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HomeMy WebLinkAbout2005 ELIZABETH A. NEVII J ~F. 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 Fe.x (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~ GREEN-PORT 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 9:30 p.m. on Saturday~ October 29~ 2005~ Raindate: Sunday~ October 30~ 2005~ 8:00 p.m. 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 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 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 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. Date: October 14, 2005 (Town Seal) Elizabeth A. Neville, Southold Town Clerk Suffolk County, New York THIS PERMIT IS NOT TRANSFERABLE MEMORANDUM TO: FROM: DATE: RE: Linda J. Cooper, Deputy Town Clerk Chief Carlisle E. Cochran, Jr. October 25, 2005 Request for Special Permit - Southold PTA Halloween Parade - Saturday, October 29, 2005 I have reviewed the above request for a special permit. I have no objection to the approval of this permit. Please have Ms. Wineberger, or her representative, contact Capt. Martin Flatley within ten (10) days after Town Board approval to coordinate traffic control. cc: Capt. Martin Flatley 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: RE: Date: Chief Carlisle E. Cochran, Jr. Lynda M. Bohn, Deputy Town Clerk Greenport Fire Department October 24, 2005 Transmitted is request of the Greenport Fire Department to change the date of the fireworks permit from October 22, 2005 to October 29, 2005 with a new rain date of October 30, 2005. Please review this request and send me your recommendations in writing. Thank you. 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 TH E 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 9:30 p.m. on Saturda¥~ October 23~ 2005~ Raindate: Sunday, October 23~ 2005~ 8:00 p.m. 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 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 projechle 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 ail 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. Date: October 14, 2005 (Town Seal) Elizabeth A. Neville, Southold Town Clerk Suffolk County, New York THIS PERMIT IS NOT TRANSFERABLE POLICE DEPARTMENT TOWN OF SOUTHOLD CARLISLE E. COCHRAN, JR. Chief of Police Telephone Emergency Dial 911 TO: FROM: DATE: RE: Lynda M. Bohn, Deputy Town Clerk Chief Carlisle E. Coehran, Jr. g::~..-'" October 13, 2005 Request for Special Permit - Greenport Fire Depm'hnent Permit Fire Works - Saturday, October 22, 2005/rain date Sunday, October 23 I have reviewed the above request for a special permit. I have no objection to the approval of this permit. cc: Capt. Martin Flatley 41405 Route25 oP.O. Box911 · Pcconic, N.Y. 11958 Administrative (631) 765-2600/2601 · Fax (631) 765-2715 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: RE: Date: Chief Carlisle E. Cochran, Jr. Lynda M. Bohn, Deputy Town Clerk Greenport Fire Department Fire works permit October 11, 2005 Transmitted herewith is the application of the Greenport Fire Department for a Fireworks Permit. Please advise if this permit may be issued. Thank you. 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 INSTRUCTIONS FOR DISPLAY OF FIREWORKS 1. Name of body sponsoring fireworks display. 2. The date and time of day at which the fireworks display is to be held. 3. The exact location planned for the fireworks display. 4. The age, experience and physical characteristics of the persons who are to do the actual discharging of the fireworks. 