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HomeMy WebLinkAboutSouthold Fire Dept ~UDITH T. TERRY TOWN CLERK REGISTRAR OF VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 FAX (516) 765-1823 TELEPHONE (516) 765-1801 February 7, 1994 TI I_1_1: The Certificate of Insurance must be filed in this office. McMann-Price Agency send a copy to me as soon as possible. Please have Thank you. JUDITH T. TERRY TOWN CLERK OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1801 SPECIAL PERMIT In accordance with Chapter 27, Section 27-1-B of the Code of the Town of Southold, a permit is hereby granted to the Southold Fire Department to hold their Annual Street Dance on Southold Fire Department property, Main Road, Southold, New York, on Saturday, September 3, 1994, from 8:00 P.M. to 1:00 A.M., provided they file with the Town Clerk a One Million Dollar Certificate of Liability Insurance naming the Town of Southold as an additional insured. Dated: February 7, 1994. Southold Town Clerk February 7, 199q cc: Police Chief Droskoski Building Department SERVI~TO THE COMMUNITY SINCE 1886 516- 765-3385 February 4, 1994 To: Southold Town Clerk Office Main Road Southold, N.Y. 11971 From: Protection Engine Co. Southold Fire Dept. Main Road Southold, N.Y. 11971 #1 F£B 7 1994 Southold Town Clerl~ Re: Permit for Annual Street Dance on September 3, 1994. Location: Southold Fire District grounds on Route 25 .Southold, N.Y. 11971 Time: 8:00 P.M. to 1:00 A.M. Desrciption: Approximately 300 people to attend, there will be food and beer sold, and there will be live D.J. and Band music. Tent: There will be one 20'x 26' tent used for the sole purpose of a concession stand. Insurance.: Insurance is on file with McMann-Price Agency Front Street, Greenport. Insurance covers Southold Fire District and Town of Southold. Tilli ~re~ Protecfion Engine Co. Secretary-Treasurer Southold Fire Dept. #1 JUDITH T. TERRY TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1801 SPECIAL PERMIT In accordance with Chapter 27, Section 27-1-B of the Code of the Town of Southold, a permit is hereby granted to the Southold Fire Department to hold their Annual Street Dance on Southold Fire Department property, Main Road, Southold, on August 31, 1991, from 8:00 p.m. to 2:00 a.m., provided they secure and file with the Town Clerk a Certificate of Liability Insurance for at least One Million Dollars naming the Town of Southold as an additional insured. Dated: August 29, 1991. Southold Town Clerk CC: Police Chief Droskoski Supt. of Hwys. Jacobs Building Department M,e)RI). ( .RTIFIC)IE .ANCE PROCUCER New York State Regional Office P. O. Box 1250 Vestal, NEw York 13851-1250 INSURED Southold Fire District P. O. Box 908 Southold, New York 11971 ISSUE DATE (MMIDD/YY) 8-30-91 ITHIS 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 COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANY LE"Ci-ER A COMPANY LETI-ER B COMPANY LETI'ER C COMPANY LETFER D COMPANIES AFFORDING COVERAGE Insurance Company of North America COMPANY LETTER E COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW 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 WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE iSSUED OR MAY PERTAIN, THE ~NSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFFECTIVE POLICY EXPIRATION CO TYPE OF INSURANCE POLICY NUMBER LIMITS LTR DATE (MMIDD,'YY) DATE (MMIDC/YY) A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X OCCUR. OWNER'S & CONTRACTOR'S PROT. G?PD19417980 3-2-91 3-2-92 GENERAL AGGREGATE * 2,000,000 PRODUCTS-COMP/DP AGG. S 2,0~0 ~ 000 PERSONAL & ADV. INJURY $1 ~* 000~ ~ EACH ~CURRENCE $ ~ ~ ~ J ~ FIRE DAMAGE (Any one