HomeMy WebLinkAboutFireworks Unlimited - Strawberry Festival 1995oS~FfOlk~O
~<
o ~ ~o~
JUDITH T. TERRY ~O'l T
TOWN CLERK
REGISTRAR OP VITAL STATISTICS 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 designated by the Town Board of the Town of
Southold for this purpose, do here
GRANT TO FIREWORKS UNLIMITED OF NEW JERSEY
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,
ON FRIDAY, JUNE 16, 1995, AT 9:30 PM (no rain dte applied for)
This dis~lav is to be given for the Mattituck Strawberry Festival.
the time and place set forth in the application therefor.
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 poirif 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
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.
~~~
-~'uclith T. Terry, Town erk
Town of Southold
(TOWN SEAL) Suffolk County, New York
May 10, 1995
Copies to:Police Chief Droskoski ate
Mattituck Fire Department
Mattituck Lions Club
THIS PERMIT IS NOT TRANSFERRABLE
FIREWORKS
UNLIMITED
Of New Je[sey
Very truly yours,
~-~~~
Joseph J. Sredniawski
Sales Manager
Geraldine Serpico P.O. Box 832 Newton, N.J. 07860 (201) 579-5856
Randy Serpieo • 39A Elm House • Douglassville, PA. 19518 • (215) 385-7967
Joe Sredniawski P.O. Box 582 Northport, N.Y. 11768 (516) 754-3781
Ms. Judith Terry
Town Clerk, Southhold
Town Hall
53095 Main Road
Southold, New York 11971
Dear Ms. Terry:
May 6, 1995
In accordance with your penal code we are hereby applying for a
permit for execution of a public fireworks display. The display is to
be given for the Mattituck Strawberry Festival beginning on the
evening of June 16, 1995. All of the required data for the permitis
provided m the permit application form along with a copy of the
required insurance and a site plan. We have already visited the site
with the local fire department and have agreed upon the services to
be provided. You prompt response in processing this request is
appreciated. Please forward a copy of the permit to the Northport
address below. If you have any questions you may reach me during
the day at (516) 346-9626.
r
JUDITH T. TERRY
~- Southold Town Clerk
i ~ g~FFO(,f-c0~
O ~ 0~
Cpl ~ ~~
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: ,,~~// ~~~7- ,/
DISPLAY IS TO BE SPONSORED BY T//QF'uJO,~~ r~I,ULJ~ry/rEjj QF/U~ ""~~/
PRINCIPAL OFFICE AT /?lI.
DATE OF DISPLAY ~ti~~ %~, ~~~ 5 ~
TIME OF DISPLAY ~:3(f p//~
RAIN DATE & TIME ~Qh}E
The following persons are to be in charge of the actual shooting of the fireworks:
Name AcZe Experience _Physical Condition
~dS~f H ~f~DNIR(n1Skl S I % o /R ~ FXCFLCErtI j
,~/~13 $T~,vc~CIC 3~ _ - S Y~~ __ ~kcFLCE~
Number and type of fireworks is as follows:
-3rr
5'/vC ~ Div prcor~JJ~v~~
fASs
SOO - ,2 " S KFLC,; r. r, r, )" Gu ITN NFI'xI - l/ 3Z
~/~ CODE,
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.
9/~/°35-
at of Application
To
ALLIED SPECIALTY INSURANCE,
10451 Gulf Boulevard
assure Island FL 33706
ll. Free 1-800-237-13355 Nati
1-800-282-6'776 Florida
IN
onaL
Certificate Number: 00008
CERTIFICATE DF INSURANCE
FIREWOFiK3 DISPLAY
NAME & ADDRESS OF INSURED
FirewarJ[s lJr,Liri,ited of
New ,J [. i"Sey
242 SY[_amor4, Raad> Bax 6
L;ougl.asviLie, PA 19518
CO hiPAN Y :
FOI_.ICY NUMBER:
LI AhIL ITY LIMIT:
RIfPD Occurrence:
Aggregate:
Ctas B F'roducis
F'OL..ICY PERIOD:
From:
To:
F.6IM9FaT..-GO~EFi9GE
Ix._N.:.._E.9._znsuLan~e.__.
