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Home My WebLink About2008ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER ~o~~pF SOUlyO~ ~~ ~ ~~ `~y~~UNiV ,~~ OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD PERMIT for PUBLIC DISPLAY OF FHtEWORKS Town Hall, 53096 Main Road P.O. Box 1179 Southold, New York 11971 Fax(631)76b-6146 Telephone (631) 765-1800 southoldtown.northfork.net I, ELIZABETH A. NEVILLE, 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: GREENPORT FH2E DEPARTMENT Phoenix Hook & Ladder and Relief Hose #2 PERMIT FOR THE PUBLIC DISPLAY OF FII2EWORKS by said organization in accordance with the provisions of Section 405.00 of the Penal Law of the State of New York on FRIDAY. Julv 4, 2008 (RAINDATE: SATURDAY, JULY 5, 2008 AT 9:30 P.M., on the property of Greenport Public Schools, Athletic Field (west side of property), 720 Front Street, Greenport, New York. 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 fueworks are discharged and only persons in active charge of the display shall be allowed inside these lines; that all fireworks that fire a projectile shall be so se[ up [hat the projectile will go in 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 lazge body of water, then they may be directed m 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 conducted shall be immediately disposed of in a way safe for the particular type of fireworks remaining; that no fireworks display shall beheld 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 soda acid 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. All conditions and laws of the State of New York and the Town of Southold regarding the fuvtg of fireworks must be met by the permittee or their agents. ~: Y~> ~~o~.-- - Elizabeth A. Neville, Town Clerk (Town Seal) Town of Southold Dated: June 23, 2008 Suffolk County, New York THIS PERMIT IS NOT TRANSFERRABLE PATRICIA A. FINNEGAN TOWN ATTORNEY patricia.finnegan@town. southold.ny.us KIERAN M. CORCORAN ASSISTANT TOWN ATTORNEY kieran. Corcoran@town.southold. ny.ua LORI M. HULSE ASSISTANT TOWN ATTORNEY lori.hulse@town.southold. ny.us ,~!: OF SO(/T ~o °~~~~ ~ ~ ~~~ ~~y00UNt'1,~ SCOTT A. RUSSELL Supervisor Town Hall Annex, 54375 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1939 Facsimile (631) 765-6639 OFFICE OF THE TOWN ATTORNEY TOWN OF SOUTHOLD RECEIVED JUN 2 0 200II MEMORANDUM Southold Town Clerk To: Ms. Elizabeth A. Neville, Town Clerk From: Kieran M. Corcoran, Esq. Assistant Town Attorney Date: June 19, 2008 Subject: GFD Phoenix H8L and Relief Hose #2 Fireworks Permit With respect to your Memo dated June 9 in connection with the referenced matter, please be advised that I have reviewed the relevant documents and the proposed permit appears to meet all elements of the Town's policy regarding fireworks permits. If you have any questions, please do not hesitate to contact me. Thank you. KMC/Ik A. NEVII.LE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER ~O~~pf SOUIyo~ • ~~0,~ ~y00UNfV ,~",~'' OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631)765-6145 Telephone (631) 765-1800 southoldtown.northfork.net To: Town Attorney Patricia A. Finneg From: Town Clerk Elizabeth A. Nevil Re: Fireworks Permit for GFD Phoenix H&L and Relief Hose #2 Date: June 9, 2008 Please review all attached documents relevant to this Fireworks Permit and advise me of your determination. Thank you. Page 1 of 1 Cooper, Linda REzr}:tYED From: Fisher, Robert Sent: Thursday, June 05, 2008 3:35 PM JUN 6 2QOi; To: Cooper, Linda Subject: GFD Fireworks Southold Taws Cletl; Linda I have no reservations about the Greenport FD and their fireworks show scheduled for 7/4/08 on the Greenport H.S. grounds as per application. Robert Fisher Fire Inspector robed.fisher@town. southold.ny. us 6/6/2008 Page 1 of 1 Cooper, Linda From: Fisher, Robert Sent: Wednesday, May 28, 2008 9:06 AM To: Cooper, Linda Subject: RE: GFD Fireworks I have no objections. I will look at the site sometime before the event to make sure there are no changes. If I discover anything I will be in contact. Robert Fisher Fire Inspector robert.fsher@town. southold.ny. us From: Cooper, Linda Sent: Tuesday, May 27, 2008 5:12 PM To: Fisher, Robert Subject: RE: GFD Fireworks Do you have any objections to