HomeMy WebLinkAbout2005 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 bercby
GRANT TO:
MATTITUCK LIONS CLUB
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 FRIDAY~ JUNE 17~ & SUNDAY~ JUNE 18~ 2005 AT 9:30 P.M.~ on the property of the COUNTY OF
SUFFOLK, managed by THE TOWN OF SOUTHOLD, known as 'STRAWBERRY FIELDS", Sound Avenue,
Mattituek, New York.
ON CONDITION THAT the bond (indemnity insurance) required shall con, hue 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 fi.om the nearest building, public highway or railroad, or other means of travel, and at least
feet fi.om the nearest above ground telephone or telegraph line, trees or other overhead obs~uction; that the audience
at such display shall be restrained behind lines at least one hundred and fifty feet fi.om 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 ak as nearby as possible in a vertical
direction unless such fireworks are to be fired fi.om the shore or a lake or other large body of water, then they may
be directed in such manner that thc falling residue fi.om the deflagration will fall into such lake or body of water;
that any fireworks that remain unfired after the display is conducted shall be immediately disposed of in a way safe
for the particular type of fireworks remaining; that no fireworks display shall beheld during any wind storm in which
thc wind reaches a velocity of more than thirty miles per hour; that all persons in actual charge of firing the
firewurks 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
extinguisbers 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: June 8, 2005
Elizabeth A. Neville, Town Clerk
Town of Southold
Suffolk County, New York
THIS PERMIT IS NOT TRANSFERABLE
POLICE DEPARTMENT
TOWN OF SOUTHOLD
CARLISLE E. COCHRAN, JR.
Chief of Police
Telephone Emergency Dial
MEMORANDUlVl
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
Mattituck Lions Club - June 16 and June 17, 2005
Greenport Fire Depactment - July 2 and July 4, 2005
Southolcl Town Clerk
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 Fiaticy
41405 Route25op. O. Box911 ° Peconic, N.Y. 11958
Administrative (631) 765-2600/2601 · Fax (631) 765-2715
ELIZABETH A. NEVILLE
TOWN CLERK
REGISTRAR OF VITAL STATISTICS
IVLARRIAGE 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
southaldtown.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 Permiis 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
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
PRINCIPAL OFFICE AT
DATE& TIME OF DISPLAY
'
[~CT LOCATION OF DISPLAY
~N DATE & TIME
The following person~ are to be in charge of the actual ~hooting of the fireworks:
N~ t~ ~r~2g Age Experience Phy~eal Condition
(Additional names and information may be submitted on an attached sheet
Number and type of fireworks is as fol[ows~ -- ~ ,,
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 P~,?~n'tl'Owner, must be submitted with the
Application. ~~t~ ~ 2~¢o./~ ~ ~r~/~' ~ ~
RECEIVED ~ ~ or ~ c,
~e~f Organization~
1,~Ix¥ : 7 ,' ,3 B ~
Si~at~ of Applic~t
Southold Town Clerk .. ~ /~1 2~
~ate
of Application
05)09/200~ 15:29 FAX 856 697 9557 VINELAND FIREWORKS CO, ~006
PoucY Ee~CTNE ~,OUCY EXPIRATION LW~T$
co 'i'Y~ OF INSURANCE ~OUCY NUMBER OATE (MI~ DATE (MM~D~
OWNED AUTO $CF~I3ULEO AUTO~ HIRED .ccld.~
~JTOS NK3N-OWNEDAUTO$ ~DIL¥1NJURY(Parpe~1 $
~)
EXCESS U~aiUTY FCX. LOW~S FOm~ ~ACH N..~ r-.l~,T s
~:,L OISEAS~.-POUCY Lean' $
O'TH~R
05/09?2005 15;29 FAX $56 697 9557 VINELANI) FIREWORKS CO. ~005
ACORD CERTIFICATE OF LIABILITY INSURANCE
OS/O4/ZO0le
P~O~UC'ER (& 56) 694-2222 FAS (~56)6gq-Z27~l THIS CI~KTIEICAT~ IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
The Bo re11 i Agency, Xnc. HOLDER. THiS CERTIFICATE DOES NOT AMEND, Ex-rEND OR
Butch N~11 Road ALTERTHE COVERAGE AFFORDED BYTHE POUCIES BELOW.
INSURERS AFFORDING COVERAGE NAIC #
COVERAGES
THE POLICIES OF INSURANCE LIB?ED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A~OVE FOR TH£ POUCY PERIOD INDICATED. NOTWITHSTAN[~NG
ANY REQUIREMENT. TERM OR CONDmON DF ANY CONTRACT OR OTHER DOCUMENT V~ITH RESPECT TO V~rlICH 11-115 CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. 'ri,IF INSURANCE AFFORDED BY THE POLICIE~ DESCRIBED HEREIN I$ SUBJECT TO ALL THE TERM$. EXCLU$1ON~ AND CONDmONS OF SUCH
POLICIES. AGGRECaATE UMIT$ SHOWN MAY HAVE BEEN REDUCED DY pAID CLAIMS.
~ ~ ~n,Eo~lt~u~.tK:e - I,OUcYmJMeER bA~(M~ DA~EIMM~]O/YY) I UMII~
CERTIFICATE HOLDER CANCELLATION
ACORD 26 (2001/08)
//