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Home My WebLink About19997 y •~ • ELI7ABETH A. NEVII.LE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER .~'~~ ~~oSUFFO(,~~OGy, ~ ~. c .c~ N Z O • ~ ,.;, _~ • 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 Fax (516) 765-61'45 Telephone (516) 765-1800 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 CREENPORT 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 29, 1999 BETWEEN 8:00 P. M. AND 8:30 P.M. (RAIN DATE: SUNDAY, MAY 30, 1999) 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 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. Elizabeth A. Neville, T wn Clerk Town of Southold Suffolk County, New York MAY 21, 1999 Date (TOWN SEAL) . ~ g~FFOG(r~~~ • OFFICE, OF'fHE TOWN CLERK ~ }T TOWN OF SOUTHOLD ELIZABETH A. NEVILLE, TOWN CLERK P.O. BOX 1179 ~01 ~ r~O SOUTHOLD, NEW YORK 11911 _ OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION for PERMIT TO DISPLAY FIREWORKS 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: r / ,/ ~~ / DISPLAY IS TO BE SPONSORED BY l or22rf ~jr'~ 1d~C7"~ ,t7 [/) "1 ~/' ~. PRINCIPAL OFFICE AT DATE OF DISPLAI TIME OF DISPLAY RAIN DATE ~ TIME /vc% o~s6a The following persons are to be in charge of the actual shooting of the fireworks: e Awe Experience Physical Condition ~~// -%~s s~~ ~~ 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. Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 -7- ate of Application Number and type of fireworks is as follows: GAS t ~~4RKtNG t~ o-C r 1 U Q 5 0o t= 7 C~~,ra~nC~ ~~t ~ ~ ART ~~~, s~~ l G~~s 'rewo rksl. 0 ~ ~ `1'ao F~,k- D ~ C.~~.rc..~~„ \~/ Sao F~ C.120.YLMCL S t (~~ ('2S ~ 0.'f12 3 .` 0 s ct~ ~. ~ I D ~ .ap k A .~ C 'N •: ~~~~ r ~~ ~ ,Y..,. ~ ~ 05/17/1999 ~'~ ~ (609)394-2222 FAX [609)694 21 T9 oNLYANDCONPER3NDRIGHTBUPONTNECERTIFICATE me eerelli Agency, 1ne• HOLDERTNISCERTIFICATEDDESNOTAMEND,EXTENDOR 'DUtOh Mi t 1 Road ALTER THE COVlRAGE AFFORDED BY THE POLIOIEE EELOW. ----- Malaga„ N7 ODE2[ CO N A RDIkGCOVLIRAGE ' COMPANY Travelers Tndemni ty A!!n: Teni Albertson Eat• ' ', A .. _. __. _ .. _ IN611RiiD ..._ _.. _.__.... _ _... ,, ._..._ _ _ _ Wlu9au Tn$V rdnce Co . - DO ~ Vineldnd Firewerki,Inc,/Fireaerka by [tro ve ® 1640 E,Garden Road _......_ _,... ~.,,,., _... _... ___.., ,.... .~,,.,,_._ _ ... ...... ....~..... Vineland, NJ 08360 LaraPANr C COMPANY D IK yy,,,,u h, 31+? ~~"" ^~ "Y ~ . 1g 1.