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HomeMy WebLinkAbout1998 ELIZABETH A. NEVII,LE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER =o~~gUFFO(~-~ G ~' x ~ • ~ ~~l * ~ao~ 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)765-1823 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 CRANT 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 ONOCTOBER 23, 1998 BETWEEN 8:00 P.M. AND 8:30 P.M. on the property of GREENPORT 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. Elizabe~ ," ~ T wn Clerk----- Town of Southold Suffolk County, New York October 20, 1998 Date (TOWN SEAL) THIS PERMIT IS NOT TRANSFERABLE -+~ - . JUDITH T. TERRY O~y~.~ ~ Southold Town Clerk ~1 ~ ~.a~ OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD RKEIVE~ A PPL I CAT I O N OCT 14 1998 for Sadhold Town Cleric PERMIT TO DISPLAY FIREWORKS Town Hall, 53095 Main Road ' P. 0. Box 1179 Southold, New York 11971 Telephone (516) 765-1801 APPLICATION IS HEREBY h1ADE, 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: ~-. ; DISPLAY IS TO BE SPONSORED BY PRINCIPAL OFFICE AT DATE OF DISPLAY lS TIME OF DISPLAY ~'- 8-,'3U~r-/ ~'-iori-.+ ,S/'o« RAIN DATE S TIME The following persons are to be in charge of the actual shooting of the fireworks: Name Age Experience Physical C,~on~dition it S ~ „?v? (/furs ---~~." ~' -~r,~ ~3 7 ~~r s -~~ _ Number and of typ e fireworks is as follows: _ /~U 9 ~ ~Gri-e- e an ~ ~ur ,'mac ~ C'~crss ~ ~i~w~~~ 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. Na a of Org niza i B °i7 -ago, ignature of A plicant Date of Application 30o t'e_e_~ C`eo.,S'c.ticv ~v~ c;~li ~~<ec-~-:MKS 1J~ !-:;c,.~~:ks ~~zlls b:55e~ `~.4~,. ~;n~~ ;n ~i~rn~~ef ~: men o.'' {- : ~ ~ i-%2 (.~G: ~ M e..-~ w , l t b~ O ri SC2Ne _--___-- ~ry^~ S~ _____ ~r~~ _ 10/97/0: ACT 14 "~S ltd ~ U4Hf9 F~ll !Fr'-~ E ~ ~ FIUf {~Hf~EY ~- S". SS'~' CERTIFICATE f~1F IN~lJ4~41W~.%!•`: ' '.:)asfh: t)Ctaa~sr 7, 1988 Bo:OWN AND lFYIJD~F[>piEY, tNC. { $Aj~PBAivC~s~AG 94104 j~ Fi~rpworks By Giron® tE140 Gardsn Road 'e,,~i, e~su:,c~l t. :, 51:c41: ~.: pa ;aria. Ercluv 1, ~, nlar E+ a::wd as . L,., :ter otinfo c'..r.r.,m tktc.~ ~.-,ailtinateholdi ,t:i .,G~r,'~ rD oofrera 3l~ ~`k7°a, ~'i''~,.'.;p8t3ora ,,.,. ~L. ,..._ F,3 Vaneland, NJ 4®9B0 ~ m(:a~,,P ~ , „r~ r,~ ~ ~stUoyd's, London ~,~ n.~r E?__, /J ~C;'ti t'a't:r anon __ GUVERAL E5 'R,Y b b fYlitA' that the peliciea I'ulz[ peiaa have bem iwued W he taleil0 ie ~ ir,~•- ! h• aiu , , E< a.iawed. Notvimltao0to~ ~y ,. ~ c~, ~+ w~' Pe1W~, the ielWatdE t f requiaefneo4 ~'4 tM medili0n of aoy .AeYmCI of other Iteeufnent .-uh rolpaC,. ~.. t ._ : b l"'AIiC ! de~rieed herein s 1uDierS foA1 ~ iaS.lCC C+ln!11 t '~.,1"' I . , , i, y irmits In 10 's Li - ~ Pokey Fes ,~~ _., • I. Co Type Of ~ Poiioy Effectiv¢ ~ci,~ratice~ ~ each aaccidenR A re are ~~1~ Ltr Insurance ~ Number Date ~ ... __.•._• _. natal Liability __ _ V ~ I ,I:MPi ~::~.wf:•"n: 3 '~.~, 4r~~r 1•~ IlremiaecJ4pet'e40a!! ~ i; ~c ~ ~ I ~9e1a2o71~0 oSlot/~+s ! c. _, a. , ;:, B Opetatiooa I ,,.;~;,,n., mCl, IACI. ~ ~~ EXCeSB Lladility ~ ~~ y FI r _ ~ ~ Vm Ih ; mt:dr, ~ - ~~~ bnlla ,~~ aa Otber' corara®C'dosa nor ePPb a BCdilti 1nJtuy or personal 1C)tlry m, or 'aw, a' Cao~; r c~; r i.s~ ~ =)~a,etefafika)..ndtn. any mee e tndudin wtmlea /e ' ' fin N wa in lbe ahueti aeWO: E , ? Type of Display: irework^ w ~~l air . , ..... . ~ Site of Display: Gr+senps t .a , ~; ~ ~~ ": oat® of <yisalAV: Jctober w 3 ~ a'.)i'r ._- ..