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Home My WebLink About2009ELIZABETH A. NEVILLE, RMC, CMC 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.north fork.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 f&r this purpose, do hereby GRANT TO: GREENPORT FIRE DEPARTMENT 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 I,aw of the State of New York at: 9:45 PM on SATURDAY, AUGUST 8~ 2009 (rain date August 9, 2009) on the property of Strawberry Fields Park in Mattituck, 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 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 of water, then they may be directed m 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 thirly 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. (Town Seal) Elizabd~ A. Neville, Southold Town Clerk Suttblk County. New York Date: Augusi 4. 2009 RECEIVED ,JUL 2 9 2009 APPLICATION PERMIT TO DISPLAY FIREWO ,Rt~S 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 ~-)oCo-o,~ DATE & TIME OF DISPLAY ~cU~,, q b EXACT LOCATION OF DISPLAY s voLi CO.TV TAX N MRE vOl ffE' The following pemons are to be m charge of the actual shooting of the firework: a~ Age Experien~ Physi~i Condition / (Additional names and information may be submitted on an attached sheet Number and type of fireworks is as follows: Manner and place of storage of fireworks prior to display: t_~_) ~,k.[ ~"o~, ~,!,_t~,,,2 / - 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 subn~ed with the Application. . ~.~_~,,z~ ~i~,' Signature of Applic~t _ ELIZABETH A. NEVILLE, RMC, CMC 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: Dated: Re: Martin Finnegan, Town Attorney Chief Cochran, Southold Town Police Department Robert Fisher, Fire Inspector Melissa Spiro, Land Preservation Linda J. Cooper, Deputy Town Clerk July 29, 2009 Fireworks Permit for Greenport Fire Department 8/9/09 Transmitted herewith are applications for Fireworks Permits for: Phoenix Hook & Ladder and Relief Hose Company, Greenport Fire Department Please advise if permits may be issued. Thank you. cc: Southold Town Board Page 1 of 1 CoOper, Linda From: Spire, Melissa Sent: Wednesday, July 29, 2009 2:29 PM To: Cooper, Linda; Finnegan, Martin; Cochran, Carlisle; Fisher, Robert Cc: Garsik, Pat; 'Al Krupski'; Louisa Evans (Ipevans@fishersisland.net); Russell, Scott; Tom Wickham; Orlando, Vincent; William Ruland Subject: RE: Fireworks Permit Application for 8/9/09 I have reviewed the application for Fireworks Permit for Greenport Fire Department on the Strawberry Fields Park, Mattituck. The fireworks site is shown on the Strawberry Fields Park site. Strawberry Fields is not Town of Southold preserved open space land. Since this is not preserved land, I have no comment on this application Melissa From: Cooper, Linda Sent: Wednesday, 3uly 29, 2009 11:32 AM To: Finnegan, Nartin; Cochran, Carlisle; Fisher, Robert; Spiro, Melissa Cc: Garsik, Pat; Al Krupski; Louisa Evans (Ipevans@fishersisland.net); Russell, Scott; Thomas Wickham (wickhamthomas@yahoo.com); V Orlando (vincent.orlando@town.southold.ny.us); W. Ruland (rulandfarm@yahoo.com) Subject: Fireworks Permit Application for 8/9/09 7/29/2009 Page I of 1 Cobper, Linda From: Finnegan, Martin Sent: Wednesday, July 29, 2009 1:36 PM To: Cooper, Linda Subject: RE: Fireworks Permit Application for 8/9/09 Linda - I have no objection to the issuance of a permit. This appears to be the same place that the Lions used for the Strawberry Festival. From: Cooper, Linda Sent: Wednesday, July 29, 2009 11:32 AM To: Finnegan, Martin; Cochran, Carlisle; Fisher, Robert; Spiro, Melissa Cc: Garsik, Pat; Al Krupski; Louisa Evans (Ipevans@fishersisland.net); Russell, Scott; Thomas Wickham (wickhamthomas@yahoo.com); V Orlando (vincent.orlando@town.southold.ny.us); W. Ruland (rulandfarm@ya hoo.com) Subject: Fireworks Permit Application for 8/9/09 7/29/2009 Page 1 of 1 Cooper, Linda From: Fisher, Robert Sent: Thursday, July 30, 2009 4:00 PM To: Cooper, Linda Subject: RE: Fireworks Permit Application for 8/9/09 Linde, I have no problems with the site for the