Loading...
HomeMy WebLinkAboutMiller, Mark EELIZABETH 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.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: MARK E. MILLER 1000 PARADISE POINT ROAD, SOUTHOLD A PERMIT FOR THE DISPLAY OF FIREWORKS in accordance with the provisions of Section 405.00 of the Penal Law of the State of New York at 9:15 PM on Saturday, July 16, 2011 (r/d July 17) on the Lomangino Dock~ 1000 Paradise Point Road~ Southold. 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 defiagration 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 points as possible within the actual area of the display. separated .... ~.O~.~.. Elizabeth A. Neville, Southold Town Clerk Suffolk County, New York (Town Seal) Date: July 7, 2011 THIS PERMIT IS NOT TRANSFERABLE RESOLUTION 2011-496 ADOPTED DOC ID: 6980 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2011-496 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JULY 5, 2011: RESOLVED the Town Board of the Town of Southold hereby approves the issuance of a fireworks permits by the Town Clerk to Mark Miller for a fireworks display on the Lomangino dock~ 1000 Paradise Point Road~ Southold on July 16~ 2011 (r/d July 17) at 9:15 PM, upon payment of the $100 fee and subject to the applicant's compliance with the requirements of the To~vn's policy regarding the issuance of fireworks permits and subject to the approval of the Town Attorney. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [5 TO 01 MOVER: William Ruland, Councilman SECONDER: Albert Krupski Jr., Councilman AYES: Ruland, Talbot, Krupski Jr., Evans, Russell ABSTAIN: Vincent Orlando Page 1 of 3 Cooper, Linda From: Fisher, Robert Sent: Thursday, June 30, 2011 11:03 AM To: Cooper, Linda Subject: RE: [New Sender - ] - Revised Application with Shell Count for Icim's 40th Birthday Show Attached - Message is from an unknown sender Linda I have inspected the site. I have no reservations about this fireworks display. Robert Fisher Fire Inspector Office - (631) 765-1802 cxt 5028 Fax - (631) 765-9502 Mobile - (631) 786-9180 Emoil - robert.fisher~town.southold.ny.us From: Cooper, Linda Sent: Thursday, June 30, 2011 7:36 AM To: Fisher, Robert Subject: RE: [New Sender - ] - Revised Application with Shell Count for Icim's 40th Birthday Show Attached - Hessage is from an unknown sender I was rather taken aback by the method of storage. Linda J. Cooper Deputy Town Clerk Town of Southold 631-765-1800 Life may not be the party we hoped for; but as long as we are here, we m~ght as well dance! If you really want to be happy, nobody can stop you From: Fisher, Robert Sent: Wednesday, June 29, 2011 12:01 PM TO: Cooper, Linda Subject: FW: [New Sender - ] - Revised Application with Shell Count for [cim's 40th Birthday Show Attached - Message is from an unknown sender Linda This is the revised application from Grucci for the mentioned celebration. I had a problem with discrepancies within their submittal. This revision is what it will be. I will be in touch after my inspection. Bob Robert Fisher Fire Inspector Office - (631) 765-1802 ext 5028 6/30/2011 Page 2 of 3 Fax - (631) 765-9502 Mobile - (631) 786-9180 Ernail - robcrt.fishcr~town.southold,ny, us From: Personnel Assistant [mailto:PersonnelAssistant@grucci.com] Sent: Wednesday, June 29, 2011 11:47 AM To: Fisher, Robert Cc: Ed Rubio; Logistics Assistant Subject: [New Sender - ] - Revised