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HomeMy WebLinkAbout2006 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 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: SOUTHOLD GOP 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 on THURSDAY~ OCTOBER 12~ 2006 at 9:00 P.M, on the property of the PINDAR WINERY, Route 48, Peconic, New York ON CONDITION THAT the bond (indemnity insurance) required shall continue in full force and effect in favor of the Town of Sunthold, and PROVIDED that the actual point at which the firewurks 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 f'om 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 arc 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 firewurks are to be fired fi'om the shore or a lake or other large body of watar, 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 at~ar 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 fa'ing 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 last 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) Dated: September 26, 2006 Elizabeth A. Neville, Town Clerk Town of Southold Suffolk County, New York THIS PERMIT IS NOT TRANSFERABLE ~ ~ ~Message Page ! of 1 Cooper, Linda From: Spiro, Melissa Sent: Tuesday, October 10, 2006 10:47 ^M To: Cooper, Linda Subject: RE: Fireworks Display Hi, I reviewed the amended site plan. The Audience Site and the Grand Illuminations/Set Piece site are not on preserved parcels. Therefore, I do not have any comments in regard to the Fireworks Permit. Melissa ..... Original Message ..... From: Cooper, Linda Sent: Tuesday, October 10, 2006 10:19 AH To: Spiro, Melissa Subject: Fireworks Display There has been a slight change in the site plan for the fireworks scheduled for this Thursday. I'm going to fax over the site plan. It is not a very good picture; I'll be faxing something that was faxed to me. Please let me know if there is a problem. Thanks. Linda J. Cooper Deputy Town Clerk Town of Southold 631-765 - 1800 10/10/2006 :0/09/200G 15:00 FAX [~001/002 RECEIVED October 9, 2006 TO: COMPANY'. ADDRESS: PHONE: FAX: FROlVE TOTAL PAGES: EliTabeth Neville Office of the To~rn Clerk 53095 Main Rd. Southold, New York 11971 631-765-1800 631-765-6145 Edward Kubio 9 Dear Mrs. Elizabeth Neville: Re: $outhold GOP Fireworks Benefit - Pindar Vineyards, Peconic, NY October 12, 2006 - at 9:00PM Attached hereto please find the: 1) Revised copy of the site plan. Any questions please give me a call. Thank You for all your help, Edward Rubio Logisdcs Manager Fireworks by Cnucci, Inc. Cell 516-655-44§6 Fireworks by Grucci, Inc. One Grucci Lane Brookhaven, NY 11719' Office #: (631) 286-0088 Fax #: (631) 286-9036 E-maih erubio@grucci.com THE FIRST FAMILY OF FIREWORKS 10/09/2008 15:01 FAX Program: Southold GOP Fireworks Benefit Event Comact: Bob Ghosio, Ir. Area Contact: Bob Ghosio, Jr S~aging Area Address: Fire Marshal: [] 002/002 FIREWORKS BY GRUCCL INC.. SITE INSPECTION REPORT Show D~.te: 10/12/06 Phone; 631-765-3?6? Phone; 631-765-3767 B.sin Date: 10/13/06 Fax: 631-765-1744 Fa.x; 631-765-1744 Pindar Vineyards Winery & Pavilion, 37645 Main Rd., Peconic, NY Town of Southold Phone: 631-765-1800 Pax; 631-765-6145 N Dischar, Ke Site: Latitude 41° 1' S8.156~N Longitude -72° 28' 4.26" W 280' Safety Zone Maximum Aerial Shell Diameter: 4" (Inches) SITE INSPECTION; DISTANCES: Inspected by: Phil Butler VIP Audience: 280% Vehicles: 280' Date: 105/06 Buildin~ Occupied: 280'+ Overhead Obstrucaions: N/A Time: 3;00pm Buildin~ Unoccupied: 2g0'+ Trees/Sl~ubs: 280' Pret~ar~d by V~dward Rublo - ~ogist~ Manager - F.