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Home My WebLink AboutSchloss, Elizabeth~ 5~FF0(X~~G~ ~ ~ JUDITH T. TERRY ~~ ~Ot' Southold Town Clerk ~! 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 Telephone (516) 765-1801 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 ELIZABETH SCHLOSS A PERMIT FOR THE PUBLIC DISPLAY OF FIREWORKS by said organization in accord- ance with the provisions of Section 405.00 of the Penal Law of the State of New York, ON Wednesday, July 3, 1991 at 9:30 P.M. at Southold Bay, Southold, N. Y. ' RaindatP~ Th~~rsda~, luly LL, 7991 at Q~30 P_M_ '~ 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 building, public highway or railroad, or other means of travel, and at least fifty feet 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 inactive 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. 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 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 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. Judith T. T~ T~ Jerk Town of Southol (TOWN SEAL) Suffolk County, New York June 10, 1991 Date THIS PERMIT IS NOT TRANSFERRABLE ,;E. ~ `~ - Issue DATE (MM/DOnr) THIS CERTIFICATE IS iSSUcD AS .~ AiATTER OF INFORMA710N ONLY AND r1100ucER # 74A CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDEA. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED 8Y THE Tanenbaum-Harber CO. , InC. POLICIES 9ELOW. 320 West 57th Street COMPANIES AFFORDING COVERAGE New York, N. Y. 10019 coMPANY A Gotham Insurance Company LETTER COMPANY $ Industrial Indemnity LETTER INJURED COMPANY LETTER Fireworks By Grucci, Znc. One Grucci Lane COMPANY D LETTER Brookhaven, N. Y. 11719 COMPANY E LETTER TED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LIS RM OR C ONDITION OF ANV CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TE CERTIFICATE MAV SE ISSUED OR MAV PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES. iOLIOY EFFECTIVE POLICY EXPIRA710N LIYITB CO TY-E OF INBURANC! POLICY NUYlER DATE (MM/OD/YYl BITE (MM/OD/VV) LTR BODILY INJURY DLL. ~ i GENERAL LIABILITY MM037045 11/13/90 11/13/91 BODILY INJURY AGG. f COMP. FOAM/BR. FORM LOL PROPERTY DAMAGE OLC. S I PPEMISES/OPERATIONS UNCEAGPOUND *Appl ies t0 PROPERTY DAMAGE AGG. S E%PLOSION b COLLAPSE HAZARD PrOdnCt S/ BI b PO COMBINED OCL. S r I PRODUCTS/COMPLETED OPER. 0 ~ S ~~ COm leted P BI 6 PD COMBINED AGG. , r ICONTRALTUAL Operations PERSONAL INJURr AGG. 000 00 f 1 r INDEPENDENT CONTRACTORS GE BROAD FORM PROPERTY DAMA X PERSONAL INJURY AUTOMOBILE LIABILITY BODILY INJURY (Par psrlon) f ANV AUTO ALL OWNED AUTOS (Prrv. PAea. ) ODDILV INJURY (Per scaOmq S Olnsr Ttun ALL OWNED AUTOS ( pnv Pne. I NIREO AUTOS PROPERTY DAMAGE S ~~~--yyy I I NON~OWNED AUTOS L--I BODILY INJURY 6 S I I GARAGE LIABILITY PROPERTY DAMAGE ~~ COMBINED I EACY OCCURRENCE S 1 , 000 , OO ,. ECLEBS LIABILITY TU9108243 11/13/90 11/13/91 AGGREGATE f 1, 000x00 p /yi'JMBRELLA FORM . OTHER THAN UMBRELLA FORM ~- j r ate o isp ay: ly 1 91 X X XX3iiFGXXXXX] ~C f X ~~~~F 7~3 Rain Date: e J No ,, , , XX C n XXXXXXX~t`g{XXXXX Location: Sou thold Bay, Sout old, New Y 4~~XINiXX} z ~ XxX~7c~kx ~ I X,~XsTCX~Cb{/X36Xdf1f Xf OTHER er i ica e q er an Elizabet Schloss; elrose Mar ne, Inc. Latham Sand and DESCRIPTION OF OPERATIONSILOCATIONS/vENICLES/SPECIAL ITEMS Gravel • Terry Latham; Town of Southold. l Insured solely as respects Fireworks Display indicated hereon. diti ona are Ad __ A r >, y SHCULD ANV OF THE ABOVE DESCRIBEC POLICIES BE CANCELLED BEFORE THE EXPIRATIOV DATE THEREOF TH'c ISSUING COMPANY WILL ENDEAVOR TO Elizabeth Schloss 10 OAVg wR:TTEN NOTICE TO THE CERTIFICATE MOLDER NAMED 70 THE #$ Cove Condiminium 0. ~• '~ ~ I FAIL T FAI CJRE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR FT B Southold, New York 11971 U LE _IABIUTV OF Ativ NiNC VPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES. , ~/ S ~ry~a sUTN D REBENTnirvE a • r • ' ' ~ ' + ' I ~•, FIREIJOkI;~ B'Y GF.UC~I -'_~ JUDITH T. T(:t~fzY Southold Town Cle, k TEL :51+=,-2`i6-gOJ6 ~ ~o~~EFa1k`o o p w ~ ~ifp! ~ r`a~~ Jun 03,0 1°:58 hJo.02~ F.02 --~.~.. Town Hall, 53095 Main Road P. 0. E3ox 1179 Southold, New York 11971 Telephone (51G) 7G5-1801 OFFICE OF THE TOWN CLERK TOWN OF 5OUTHOLD APPLICATION for PERMIT TO DISPLAY FIREWORKS , o ftheCPenaO1 Law ofEtRl NBState of ~Nlewr York, forla pe mit ito d sp ay f'oreworks Oas -- hereinafter specified: DISPLAY IS TO BC SPONSORED BY Elizabeth Schl ss ~(,S' ~ PRINCIPAL. OFFICE AT~ ~ ,~~_-7 .~^_ 7T- DATE OF pISPLAY Ju__ a~ 3E,d, 1991 TIME OF DISPLAY __ 9;30 Cz.m; RAIN DATE E TIME July 4th, 1991 9;30 p.m. The following persons are to be in charge of the actual shooting of the fireworks: Name Awe Ex erience ___i?________ Physical Conditlpn .john Stifanich ~ ~ 30 ~ g veers ._ E Marc Pennincgton `~ 33 ____ 2 ears ~•~ E_x_cellant ,: Number and type of fireworks is as follows: S eciai Effects and Illuminations - over 100 cs 5 eciai Fireworks Class B _~•over 3000 c~~^ ,;;. The fireworks will be stored in a covered truck prior to shooting on the graurtds. and in Dot approved 12-13-65 Cartons. Attached hereto and made a part hereof is a diagram of the grounds on which the display is io be held. Also attached is a certificate or policy of insurance coverar~e. ivmne of organization UJ-~`"7"~ s ,,. ay ~ ~ , Signature of Applicant""-'•~"~- ~~e ~' ~~~~1L. Date of Applicati~•o°