-~~ iyan JB,.:: ~1YE!. a iy~ ::{ o- .wry ta, .:' ; ht!;,, ~. ~ ~~ .. TF16 POLICY PERIOD F ~ ~ T 313 TO CERTIFY ' ~ T POLICIES Op INSURANC L " G ~L W HAVE ~N ISEUED TO THE ~NBURE[7 NAMED AECb'E ~ INDICATED, NOTWITH6TANOUIG ANV REOUBREMEMT, TERtn OR CONDI?ION OF ANY CONTRACTOR OTHER DOCUMENTVYTH REEP[CT TO WHICH TMI& CERTIFICATE MAY EE 139VEOOR MAY PERTAIN, THE INSURANCE AFFORDED EY THE POLICIES DE3CRIBEO NERE!N !8 SUBJECT t0 ALL THE TEflMS, E%CLUSK)NE ANO CONDRIONSOF SUCH POLIOBS LIMBS SHDWN MAr NAVE BEEN REDUCED 9Y PAA7 CLAIMS. co ~ POL!CYM MBER ~ PdJCYCFPEOTP/! jrolKrexPeuTlOn' uYlTi U tYPEOFIN9URANCE LTR i ! DATE OAMR7D/YT) ( OATS (MY/ODR'r) j GENERAL {MBa.IiY i ` DSNEML ADORfiGATE t ........ ._... .. ~. ....,._. i, I LONMEROVLLGENERAL IwEILITV' PRODUCTi•[OMP/0- ; ~~ { .r ~ j LlAIM6 MAO[ f ;OCCUR j PER60NAL B ADU m.AIRV i ~ , ' GYVNER'8 A CON7RACM0. 6 PROT i EACN OCCURRENGfi ~' 1 ! i 'TIRl DMMCE (Am/ene5re { ~ aien ez~ imr ene Petior i : s i AUTOMOEILE LUIMLYIY l ~; r,OMDMEO E!NGLF LIMIT / 3% IANY AUTO i .; __,.6.,00Q,,000 ~~~ ~~i ALL ONRlED AUTOS ~~ i E07L" mJURv ~. .., i I ; BCHEb0.6D AUTOD --I bRl RT17TDa946-9i A i (Perppron) ~ 03/31/1999 ~ 03/31F2000 ~~~- ---- °'-~~^ ----'-'-"" I wRED AUTOS BOSxLY INJDRr ~~ { I _~~~~ NON-0VMEO AUTOS ~' .. i fpe•axberol I ...., ~...~ ......... ~ ....... .......' i j j .PROPIRTY DAMAG! :1 1 MGe LIAEIUir ~~ ~; AUTO ONLV.EAACLIbENT ~S' ', AN'AUTO ~ ~ ! ~,_TMAIV AUTD ON Y... 3~n"~ e'~.vaA'Rl~~i :ia: I ~ ' ~~~' ' FVICN ACCIDENT'. 6 i AGGPEGRTE;i f EYCSSE LUIWMTY ! - 'EACH OGDURRFNCE .,..,:.i ~.~~~.. _... . ~...... ~( UMi0.elLA FORM ~ I ; i ~I AGGREGATE : S , _ .._ _....._.... ........ ..~.. ~. , ..,. ... I OTHER THAN UMBRELU FORM ! _~ ~ a r ~ YfORaERA COMPFNDATON AND ! ~~ :, ! _ -.?~..,...... ITC % ; ER ~' g',;,°: ..r x~sr ~. . (lMRLOYW'LlAbillTV EL EACH ACCIDENT a 500 000 ~ e ILHl RROPRIETOk NCI }110-03 •027176 ; 04/01/1999 ~ 04/0 S/2000 EL nIFEA6E-POLICY LIMIT I i 600 000 -ARTNERSIe%ECUTiYE i OPPICERB ARE', ! E%CL j i EL DIifiAEE • EA eMPLDYCF E S 00 , 000 s - noN evsr u isp ey Dete: May 29, 19D0 ain Data: May 30. 1999 ( ' l.E~ 9~#'sKjlkrn sS:" G 4_ :~oa ~'`~: S S' y~ ~tia^^I , 'F£-c~~a 71'. 'Efblrs, 'n ;i~~ Y~i';$, . : ,: i~ ~ ,. 3~~i,^y~ ,': . .. { , +' n .. ..,. A 'A Ji RI . . NYOF TMEAeOYe oE[CRISEO POLK:1[a 9! CANClLLEO O[RORE THE lllouW~ E%PIMTIDN DATE TNeR[OP, M[ R[UINO ODYPANY WILL ENDEAVOR TD MAIL -1'J.OAYa WIIMTEN NOT1CeT0 THE CERTINCATE MOLOlR NAMED TO THE LEFT, Gree nport Youth Acti vi ti eR CUT FMIURE YO MNL iUCX NOTICE iNALL IMPOSE NO p[MGATION OR UAMLITY R e t e N a r r i a OP ANY VINO ! i~~R TATIVq. 