fire) $ 50 ~ ~ MED. ~ (~y ~e ~) $ ~,~ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY EXCESS LIABILITY UMERELLA FORM OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY COMBINED SINGLE $ LIMIT BODILY INJURY $ (Per person) BODILY INJURY $ (Per accklent) PROPERTY DAMAGE EACH OCCURRENCE AGGREGATE STATUTORY LIMITS EACH ACCIDENT $ DISEASE--POLICY LIMIT $ DISEASE--EACH EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS;LOCATIONS/VEHICLES/SPECIAL ITEMS /he Certificate Holder is an Additional Insured per the CG-2026 endorsement with respects to a "Street Dance" b~ing held on 8-31-91. CERTfFICATE I.I(:)LGER CANCELLATION ~ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE "'"orr 'o 1991 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. Town of Southold Main Road Southold, New York 11971 ACORD 25-S (7190) AUTHORIZED REPRESENTATIVE ©ACORD CORPORATION 1990 SOUTHOLD FIRE DEPARTMENT P.O. Box 1469 Main RoacL NY Rt. 25 Southold. New York 11971 (516) 765-3385 AUG 8 0 FJgl Chief Mike G. Davids, Sr. (516) 765-2457 F~rs! Assistant Chief William H. Sawicki (516) 765-1567 SeconcY Assistant Chief William E Salmon (516) 765-5680 Secreta~ Keith Purcell (516) 765-1330 Treasurer Ronalcl Butkovich (516) 765-2139 Re: Location: Time: Description: Tent: Insurance: August 30,1991 Southold Town Clerk OFFice Route 25 Southold, New York 11971 Southold Fire Department Route 25 Southold, New York 11971 Permit for Annual Street Dance on ~u~ust 31,1991 Southold Fire District F~ounds on State Route 25 Southold. 9~00 P.M. to 1:00 Approximately 300 people to atten, there will be Food and beer sold, and there will be live D.J. music. There will be one 20'x20' tent used for~ the sole purpose of a concession stand. Insurance is on File with McManniPrice Insurance ~ency F~ont ST. Oreenport. Insurance covers Southold Fire Di&trict and Town of Southold. R. Wein~-a~. t 1st. Lieutenant Protection Engine Co. 1 Southold Fi~e Department JUDITH T. TERRY OFHCE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 FAX ($16) 765-1823 TELEPHONE ($16) 765-1801 SPECIAL PERMIT In accordance with Chapter 27, Section 27-1-B of the Code of the Town .of Southold, a permit is hereby granted to the Southold Fire Department to hold their Annual Street Dance on Southold Fire Department property, Main Road, Southold, on September 1, 1990, from 8:00 P.M. to 2:00 A.M., provided they secure and file with the Town Clerk a Certificate of Liability Insurance for at least One Million Dollar§ naming the Town of Southold as an additional insured. Dated: August 27, 1990. Judith T. Terry Southold Town Clerk CC: Police Chief Winters Supt. of Hwys. Jacobs Building Department A4, Oltlt. PRODUCER Volunteer Firemens Insurance Services New York State Regional Office PO Box 1250 Vestal, NY 13851-1250 CODE SU~CODE INSURED Southold Fire District PO Box 908 Southold, NY 11971 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 COVERAGE AFFORDED BY THE POLICIES BELOW COMPANIES AFFORDING COVERAGE COMPANY LETTER A COMPANY LETTER B Insurance Company of North America COMPANY LETTER C COMPANY LETTER D COMPANY LETTER E COVERAGES THIS ~S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOT~NITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PArD CLAIMS. POUCY EFFECTIVE POLICY EXPIRATION ALL LIMITS IN THOUSANDS DATE (MMIDD/YY) DATE (MM/DD/YY) ~r~ TYPE OF INSURANCE A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X OCCUR. OWNER'S & CONTRACTOR'S PROT. AUTOMOBILE LIARILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY EXCESS LIABILITY OTHER POLICY NUMBER GPPDI9417980 3/2/90 3/2/91 OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY GENERAL AGGREGATE $ 2 ~* 000 PRODUCTS-COMP/CPS AGGREGATE $ 2 ~ 000 PERSONAL & ADVERTISING INJURY $ i ! 