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HomeMy WebLinkAboutMorrow, Roy & NancyELIZABETH A. NEVILLE, MMC TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS OF MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, NewYork 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 Flatley, Southold Town Police Department Robert Fisher, Fire Inspector Melissa Spiro, Land Preservation Linda J. Cooper, Deputy Town Clerk November 29, 2011 Fireworks Permit sponsored by Roy and Nancy Morrow Transmitted herewith is an application for a Fireworks Permit for New Yeard Eve celebration by Roy and Nancy Morrow for Saturday, December 31,2011 at midnight. Please advise if you have any objections to a permit being issued. Thank you. cc: Southold Town Board ELIZABETH A. NElqLLE TOWN CLERK RE OISTP~Ait OF VITAL STATISTICS MARRIAQE OFFICER% Town Hall. 58095 Maim Road P.O. Box 1179 8ou~hotd, I~ew York 11971 F~: (631) 765-6145 Telephone (631) 7a~1800 southoldtown.nor~hfork, net OFFICE OF THE TOWN CLEP. I{ TOWN OF SOUTHOLD ,APPLICATION PER]MIT TO DISPLAY FIREWORKS APPLICATION IS I-IEREBY MADE, pursuant to thc provisions of Section 405.00 of the Penal Law of the State of New York, for a pem~it to display fireworks as hereinafter specified: DISPLAY IS TO BE SPONSORED BY Roy & Nancy ._M~rrow PRINCIPAL OFFICE AT Ken White Jr. Gmenport FD, 240 6th Ave., Gmenport, NY DATE & TIIVIE OFDISPLAY '12/3'1/'1'1 Time: '12:00 am Midnight EXACT LOCATION OF DISPLAY Shelter Island Sound, Gmenport (map attached) RAIN DATE & TIiVIE None The following persons are to be in charge of the actual shooting of the fireworks: Name Age Experience Physical Condition Lawrence Racioppo 62 5 years + Health Excellent asst: Christoper Raci0ppo 22 2 years Health Excellent (Additional names and information may be submitIed on an attached sheet Number and type of fireworks is as follows: 2-3"=296, 4"=105, 5"=53, 6"=27. total Cakes=10. Manner and place of storage of fireworks prior to display:. ..D_e_li_very will be day of display Attached hereto and made a part of hereof is a diagram of the grounds on which the display is to be held. Also attached is a certificate or policy of insurance coverage, amc of Or~ization Si~a~ture o f Applicant //-27-// Date of Application ,STA'T~ OF N~4~, YORK - DEPARTMENT OF ~t~ ~c~o~o A~:~ ' '. 'N~ ~Roxl~ ~ ~UDI~NCE ONLy TMS CARD MUST BE C ~ USING pv~ ~Rt~ ~C & NYS C~TiFiCATtONS REQu~D IN NYC Date: 11/22/11 SPONSOR: Roy & Nancy Morrow Fireworks Company Pyro Engineering, Inc. 400 Broadhollow Rd. Suite 3 Farmingdale, NY 11735 Show Date(s): 12/31/11 Rain Date(s): None Location: Shelter Island Sound in Greenport, NY I. TotalnumberofClassB shells being used is 481. Total Cakes = 10. Sizes between: 2 inches and 6 inches in diameter. 2. All shells are DOT approved. 3. Display will be fired electrically and manually. 4. Delivery to start loading equipment and product onto barge: 8:00 am on 12/31/11. 5, All displays will comply with all requirements as set forth in NYS Penal Code 405 and NFPA 1123, 1124. 6. Pyro Engineering, Inc. has complete understanding of all rules and regulations governing public fireworks displays and this display will be in accordance with those rules and regulations. 