fireworks es epplied for in the enclosed c~pplication. Robert Fisher Fire Inspector robert.fisher@town.southold.ny.us From: Cooper, tinda ~ent: Wednesday, July 29, 2009 11:32 AM To: Finnegan, Martin; Cochran, Carlisle; Fisher, Robert; Spiro, Nlelissa Cc: Garsik, Pat; Al Krupski; Louisa Evans (Ipevans@fishersisland.net); Russell, Scott; Thomas Wickham (wickhamthomas@yahoo.com); V Orlando (vincent.orlando@town.southold.ny.us); W. Ruland ( rulandfarm@ya hoo.com ) Subject: Fireworks Permit Application for 8/9/09 7/30/2009 08/03/2009 M0N 07:48 FAX 07/31/2009 11:33 FAX 856 697 9557 ¥IN~LAND FIRE~ORI[S CO. ~ 003/003 '~ oo~ _A_COR,D CERTIFICATE OF INSURANCE E CO TYRE OF INSUIZANCE I pOLICY ~U~-BER EF'FECTNE LIMITS OF'L~BI~ a ~TOM6BILE LIABI~ .... 1337272101 O~114/2009 COMB~N~ SINGLE LIMIT ~ $ 1.~0,o0o ~ ~ PROPE~DAMAGE ~ 0~LLISlON ~ ~.~d. 0111412010 [ ~GR EGAT6 $ e,O00.O00 C ~CESS UMBREL~ COVE~E G~0~TS2002 ~11~0~ ~ss et U.~ Sa, Mi~n -- $"' S.000.0OD THE EXPIaTiON DATE ~EREO~ ~5 ISSUING INSURER ~LL ENDEAVOR TO ~IL 30 DAYS WRI~N N~ICE TO THE C~TIFICA~ HQLD~K NAH~ ~ ~E I~landla, NY 11749 08/03/2009 ~ON 07:48 FAX 07/31/2009 11;33 FAX 8E6 807 9557 YINELAND PIP. EWORRS c0. ~ 002/003 ~ oo2 ACORD. __ CERTIFICATE OF INSURANCE A INSUREDCompany RO. LT ~P~O~ ~ GENE~LLIAa~LIW '--' ~00292601 g1,'14t200~ ~H OCCURRENCE C 6XC~S UMBREL~ COVE~GE G2Z0~752002 01t~4~g ~cea$ et Unde¢l~ng $4, M~llon ~$ 5,000,~0 Fi~orks DJsp~y DO~: ~l 8,'~ Rain Date; ~g~t 9. 2009 "' PhenJXp. O, BoxH58 & L and Relref Hoa~ Gompanles .~.--~. 08/03/2009 MON 07:48 FAX ~001/003 fI~ G ~'V~A Y D F-,P AR Tf fE ~ff Tow'm of Souc~old 275 F~:o~/c Laa~. P.O, Box 178 ~co~c, New York 1195~ PETER W. HARRIS SUPERINTENDENT OF HIGHWAYS FAX'COVERSHEET F.~ ?~UlVlBER: DA]'~: tN1J3r~BER OF PAGES: FROM: $OUT~tOLD TOW~ I~[G-ItWA Y DEl?A-rlTI~F.N'r COM3KENTS: SHOULD YOU HAVE ANY QUESTIONS, OR PROBLEMS RECEIVING T~IS FAX TRANS/~t f iAI., PLEASE EI'BCI~R .lYltONE (631)765-3!40-O11 FAX ( 63] )765-1750. POLICE DEPARTMENT TOWN OF SOUTHOLD Iblephone Emergency Dial 911 CARLISLE E. COCHIL~.N, JP,. Chief ~!t'Police TO: FROM: DATE: RE: Linda J. Cooper, Deputy Town Clerk Chief Carlisle E. Cochran, Jr.(-~_~ July 30, 2009 Fireworks Permit - G-reenport Fire Department Sunday, August 9, 2009 I have reviewed the above permit and have no objection to the approval. cc: Capt. Martin Flatley 41405 l/.oute25* P.O. Box 911 * Pcconic, N.Y. 11958 Administrative (631) 76S-2600/2601 · Fax (631) 765 2715 ELIZABETH A. NEVILLE, RMC, CMC 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 PERMIT For PUBLIC DISPLAY OF FIREWORKS 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 FIRE DEPARTMENT 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 Friday, July 3, 2009 (r.d; Saturday, July 4) on the property of GREENPORT PUBLIC SCHOOL, north side Front Street and east side Moores Lane, 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 feel from the nearest above ground telephone or telegraph line, trees or other overhead obsl~uction; that the audience at such display shall be restrained behind lines at least one hundred and fi~y feet from the point at which the fh'eworks are discharged and only persons in active charge of the display shall be allowed inside these lines; that all fffeworks 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 of 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 so, da 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. . . Elizabefl~ A. Neville, Southold Town Clerk Suffolk County, New York (Town Seal) Date: June 29, 2009 THIS PERMIT IS NOT TRANSFERABLE Page 1 of 1 Cooper, Linda From: Finnegan, Martin Sent: Monday, June 29, 2009 2:55 PM To: Cooper, Linda Subject: RE: Fireworks permit for GFD Approved. Sorry for the delay. From: Cooper, Linda Sent: Monday, June 29, 2009 2:52 PM To: Finnegan, Hartin Subject: Fireworks permit for GFD Hi Martin, I had sent over a copy of the request for a Fireworks Permit for Greenport Fire Department on July 3. I have received responses from the police, Land Preservation and the Fire Inspector. No one has any problems or issues with issuing the permit but I have not yet received your approval. So, whenever you have a chance ....... Thanks. Lind ooper Deputy Town Clerk Town of Southold 631-765-1800 Ltfe may not be the par~ we hoped for, but as long as we're here, we mtght as well dance! 