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HomeMy WebLinkAbout2010ELIZABETH A. NEVILLE, RMC, CMC 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 morthfork.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 oiz 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 Saturday, May 29, 2010; Raindate: Sunday, May 30, 2010 on the property of GREENPORT HIGH 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 PROV1DED 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 &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. .......... ............... Elizabeth A. Neville, Southold Town Clerk Suffolk County, New York (Town Seal) Date: May 26, 2010 THIS PERMIT IS NOT TRANSFERABLE ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRL&GE OFFICER RECOI~OS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P O. Box 1_179 Southold, New York 11971 Fax !631) 755-6145 Telephone (631) 765-1800 ~outholdtow n.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 die Penal Law of State of Nexv York. Jbr a pemlit to display lireworks as hereinafter specific& DISPLAY IS TO BE SPONSORED BY Star }lose ComEg?y (Green~gr_t.._~ PRINCIPAL OFFICE AT 240 6th Avenue, Greenoort. 1~ 1196A DATE & TIME OF DISPLAY Hay 29, 2010 10:00 pm EX.4CT LOCATION OF DISPLAY Greenport High School RAIN DATE & TIME_ May 30, 2010 The following persons are to be in charge of the actual shooting of tile fireworks: Name Age Experience Physical Condition Denn±s H:i. rante DOB: 8/11/50 5 Fears + Health: Excellent (Additional names and intbrmmion may bc sobmitted on an attached sheet Number and ~pe of fireworks is as follows: 1.3G 2.5-3 inch= 364, 4 inch=51, total cakes= 5. (1.AG) Manner and place of storage of firesvorks prior to display: Storage at Westhampton facility. Product delivered day of display to site. ,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. Star Hose Company (Greenport FD) Name of Organization Signature of Applicant Date or/Application ALLIED Apdl 8, 2010 RE: Pyro Engineering, Inc. dba Bay Fireworks Gentlemen: A Certificate of Insurance for Pyro Engineering, Inc. dba Bay Fireworks for the 2009/2010 term is attached. Since they do not renew until May 14, 2010, a copy of your request will be placed in their renewal file and an updated certificate will be issued as soon as lhe renewal policy number is assigned. Pyro Engineering, Inc. dba Bay Fireworks is in good standing with our company and has always been very professional. We are pleased to have the privilege of representing them. Please lel me know if there is anything I can do to sen/e your needs. Our phone number is (800)237-3355 x1282. Thank you for your cooperation regarding this matter. Sincerely, Shelly Godde Account Representative 1041 Gulf Boulevard, Treantre Island, FL 33706 85 N-E. Loop 410, Suite f.~00 San Ank~io, Te. xas 7821(5 ACOR[: 'V CERTIFICATE OF LIABILITY INSURANCE ~Allied Specialty Insurance, Inc. 'IHIS CERTIFICATE IS lSSUED AS A MATTER OF INFOmiJATiON ONLy AND CONFEI%S NO R~-=tITS UIK3N ~IE CERTIFICATE 10451 Gulf Boulevard HOLDER. THI8 C~<iiPICATE DOE~ NOT AMEND, EXTEND OR Treasure Island, FL 33706-4814 A~THR THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1 - 8 00 - 23 7 - 33 55 INSURER8 AFFORDING COVERAGE NAIC # Pyro Engineering, Inc. ~a~a~ T .~. E. Insurance Company dba: Bay Fireworks ,~u~,~ 400 Breadhollow Road, Suite 3 Farmlngdale, NY 11735 COVERAGES ~P.~ u~u~, SAMPLE 5/14/20t0 5/14/2011 ;.~.~ occ~ $1.000.000 A -- ~ s2,~0,~ ~'~ SAMP~ ~t~0 ~ 5/1~2011 c~ ~E LI~T ~OC~. ~ ~US ~. SAMPLE 5/14~0~0 ~0~1 ~H~m ~ 4~.~ A ~ s 4,0~,~0 , or~R~? ~ ~1~0t0 511~11 ~ a ~ ~.L ~. ~ ; 1,0~,000 ~ ~C. ~. ~ ~.~ ; 1.0~.