5. The number and kind of fireworks to be discharged. 6. The manner and place of storage of such fireworks prior to the display. 7. A diagram of the grounds on which the display is to be held, showing the point at which the fireworks are to be discharged, the location of all buildings, highways and other lines of communication, the lines behind which the audience will be restrained and location of all nearby trees, telegraph or telephone lines or other overhead obstructions. 8. Such other information as the Southold Town Clerk may deem necessary to protect persons and property. Written permission of the property owner is required. 9. An indemnity insurance policy with liability coverage and indemnity protection of $1,000,000.00 per person for bodily injury; $1,000,000.00 per accident; $1,000,000.00 property damage. 10. The Town Clerk of the Town of Southold must have the insurance policy in her possession before the fireworks permit is issued. The named insured must read: TOWN OF SOUTHOLD. 11. Application for a fireworks permit must be made at least five days in advance of the date of the fireworks display. (The above instructions are in accordance with the Penal Law, Article 405 - Licensing and other provisions relating to fireworks.) ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION PERMIT TO DISPLAY FIREWORKS APPLICATION IS HEREBY MADE, pursuant to the provisions of Section 405.00 of the Penal Law of the State of New York, for a permit to display fireworks~as hereinafter sp~ecified: DISPLAY IS TO BE SPONSORED BY PRINCIPAL OFFICE AT -"~.'~'o/ DATE & TIME OF DISPLAY ~'~c-~.~./ EXACT LOCATION OF DISP~LAY RAIN DATE & TIME ~q C]&~f The following persons are to be in charge of the actual shooting of the fireworks: ~k~ ~~C~-'l fi'%' Age ~ Experience (Additional names and information may be submitted on an attached sheet type of fireworks is as follows: Mcner and place o,f storage of fireworks prior to display: ~.~/,'it/ b-E O/~X~/~r-cc~ ~ Attached hereto and made a part of hereof is a diagram of the grounds on which the display is to be held. Also attached is a certificate or policy of insurance coverage. NOTICE: Written permission, with signature of the Property Owner, must be submitted with the Application..~~j ~'~ ~~'-7~ -'~ -0' .~ /-~ame ~f~rgani.~ation , //' Si~at~e oF Applic~t Date of A~plicati0n /\ ~ OO ce% Lckv~e_ 10/04/2005 14:06 FAX 856 697 9557 * 0CT~3c~(~0N) 15:~6 eSI H~INTZ VINELANI) FIREWORKS CO, (FA×)?6$ 559 7465 [~002 THAT THE POLI~Jc~ OF INSURANC,~ LL.%'TT~3 ~W H&~ ~N ~UED ~ THE ~ ~ ~VE F~ ~E P~I~ ANY O/= ~ *,~OVE DEGCRII~ED POLICIES BE CAN"'~ * ~ WEFORE THE P. XpIR~TION D=,TE 'tHE ISSUING COt~ANY WILL ENDEAVOA 1'O MAIL 10 DAY~ WRITTEN NOllCE '~O THE gUT FA~I,U~E TO MAll. b'UGH NOTtCE 5HAkL IMPOSE NO 10/04/2005 14:06 FAX 856 697 9557 VINELAND FIREWORKS CO. [~003 ''OCT', ~.2005-11:06AM 'ACORD. CERTIFICATE OF LIABILI Tke Bor~11~ Agency, Dutch ~11 r~u, [ ~-7---t-r, ONLY AND COHFE~ NO ~G~ UPON ~E HO~E~ ~ ~ .......... ~1~ B~ ~ ~ ~GE ~ ~v ~n~ r~ , INSU~RS A~DI~ ~ ~C 1N~ ~ 21l Knapp Place 10/04/2005 14:06 FAX 856 697 9557 VINELAND FIREWORKS CO. ~004 ,,'"~CT:"L2005_11:O6AM 'ACORD. CERTIFICATE OF The Bore11~ Age~Cy~ ZaC, MAY PFRTAIN- Tl~ ll~tJRAN~ ~r r ~ra~ . POLICIES. AG~TE LIMITS ~HC)WN MAY HA~E BEEN RIL=DUC~D BY PAID CLNM$ CERTIFIOATE HOL~ER AeORO 2S (2001/08) LIABILITY INSURANCE ~.