the fireworks scheduled for July 4 on the Greenport High School athletic field? It is the same location, same techs, same type of fireworks...only difference is there will be 600 shells instead of the 400 used for the May 24 event. Linda J. Cooper Deputy Town Clerk Town of Southold 631-765-1800 /. je may not be the parry we hoped for, but as long as we're here, we might as well dance From: Fisher, Robert Sent: Wednesday, April 30, 2008 3:06 PM To: Cooper, Linda Subject: GFD Fireworks Linda, I have inspected the site and have no reservations about the planned fireworks display scheduled for 10:00 PM on May 24, 2008 on the Greenport School District property at the indicated location. If any questions please contact me. Robert Fisher Fire Inspector robert.fisher@town. southold.ny. us 5/28/2008 Page 1 of 1 Cooper, Linda From: Cooper, Linda Sent: Tuesday, May 27, 2008 5:12 PM To: Fisher, Robert Subject: RE: GFD Fireworks Do you have any objections to the fireworks scheduled for July 4 on the Greenport High School athletic field? It is the same location, same techs, same type of fireworks...only difference is there will be 600 shells instead of the 400 used for the May 24 event. Linda J. Cooper Deputy Town Clerk Town of Southold 631-765-1800 L fe may no! be the party we hoped for, but as (ong as we're here, we might as we(( daze ~ From: Fisher, Robert Sent: Wednesday, April 30, 2008 3:06 PM To: Cooper, Linda Subject: GFD Fireworks Linda, I have inspected the site and have no reservations about the planned fireworks display scheduled for 10:00 PM on May 24, 2008 on the Greenport School District property at the indicated location. If any questions please contact me. Robert Fisher Fire Inspector robert.fisher@town. south old. ny. us 5/27/2008 April 16, 2008 Linda Copper Deputy Town Clerk Southold Town Clerks Office Southold, NY 11971 Dear Linda; I am forwarding you three fireworks applications. Two of the fireworks displays are going to be held at the Greenport Public School athletic field on the northwest part of the school property next to Moores Lane. I have dropped ofI' copies of the insurance and have filled out the permit application for the use of the school property. As soon as I receive the approval statement I will deliver them to you. I should have them know later than sometime next week. Res~ctfully yours,. J(' ~ ~~~~ Peter W. Harris Page 1 of 1 Cooper, Linda From: Spiro, Melissa Sent: Thursday, April 24, 2008 9:45 AM To: Cooper, Linda Subject: Firework Permit on GHS Linda, I have reviewed the applications for Fireworks Permits for: Star Hose Company #3, 5/24/08, GHS Athletic Field; and Phoenix Hook & Ladder and Relief hose #2, 7/4/08, GHS Athletic Field. Greenport School is not Town of Southold preserved land. Since this is not preserved land, I have no comment on these applications. Melissa 4/24/2008 ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATIST[CS MARRL4GE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER ,6p'~OF SOUIbp~ ~~~ ~ ~o ~ OI~COU~~ OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: Chief Cochran, Southold Town Police Department Robert Fisher, Fire Inspector Melissa Spiro, Land Preservation From: Linda J. Cooper, Deputy Town Clerk Dated: April 22, 2008 Re: Fireworks Permits for 3 Events Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631)765-6145 Telephone (631) 765-1800 southoldtown.northfork.net Transmitted herewith are applications for Fireworks Permits for: Star Hose Company #3, 5/24/08, GHS Athletic Field Mattituck Lions Club, 6/13&14/08, land off Sound Ave., Mattituck Phoenix Hook & Ladder and Relief Hose #2, 7/4/08, GHS Athletic Field Please advise if permits may be issued. Thank you. cc: Southold Town E3oard ELIZABETH A. NEVH.LE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER ho~~pF SO(/T~o~ • ~O ~~y00UNiY,~ OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION PERMIT TO DISPLAY FIREWORKS Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork.net APPLICATION IS HEREBY MADE, pursuant to the provisions of Section 405.00 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 PRINCIPAL OFFICE AT DATE & TIME OF DISPLAY , , ~ ,i EXACT LOCATION OF DISPLAY SUFFOLK COUNTY TAX MAP NIJMI RAIN DATE & FOR The Following persons are to be in charge of the actual shooting of the fireworks: 1e Age Experience ~- ~ ~ ~ ss ~~~ Y~« ~.1 ~ ~ ~,~ 7.QrrS (Additional names and information may be submitted on an attached sheet Number and type of fireworks is as follows: Phy ical Condition ~o~~ C~rn~! C«,~~ Manner and place of storage of Sreworks prior to _ _ Attached hereto and made a part of 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. NOTICE: Written permission, with signature of the Property Owner, must be submitted with the Application. to -~ ~~~ll, p2od~Q' . 