~0 ~1~ ~ ~ a~ ~der ~is GGL ~ a~ f~ t~ u~ ~ eny ~, ~ ~ ~u~ ~m ~o~, H~, ~a~ m ~ ~u..S. G~I mlCATE HOLDER ~LLR~N CERT ~ S~P~ ~NTA~ ',/'7/~ ACO~ 2S (ZO09101) ~ ,~. ~ )9 ACORD COl The ACORD name and logo are registered man%s of ACORO 4, AIIdgh~reaerved 2010~04-,~7 09:24 system 9upport 4043055572 >> 16313908621 P 1/4 U,S. D¢~il~T~nt I?Oi C. hJlr~bJ, A~, C:olJ~g: I%ff., GA 30~]? /~pri123, 2010 Ms, .lo-^one Pyro Engineering INC. 400 Bm~lhollow Road, guile }:armingdsle, NY 11735 Dem' Ms, 'l'¥iola: We roue,veal your letter rogar~{mg your prolx~ed firowork,x display for the show at~ ,.reenport/rhgh ge[mol in G.r~enpor{, NY. I.,~¢tatian of Show: Mooreo~ Lane and Mon~ll Tmil~ Gre~fl, NY i~ffl~ng: 41-06- I IN 1 072-~-20W Dat~ oflhe ahow: MAY29, 2010 Rain Date: May ~0, 2010 Approximate Slart ~m~ IO:OOpm Duration of Firework Di~pl~ly: Le~s lhan l0 mi~]u~ + C?~tact Lockhoed Martin Vlight S~rvk:a gtafion, t..877-497-6867, ~t least six hours poor Io tile sch~u{~ time of the ti~wo~ disphy lo a~t t~ issuanc~ of a Notiou to A:irm~n Advisory. beginning the fireworks display, O'ur offlco has no objm:lion to tii.s croat providud all Hm above notfficaltoos and This lctlur disposas of thc Fod~al Aviation Administmtion's ialorest in thN mater ~1 should not ~ ~m~i~ed us ~u~r~in~ or inv~ii&ting any ~xisling ~lcs or ~gulatiun~ pl~mul~ by any other fed~l, ~a~ couniy, or munioi~l ~rn~nl, ~ich m~y ruqu~d [bt this display, PI~ be s~u to inclnd~ on all fh~l~ display ~q~ more {{c~u'atc l~iona m' Iongi~id~: m~ lafitud~ ~r d~pluy, 2010-04,,27 09:24 syst~n support 40430555?2 ~, 16313908621 P 2/4 5605, CERTIFICATE OF LIABILITY INSURANCE ]5/1'"'~4/201 ~c~ Allied Specialty Insurance, Ina. TH~ CER~F~A1E ~ ~$UED ~ A MAWR ~ I~OR~N ~LY ~D C~F~ NO ~ U~ ~E CE~CATE 10451 ~lf Boulevard ~. ~S ~R~ ~ ~ ~END. ~NO ALW~ ~m ~E A~O~E$ mY TH~ P~C~ B~L~. Treasure Island, FL 33706-4814 1-800-237-3355 ~S ~FO~G CO~$E ~ ~U~py~gl~g,~c. mN~A~T.H.E. Insurance Company dba: ~ ~mwo~ ~: ~O Br~dhollow Road, Sul~ 3 ~. c: Fa~i~dal~ NY 11735 C~E~G~ THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED FAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERllFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY T~E POUClES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUBIONG AND CON~S OF SUCH POL[CIEa AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. F~,~ occ~.c~ sl.000.OOO 9--~'~L U~J'~ CPP0101284-00 5/14/2010 5/14/2011 x C0~.~..C~(~N~_U~Lr~ ~s~s,E.==..=.~ sl00,000 ] CLAIMSMAOE [] OCCUR MED EXP(,~/Oee~ $ A __ ~muE u~Ln-Y CPP0'101284-00 5/'14/2010 5/14/2011 CO~.E~ S~,~.~ UN~' $1,000,000 axc~'ss ~ UM~LL~ U~mL'Y ,?.ACH OCC~ENC~ $ ~ OCCUR [] ~ I&I, DE ELP00'I0296-00 5/t4/20t0 5/t4/201t ~C~.E~E $ 9,000,000 A AN~I E~PLOI~I~ L~ ¥/N WC103~15 5/14/2010 5/t4/20tl A.Y P~OP~TO~/~'r~X~CUT~E S 1 .OO0.0O0 ~ ~ NH) EC., mE - E~ ~..0'~.~ ~ t ,000,000 SP~LAL Pm b~low EL mE. POUCY UMIT $1.0~1.000 AS ADDITIONAL INSURED AS RESPECTS TO GENERAL LIABILITY PERTAINING TO THE OPERATIONS OF THE NAMED INSURED ONLY: SEE THE ATTACHED ADDENDUM The above Commercial Ger~ral Uabtllty policy afro,s bod~y iltjUly & ~r[y damage liat~ity coverage mis4ng directly from ;I lirev~rks display, however, no Marine. Hull & Machinery, P&I or Pollution Liability coverage is a~rded under this CGL po~ mtsing from Ihe ~ ~f a~y barge, et displays conducted ['rom docks, ~, wharves ~r Itoe~n§ p~afforms. CERTIFICATE HOLDER GREENPORT FIRE DEPARTMENT 240 6TH AVENUE GREENPORT, NY 11944* CERT # 1007 ACO~D 25 (2009~1) CANCELLA'IION ~,,-,.