HomeMy WebLinkAbout2000f ..
ELILABE1'H A. NEVILLE
TOWN CLERK
I(I!G 159'KAR OF VITAL STATISTICS
MARRIAGE OFFICER
ltRC-0HDS MANAGEMENT OFFICER
':!Ch:UUM UP' LNI'ORMA'1'ION OFFICER
• ,~~~-_
+, O~~g~FFOC~-co-..
y. G :,
bio y` ~.
W ~ ~J
y ~ ~~ '.
~.
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
PERMIT
for
PUBLIC DISPLAY OF FIREWORKS
i
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (631)765-6145
Telephone (631) 765-1500
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:
GREENPORT YOUTH ACTIVITIES
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 SATURDAY, MAY 27, 2000 AND
SUNDAY, MAY 28, 2000 AT 10:00 P.M. on the property of CREENPORT
PUBLIC SCHOOL FOOTBALL FIELD north side Front Street Creenport 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 b_e 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.
Elizabet A. Neville, Town Clerk
Town of Southold
Suffolk County, New York
MAY 26, 2000
Date
(TOWN SEAL)
THIS PERMIT IS NOT TRANSFERABLE
--~
•~:r
• _
.
UFFO(
-
~
OS
~
ELIZABETH A. NEVII.LE o~
D
~`Z` Gym
TOWN CLERK p '~
REGISTRAR OF VITAL STATISTICS
MARRIAGE OFFICER y x
~' •
y
O~
RECORDS MANAGEMENT OFFICER ~ol
~a
FREEDOM OF INFORMATION OFFICER ~
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
APPLICATION
for
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516)765-1823
Telephone (516) 765-1800
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 BE SPONSORED
PRINCIPAL OFFICE AT
DATE OF DISPLAYJA}
TIME OF DISPLAY
RAIN DATE & TIME
The following persons are to be in charge of the actual shooting of the fireworks:
N me Age Experience Ph sical Condition
~/'y a'/ ~~r5
C : are: S ~S'~ 9 V~P~irS ~eeo~
~-
o~aGo
The fireworks will be stored in a covered truck prior to shooting on the grounds.
Attached hereto and made a
the display is to be held.
coverage.
RECEIVED
14 !~
Soulhhold Town Clsrk
part of hereof is a diagram of the grounds on which
Also attached is a certificate or policy of insurance
yi7- dy~~
MRY 18 '00 09~33RM FIREWORKS BY GIROIVE P.3
YaAUr a ro slxe 4I d Nom Na JO 1'-6IL 1u1j paY!tL ~Z }loduoup
Au~ern ro Nouva~to ar eMrWl 11rIM e'JYON xont 11rW Ot ++M sas{d ddsuX ZiZ
'un tNA el ~nN uacla+ urowwr+ aHi D~ eo0dr NLLYM oArD -OC ~H t7ad
wn 01 YOAYiam n11M Axwnm IMM91 3w '+OeY~IL lira NOLLYNI+Ne N~ND~r q~nox yMdatrag
aw axone rm,eoNra at agnOd aaeYDaaa aAew aw do ANr otnoNe
