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HomeMy WebLinkAbout2008 - Denied El J~BETH A. NEVH .I,F~ TO~N CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER P,~CORDS MA~AG~NT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall. 53095 Main Road P.O. Box 1179 8outhold, New York 11971 Fax (631) 765-6145 Telephone (89I) 765-1800 southoldtown.northfork.net OFFICE OF ~ TOWN C! TOWN OF SOUTHOLD / APPLICATION PERMIT TO DISPLAY FIREWORKS APPLICATION IS HEREBY MADE, pursuant to the provisions io~ S~ction 405.00 of the Penal Law of the State of New York, for a permit to display fireworks as herein}tier ~pe%ified: D,S LAY IS TO BE SPONSORED ,ide For PRINCIPAL OFFICE AT Stonybrook University, %H$(~}~S~Q L~2 Rm#106 Stonybrook; NY DATE & TIME OF DISPLAY October 25, 2%08 J 8:30 PM 11794-8231 EXACT LOCATION OF DISPLAY Duck ~Walk ~,tne~ards North, ~35 Main Rd. Southold, Ny RAIN DATE & TIME NONE ' I ~ The following persons are to be in charge of ~¢tual shooting of the fireworks: ~ame Age / Ex)l~nCeoce Physical Condition Dave Belling ~. 27 ~'1 9 ~e' ,ears Excellent y% Rob Lyons "x 56 ~ 5 ars Excellent Ro_~b Ceele_____~_y \~ /,, 4 years Excellent (Additional names and info=ation m~ty ]h~% submi~ed on an attached sheet Number and ~..t~e of fireworks is as [ollbWs: Manner and place ~f~ ewor'ks prior to display: Westhampton Facility Pyro Engineering, l~e.~fii'ITl~y .... -delivery day of display Attached hereto and m..ade a'~art of hereof is a diagrara of the groonds om which the display is to be held. Also attached is a certificate o~ policy of insurance coverage. ACORD , CERTIFICATE OF LIABILITY iNSURANCE 10031970 I OATE M ' 10/17/2009 Fort Wayne IN 46804 INSURERS AFFORDING COVERAGE NAIC # c/o Stony Brook Universtiy, saw, HSC, L2Room 103 Stony Brook, NY 11794 INSURERC: A Member of the Spots, Leisure & Entertainment RPG INSURED 0: ~VE~G~ THE POLICIES OF INSURANCE LISTED BELOW HAVE KEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERtOO INDICATED. NOT~NI~-ISTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT CE OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED CR MAY PERTA~, THE iNSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS CE SUCH POLICIES. AGGREGATE LIMITS SHOWN 4AY HAVE aEEN REDUCED BY PAID CLAIMS. LTR INSBD ~ ~ IL*4~URAa(;E P'DkJCY HUMSED DATE ~ kl~f~l:ll:t/Y'~ DATE {MIA*DI:~r ~ L~ ^ GEP~ Ue#.ITY 6BRPG0003003055900 10/25/[.~003 10/27/2008 EACH CC(~J RRENC~ -- 12:01 AM 12:01 AM DAMN~ETO RENTED I CLAIMB~DE [] OCCUR MEDEXP(An~ocepemon) ~,900 pEDSCNAL & ADV INJURY $1,000,030 GENERAL AGGREGATE ,~2,030,000 Event: Duck Walk Event ( Walk Only) Event Location: Duck Walk Vineyard, Soathold NY Attendance: 1,500 or Less Certificate Holder is an Additional insured Cert# 3414 CERTIFICATE HOLDER CANCELLA'I~ON DATETHEDEOF,THEISSUINGINSURER WILL ENDEAVORTOMAIL 30 DAYSWRi~CreNNOTICETO C/O Elizabeth Neville (Tow~ Clark) THE CERTIFICATE HOLDER NAMED TO THE LEFT, BLT FAILURE TO DO SO SHALL IMPOSE NO I 53095 Main Rd. O~LIGAT~N OR LIABILI3~ OF ANY KIND UPON THE INSURER, iTS AGENTS OB R EPRES~I~ITATIVES Southeid, NY 11971 Owner or Lessor of Premises ACORD 25 (2001/08) © ACORD CORPORATION 1988 ACORD. CERTIFICATE OF LIABILITY INSURANCE I~,=, 1OGl~Olvd. ONLY AND CONFERS HO ~IGH'/'G UPON THE 1NSUHERB AFFORDING ~OV~IE NNC # DBA: 8ay~ Formlngdde, NY 11736 COVERA~E~ U.S. Department of Trcw~ortotion Fe~leral AVt~flon Administration Federal Aviation Administm'~on Operations Support 1701 Columbia Ave College Park, GA 30337 August 5, 2008 Ms. lo-Anne Smtzzieri Pyro Engineering, Inc. 400 Broadhollow Rd. Suite 3 Farmingdale, NY 11735 Re: Fireworks Display fi.om Southold, NY Dear Ms. Struzzieri: We received your letter regarding your proposed fireworks display from Southold, NY. The time of the display will be between 8:00 pm and l 1:00 pm, duration 15-20 minutes, on October 25, 2008. No rain date has been scheduled. Our office has no objection provided the maximum shell height does not exceed 900 feet above ground level and the following conditions are met: Contact the Lockheed Martin Automated Flight Service Station, 877-487-6867, at least six hours prior to the scheduled time of the fireworks display to affect the issuance of a Notice to Airmen Advisory. This letter disposes of the Federal Aviation Administration's interest in this matter but should not be construed as superseding or invalidating any existing rules or regulations promulgated by any other federal, state, county, or municipal government, which may be required for this display. Sincerely, Mark D. Ward Group Manager, Operations Support DUCK WALK VINEYARDS September 12, 2008 ELIZABETH NEVILLE Town of Southold Office of the Town Clerk PO Box 1178 Southold, NY 11971 J(>ANNE TRIOLO Bay Fireworks 400 Broadhollow Road, Suite 3 Farmingdale, NY 11735 Please accept this letter as permission for Bay Fireworks, 400 Broadhollow Road, Suite 3, Farmingdale, NY 11735, to conduct a fireworks display at Duck Walk Vineyards, 44535 Main Road, Southold, NY 11971, on behalf of the Ride For Life (ALSFundraiser. Our permission is contingent of Town of Southold approval. can be reached at 871.5119 with any questions. Bestregards, KERRY MCKILLOP Events & Marketing Duck Walk Vineyards Pindar Vineyards 631.765.3500 C 871.5119 44535 Main Road, Southold, NY 11971 (631) 765-3500 fax (631) 765-3509 duckwalkvine@otponline.net 2007-04-G5 f4t52 t63~28861n2 :,= 1~3t5493t5t 341 · 13:84 631928457~ PAGE RIDE FOR LIFE DUCKIqALK NORTH_ 83