6~29/2009 Page 1 of 1 Cooper, Linda From: Spiro, Melissa Sent: Wednesday, June 24, 2009 11:31 AM To: Cooper, L[nda Subject: Fireworks Permit for Greenpot Fire Deptment 7/3/09 Linda, I have reviewed the application for Fireworks Permit for Phoenix Hook & Ladder and Relief Hose Company, Greenport Fire Department for 7/3/09. Greenport School is not Town of Southold preserved land. Since this is not preserved land, I have no comment on this application. Melissa 6/24/2009 Page 1 of 1 Cooper, Linda From: Fisher, Robert Sent: Thursday, June 25, 2009 9:43 AM To: Cooper, Linda Subject: Greenpoty FD Fireworks Linda, I inspected the site for the Greenport Fb fireworks display on 07/03/09 and have no reservations about the location as specified in the application. Robert Fisher Fire Inspector robert.fisher@town.southold.ny.us 6/25/2009 Memo To: Linda Cooper .! From: Capt~ Martin Flafley, Executive Offi~ Date: June 23, 2009 Re: Fireworks Permit for Greenport Fire Dept. I have no objection to the fireworks disphy planned by the Greenport Fire Department on July 3, 2009 and will plan accorAingly for the department ELIZABETH A. NEVILLE, RMC, CMC 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~ Dated: Re: ~artin Finnegan, Town Attorney hief Cochran, Southold Town Police Department belert Fisher, Inspector Fire issa Spiro, Land Preservation I,inda J. Cooper, Deputy Town Clerk June 5, 2009 Fireworks Permit for Greenport Fire Department ~/3/09 Transmitted herewith are applications for Fireworks Permits for: Phoenix Hook & Ladder and Relief Hose Company, Greenport Fire Department Please advise if permits may be issued. Thank you. cc: Southold Town Board 04/06 '09 THu 14:48 FAX 631 765 6145 S0/WHOLD TOWN CLERK *** Highway Dept ~001 FJ,TZABETH A. NEVILLE, RMC, CIVIC TOWN CLEP.,K REGISTRAR OF VITAL ~TATLqTIC$ MARRIAGE OFFICER RECORD8 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 south oldtown.nor thfork_nat OFFICE OF TH l~l TO~fN'.CLERK TOWN OF SOUTItOLD 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 lo display fireworks as hereinafter specified: _. /~ , DISPLAY IS TO BE SPONSORED BY %~1t xs~ L o~f~. ' ' } DATE & TIME OF DISPLAY . ~, ~J ~ c~ ~oo'{~. 0 SWgOLK CO TA r L ? SUM Eg gOR SITE Thc followMg pe~ons are to be ~ charge of the actual shooting of the firework: ~a~e_( ~ ~:~(,[2~ ~ Age Experience (Additio~ names ~d ~o~a~on may be ~b~ed on ~ a~ach~ sheet Number and ~pe of fir~o~ is as follows: Physical Condition Manner and p~ce of stor, age of, firework~ p:or to display:_~-~Je~-~c ,,j,',[ ~ ~/fye,--a~/ ~ tf 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 Propert3., Owner, must be submit~ with the Signature o£Applieant Date of Application GREENPORT PUBLIC SCHOOLS 720 Front Street Greenport NY 11944 APPLICATION FOR USE OF SCHOOL FACILITIES The Administration is responsible for the use of all school facilities in order that they may consider your request for such use, kindly complete the following: I. Facilities Use Request~p for the pm-pose of f~77~--e o~ar"~-.q Will th~-activ~ty be oben to the public.'? Admission of at (time) will be charged; proceeds will be used for at Greenport Public Schools on Does applicant agree to submit financial records for examination upon requests? ;C'fi._< 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? ~_g Name Telephone of the person responsible on this occasion. Il. 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 guarantee 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 vi/ith 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 area by the applicant who will promptly make good on tony 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 ~nade until this application is returned and approved by the district's Chief School Administrator. IV. Rental Fees Other Fees or Conditions Auditorium for performance $100 Auditorium for practice $5O 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 charged $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. V. 