212 Knapp Place Greenport Lenp Tila, NY 11944 wEfio CEP ,IE T~)F.: ^+.4~~,5 .G ~~y, 'kY.f A{~7 $3" < G <~; ! ': ~ ~ 7 P ~ ~ ) i ~ -:y :..,v tl,{~+~ .•;" ,.nn'~ . itr' •~~" i V ! ~ 'vnR , ~ l, ~ . r 2 ,t yy :Ti' , ~ , , , i r~d ..v ~ ,r 3hJU~IU J.8 5N?J~"'132iI~ '.ld'?c':f; 55. Ec 1,dlJ 05i20i99 18:33 W. M. DLIKE£SCO. BRQWNAHUhPFiREY ~ 669 697 9557 NU.471 a,ni MRpI!'MN-1 PIIOpI{61 _ M Q BrewD ~ H:eaphroy Swplne Linca ^i M AA1t~~p 0 MO~DEn T?I~ ~~AT~ I Ex1tl~0 8 i S00 10i M t St S it n t fOL oR a~ n tllD M P r ~ ata ~ 60 s eli pomtry . u e , ban Frnndtco CA 91101 COMPAlMrS A CoVillaot , .._ ~A UederwriteTS, Leydo ! CNA At FlrewoekE sy Gireae cawe•Nr s 1610 Gafdea Read . + viDieleod~ NJ ~~ eaN`eN -- V9 d1+~AN. TMe IB TO CE4TIiti TNAf 711E POLICI/t Df INtVf WJCE U87ED EEIOW INVE EEEN ItfUED TO THE IN9VOIE0 NAIMriO AEDVL v011 THE -CL1CY PEIMCD INDICATED. N'T WrtIIeTANOPIG wNY pEpUMEMENT, TERM OR CONdTIRII CP ANY CONTRALY OII,ORIEII DDCUMENT Wf'YI RBePECT TO WINCH T1118 CERTIFICAY! MUIV BE 1841lEO ell MAtl PER7AM, TMH INSIIAANCE APPDRDED By THE POLICIES OEeCRIBED HEREIN 18 tU61EC7 70 ALL INi 7ePME, S AI'7 CONDITIDNe OF ! PCtICIEi, OMITS BNOW Mev NwvE eEEN RlDI+CPA W PAID 8. P/Pl Ot uN11RANm FAlIet/IIIMIeA OAfEOAMAin1') eAllEelllellNrf Nlne p eFwewel.woluel Z!9/Q31S OSf31N! ~II00 OENEIVIeeoRSllve 6 celolwauttvEe4WY0.R+ -RppN,Te-ODwip--- s s DE 2"' aellw wwE [~ accvR Pt7tedNti sOr ewRr t 1.011E oNlNeveecovfll)CTppernar e.d+O dMENCe e wowM ! YCO eV YM w ! ~MR OIIMYIUNVN ~ CO4eNMD tMq\E WR i Avt AIttO ~uowN®~uro! ~ eoeluwuum ! OOIKOIA.EO wrlos i Prwleonl NNKD M/fOB eooltrawnr ! Nd-OWNE1 N/f0! I IOd'tl~ NIyLelv0eAY1GE ! eeAAee UAMA^' w~llO WRr.6A /OC10nllT ' ! YIr ~Vfo OTIFA TN/M _ ETON A001QeNt e ! eW WWIF e~EU OE"AYeeBM:E t NYe0E1LfOaM ecnllmATE bw, ! ~OlMp{epWaYeneNAM ~~ .... ~ e>rwe.e~+' Iue1vR ME1CN AeG1FN- ~~~M!*~ 1NCl Kd .POlIGY17Ni' wrplNEaYe7epTV6 Qeew upp ~ El0 EerwvEe t 1n'[e euarmaa.aw ilenalriaanlDls 1) Greeepors Yoot4 AelivlgeS, 2) Viliege e! Gseeeporf, ~) Town o! 6oYt4old, t) G rk Publle ScAools, s) SUter DoUnr BaoMi asil 6) aceuglon loroaeoe nn Addltioaol InEaredi of ItsepectE e eeeue ANr ar iNR Ae9Ye ateeelem RxIdA n 0lIIOfALd MP011t rRE GroeeporsYDWllActivitlm exeleelell utt TNpiiv, de IEdNq etewwW 7RLL OOeeroe To ren