7. Personnel representing fireworks display company: Lead: Larry Racioppo 8. Technician(s): tba Christopher Racioppo Firewffrks Company'Rep/esentat/ve - U.S. DEPART~ENT OF 38820~15 DATE: U,$.COASTGUARD PERMIT FOR MARINE EVENT C ~-4424 (Rev. (~04) 01 -SLIS-554-011 NAME OF EVENT LOCATION DATE OF EVENT Greenport First Night Shelter Island Sound Near Greenport 31 Dec 2011 from 2330 to 0030 Fireworks Displa}~ Rain Date (NONE) SPONSORING ORGANIZATION NAME OF REPRESENTATIVE TITLE East End Seaport Museum Jo-Anne Triolo (631) 390-8620 Administrator Your application for the following event has been approved. Spc~ia[ services to be rendered by the Coast Guard ate listed. You arc reminded that your organizatico is primarilyresponsib[e for ~ffoty in ~e regatta anna and that this permit do~ not relieve you of such responsibility. Partlelpants shall be adequately briefed and their boat equipped as required by law. A permit may also be required by a state, county or municipal app[icatinn you will notify this office. I X ! Tl~ere will not be a Special Local P. egnlatinn issued, No Rlmtriction [] Them will be a Local Notice to Mariners issued to inform is placed on tho use cf any navigable waters by other porlies, Your maritime interests and solicit their cooperation. event shall not obstruct any channel or normal shipping lane, er intetTere wlth anya~d to .avigalion. The Committeeraan [nChargn [] Tnere will not be aRegatlaPatrolasstgnod by 0to CoaslGuard, shall control participants to prevent oondll[nns hazardous to other cra~ in the area, [] There will be a Regatta Patrol assigned by the Coast Guard. The attached instruction for PatroI Commanders outlines thek [] There wilt be a Special Regulation i~ued establishing a responsibility and authority. You should work out spealfio details Restricted area and other controls, You will be provided a copy for with Patrol Commander. Guidance. Thc Committeeman in Charge shall control participants to prevent conditions hazardous to other cant in foe aro;~ ['~ Additional safety equipment is st[painted below. If Coast Guard assistance is needed during the event, please contact tho following on VIIF-FM Channel 16 ( 156,8 Mhz), or at thc following numbers: Coast Guard Station Monatuk (631) 668-2773 or Sector Long Island Sound al (203)468-4401. IF AVAILABLE, a Coast Guard Au×iliary patrol boat will be on scene to assist. As the event sponsor you we required to meet the following eondlt[on~: 1. You shall mark the 600' safei'y zone in the waters of Long Island Sound with buoys at least 14" in diameter placed at least every 300 yards surrounding the fireworks lam~¢h site located at approximate position: 41 o 05' $8" N, -072a 21' 11" W, There shall be no other boats, tugs or support vessels in the safety zor~ while the fireworks display is being launched. 2. Patrol vessels are required to carry a ~ mar[ne radio and must monitor Channel I3 should any vexsel need to contact them. 3. The loading of fireworks for this event is subject to compliance with 33 CFR § 126. Failure to comply with these provisions may result in Cancellation of your fireworks event. BY approving this event, the Coast Guard does not assume responslbillty for the safety of the event participants. You are reminded that you, as sponsor, are responsible for conducting this event in as safe a moaner as pos~le. PREVIOUS EDITiON MAY RR TOTAL P.001 DEPARTMENT OF THE TREASURY - BUREAU OF ALCOHOL, TOBACCO AND FIREARMS LICENSE/PERMIT (18 U.S.C. CHAPTER 40, EXPLOSIVES) Christopher R. Reeves Chief, FederaJ F_~plosives Licer~ffg C e~l ter ~ I~,) Bureau of Alcohol, Tobacs~ 244 Needy Road Madlnsburg, West ~,r~ DBA BAY FIREWORKS &~NTN%RYJ~O IMPORTER (IPI) -': 51~IMPORTER OF 400 BROACCClO[~6,W ROAD, SUITE FC~RMING~A~ NY 11785- PYRO ~4~t~II~E~I~R[~ DBA I~A¥ ~R~W~S & INTEL PYRO IMPORTER ~ ~H~L~OW ROAD, SUITE 3 CAR~N~, NY 117~- [LS. I)epm~'mcnt of'lYansportation ~Stol'a gel-vice Center Operatkms Support Group AjV-E2 1701 Columbia A. ve. C. olle~c I ark, GA .