1 Date of Ap lication 04/15/2008 Ia:52 FA% 856 897 9557 VINELAND FIRER'ORfiS CO. ~ 008 ~ yy, fl.( ry I •. Y 1~`(~f,,~ ,~1E,,~jry $ y~ o,r{;a~al~~ 1 i 5,_ 1 ( ' 1 .r...7 N 1 yl Ar l 1 ~ 1' r 1'f. '., ~ ~ n h h I~ dri ~ t tl4ail C~~ 1'1113 I AV~ ~ . r M I [ 1 ..r~` ~y `~, q~r,~yy 1 - r'.1 f :`I T '7ti ~ r~T 9 ~ Yr kl ~ ~ ~ ~ I , l ~ r ~ ,p ~ I ;M (I i'~ 1 ~e ~/n 'uwpr :11 T-M 1N ~ : ' 0:~~~ :- y , . I . . 4 PRODVGER THIS CERTIFICATE IS ISSUED A$ A MATTER OF INFORMATION ONLY AND Comldned Spedahkf Inlernatianel, Inc, CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, TryIS CERTIFICATE 8362 Tamarack Vllla(e DOES NOT AMEND, EXTEND OR LATER THE COVERAGE AFFORDED BY THE SuOe 119 POLICIES BELOW. Woodbury Mlnnegple 55125 WSURERS AFFORDING COVERAGE INSURER A: UnderwAlers, Lbyde of London INSURED INSURER B: Vlnelan0 Rrsworke G.r., Inc 1640 Gard n Road INSURER C: e VlnelaM Now Jertey ]8360 COVERAGES THIS IS T'O CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE NAMED INSURED A80VE FOP THE PERIOD INDICATED. NOTWfI HSTANDING ANY REgUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY E E ISSUED OR MAY PERTA W, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 5 SUBJECT TO ALL THE TERMS, EXCLUSNJPIS AND C ONDITIONS OF SUCH POLICIES NCLIIONG, BUT NOT LIMITED TO THOSE FOLLOWNG: LIM fT$ SHOWN MAY HAVE BEEN REDUCED BY PAH7 CLAIMS. ADDITIONAL CONDfiK7NS ANO EXCLUSIONS; 1) THE INSURANCE EVIDENCED BY THIS CERTIFICATE IS LIABILITY INSURANCE ONLY, fT IS NOT q BOND OR AN I FORM OF Sl!<iETY AGAWST WHICH 90MEONE OTHER AN •WSURED' MAY ASSERT A CLAIM OR BRNG ANV ACTION. SUBJECT TO POLICY TERMS, COEDIT10N,i, DEFINETKXTS ANO EXCLUSIONS THE INSURANCE ONLY INDEMNIFIES AN WSURED AGAINST CERTAIN LEGAL LIA81LffY, 2) THE NSURANCE DCES NOT COVER CUIMS FOR BODILY INJURY OR PROPERTY DAMAGE OF THE NAMED WSURED'S SHOOTER(S) ASSISTANT(S) OR ANV OTHER PERSOI I(S) WGLUONG ANY VOLUTEER(S) PARTICIPATING N ANY WAY W ANV DISPL,gY OR SPECIAL EFFECT PERFORMED OR EXECUTED BV THE NAMED WSf IRED . 9)COVERAGE DOES NOT APPLY TO CLAIMS FOR BODILY INJURY OR PROPERTY DAMAGE ARISNG OUT OFT}{E NSURED'S FAILURE TO FOLL01 I NFPA OR OTHER APPLICABLE REOUIREMENiS, LAWS OR RECOMMENDATIONS, WCLUDING THOSE RELATWO TO POST DISPLAY OR SPECIAL EFFEC-~~ SEARCHES OR CLEAN UP- fA TYPE OF I VSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE MM/DDlYYJ DATE (MM/DO A GENERAL LWf-.ILITY 11$0147479x007 uty 08, 2007 JWy Oa, 2008 EACH ACCIDENT $5.000,000 CLAIMS MADE MEDICAL EXP $5,000 (any one perean) FIRE LEGAL LIABILITY 550,00p GENERAL AGGREGATE $5.000,000 PFK)DUCTS-COMP/OPS AGG 57,000,000 AUTOMOBILE I~IABILfTY COMBINED SINGLE LIMIT $ (Ea acclden0 ANY AUTO BODILY INJURY $ ANY OWNED F:UTO TOS F (Per person) JJULEDF U SCH HIRED AUTOS BODILY INJURY S NON-0WNED , 111705 (~ °°'~n11 PFlOPER7Y DAMAGE S (Per Person) EXCE5S LIA&LITY EACH ACCIDENT S FOLLOWING FnRM AGGREGATE f WORKERS C011PENSATION WC STATU- OTHER AND TORY LIMEYS EMPLOYERS' L ABILETY S E.L. EACH ACCIDENT $ E-L DISEASE-EA EMPLOYER $ E.L. DISEASE•POLK:V LIMIT 5 OTHER DESCRIPTION OF DPI:RATIONSILOCATION$/VEHICLES/EXCLUSIONSADDED BV ENDORSEMENTISPECIALPROVISIONS GfeenpoA Flre Deparsr em ee apprtSer; Vllage of GrearpoA; Town of SoNhdd; GreenpoA Publlc Schosle; Greerpotl High Scholl antl fAue Sky Amusement are Atldabnel Insured as re ipaCls the JUty 4, 2008 (RD: July 5, 2008) FlrewoAa Display el GreenpoA Hlgh SchOOI grounds, Gre6npoA Long Island, NY CERTIFICATE HOIDET CANCELLATION Grearpod Flre DePeM ani SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE 212 Knapp Place THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE GreeOpoA Long Island, NY 11944 CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FA0_URE TO MAIL SUCH NOTICE SMALL IMPOSE NO COMPA N OBLIGATION