Asia: Pak ReerL ,~ ,,, esa sI~MPtEe canes ro ma elellnelnn: ed.oEil aelre ro IRE uol, 212 KnePF ~~ evr wrwloe » a euiN None MAk NO eeuen~oll a uell-rn ~ tAIIR rsuaa M AM arolr I NerYol4 ]Il1e e 2'd 31JOilIJ J.fl S>IJCi13JI~ WdS_~d~f Eb, 8c' ~,Fiid~ 05iZ0/99 19:33 W. • CC.9RLU~NRHI#'~HREY • 699 S97 • h0.491 1.1ee E'd 3NObIn 1,8 S11JOf73dId Wd92:E0 65, e:2 ,ldW 9ranl bvrNEW YORK p1FS5 ppr-2B-99 Iarlfaln free R),j~2 A9i6B9 697 9557 ~a9e 1~ S u.3. 76pOMnsnt PtBW Yank Automated Inl.mailongi r c[a ArrwRi Arenue at trdhtportatian F']ghl serdet Sfatlon Ronkadloma, NV 1117e•7~",3 redOrgi Aviplion AamlMahotlen April 27, 1949 Mrs. Rose Girnne Fireworks by Girona 1640 Garden Road Vineland, NJ 08360 Dear Mrs. Girone: Our office has no objections to the propostd fireworks display scheduied for Greenport Nigh School Grounds, Greenport, NY. The tithe oftlre display will be approximately 9:30 p.m. on May 29, 1999 for an 13-22 minute dutatior,, witkt a reiadatt•, of May 30, ] 999. It should bs noted that no shell shall exceed 600 feet and the fallowing conditions must also be met. 1. Contact the Supervisor of the New Xork TRACON at (516) 683.2984 at least two hours prior to your display fo uego6ate any altitude littuta!iona or tirr_e frwne restrictions, if Way are required. 7. Contact the New Yotk Automated intertlational Flight Service Sration at (5 i 6) 471- 7394 atleast Six hours prior to the scheduled detonation of tl:e fireworks display Ic effect the tssttarloe of a Notice to Airmen Advisory (NOTAM) This letter dlspoaes of the Federal Aviation Adlnittistration's interest ixl this matter, but should not be construed as supetaodirtg or invalidnilttg any existing rules or reg~.0atiors promulgated by auy other federal, state, county or municipal goverrunent, which tnav be required for this display. Sin e , onald , . R $geri Manager, New York AIFSS ~','1 3110uI9 J:3 SI~Cr13dL' !~dLc'r~t, ~,;. ~~3 ,'HI~I ELIZABETH A. NEVII.LE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER v~~Q CO 4; J' ~~ Gy~+Ft's a .~ ~0 N`~,- ,? O y~ ~ p~~ ; ~j ~ ~~~, `J OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD PERMIT for PUBLIC DISPLAY OF FIREWORKS Town Hall, 53095 Main Road P.O. Bo 1179 Southold, New~rk 11971 Fax (516)765-1523 Telephone (516) 765-1800 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 FRIDAY, OCTOBER 15 1999 BETWEEN 8:00 P. M. AND 8:30 P.M. on the property of CREENPORT PUBLIC