-_ _._ L r 913 51 _ _ .._-- _- -
__ ~:1:4 44:52 451. GS L# _--
__$1LL.4i14:.4514__._*_--
3/U..'./y5
3/ 0'x/96
ADDITIONAL INSURED
Mattituck Lions C1 &/or Town of
Riverhead, NY Z/or Town of Southold.
NY &/or Mattituck-Cutchogue HS ~/or
EXGE&8_CQ~Eg9GECty of_Suffolk,z_I)ept PK
Rec & Conservation
Excess of Excess of
0/UO/00
0/00/00
0/QU/OU
0/00/00
~ - COMBINED SINGLE LIMIT
In :r:e F.ya;nt of any material. change in, or cancellation of said palicyties),
th?F •;'omi:;rigy will. e~ideavar to give written notice to the party wham this ce?"-
tif![:<at[= is issued, but failure to give such no#ice shall impose no liability
r.,r J:; t i ga i i an upon tJ?e CamhanY.
NAt1E iE ADDRESS OF CERTIFICATE HOLDER: DATE OF DISPLAY: d~ene•--16~ 1995
Mattituck Lions Club RAIN DATE: ~SYne-77; 1995
/Lewis Newton & Sons DISPLAY AMOUNT. ~
C/0 Ray Gramazio LOCATION OF DISPLAY:
PO Box 64 Mattituck High School
7tMatt,~tuokdl~TYn~lpb2±h potlcy' th<'3t atL dlspl.ays be reported #o the Company at
ea ;- '~'~} h[?u?-s in advance of the dispLaY date.
7hi ~-_:cr°tificate neither affirmatively nor ne9ativeLY amends, extends or alters
ti',r. o~<<n?-:a~'ae afford[ad hY 'the PoLicY(ies) described hereon. NO'iE: In the event
tha r<a!'o ar- imcirament wea#her prohibits this disPLaY, coverage wilt aPr~y
nn ,. ~~ub;[-q.uer,t date on whi[-h the disPLay is held, within the 'terms of thr
,nt,::~ c;i+'r,trac~t, CLea?ruP an[1 poLiciT?g of the disPLay arF+ the resPOnsibiLitt
;hey^.oti.al~incJ are add itionat ir~sure[is: anY fair, orexhibition, assacia#ion
.r,po~•.-=irii•n~ ai'ganiz:itii?r, ar commit'tc=e, the awnEr or Lessee of any premises usFd
-.y !i,e ~'tarned Insured, ar any' Public author°itY granting a Permit to the Named
,:-... __...7pi is acc!dents arisin -9 9
i, u'a •.1 S"rlyde i:i idt i,n J.'Y as ,reSl ~ g OIAt Of nP LI EnCE bf the
Vani e:,;; ,Lr?~!!, ;.. ad al'" tfi£.' Namr2d ~Insur"ed'S emp 1. oyees aC'tl ilg In the CO Ur'Se and SCOpe
!;f ii,eir ~:-~npLo'yment. ,visa, as additional Named Insured, anY Independant Con-
rrar::sor wtr~; fi?•es the display on behalf of the Named Insured. This insurance
:i [; r?: 'iiiit ~!!•+p L'y to any ~fai iu~ie to po Lice or ctea nup the disPLay: or Liability
r i . : ng tt?•~r[a from.
Thi<.; certificate is not valid unless an original signature appears below.
SCaPIes Not Valid)
Da'ei; ai' Le:irt,~t'!c:<:,te Lssuan,_e
Authorized S+gnature
ALLIED SPECIALTY INSURANCE, INC.
i
0 I
~~
I
c-
~ ~~ ,y
~~p~~ .
'1RFwt~R1~5 ~17~~ ~~~-~~
c~o~ ~u~~ l~~ Iq~~S
/'~nrTCtUC(c l~~J~
KZ(~~)
'C y
G ~~d ,~--~ 2l0 ~
~~v
~~,~~ tiG
~f
. ~+~~
~Sb
wl
rt
T
~~~~
;_
7
~,aRKS - 3 :t~ ~
.po5~_~~_cN ___ - -
~on
a90'
alt; ~ ~~oo I
cr`~_