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HomeMy WebLinkAbout2012ELIZABETH 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.nor th fork.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 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 Friday~ May 25 and Sunday~ May 27~ 2012 (r/d 26th and 28th) 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 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 iask. that there shall be at least t~vo 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 disp~.~ Elizabeth A. Neville, Southold Town Clerk Suffolk County, New York (Town Seal) Date: April 30, 2012 THIS PERMIT IS NOT TRANSFERABLE  RESOLUTION 2012-355 ADOPTED DOC ID: 7790 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2012-355 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON APRIL 24, 2012: RESOLVED that the Town Board of the Town of Southold hereby approves the issuance of a fireworks permit by the Town Clerk to Star Hose Company of the Greenport Fire Department, for a fireworks display on May 26 and May 28, 2012, at Greenport High School's field, Greenport, New York upon the payment ora single fee orS100 and subject to the applicant's compliance with the requirements of the Town'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 [UNANIMOUSI MOVER: William Ruland, Councilman SECONDER: Albert Krnpski Jr., Councilman AYES: Ruland, Talbot, Doherty, Kmpski Jr., Evans, Russell ELIZABETH 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, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.nor thfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD ro~ From: Dated: Re: Martin Finnegan, Town Attorney Chief Flatlcy, Southold Town Police Department Robert Fisher, Fire Inspector Melissa Spiro, Land Preservation Linda J. Cooper, Deputy Town Clerk April 10, 2012 Fireworks Permit sponsored by GFD Transmitted herewith is an application for a Fireworks Permit for May 26 and May 28, 2012 by GFD at Greenport High School Please advise if you have any objections to a permit being issued. Thank you. cc: Southold Town Board EL]L~ A. NEVILLE TOWN CLERK REGI~'rRAR OF VITAL STATISTIC~ MARBJ. A(~E OFFICER Town Hall. 58095 Maiu Road PO. Box 1179 l!k~ul;hold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 ~outholdtown.northfork.net OFFICE OF TIlE TOWN CLERK TOWN OF SOUTHOLD APPLICATION PERMIT TO DISPLAY FIREWORKS APPLICATION IS HEREBY MADE, pursuant w the provisions of Section 405.00 of the Penal Law of the State of New York, for a permit to display fireworks as h~reinafier specified: DISPLAY IS TO BE SPONSORED BY Star Hose Company (Greenport FD) PRINCIPAL OFFICE AT 240 6th Avenue, Greenport, NY 11944 DATE & TIME OF]DISPLAY May 25, 2012 and May 27, 2012 @ 10:00 pm EXACT LOCATION O15' DISPLAY Greenport High School I~k[N DATE & TIME May 26, 2012 and May 28, 2012 The follow/ug persons are to be in charge of the actual shooting of the fireworks: Name Age Experience Physical Condition Dennis biirante DOB:g/Il/50 5 years + Health: Exce'llent (Additional names and information may be submitted on an attached sheet Number and type of fireworks is as follows: 1.3G Fireworks 2 inch to 4 inch shells=447 for each night plus il£uminatlons. Manner and place of storage of fireworks prior to display: Storage at Westhampton facility. Product delivered day of display to display 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 (Greenpod FD) Name of Orgmnization Date o f Applic~tlon F, LI7~ETH A. N~EVILLE TOWN CLERK REGISTRAR OF VIT~ ~ATI~t ~ ~GE O~R ~CO~ ~AG~T O~CER OFFICE OF THE, TOWN CLERK TOWN OF SOUTHOLD Town Hall. 53095 Main Roa~ P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 ~outholdtovrn.northfork. net INSTRUCTIONS FOR DISPLAY OF FIREWORKS 1. Name of body sponsoring fireworks display. 2. The date and time of day at which the fireworks display is to be held. 3. The exact location planned for the fireworks display. 