Application with Shell Count for Icim's 40th Birthday Show Attached - Message is from an unknown sender Hi Bob, Per your request, please find a revised permit application for the below mentioned show. Please advise if you need anything else. Thanks so much! Event: Location: Latitude: Longitude: Date: Rain Date: Time: Duration: Icim's 40th Birthday Party Lomangino Dock, Southold, NY 41.0 02' 22.53"N 72 ,0 23' 20.11"W July 16, 2011 July 17, 2011 9:15 PM 6-8 minutes Best regards, Vanessa Vanessa L. Siders Personnel Assistant Fireworks by Grucci One Grucci Lane Brookhaven, NY 11719 Ph: 631.286.0088 ext. 38 Fax: 631.286.9036 PersonnelAssistant(~Grucci.com ~ Ptease consider the environment before printing this email, 6/30/2011 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 Mark Miller PRINCIPAL OFFICE AT 1000 Paradise Point Road, Southold, NY 11971 DATE & TIME OF DISPLAY Jul,/16, 2011 9:15pm EXACT LOCATION OF DISPLAY SUFFOLK COUNTY TAX MAP NUMBER FOR SITE RAIN DATE & TIME Jul,/17, 2011 9:15pm The following persons are to be in charge of the actual shooting of the fireworks: Name Age Experience Physical Condition Steve Yalamas 48 18 Excellent Michael Sullivan 54 12 Excellent (Additional names and information may be submitted on an attached sheet Number and type of fireworks is as follows: Illuminations - 2420pcs 2 V2"= 300pcs 3" = 730pcs Manner and place of storage of fireworks prior to display: In UN-Approved boxes stored in a locked box truck 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. Fireworks by Grucci Name of Organization Signature of Applicant 6/23/11 Date of Application Updated 9/27/06 TO: l.inda Cooper COMPANY: Deputy '['own Clerk PHONE: 631 765 1801 FA'K: 631-765 6145 ADDRESS: 53{)95 Main Road (]utcl~ogue, Xxt' 1197 l FROM: l(d Rubio I)car Ms. Cooper: Attached please find t ne following documents for thc Fircxvorks Display listed bcloxv that we spoke about previously: 1) Check in the Amount ors100.00 to cover thc permit fee }:,vent: I .ocation: Latitude: i xmgitudc: Date: Ram Date: Time: Duration: Family Celebration Lomangino Dock, Southold, NY 41" 02' 22.53'N 72° 23' 20.1 i"W July 16,201I July 17, 2011 9:15 PM 6-8 minutes If you have any questions or need any further information, please feel frce to contact me. Sincerely, Edward Rubio Logis~cs Manager [:ircworks by Grucci, inc. Cell 516 658-4486 rile FIRST FAMILY OF FIREWORKS lax~ (631) 286 9036 June 23, 2011 T( ): C()MPANY: Ai)i)RI~SS: Pl |:ROM: l:irc Marshal Bob Fisher Building Dept. 54375 l{outc 25 P.(). F, ox 1179 Soutliold, NT 631 765 18t)2 631-765 664l l';d Rubk~ Dear Mr. Fisher: Attached please find the folloxving documents fl)r tlie i:ircworks Display listed below that we spoke ab(mt previously: I) Application to Display lqrcworks 2) Sitc Plan 3) Insurance Certificate 4) FAA Notification 5) Letter to Sponsor 12titude: I xmgitude: Date: Rain Date: Time: Duration: Icim's 40'h Birthday Part)' Lomangino Dock, Soutliold, NY 41" 02' 22.5Y'N 72° 23' 20,11 "W July 16, 201l July 17, 2011 9:15 PM 6-8 minutes If you liave any questions or nccd any furtlicr information, please feel free to contact me. Sincerely, I edward Rubio I~og~stics Manager Fireworks by (;rucci, Inc. (MI 516 658-4486 'file FIRST FAMILY OF FIREW¢)RKS ~631) 286 I)088 (631) 286 9036 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, fbr a permit to display fireworks as hereinafter specified: DISPLAY IS TO BE SPONSORED BY Mark Miller PRINCIPAL OFFICE AT 1000 Paradise Point Road, Southold, NY 11971 DATE & TIME OF DISPLAY July 16, 20ll 9:15pm EXACT LOCATION OF DISPLAY SUFFOLK COUNTY TAX MAP NUMBER FOR SITE RAIN DATE & TIME Jul,/ 17, 2011 9:15pm The following persons are to be in charge of the actual shooting of the fireworks: Name Age Experience Physical Condition Steve Yalamas 48 18 Excellent Michael Sullivan 54 12 Excellent (Additional nmncs and infbnnation may be submitted on an attached sheet Number and type of fireworks is as follows: lllmninations = 100pcs 2 ½"= 100pcs 3"= 720pcs 4" = 500pcs Manner and place of storage of fireworks prior to display: In UN-Approved boxes stored in a locked box truck 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. Fireworks by Grucci Name of Organization By. Signature of Applicant 6/23/11 Date of Application Angle racks out over water giving one third off to the Safety Zone per NFPA 1123 3" Max Shell Size Icim's 40th Birthday Party July 16, 2011- Fireworks by Grucci Site Location Maximum shell size 3" NFPA 1123 210' Safety Zone Latitude: 41° 02' 22.53"N Longitude: 72° 23' 20.11"W All Information contained on this document is copyright material and the intellectual property of Fireworks by Grucci Inc. Reproduction and/or circulation without approval of Fireworks by Grucci is prohibited Rev 1 6/17/1 1 .4CORD CERTIFICATE OF LIABILITY INSURANCE I Sf ?J20' OATE'M"'DD Y YI 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 [he 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 NAME: PHONE FAX INSURED Fireworks By Grucci, Inc. and/or Pyrotechnique By Grucc~., Inc. and/or Philny Effects, Inc. ADDRESS PRODUCER CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE INSURERC:NY State Fund Melville 3841 23809 COVERAGES CERTIFICATE NUMBER: 193i033855 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN 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 SE 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 IN~R i ADD[ SUBF POLICY E~F ~OLiCY EX~ i SCHEDULED AUTOS J PROP~R~ DAMAGE I I if yes describe under(Mandato~ In NH)~ I I E L 01SEASE E~ EMP[~yE~ $79~i~i Le~ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRISED POLICIES BE CANCELLED BEFORE THE EXP RAT ON DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD 2011 TO: Johu Foruito Air Traffic Control Specialist COMPANY: ()potations Support (koup Kastcrri Service .\ rca Air Traffic ()rgamzation 1701 Cokmlbia Avenue (2ollcgc l'ark, (;:\ 30337 E-MAIL: PHONE: 4O4 31)5-6364 FAX: 404-305-5672 To: David Phillips ATO I'~astcm Service Center E-mail: David. R.Phillips~faa.qo_v CC: 9-ATO-ESA-OSG-Fireworks~,faa.qov TOTAL PAGES: I Plcasc be advised of the fi~llowing Fireworks displays: [:~vent: Location: l,atitudc: l.ongitude: Date: Raiu Date: Time: I)uration: Icim's 40"' Birthday Party Lomangino Dock, Southold, 41" 02' 22.SY'N 7? 23' 20.1 I"W .July 16, 2011 .July 17, 2011 9:15 PM 6 8 minutes NY The maximum altitude of the Fkcxvorks will not exceed 1000 feet. In letter form, please acknowledge the receipt and approval of this notification. ~I hank you for your prompt rcply. Thank You, [:.dward Rubio l.ogistics Manager l'ircworks by (;mcci, Inc. Cell: 516 658 4486 Fireworks by (;rucci, Inc. ( )nc (;rucci I.anc Brookhavcn, NY 11719 Office #: (631) 2864)088 Fax #: (631) 286-9036 mail: 1 (1~, ul)io~/)grucci.com THE FIRST FAMILY OF FIREWORKS