~.T^~.. ,/' ~ ~ 1081l-.2~oo ACOR0 CORPORA11OH. A] ghts reserved. The ACORD numo 8nd logo ore regLst~red marks of A¢ORD ALLIED ADDENDUM ATTACHED TO AND MADE PART OF CERTIFICATE OF INSURANCE ISSUED ON THE DATE OF 5/14/2010 ON BEHALF OF: INSURED: PYRO ENGINEERING, INC. DBA: BAY FIREWORKS POLICY NO: CPP0101284-00 & ELP0010296-00 DISPLAY LOC: GRF~NI?ORT HIGH SCHOOL, GREENPORT, NY DISPLAY DATE: 5/29/2010 RAIN DATE: 5/30/2010 THE FOLLOWING ARE NAMED AS ADDITIONAL INSUREDS AS RESPECTS GENERAL LIABILITY PERTAINING TO THE OPERATIONS OF THE NAMED INSURED ONLY: STAR HOSE COMPANY GREENPORT FiRE DEPT VI[ J .AGE OF GREEN'PORT TOWN OF SOLrI'HOLD SUFFOLK COUNTY GREENPORT UFSD COI# 1007 ,rtl J.IgD SPECIALTY INSURANCE, INC. 1041 Gulf Boulevard, Treasure laland, FL 33706 85 N.E. Loop zH0, Suite 600 San Antonio, Texas 78216 ELIZABETH A. NEVILLE TOWN CLERK REGIST~ OF VITAL STATISTICS MARRIAGE OFFICER RECORD~ MANAGEMENT OFFICER FREEDOM OF INFOI~&~TION OFFICER Town Hall. 53095 Mnin Road PO Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone {631) 765-1800 ~outholdtown.northfork. net OFFICE OF THE TOWN- CLERK TOWN OF $OUTHOLD INSTRUCTIONS FOR DISPLAY OF FIREWORKS I. Name o 'body sponsoring lireworl,:s display. Fhe date and time or'day al which the fireworks display is to be held. 3. Tile exact location pbnncd tbr the fireworks display. The age, experience and physical characteristics of the persons who re ) do the actual discharging of the fireworks. 5. The ntm~ber and kind of fireworks to be discharged. The manner and {)lace of storage of such fireworks prior to thc display A diagram of the grounds on which the display is to be held. showinu the noint at which the fireworks are to be discharged, the location of all buildings, highways and other lines of communication, the lines behind which tile audience will be reso-ained and location of all nearby trees, telegraph or telephone lines or other overhead obstructions. 8 Such other {nfbrmation as the Southold Town Clerk may deem necessary to protect persons and property. 9. ,~n indemnity insurance policy with liability coverage and indemnity protection or' $l,000,000.00 per person for bodily injury,; $1,000,000.00 per accident; $1,000,000.00 property damage. Ii). I'he Town (.It~rk oI the Town of Somhold must have the insurance policy in her possession before tim fireworks permit is issued· The nmned 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 arc in accordance with the Penal Law, Article 405 - Licensing and other provisions relating to fireworks.i ELIZABETH A. NEVILLE, RMC, CMC 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~ Dated: Re: Martin Finnegan, Town Attorney Chief Cochran, Southold Town Police Department Robert Fisher, Fire Inspector Melissa Spiro, Land Preservation Linda J. Cooper, Deputy Town Clerk May I2, 2010 Fireworks Permit for Greenport Fire Department 5/29/10 Transmitted herewith are application for Fireworks Permits for: Star Hose Company, Greenport Fire Department Please advise if permit may be issued. Thank you. cc: Southold Town Board Page 1 of 1 Cooper, Linda From: Krauza, Lynne Sent: Monday, May 24, 2010 10:26 AM To: Cooper, Linda Cc: Finnegan, Martin Subject: RE: fireworks permit application Hi Linda, Martin approved this permit. Thanks. Lynne From: Cooper, Linda Sent: Friday, May 21, 2010 2:53 PM To: Fisher, Robert; Spiro, Melissa; Andaloro, Jennifer; Finnegan, Flartin; Hulse, Lori; Krauza, Lynne; Al Krupski (alkrupskitown@yahoo.com); Chris Talbot (christptal@yahoo.com); Louisa Evans (Ipevans@fishersisland.net); Russell, Scott; V Orlando (vincent.orlando@town.southold.ny.us); W. Ruland (rulandfarm@yahoo.com) Subject: fireworks permit application I thought this had been sent out last week but I couldn't find the proof so I'm sending it again. It's for Memorial Day weekend so I would appreciate a resonse as soon as possible. Thank you! 5/2 4/2 010 Page 