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Home My WebLink About1977., r TOWN OF SOUTHOLD PERMIT FOR PUBLIC DISPLAY OF FIREWORKS I, JUDITH T. TERRY, Tocan Clerk: of the Tocan of Southold, Suffolk County, New York, being an officer duly designated by the Town Board of the Town of Southold £or this purpose, DO HEREBY GRANT TO Midway Amusement Inc., & Southold Fire Dept. A PERMIT FOR THE PUBLIC DISPLAY OF FIREWORKS by said organizati_an in accordance with the provisions of Section 405.00 of the Penal Law of the State of New York, on Fridav Aueust 5,~g~'7 - 10:00 P (Rain Date Saturc3av A„m,e+ Fy~10.77 ~ n nn p ~g~~_ at the time and place set forth in the application therefor. ON CONDITION THAT the bond (indemnity insurance) required shall. II continue in full force and effect in favor of the Town of Southol DATED at SOUTHOLD, New York, this 4th day of At__---'~'"-~- 1977~* DITH T. TERRY, To Clerk Town of Southold, Suffolk County, New York. S E A L __--~-__ CERTI FICATE OF INSURANCE CERTIFICATE NO.: X)g( 86" ' FIREWORKS COST:~S500.00 ^ AMERICAN HOME ASSURANCE COMPANY Q NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA. ^ THE BIRMINGHAM FIRE INSURANCI: COMPANY OF PENNSYLVANIA ^ THE INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA 102 MAIDEN LANE, NEW YORK, N.Y. 70005 This is to certify that the insurance policies specified below have been issued by the company Indicated above to the Insured named herein and that, subject to their provisions and conditions, such polfcles afford the coverages Indicated insofar as such coverages apply to the occupation or business of the Named Insured as stated. TN15 CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMM EN DS, EXTENDS OR ALTERS THE COVERAGE Is) AFFORDED BY THE POLICY (IES) LISTED ON THIS CERTIFICATE. Nom.oFinsured: NEW YORK PYROTECHNICS PRODUCTS COMPANY, INC. and Sponsors or Property Owners or Committees or Municipalities as Additional Insureds. Address: Association Road; Bellport, Long Island, New York 11713 ocoupeNon or sosinss: Fireworks Displays -Contractor Location of operations: Southold Fire Dept, grounds _ Aug. 5, 1977 Type of Work Covered: FI reWOrks Display DATE OF DISPLAY: Covooges PolieY Numbo ENeetive Dale ExPlretlen Dab Limks of Liobil lty Workmen's Compsnsotion - Statutory Bodily Injury Liability icyc each Other thon Automobile Fireworks Display 5119-71-75 6/19/77 4/15/78 ~ , , , , , , ,, , , , , , • , , eecurrsnce L I abl l l ty _ 5 ............... oggngets Property Damage Liability tir Other ihon Automobile , , , , • eeeunence rt Fireworks Display 5119-71-75 6/19/77 4/15/78 Liability 5 ... .. .. ........ epprsgete Automobile Bodily Injury each Liability 5,,,•........... Verson each $ „ eeeunence Automobile Property Demoge - each Liability $ ............. .. eecurrencs *`$1,000 000.00 Combir Single Limit OTE: to event rain or in lament weather prohibit t is display, overage wilt apply on ubsequent date on which is la is held within th terms of th is contract. Cleanup and policing of the display area are the responslDlll>:y or lane oponsor. 'Indicate in ihs space following the asterisk above the type or types of coverage afforded by the Dolicy. This Certificate Issued To: Name Sponsor: Southold Fire Dept. Address Southold , N.Y': Date Aug. 1, 1977 ec AulSorfzed Repre~enl live Iip6 21033 ' . Z"ihe CrystaCine (T~anu f acturinq Company, Inc. 700 Boisseau Avenue Southold, New York 11971 ® ® ® ~ ~ ~ ~ ~ ~ a Tel.: (516) 765-1844 ESTABLISHED 1920 August 3, 1977 To whom it may concerl~, Permission has been granted to the Southold Fire dept. to use our premises for the purpose of fire works display. On the condition that the bond (indemnity insurance) required shall continue in full force and effect in favor of the Town of Southold. Robert H. N kus President-Cr stal e Lc2 d ~~ z '~ a ,~,, .Q ~-~ _~ ~r~ fruClt F ,~ ~ r rr~ L- ~ -~ _.---_- ru G~ ~~,..~.. L 2~; d --~,o~d ~~ ~~ ~: , -~-$E`~~~'~z ~= ~' ~ ~ is.1 o I ~ L ~~ FiYL Tructt 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 ra~ a ~/~~Se tents, with principal office at f~as'~~ c New York, and will be held on ~ ~~ us`f day m nth 1g '7 ~ at /0.00 P.M. hour RAIN DATE: The following persons are to be in charge of the actual shooting of the fireworks: Name/ r ~ Experience Physic//~~al Condition re~i'x Gr~cc l ~Jr. 26 8~-/r3. CYOe~~ CSr CG /~(U r,~~ ~~ O VYS. C-Oes C7` N`u~mber and~/type of firewo/rks is as follows: y L~ "/Y~r~~c. ~ S/tie/~5 D ~ ~..~ ~. /e S/z e /~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 organi~~tion T- BY ~C,Lv~ Dated: at New York.