~I_ G, September 25, 200~ POLICE DEPARTMENT TOWN OF DUTHOLD CARLISLE E. COCHRAN, JR. Chief of Police Telephone Emergency Dial 911 TO: FROM: DATE: RE: Linda J. Cooper, Deputy Town Clerk Chief Carlisle E. Cochran, Jr. ~ September 26, 2006 Request for Special Permit - Fireworks - Southold GOP at Pindar Thursday, October 12, 2006 I have reviewed the above request for a special permit. I have no objection to the approval of this permit. ce: Capt. Martin Flatley 41405 Route25 op.o. Box 911 · Peconic, N.Y. 11958 Administrative (631) 765-2600/2601 · Fax (631) 765-2715 Page 1 of 1 Cooper, Linda From: Fisher, Robert Sent: Tuesday, September 26, 2006 12:34 PM To: Cooper, Linda Subject: Fireworks Permits Linda, I inspected the sites listed below. I see no reason to deny the fireworks permits for either site. Nick Aroniadis dated 09/25/06 for display on 09/30/06. Pindar Vineyards dated 09/20/06 for display on 10/12/06. A suggestion that section, block, and lot number be included on the permit application. It would help in determining location and in some cases which fire department may be involved. Thanks Bob Fisher Fire Inspector 9/26/2006 Message Page 1 of 2 Cooper, Linda From: Spiro, Melissa Sent: Tuesday, September 26, 2006 9:35 AM To: Cooper, Linda Subject: RE: Updates Site Plan for Southold GOP Hi, Pindar Winery (Audience Site) and the vineyard to the north (Discharge Site) are not preserved parcels. Therefore, I do not have any comments in regard to the proposed Fireworks Permit for October 12, 2006. Melissa ..... Original Message ..... From: Cooper, Linda Sent: Monday, September 25, 2006 3:39 PM To: Spiro, Melissa Subject: FW: Updates Site Plan for Southold GOP Melissa, Here is the correct site plan for the Pindar Fireworks. Please let me know if there is a problem with the location. Linda J. Cooper Deputy Town Clerk Town of Southold 631-765-1800 From: Ed Rubio [mailto:erubio@grucci.com] Sent: Monday, September 25, 2006 3:34 PM To: Cooper, Linda Cc: Ed Rubio Subject: RE: Updates Site Plan for Southold GOP Hello Linda, Please find attached the updated site plan for the Southold GOP fireworks display scheduled for October 12, 2006. Please feel free to call me at anytime if you have any questions or concerns. Thanks again for all your assistance. Sincerely, Edward Rubio Logistics Manager Fireworks by Grucci, Inc. One Grucci Lane Brookhaven NY 11719 9/26/2006 FIREWORKS BY GRUCCI~ INC. ~ SITE INSPECTION REPORT Program: Southold GOP Fireworks Benefit Show Date: 10/12/06 Rain Date: 10/I3/06 Event Con~ta: Bob Ohosio, Jr. Phone: 631-765-3767 Fax: 631-765-1744 Staging Area Contact: Bob Ghosio, Jr Phone: 631-765-3767 Fax: 631-765-1744 Staging Area Address: Pindar Vineyards Wine~ & Paviliorg 37645 Main Rd., Peconic~ NY Fire Marshal: Town of Southold Phone: 631-765-1800 Fax: 631-765-6145 NFPA 1123 70' per inch max Aerial Shell 