~:R THE coVBRA(SE AI~::~EO BY THE pOU~ea uE~,~--. _ O4/OX/2ODG ~-- ~'"'~ORD CORPORATION 10/25/2005 13:05 FAX 856 697 9557 ¥II~EIANI) FIREWORKS CO. ~002 'OET-Z~-ZOOSiTUE) O9:~Z EOMBINEO 5PEEIRLTIE5 INT. (FRX)$SI8550088 P. OOI/OOI · ~ODUDEfl rHl~ C~H1 iPIF. ATE tS ~R ~ k MA~ ~ I~ O~Y ANO ~ NOT AMEND, ~END OR ~ ~E ~ ~ BY ~ ~ ~ ~ ~LICIE~ ~W, ~ ~o ~125 INSURES ~ING ~E ~ ~ ~. rn= ~ ~ ..... ~RAGE5 =~1~ ~Y BE I~U~ ~ ~Y ~A~, THE ~OE A~ BY ~E P~ ~ HEREIN ~ ~ TO ~ ~ ~S, ~US~ ~ ~D~ OF S~ ~1~ ~CLUD~. BUT ~ ~ TO T~ ~ ~ ~ ~Y HA~ ~ R~ED BY ~1~ ~E~ ~Y~ LI~ ~L~ ~E ~ ~U~ ~ N~BER DA~ ~ DATE (M~ A ~ L~L~ I11 ~0~ ~ ~ ~ Ju~ ~, ~ ~ ~ ' ~o ~o ~ U~S $ 10/25/2005 13:06 FAX 856 697 9557 VINELAND FIREWORKS CO. [~003 " Nc 677 L 1 .OCT. 25, 2005,, p,c, un~ ~.,~'n u trt~A~= OF LIABILI~ I SU~N E ,0/./20o, O~ccb ~11 Road A~ Na~ag~., N2 08328 IN~UR~FORDING~GB I~ V~nelahd F4reworkS CD..Z~c. CERTIFICATE HOLDER ACORD 25 (200'U08) t~ANO ELLATION 10/25/2005 13:06 FAX 856 697 9557 VINELAND FIREWORKS CO, A(;u~<l~,. u~-~ ~ u-~uAp- OF LIABILITY INSURANCE Th= Borelll Agency, Dutch R~ll Road ~004 .NO. 677 .P. IO/04/zQ01 ONLY ANO COKFEFqB NC) ~G~ ~N ~ ~FI~T~ INSURERS AFFORDING COVERAGE NoN.o~r~ AUTOS W¢S-33S-30X~13-01S 04/0Z/200~ ~4u~d~_~e~Nem LMT CE~'I1FICATE HOLDER 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 thfork.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. ~ 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 Saturda¥~ May 28~ 2005~ Raindate: Sunda¥~ May 29~ 2005 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 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 fxom the nearest above ground telephone or telegraph line, trees or other overhead obstruction; that the audience at such display shall be reslxained 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 projeclile 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 frreworks shall be over the age of eighteen years, competent and physically fit for the task, that ~ere shall be at least two such operators constantly on duty during the discharge and that at least two soda acid or~ther appro, ved 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 ~. Neville, Southold Town Clerk Suffolk County, New York (Town Seal) Date: May 26, 2005 THIS PERMIT IS NOT TRANSFERABLE POLICE DEPARTMENT TOWN OF SOUTHOLD Telephone Emergency Dial 911 CARLISLE E. COCHRAN, JR. Chief of Police RECEIVED TO: FROM: DATE: RE: Linda J. Cooper, Deputy Town Clerk Chief Carlisle E. Cochran, Jr.~2~-- May 24, 2005 Request for Special Permit - Fireworks Permits (3) Greenport Fire Department - May 28, 2005 Mattituck Lions Club - June 16 and June 17, 2005 Greenport Fire Department - July 2 and July 4, 2005 Southold Town Cle~'k I have reviewed the above requests for special permits. I have no objection to the approval of these permits. Please have the appropriate representative from each organization, contact Capt. Martin Flatley within ten (10) days after Town Board approval to coordinate traffic control. cc: Capt. Martin Flatley 41405 Route25 oP.O. Box 911 · Peconic, N.Y. 11958 Administrative (631) 765-2600/2601 · Fax (631) 765-2715 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 Linda J. Cooper, Deputy Town Clerk May 18, 2005 Fireworks Permits (3 applications) Transmitted herewith are applications for Fireworks Permits for the following: Greenport Fire Department, 5/28 Mattimck Lions Club, 6/17 & 6/18 Greenport Fire Department, 7/2 & 7/4 Please advise if these permits may be issued. Thank you. 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 hereina~er specified: DISPLAY IS TO BE SPONSORED BY PRINCIPAL OFFICE AT ~'~t~)4 DATE & TIME OF DISPLAY ~3c-~.