~0~.~7 November 8,2011 Ms. Jo-Anne 'lYiolo Pyro Engineering, INC. 400 Broadhollow Road, Suite 3 l:armlngdate, NY 11735 Dear Ms. Triolo: We received ),our letter regarding your proposed fireworks display for: Greenport Holiday Corem ittee Date of~:he show: 12-31- 2011 Rain Date: n/a Approximate Start Time: 12 midnight Duration of Firework Display: 12 minutes Height of Fireworks: 700 feet Location of Show: Barge in Shelter Island Sound oear Greenport, Greenport NY Steps to be taken bv Firework Company: Fireworks staff should remain vigilant to ensure that no aircraft are in the area prior to beginning thc fireworks display. Our office has no objection to this event provided ail the above notifications and prccaudons arc Inet. This letter disposes of the t'cderal Aviation Administration's ioterest in this matter but should not be consirned as superseding or invalidating any existing rules or regulations promulgated by any other t~deraL state, county, or mnnicipal government, which may be required for this display. Ple~e be snrc 1o include on all Valero display request, longitnde and'latitudes for display. If you have any que~Jions concerning this event, please contact David Phillips at 404-305-5574. Sincerel~ ' ? - Ivlark D, Ward Group Manager, Operalions Support Eastern Service Area Air Traffic Organi~tion CERTIFICATE OF LIABILITY INSURANCE [ 11121/201°AT 'M D I PRODUCER Allied Specialty Insurance, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 10451 Gulf Boulevard HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Treasure Island, FL 33706-4814 1 - 8 0 0 - 2 3 7 - 3 3 5 5 INSURERS AFFORDING COVERAGE NA[C # ,NSU~D Pyro Engineering, Inc. [NSURER~c T. H. E. Insurance Company dba: Bay Fireworks INSURERS: 400 Broadhollow Road, Suite 3 INSURER C: Farm ingdale, NY 11735 ~NSURER 0: COVERAGES ANY REQUIREMENT, TERM OR CONDFFION OF ANy CONTRACT OR OTHER DOCUMENT WiTH RESPECT TO WHICH THIS CERTIFICATE MAY SE ISSUED OR GE--NEPAL LIAS~UTY CPP0101284.0t 05/14/201t 05/14/2012 ~ACH OCCURRENCE $110001000 ICL~MSM~E [] occur 3~u~x~o~p.~on) s A _ PERSONAL & ADV INJURY $1tO00t00O --: GENEP~,LAGGREGATE S2,000,000 .RD- A~UTOMOB lEE LIAJ~LITI¢ CPP0101284-01 0511412011 05/14/2012 COMB IN~[3 SiNC-LE LIMI¥ $ 1,000,000 ~ occu. [] CL~S~O~ ELP0010296-01 05/1412011 05/14/2012 ~ACHOCCURR~.C~ $ 9,000,000 ^G~ $ 9,000~000 A $ ^.o~.~o¥=.S,L~,~rn. ¥~. WCl13584 05/14/2011 05/14/2012 X:l~o~¥r,~sl I°~- A OFFICE~MEMBER EXCLUOED? ~ ~. ~CH ACCIDENT (Man~o~ in NH) E.L DIS~SE - ~A EMPLO~E $ ~ ,000,000 DiSP~Y DATE: 1~31/11 ~IN DATE: NONE LOCATION: Shelter rsiand Sound, Greened, NY. RE: GENE~L LIABrLI~, THE FOLLOWING ARE NAMED AS ADDITIONAL INSURED ~N RESPECTS TO THE OPE~T[ONS OF THE NAMED [NSUR~ ONLY: To~ of Sou~old; ~llage of Greenpod; Suffolk Count; Busings Improvement Dis~: C~te[Io Marine; Steve ~a~; Lou Co~; Roy & Nan~ Mowow. The above Commercral General Uab[l[~ policy affords bodily inju~ & prope~ damage liabrli~ ~verage ads[rig di~[y ~m a fimwo~s