280' minimum Discharge Site: Latitude 41° 1' 58.156'N Longitude-72° 28' 4.26" W 280' Safety Zone N Audience ] Maximum Aerial Shell Diameter: ~ITE INSPECTION: DISTANCES: 4" (Inches) I Can Illuminations be used? Yes Inspected by: Electronically Date: 9/25/06 Time: 3:00pm VIP Audience: 280'+ Vehicles: 280' Building Occupied: ] 280'+ Overhead Obstructions: N/A Building Uncccupied: 280'+ Trees/Shrubs: 280' Prepared by Edward Rubio Logtstics Manager F.B.G. September 25, 2006 Message Page 2 of 2 Phone: 631-286-0088 Ext. 21 Fax: 631-286-9036 Cell: 516-658-4486 Email: ERubio@grucci.com URL: www.grucci.com Confidentialify Statement: This message is intended for the designated recipient(s) only. This message contains confidential and legally privileged, along with any document, files or previous email messages that are attached. If you are not a designated recipient of this message, you are hereby notified that any disclosure, copying or use of the information in this message is prohibited. If you believe this message has been sent to you in error, please destroy it and notify the sender by reply email or by calling 1-800-227- 0088. Thank you. 9/26/2006 September 11, 2006 TO: COMPANY: ADDRESS: PHONE: FAX: FROM: TOTAL PAGES: Elizabeth Neville Office of the Town Clerk 53095 Main Rd. Southold, New York 11971 631-765-1800 631-765-6145 Edward Rubio 9 Dear Mrs. Elizabeth Neville: Re: Southold GOP Fireworks Benefit - Pindar Vineyards, Peconic, NY October 12, 2006 - at 9:00PM Attached hereto please find the following: 1) Application copy 2) FAA Letter 3) Letter to Sponsor 4) Site Plan 5) Shell Count 6) Certificate of Insurance 7) Chief Pyroteclmician Data Sheet 8) Letter of permission to use land for display Any questions please give me a call. Thank You for all your help, Edward Rubio Logistics Manager Fireworks by Gmcci, Inc. Cell 516-658-4486 Fireworks by Gmcci, Inc. One Grucci Lane Brookhaven, NY 11719 Office #: (631) 286-0088 Fax #: (631) 286-9036 E-mail: erubio@gmcci.com / THE FIRST FAMII.Y OF FIREWORKS 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.nor th fork.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: PRINCIPAL OFFICE AT fO DATE & TIME OF DISPLAY EXACT LOCATION OF DISPLAY The following persons are to be in charge of the actual shooting of the fireworks: Name Age Experience Physical 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: fLIt ;L..,t 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. Name of Organization ~ignatUre ;f App~ Date of Application September 11, 2006 TO: Mr. Frank Jordan COMPANY: FAA - JFK FAX: 718-995-5693 Primary- 5687 Back-up FROM: Edward Rubio TOTAL PAGES: 1 Dear Mr. Jordan: Please be advised of the following Fireworks displays: EVENT: Southold COP Fireworks Benefit LOCATION: Pindar Vineyards, Peconic, NY LATITUDE: 41'~ 2' 30.998" N LONGITUDE:-72* 27' 35.371" W DATE: Oct. 12, 2006 Rain Date: Oct. 13, 2006 TIME: APPROXIMATELY 9:00 PM for 3 -4 minutes. The maximum altitude of the Fireworks will not exceed 900 feet. In letter form, please acknowledge the receipt and approval of this notification. Thank you for your prompt reply. Thank You, Edward Rubio Logistics Manager Fireworks by Gmcd, Inc. Cell: 516-658-4486 Fireworks by Grucci, Inc. One