OR LIABILITY OF ANV KIND UP N TH E Y, ITS AGENTS OR REPRESENTATIVES O / ~ / /NkMY/CIL ICt./K'~ . A ED REPRESENTATIVE 04/15/2008 17:5a FAS 856 897 9557 dINELAND FIREWORKS CO. f~009 .r~___, ris"`". '4. `~°°~ ':4'rmF'ICATE OF LIABILITY INSURANCE N0~ 901-P. 4/6,~--- "RDO1C~ 0856)694--2222 FAX <856) 694-2279 TENS CERTIFlCgTE IS ISSUEDAS A MAll'ER OF INFO/RAMTIONa The Bo-'elli Agelcy, I+1C. ONLY ANDCONFERSN 333 Dut[iT N711 Road HOLDER THIS CERTIFI OCA~GHTS UPON THE CEFtT7ROq-I~ P, 0. Box 376 TER THE COVERAGE AFFO~~ BYTTHE ~~~1EPID oW. Malaga„ N7 08328 INSUIZERgq,FpOROINGCOVERAOE Naslu~o inelan Fireworks, Tnc, wsuReRA N41C# 1640 E_ Ga•den Road Liberty Mutual Insurance Go, Vineland, 117 08360 ~~B` NsuREa c Bl9UREx R ~~,,,,'`~~ B17YRER E OF BEEN ISSUED TO FOR TERMS, BsERAL L1ABU.1r ~CBNMEnugl, aENER11 tAABII_17T' ClAa1$ w-bE ^ OCCUR TM ~~ ANVarro A(1 owM>D AU gyros laa~KeD Auros m~D Auros NowOWNBD AL rO5 ~dRAfiEl111Blun' ANTAVTO ~.~ aA~sw~o6 DEDUDT,au: aer6NrgN , WOPJQ:RS WMPEN94TIONA VD 6VPL01'1~S' LIABIIIIT' A ~~- °FTe~uDEeRn ~umt Isplay tlatep 7uly-4;°Z lin date; July S, 2[08 E7STIFICATE NO nFa Greenport Fire .)apartment 212 Knapp place Greenport LT, N/ 11944 ORD zs RooTrosl WOFi OOOURRENCB a DAMJGB O RFNIEp ! Mm Exp W~yaro oasay i veRS9wtiaADVlrylxyy s ~eB.uADCaewrE ! rROOUCrs-caNa~Drwco a c>tiwc sNatF uor ! eanrrpu~y (P~wrs~n ! BODaY wantr IPx+raAe~~ll a ~R]Y DnNAG6 'maaeM i AUTO ON~Y•6AACOID6NT ! OTHER T1~w PA ACC ^ AUTOORyY~ AGG a r s 1 s sxou~DAxroF71{eAaDyeoro~p~ep __~,,,~„ aw6UlTwx DATE TxaesOF, Tx¢reu B6~ronerxe l0 wo IwluRaa wig EwoeAVORTO wAw wrs YVRlrioi NDnC6 to THE OdtTl7GATE NOIAER wnrEa TO n¢.aT. BUT FA~URE TO wNL~ NO71CESNALLIHpOyN NOpB4bAT10N OR LMal,f1Y 1988 9/15/2008 1:53 FAS 856 697 9557 VINELAND FIRE{fORKS CO. I~j010 Inrn. 14L. Lwu~~ i:glrm - N0. 901~P, 1/6N,,,~,,,,,,,I AI~VIr-iN vcrc~ ~FICATE OF LIABILITY INSURANCE o4~la~zooa °11Opy~ (85~694.2Z22 FAX (856)694-2279 T1i1SCERTIFICATEL51&SUEDASAMATIEROFRVFORNWTION TBe Borel l i Age icy, Inc, ONLY AND CONF~S NO RIGHTS UPON THE CERTIFICATE 333 Dutch Mill Road A~LT~ERTHEH~`C~ER~TG~ OoRGbE~DIVgOYTAAAEPNODLICIE~~OR P.O. Bo>r 376 Malaga, , NJ 08328 INSURERS AFFORDING COVERAGE NAIC # vSvR>:D V1ne and ~ireYMpr s Co.,Inc. Du;Lr+I:RA: NATIONAL CONT2NEN7Al INS. CO. 1640 Gdrdcn Road wsweERe: Vineland, V7 08360 ~,~„ THE 70 THE OlS1ER THE sF~anLUAeIU v - - EACH000~ntrtENCE B toMMERCIA.ciENNERAL Lwe~.ITY ~ GIIJIAS MADE O OCCUR ' • lABO E7Q (A,b' WM pe,am) S PERSONAL6ADVDUURY S dfllERwL AGGREGAI6 S 4EHL AGORWAYi LIMI'fAPPIJEe rFx -PRO, PRODUCTS-COAM,OP AGO i rOl~lOY lOC u"°rDeiF,,,,o~' CN70006912747 a oa~zo/2ooa 04/2o/z0D9 X N/TAUTD L~«rBIH~D swOLE L.mi' 'eq~ s P110WN~AUT03 5,000 OOO A sa+mueorvros ~a~va~w;) ~ i NIRED AUYOS NOH.pYyrgp, JJT06 BppILY wJUIYY i (PaaQxan) ~~ d e q ~E B c. d (P GA FAGE LIABi.fN AU700HLY-FAACCIDEM S ANYAUTO OTNERTWW EA AOC i AuiO ONLY: Ado i E[CESSAnreiB31I LWBBJiY EACW OCCNWEHOE S OCCUR C ] aAIMS MADE . AQGREGATE i DWUCTIBLF t RE'TENYION i r ~lAND wC STA S f]IP,mIRStlYelul7 ANYPROPfLETaRNAR1lA'.tvExECU71VE OFFy 'f.EpMpABEA fiiC[U'.IBD'r EL EAOH ACCnv+i i M»s. Oa,aloa ur,ew E.L DIB6t5E- F.AEM1mLO i ay sate; July 4, 2 date; July S, 2008 G7~eenpprt Fire Department 212 Knapp PI~Ce 4reenport LI, NY 11944 ACORD 2a (2001lOS) sNOULO ANYpFTNeABOYE DESCRIBED PO,1pE9 De OANCEtIFD Bel:og6 trrE e1[PgtATN/N DATE TIIEnECP, TNC ISSUING DauR6R NBLL ENDEAVORIO YNl 1o DarBwalrtFa/NDnCE TO TNeCERTIgg1,Tq IN)LAER NAMED 70T1~LtiT. BUT PAB.URE'(O Wll such NOTIOE SNALL WPpeB Np OBVJGATgN OR LNBSli'f 1988 ~y a~b~ Sys 00 ~ ----~ S~,'P1,"'~i s P"°ps P"~"`J a~Ub~~a~ ~~~5 -~;s 6,~,,~,~ ~~~~~~~ ~ooD~ ' GREENPORT PUBLIC SCHOOLS 720 Front Street Greenport NY 11944 APPLICATION FOR USE OF SCHOOL FA( ~MI~ ~Y M Mn 1ec ^lne~ ee.•- The Administration is responsible for the use of all school facilities in order that request for such use, kindly complete the following: (Organization) v ~ h~~~-'~ the use of 1~1 D ~, ~~. 1 `~~8 ~1v consider %~ l~e~~.+t...f requests it Greenport Public Schools for the purplose//of , ' •• J ~ /u on (date) ~ Ju~/~! /~~-,-~oo~(~ J~,ls S-aoo~~ at (time) ~,ps-~ Will the actact-iv~be open to the public? PS Admission of /~~) will be charged; proceeds will be used for (;,2e.3,~/~ ~~ ,u~~`, Does applicant agree to submit financial records for examination upon requests? Yc Does applicant agree to conform to the regulations of the Board of Education and all laws regulating to the use of school property including Section 414 printed on the reverse side of this application? ~ Name r r~~S Addressai~~a~~ ace, ree.