000 EACH OCCURRENCE $ 1 , 000 FIRE DAMAGE (Any one fire) $ 50 MEDICAL EXPENSE (Any one person) $ 5 COMBINED SINGLE $ LIMIT EODILY INJURY $ (Per person) BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ EACH AGGREGATE OCCURRENCE $ $ STATUTORY $ (EACH ACCIDENT) $ (DISEASE--POLICY LIMIT) $ (DISEASE--EACH EMPLOYEE DEECRIPTION OF OPE~TIONSILOCATiONS~EHICLESlRESTRI~IONSiSPECIAL ITEMS The Certificate Holder ia an Additional Insured per the CG-2026 endorsement with respects to a "Street Dance" being held on 9/1/90. CERTIFICATE HOLDER Town of $outhold Main Road Southold, NY 11971 ACORD 25-S (3188) RECEIVED AU8 2 9 'lggo CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ~'0 DAYS WRI"CrEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAiL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ~D CORPOI~TION 1988 ',08 '23, 90 AM *ERNSTROM & EFFERON P02 PRODUCER Volunteer F1remens Insuzance Ssrvlces New York Stats KsSlonal Office Fo Box 1250 Vestel, NY 13851-1250 CERTIRCATE OF INSURANCE 8/23/90 THIS CERTIFICATE lB IBBUEC AB A MA~-rER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE OS~TIPICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED DY THE POLICIES BELOW Southold Fire District PO Box 908 Southold, NY 11971 ~OVERAOE$ COMPANIES AFFORDING COVERAGE LETTER COMPANY LETTER B Insurance Company of North A~erica COMPANY u'-~. D THIB lB TO CERTIFY THAT THE POLICIES OF iNSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWlTHBTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH REBPFCT TO WHICft THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUClE~ DEGCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLU,91ONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, POLICY EFFECTIVE POUC¥ EXPIRATION AL% LIMITS IN THOUSANDS DATE (MM,'DD/YY) DATE IMM,'DD/YY) OTHER GPPD194 ~ 7980 3/2/9o 3/2/9]. OENERA~ AGGREGATE $ 2,000 PERSONAL & ADVERTISING INJURY SltO00 The Certificate Holder is an Additional Insured per the CG-2026 endorsement with respects to a "Street Dance" being held on 9/1/90. ERTIFICATE HOLDER Town of Southold Main Road SouChold, NY 11971. CANCELLATION SHOULD ANY OF THE ABOV~ DESCRISED POLICIES BE CANCELLED SEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WiLL ENDEAVOR TO MAIL _~_ DAYS WRI~EN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES, SOUTHOLD FIRE DEPARTMENT P.O. Box 1469 Main Road, NY Rt. 25 Southold, New York 11971 (516) 765-3385 Chief Peter J. Grattan, Jr. (516) 765-1899 First Assistant Chief Mike G Davids, Sr. (516) 765-2457 Second Assistant Chief William H. Sawicki (516) 765-1567 Secretary Louis J. Waiters, Jr. (516) 765-3421 Treasurer Ronald Butkovich (516) 765-2139 RECEIVED .RUG 2 ? 1990 Souf~Id T,~,~.~ RODUCER Volunteer Firemens Insurance Services New York State Regional Office PO Box 1250 Vestal, NY 13851-1250 CODE SUB-CODE INSURED Southold Fire District PO Box 908 Southold, NY 11971 ISSUE DATE (MM/DD/YY) 8/10/90 THIS CERTIFICATE IS ISSUED AS A MA~i-ER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THiS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW COMPANIES AFFORDING COVERAGE COMPANY LE~FER A COMPANY LETTER B Insurance Company of North America COMPANY LETTER C COMPANY LETTER D COMPANY E LE?FER COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW 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 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFFECTIVE POLICY EXPIRATION ALL LIMITS IN THOUSANDS DATE (MM/DDIYY) DATE (MM/DD/YY) ~r(~ TYPE OF INSURANCE GENERAL LIABILITY A Z COMMERCIAL GENERAL LIABILITY CLAIMS MADE Z OCCUR. OWNER'S & CONTRACTOR'S