display, however, no Ma~ne, Hul~ & Ma~ine~, P&I or Pollution Lia bili~ ~vemge Is afforded under this CGL po;icy adsing from the use of any barge, do~s, piem, ~a~es or floating plaffo~s. CERTIFICATE HOLDER CANCELLATION Roy & Nancy Morrow Bay Avenue Greenpod, NY 11994 CERT #1578(Revisedll~lH1) ACORD 25 (2009/01) SHOULD ANYOFTHE ABOVE DESCRIBED POIJCI~S BE CANCELLED BEFORE THE E~(piRA3~ON : . / © 198~-2009 ACORD CORPOPJ~¥10~. All rights reserved. The ACORD name and logo are registered marks of ACORD Page 1 of 1 Cooper, Linda From: Jo-Anne Triolo [joanne@bayfireworks,com] Sent: Thursday, December 15, 2011 12:29 PM To: Cooper, Linda Subject: Greenport NYE 12/31/11 Hi Linda, Sorry to go back and forth with the Greenport NYE event but Ken White just called to say the NYE fireworks event is off. They are looking into a show in May so....please cancel the application for 12/31/11. Please confirm receipt of this cancellation. Thank you and have a Happy Holiday. Sincerely, Jo-Anne Jo-Anne Triolo Pyro Engineering Ina dba Bay Fireworks 400 Broadhollow Road, Suite 3 Farmlngdale, NY 11735 631-390-8620phone 631-390-8621fax Please confirm receipt of this e-maiL 12/15/2011 ~I,17~ETH A. N~'~ J.E, MMC TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS OF MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER Town Hall, 53095 Main Road PO. Box 1179 Southold, NewYork 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork.aet OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: From: Dated: Re: Martin Finnegan, Town Attorney Chief Flatley, Southold Town Police Department Robert Fisher, Fire Inspector Melissa Spire, Land Preservation Linda J. Cooper, Deputy Town Clerk November 29, 2011 Fireworks Permit sponsored by Roy and Nancy Morrow Transmitted herewith is an application for a Fireworks Permit for New Yeard Eve celebration by Roy and Nancy Morrow for Saturday, December 31,2011 at midnight. Please advise if you have any objections to a permit being issued. Thank you. cc: Southold Town Board ELIZABETH A. TOWN CLERK REGISTRAR OF VITAL 8TATIb-"PIC8 MARRIAGE OFFICER RECORD8 MANAGEMENT OFFICER FREEDOM OF INFORMAq~IOIq OFFICER P.O. Box 1179 8outhold, New York 11971 ~l~hone (631) 765-1800 OFFICE OF ~ TOWN CLEP, JK TOWN OF SOUTHOLD APPLICATION PERB, HT TO DISPLAY FIREWORKS APPLICATION IS HEREBY MADE, pursuant to the provisions of Sec~ou 405,00 of the P~nal Law of State of Nsw York, for a permit to display fu'vworks ~ hcreinaf[~ specified: DISPLAY IS TO BE SPONSORED BY Roy & Nancy Morrow PRINCIPAL OFFICE AT Ken White Jr. Greenport FO, 240 6th Ave., Gmenport, NY DATE & TI'IVJ~ OF DISPLAY t2/31/11 Time: 12:00 am Midnight EXACT LOCATION OF DISPLAY Shelter Island Sound, Greenport (map a~tached) PAIN DATE & TIME None The following persons are to be in chin-ge of the actual shooting of the fireworks: Name Age Experience Physical Condllion L~.~q~_Rac~ 62 5 years + liealth Excellent 2z 2 years ea th (Additional nmm~ and information may be submitted on an al~ached sheet Number and type of fireworks is as follows: 2-3"=2~6, 4"=105, 5"=53, 6"=27. total Cakes=10. Manner and place of storage of fireworks prior to display: .