~ tiy~i/~ir~F~ Telephone # S~'l'I-,~~~ rJ of the person responsible on this occasion. II. Insurance Information A certificate of insurance of at least $1,000,000 public liability per occurrence and $2,000,000 aggregate property damage insurance shall be submitted at least three days in advance of the event and must designate both the using organization and the Greenport Union Free School District with ISO endorsement CG2026. The absence of such a certificate will preclude use of the facility. The policy must contain a 30-day guazantee notice of cancellation. The user agrees to indemnify the district for any applicable deductibles. III. Rules Governing Use of Facilities A. No smoking is allowed in the building or on the grounds. The organization using the facility is responsible for enforcement. B. No drinking of alcoholic beverages is permitted. C. Activity shall be restricted to that area for which permission is granted. D. Activity shall not extend beyond hours approved by the district. E. Programs shall not interfere with regular school schedule. F. Organization shall be responsible for moving its equipment into and out of the building. G. The supervisor of the activity shall be present before it is due to start and remain with the group until all have left. H. In the absence of administrative personnel, the custodian is charged with the responsibility of the building. I. School authorities must have free access to all rooms at all times. J. A careful examination will be made after use of the azea by the applicant who will promptly make good on aziy loss or damage which might have occurred. K. No school. property or equipment is to be altered or removed from the premises. L. This license is revocable at any time by school authorities. M. No reservation will be made until this application is returned and approved by the district's Chief School Administrator. IV. Rental Fees ~ Other Fees or V Signed Auditorium for performance $100 Auditorium for practice $ 50 Gymnasium for performance $100 Gymnasium for practice $ 50 When an approved activity takes place outside the normal hours of school operation, the organization will be chazged $40.00 per hour for personnel services for a minimum of 4 hours. This all must be paid seven days in advance and is not refundable unless the district receives notification of cancellation at least 48 hours in advance. I agree on behalf of the above-mentioned organization that all members and guests will observe the regulations and that we, individually, and as an organization, will assume all financial responsibility for any and all damages done to the Greenport School property during the above- mentioned period of use. We also agree that our organization will at all times hereafter indemnify the above-named school against any loss, damage or expense of any kind, which said school may sustain 'ncur because of the use of the above-mentioned building by our organization, and we f er will ol~aid scho harmless for loss of any kind in connecti/on/herewith. Date: '7/~/~ Applicant Granted ® Denied ^ ~~ Superintendent of Schools Specific Details of Use: Date: / ~ 0~ EXCERPTS FROM SECTION 414 OF THE EDUCATION LAW "...The Boazd of Education of each district may...permit the use of the school house and rooms therein, and the grounds and other property of the district, when not in use for school purposes, for any of the following purposes: For the purpose of instruction in any branch of education, learning, or the arts. For holding social, civic and recreational meetings and entertainments, and other issues pertaining to the welfare of the community; but such meetings, entertainment and uses shall be non-exclusive and shall be open to the general public. 