PROT. AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY EXCESS LIABILITY OTHER POLICY NUMBER GPPD19417980 3/2/90 3/2/91 OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS' LIADILITY GENERAL AGGREGATE PRODUCTS-COM PLOPS AGGREGATE PERSONAL & ADVERTISING INJURY EACH OCCURRENCE FIRE DAMAGE (Any one fire) MEDICAL EXPENSE (Any one person) COMBINED SINGLE $ LIMIT BODILY INJURY $ (Per pemon) BODILY INJURY $ (Per eccidertt) PROPERTY DAMAGE ' $ EACH OCCURRENCE $ 2,000 2,000 1,000 1,000 50 5 AGGREGATE $ STATUTORY $ (EACH ACCIDENT) $ (DiSEASE--POLICY LIMIT) $ (DISEASE--EACH EMPLOYEE DESCRIPTION OF OPERATIONS/LOCATIONS~EHICLE~RESTRICTIONSISPECIAL ITEMS The Certificate Holder is an Additional Insured per the CG-2026 endorsement with respect to a Parade & Old Fashioned Drill being held on August 11, 1990, CERTIFICATE HOLDER Town of Southold Main Road Southold, NY 11971 Att: Betty Neville ACORD 25-$(~88) CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPAN~,~E~AVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE~ED TO THE LEFT, SBT FAILURE TO MAIL SUCH NOTICE SHALL IIV~j~= I~ ~) ~I~I~ION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGEN~ R~P~5~',~TIVES, AUTHORIZED REPRESENTATIVE ~ Idll["} ,~i  /~ACORD CORPORATION 1988 JUDITH T. TERRY OFFICE OF THE TOWN ~LERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box l 179 Southold, New York 11971 FAX (516) 765-1823 TELEPHONE (516) 765-1801 July 18, 1990 Thomas M. Helinski Parade Chairman Southold Fire Department P. O. Box 1469 Southold, New York 11971 Dear Tom: Enclosed is the certified resolution of the Southold Town Board granting permission to use Town roads for the August 11th parade. Please. note that the parking area behind the fire house and the east and west access roads belong to the Southold Fire District, therefore the Town's permission is not required. Please be sure to file the Certificate of Insurance for one million dollars with me before the 11th of August. Thank you for your cooperation. Very truly yours, Judith T. Terry~ Southold Town Clerk cc: Police Chief Winters JUDITH T. TERRY TOWN CLERK REGISTRAR OY VITAL STATISTICS OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 FAX (516) 765-1823 TELEPHONE (516) 765-1801 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON JULY 17, 1990: RESOLVED that the Town Board of the Town of Southold hereby grants permission to the Southold Fire Department and Southold Fire Department Racing Team, First Settlers, to use the following Town roads for staging of men and equipment for their 20th Annual Old Fashioned Parade and Drill, on Saturday, August 11, 1990, beginning at 6:00 P.M. (rain date: Sunday, August 12, 1990, beginning at 1:00 P.M.), provided they secure and file with the Town Clerk a Certificate of Insurance for One Million Dollars naming the Town of Southold as an additional insured: Tuckers Lane, Griswold Street, Terry Court, and Glover Street. ~-- Judith T. T&l;ry~/~ Southold Town Clerk July 18. 1990 SOUTHOLD FIRE DEPARTMENT P.O. Box 14~9 Main Road, NY Rt 25 Southotd, New York 1 ~971 (516) 765-3385 July 1, 1990 Chef J. Grattan. Jr. ,765-1899 ~. Davids, Sr. 755-2457 rant Chief William H, Sawicki (516) 765-1567 Secretary Louis J, Waiters, Jr. (516) 765-3421 Treasurer Ronald Butkovich (516) 765-2139 Southold Town Board Town Hall Main Road, Route 25 Southold, New York 11971 Dear Board Members: The members of the Southold Fire Department and the Southold Fire Department Racing Team, First Settlers, respectively ask you permission to use the following town and state highways and municipal parking areas, for our 20th Annual Old Fashioned Parade and Drill, on Saturday, August 