'(6i/9 O1g100/LZJS LQIdgQ es~aoASaug r gDOdan[ ae tpaminl I~D[1lPPY i~t
7daa ~ YsDdatwadJ (9 a+ag9 m[foU+~!8 (9 q~q~8 Dl14nd~~f3 ~-
Ppg1~87o a1OZ !E ~~`J 7o a7~A (Z wPNPatl ~d saDdwt+a CI
atmll ~rgawlea~Dela,uvcllYDOVfeouraan ro Nd1YlYDgO
raven
s wave-eo 1019 eAWga NYaN1Ytld
lgrt^. ADnDd •aeY39q 13 ~ IONI Agl7tltlOtltliw
s 1N+DIDD'/MJYaIa AAnemldW3AD~d~
9 i r DMr NO4raledWal atl)7NIDM
.~ s wno~ vtYYmn NMY i
s alvoerOw Naa'nvrawn
s 3oNerYnDDONOre Ate'"9~
1 alrDau
yrYDID'Jr NDYa
I uiNO olnr rvrtuYawD °1"r ""Y
iNeoIDDYYe • AsNO Duw Alnrrn ewave
s aoYwYa AlWadOtl+
D~wmuH> ~ eoinvoexmo•NDN ~ g
+ AYnrwAigDa aolrwoaelN g
(UMYd Yd) 90L1r oemo3ND8 X
1~. AtlnrNl A7N703 tD+nraeNAb ~7/
QIfIV ANY
000`000`T s llwnana+e OeNYwo~ OWLO/OS 66/LO/OC 66iT•6tOZTX7 Au,larnsmonolm 8
(wu euo ) mw
e,uare i~YwrD3tlli
e noNallYrgoo NDY3 lOYe a.laloYwnoD t 4tl3NAM7
1 Atlrlr'NI ADM 01YNOt11ad ~ ~ Y+11D0 ® eDYW lWMq
t Off'/ dWDD •tiDnOafd A1neMl~Y1WVaD?wDYtNwOD
1 azvmrooviweNen TO/Tf190 001[£/90 8L0000H'LRJNIQ Ain'sn,weNao V
flan UAImrrOllrO IAA/CDA'ad lira Iae11fW ADflOd YJYr11NNl rDadAA ~~
NatWYgl AOnO+ fADdeda AOflOd
'9WIY10 01Yd A® 03OfIQ~Y NiN SAYH AYW NMOHS SLWn'WI01'IOd HOnB i0 SNO1110N0:! dNY SNOISfIb%a
'SWtl31 9Wl'I~Y 011.73nSf18 SI NI3y9H 03SIYDgO SSI01'gd 3Nl AY OSQiOJJV iONYtlf19Nl 3Hl'NIYItl~d AYW Y00lnfSl SB AYW 91YOIdIlYSO
SINL HOIHM Ol lOSdBdtl FILM JNaWn000 N3H10 YO lOYY1N00 ANY d0 NOWON00 tl0 WY31 '1NlNetllnp3tl ANY ONIQNYiSN11ALLON'031tl01QJl
OOIYid AOIIOd SHl YG iAOGY 03WYN OSYnSNI 7H101 OSnSSI Nai9 3wrH MOl1S 0liSll30NVYnSNIlO h110nOd 3H11YHl AdI1YH001 BI SIHl
ANrdNDD ~ 09EB0 fN+pueLwaA
a 'PH ~9~9 Ob9L
ANrewoD Nuoas~ 6q s~aoYU~e] E+ly
vx eras ^ •an `~.i +~+~ana p!e
ANYdWW O-YIIfNI
~PRM Jo aP~al'I'~L!~+Ir+PYfl ANYdWOD
NgYOaIJr s IiN00 -O1-6 ~b~r~3 ~S
s7pjior maYOiir ^ no0 esu Ysl 009 o3Pr9'L9 s n~~ ~00-
YOW ~ fsu%NOdNn ~1~ii91H ON I Y~Yi~N00 cN~-°IOY ~~ ~ ~ ~ ~ $
Y311r1Y r mnsa a ur uYS Nl ~~d
~00,,A, °,~~ro°;9 ; ~~~
•
. •
' ACORD ...
S
~~
'
'. ~,
. ~ ~ 09/09/2000 x3
'.: C ~
~
R (996)69a-2222 (856)894-2279 NO R1099TE UPON THE CERTIFICATE
ONILY AND QONFERE
~hE Eere111 ASaney, Inc. HOLDER. THIE O'ERTIFICATR DOfE NOT AMEND, EXTEND OR
'DUtch~Mill Read ALTE07 THE COVERAGE AFFORDED EY THE POLICICf ERLOW.
Mal a9a„ N] OS32fi
C ~ ..... .... ....E AFF RD
.. .. .......... ...... ....
~~.....~ .............._..... ~.....~.,. ~...~....
~
~
'~
...
....... ~.
e rtY Mutual In surane^
Ca.