1 of 1 Cooper, Linda From: Spiro, Melissa Sent: Monday, May 24, 2010 8:56 AM To: Cooper, Linda Subject: RE: fireworks permit application Linda, I have reviewed the application for Fireworks Permit for Greenport Fire Department, Star Hose Co, for 5/29/10, Greenport School is not Town of Southold preserved land. Since this is not preserved land, I have no comment on this application. Melissa. From: Cooper, LJnda Sent: Friday, May 21, 2010 2:53 PM To: Fisher, Robert; Spiro, Melissa; Andaloro, 3ennifer; Finnegan, Martin; Hulse, Lori; Krauza, Lynne; Al Krupski (alkrupskitown@yahoo.com); Chris Talbot (christptal@yahoo.com); Louisa Evans (Ipevans@fishersisland.net); Russell, Scott; V Orlando (vincent.orlando@town.southold.ny.us); W. Ruland (rulandfarm@yahoo.com) Subject: fireworks permit application I thought this had been sent out last week but I couldn't find the proof so I'm sending it again. It's for Memorial Day weekend so I would appreciate a resonse as soon as possible. Thankyou! 5/24/2010 Page 1 of 1 Cooper, Linda From: Fisher, Robert Sent: Wednesday, May 26, 2010 9:22 AM To: Cooper, Linda Subject: RE: fireworks permit application Linda, I reviewed the permit and inspected the site 5/25/10 and have no reservations. Robert Fisher Fire Inspector robert.fisher@town.southold.nyus From: Cooper, Linda Sent: Friday, May 21, 2010 2:53 PM To: Fisher, Robert; Spiro, Melissa; Andaloro, ,lennifer; Finnegan, Martin; Hulse, Lori; Krauza, Lynne; Al Krupski (alkrupskitown@yahoo.com); Chris Talbot (christptal@yahoo.com); Louisa Evans (Ipevans@fishersisland.net); Russell, Scott; V Orlando (vincent.orlando@town.southold.ny.us); W. Ruland (rulandfarm@yahoo.com) Subject: fireworks permit application I thought this had been sent out last week but I couldn't find the proof so I'm sending it again. It's for Memorial Day weekend so I would appreciate a resonse as soon as possible. Thank you! 5/26/2010 Page I of I Cooper, Linda From: Cochran, Carlisle Sent: Wednesday, May 26, 2010 11:14 AM To: Cooper, Linda Subject: Re: Fireworks in Greenport Ok From: "Cooper, Linda" <Linda. Cooper~town.southold.ny.us> Date: Wed, 26 May 2010 10:36:28 -0400 To: Cochran, Carlisle<chiefcochran~town.southold.ny.us> Subject: Fireworks in Greenport I had emailed a Fireworks application to you fnr firc~wnrl(~ nn M~v 29 in Greenport. I have received approval from everyone but you. Linda J. Cooper Deputy Town Clerk Town of Southold 631-765-1800 Life may not be the party we hop6d for, but as long as we are here, we might as well dance! If you really want to be happy, nobody can stop you. 5/26/2010 ELIZABETH A. NEVILLE, RMC, CMC 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 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¥~ July 3~ 2010 and Sunda% July 4~ 2010 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 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. .......... .............. Elizabeth A, Neville, Southold Town Clerk Suffolk County, New York (Town Seal) Date: June 21, 2010 THIS PERMIT IS NOT TRANSFERABLE Rudder, Lynda From: Sent: To: Subject: Fisher, Robert Thursday, June 17, 2010 3:45 PM Rudder, Lynda GFD Fireworks permit request Lynda I inspected the site and I have no reservations about issuing this permit. Robert Fisher Fire Inspector robert.fisher~)town.southold.ny.us ..... Original Message ..... From: Rudder, Lynda Sent: Wednesday, June 16, 2010 11:16 AM To: Finnegan, Martin; Krauza, Lynne; Cochran, Carlisle; Tomaszewski, Michelle; Fisher, Robert; Doroski, Melanie; Spiro, Melissa Subject: Fireworks permit request Rudder, Lynda From: Sent: To: Subject: Finnegan, Martin Wednesday, June 16, 2010 2:23 PM Rudder, Lynda RE: Fireworks permit request I have no objection but let's tell Pete that Melissa said it is prohibited. That would be a hoot. ..... Original Message ..... From: Rudder, Lynda Sent: Wednesday, June 16, 2010 11:16 AM To: Finnegan, Martin; Krauza, Lynne; Cochran, Carlisle; Tomaszewski, Michelle; Fisher, Robert; Doroski, Melanie; Spiro, Melissa Subject: Fireworks permit request Rudder, L}/nda From: Sent: To: Subject: Cochran, Carlisle Wednesday, June 16, 2010 2:00 PM Rudder, Lynda RE: Fireworks permit request I have no objection to the issuing of this permit. Carlisle E. Cochran Jr. Chief Southold Town Police PO Box 911 Peconic, NY 11958 Hqs Phone 631-765-2600 Admin Phone 631-765-2671 Admin Fax 631-734-2315 Main Fax 631-765-2715 The information contained in this e-mail message is intended only for the personal and confidential use of the designated recipient named above. This message may be a Law Enforcement communication that is security sensitive and confidential. If the reader of this message is not the intended recipient, you are hereby notified that you have received this message and any attached documents in error, that any review, dissemination, distribution, or copying of the message and documents is strictly prohibited. If you have received this message in error, please notify us by e-mail or telephone immediately and delete it and any accompanying documents. ..... Original Message ..... From: Rudder, Lynda Sent: Wednesday, June 16, 2010 11:16 AM To: Finnegan, Martin; Krauza, Lynne; Cochran, Carlisle; Tomaszewski, Michelle; Fisher, Robert; Doroski, Melanie; Spiro, Melissa Subject: Fireworks permit request Rudder, Lynda From: Sent: To: Subject: Spiro, Melissa Wednesday, June 16, 2010 11:24 AM Rudder, Lynda; Finnegan, Martin; Krauza, Lynne; Cochran, Carlisle; Tomaszewski, Michelle; Fisher, Robert; Doroski, Melanie RE: Fireworks permit request Hi, I have reviewed the application for Fireworks Permit for Greenport Fire Department for 7/3/10 and 7/4/10. Greenport School is not Town of Southold preserved land. Since this is not preserved land, I have no comment on this application. Melissa ..... Original Message ..... From: Rudder, Lynda Sent: Wednesday, June 16, 2010 11:16 AM To: Finnegan, Martin; Krauza, Lynne; Cochran, Carlisle; Tomaszewski, Michelle; Fisher, Robert; Doroski, Melanie; Spiro, Melissa Subject: Fireworks permit request ELIZABETH A. NEVILLE, RMC, CMC TOWN CLERK REGISTIIAR 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: Martin Finnegan, Town Attorney Chief Cochran, Southold Town Police Department Robert Fisher, Fire Inspector Melissa Spiro, Land Preservation Lynda M Rudder, Deputy Town Clerk June 16, 2010 Fireworks Permit for Greenport Fire Department 7/3 & 4/10 Transmitted herewith are applications for Fireworks Permits for: Phoenix Hook & Ladder and Relief Hose Company, Greenport Fire Department Please advise if permits may be issued. Thank you. cc: Southold Town Board ELIZABETH A. NEVILI.~, 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) 765-1500 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: DISPLAY IS TO BE SPONS~.O,RE~D BY ~ka.~a~ X/~[~]. at z~c~_ ~[?a4'~,_q.& Cc~q tDo.~,',a q PRINCIPAL OFFICE AT ~e~q ~t~! ~&~,C~ ~'i~7~i~ ~_~e~r~ '~-~O~,~ OATE&TIMEOFOISPLAY , ~ s vor co xv ~N DATE & TIME The following persons are to be in charge of the at.al shooting of the firework: Name Age Experience Physical Condition ~ .