11, 1990, 6:00 p.m., (rain date: Sunday, August 12, 1990 at 1:00 p.m.) For the staging of men and equipment: Tuckers Lane, Griswold Street, Terry Court and Glover Street. For the line of march: NY Route 25 from Tuckers Lane, through the village to the fire station. For the Old Fashioned Drill: the municipal parking area behind the fire house and the access roads to the East and West of the fire house. Your consideration of this request is appreciated. Respectively yours, Thomas M. Helinski Parade Chairman CC: Chief of Police, Daniel Winters Southold Board of Fire Commissioners IA4 4tltlt. CERTIFICAte OF INSURANCE -' .... /PRODUCER Volunteer Firemens Insurance Bervlces New York Bta~e Res~onal Office PO Box 1250 Yeata1, Ny 138f1-1250 THIB CERTIFICATE ]B II°SUED AB A MATTER OF iNFORMATION ONLY AND CONFER~ NO RIGHT8 UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES HOT AMEND. EXTEND OR ALTER THE COVERAGE AEFORDEO BY THE POLICIES DELOW Southo~d F~re Distr~ct ~rriR C PO Box 908 Southold, NY 11971 LETTERCOMPANY O COMPANIES AFFORDING COVERAGE Ineurance Company 0£ l;ol~r.h America COVERAGES CO .TR A THt9 IS TO CER?IF¥ THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INOICATFD, NOTWlTHgTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENI WITH RESPECT TO WHICH THII~ CERTIFICATE MAY BE I~.~illEt') OR MAY PERTAIN. THE IN~GRANCE APEORDFO DY THE POLICIES DE$CRIBEO HEREIN IS SUBJECT TO ALL I HE TFHM.~ EXC. i USI(.IN$ AND CONDITIONS OF SUCH POLICtE.C;. IIMITS SHOWN MAY HAVE BEEN REDUCED RY PAID CLAIMS. FOLIC~ EFFECTIVE POLICY EXPIRATION NON-O~NEB OTHER POLICY NUMBER GPPD19617980 3/2/9o 3/z/gt STATUTORY $ (OI~EA~E--POLICY LIMIT) ~S¢~PTIONOFOPERA?ION~LOCATIO,E~EHICLES/RES?RIC?IONEISPE¢IALI?EM$ The Certt.iJ.cate Holder Is an Additional Insured per ~he CG-2026 endorsement wt~h respec~ to a Parade & 01d Fashioned Drill bei.n~ held on Ausua~ 1], 1990. CERTIFICATE HOLDER Town of Southold Hain ~oad $ou~hold, NY 11971 ~CORD 2~-$ {$/88) CANCELLATION e SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ~(} DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THI~ COMPANY, ITS AGENTS OR REPRESENTATIVES. ACORDCORPORATION 198 8/16/90 Called Pete Grattan 765-1899 to tell that Southold Fire Dept. will need a Special Permit for the Street Dance in September. He said that the Chairman is Buddy Jacobi, he will pass the information on to him. A4 ORIk PROOUCER Volunteer Firemen's Insurance Services New York State Regional Office 400 Plaza Drive Binghamton, NY 13903 CODE SUB-CODE INSURED Southold Fire District PO Box 908 Southold, NY 11971 8/2/89 NO RIGHTS UPON THE CERTiFiCATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW COMPANIES AFFORDING COVERAGE COMPANY LETTER A COMPANY LETrER B Insurance Company of North America COMPANY LETTER C COMPANY LE~CrER D COMPANY LETTER E THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE IN~URED NAMED A~OVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT O~ OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES OESCRISEO HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY P~) CLAIMS. GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X OCCUR. OWNER'S & CONTRACTOR'S PROT. AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON~WNED AUTOS GARAGE LIA~IMTY OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY OTHER GPPD19417980 3/2/89 3/2/90 LTR GENERAL AGGREGATE $ 1,000 PRODUCTS-COMP/UPS AGGREGATE $ i ~ 000 PERSONAL & ADVERTISING INJURY $ i ! 000 EACH OCCURRENCE $ i ! 000 FIRE DAMAGE (Any one fire) $ 50 MEDICAL EXPENSE (Any one person) $ .