Li
b
,
COMFANY
!M:
bartien
.
.. ...
i
, A
... ....''.
........~..~,,,,.,~,.~...,.,....,...............................,.,.,,,,.~.,...~.._....._.......,.............,.......
.
. ....
...,
.,.........__._ ..............
.
.,..
..
...
...
NeullEO L
C~~
I
E
Vi
nel
to.
nc.
antl
Firework
1fi40 !. Garden Road ..................................~,~~,...................__............,....,....,...,~,~,,...._................. .......,,,...,.,.
~
vi nel and, NI 09360 '~ co CANY
EDMaANv
D
~~ ~ ~
E
~
~iHAT~TNE ~OLIGlD O~INEURANCE LW DEELO
.R7IFY
TMIB ~ISTO O CYP
w NAVE OEEN UE IN UFIE~NAMR
INDICATED, NONdTMQTANDINfl AHY REQUIREMENT, TEAM OR CONDITION OFANY CONTMCT OR OTHER DOCUMENT METH RNPEC'T TD WMICN YFIIS
CERTPICATE MAY EE IEEUEO OR MAY PERTAIN, THE INSUMNCEAFFORDED 9Y 7NE POLa:IES DESCRISlO HEREIN IE SUEJECTTD ALL THE TERMfi.
IXOLUSIONS AND CONDI710NS OF SUCH POLICIi6~ LIMITS SNONN NIAY NAVE SEEN REDUCED MV PAID CLAIMS.
f
Da i TyFE OFINNIMNtlE ! POLN:INYMEER
L711{
I i FOLNJI'SFFaCTNE ''~POUOVOVIM710N LEEIIE
DATa1MMlODM') DATE INMIDOIYYI
OFNERaL LIANLRY i i 6ENEML AGGREGATE .. i i _ ............ ..
~~.
E MMCROVL GYiRALLw-ILRY'
I FROOI/ETa CONFgFAOD 7
CLAIME MADE ,OCCUR
I .. .,., ,
PERBONALf ADVINJLRY 7 ..,,,. ,,,
j
~
70R8 PROF
~~lRSBEON7RAC~~~~
I
EACH OCClRe1E .. _
NCE 7
I
! .
~ ( FIVE DAMAO!(Mrane ire) :3 ... ,.,
..... ,
,... ........ .. I (~ s
f ',
MlD ENP roaalwn) ~ 7
; ,
AYTONOaIU LYYIIUTY
s..... `
;COMBINED BINGLC LIMR ' f
ANY AUTD i
""~~ .......~.~„~~~~~...~~~„~,........~........_ .. ....... ....~~~~~. ...... .......
_~ALL OVMED AUTOB '~, iE001LY INJURY
1
~ I ' (Px pMEM)
aEHlDULm Mff01
,
I ~ > + . ............... .,. ,.. .. ..~~....~.~.~
~.......
''' ''7 NMWDALITOi ~ ~:' { :' BODILY INJURY a
......
! '
'(FeraWdEntl
i
1...,.t NON,GYYr1ED AUT07
: ,
E
....:,
'
j.....„' ............................. ~~~~......~... ~~~...~„ i ' PROPERTY oNMOE
~ i
i r
i
DRRAOE LIAMILITY y ' AUTO ONLY-eA AOEIOCNT ', i
i
•
...
'
' ANY AVTO
j ', OTIIERTNAN AVfO ON[V
IJ
'~ ' ':'
i k¢,
... .
__...
~
._..,
'
i ,
I
i i WJAEEIOlNTl7
.
