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TOWN OF SOUTHOLD
PERMIT FOR PUBLIC DISPLAY OF FIREWORKS
I, JUDITH T. TERRY, Tocan 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
A PERMIT FOR THE PUBLIC DISPLAY OF FIREWORKS by said organization
in accordance with the provisions of Section 405.00 of the Penal
Laca of the State of New York, on T„~~ a, T aszn at 8.39 ~~~
Ra'
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 Southolc
DATED at SOUTHOLD, New York,
this 26th day of Tune 19,7.80
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JUDITH T. TERRY, To Clerk
Town of Southold, Suffolk _
County, New York.
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22420 MAIN ROA D. ORIE NT. L. L. N. Y. 1195]
Olt: (5181 323-25]0 - Ras.: 151 61 323-2413
June 12, 1980
To Whom It May Concern,
This is to advise you that coverage for a
fireworks display at Village Lane, Orient has been
requested by a representative from the Orient Fire
District.
The requested coverage will be the same as in
1979. If there are any changes please advise.
Very truly yours,
`'~t.O~,~d.~- pie-~"~~~
Floyd F. King, Jr.
ASSOCIATES
MARILVN P. NORKELUN
323-3649
WILMA HOFFMEISTER
765-5532
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APPLICATION
T0: JUDITH T. TERRY, TOWN CLERK, TOWN OF SOUTHOLD
APPLICATION IS HEREBY 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 specifi~eAd: ~
The display is to be sponsored by /yf9'/(%/~ ~ Fi R e
t ~, with principal office at ~G ~i~ ~ ~ r
~Ne~ ork, and will be held on TH , TN
day month
19_~ at O P•P'I•
hour RAIN DATE:`
The following persons are to be in charge of the
actual shooting of
Name
~nL o ~' ~T ~e~t.Q
~oh~a~~..~owa~
Jett ~ R, f)o wG.
the fireworks:
Awe Experience Phvsical Condition
WSJ ~.~ -,~~~`e • ~ o o D
Number and type of fireworks is as follows:
F.~R ~ iy a /X. /r_~_~' fl ~ /S'~ S.4 a p"S
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,
name of or~~fization
Dated: ~
at non 40S1'~~' New York.
t6~ ^tl0 ~ `(CS Pu~?~
DIANE M. VOLINSKI
NOTARY PUBLIC, Sfata of New York
No. 52.4633608, Suffolk Cou,
Term Expirac March 30, 1
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1~~ ORIENT TRUCHING & CONSTRUCTION CO., Inc.
Romcnr Doucuss, Pra.
/~ w~~ ORiHNT, LONG ISLAND, N. Y.
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