~ COMBINED SINGLE $ LIMIT BODILY INJURY $ STATUTORY $ (EACH ACCIDENT) $ (DISEASE--POLICY LIMIT) $ (DISEASE--EACH EMPLOYEE DESCRI~I~ ~ OPE~ON~LOCATIONS~EHICLES/R~TRI~ION~SPECIAL ITEMS The Certificate Holder is an Additional Insured per the CG-2026 endorsement with respcets to the use of their premises for a Parade and Old Fashioned Drill being held on August 12, 1989. Town of Southold Main Road Southold, NY 11971 AUG 9 1989 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIV SOUTHOLD FIRE DEPARTMENT RACING TEAM MAIN ROAD SOUTHOLDt NEW YORK 11971 July 28, 1992 Southold Town Board Southold Town Hall Main Road Southold, New York 11971 Re: Parade and Drill JUL 9 199 Gentlemen: This is to inform you that the Parade and Drill originally planned to be held on Saturday, August 8, had been cancelled. 1992 Thank you for your attention in this matter. Very truly yours, Thomas Grattan, Jr. Captain, Racing Team TG:kh CC: Chief of Police Stanley Droskoski CC: Southold Fire District Board of Fire Commissioners JUDITH T. TERRY TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1801 SPECIAL PERMIT In accordance with Chapter 27, Section 27-1-B of the Code of the Town of Southold, a permit is hereby granted to the Southold Fire Department Southold Fire Department Racing Team, First Settlers, to hold their 22nd Annual Old Fashioned Drill, which will begin following their 22nd Annual Old Fashioned Parade which begins at 6:00 P.M., Saturday, August 8, 1992 (rain date: 1:00 P.M., Sunday, August 9, 1992), provided they file with the Town Clerk a One Million Dollar Certificate of Liability Insurance naming the Town of Southold as an additional insured. DATED: June 19, 1992. Judith T. Terry ~' Southold Town Clerk June 17, 1992 cc: Police Chief Droskoski Supt. of Highways Jacobs JUDITH T. TERRY TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1801 OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON JUNE 16, 1992: RESOLVED that the Town Board of the Town of Southold hereby grants permission to the Southold Fire Department and Southold Fire Department Racing Team, First Settlers, to use Tuckers Lane, Griswold Street, Terry Court and Clover Street, Southold, as staging area and parade route for their 22nd Annual Old Fashioned Parade and Drill to be held on Saturday, August 8, 1992, at 6:00 P.M. (rain date: Sunday, August 9, 1992, at 1:00 P.M.), provided they file with the Town Clerk a One Million Dollar Certificate of Liability Insurance naming the Town of Southold as an additional insured. Judith T. Terry 6/ Southold Town Clerk June 17, 1992 cc: Police Chief Droskoski' Supt. of Highways Jacobs AO41 IIIL PRODUCER Volunteer Firemens Insurance Services New York State Re§ional Office PO Box 1250 Vestal, NY 13851 COMPANIES AFFORDING COVERAGE COMPANY A LETTER Indea~ity Insurance Cca~Jany COMPANY INBURED LETTER B Southold Fire District COMPANY LETTER C PO Box 908 Southold, NY 11971 COMPANY LETTER O COMPANY LETTER E THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW 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 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAlD CLAIMS. ~CT~ TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MMIDDIYY) DATE (MM/DD/YY) LIMITE A GENERAL LIABILITY GENERAL AGGREGATE $ 2, O00,000 X COMMERClAL GENERAL L!ABILITY GPPD19417980 3/2/91 3/2/92 PROCUCTS-COMPIOP AGG' $2,000,000 CLAIMS MADE XOCCUR. OWNER'S & CONTRACTOR'S PROT. AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY PERSONAL &ADV. INJURY $ 1 ~, 000,000 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (A"Y °ne fire) $ MED. EXFENSE (Any one pe~on . $ 5.000 COMBINED SINGLE LIMIT $ BODILY INJURY (Per person) BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ EXCESS LIABILITY EACH OCCURRENCE UMBRELLA FORM AGGREGATE OTHERTHANUMBRELLA FORM WORKER'S COMPENSATION STATUTORY LIMITS EACH ACCIDENT AND DISEASE--POLiCY UMIT EMPLOYERS' LIABILITY [ DISEASE--EACH EMPLOYEE OTHER DEBCRIPTION OF OPERATIONSILOCATIONB/VEHICLESISPECIAL ITEMS The Certificate Holder is an Additional Insured per the CG-2026 endorsement. Town of Southold RECEIVED MAR 1.. 