Gmcci Lane Brookhaven, NY 11719 Office #: (631) 286-0088 Fax #: (631) 286-9036 E-mail: ERubio@grucci.com THE FIRST FAMILY OF FIREWORKS September 11, 2006 Bob Ghosio, Jr. 33 Sunset Lane Greenport, NY 11944 Phone: 631-765-3767 Fax: 631-765-1744 Re: Southold GOP Fireworks Benefit - Pindar Vineyards, Peconic, October 12, 2006 - at 9:00PM Dear Mr. Ghosio: Enclosed, please find the Town of Southold display permit application for the Fireworks Display specified above, Insurance certificate, ske plan, shell list, chief pyroteclmidan data sheet and Copy of FAA Letter for your event. Please complete the "Sponsor" Portion of the form, sign k and return k to the Town Clerk's Office as soon as possible so they may process the permit. The address is as follows: Elizabeth Neville Office of the Town Clerk 53095 Main Rd. Southold, New York 11971 If you have any questions, or if I can be of further assistance, please do not hesitate to contact me. Thank you for your help and cooperation in this matter. Sincerely, Edward Rubio Logistics Manager Cell 516-658-4486 Fireworks by Gmcd, Inc. One Grucci Lane Brookhaven, NY 11719 Office #: (631) 286-0088 Fax #: (631) 286-9036 E-mail: ERubio@gmcci.com THE FIRST FAMILY OF FIREWORKS FIREWORKS BY GRUCCI~ INC. SITE INSPECTION REPORT Program: Southold GOP Fireworks Benefit Show Date: 10/12/06 Rain Date: 10/13/06 Event Contact: Bob Ghosio, Jr. Phone: 631-765-3767 Fax: 631-765-1744 Staging Area Contact: Bob Ghosio, Jr Phone: 631-765-3767 Fax: 631-765-1744 Staging Area Address: Pindar Vineyards Winery & Pavilion, 37645 Main Rd., Peconic, NY Fire Marshal: Town of Southold Phone: 631-765-1800 Fax: 631-765-6145 NFPA 1123 70' per inch 4" max Aerial Shell 280' minimum Discharge Site: Latitude 41° 2' 30.998"N Longitude -72° 27' 35.371" W 400' Safety Zone N Audience ] Maximum Aerial Shell Diameter: 4" (Inches) ] Can Illuminations be used? Yes S1TE INSPECTION: DISTANCES: Inspected by: Electronically VIP Audience: 400'+ Vehicles: 400' Date: 9/4/06 Building Occupied: 400'+ Overhead Obstructions: N/A Time: 11:00am Building Unoccupied: 400'+ Trees/Shrubs: 300' Prepared by Edward Rubio Logistics Manager- FB.G. September 4, 2006 September 11, 2006 Re: Southold GOP Fireworks Benefit - Pindar Vineyards, Peconic, NY October 12, 2006 - at 9:00PM SHELL SIZE NOT TO EXCEED 4" Shell Size Description 1" Roman Candles 1.5" Comets 1.5" Multi-shot Cake Comets 2" Comets 2" Multi-shot Cake Mines 2" Roman Candles 2.5" Multi-shot Cake Shells 3" Mines 3" Assorted aerial shells 4 ' Mines 4" Assorted aerial shells Assorted aerial shells consist of ChtTsanthemum's, Comet's, Peony's, Titanium Salutes, Palm Trees, Willows, etc.. Titanium Salutes are limited to 3" only. Total: Not to exceed 1210 Firework Shells and 850 Illuminations Type: Fireworks UN0335 (Display Fireworks) (Explosive 1.3G) Fireworks UN0336 (Special Effects) (Explosive 1.4G) Thank You, Edward Rubio Logistics Manager Fireworks by Gmcci, Inc. Cell: 516-658-4486 Fireworks by Gmcci, Inc. One Grucci Lane Brookhaven, NY 11719 Office #: (631) 286-0088 Fax #: (631) 286-9036 E-maih ERubio@gmcci.com THE FIRST FAMILY OF FIREWORKS ACORD.