~ / ' (Ad&t~onal n~es ~d info~ation may be submi~ed on ~ a~ached sheet Number and ~pe of firewor~ is as follows: , Manner aud place of storage of fireworks prior to display: b~l:dqg'O~ '~ ~-o 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,sul~aitted with the ~Organizati~ ~gnat~e of Applic~t Date of~pphcatmn * '~c°~ CERTIFICATE OF LIABILITY INSURANCEI .A~,.,~, ~ 6/11/2010 COVERAGES CERTIFICATE NUMBER: 119723'7247 REVISION NUMBER: Date of Display: July 4, 2010. Location of Display: Greenport High School 720 Front Street Greenport, NY 11944. Additionally Insured: Certificate Holder, Town of Southold, Village of Greenport, Greenport Public SchoolsI Greenport Fire Department and Blue Sky Amusements. CERTIFICATE HOLDER CANCELLATION Phenix Hook & Ladder Co. and Relief Hose CO. PO Box 58 3rd Street Greenport NY 11944 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA'RON DAI~ THEREOF, NOllCE WILL BE BEUVERED IN ACCORDANCE WITH ~.IE POUCY PROVISIONS. © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo am registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE1 6/11/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETINEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endomed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A steternent on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER: 1318694655 REVISION NUMBEI~ THIS IS TO CERTIFY THAT THE POLICIES OF iNSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD iNDICTED. NOT~MTHSTANDING 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 8Y 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. CERTIFICATE HOLDER CANCELLATION Phenix Hook & Ladder Co., and Relief Hose Co. PO Box 58 3rd Street Greenport NY 11944 © t988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD GREENPORT PUBLIC SCHOOLS 720 Front Greenport, NY 11944 APPLICATION FOR USE OF SCHOOL FACILITIES The Administration is responsible for the use of all school facilities in order that they may consider your request for such use, kindly complete the following: Will activity 1~ open to the public? ~/-e S A~mission of /~/~ ~ ~ will I~ charged; proca~l~ will be ~ for (Organization) ?f,4en,'~ . . . .~; · requests at Greenport Public Schools /~ ~/-~ / Does applicant agree to submit fumncial records for examination upon requusts?___.z~ Does applicant agree to. conform to the regulations of the Board of Education and all laws re~lating to the use of school properW including Section 414 printed on the reverse side of this application? ~,~ Name "~a~.J -/:~o~ Address ~/~.~ Telephone # ~/~"~- c~9.,~3 ~' of the person responsible on this occasion. II. Insurance Information A certificate of insurance of at least $1,000,000 public liability per occurrence and $2,000,000 aggregate liability insurance and $50,000 property damage shall be submitted at least three days in advance of the event and must designate both the using organization and the Greeoport Union Free School District with ISO endorsement CG2026. The absence of such a certificate will preclude use of the facility. The policy must contain a 30-dsy guarantee notice of cancellation. The user agrees to indemnify the district for any applicable deductibles. Ill. Rules Governing Use of Facili6~ A. No smoking is allowed in the building or on the grotmds. The organization using the facility is responsible for enforcement. B. No drinking of alcoholic beverages is permitted. C. Activity shall be restricted to that area for which permission is granted. D. Activity shall not extend beyond hours approved by district. E. Programs shall no~ interfere will reguler school schedule. F. Organization shall be responsible for moving its equipment into end out of the building. G. The supervisor of the activity shall be present before it is due to sta~ and remain with the group until all have leR. H. In the absence of administrative personnel, the custodian is charged with the responsibility of