3. For meetings, entertainments and occasions where admission fees are charged, when the proceeds thereof are to be expended for an educational or charitable purpose; but such use shall not be permitted if such meetings, entertainments and occasions aze under the exclusive control, and the said proceeds are to be applied for the benefit of society, association or organizations of veterans of the military, naval and marine service of the United States and organizations of volunteer firemen." Revised 9/1/2001 ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 7~5-6145 Telephone (631) 765-1800 sour holdtown.northfork, net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD PERMIT For PUBLIC DISPLAY OF FIREWORKS 1, ELIZABETH A. NEVILLE, 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: GREENPORT FIRE DEPARTMENT STAR HOUSE CO. #3~ THIRD STREET, GREENPORT 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 at 10:00 PM on Saturday~ May 24~ 2008; Raindate: Sunday~ May 25~ 2008 on the property of GREENPORT PUBLIC SCHOOL Athletic Field~ north side Front Street and east side Moores Lane~ Greenport ~ New York. ON CONDITION THAT the bond (indemnity'insurance) required shall continue in full forchand 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 feel 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 in active 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 in 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 &water, then they may be directed in such manner that the falling residue from the deflagration will fall in to such lake or body of water; that any fireworks that remain unfired after the display is conducted 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 &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 soda acid 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 &the display. ........ :7 ............. ~-~;~.-7 ............. - ..... Elizabeth A. Neville} Southold Town Clerk Suffolk County, New York (Town Seal) Date: May 22, 2008 THIS PERMIT IS NOT TRANSFERABLE Page 1 of 1 Cooper, Linda From: Fisher, Robert Sent: Wednesday, April 30, 2008 3:06 PM To: Cooper, Linda Subject: GFD Fireworks Linda, I have inspected the site and have no reservations about the planned fireworks display scheduled for 10:00 PM on May 24, 2008 on the Greenport School District property at the indicated location. If any questions please contact me. Robert Fisher Fire Inspector robert fisher@town.southold.ny.us 5/23/2008 Page I of I Cooper, Linda From: Spiro, Melissa Sent: Thursday, April 24, 2008 9:45 AM To: Cooper, Linda Subject: Firework Permit on GHS Linda, I have reviewed the applications for Fireworks Permits for: Star Hose Company #3, 5/24/08, GHS Athletic Field; and Phoenix Hook & Ladder and Relief hose #2, 7/4/08, GHS Athletic Field. Greenport School is not Town of Southold preserved land. Since this is not preserved land, I have no comment on these applications. Melissa 4/24/2008 ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: From: Dated: Re: Chief Cochran, Southold Town Police Department Robert Fisher, Fire Inspector Melissa Spiro, Land Preservation Linda J. Cooper, Deputy Town Clerk April 22, 2008 Fireworks Permits for 3 Events Transmitted herewith are applications for Fireworks Permits for: Star Hose Company//3, 5/24/08, GHS Athletic Field Mattituck Lions Club, 6/13 & 14/08, land off Sound Ave., Mattituck Phoenix Hook & Ladder and Relief Hose #2, 7/4/08, GHS Athletic Field Please advise if permits may be issued. Thank you. cc: Southold Town Board ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION PERMIT TO DISPLAY FIREWORKS APPLICATION IS HEREBY MADE, pursuant to the provisions of Section 405.00 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 ~-C~c ~_ C~c3w~ x~7 ~.--~ PRINCIPAL OFFICE AT DATE & TIME OF DISPLAY E~CT LOCATION OF DISPLAY SUFFOLK CO~TY T~ ~N DATE & TI~ The following persons are to be in charge of the at.al shooting of the firework: (Addition~ nines ~d infomation may be submi~ed on ~ a~ached sheet Number and Wpe of firewor~ is as follows: Manner and place of storage of fireworks prior to display: ~-~'7.~,,xvr-/~c ~ ~t,;[[ ~z~ Attached hereto and made a part of 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. NOTICE: Written permission, with signature of the Property Owner, must be submitted with the ~¢[am.