___._ - - Additional Insureds taiti) respect to tha above Qas,,, ~; a:'~ )~ t) Cireenport Youth Al.tivttiss 2) Gre®nport Fire Department 3) Village of Grlaenport 4) Town Of South HOid -' -- 5) Grel3nport Public School t t.~r: 1 . n710~~ ~ ...w i t :~ /! ~ ,~ be anceted stlt,!!r4 .. rr _'.~),::d!, ,. :.e ~;'.;a, , ttSe lSBillR CfOa~~'~ ,;, iti , ,: ~":. ,~ :.. of . ~.a a - lxet~icste ttollter - ..mar.-~. ~wT2 una ncB ,ac ?h,p171 '~~;! ~epresentatly®: Greanport Youth Activiti®s ;:t a Knapp Place t~reenport Long Island, New York ' 194 %J' !. . ~ ' ' ~ ,.~v; ~,;~ ,. i t,~,ara.ti h~~ r:,0.CL9UM f3eCIt~W3 ) • i7CT 1d 'a° 1F)'E~3Hh1 T"~EITF'4"= _ ' ,-- R-•~ .. I ~I1 acof~o +~ ~ ~~~~~~~~~F~i~ ~r~~,~ PRDDuoeR (6)9)694-6222 FAX (6093694-2279 r 0! fhe Borelli Agency, Inc. I M< Dutch Mill Road At Malaga„ rl) 08328 aoe Attn: Antoinette Albertson Exs: .......... INSUREC. ._ ..... .... COA Vinl9land Fireworks, Inc,T/A Fi rl:works by Gi rone ' 1644 E. Carden Road C01 Vin El and, N] 08360 cor 'PH1515 TC C~~`fIFY THAT °~HE POLICIES OF~~INSJRAACE ! I;,Te7'eELb'+V HAVE~EEE`P INDICATEIJ, NOTWITRSTANUINC3 ANY RECWREMEN'f, TERM CR CONDITION OF ANY CERTIFI0JITE MAY BE 15SUEC OR MAY PERTAIN. THE INSURAEJC-e HFF0~4DE^ 8'~ TF EXCLUSiC NS ANC CONDITIONS OF SUCH POLICIES. uMl?5 SHC^iVN MAY HAVE P.EEl TYPE OF INSURANCE ~ ~ ~ POLICY NUMBER ~ POLIOV TA DATE( ,GENERAL LIABILITY : COMIdEFCIAI GENERAL LIaSiLITV ~, i rnr ~' ~ ~ CLAIMS tdADE ~ OCCUR ~' v: tbL. _. ..,.,.: OWNER'$ S CONTRACTORS PROT : AUTOMONILE LIABILITY -_ )(~ ANV 4UT0 ' 0.LL 9YYNE0 AUTOS A scH;DULEDwTDS ':68LHT172D4946-98 03/c ' ~' NIRED AUTOS X NON•DVmEO AUTCS GARAGE LIABILITY -•~ ~, ~~~~ ANY AUtG EXCE86 uABaITV '~. UMFIRELLA FORM ' OTYiER THAN UM9RELLA FORM WCRREf:B COMPENSATION AND ~-•_- ' ' EMPLOYERB'uABILITY ' B TYiE PRCIPRrETOR! ~.X..: INCL ~'1~~-9-03-02717$ ~'. G'S/ PARTNE RSSEXECJTIVE OcF!CEft4 ARE: : EXCL ~, OTN -- D SCRIPTION OPERATON LOCkTION 2NtCLE51 BCIALITEM i5play !)ate: October 23, 1996 ain Data: TBD xx u~f ~:.n< uk ~',Y'k6:....mt YA; l4k-. Si. ..~. .'fr:~ 5. .m... v fS'.. i/ i GI'eenport Youth Activities a:.a Knap Place Greg2nport, L.I. , NY A A@„W'~~~'~(~~'r3 v y ~ h S.yx~ ~ ,Y iY e3` as ~. JJ j,~ 5~~ A~ l 11 ~~ If ~. r~ 'c x N) ~ y f ', i " Of ii IE ::. c I I R -!. ':: ti'.vCS aFI :. r M , 1>n, J .. . ..f a ,,,~, 5 ' ~, , 7 ,I 5= FO~~TME p~C)uCV PE~ti~ib " . ~ • RESPECT TO'NHICM TfiiS -f '. ~ '.ECT'tO ALL ThE TERMS, '.I'.': n: I,,... LIMITS w ~~, ! -~- ':E ~ ,G REGATE S 'F i'-CDrdPIpP AGG S .. ~ .. .. :-E ~r a ADv INJURY ~ S is ~, ~;,;RRENCE ~~ ~ : S .. 1f-0E(Any one 4te) ~3 ":any One perxon) $~ : ~ L SiNGL,E LIMIT 5 5,':)00,000 f 1URY S .. ~.) S •, )'JRY .~ ivlt) +~ V:i'TI DAMAGE 5 a . ~~ EA ACCIDE f 5. I YaNIUT'O DNLYI ~° 1 ~'%%,) t~F `~• Et CN ACCIDENT S AGGREGATE 8 .r ,;:JRRENCE i4 x :i ~L MIS X ER fia, ~.' kh„,~>t. o3E•PCLICVL1Mi" SSOO,000 " r '~'I .: I OO , OOC ' "+:~E • EA EMPLOVFE $ SOO , OOO ~^ ~~ f ~: ~, , , , _ r , U . ~' - R ,..ICIC9 8E CANCELLED @EPORE TH v .J 'P... ,~,., . "I c'., .: y'~.~ :1.MPANY WILLENDEAVOR TO MAIL' L .. ` "I_ , „^..... ~' : TVFICATE NOLOER NAMED TO T {E LErr, . ne r. JT ~~. ~:_: ]F ~ _.'MPOSE NO DEL{OATfON OR LIP BIUTy ,.. C_J .. .1611 ^ . '.'F'JTS O0. REPRESENTA11VE8. __.. J L L. r t ,..,. _ _ ._ ~~Y M