ELIZABETH A. NEVILLE, RMC, CMC TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER [II~;C()RDS MANAGEMENT ()FFICER 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: c';gMartin Finnegan, Town Attorney ChiefCochran, Southold Town Police Department Robert Fisher, Fire inspector O/t-Melissa Spiro, Land Preservation Linda J. Cooper, Deputy Town Clerk June 27, 2011 Fireworks Permit sponsored by Mark Miller Transmitted herewith is an application lbr a Fireworks Permit lbr a family celebration sponsored by mark Miller lbr Saturday, July 16 at 9:15 PM. Please advise if you have any objections to a permit being issued. Thank you. cc: Southold Town Board June 23, 201 l TO: l,inda Cooper COMPANY: DcpuU Toxvn Clerk PHONE: 631 765 180l FAX: 631-765 6145 ADDRESS: 53095 Main Road Cutchogue, NY 11971 FROM: lad Rubio dUiq 2 7 201 Dear Ms. Cooper: Attached please find the folloxving documents for thc I?irexvorks Display listed bclo~v that we spoke about previously: 1) Check in the Amount of $100.00 to cover thc permit fee Location: Latitude: Longitude: Date: Rain Date: Duration: Family Celebration Lomangino Dock, Southold, NY 41° 02' 22.5Y'N 72° 23' 20.11"W July 16, 2011 July 17, 201I 9:15 PM 6 8 minutes If you have any questions or need any further reformation, please feel free to contact me. Sincerely Edxvard Rubio Logistics Manager Fireworks by Grucci, Inc. Cell 516-658 4486 THE FIRST FAMILY OF FIREWORKS ()fficc #: (631) 286 0088 I"ax 8: (631) 286 9036 l: mail:l~Rubio(a~grucc~.com 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 Mark Miller PRINCIPAL OFFICE AT 1000 Paradise Point Road, Southold, NY 11971 DATE & TIME OF DISPLAY July 16, 2011 9:15pm EXACT LOCATION OF DISPLAY SUFFOLK COUNTY TAX MAP NUMBER FOR SITE RAIN DATE & TIME July 17,2011 9:15pm The following persons -',re to be in charge of the actual shooting of the fireworks: Name Age Experience Physical Condition Steve Yalamas 48 18 Excellent Michael Sullivan 54 12 Excellent (Additional names and infonnation may be submitted on an attached sheet Number and type of fireworks is as follows: Illuminations - 100pcs 2 ½"-- 100pcs 3" = 720pcs 4" - 500pcs Manner and place of storage of fireworks prior to display: In UN-Approved boxes stored in a locked box truck 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 Propert70wner~ must be submitted with the Application. Fireworks by Grucci Name of Organization Signature of Applicant 6/23/l 1 Date of Application Angle racks out over water giving one third off to the Safety Zone per NFPA 1123 3" Max Shell Size Icim's 40th Birthday Party July 16, 2011- Fireworks by Grucci Site Location Maximum shell size 3" NFPA 1123 210' Safety Zone Latitude: 41 ° 02' 22.53"N Longitude: 72° 23' 20.11"W A~I Information contained on this document is copyright material and the intellectual properS/ of Fireworks by Grucci inc. Reproduction and/or circulation wilhout approval of Fireworks by Grucci is prohibited. Rev 1 6f17/11 CERTIFICATE OF LIABILITY INSURANCE I /17/ 011DA'E MM' D VYYI 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). PRODUCER B~itton-Gallagher and Associates, Inc. 6240 SOH Center Rd. Cleveland OH 44139 INSURED Fireworks By Grucci, Inc. and/or Pyrotechnique By Grucci, Inc. and/or Philny Effects, Inc. CONTACT NAME: PHONE I FAX INSURERD:Lexi~ton Ins CO 9~37 COVERAGES CERTIFICATE NUMBER: 19 310 3 3 8 5 5 REVISION N UMBER: 