~~......1 ~~~........~~~ .................~-,.,....~....... ~~~ i
I i..,.....~~~~..~.~~~~,~~,..~~~ ...............p.,.........,,. ~. ~................ .., ~~
! ADDREGATS,1
'
!SCliS LIASe,nV I : EACH OCCURRBYCE i
! (
UMBRELLA FORM
I
S ~~
~
{
~ ~ AND
~ 1
(
'
I
T
O
X
l! EMMLOVERC
L
ylCl-335-901113-010
A
~ ' 0,0,
L •.•• • . ~ 900, 0
i
04/03/2000 OA/01/2001
~
D
LIMT ~
OI
j
E BE ~OUCY
00
0
5
' g
MCl
€ ,
, 0
_.,
,
'•"i
~
'
'., IaRTN~7RCUTIVR
OFFIC[RSME' 1XCLi ~ : i
EL DIi1A7B.aA WFLOYlE
3 0 000
{
E
7A. EEIAL
i splay DateL May 27,2000
a1n Datal May 79, 200D
.. ..., ~~'1'. 'ELI .'. .'YI~ ~N'+[.
'~~ L.
... iV:n roi ~ t~d; ~~li "snu 'k .'iii ~ : i:.
' .
lal01a.0 aNVOF TNB ABOYE DEBCIIaECPOUCIEBNEANEELLaD ~FORE7NL
EIPIMTION DATE TXERROF, THE NIBNIND OOMMM/VRLLENPEAYDR Tb MAIL
10-DAYB WIIRTM NOTIe7TOTNIB CEJITROATE DN NAMN70 THE LEFT.
Creenpo rt Yeuth Aeti vi tiaE Mu*Fayux~m~~l~~l~ IGATIDN On LM1luTY
Pete Ha rria OF ANY ~La1D~YFON THE OOMPA ITa ADdN7B R®ENTATIYEB.
212 Knape P1 ace
rt L.I., NV 1194
9
Gree
n
p
O ~~C;j•
-
Fa
Ba
pp
~~~~
1:
~;~ . ER•Ylfe7fiG~~1'.. ~, k. ., Mr :fa., .. 1aS ~~ FR;., ql.Q,.. .:~,. I a ~ H'e
I. '.1 i'P ~ :~?i~re x .•?V! .x :. ,..
S'd 3hY?JI9 AH SN'JOM3aI~ Wt16E:60 00~ BS l~tiW
• •
MAY 18 '00 03~16PM FIREWORKS BY GIRONE ?.4
'. •
03~17i2~ 16:47 FFlRfiLLON g550C1ATE5 ~ 18566479551
•Rom- ~~~
~~ 9ua
TlFfrnwo~ela~ ~
~4o arAm Rod
9iuelsndr N] 0l76~
m,l,mo w.
eenxAla++
oagw+
~~
r4 wu
r
1r:e
~aw~c~
M..~•
~p„~ew ewnwu~m
e:rs u-aa (X] oaaa
a::wAeae~~
wrr~ure
w.aenrswroe
~y{/p Yf10e
:eei0111f05
1~0lYOW:® X11106
~~
~~
c ~"
1e.~.~.~
W RN.~
WOIMFM NIIMNM7101Y1e
Y{p-~ WNN
f16PROPIMR01r. _ ~ WC~
~A.geo 1+lebol4
Lollvral0
it G>ratP~ T6
4) GraeflMer{ 1'M
p~prlmeae er6
zo~u mnu+9 osnvao
loN1AI ~ 100 earenIDnuusw:rt ~ 1~~
EX17814.1Y~
~~ e
~o.°rv: r ~
lpePfWIr OYM06 ~
••
4 .a;. '~'ri'.t.
~ ~,~ .
`Bi~1oi ~~ _
~xeet Crrropo~t ~) Twm rt ieulhNd
pour BAs61e ~ Gnapr6 ~
M RWNte ~ 1~IreroeiN n~R~' °A
Mpy`6 MY r TM 6e646 NeCMem eQllaa M CJMNKO M1r6 nw
I eauu+>o:1 wee r1ol~er, np ierN6 eer~1:. r~ Mwwn ro r:1:-
;p. e.w vernr wanes m iwe opnrsen Nxee>t 1w~ x n16 ~~
an~raw ~o ~ ~ J:2nw aMU:reM ~ ea:enne>r a6 uu-rtr
GnwlFnrt'You1fi A~tlvWr
Are lfarrl.