~le~li_very will be day of display Attached hereto and made a part of hereof ts a diagram of the grounds on which the display is to be held. Also attached is a certificate or policy of incarnate coverage, ' /' Name of Or~ization $i~ture of Applicant Date of Application ' --~ Page 1 of 3 Cooper, Linda From: Jo-Anne Triolo [joanne@bayfireworks.com] Sent: Wednesday, December 14,2011 12:54 PM To: Cooper, Linda Subject: Re: [New Sender - ] - Fwd: Greenport NYE - Message is from an unknown sender Attachments: Aaron Rosenzweig license.pdf Hi Linda, I was just informed that the lead technician for the event will be Aaron Rosenzweig. 1 have attached his NYS Dept. of Labor License. Name Age Experience Physical Condition Lead: Aaron Rosenzweig 35 yrs 7 years + Health Excellent asst: Thomas Rice 47 yrs 5 years + Health Excellent The original technician assigned to this show was reassigned when the show was first cancelled. Please add this information to the original application. Thanks again for your help. Sincerely, Jo-Anne On Wed, Dec 14, 2011 at 12:12 PM, Cooper, Linda <Linda. Cooper~town.southold.nv.us> wrote: Thank you; I just received your email. I have a copy of the application Ken submitted and unless them am any changes it will be fine to use. The next Town Board meeting is 12/20/11 so I will go ahead and place a resolution on the agenda to permit the fireworks display. I sincerely appreciate that you got in touch with me with the change in plans. Liada ~. 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 rmght as well dance! The difference between try and triumph is a little "umph"! 12/14/2011 Dec 14 11 02:58p Blue Water Marine 732 229-8331 pl STATE OF NEW YORK - DEPARTrClENT OF LABOR AARON ,] R~ENZWEIG CLASS; A ANY DfSPLAY T~IS CARD MUST E~E CARRIED WHEN' USING PYROTECHNICS NYC & NYS CERTIFICATIONS REQUIRED IN NYC - Date: 11/22/11 SPONSOR: l/oy & Nancy Morrow Fireworks Company Pyro Engineering, Inc. 400 Broadhollow Rd. Suite 3 Farmingdale, NY 11735 Show Date(s): 12/31/11 Rain Date(s): None Location: Shelter Island Sound in Greenport, NY 1. Total number of Class B sholls being used is t~81. Total Cakes = 10. Sizes between: 2 inches and 6 inches in diameter. 2. Ail shells are DOT approved. 3. Display will be fired eleotrically and manually. 4. Delivery to start load/ng equipment and product onto barge: 8:00 am on 12/31/11. 5, All displays will comply with all requirements as set forth in NYS Penal Code 405 and NFPA 1123, 1124. 6. Pyro Engineering, Inc. has complete understanding of all rules and regulations governing public fireworks displays and this display MIl be in accordance with those roles and regulations. 7. Personnel representing fireworks display company: Lead: Larry Racioppo 8. Technician(s): tba Christopher Racioppo Firewffrks Company'Rep[esentafive - NOV-08-2011 i0:~2 P.O01/O01 U,S,COASTeUARO PERMIT FOR ~NE ~E~ 08 Novem~r c e~ (~. ~ 01 ~L1S-~11 N~ OF E~NT ~CA~ON DATE OF Gr~ Fl~t N~t S~lter bland ~und Near Gr~n~ 31 D~ 2011 from ~ to S~NSO~G ORG~TION NAME OF ~PR~E~AT~ TITLE g~ End ~ M~m Jo-An~ Trio (~1) 3~ Ad min~(~tor ~min~ ~ ~ur o~ ~ p~ly ~ible ~r ~ in ~ ~ ~ ~d ~ ~b ~it d~ n~ ~ ~ of~ ~1 i~ wl~ ~y ~ lo ~]~on. ~e Co~ ~ ~ ~ ~ will not be a Rc~ P~I ~[~ b~ ~ Co~ G~r~, ~11 ~1 ~f~ m p~t mndlttons h~ous ~ ~in~ ~ ~ will ~ a ~ P~I ~ by ~ C~ G~. ~ ~ w~l be a Sp~i~ ~fl~ ~ ~ a ~bilf~ ~d n~. You ~d ~ out ~ific ~ ~ S~en Mo~k (631) ~2~ or ~c~r Long ~d ~ ~ ~68-~1, · AV~L~L~ a C~ Gu~ A~I~ BY ~Pmvins ~b ~n~ ~ ~ O~ d~ not ~v ~o~bjli~ ~r ~e s~ of ~e event ~ci~, You ~ remindcd ~y~ ~ P~VIOUS ED~ION ~Y BR TOTAL P.OOI DEPAJ:{TMENT OF THE TREASURY ~ BUREAU OF ALCOHOL, TOBACCO AND R REARMS