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HomeMy WebLinkAbout1983TOWN OF SOUTHOLD ~' ~ ~~ PERMIT FOR PUBLIC DISPLAY OF FIREWORKS 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 hereby GRANT TO ORIENT FIRE DEPARTMENT 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 July 3. 1983 at approx. 8:30 P.M. Rain D tP: July 4 1983 at aporox 8'30 P M at 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 point at which the fireworks are to be fired shall be at least two hundred feet from the nearest build- ing, public highway or railroad or other means of travel, and at least fifty feet from the nearest above ground telephone or tele- graph line, tree 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 of 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 fire- works display shall be held during any wind storm in which the wind reaches a velocity of more than thirty miles per hour, that all the 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 constant- ly on duty during the discharge and that a.t 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. DATED: JUNE 30, 1983 i /~C.Y'Ti . ~.... ~~i~ ~ cam---- J IT T. TERRY, Town Cle m- Town of Southold, Suffolk County, New York. S E A, L ~~ i THIS PERMIT IS NOT TRANSFERRABLE. r ~+ a ~, ~ i m . '"' r t rv ~ 4 f r` ~ z~ ~ ~ x ! ~ i ~y~1A, f ~ ~~>~ r y ~'~ ' " ti ~ 1 , a i ' U ., ~ s~ S~ J tfi % rsr ~ F w- sr y ~ ~ ~ h ~ ~ ~ Y ti `#4 ~~[~ 416 ~ ~~~ r ~ l eWi ) •9 ~ M d < • ! ~ ^ ~ I ~ ~ 1 LF'1r T S ~, ~ ~~ F "' ~ rs w ~ ' ~ ~ ~ r ~ , . APPLICATION T0: JUDITH T. TERRY, TOWN CLERK, TOWN OF SOtJTHOLD APPLICATION IS IiEREBY MADE, pursuant to the pro- visions of Section 405.00 of the Penal Law of the State of New York, for a permit to display fireworks as hereinafter specified: The display is to be sponsored by Civ ,' °//u f f- , e ~~°~~~ .with principal office at Qir~ Goo J r' ~ err "" ~ New York, and will be held on SKU~°< ~ ~'~~~ ~ day month 19~ at 3~ P.M. hour RAIN DATE:~rGt©w J a~ ~~i "~~' The following persons are to be in charge of the actual shooting of the fireworks: Name AA~ee Experience Physical Condition L N ~OK f 'N '2 ~~ ~ ~ ~ 1~7-~ it~4f~QUSO~ ~ 3s ~~/S~ ~ ! v~- , Ck[n/ ~/k l r ~xcr//ih -/ Number and follows : orks is as ew f fir tyge o A ~ ~ /~i'[-G(~ / iaf ~/~S ~i ~~ '/r l / ~u wl /fir// 1/4/°vN9 / F ~nN4/ / ~~r l(J vK ~0. The fireworks will be stored in a covered truck prior to the shooting on the grounds. \ Attached hereto and made apart hereof is a diagram of the grounds on which the display is to be held. Also attached is the certificate or policy of insurance coverage. Respectfully submitted, ~r, .,.. Five ~~ ~` name of/ organization By ~~~~- Dated: ~Cr,~Je '~~ ~ ~~ ~ at uD u.~~ ~ ~ Ne/w~ Yor-k-.y~ ~ r~-iI C-('mot-w- ~l-~'~ ftIiRBETN 11NN NEVILL~ NOTRRY PUBLIC, State of New York No. 528125850. Suffolk Co}Ulry/ Term Expires Marth 30, 1 -/~ el~i/\/ynY_-i(~1i\/lei-i\Il+liT~~ __-. -~-. -~...-a-.