~~ Ip~nd, NY 11!14
8'd
3WOJI~ AH S71ri0M3JI~ WCSC:60 00~ BS /.FiW
•
MFW.17.2000 11:11RM BOREL.LI R6ENCY N0, 340 P.2/2
oaTa paMlaon-I
D9 09/2909
(I9gi04-1231 (ISB)894-3219 LT PM10 ~ iFFi TNfiG PIG7R
~1
he iarelli AdanoY, Ine, ~~~_~OR
iip~p~,T~ p9CM19Ti~p/~TEDOYNOT
puSdh Ni11 Rsad A4TCR111lCCVrRAOlAFPOhORDOY"'~^'~I"~'~'~'
MalAia„ N) O927a I ,,,
...,.,,,~,,.,......,,, ,~ ,.,,,~..
. ..
„~
1.,,11,11.1.1r"'
'..
~
Rst: Y
~4 S u a1 I II i N
L i b i riy
CO.
~ ~ n o ~
•o1BANN
Atlnl Tpni Ache repsn ,,,
.......,,,,,, ,, , ,....,.... ....................... . ............................,.,.,.,,,,.. , , ..I_
,,, ,,.,,.., ........................,.. ,,.,,.,,,.........,.. ,....,.,.,..,, ., ,.,,,......... ,,,,,,,..........,,,,,..,,, ,
'
Vinatand Firaworka Co., Ine, eoNMNr
6
io4a a. Da~dan Read I•~,,,,,,,,,,,,,,,,,,_.......,...,.....,,,....,....................,...,-....,,,,...,,,.,..._.._................,...........,.....,......
~~
Vineland, k7 D02ip ~
~,.p..p.~~.~....., .......,,~,~„~,,,~,,,,~„ ......... ......~...~.,.~~~~.,~.,.....,....................~..,.~~,,,~„~,,,~~~~....... _.
~ D
M ~ 1i
n1DNerANT ToumD i
7t
D L D
lD
i
iaD
NNY~
H
l
N N w+uior'I'D
D
I
......' ~N ~ T
4 ..
K
1
M
i.._ .. ,..,.,,1
l
l
nRUVee usueD oRMAr P291TAIN,TN91NiuNAMOifAPFD
IMEpuo D NT PAID OlJdhiR•
RMOWII W1Y ~N 9Y9~~ OW
ii~CWaDNe a ONDRIGM OF WaN PaLICia9. L~
~.~•,
..... ~....~...~. ~ ~ ~~~...~......~.~......~.... ....mmm~,ry,n,,,,,,.n
oopp 'RI~Ma1NINaN~'E ~ f.LIGrNaM1111
L7R, y ,
iPOlq-aFF'IOINd ±PDtFT N; wTp
t W7MNW9pa71 I aMT{~ •
'~ fanaM~ Wadm I ,
,,,,,,..,,.. , ,...,
~ f RNaPK •eaRpoAli ~ •
,
I... ' iDMkR01AL0ailRau~LIA91L11Y : .
,
i
I i!'RD~:~rICfAdo.l j
T--•,•.... ~~~~ ......~.......~.
~
~
'
~
ia~NMOi1. ••~DDGA11
, ~a
KNaONALiADY
NJI~I~Y
~ i
'
OYM[MEa CONnUi10M PADTI ~ i'~ry.Cepi"~6.F......,,d,~,.
( . „ ~ _~,~,.......~..,..,,~,,,.
~
' ~ 1nNaaMM~poYanaou 14
,,,,,,,.,,,,,,,,,,,,,,,,,,,,, ,,,,,,,
y.,, ,,.....,..,..,,............
AYiDY01Li4Mi41i'I ~aaMppli-00T101i1Mff la
.............~.~~„~,..~,.~„~,,,,,,.,,,.,,,.,..,..,. ~...,. ~...,.
„~„
,.._.., aIi OYM+IpDAUi06 ~
i..... i 7 i
DILTIN
~
ipipYL2AADTDa j ~ j '~
~ ~,.,.~~ ~~~~.~.... +.........~~.._...........~....