* CERTIFICATE OF LIABILITY INSURANCE8/21/2006DATEIM"'DD"' I PRODUCER Phone: 440-248-4711 Fax: 440-248-5406 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Britton-Gallagher and Associates, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 6240 SOM Center Rd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Cleveland OH 44139 INSURERS AFFORDING COVERAGE NAIC # NSURED INSURERA: National Union of Pittsburgh Fireworks By Grucci, Inc. INSURER8: Granite State Insurance Co. 1 Grucci Lane ~NSURERC: Axis Surplus Ins Company Brookhaven NY 11719 INSURERD: NY State Fund - Melville INSURER E: COVERAGES THE POLICIES OF INSUP~CE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED N~24ED ABOVE FOR THE POLICY PERIOD INDICATED. NO~4ITNSTANDING ANY REQUIREMENT, TEP~ OR CONDITION OF ANY CONTP~ACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE HAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS A~D CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SWOWH MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR %DD*[ POLICY EFFECTIVE POLICY EXPIRATION LTR N~R[ TYpE OF INSURANCE POLICY NUMBER DATE IMMIDD/YY~ DATE IMMIDO/'fyI LIMITS A GENERALLIABILITY 1072388 2/17/2006 !2/17/2007 E~CHOCCURRENCE $ ~ , 000 , 000 DAMAGE TO RENTED $ 50, 000 X COMMERCJAL GENERAL LIABILITY PREMISES (Ea occurence) I CLAIMSMADE [] OCCUR MEDEXP(Anyonepemon) $ PERSONAL&ADVINJURY $ 1~ 000~ 000 GENERALAGGREGATE $ 2, 000, 000 GEN'LAGGREGATE LIMITAPPLIESPER: PRODUCTS-COMP/OPAGG $ 2, 000, 000 B AUTOMOBILELIABIMTY CA62659113 2/17/2006 2/17/2007 COMBINEDSINGLELIMIT $ i , 000 , 000 ~ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) ~-- HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) __ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EAACClOENT $  ANYAUTO OTHERTHAN EAACC AUTO ONLY; AGG $ C EXCESS/UMBRELLA LIABILITY EAUT06151 2/17/2006 2/17/2007 EACHOCCURRENCE $ 4 , 000 , 000 X~ OCCUR ~ CLAIMS MADE AGGREGATE 000, 000 $ X~ DEDUCTIBLE $ RETENTION $ 1 0, 0 0 0 $ WC STATU- D WORKERSCOMPENSATiONAND I2673978 11/29/2005 11/29/2006 X [TORYLIMII~I [OET~' EMPLOYERS' LIABIL]TY E.L. EACH ACCIDENT S ~ 00, 000 ANY PROPRIETORJPARTN ERJEXECUTIVE OFFICER/MEMBEREXCLUDED? EL. DISEASE-EAEMPLOYEE $ 500~ 000 If yes, describe under SPEC AL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Date: October 12, 2006; Rain Date: TBD Location: Pindar Vineyards Winez~; & Pavilion. Route 25, P.O. Box 332, Peconic, NY Additional Insured: Southold COP, P.O. Box 368, Peconic, NY 11958; Pindar Vineyards winery & Pavilion; Town of Southold; City of Peconic; State of New York CERTIFICATE HOLDER CANCELLATION Southold COP c/o Bob Ghosio, Jr. 33 Sunset Lane Greenport NY 11944 SHOULD ~NY OF THE ABOVE DESCRIBED POLICIES BE CA~CELLED BEFORE THE EXPIP~TION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ~ KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08) © ACORD CORPORATION 1988 September 11,2006 As per the document N.F.P.A. 1123-2000 Code for Fireworks Display and the Town of Southold regulations, the following information is provided. SponsodClient Name: Southold GOP Fireworks Benefit - Bob Ghosio, Jr. Location and Date of Fireworks Display: Pindar Vineyards, Peconic, NY October 12, 2006 - Rain Date: Oct. 13, 2006 @ Approximately 9:00PM Chief Pyrotechnician: Health: Age Years Experience: Chris Carlino