LICENSE/PERMIT (18 U.S.C. CHAPTER 40, EXPLOSIVES) 400 BROAT3T~IOF~E)W ROAD. SUITE PYRO I~I~INI=~RIN(~. INa I~BA i~e:!j, i=Ji:~,~iKS & INTNTL PYRO IMPORTER ,~ ~I~3/~J~OW ROAD. SIJ[TE 3 I~.FT~'~;~'~ NY 11785- ATF F 6400.14~400,15, Pa~t I (8/99) [LS. Department of 'l'ransportation Opuratinlts Suppor~ Lironp AJV-E2 1701 Columbia Ave. Collc§e Park, GA 30337 Novcmbcr 8,201 l Ms. Jo-Aane Triolo Pyro kngincerhtg, INC. 400 Broadhollow Road, Suite 3 Farmingdale, NY 11735 Dear Ms. Triolo: We received your letter regarding your proposed fireworks display for: Grccnport ttoliday Corem ittee Date ofthe show: 12-31- 2011 Rain Date: n/a Approximate Start Time: 12 midnight Duration of Firework Display: 12 minutes Height of Fireworks: 700 feet Location of Show: Barge in Shelter Island Sound near Grecnpor~ Gr~2nport NY Steps Io be taken by Firework CompanY Fireworks stafrshould remain vigilant to easurc that no aircraft arc in the area prior to bcgimfing thc fireworks display. Our office has no objc~:tion to this event provided all the above aotifications and protections arc met. This letter disposes of tile l-cderal Aviation Adminlstration's interest in this maser but should nat be construed as ~uperaeding or invalidating any cxisdng rules or regulations promulgated by any other fL~lerel, state, coaaty, or municipal government, which may be required for this display. Please be safe to iueludc on all future display request, longitude sad latitudes for display, If you have any queaJion~ concerning fl~is evenL please contact David Phillips at 404-305-5574. Sincercl)'. ? ' Omnp Manager, Operations Support Eastern Service Area Air Traffic Organization CERTIFICATE OF LIABILITY INSURANCE p.o~uc~ Allied S~cialty Insurance, Inc. ~18 CE~FICA~ ~ ~UED AS A ~ OF [NFOR~ON ONLY ~D C~FE~ NO RIG~ UPON ~E CE~FICATE 10451 Gulf Boulevard HOLDE~ THiS CE~FICA~ OO~ NOT AME~, ~ND OR AL~R ~E CO--GE ~O~ED BY ~ POLICIES BELOW, Treasure Island, FL 33706-4814 ~ - 800 - 237 - 3355 INSURES A~ORDING COVE~GE N~C Pyro Engln~Hng, Inc. ~. T. H. E. Insurance Company dba: Bay Fire~rks 400 B~dhollow Road, Suite 3 Fa~lngdale, ~ 11735 COVERAGES THE POLIGIE8 OF INSURANCE LISTED BELOW HAVE B~EN iSSUED TO THE IN~URED ~D ABOVE FOR THE POLICY PERIOD INOICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONOFI'ION OF ANY CONTRACT OR OTHER DOOLIMENT Wi~n4 RESPECT TO WHICH THIS C~ERTIRCATE MAy BE 1~SUED OR MAY PERTAIN, '114E INSUI~ANOE AFFORDED BY THE POLICIES DIESCRSED H~EI. I~ SUBJECT TO ALL THE TERMS, EXCLUSIONg AND CONDITIONS OF SUCH .OLICllES. AGGRC-SATE LIMITS SHOWN MRY HAVE BEEN REDUCED BY PAID CLAIMS. o~e, exAc UA~U,n CPP0101284-01 05/14/2011 05114/2012 F. AC~ cccunae,~ ~ 1.000.0qq A __ PERSoH~& ~v ~ s 1,000,000 __ ~,~ ~-~c~ ,2,0O0~0O0 2,000,000 *UTOa~,.e u~crn CPP0101284-01 05/14/2011 05114/2012 (h ~.d~ s 1,000,000 ~c'~r~, U,UB.EU.~ UABU. m' s 9.000.000 ~ ~ ELP0010296-0~ 05/1,4/201t 0,5/14/2012 AGGREGATl~ $ 910001000 -- ,~oe~.romu. u~.Lrr Yn~ WCl13584 05/14/2011 05/14/2012 Xl,ro.¥,~.~[ I°'~-~ A OFFICER/MEMBER EXCLUOm7 [] E-L EACH 'a"~GIOENT $ "~ i000tO00 IM~dmmb)~ Iff N~41 E.L OESEASE. EA EMPLOYEE S 1 ~Ec~_ P.~o.~ ~,... F-~- =~. POU~ UM.* S 1~O00~OOp ~;=K ilrrCATE HOLDER CANCELLAllON Roy & Nancy Morrow Bay Avenue Greenport, NY 11994 CERT #1578 (Revised 11121/11) ACORD 25 (2009101) ~ 1988-2009 ACORD CORPOR/{'rlON. All rights reaerved, The ACORD name and logo are reglstsmd marks of ACORD