4. The age, experience and physical characteristics of tho persons who are to do the actual discharging of thc fireworks. 5. The number and kind of fireworks to be discharged. The manner and place ofstoragc of such fireworks prior to thc display. A diagram of the grounds on which the display is to be held, showing the point at which the fireworks are to be discharged, the Ineation of all buildings, highways and other lines of communication, the lines behind which the audience will be restrained and lneation of all nearby trees, telegraph or telephone lines or other overhead obstructions. 8. Such other infonnatinn as the Southold Town Clerk may deem necessary to protect persons and property. 9. An indcannity insuranco policy with liability coverage and indemnity protection of $1,000,000.00 per person for bodily injuxy; $1,000,000.00 pex accident; $1,000,000.00 property damage. 10. The Town Clerk of the Town of Southold must have the insurance policy in her possession before the fireworks permit is issued. The named insured must read: TOWN OF SOUTItOLD. ' I I. Application for a fireworks permit must be made at least five days in advance of the date of the fireworkn display. ' (The above instructions arc in accordance with the Penal Law, Axt/cle 405 - Licensing and other provisions relating to fireworks.) ! S'rATE OF NEW YORK - DEPARTMENT OF LA~R ; I EXPII:I'~ ~/12 , . [ DEPARTMENT OF THE TREASURY - BUREAU OF ALCOHOL. TOWN'CO AND FIREARMS LICENSE/PERMIT (18 U.S.C. CHAPTER 40, EXPLOSIVES) 244 Ne~ly Road DBA BAY FIRE~/O[RKS &~N~'~ I~'¥~RO IMPORTER (IPI) 51 -IMPORTER OF FIRE[~OFI)~ t~A~O. 400 BROAD~rKN.~.O~f ROAD, SUITE 3 F~/~MI~ N~ 11735- PYRO BI~II~NE~RING; INC E)~A ~ F~,g~li~KS & INTNTL PYRO IMPORTER 4~) ~;~"~[-OW ROAD. SUITE 3 ~, NY 11735- U.S. Department of Transportation FebruaD' 24. 2012 Eastern Service Center Operations Support Group AJV-E2 1701 Columbia Ave. College Park. GA 30337 Ms. Jo-Anne Triolo Pyro Engineering, INC. 400 Broadholiow Road. Suite 3 Farmiogdale, NY 11735 Dear Ms. Triolo: We received your letter regarding your proposed fireworks display for: Star Hose Company Dateoftheshow: 5-25-2012 and 5-27-2012 Rain Date: 5-26-2012 and 5-28-2012 Approximate Start Time: ]0:00 pm Duration of Firework Display: l0 minutes Height of Fireworks: 400 feet Location of Show: Moores Lane, Gmenport NY Steps to be taken by Firework Company: or Fireworks staffshould remain vigilant to ensure that no aircraft are in the area prior to beginning the fireworks display. Our office has no objection to this event provided all the above notifications and precautious are reel This leU. er disposes of thc Federal Aviation Administration's interest in this matter but should not be construed as superseding or invalidating any existing rules or regulations promulgated by any other federal, state, count)-, or municipal government, which may be required for this display. Please be sure to inclode on all future display request, longitude and latitudes for display. If you have a, ny questions concenting this evcnL please contact David Phillips at 404-305-5574. Sincerely, ... /? ~ ./~./ /~. ' Group Manager, Operations Support Eastern Service Area Air Traffic Organization CERTIFICATE OF LIABILITY INSURANCE 103 2 20 "T THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIRCATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EX'TEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED certificate holder in lieu of such endorseme~t~sI. ~ooucea Allied Specialty Insurance, Inc. NA~:COanACT 10451 Gulf Boulevard f~c.~e.~ ~t,: t ~ .er Traasum Island, FL 33706-4814 A~.~: 1-800-237-3355 amu~l Ae~mms cowe~E ~uc # ~.su~R A: T.H.E. Insurance Company 12866 dba: Bay Firewo~s mSU~Ee c: 400 Broadhollow Road, Suite 3 Fanningdale, NY tl 735 mu.