Excellent 40 14 Assistant Pyrotechnicians: Health Age Years Experience: Al Tellenkamp Excellent 42 3 Product: Firework Shells 1.3G explosives, UN0335, Maximum Aerial Shell Diameter = 4 inches. Storage will be at secured safety zone in D.O.T. approved fiberboard containers Cf UN-4G, and stored in company vehicle approved for this purpose. Fireworks by Grucci complies with all requirements of the NFPA 1123 and The Town of Southold. The above information is submitted and verified by: Edward Rubio Logistics Manager Fireworks by Grucci, Inc. One Grucci Lane Brookhaven, NY 11719 (631) 286-0088 - Phone (631) 286-9036 - Fax VINEYARDS P.O. bOX 332, PeCONIC, NY ~ !958 teL: (631 ) 734-6200 FAX: (631) 734-6205 September 7, 2006 To Whom It May Concern: ~V~e give permission ~ Pin~tr Vineyards to hold a fireworks display for the Sonthold GOP on 0ctobe,r 1~, 2006fit 9 p.m. , -Herodotus It~ an~ 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.north fork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD ro~ From: Dated: Re: Chief Cochran, Southold Town Police Department Robert Fisher, Fire Inspector Melissa Spiro, Land Preservation Linda J. Cooper, Deputy Town Clerk September 20, 2006 Fireworks Permits Southold GOP ~ Pindar Transmitted herewith are applications for Fireworks Permits for Southold GOP (fireworks by Gmcci) at Pindar Vineyard on October 12, 2006 at 9 PM. Please advise if the permit may be issued. Thank you. NOTE: A clearer location map is being UPS'd to this office. 09/20/2006 14:00 FAX ~001/009 September 11, 2006 TO: COMPANY: ADDRESS: PHONE: FAX: FROM: TOTAL PAGES: EliT-~heth Neville Office of the Town Clerk 53095 Main 1~. Sourhol& New York 11971 631-765-1800 631-765-6145 Edward Rubio 9 Dear Mrs. E1Lzabeth Neville: Soufiiotcl Town Clerk Re: Southold GOP Fireworks Benefit - Pindar Vineyards, Peconic, NY October 12, 2006 - at 9:00PM Attached hereto please find the followhag: 1) Application copy 2) FAA Letter 3) L~er to Sponsor 4) Site Plan 5) Shell Count 6) Certificate of Insurance 7) Chief Pyrotechnieian Data Sheet 8) Letter of permission to use land for display Any questions please give me a calL Tha.qk You for allyour help, Edward Rubio Logistics Manager Fireworks by Grucci, Inc. CeU 516-658-4486 Fireworks by Grucci, Inc. One Grucci Lane Brookhaven, NY 11719 office #: (631) 286-0088 Fax #: (631) 286-9036 E-mail: erubio~grucci.com THE FIRST FAMrI.Y OF FIREWORKS 09/20,/2006 14:00 FAX ~]002/009 ELIZABETH A. NEVILLE TOWN CLERK REGISTP. AR OF VITA/~ STATISTICS I¢-A~RL~GE OFFICER RECORDS NL&NAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, $8095 Main F~ad P.O. Box 1179 Southold, New York 11971 F~x (631) 765-6145 Telephone (631) 765-1800 southoldtown.nortlffork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION PERMIT TO DISPLAY FIREWORKS APPLICATION IS I-~R. EBY MADE, pursuant to the provisions of Section 405.00 of the Penal Law of the State efNew York, for a permit to display fireworks as hereinafter specified DISPLAY IS TO BE SPONSORED BY -~OO'~ PRINCIPAL OFFICE AT ?D0 ~oX $~g /t~j~ /~/'Y/ //~'7~ DATE & TIME OF DISPLAY /0//~/06 EXACT LOCATION OF DISPLAY.,~. ~';~d4~- The following persons are to be in charge of the actual shooting of the fireworks: Name