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 dust 'gm-'6FTff~r because of the use of the above-mentioned building by our organization, and we fu/~er~d~t~ schoo~armless for loss of any kind in connection herewith. Signed: (_/,~ ?o A ~_~, .~_e~'/ Date: Applicant Granted ~1 Denied [-I ~?~ Date: Superintendent of Schools Specific Details of Use: EXCERPTS FROM SECTION 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: 1. 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. For meetings, entertaitm~ents 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 organizations of volunteer firemen." Revised 9/1/2001 ACORD,. CERTIFICATE OF INSURANCE ,SSUEOATE0 i 00g PRODUCER This certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This Certificate does not amend, extend or alter the MCGRIFF, SEIBELS & WILLIAMS, INC. coverage afforded by the policies below. RO. Box 10265 Birmingham, AL 35202 COMPANIES AFFORDING COVERAGE 800-476-2211 Company United Slates Fire Insurance A INSURED Company James River Insurance Company S. Vitale Pyrotechnic Industries. Inc. B dba Pyrotecnico P.O. Box 149 Company Westchester Surplus Lines Ins New Castle, PA 16103 C Company D Company E Th s s o certify ha the po ides of *nsurance descr bed here'n have been ssued o he Insured named here~n 'or the policy period indicated. Noh~ithstanding any requirement, term or condition of contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, conditions and exclusions of such policies. Limits shown may have been reduced by paid claims. CO TYPE OF INSURANCE POLICY NUMBER EFFECTIVE LIMITS OF LIABILITY LT EXPIRATION B GENERAL LIABILITY 000292601 01/14/2009 EACH OCCURRENCE $ 1,000,000 ~] Commefc~l Genera4 Liability 01/14/2010 FIRE DAMAGE $ 100,000 I'-I c~ams Ma~e I~ Occurrecce MEDICAL EXPENSE $ EXCLUDED [] Ov~efs' and c..o~¢ec~ors' Protection PERS. AND ADVERTISING INJURY $ 1,000,000 [] GENERAL AGGREGATE $ 5,000,000 Gee~ral Ag~egate Limit aortaes per: PRODUCTS AND COMP OPER. AGG. $ 2,000,000 A AUTOMOBILE LIABILITY 1337272101 01/14/2009 COMBINED SINGLE LIMIT $ 1,000,000 [] Any Au~on,~e 01/14/2010 BODILY INJURY (Per pemon) $ [] A, Owned Au~es BODILY INJURY (Per accident) $ [] Hired Autor~o~les PROPERTY DAMAGE (Per accident) $ [] No~wned Automebiles COMPREHENSIVE ;1000 deductible [] COLLISION ;1000 deductible WORKERS' COMPENSATION WC Statutory Limit I AND EMPLOYERS' LIABILITY EL EACH ACCIDENT $ EL DISEASE (Each employee) $ EL DISEASE (Policy Limit) $ B EXCESS LIABILITY 000296261 01/14/2009 EACH OCCURRENCE $ 4,000,000 · 1~ I~c~aims Made 01/14/2010 AGGREGATE $ 4,000,000 C EXCESS UMBRELLA COVERAGE G22054752002 01/14/2009 Excess of Underlying $4, Million $ 5,000,000 01/14/2010 $ $ Fireworks Display Date: July 3, 2009 Rain Date: July 4, 2009 Location: Greenpert High School grounds, Greenport Long Island, NY Greenport Tire Dept., Village of Greenpert, Town of Southold, Greeport Public Schools, Greenport High School and Blue Sky Amusement. The above listed are Additional Insured respects to General Liability policy as required by wdtten contract subject to policy terms, conditions and exclusions. CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITi'EN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Authorized Representative Greenport Fire Department .... 212 Knapp Place Greenport, NY 11944 . \ ELIZABETH A. NEVILI.E~ RMC, CMC 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 PERMIT For PUBLIC DISPLAY OF FIREWORKS 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 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 23~ 2009; Raindate: Sunday, May 24, 2009 on the property of GREENPORT HIGH 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 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 fi~y 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 dire~ion, 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 in to such lake or body of water; that any fireworks that remain unfired at, er the display is conducted shall be immediately disposed of in a way safe for the particular type of fn'eworks remaining; that no firaworks 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 end 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. Elizabeth A". Nev'flle, Southold Town Clerk Suffolk County, New York (Town Seal) Date: May 14. 