~-~-~~...-a-.v•.. - ~IS;Na:II1fIN:i I>•LyFSY11 LZFynta',L\ i ia:LlaRl SN:1;.F\RN.`~Eldl\~:\PUiNHPIi ia~:[.1:nx:1 F<nSN: ~GI><waiila[N~tla:[N1N§:. ~~ ,•. iiLIRIN~S(L1[N9/>•.L7aF12L4ZTId1ZU)•fiii:h=.l:a_l~ia:lT.lalNpva:LiflZ11L.I:T7a.1:17i1.1a•Y.nrll~'1~69a.7:Tau1s- NAMF AND ADDRESS OF AGENCY ~ - - --- Roy H..Reeve Agency Ins. I COMPANIES AFFORDING COVERAGES Main Road PO Box 54 Mat6ituck, New York 11952 COMPANY A Travelers Insurrance Company LETTER COMPANY LETTER NAME AND ADDRESS OF INSURED Orient.Fise District O:chard Street Orient, New York 11957 This is to certity that policies of insurance of any cont2ct or other document with r terms, ezdosions and conditions of such COMPANY LETTER COMPANY D LETTER COMPANY E Travelers Insurance Company LETTER [he insured named above and are in force at this time. Notwithstanding any requirement, term or co may be issued or may pertain, the insurance afforded by the policies described herein is subject to . COMPM{V Poucv Limits of Liability in Thousands (000) LETTER TYPE OF INSURANCE POLICY NUMBER F%PIRATION DATE EACH 1 _ AGGREGATE _ OCCURRENCE GENERAL LIABILITY - A ©coMPREHENSIVE FDRM 650-606E159-A-Ind-81 9/26/®3 BODILY INJURY § 1,000 E 1 000 , ^ PREMISES-OPERATIONS PROPERTY DAMAGE E § ^ E%PLOSION ANp COLLAPSE HAZARD ^ UNDERGROUND HAZARD --_-' ^ PRODUCTS/COMPLETED OPERATIONS HAZARD ^ BODILY INJURY AND CONTRACTUAL INSURANCE PROPERTY DAMAGE E b ^ BROAD FORM PROPERTY COMBINED DAMAGE ^ INDEPENDENT CONTRACTORS ^ PERSONAL INJURY ___ E PERSONAL IN JURY AUTOMOBILE LIABILITY eoDlLV wJUav MPR ^ C (EAC H PERSON) E O EHENSIVE FORM BODILY INJURY EACH A E ^ OWNED CCIDENT) ( HIRED PROPERTY DAMAGE b __ ^ NON~OWNED BODILY INJURY AND 11 PROPERTY DAMAGE E 1 COMBINED EXCESS LIABILITY -_ --- - - ^ UMBRELLA FORM BODILY INJURY AND ^ OTHER THAN UMBRELLA PROPERTY DAMAGE E 8 COMBINED FORM WORKERS' COMPENSATION STATUTORY d an -- EMPLOYERS' LIABILITY § leu:rv ncrloerv OTHE 1 St -_ ory reme E Bldg. 650-6DBE159-A-Ind-81 9/26/83 f5D,00D Fire Cavezage Onl; DESCRIPTION OF OPERATIONS/LOCATIONSNEMICLESFireworka Die play Monday 7/x/83-Rain Date Tuaa 7/~/®3 from the property of Orient Wharf Co.Ine. known as Orient Wharf, V311ase Lane, Orient, New York Liability coverage for addal insured of Orient Yhart Co. Inc. 3/or Orient Yacht Club. Cancellation: Should any of the above described policies be cancelled before the expiration date thereof, the issuing com- pany will endeavor to mail _ days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: Orient Mharf Co. Inc.B/or Osient Yacht Club c/o Floyd F. King Jz. 22420 Mein Road Orient, New York ~teg~ AGORD 25 (1-]R) DATE Issueo: June 13, 1983 ~f~ ~. r ~~' ~U H E PRESENTATIVE Or; sN f ire. ~~r~ty~TWt~ y ~ .. ~,,;~~~y T~i~ 3,~y~3 F; r~ Wdr~ (~ir~/a - - Z LoKg,~s /aK~ Sam ~, e~. ----'%^ pR,t~~UT /~-R, gQ ~ ~\,\. .- ~~ ~~~~ ~y. .~ ~ '~ ~ ,ti. ~~ ..,,;= _~y~-f ~ A .' ~. S:Y~ o F ~:,ew~v~S Dj s(~ta~/ ~ea.ch STa'~e ~q y Cra vo~;h s rs r3ci y