Age Experience Physical 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 t/o display: 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 Appflcation. Name of Organization Date of Application 09/20/2006 14:01 FAX ~003/009 September 11, 2006 TO: Mr. Frank Jordan COMPANY: FAA - JFK FAX: 718-995-5693 Primary - 5687 Back-up FROM: Edward Rublo TOTAL PAGES: I Deat Mt, Jordan: Please be advised of the following Fireworks displays: EVENT: Southold GOP Fireworks Benefk LOCATION: Pindar Vineyards, Peconic, NY LATrruDE: 41' 2' 30,998" N LONGITUDE:-72* 27' 35.371" W DATE: Oct. 12, 2006 Rain Date: Oc~. 13, 2006 TIME: APPROXIMATELY 9:00 PM for 3 -4 minutes. The ma.mum altitude of the Fireworks will not exceed 900 feet. In letter form, please acknowledge the receipt and approval of this notification. Thank you for your prompt reply, Tha~.k You, Edward Rubio Logistics Manager Fireworks by Grucck Inc, Cell: 516-658-4486 Fireworks by Grucci, Inc. One Gmcei Lane Brookhaven, NY 11719 Office #: (631) 286-0088 Fax #: (631) 286-9036 E-mail: ERubiot~gmcci.com THE FIRST FAMILY OF FIREWORKS 09/20/2008 14:01 FAX ~004/009 September ll, 2006 Bob Ghosio, Jr. 33 Sunset Lane Greenport, NY 11944 Phone: 631-765-3767 Pax; 631-765-1744 Re: $outhold GOP Fixeworks Benefit - Pindar Vineyards, Peeonic October 12~ 2006 - at 9:00PM Dear IVlr. Ghoslo: Enclosed, please f'md the To~rn of Southold display permit application for the Fireworks Display specified above, Insurance certificate, site plan, shell fist, chief pymtechnician data sheet and Copy of FAA Leaer for your event. Please complete the "Sponsor" Portion of the form, sign it and return it to the Town Clerk's Office as soon as possible so they may process the permit. The address is as follows: ELizabeth Neville Office of the Town Clerk 53095 Main Rd. Southold, New York 11971 If you have any questions, or if I can be of further ass~ance, please do not hesi*ate ~o contact me. Thank you for your help and cooperation in this matter. Sincerely, Edward Rubio Logistics Manager Cell 516~658-4486 Fireworks by Grucci, Inc. One Grucd Lane Brookhaven, NY 11719 Office #: (631) 286-0088 Fax #: (631) 286-9036 E-maih ERubio@grucci.com THE FIRST FAMILY OF FIRI~WORKS ,~./20.,."2008 14:01 FAX SouthoId OOP Fir~work~ Benefit FIREWORKS BY GRUCCI. INC. SITE INSPECTION REPORT Show Date: 10/12/06 Bob Ghosio, Jr. ~005/009 RainDate: 10/13/06 PhOn~: 631-765-3767 Fax: 631-765-1744 Staging Area Contect: Bob Ohosio. Jr Phone: 631-765-3767 S~aging Area Address: Pindar Vineyards Wintery & Pavilion, 37645 Main Rd., P~conic, NY Fax: 631-765-17~, Fire Marshal; Town of Somhold Phone: 631-765-1800 Fax: 631-765-6145 NFPA 1123 70' per inch max Aerial Shell 280' minimum D~e_~__~e Site: Latitude 41° 2' 30.998"N Longitude -72° 27' 35.371" 400' Safety Zone N Audience ] Maximum Aerial Shell Diam~ner: 4" Caa Illuminations be used? Y~s SITE INSPECT[ON: DISTANCES: Inspected by: Electxonically VIP Audience: 400'+ Vehicles'. 400' Date: 9/4/06 Building Occupied: 400'4- Overhead Obsl~letinns: N/A Time: 11:00am Building Unoccupied: 400'+ Try, es/shrubs: 300' pr~parad by Edward Rubio - Logi~tiat Managmr - F.B.G. .