* ~:~ ~N DATE & TIME ~k~ a ~ m~t) ~0 ~ - - The following persons are to be in charge of the actual shooting of the fireworks: ~C~ Age Experience Physical Condition (Additional n~es and info~ation may be submitted on ~ attached sheet Number aua Wpe of fireworks is as follows: Manner and place of storage of fireworks prior to d~splay: Attached hereto and made a pa~ 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. ~ of~rg~ization / Si~ature of Applic~t Date of Application ~ C)d~ ce_% ~..ck~e_ 0~/09/20~5 15:28 FAX 856 697 9557 VINELAN]) FIREWORKS CO. ~003 ACORD CERTIFICATE OF LIABILITY INSURANCE I ( 8 5 6 )'6'~-- ~ - 2 2 2 2 F~ ( 8 $ ~ ) 6 9 4 - 2 2 7 9 THIS IS I~UED AS A OF INFOR~ON ONLY AND CONFERS NO RIGHT8 U~N ~E CER~FICATE The Bore1 1 i Agency, Zflc. HO~ER. ~IS CER~F~A~ DOES NOT ~END, ~END OR Dutch H ~ 11 Road AL~R THE CO~GE AFFORDED BY ~E ~CI~ BELOW. COVERAGES THE PSUCIE$ OF INSURANCE LISTED BELOVV HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT ~MTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAJN, THE INSURANCE AFFORDED BY THE POUCIE8 DESCRIBED HEREIN IS SUBJECT TO ALL THE ~RMS, EXCLUSIONS AND CONDITIONS OF SUCH POUGIES. AGGREGATE LIMITS SHOWN MAY HA~ EEEN REDUCED BY PAID CLAIMS. LTR~ ~' 1y~ OF INgURAJV~E__. POLJCY NUMBER D~,TE f MM/D~iYY) DAT~ IMM/OD/YY} $~.H~RAL UAeiUTY e*c:~l OCCUrreNCe $ CERTIFICATE HOLDER CANCELLATION ACORD 25 (200t/08) ©~a~O~ CORPORATION 1989 05/[3/2005 13:18 FAX 856 697 9557 VINELAND FIREWORKS CO. [~]002 ~.~- I J-~,uu~ ~l-Nl J 09:~1 ES I-EIq [FAX)A l~;'09DO13 P. OOI/OOI ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER 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.nor thfork.net INSTRUCTIONS FOR DISPLAY OF FIREWORKS 1. Name of body sponsoring fireworks display. 2. The date and time of day at which the fireworks display is to be held. 3. The exact location planned for the fireworks display. 4. The age, experience and physical characteristics of the persons who are to do the actual discharging of the fireworks. 5. The number and kind of fireworks to be discharged. 6. The manner and place of storage of such fireworks prior to the display. 7. A diagram of the grounds on which the display is to be held, showing the point at which the fireworks are to be discharged, the location of all buildings, highways and other lines of communication, the lines behind which the audience will be restrained and location of all nearby trees, telegraph or telephone lines or other overhead obstructions. 8. Such other information as the Southold Town Clerk may deem necessary to protect persons and property. Written permission of the property owner is required. 9. An indemnity insurance policy with liability coverage and indemnity protection of $1,000,000.00 per person for bodily injury; $1,000,000.00 per accident; $1,000,000.00 property damage. 10. The Town Clerk of the Town of Southold must have the insurance policy in her possession before the fireworks permit is issued. The named insured must read: TOWN OF SOUTItOLD. 11. Application for a fireworks permit must be made at least five days in advance of the date of the fireworks display. (The above instructions are in accordance with the Penal Law, Article 405 - Licensing and other provisions relating to 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.