11
+
,
'
HIIIiDAlfloa i i i 1 0
~
~
i NoNaui~a Avroa I r ~
......, , ,
,,,.,......
,.
.
"
........
~ , ,,
,
„ ,
.
.
.
.. ......
,
,
,,
.,
.
.. ~ ,,,,,,,,,,,,,,,.......,.,,,,,, ,.,,,,,,,.,, ' ~ ~ ~MtOMl1Y oMMM1 .4
r
gaRa0F l41~LnY I I S ~AVTO pA.Y•MA000OR ~i
~
s"°'•`. I
Nlyeuro I ;'iiT1+iI1TwAi~iw-C'611:r~.,
i ! ~ ~
~11 ii001osrt11
t
, ,,.~ , , , , .. ,,..,,....,,.,.._,.....,,.
,
, ,._.,,,.,,.
,,,,,,,,,,,,,,,,,
ti ~., ,,,,,,,....
,.
I
', bRp1 W91LRT ! ~ '~ . FadN OCDDRpaNOB i,= ..............................
~
.'
„
t'iuM9A9LAraPM I ~ ~
"°.011~6,"Yt.,..,,,..~~~~'~,
.., ... .,.~
'0 ,.....~ ....... .......
„ ,..y.
'
..;orla,RTwieuN.Nwa I `
alaaeo wTaNroxo
P-aT~1{' ry ~.,.„J..,,,...,.....a.l.x..l......,
r
NT
n
!1914!5-301119-010
'
? i
.~.,., ,,,,¢,AR,reao,.
,,,,,,,
04/01/200D 04/01 2D01 ~ a
~ ~~.~.~~~~.~.••.......~
/
A
T diTOW
P
~
~
^~
pI9Wi
l......_.,,,
„~~AA.R.A,A.
., ',,,,,,,,,,,,,, ,,,,,,,,,
~
i
~
~;
'
'
01R1 i
8.p1p17~!t un,IPl.oraa
i
I ~ I
1aplay Dllai M.Y 19,IOpa
a1n.Daui TAD
~ 1NDIIIIIANT OP TNRA9M 9MDIia®foIMRiMMNai4,m ~PowN711R
iIDANTNW OAT9 THR11pP,TNa W YIMpoDMpAlry VALLgOaAYDRTO MAL
1D-CaTai4NITHM M07k1iTO211MONNTfWATI Yipwa.nwp7a TNRtM,
G raonpoR Tooth Acsi vi Si es aYf pANAINEKADYL4WNNOTfatMNKLIMfoM NDOWOaTION OP LNgl1TT
Pat. Hafrli '~p~ ate,
712 knapp Piaea
G~..NperS L,S., NT 11944
A a
01'd 3WOLII9 1,8 S71JOM3aI.i Wti6b:60 00~ 8T J,CIJ
-_-__ ~.. ~~~~.~~~ ~r~~wr~ew AII'5 KG BE19
6'd 3NOJI0 hfl SYIJOM3aId Wd02:E0 00. BS .ICIJ
~f~S ( ~H~RK~NG 1. o~
5 0o t= T
~'.\mrowe.2.
•
{
as
D~
i
S'oo F'i
C1Q0.YGMCt
~{~E t ~ CART ~S~ sad l G~~s
WO
~~S T
~')') 0~ ~.e,s L, ane~
C.~eora~.~
3
a
.`
=~
s
d~
~~gpFFO(~-CO
GS
=~o
o -
V1 x
W ~
REGISTRAR OF VITAL STATISTICS '
MARRIAGE OFFICER
RECORDS MANAGEMENT OFFICER
FREEDOM OF INFORMATION OFFICER
ELIZABETH A. NEVII.LE
TOWN CLERK
•
OFFICE OF THE TOWN CLERK
TOWN OF SOUTHOLD
C~
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
Fax (516)765-1823
Telephone (516) 765-1800
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 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 $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 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 disalav.
(The above instructions are in accordance with the Penal Law, Article 405 -
Licensing and other provisions relating to fireworks.)