~ of Organization Signature of Applicant I~ate of Applica{ion 04/15/2008 13:51 FAX 856 697 9557 YINELAN~ FI~WORKS CO. ~002 Sure 119 ~LICIES BELOW, SOVERAGES THIS I~ TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE NAMED INSURED ABOVE FOR THE PERIOD INDICATED, NOTW[] HSTANDING ANY REQUIREMENT, TERM OR COND FFION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS 3.ERTIFICATI~ MAY E E ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIDED HEREIN IS SUBJECT TO ALL THE TERMS, ~_XCLUSIONS AND E C. ND~TIONS OF SUCH POCICIP-~ INCLUDING, BUT NOT LIMITED TO THOSE FOLLOWING: UM ITS SHOWN MAY HAVE BEEN REDUCE D BY =AID P_AJUMS. ADD'~ IONAL CO~NDITIOCdB AND EXCLUSIONS; 1) THE INSURANCE EVIDENCED BY THIS CERTIFICATE IS LLABILR~' INSURANCE ONLY, rr IS '4CT A BOND OR AN'! FORM OF SURETY AGAINST WHICH ~IOMEONE OTHER AN 'qNSURED" MAY ASSERT A CLAIM OR BRING AJ'./Y ACTION. SUBJECT TO =OUCY ~RMq, COl JOITIO~S, DEFINITION~ AND EXCLUS/ONS THE INSLIRANOE ONLY INDEMNIFIES AN INSURED AGAINST CERTAIN LEGAL LIABILITY. 2 FHE INSURANCE DC'ES NOT COVER CLAIMS FOR I~DILY INJURY OR PROPERTY DAMAGE OF THE NAMED INSURED'S SHOOTER(S) ASSISTANT(S) OR ~ OTHER PERSOI .'{S) iNCLUDING ANY VOLUTEER(S) pAR~CIPATING IN ANY WAY IN ANY DISPLAY OR SPECIAL EFFECT PERFORMED OR EXECUTED 3Y THE NAMED ~ IRE0.3)COVERAGE DOES NOT APPLY TO CLAIMS FOR ~3OtLY INJURY OR PROPERTY DAMAGE ARISING OUT OF THE INSUF[ED*S -'AIL~RE TO POLLOt I NFPA OR OTHER APPtJCABLE REQUIREMENTS, LAWS OR RECOMMENDATIONS. INCLUDING ~-IOSE RELATING TO POST DISPLAY :)R SPECIAL EFFEC' ' SEARCH E-.B OR CLEAN UP, TYPE OF I '~SURANCE POLICY NUMBER U ~ILITY 1150147479/007 ANY AUTO SCHEDULED, ~UTO$ EXCESS LIASII ,ITT FOLLOWING F )RM POLLY EFFECTIVE DA~ {MM/DD/YY~ POliCY EXPIRATION J~ 05. 2oM WORKERS CO MPENE, ATION ? [ IABILR'Y LIMITS (any one pemon) P RODUCTS-COMP/OpS AGG OOMBINED SINGLE LIMIT -~a a~'Ide nl) E~ODILY INJURY [Per BODILY INJURY ~ar ac~dam) ~ROPERTY DAMAGE -~ACH ACCIDENT ~,GGREGATE NC STATU- OTHER )RY LIMITS ~:.L. EACH ACCIOENT :'.L* DISEASE-FA EMPLOYER ~,.L DfSE~E-POUCY LIMIT AUTHORIZED REPREBENTATr'~ 3ESGRIPTION OF OP _=FIATiONS~LOGA~ON~/VEHIC LES/E~CL USIONS ADOED BY ENDORSEMENT/SPECIAL PROVISIONS 212 Knapp Plac~ THEREOF, ~-IE iSSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRil'rEN NOTICE TO THE 04/15/2008 13:51 FAX 856 697 9557 VINELANI) FIREWORKS CO. ~L'" ~,,, -',--.-. ,FICATE OF LIABILITY' The Borel]~ Agency, Zflc. FAX 333 Dutch Iq~l] goad F.O, Box 376 Iq~laga,, N30~:28 [640 E. Ga Pden Road V~neland, N~ 08360 ~003 INSURANCE ~o.~o1 P. 6/6.;--~---~--~ o4/14/20o~ THL5 CL~'RTiF1C. ATE IS ISSUED AS A MATTER OF INFORMATiON ONLYAND CONFERS NO RIGHTS UPON TIlE CF-.RTI~IC..ATE - ,ORDED BYT.,. POLI,~. ES BELOW. INSURF.~,,~ AFFORDtNG COVER~G E NAJC ~ THE F'OUCI~.~ OF ~ RAN¢E LINED BELOVV HAVE BEEN I~b-'UED TO THE JN~IJRED NAMED AJ~OVE FOR THE POucY PERIOD INDICATED NOTWITIt.~TANDING ~ p~I~QUIREMENT, ~:[1:~10~ eoavmo~ OF ANY CoN'reACT Ce OTP, ER DOCU~ENI' WITI4 ~E~ERAL IJa~u- y ~~ ~ ~" ~" ~ , soo, datel ~y 25, ~OA~ HOLo~ Star ~se co. No. 3 of GPeenport F~ re DeparCmel t 212 I~napp Place Gl'eenpol~ [_T~ NY 11944 .CORD 2s (2o01/08) ~/t, CO~PORATiON 1988 04/15/2008 13:$4 FAX 856 697 9557 VINELAND FIREWORKS CO, - "- ...... "'~',-= OF LIABILITY INSURANCE ~:~m' ~ "2222 FAX (856)694-2279 The i~relli Agency, ~c, 333 Dutch M~ll Road P.O. Box 376 ~alaga,, N.1 0~j28 ws~ ¥~neland~reworEs Co.,Inc.' 1640 Garden R~ad V~eland, ~L1 0g~60 ~004 ~0. ~o~ .... ~, CERTIFICATE is ISSUED A3 A ~ER OF N~ _.,~R ~E ~G~ ~F~ BY THE ~LIC INSU~s ~ORDING ~tE POUQF_.~ OF JN~LI,_~__ C~ L~ i ~D ~LOW ~ B~N I~UED ~ ~QUI~T, ~:.~ ~ CON TO THE INS~ - D~ OF ~ ~ OR O ~ FOR ~E POM~ ~Y ~N, THE I~ J~ ~FORD~ ~ DO~M~ ~ R~PECT ~CA~D. NOOn. DiNG BELOW, CN300069127~7 a~l~R ain date; May 25, 2008 Star I~ose Co. Ilo. 3 of Greenport Fire Department: 2/,2 Knapp Plac(~ Gr~enl~ort LZ, I~¥ 11944 The Admm~sU'atmn is res cy ma~sidor your request for such use,'ldndly complete the following: I. Facilities Use Request (Organization) ~'7',~ the use of (date) ,../~'f',,9 r.,, 2.c/, 2,~' ,,6,,~ o ~..~ at(time) wm actiwty to p hli¢* Admission of t~ will be charged; proceeds will be used for t3~-- ,~'"~' e ~ at Greenport Public Schools on Does applicant agree to submit financial records for ~zamiualion upon requests? ~,o~ e~. Does applicant agree to conform to the regulations of the Board of Education and all liws regulating to the use of school propen'y including S~ecti~414 printed on the reverse side of this applicafion~?