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 STATION NO. 1~ 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~ July 2~ 2005 and Monday~ July 4~ 2005~ Rain Date: Saturday~ July 3~ 2005 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 Southnld, 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 lxavel, 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 Ymes; 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 in such manner that the falling residue from the deflagratinn 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 firewurks 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 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. -~-i~]e~-Southold Tox~'~]~ Suffolk County, New York (Town Seal) Date: May 8, 2005 THIS PERMIT IS NOT TRANSFERABLE POLICE DEPARTMENT TOWN OF SOUTHOLD Telephone Emergency Dial 911 CARLISLE E. COCHRAN, JR. Chief of Police RECEIVED MAY 2 5 2005 TO: FROM: DATE: RE: Linda J. Cooper, Deputy Town Clerk Chief Carlisle E. Cochran, Jr,~- May 24, 2005 Request for Special Permit - Fireworks Permits (3) Greenport Fire Department - May 28, 2005 Mattituek Lions Club - June 16 and June 17, 2005 Greenport Fire Department - July 2 and July 4, 2005 I have reviewed the above requests for special permits. I have no objection to the approval of theE permits. Please have the appropriate representative f~om each organization, contact Capt. Martin Flatley within ten (10) days after Town Board approval to coordinate traffic control. cc: Capt. Martin Flatley 41405 Route 25 * P.O. Box 911 · Peconic, N.Y. 11958 Administrative (631) 765-2600/2601 · Fax (631) 765-2715 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 Linda J. Cooper, Deputy Town Clerk May 18, 2005 Fireworks Permits (3 applications) Transmitted herewith are applications for Fireworks Permits for the following: Greenport Fire Department, 5/28 Mattituck Lions Club, 6/17 & 6/18 Greenport Fire Department, 7/2 & 7/4 Please advise if these permits may be issued. 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 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 s DISPLAY IS TO BE SPONSORED BY ~ ?K ~k PRINCIPAL OFFICE AT ...,,Q/~.,~ 'hJ/~ r~ ~ ~_ DATEa TIME OFDISPLA~ ~a ~,X~/t~/~ ~ E~CT LOCATION OF DISPLAY ~c~ ~ v~ ecified: The following persons are to be in charge of the actual shooting of the fireworks: N~ Age Experience (Addi~onal nines ~d info~ation may be submitted on ~ attached sheet Physical Condition Number and type of fireworks is,as follows: Manner and place of storage of fireworks prior to 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 Application. - N~Organization ~ ' t/ ~'Si~tt~re of Applicarit . 05/~9f200~, 15:30 FAX 856 697 9557 ¥INELAND FIREWORKS CO. ~011 55341~1 Issue Date.~ New Jemey 0a360 iN~U~.~ n~ ~OF~ ~ OA~ ~ ~ ~ ~ BODILY I~ ~ ~ILY I~Y (~ ~ ~M~N ~ ~A~ O~R~Y ~L. ~ S , 05/~0/2005, 15:30 FAX 856 697 9557 VINELANI) FIREWORKS C0, ~012 ACORD . CERTIFICATE OF LIABILITY INSURANCE ~DDUCER (l~ ~;6)694-222Z F~ (~ 56)694-22~ THIS C=~wICA~ IS I~UED ~ A ~R ( F INFO~flON ONLY AND CONFE~ NO ~GHTS U~N THE CERTIFI~ The Bore114 A~ency, /nc. ~ER. ~iS CER~A~ D~S NOT ~END, E~END OR Dutch H ~ ] N Raad AL~R THE ~GE AFFORDED BY THE POLICIES BEL~* Halaga,, NJ OI32; INSU~AFFORDINGCOVE~GE NA~W FOR THE POLICY PERIOD INDICATED, NOTV~THSTAN DING ANY REQLIIRteM~NT, TERM OR CONDITION OF ANY CONTI~CT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICAT~ MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE/NFFORDED BY THE POLICIES DF-SCRIFtED HEREIN IS SUBJECT TQ ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGRE[GATE LIMITS SHOW~ MAY HAVE BEEN REDUCED BY PAiD CLAIMS. RETENTION $ Phenix H&L Co. & Rel~ief Hose No. 2 Co. OFANYKINOUPON,~I~IN$UR~IT~AG~NT$OI~RE~ENTA~IVE~ 2~2 Knapp piece ACORD 25 (2001108) /\