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TOWN 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 2, 1978 at 8:30 P.M.
Rain Date: July 3, 1978 at 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 Southol
DATED at SOUTHOLD, New York,
this 21st day of June 1978•
J~TDITH T. TERRY, Towfi Clerk
Town of Southold, Suffolk
County, New York.
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22420 MAIN ROAD. ORIE NT. L. L. N. Y. 11957
O(I.. 151 81 323-2 5]0 - flea: 15161 323-2613
This endorsement forms a part of Policy ~k12 SMP 310863
Orient Fire District
Orchard Street
Orient, N.Y. 11957
Effective Date July 2nd.
ASSOCIATES
MARILYN P. NORKELUN
323-3649
W ILMA HOFFM EISTER
765-5532
This endorsement provides coverage under section 405.00 of the
penal Law of the State of New York.
In consideration of an additional premium it is agreed that
coverage under Sect. 1 liability is afforded for a firework
display by the Fire Department on village wharf, Main Street,
Orient, New York in behalf of the Town of Southold.
As respects this event, The Town of Southols is an additional
named insured, in the event of rain on the day, coverage will
be afforded for rain date: July 3rd.
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P. O. Box~~ ~ Tel. ORienc ~i-
~/}~~ ORIENT TRUCKING & CONSTRUCTION CO., Inc.
!~/ Ronear Doacnwss, Pres.
ORIENT, LONG ISLAND, N. Y.
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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 specified: ,
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The display is to be sponsored by c°
,~~~~~~-(~~'; with princ~ office at
New York, and will be held on ,
~7~ day ---~month~
h~our~ RAIN DATE:
The following persons are to be in charge of the
actual shooting of the fireworks:
Name A~e_ Experience Physical Condition
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~~l n S S X~~~h! ~Q °~ ~ ~r O D
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Number and type of fireworks is as follows:
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The fireworks will be stored in a covered truck
prior to the 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
the certificate or policy of insurance coverage.
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Dated: 6 //.s/7a
at ~ o .~ New York.
6~ ~, a.
Respectfully submitted,
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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 specified:
The display is to be sponsored by C
fiR e /~P~/ , with principal office at ~~/P~~/~Y
New York, and will be held on ~~ ~ ~ /!
day month
19~, at t~~ D P.M.
hour RAIN DATE•
The following persons are to be in charge of the
actual shooting of the fireworks:
Name cam. age
,g. SPA s ~ /YoR k,C cal _~
Experience
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Physical Condition
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Number and type of fireworks is as follows:
The fireworks will be stored in a covered truck
prior to the 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
the certificate or policy of insurance coverage.
E
Dated:
at ~ New York.
Q ._t~.-a-2.
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Respectfully submitted,