SCHOOL, FOOTBALL FIELD north side Front Street, Greenport 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 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. Q ---- Elizabeville, To n Clerk Town of Southold Suffolk County, New York October 12, 1999 Date (TOWN SEAL) THIS PERMIT IS NOT TRANSFERABLE ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER ~o~OgpFFO(~-~ G H = ~Wy~ • ~ ~~1 ~ ~ao~ 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 BE SPONSORED BY PRINCIPAL OFFICE AT~y'.~~ {~ DATE OF DISPLAY /~~~~ ,,,~ j TIME OF DISPLAY /°~-~ ~p~,,, ~ RAIN DATE E TIME T % zo ~~_ The following persons are to be in charge of the actual shooting of the fireworks: i~~e ~ Age Experience Physical Condition {~ ~ri~ S f/ ```~ c,/ Number and type of fireworks is as follows: rew~~ks Sy ~~- rieS~HS ~,s~~r ~4h ~ hc` . The fireworks will be 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. B1{ ~~~~~~ ~P, ~~ Signature of A licant Date o Application • A~ Y !0 FROOikER THtt3 CR t1ED AS A MATTtR L< 1 A tNiLY AND CDNf[R! tt0 RIDHTi UPCN THE CiRTtfICATR Brown & Htanphrey 6urplua 16Ma HOLDER. Trita cetmflCATH DOEti NOT AMEND, iXTLND OR 400 Montgomery 8t. Saitc 500 AL E AFFORDED RY THE iLOW, San Francisco, CA 94194 Ct1MPANIEB AFFONWNtL QOVERAGE ~A~ Underwriters, Idoyda & CNA Re EpURED O~p~. Ffiroworka By Girone I s Royal InEnrance Company _ 1640 Garden Road Vineland, NJ 08360 CDMFANv c VS coMDANY TN18 !e TO CERTIFY THAT THE -DLICIEa OF INSURANCE LISTED l1EUDW NAVE BEEN IEaUED TO ThE INSURED NAMED AECVE fOR THE POLICV fER10D INgICATED, N0TINKNSTANDWO ANY REQUIREMENT, TERM OR CONDRION Of ANY GONTIIACT OR CIklEfipOCIIME-iFWRY1~REBFaOT°1'0 WNICNTHIE CE!RTIFlCA7E MAY aE ISSUED ORJAAX~ERTAIn~SNE.IWSURAN6E-ARFORDlD aV Tt! ~ICIEB D IaED Np1EIN 16 BueJECY TO AlL THE TF.RMB, ExC~uNONS AND CDNDITIbN9 OF 9UCH POLICIES. WMITB SNCWN MAY NAVE BEEN REDUCED aY PAID CLAIMS. L~TR TT}EOTNaYRARC[ POLiCP,AIeaEA R~i~'r+4 ~Dp}l lMMaaD'Yl 'i taEfi /), OLNERAL WMLm ~- ~ R ~RAl AGG11EGATE i Z~i~ i ~ 95t~1/~ Q~ /31/QD ~' DeMAaNCIAIGENCRAL LIALLITV ! '~, i ARDIXIGTB-CDMFADF AGG DD CIAAIi MADE ~I GCCUIF' ~ ~ PEA90NALi ADVINAJRY 1 OWN@I'8 A CONTRACTOR'S PROT I ~, I EAQM pFCtJN1~NCE i l.tb ' AUT DEWaILE UAMUTV , 'i COMBINED TINGLE LMR ! AIV" AVTO I ALIOWNED AUiOI I ~ BODILY INJURY ! OCREDOlEO AUTOE I IN w+N+1 NueaAUTOe >~pI;YIwnRv i NON•ONA1E0 AUTOb t i I i PRDPERT`DAwWE ! aARAOE LIAaLITY h AUTOONLY- EA ACtlDENT ANY Al1TD