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Home My WebLink About1986~ SVFFU(XC~~~ Town HP II O 53Box n1179 Road Southold, New York 11977 ~ ~ Telephone JUDITH T. TERRY ~.~ ~~~' (516) 765-1801 Southold Town Clerk 0.(~ OFFICE OF THE TOWN CLERK 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 here GRANT TO SOUTHOLD FIRE DEPARTMENT A PERMIT FOR THE PUBLIC DISPLAY OF FIREWORKS by said organization in accord- ande with the provisions of Section 405.00 of the Penal Law of the State of New York, O N Saturdav, September 6. 1986 at 8:30 P.M. (rain date Sunday. September 7. 19'86) at the property of Southold School District. Oaklawn Avenue. Southold. New York 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. Terry, Town C rk Town of Southold (TOWN SEAL) Suffolk County, New York August 28, 1986 Date THIS PERMIT IS NOT TRANSFERRABLE ~ S~FFOG(r~~~ JUDITH T. TERRY O,y~~ ~ Southold Town Clerk '~7Q1 ~ ~la~~ OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION for PERMIT TO DISPLAY FIREWORKS Town Hall, 53095 Main Road P. O. Box 1179 Southold, New York 11971 Telephone (516) 765-1801 APPLICATION IS HEREBY MADE, 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 Southold Fire Department PRINCIPAL OFFICE AT Main Road - Rt. 25, PO Box 397, Southold, NY 11971 DATE OF DISPLAY Saturday, Sept 6, 1986, (raindate - Sunday, Sept 7) TIME OF DISPLAY 8:30 PM RAIN DATE & TIME as above - 8:30 PM The following persons are to be in charge of the actual shooting of the fireworks: Name Vincent Grucc Miles Taylor Sal Camarada Acme Experience Physical Condition 22 4 years experience excellent 23 3 years experience 22 3 years experience Number and type of fireworks is as follows: SOOaerial shells. Class B special fireworks. excellent' excellent 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. 'ou7Hc7C.i~ ~~~~ Name of O,raaniz SignattiFe of Aj~/plicant Date of Application ~~;~Ll~ G. ~~S~~t=~ ('=7 Ass IS ~ I~,~r c c-~ I t-F [`l{,~u2wtv~N ~ R~t~weRKS CaiMWll7iC-~ PF.G000ER P:cghorn Island Agency, Inc. 3 ILZrbor Raid Colcl SprirxJ [lart~or, NY 11724 IruuRED D!Y Pyrotedlnic Producl-s Co. , Inc. Fi_raaorks by Cv1.~L1C C1. association Raid P.ellport, Nl DATE In~hvoonv7 THIS CERTIFICATE 7S ISSUED AS A MATTER OF INFORMATION CNLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DGES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED HY THE POLICIES 9EL0'N. CO,'~1S~=.il1C5 .4FFt7RG1iVG CO'J~rZ&GE cc:APANr A - - L~TTEa Lexingtol "^'APANY ~ - LETTER CCMPAHY LETTER CCMPPNV LEr. ER CCS+PA.NY LE%Ea Insurance Cort>p<~ny TH15 !S TO CERTIFY THAT POL'GES GF iNSUAA*+CE ! .STED BELC'N,HAVE BEEN !SSL'ED TO'He :`ISUH'eD 'JAtdED A_OVE FCR THE r`C! !C°. PERiOO:PICiCA TED. NOT`.NITh'S i AHDING ANY REOUiREME2IT, TERM GR CCNDI7;CN G ANY CGNTAACT CR OTHER DOCL'YiENT 'NiTH RESPECT TO 'NHiCH i HiS C°RTIFIGATE SLAY HE ISSUED CR .'dAY PERTAIN, THE INSURANCE AFFCRCc0 BY THE POLICIES DESCRIBED PEREIN i; SUw'EC7 TO P.LL THE TERMS, EXCLUSiCNS. AND CCNDh TICNS CF SUCH PCL'C:ES. ' CO TYPE OF :NSL'n'ANCE PCLICY NUfd6E R ~ / - ~- P ~~ "• L LiAd L' ~ NITS iN THCUSA\05 - LTA~ . Ca c n~ ~~vn pa c ~. fir; ,,,; lYl ~ 'A ~~ ~.,cruaa. CE AGCae A ~`. _ ~ n. GE ~~ NERAL LIABILITY ~ ~ ~ ~~~oloII n/lo/as 4/lo/B7 HGD~LY IruuPV ! r 1 1 1 ` I COMPR°NEVS'~.VE FCRS1 S ~ ~ ~ S M S CFE4 1T ' ~ - I I ~ 1 1--.1 , JS ~ C~ UNDER RAJ^d0 ~ E%P 5 ~4 i -0~ 7-E P."ti;:RO i aaoc ~ C.~rnn ~ ~ ~ ~ E ,~~ < PRaehGSCGMPLr G^,P=_flAT;atis CGNTRACTUAL Certificate #~ 1,000, Bi a a0 CGNBiHEO 1,000, tt:CEP69GE"JT SGMRFCTGRS 1 1 ~_ /may' SPOAD FCRM PRCPER"/ D.ANIAGE 1riC1 . _ _ ' ti:'~ ' ~ PERSONFL INJURY 1t 1 7 l PERSvNAL INJURY ,IQ ___ . 1c . llraac form I A UTOMOBILE LIAHIUTY 'We/ I ANV AUTO r+iaa'+ xP a=nS:x1 ~" j - ALL OWNED AUTOS ;PRIN. PASS.) aoc:~,v ALL OWNED AUTOS OTHER THAN} PRIN. PASS. / v wuRV IP'.R FIX7CENn HIRED AUTOS PROPERiv - NON-OWNED AUTOS DAMAGE GARAGE LIABILITY HI a PD :~ CCMHwE01 ~ J EXCESS LIABILITY ~ ~ OMRRELLA FORM el a aC I CGLIBINED C V @ V OTHER THAN UMBRELLA FORM WORKERS'COMPENSATION ~ STnrUTCRV I = AND - $ (EACH ACCIGENTi _ _~ EMPLOYERS' LABILITY ~ ~ (OISEASEPOLICY L!"dlTl _ - ~ ~ $ IOISEASFEACA EhIPLCYEE OTHER DatC O~ D]_`ip1:1 :' ~ I~,in Dat-^ Septem r 6 19 6 ~ Se ter 7; 1986 i i p Sepptember 13 1986 ~ on oC U .:;p Locat ay pro er of Sputholi Public Schools (Site of infield) DESCRIPT!GN CF CPERATICNS;LCCATIGNSNEHiCL`cS/SPECIAL TE4!9 Southold Fire Department/District nddi I_ional In::,>u-cxl on]" als respects above FirEworks Display Southold Union Free School District t?o. 5 / Town of Southold Southold Fire Department P.O. Box 397 Main Road, Southold, NY x.1971 SHOULD ANY OF 'HE PIRAT1~„J DA?E TI MAIL -~U DAYS W LEFT. BUT FAILURE T( OF ANV KIND UPGN l 3ED PCLICIES HE CANCELLED BEFORE THE EX- ISSUING COMPANY WI L 'eNDEAYOR TO TO THE CERTIFICATE HOER NAA~EO. TO TM'e Attn: Don Fisher y ~~ R~ \~" b 0~ N~ ~i w 1' r' 1 • 1 a U 1 a rn ~~ ll- i~ l!) c 0 ~~ fa _~ V' 9 r, _( s. sartEU- f3~i¢ Iti1 D }~