2009 THIS PERMIT IS NOT TRANSFERABLE ELIZABETH A. NEVILLE, RMC, CMC TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hail, 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 OFSOUTHOLD To~ From: Dated: Re: .~hieifer Andaloro, Assistant Town Attorney f Cochran, Southold Town Police Department .~elert Fisher, Fire Inspector issa Spiro, Land Preservation Linda J. Cooper, Deputy Town Clerk May 6, 2009 Fireworks Permit for Greenport Fire Department Transmitted herewith are applications for Fireworks Permits for: Star Hose Co. #3, Greenport Fire Department Please advise if permits may be issued. Thank you. cc: Southold Town Board EI,IT. ABETH 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- PRINCIPAL OFFICE AT -~,'/~rf DATE & TIME OF DISPLAY ~c~,,~,~c~c~,/.O.~,~?ao9 E~CT LOCATION OF DISPLAY ~¢ SUFFOLK CO~TY T~ ~ NU~ER FOR SITE o~- ~ t - ~.g~*) ~h' DATE & TIME ~ ~ The following persons are to be in charge of the ac~al shooting of the firework: Physical Condition Name Age Experience (Additional names and information may be submitted on an attached sheet Number and type of fireworks is as follows: Manner aad place of storage of fireworks prior to display: ~-~f~,.~o/~c~ '-~ b~ ~,I,.~.~c/ 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. / ~o~ Organi~a[ion - ' / Signat~e of Applic~t ~at~ o~ Application GREENPORT PUBLIC SCHOOLS 720 Front SU-ee~ Greenport. NY i 1944 APPLICATION FOR USE OF scHOOL FACILITIES The Administration is responsible for the use of all sehonl facilities in order that they may consider your request for such use, kindly complete the following: I Facilities Use Request (Organization) ~'~'~ ' . ,,r'/(/r'/,~- requests ~' c' -' at Grecnport Public Schools re use of ?'- ,' ~ ~Z_ £' / o ~ (c' ~' ~ ) ~' ~ t°(~ ~ ,f' f0rthepurposeof _:,11).~ /icL': C_~.X--e~"°'Pz'~t .F?')_ .... (date) .j,~ t ~ 2.5, ~-~,~7 /~c~/~,~o2vat(time) g'/O t~'/~/'' Will activity ~ Open t~o the ~/ublic? c/' ~, *L" · Admission of t't../~2, will be charged; proceeds will be used for Does applicant a~._ec to submit financial records for examination upon requests? ei/.e,, c; D~e to confo~ to~gulations of the Board of Education and all llws regulating to the ~ of sqhool property including Section'~4~ printed on the reverse side of this application? '~'T-~~of the person responsible on this ocoas~on. II. Insurance Information A certificate of insmance of at least SL000,000 public li~oility 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 Greenpor~ Union Free School Dis~ct with ISO endorsement CG2026. The absence of such a certificate wi. Il preclude use of the facility. The policy must contain a 30-day guarantee notice of cancellation. The user agrees to indemni~y the district for any applicable deductibles. IlL Rules Governing Use of Facilities A. No smoking is allowed in the building or on the groands. The organization using the facility is responsible for enforcement. B. No drinking of alcoholic beverages is permitted. C. Activity shall be resa'icted to that area for which permission 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 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. im the absence of administrative personnel, the custodian is charged with the responsibility of the building. School authorifie~ must have flee access to all rooms at all times A careful examination will be made atter use of the area by the applicant who will promptly make good on any loss or damage, which might have occurred. No school property or equipment is to be altered or removed fi`om the premises. This license is revocable at any time by school authorities. No reservation will be made until this application is returned and approved by the district's Chief School Administrator. 