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 I dEcT I i LOC CERTIFICATE HOLDER CANCELLATION Mark Miller 1000 Paradise Point Road Southold NY 11971 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD June 23, 2{)11 TO: COMPANY: E-MAIL: PHONE: FAX: To: E-mail: CC: TOTAL PAGES: John lVornito Air Traffic Control Specialist Operations Support Group Eastern Sen'ice ,\rea Air Traffic Organization 1701 (Zolumbia Avenue Collcgc Park, GA 30337 John. l"ornito(a~ faa.gov 404 305 6364 404 305 5672 David Phillips \TO l:,astem Service Center David. R.Phillips@faa.gov 9-ATO-ESA-OSG-Fireworks~.faa.flov I Please he advised of the folloxvmg Fireworks displays: l:.vcnt: I x)cation: ] ,atimdc: l ,ongitude: l)atc: Ram Date: Time: Duration: Icim's 40'~' Birthday Paru' lx)mangino l)ock, Southold, NY 41" 02' 22.53"N 72° 23' 20.11"W July 16,2011 July 17, 2011 9:15 I)M 6 8 nfinutes The maximum altitude of thc Fireworks will not cxcccd 1000 feet. In letter form, please acknowledge the receipt and approval of this notification. Thank you for your prompt reply. Thank You, 1 :~dward Ruhio I x)gistics Manager I :irexvorks by Gmcci, Inc. Cell: 516 658 4486 }:ircworks by (;rucci, Inc. ()ne Grucci Lane Brookhaven, NY 11719 Office #: (631) 286 0088 Fax #: (631) 286 9036 E-mail: ERubio(~grucci.com THE FIRST FAMILY OF FIREWORKS June 23, 2011 TO: ADDRESS: Pl I()NE: FAX: E MAll.: I:R()M: Mark M[iller 1000 Paradise Point Road Southold, NY 1197l 631 747 5890 631-369 4900 mnfiller@nfillcrcnv.com Ed Ruble Attached please find thc following documents for the Fireworks Display listed below. Please send a check in the amount of SI()().()() to I&~da Cooper, I)eputy Town Clerk, to cover the pcrnfit fee. ~\ letter addressed to Ms. Cooper is cuclosed to accompany the check. 1) Application t,) Display Fireworks 2) Site Plan 3) Insurance Certificate 4) FAA Nitrification Event: Location: Latitude: Longitude: Date: Rain Date: Time: Duration: Icim's 40'~' Birthday Party Lomangino Dock, Southold, NT 41° 02' 22.5Y'N 72° 23' 20.11"W July 16, 2011 July 17,201l 9:15 PM 6-8 minutes If you have any questions or need any further information, please feel free to contact mc. Siucerely, ,gl? ) . I :,dward Ruble Logistics Manager Fireworks hy Grucci, Inc. Cell 516 658-4486 t:ircworks b} (;rucci, lnc ( )nc ( ~rucci L:mc THE FIRST FAMILY OF FIREWORKS Office g: (631) 286 0088 Fax#: (631) 286 9036 mail: I'i R ubi~(a}gr ucci corn June 23, 2011 T(): COMP:\NY: ADDRESS: PI I()NF,: fax: FR()M: Fire Marshal Bob Fisher Building Dept. 54375 Route 25 P.O. Box 1179 Southold, NY 631 765 1802 631 765 6641 lld Ruhio Dear Mr. Fisher: Attached please find the folloxving documents for the Fireworks Display hstcd belo~v that xve spoke about previously: 1) Application to Display Fireworks 2) Site Plan 3) Insurance Certificate 4) FAA Notification 5) Letter to Sponsor ] ,ocation: 1 ,atitudc: Longitude: Date: Rain [)ate: Duration: Icim's 4ffh Birthday Party Lomangino Dock, Southold, 41" 02' 22.SY'N 72° 23' 20.11"W .July 16, 2011 July 17, 21)11 9:15 PM 6 8 minutes NY If you have an)' questions or need any further infi)rmation, please feel free to contact inc. Sinccrcly, l'~dward l~.uhio I x)gistics Manager Fireworks hy Grucci, Inc. Cell 516 658 4486 Fireworks by ( ;rucci, Inc. ()nc ( ;rucci I ,ant 14ro~kha~cn, N't 11719 THE FIRST FAMILY OF FIREWORKS ()fficc ~: (631) 286 0088 [;:tx #: (631) 286 9t}36 I'; mail: [' l~,ubiiK~/)grucci.com