~.../o,o ~ Name - ' ~ Address Telephone #~of the person responsible on axis occasion. H. Instwance Information A certificate of insuranee of at least $1,000,000 public liability per occurrence and $2,000,000 aggregate liability insurance and $50,000 property damage shall be submitted at least three days in advance of the event and must designate both the using organization and the Greenport Union Free School District with ISO eudorsemant CG2026. The absence of such a certificate will preclude use of the facility. The policy must contain a 30-day guarantee notice of cancellation. The us~ agrees to inde~anify the district for any applicable deductibles. in. Rules Governing Use of Facilities A. No smoking is allowed in the building or on the grounds. The organization using the facility is responsible for anforceanont. B. No drinking of alcoholic beverages is permitted. C. Activity shall be restricted to that area for which pa'mission is granted. D. Activity shall not extend beyond hours approved by district. E. Programs shall not interfere will regular school schedule. F. Organization shall be responsible for moving its equipmeat into and out of the building. G. The supervisor of the activity shall be present before it is due to start and remain with the group until all have left H. In the absence of administrative personnel the custodian is charged with the responsibility of the building. I. School authorities must have free access to all rooms at ali times J. A careful examination will be made ater use of the area by the applicant who will promptly make good on any loss or damage, which might have occurred. K. No school property or equipmant is to be altered or removed from the premisesl L. This license is revOcable at any time by school authorities. M. No reservation will be made until this application is returned and approved by the disuict's Chief School Admhislrator. IV. Rental F~ Auditorium for performnne~ $100 Auditoriura for practice $ 50 Gymnasium for performance $100 GymnaSium for practice $ 50 Whan an approved activity takes place outside the normal hours of school operation, the organization will be charged $40.00 per hour for personnel sorvices for a minimum of 4 hours. This all must be paid seven days in advance and is not refundable unless the district receives notification of cancelladon at least 48 hours in advance. Signed: Specific Details of Use: I agree on behalf of the above-mentioned organization that all members and guests will observe the regulations and that we, individually, and as an organization, will assume ali financial responsibility for any and all damages done to the Grcenport School property during the above- indicated period of use. We also agree that our organization will at all times hereaRer indemnify the above-named school against any loss, damage or expense ofeny kind, which said school may sustain or incur because of the use of the above-mentioned buiIding by our organization, and we further will hold said school harmless for loss of any kind in connection herewith. Applicant ~ - - Superint~dent of Schools Date: EXCERPTS FROM SECTI(~N 414 OF THE EDUCATION LAW "...The Board of Education of each district may...permit the use of the school house and rooms therein, and the grounds and other property of the district, when not in use for school purposes, for any of the following purposes: For the purpose of instruction in any branch of education, learning or the arts. For holding social, civic and recreational meetings and ente~alnments, and other issues pe~aining to the welfare of the community; but such meetings, entertainment and uses shall be non-exclusive and shall be open to the general public. For meetings, entertainments and occasions where admission fees are charged, when the proceeds thereof are to be expended for an educational or charitable purpose; but such use shall not be permitted if such meetings, entertainments and occasions are under the exclusive control, and the _said proceeds are to be applied for the benefit of society, association or organizations of veterans of the military, naval and marine service of the United States and orgsnizations of volunteer firemen." Revised 9/1/2001