~ptember 4, 09/20/2008 14:02 FAX ~ 006/009 September 11, 2006 Re: Southold GOP Fireworks Benefit - Pindax Vineyards, Peconic, NY October 12, 2006 - at 9:00PM SHELL SIZE NOT TO EXCt!ED 4" Shell Size Description 1' Roman Candles 1.5" Comets 1.5" Multi-shot Cal~ Comets 2" Comets 2" Multi-shot Cake Mines 2' Roman Candles 2,5" Multi-shot Cake Shells 3" Mines 3" Assorted aerial shells 4" Mines 4" Assorted aerial shells Assorzed aerial shells consist of Chrysanthemum's, Comet's, Peony's, Titanium Salutes, Palm Trees, Willows, etc. Titanium Salutes are limited m 3" only. Total: Not to exceed 1210 Firework Shells and 850 Illuminations Type: Fireworks UN0355 (Display Fireworks) (Explosive 1.3G) Fireworks UN0336 (Special Effects) (Explosive 1.4G) Th~k Edward Rubio Logis~cs Manager Fireworks by Gtuc~ Inc. Cell: 516-658-4486 Fkeworks by Gmcd, Inc. One Grucci Lane Brookhaven, NY 11719 Office #: (631) 286-0088 Fax #: (631) 286-9036 E-mail: ERubio@grucci. com THE FIRST FAMILY OF FIREWORKS 09/20/2006 14:02 FAX ~007/009 ACORD., CERTIFICATE OF LIABILITY INSURANCE .;;ODUCE. Phone: ".40-2~8-~,711 Fa~: ~40-24e-5405 THIS CERTIFICATE IS 18SUED AS A MATrER OF INFORMATION ~ricton-Gallagher and Associates. ThC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 6240 SOM Center Rd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Cleveland O~1 44139 INSURERS AFFORDING COVERAGE NAIC ,.su.;D ~NSU~A: ~at~onal Union of Pittsburgh Fireworks By Grucci, Inc. ]NSU~S: Granite State Insuranc~ Co. 1 Grucci Lane ~NSU~E~C: Axis Surplus I~S Company Brookhaven NY 11719 ~8u~o- NY Stata Fund - Melville INSURER E'. COVERAGES A u__~E~.~uaalu?* 1072388 2/17/2006 2/17/2007 E~CHOCCURRE~C~ S 1, 000, 000 $ 10,000 D wo~sco..~s*~o.*~ I2673978 Z1/29/2005 11/29/2006 ~o~Hm~ ~ ~R CERTIFICATE HOLDER CANCELLATION Souchold GOP e/o Bob Ghosio, 33 Sunset Dane SHOULD ~ OF TEE ASOVE DE$C~/BED ~OLICIES BE CANCELLED B[F~RE THE EXPIRATION DATE ~EEOF, T~E ISSUING INSURER ACORD 25 (2001/08) ©ACORD CORPORATION 1988 ~9,,/20/~006 14:03 FAX ~008/009 September 11, 2006 As per the document N.F,P.A. 1123-2000 Code for Fireworks Display and the Town of Southold regulations, the following information is provided. Sponsor/Client Name: Southold GOP Fireworks Benefit- Bob Ghosio, Jr. Location and Date of Fireworks Display: Pindar Vineyards, Peconic, NY October 12, 2006 - Rain Date: Oct. 13, 2006 ~ Approximately 9:00PM Chief Pyrotechnician: Health: Age Years Experience: Chris Carlino Excellent 40 14 Assistant Pyrotechnicians; Health Age Years Experience: Al Tellenkamp Excellent 42 3 Product: Firework Shells t.3G explosives, UN0335, Maximum Aerial Shell Diameter = 4 inches. Storage will be at secured safety zone in D.O.T. approved fiberboard containers # UN-4G, and stored in company vehicle approved for this purpose. Fireworks by Grucci complies with all requirements of the NFPA 1123 and The Town of Southold. The above information is submitted and verified by: Edward Rubio Logistics Manager Fireworks by Grucci, Inc. One Grucci Lane Brookhaven, NY 11719 (631) 286-0088 - Phone (631) 286-9036 - Fax ,09/20~200G 14:03 FAX ~009/009 VINEYARDS P.O. BOX 33z~ pi;CONIC, NY 1 IgSe TEL: (63 I ) '734-6200 FAX: (63 I ) 734-6205 Scptember 7~ 2006 To Whom It .May Concern: Wc give permission .~r Vineyards to hold a lircworks display for the Southotd