0 1992 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITrEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KiND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. iAUTHORIZED REPREBENTATIVE SOUTHOLD FIRE DEPARTMENT P.Q Box 1469 Main Road NY Rt. 25 Southold, New York 11971 (516) 765-3385 JUN June 10, 1992 Chief Mike G. Davids. Sr (516) 765-2457 F~rst Assistant Chief Wilham H. Sawicki (516) 765-1567 Second Assistant Chief William F. Salmon (516) 765-5680 Secretary Keith Purcell (516) 765-1330 T~'easurer Ronald Butkovich (516) 765-2139 Southold Town Board Town Hall Main Road, Route 25 Southold, New York 11971 Dear Board Members: The members of the Southold Fire Department and the Southold Fire Department Racing Team, First Settlers, respectively ask your permission to use the following town and state highways and municipal parking areas, for our 22ndAnnual Old Fashion- ed Parade and Drill, on Saturday, August 8, 1992, at 6:00 p.m.,(rain date: Sunday, August 9, 1992 at l:00p.m.). For the staging of men and eguipmentl Tuckers Lane, Griswold Street, Terry Court and Glover Street. For the line of march: NY Route 25 from Tuckers Lane, through the village to the fire station. For the Old Fashioned Drill: the municipal parking area behind the fire house and the access roads to the East and West of the fire house. Your consideration of this request is appreciated. Respectively yours, Captain of the First Settlers Racing Team CC: Chief of Police, Stanley Droskoski Southold Board of Fire Commissioners PRODUCER McMann Price Agency Inc. PO Box 2065 Greenport, NY 11944 iNSURED Southold Fire District PO Box 908 Southold, NY 11971 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORM~A~qON'/O~cY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANY LETTER A COMPANY COMPANY LETTER C COMPANY COMPANY LETTER E COMPANIES AFFORDING COVERAGE Insurance Co. of North America COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN iSSUED TO THE iNSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOT~NITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POUCY EFFECTIVE POLICY EXPIRATION CO TYPE OF INSURANCE POLICY NUMBER LIMITS LTR DATE (MM/DD/YY) DATE (MMIDDIYY) GENERAL LIABILITY XX COMMERCIAL GENERAL LIABILITY CLAIMS MADE XX OCCUR. OWNER'S & CONTRACTOR'S PROT. GPPD19417980 03/02/91 03/02/92 GENERAL AGGREGATE $~ # 000 PRODUCTS-COMP/DP AGG. ~ · O00 PERSONAL & ADV. INJURY $11000 EACH OCCURRENCE $1 # 000 FIRE DAMAGE (Any one fire) $ 50 MED. EXFENSE (Any or~ AUTOMOBILE LIABILITY COMBINED SINGLE ANY AUTO LIMIT ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON~WNED AUTOS (Per accident) GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY RECEIVED EACH OCCURRENCE AGGREGATE UMSRELLAFORM OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION EACH ACCIDENT $ AND ~oId TIDW~ C~ DISEASE--POLICY LIMIT $ EMPLOYERS' LIABILITY DISEASE--EACH EMPLOYEE $ OTHER CESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS The Certificate Holder is an Additional Insured per the CG-2026 endorsement with respects to th use of their premises for a Parade and Old Fashioned Drill being held on August 10, 1991. CERTIFICATE HOLDER Town of Southold Main Road Southold, NY 11971 i ACORD 2~S (7/90) CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE iSSUING COMPANY WILL ENDEAVOR TO MAIL '~ DAYS