sk ~~4 ~' . 't~L ~~~, .~..,..~,... ,
A P1~.` PYJR ~ Pt18',~ P~~''lk4Y OF' k't)1ti;B Rry sal,$ 40th
~satiaD Au aeeeacde3~ec ~.th tl-e P~'e~'ieitme ' t;eotioaa 1a~4-e-
tar the Pamal Law at the spa*e +~' Pse~w 'Ypr2~. aq~ ..~~~..,~,
at thta tirre- auk ptr~oe eet rtrrth iu the ay~lleatitfat thereraar,
cai oo~dlticu that the bt3s3d ~ ~~~ s~ne.l ~equiaed
s~a1a. cavet3Qwe !~ ruu tcr3na axed er'reat ~ r e~ thtl Cann
ar Southold.
Hated at 3c~uthoid. New 'Ye7~b,
this daq or ~,,,~,. 19i~:i,
(SEAL}
TOWN 9~' SOII~Id?, S~'t~1k
Geuu'b3-s 'l~irp Yeark.
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Effective from JULY l}, 1953 Amending Policies numbered SLG 211}0006
AL 12:DI A. M. Standard Time
Issued to
NORTH FORK COUNTRY CL
The Travelers Insurance Company Additional Premium h~- p1 Return Premium
The Travelers Indemnity Company Additional Premium Return Premium
The Travelers Fire Insurance Company Additional Premium Return Premium
It is agreed that as of the effective date hereof these policies are amended in the following particulars:
1. LIMITS FOR COV B DIV 1 ARE CHANGED TO READ: 25,000 EACH ACCIDENT
2. TO INCLUDE THE FOLLOWING CLASSIFICATIOM: FIREWORKS EXHIBITImNS-
SPONSOR'S RISK ONLY Jf326S-FOR A PERIOD OF 1 DAY, NAMELY 7/I+/53•
2. TO INCLUDE THE INTEREST OF THE TOWN OF SOUTHOLD, SOUTHOLD,
SUFFOLK CO, NY AS RESPECTS THE ADDITIONAL CLASSIFICATION.
FIREWORKS EXHIBITIONS-SPONSOR'S RISK ONLY CODE 326S
FOR THE PERIOD OF 7 DAY, 7/1.1/53
Changes affecting insurance afforded by The Travelers Insurance Company are executed for that com-
pany only. Changes affecting insurance afforded by The Travelers Indemnity Company are executed for
that company only. Changes affecting insurance afforded by The Travelers Fire Insurance Company are
executed for that company only.
If any additional premium is noted above, this endorsement is issued in consideration thereof.
If any return premium is noted above, the receipt thereof is acknowledged upon acceptance of this en-
dorsement.
THE TRAVELERS INSURANCE COMPANY THE TRAVELERS INDEMNITY COMPANY THE TRAVELERS FIRE INSURANCE COMPANY
~°°' ^•e umaarD Secretary Secretary
Date of Issue 6/19/53-Gz
BKLYN MARS W. FLA~AN
Branch Office Producer ,
t -
. .~ '
C-443z Secnsc PIDxrED Ix us.A• 5.49 Countersigned b
THE TRAVELERS
Abe aGrabelerg 3Jugurance (Goutpanp
Frye ~rabeCerB 3lnbernuitp (~nrnpanp
This is to certify that policies of insurance as described below have been issued to the insured named below
and are in force at this time. If such policies are canceled or changed during the periods of coverage as stated
herein, in such a manner as to affect this certificate, written notice will be mailed to the party designated below for
whom this certificate is issued.
I. Name and address of insured NORTH FORK COUNTRY CLUB
8/S f1AIN ROAD, CUTCH06UE, SUFFOLK CO, NEW YORK
2. Location of operations to
3. Name and address of party [o
SOUTHOLD SUFFOLK CO, NY
TOWN OF SOUTHOLO
SOUTHOLD SUFFOLK CO, PJY
4. Coverages for which insurance is afforded Limits of Liability Policy NU mbar Policy Periotl*
Workmen's Compensation and Employers Compensation-Statutory **
Liability in the state named in item 2 hereof
Bodily Injury Liability-except automobile **
$100 000 each person
--chiding Protective $ 300, 000 each accident
--------------- ----------- SLG 214006 ~ /x/53/54
ProPertyDamegeLiability-except automobile
$ 5 , 000 each accident
chiding Protective $ aggregate
**
Bodily Injury Liability-automobile $ each person
$ each accident
Property Damage Liability-automobile $ each accident
*Policy is effective and expires at 12:01 A.M., standard time at the address of the named insured as stated herein.
**Absence of an entry in these spaces means that insurance is not afforded with respect to the coverages opposite
thereto.
I Description of Operations: - ,
FIREWORKS EXHIBITIONS-SPONSORTS RISK ONLY ~f326S
Liability for damage to property caused by ^ Blasting or Explosion, or ^ Collapse of or Structural Injury to
(Enter X in block applicable)
any building or structure is excluded from operations classified as
The insurance afforded is subject to all of the terms of the policy applicable thereto.
This certificate is executed by The Travelers Insurance Company as respects insurance afforded by that com-
panyunder the policies designated above; it is executed by The Travelers Indemnity Company as respects insurance
afforded by that company under the policies designated above.
Branch Office-BROOKLYN
Date ~/~3~ c~-6~ p~;9~~;-FLANACAN
C-SStH A-SO PPI NTEO IH II.S.R.
THE TRAVELERS
THE T'RAVELER~
B~
,,
~. {~. f
/•
INSURANCE COMPANY
tNDENI<AYITY COMPANY
. • ' .f i
:~:
_.
is hereby mrde. pnrsnsnt to flat Dsowiai~fs of the
t°en+~l Law. ~.tets of der Port. °Actian 1414-s, tbs F pessit to display
tirewosb ss herettter speeiried.
'The bisplay is to be spoasar ed e" R„ff~lk Non .1 .n pi r ~ork~~
_,_~„_..~ith prinaiprl otfies et Sial l ~ art. r..=- i_.
`~pr Yo rlr r~Q w! 11 l?e bald on ~
• "' r ,~..,'~ v C. • 1963 et
00 ~'7 e e -
p.01.
vu
The tol:.oeie~ per~o~ Are to be in eh~r~ee of the rct~l st~oot•
~ of the riretiorb s
,~, St=~s'`~~„~,~, ~ f~I: ZC r L- C: CHF.IfiZOK.{
6 Felix Gznc~i_~ 48 27 years good
Anthonv DiDier 38 8 years good
p~ns8er rM type of rirerorirs is re follows:
~ D, _ ~ftl~ u w D. Sc % frcvc
7be tirewor s mill *ae atoree is ~ cor rod trneh prior to the
hootisfR os the Ibroun6s.
• rttrdt~3 hereto rek! ssde ~ ~trt barest is die~ma of the 6roYOds
on w2sich tine display la to ae Mld.
~aea~taectirsly bait
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e ~/ s~~. Yatlr
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~/~e ~ Uoztl~ /~ozk nn~ouutzc~ Cub
~.utck cue, JV. ~.
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