I g7NER THAN AuTD ONLY: B ~ezcenIA ~m •p11A1A3498 I OS13ll99 i 1/31/00 E~-AOr,~~r~ y~"`~ ~i`~ '~ x ' OTHER THAN uA1BR6LLA FORM I i woMtERicaaRauTleN aND M~iwcRr uAaluTY '~ i ELtiAOR ACCIDENT I i THE TROPRIET(11V ^ INGL i EL DIEEABE•F000Y UMR E +AmB Lulbiliw I I huluded DEECRIPTION 0-oicaATIOMLAACATxEwrERICLEwiFEOIAL 17Elai 1) Greenport FYre Deparimmt, 2) Gtecaport Youth AMivitieE, 3) Tovro of Southold, 4) Greaaport Public 6chool and S) V81eie aP Greeaport are Additional IMEUrada a. Reipeete a Fitvworlu Duphty oM Gtwnport Youth Activiliei Atha Pete Harrill 2121Ztnpp Place Greenport Lori IElaad New York 11944 z'~ lNWLa ARr OF TXl AEOVE OLlCNeia roNCIEi tl CANCELLED aiEDla T!M ei{MRATION DATE TKgOF. TM IiiVIMe CdMANY wRU eNDEAVOR TD NuL ~_ DAra wMTrEN NoTlee TG 7NE oERTSIeIATE IgLOM~ NAMED to THE LEFT, auT FNLORe T~MAa EucN NOTICE fIMLI IA~llt ND OELIaATIq{I 011 uAa-m 3WOJI9 AH S~iJOM3b~_' Wd2Z:c'0 66, L8 1~0 E'd 3hJOJI~ ~L SNa0M3bI.i Wd~?:?0 6E, L6 1~0 e~,' ~ `: ~ ,: ~ +, ' :^.' ~ DA74IMANDDIYYI iY; ' '~. z.a °"$ ~'~:..~~~ z~~...•~ roaw~wwxx.w ~I'aa ,C ~ s, x~ 1~~ , ; , .. ., .. 10(08/1999 ?ti (636) 94-222 FAX (B 56) 6 9/- 2 2 79 9 h e B e r e l l i A e n c Inc . ONLY AND CONFEREi N0 RIGNTi YPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOER NOT AMEND, EXTEND OR Outeh Mtll Road ALTER THE COVERAGE AFFORDED EY THE POLICIES BELOW. Malaga„ N] 06328 CONIPANIE9AFFORpINGCOVERAOE j ._._.. _...... _... ..._... ...._ ..... .. ............. ........... _... ..... .........._.. _.... .... cOM-ANV Wausau Insurance Co, ApA1 Toni A16ertsen ERt: A ~ ~INBURlp...._...__. ..._.... .. ...__.._... ... ..._ _._. .... _ ._ ... .... ....... ._.. .. .. _._.. . _.............. ._.. _.._.. _.._.._.. Vineland Fireworks, Inc. CO BANY i 1311 E.Oarden Road '. __._. _. ..._..._.. ... _.. ...... ....... __..._._. ... Vi nal and, N] 06360 '~ Con°CurY fOMFANY D a~. ~~ TH 16 TO CERTIFY THAtTHE POUCIE60f M6LRANCE LIBTED~EELCw PAYE BEEN lB6U~D TO THE INSURED NAMEb AfiOVE FDR FM[ POLL Y PERIOD L+~ ~ I' INDICATED, NCTWI?H6TANDING ANY RECUIREMENT, TERM OR CONDITION OF RNY CONTRACT OR CTNER DOCUMENT WITH RESPECT TO WHICH THIS C6RTIFICATp NAY BE ISSUED OR MAY PERTAM, THfi IN9UMNCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 16 6UBJE0T TO ALL THE TERM6, EXCLUSION3 AND CONDITION90F OUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS ' 'POLICt'lRECTNS ;POLICY EXMMTIDN L~ TYPE OF INWMNOE POLICY NUMBER LIMITS : DATA IMM/OOn'Y) DATE IMMIDWYYI . dENSMllLaItITY ~. ~ BENEMt AGGIIEOATE B ~CONMEIONL CENEMILMWTY; ~ PRODUCTS COMPXM AGD '.t z ICLANdAV1DE OCCUR; ,,: • ~ ~ ~~~ PERSONAL l AOV INJVRY d 1 3 ORMER'6 i COIJTRACTORBPROT .. ... ... :.. ........ _... ~ GCX OCCURRlNCE ' t , !._. ._...._. .... _.. .... i • ~ FIRE OANNGE IAfry oM f'e) ~. d c MaD iXP WY xe pxaonJ,.. ~ i k AeroNdme LurLnv ~ ~ ~ ... _...~, ANYAUTO ; COMBINED JINGLE LIMIT t I ALL OYAVED AUTOd I .. ........__.... ..,. .._......... .__....... ~II Y ~J LIRY ; t ~, SCHEDULED AUT08 ~ I ~NR6D Al1T06 I ~ _._.,.......... ..:.. ... .... ...___. ....__.. E ~ BODILY INJURY ~ t ,, , -NONCPMED AUT08 ( ~ (PM aaJ44n11 : I t _......_._.... . .. .. . ~ ~ 6...•,.;- ....................~......,.......... ~. ... ..... i . ! PRO-CRTY DAIAAGE ~: a i ~ LNMLNV ;AUTO ONLY~EAACCIDEHf I t j ANY AUTO .. , - - _. i AUTO ONLY. I. OTHCR THAN ~ art ~ . . ' ., . .,. , ...... e EACH ACCIDENT' s ... ADOREQJ.TE~6 EXCEW LYeIL11Y .... _ } ' EACH OOGURRENCE '. d i UMBRELLA FORM ............. .... ... „.. .~~................. ~. AOOREGATE ... ..... t ~ i ~'pTNER TNAN'JNaRELLA PORN ~ ~ ..... _ ........... .......,. ! •~~",.•. ~.•.•..,{ YAIRKERf COMPENSATION AND ' X TOR lIM B ER '' ~ ~• " ' (EMPLOTERB•LIAMLITY , r'+ - , ", 1110-03-027170 A ~rnE PaOPRIErdu ' IN E EACH ACCIDENT t 500 000 :Oa/O1/1999 04/01/2000 ~~ ~~ ° CL t PARTNERBIEXECUTIVF ' ~ £L DISEASE POLICY LIMIT . d SOD 000„ D ~ ~OPFNaRt ARF: 'EXCL. EL 018EME-ER FMPLOYEE t 500,000 j I _ DEteIUPTON ONSlLOW71ON '-- 19p7Py Date: Ot COber 15, 1999 ain Date: TBO y I, g. :.'x w.. f`x g~ ~'xH ~':AYf k.s.sn'~iSun .>kA Y:S,N:. ~. 'i:. ~ ... '~'x x .Si: wkv74Z (:. f ~ ~dl~ . r.c. . ~ fHDYLOANT pi Tfi ABOVB DFBCItleBD POLICIES BE CANCELLED BERORE TXE EXMMRON DATE THEREOF, TNf NSNNC DOMMNY WLL ENDEAVOR TO MAIL Green ps rt VCUth ACttVi tl V.3 ~D.-OAa'd NMTTF.N ADTIFETD THE CERTIFN:ATF MOLDER ILIMED TO THE LEFT, Pet4 Xarr19 aViPARURE TO MM48UCM NOTICE tNALL IMPOSE NOOWOATION OR LIAa1LITY 212 Xnapp P1 ace ~~ •r~~ GrlenoonL. L,I „ NY 11944 uTHOrozEeR 4DVE ~' ~ . ki w+ ~R;"' A kN f. ~ ~v ~;'' 4 ~' '; v~ ~ !' ~ is q 4,.. :. ~ ~~ 3'I v , . .. , g s: P . t•'d .,,,. 3NOrI~ ~,8 SN?JOM3~Ia Wd42:3L~ 6S, La 1JC ~~ ~-; ~e. w~a 1cs Sl~ztl ; ip ~S a r ~-~,w.-, ~ i vie' i+~ L1 iav~z~e~t ~: Een o~T ~r~ (,e.(~cr~ ine..-~- w : Il b~ a~~ Beene ~,S~~~y ~ i~Sk~ ~ +~ la r.,,~~teS r ~~ ~ ` Il C ~~~-~-- f";~/~ S~ar~ ~ ~' r.~~ sly I T ~~~~.