WRI"n-EN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON ,THE COMPANY, ITS AGENTS OR REPRESENTATIVES. /./ - ,~ / ©ACORD CORPORATION 1990 JUDITH T. TERRY TOWN CLERK REGISTRAR OF VFFAL STATISTICS OFFICE OF THE TO~ C~ TO~ OF SO.HOLD July 23, 199~ Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 FAX (516) 765-1823 TELEPHONE (516) 765-1801 Dear Henry: Just a reminder that I have not received the Certificate of Liability Insurance for the August 10th Parade and Drill. Please contact your insurance company and be sure I receive the certificate as soon as possible. I must have it before the event. Thank you very much.- JUDITH T. TERRY TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southgld, New York 11971 Fax (516) 765-1823 Telephone (516) 765-1801 SPECIAL PERMIT In accordance with Chapter 27, Section 27-1-B. of the Code of the Town of Southold, a permit is hereby granted to the Southold Fire Department and Southold Fire Department Racing Team, First Settlers, to hold their 21st Old Fashioned Drill, which will begin following their 21st Annual Old Fashioned Parade which beings at 6:00 P.M., Saturday, August 10, 1991 (rain date: 1:00 P.M., Sunday, August 11, 1991), provided they secure and file with the Town Clerk a Certificate of Liability Insurance for at least One Million Dollars naming the Town of Southold as an additional insured. Dated: July 8, 1991. Judith T. Terry~ Southold Town Cle~rk cc: Police Chief Droskoski Supt. of Highways Jacobs JUDITH T. TERRY TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-1823 Telephone (516) 765-180 l OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON JULY 2, 1991: RESOLVED that the Town Board of the Town of Southold hereby grants permission to the Southold Fire Department and Southold Fire Department Racing Team, First Settlers, to use the following Town Roads for staging of men and equipment for their 21st Annual Old Fashioned Parade and Drill, on Saturday, August 10, 1991, at 6:00 P.M. (rain date: Sunday, August 11, 1991, at 1:00 P.M.), provide they secure and file with the Town Clerk a Certificate of Liability Insurance for at least One Million Dollars, naming the Town of Southold as an additional insured: Tuckers Lane, Griswold Street, Terry Court, and Glover Street. ~ - Judith T. Terry Southold Town Clerk July 3, 1991 SOUTHOLD FIRE DEPARTMENT P.O Box 1469 Main Road NY Rt. 25 Southold, New York 11971 (516) 765-3365 Chief Mike G. Davids, Sr (516) 765-2457 F, rst Assistant Chief William H. Sawicki (516) 765-1567 Second Assistant Chief William F. Salmon (516) 765-5680 Secretary Keith Purcell (516) 765-1330 Treasurer Ronald Butkovich (516) 765-2139 May 15, 1991 Southold Town Board Town Hall Main Road, Route 25 Southold, New York 11971 JUL 1 1991 Dear Board Members: The members of the Southold Fire Department and the Southold Fire Department Racing Team, First Settlers, respectively ask your permission to use the following town and state highways and municipal parking areas, for our 21st Annual Old Fashion- ed Parade and Drill, on Saturday, August 10, 1991, at 6:00 p.m.,(rain date: Sunday, August 11, 1991 at l:00p.m.). For the staging of men and equipment: Tuckers Lane, Griswold Street, Terry Court and Glover Street. For the line of march: NY Route 25 from Tuckers Lane, through the village to the fire station. For the Old Fashioned Drill: the municipal parking area behind the fire house and the access roads to the East and West of the fire house. Your Consideration of this request is appreciated. Respectively yours, Henry Smith Captain of the First Settlers Racing Team CC: Chief of Police, Stanley Droskoski Southold Board of Fire Commissioners