the building. I. School authorities must have free access to all rooms at all times J. A careful examination will be made aRer use of the aren by the applicant who will promptly make good on any loss or damage, which might have occurred. K. No school property or equipment is to be altered or removed from the premises. L. This license is revocable at any time by school authorities. M. No reservation will be made until this application is returned and approved by the disUict's Chief School Administrator. ACORD CERTIFICATE OF LIABILITY INSURANCE I THIS cE~RTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZEO REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPOR]'ANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed, If SUBROGATION IS WAIVED, subject to the temps and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). Britton~Gallagher and Associates, Inc. PHONE COVERAGES CERTIFICATE N UMBER: 13:18694655 REVISION NUMBE R: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD II~DICATED. 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, j CLAJMS-MADE [] OCCUR MEDEXP(Ar~oneperson) CERTIFICATE HOLDER CANCELLATION Phenix Hook & Ladder Co,, and Relief Hose Co. PO Box 58 3rd Street Greenport NY 11944 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRAI~ON DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WiTH THE POLICY PROVISIONS, © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD ACORD CERTIFICATE OF LIABILITY INSURANCE oA I. =D i ~ 6/11/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed, If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). CONTACT Britt0n-Gallagher and Associates, Inc. PHONE COVERAGES CERTIFICATE NUMBER: 119723 ? 24 ? REVISION NUMBER: 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. INSR ADDL lUBE pOLICY EFF POLICY EXP [CLAIMS-MADE [~] OCCUR MED EXP (Any or~ person) $ Date of Display: July 4, 2010. Location of Display: Greenport High School 720 Front Street Greenport, NY 11944. Additionally Insured: Certificate Holder, Tow~ of Southold, Village of Greenport, Greenport Public Schools~ Greenport Fire Department and Blue Sky Amusements. CERTIFICATE HOLDER CANCELLATION Phenix Hook & Ladder CO. and Relief Hose Co. PO BOX 58 3rd Street Greenport NY 11944 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DA~ ~IEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. © 1988-2009 ACORD CORPORATION. All Hghte reserved. ACORD 25 (2009~09) The ACORD name and logo are registered marks of ACORD DATE (M M/D D/Yyyy} ACO_R_D , CERTIFICATE OF LIABILITY INSURANCE 06/14/2010 PRODUCER 631. 477. 1680 FAX 631. 477. 8930 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION McMann Price Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 828 Front Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 2065 Greenport, NY 11944-0876 INSURERS AFFORDING COVERAGE NAIC # NSURED Village of Greenport Fire Department INSURERA Arch Tnsurance Company PO Box 58 INSURERB -- Greenport, NY 11944-0058 ~NSURERC INSURER D iNSURER E COVERAGES 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 POL C ES DESCR BED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED SY PAID CLAIMS. ISR!