17. Rental Fees Other Fees or Conditions: Auditorium for performance $100 Auditorium for practice $ 50 Gymnasium for performance $100 Gymnasium fur practice $ 50 When an approved activity takes place outside the normal hours of school operation, the organization will be charged $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 £mancial responsibility for any and all damages done to the Greenport School property during the above- indicated 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 or incur because of the use of the above-mentioned building by our organization, and we further will hold said school harmless for loss of any kind in connection herewith. EXCERPTS FROM SECTJON 414 OF THE EDUCATION LAW "...~he 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: I. For the purpose of instruct/on 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. For meetings, entertainments and occasions where admission fees are charged, when the proceeds thereof are to be expended for an educational or charitabJe 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 organizations of volunteer firemen/" Revised 9/1/2001 L_ R.~b ,suJtq£D -" -/-L '-- f.-~ ,,..tt h'¢4 A Page 1 of 1 Cooper, Linda From: Spiro, Melissa Sent: Thursday, May 07, 2009 1:54 PM To: Cooper, Linda Subject: Fireworks Permit for Greenport Fire Department Linda, I have reviewed the application for Fireworks Permit for Star Hose Co. #3, Greenport Fire Department. Greenport School is not Town of Southold preserved land. Since this is not preserved land, I have no comment on this application, Melissa 5/7/2009 POLICE DEPARTMENT TOWN OF SOUTHOLD CARLISLE E. COCH1LX. N, IR. Chi<f cf Police Telephone Emergency Dial 911 TO: FROM: DATE: RE: Linda J, Cooper, Deputy Town Clerk Chief Carlisle E. Cochran, Jr. ~ May 7, 2009 Fireworks Permit - Greenport Fire Department Saturday, May 23, 2009 - rain date Sunday, May 24, 2009 I have reviewed the above permit and have no objection to the approval. Eng. cc: Capt. MartinFlatley 41405 Route 23 · P.O. Box 911 · Pcconic, N.Y. 11958 Administrative (631) 765 2600/2601 ° Fax (631) 765-2715 05/08/2009 15:54 FAX 856 697 9557 VINELAND FIREWORKS CO. 1~002 I ACORD= I CERTIFICATE OF INSURANCE, pRODUCER Thi~ certh3cate Is issued as ~ matter of information only and confers no ri°bra D E ~1 c~alme Ma,~, ~ O,=~.,,,~ MEDICAL EXPOSE $ EXCLUDED WORKERS'COMPENS&TION INCSlalutorvLImJ{l I Other I C EXCEEiS UMBRELLA COVERAGE G2~054752~02 01/14/200g EXC.~SS o~ Underlying $4, I~lll .o~ $ 5,000,000 0~1~4/2010 $ $ Greetq~rt Fke De~artmeflL Gteeftpor[ public Schools, Tow~ of 8ouflx~l, V'dlage of Gmenport, All Star Amusemetffs. The above listed are Additional It~sured respects to General Uab~ policy aa .~q. uired by wfi~en ~ subject to policy terms, eor~ltJons a~d .~...duslona. Stat Hose Company ~3 Authorized R~resentatlve Greenport Fire Department c/o 212 Knapp Place~ ~..'~ a-. Page 1 of 1 Cooper, Linda From: Fisher, Robert Sent: Wednesday, May 13, 2009 3:36 PM To: Cooper, Linda Subject: Greenport FD Fireworks Linda inspected the site for Greenport FD fireworks for May 23. I hove no objections. Robert Fisher Fire Inspector robert.fisher~town.southold.ny.us 5/13/2009 Page 1 of 1 Cooper, Linda From: Andaloro, Jennifer Sent: Thursday, May 14, 2009 7:59 AM To: Cooper, Linda Subject: RE: Fireworks Hey Linda, I have reviewed the application and it is okay with me. Thanks for the reminder!! Jen From: Cooper, Linda Sent: Wednesday, Hay 13, 2009 3:49 PM To: Andaloro, Jennifer Subject: Fireworks I know you have more than enough work on your plate but I just wanted to remind you that I need an OK from the TA's office before I can issue the fireworks permit for the Greenport Fire Department on Saturday, May 23. The Land Preservation, Fire Inspector and Chief of Police have all okayed the application. Everything is the same as it had been for the past several years. Thank you. L/nda ooper Deputy Town Clerk Town of Southold 631-765-1800 Ltfe may not be the pariy we hoped for; but as long as we're here, we might as well dance! 5/14/2009