~DD'I I POLICY EFFECTIVI POLICY EXPIRA'HON GENEP~ALLJABILITY MEPK06726904 06/01/2010 06/01/2011 I EACHOCCURRENCE $ 1,O00,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100 000 ] CLAIMS MADE L~ OCCUR MED EXR (Any .ne person} $ S, 000 A __ PERSONAL & ADV INJURY $ I , 000,000 GENERAL AGGREGATE i $ 10 ~ 000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/DP AGG $ 10 ~ 000, O00i ~ POLiCY~PRO' : EXCESS/UMBRELLA LIABILITY MEUM06473404 06/01/2010 06/01/2011 EACH OCCURRENCE $ 5, O00,000 I OCCUR I~ CLAIMS MADE AGGREGATE $ WC STATU- OTB- WORKERS COMPENSA~]ON AND I TQRY IIMIT~ I I FR th respect to a fireworks display by Greenport Fire Department at the eenport School on 7/3/10 and 7/4/10 and the Cole Bros. Circus on 7/14/10 and 7/15/10. ERTIFICATE HOLDER Greenport Union Free School District 720 Front Street Greenport, NY 11944-1599 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX PIP~ATION DATE THEREOF, THE ISSUING INSURER 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 THE INSURER, ~TS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE CORD 25 (2001/08) FAX: 631.477. 2164 ©~CORD CORPORATION i988 IMPORTANT If the certificate hotder is an ADDITIONAL INSURED, the policy(les) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s), DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon ,CORD 25 (200tl08) IV. Rental Fees Auditorium for performance $100 Other Fees or Conditions: Auditorium for practice $ 50 Gymnasium for performance $1 O0 Gymnasium for practice $ 50 When an approved activity takes place outside the normal hours of school operation, the organization will be charged $40.00 per hour for personnel services for a minimum of 4 hours. This all must be paid seven days in advance and is not refundable unless the district receives notification of cancellatien at least 48 hours in advance. V. I agree on behalf of the above-mentioned organization that all members and guests will observe the regulations and that we, individually, and as an organization, will assume all financial responsibility for any and all damages done to the Grecnport School property during the above- indicated period of use. We also agree that our organizatien will at all times hereafter indemnify the above-named school against any loss, damage or expense of any kind, which said school may sustain or incur because of the use of the above-mentioned building by our organization, and we Signed: _ ~ ~ (..~o, J~. _~;;/~yct75// ~-~"-) Dat e: .5/~___ .,/~, o.96,d ....~..~ .-----~nplicant ~ / y Grant,; Denied ~ Date: Details Superintendent of Schools ' of USe: EXCERPTS FROM SECTION 414 OF THE EDUCATION LAW "...The Board of Education of cach district may...permit the use of the school house and rooms therein, and the grounds and other properO, of the district, when not in use for school purposes, for any of the following purposes: 1. For the purpose of instruction in any branch of education, learning or the arts. For holding social, civic and recreational meetings and entertainments, and other issues pertaining to the welfare of the community;, but such meetings, entertainment and uses shall be non-exclusive and shall be open to the general public. For meetings, entertainments and occasions where admission fees are charged, when the proceeds thereof are to be expended for an educational ur charitable purpose; but such use shall not be permitted if such meetings, entertainments and occasions are under the exclusive control, and the said proceeds are to be applied for the benefit of society, associatien or organizations of vetenms of the military, naval and marine service of the United States and organizations of volunteer firemen." Revised 9/1/2001 POLICE DEPARTMENT TOWN ©F SOUTHOI,D CAPd. ISLE E. COCHRAN, JR. Chicf ~¢' Police Tolephone Emergency Dial 91 1 TO: FROM: DATE: RE: Lynda M. Rudder, Deputy Town Clerk Chief Carlisle E. Cochran, Jr. ~ June 16, 2010 Fireworks Permit - Greenport Fire Department July 3 & July 4, 2010 I have reviewed the above permit and have no objection to the approval. cc: Capt. Martin Flatley 41405 Route 25 · P.O. Box 911 · Pcconic, N.Y. 11958 Administrative (631) 765 2600/2601 · Fax (631) 765-2715