~ F: -- COVERAGES CERTIFICATE NUMBER: REVISION N; ~Mn;R: THIS IS TO CCI~ I icy THAT THE POLICIES OF INSURANCE LISTED BELONV HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO'~MTHSTANOING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT ~ RESPECT TO WHICH THiS CERTIFICATE MAY BE I~SUED OR MAY PERTAIN. THE INSURANCE AFFOROED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDFFIONS OF SUCH POLICIES. UMITS SHOWN MAy HAVE SEEN REDUCED BY PAID CLAIMS. E~CH OCCU~RE,C~ s 1,000,000 e~N~P.A~L~'~U~ Jl CPP010¶284'01 )5/14/2011 05/14/2012 ~TO~m'~ A ~ COM*~E,C<ALGENE~ALUAaUTY P~E~SES~..~ si00.000 -- PE RSDNAL & ADV INJtJRY $ ~J ,000s000 __ c~NimAL ~.e,EC. AT~ $ 2~000~000 GE N'L ACTOR EGATE UI~T APPLtES PE~: Ff~3OIJ~rs - COM p/[3~ AGG $2,000,000 COt~NEO SIt*4G~[ LIMIT ; t ~000,000 A ~;oaoe~u~ry CPP0101284-01 05/14/2011 05/14/2012 A ~ ~(C~qSUAOUV'O~a'ALL~I IX~ocCU~cL~MS'M'~ ELP0010296'0t 05/14/2011 05/14/2012 ~'~C, OCCU~NC~ ;9,000,000 o~u J J.ET~nO.S /~,~T~ #9,000,000 ,'JmeMPLOYa~t. MStLny yi. NC113584 05/14/2011 05/14/2012 X JTmyUu~mJ OF; ICERRdEMBE~ E~CL Ui]ED? [] NrA E.L EACH AC~JOE~T $t,000,000 ~'~"~T~S ~. ;.~- ~s~s~- ;* ~.._o~ # 1,000,000 ~.L. ~.S~ - ~.~V U~ $%000,000 ATE HOLDER CANCELLATION Greenport Fire Department 240 6th Avenue Greenport, NY 11944 CERT ftU631 **Cetlfficate to be upGab,d at Renewal** ACORD 25 (2010J05) · * 1988-2010 ACORD CORPORATION A Hghts reserved. The ACORD name and logo am registered marks of ACORD AI_I_iF_L-I To Whom It May Concern: Re: Pyro Engineering. Inc. dba: Bay Fireworks Dear Sir/Madam: A certificate evidencing insurance for Pyro En~neefing, Inc. dba: Bay Fireworks for thc 2011/2012 term is attached. Since they do not renew until May 14, 2012, a copy of your requeat w/Il be placed in their renewal file and updated ~Iieates will be issued as soon as (he renewal policy number is assigned. Pyro Engineering, Inc. dba: Bay Firework~ is in good standing wilh our compun) and has always been very professional. We are very pleased to have (he privilege of rcgreaenting them. If you need anything further please feel free to contact me at 1-800-237~3355 x1282. Thunk you for your cooperation regarding this matter. SinoewAy, Tammy Catterton Account Representative Allied SpecialW Insurance Company Al .!-Iliad SPECIALTY INSUP,2d',~CE. INC. 1(]-15l Gulf Bo,~, ~4nl. I ,'.~ ~e lsLad. I-ioml .~.l'/f16 · ;21 31.. -(~ I olio ~' ;-' '3 · * ] ~X ,zt 367-5 '4- l ~P 85 .,"..L, Loop [0, S'4ile (gl0. San ~lon[o. 1, xa,- 7k 16 · "0 3 '. -1,,21 · ~ ~t:x/_..n., /4 · ! ~.X 21 [I ~'ll .. ELIZABETH 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 Fsx (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 Wednesday~ July 4~ 2012 and Saturday, July 7~ 2012 (r/d 7/5 and 7/8) on the proper~y of GREENPORT PUBLIC SCHOOL~ on the athletic field, 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. Suffolk County, New York (Town Seal) Date: June 19, 2012 THIS PERMIT IS NOT TRANSFERABLE (~' RESOLUTION 2012-520 ADOPTED DOC ID: 7951 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2012-520 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JUNE 19, 2012: RESOLVED that the Town Board of the Town of Southold hereby approves the issuance of a fireworks permit by the Town Clerk to Phoenix Hook & Ladder Company No. 1 and Relief Hose Company No. 2 of the Greenport Fire Department, for a fireworks display on Wednesday, July 4th and Saturday, July 7th 2012, at Greenport High School's field, payment of a fee of $200, subject to the applicant's compliance with the requirements of the Town's policy regarding the issuance of fireworks permits and subject to the approval of the Town Attorney and the Fire Marshal. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: William Ruland, Councilman SECONDER: Albert Krupski Jr., Councilman AYES: Ruland, Talbot, Doheny, Kmpski Jr., Evans, Russell To: Lynda Rudder RECEIV£O From: Peter Harris dUN Re: Fireworks permit Southold Town Clerk Date: June 19, 2012 Hi Lynne I'm sending you the application for my fireworks permit for Greenport Fire Department's July Fourth and July Seventh fireworks diplays held each year at the Greenport High School. I got to the school to late yesterday to pick up the permit from them to add to the paper work that you need. Please put the fireworks application on today's agenda for approval. I realize that I will not receive my permit until I forward you the approval from Greenport High School, but I don't want to hold up the process. Thanks, Pete ELIZABETH A~ NEV~ J .F.? 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, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 southoldtown.northfork.net OFFICE OF THE TOWN CI,ERK 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 a,s hereinafter specified: DATE & TIME OF DISPLAY ~ ~ ~ Id '~ /d ~ ~INDATE&TIME ~ ( ~l/ r The following pe~ons ~re to be in charge of the ~¢m~l shoot~g of the firework: Name Age Experience Physical Condition I (Additional names and information may be submitted on an attached sheet Number and~ ~pe 9f fireworks is as ,follows: Manner and place of storage of fireworks prior to 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. NOTICE: Written permission, with signature of the Pr_Lq~rt¥ Owner, must be submit, ed with the By Signature of Applicant Date of Ap'plication AC ORb* CERTIFICATE OF LIABILITY INSURANCE DArs ""OD I ~ 6/18/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CER~FICATE 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 BEI~VEEN 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 PRODUCER NAME: Britton-Gallagher and Associates, Inc. PHONE I~C. No. ExU:440-248-4711 I ~=~. Uol~r40-544-1234 6240 SOM Center Rd. E-MAIL Cleveland OH 44139 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :New Hampshire Insurance Co _~3841 INEURED INSURER e :New Hampshire Insurance Co. _~3841 Legion Fireworks Co., Inc. INEURER C :,Axis SurDlus Ins Company !1~020 10 Legion Lane Wappingers Falls NY 12590 INEURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 485254144 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 kDDL ~U~R POMCY EFF POLICY EXP I CIAIMS4'IAD~ [] OCCUR MEDEXP(An)'oneperson) $ C UMBRELLA LLAB IX I OCCUR EAU731294 )/15/2012 ~/15/2013 EACH OCCURRENCE ~- EXCESS NAB~] CIA,MS-MADE AGGREGATE $4,000,000 DED I I RETE ION $ $ Date of Display: July 4, 2012 and July 7, 2012. Rain Date: July 5, 2012 & July 8, 2012. Location Df Display: Greenpor[ High School 720 Front Street Greenport, NY 11944. Additionally Insured: Certificate Holder, Town of Southold, Village of Greenport, Greenport Public Schools and Greenport Fire Department. CERTIFICATE HOLDER CANCELLATION Phenix Hook & Ladder Co. #1 & Relief Hose Co. #2 PO Box 58 3rd Street Greenport NY 11944 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED eEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL eE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2010195) © 1988-20t0 ACORD CORPORATION. All rights reserved. The ACORD name and logo ars registered marks of ACORD CHIEF WAYDE MANWARING 1ST ASST. CHIEF HARRY BREESE 2N° ASST. CHIEF WAYNE MILLER CHAPLAIN C. KUMJIAN TREAS/SECRETARY J. KALIN Organized 1845 (631) 477-9801 - STATION 1 (631) 477-8261 - STATION 2 (631) 477-1943 - CHIEFS OFFICE (631) 477-4012 - FAX THIRD STREET. RO. BOX 58 GREENPORT, NY 11944 Email: gfdfire @ optontine.net www. greenportfd.org June 26,2012 Chief Wayde Manwaring Greenport Fire Department P.O. Box 58 Third Street, Greenport 11944 Deputy Town Clerk Linda Cooper Southold Town Hall Main Road, Southold 11971 RECEIVED JUN 2 7 2012 $outhold Town Clerk Dear Ms. Cooper I have been requested by the by members of the Phenix Hook & Ladder Co. #1 and Relief Hose Co. #2 to give permission for two fireworks displays to take place on Wednesday night July the Fourth and Saturday night July the Seventh at the Greenport High School athletic field offofMoores Lane in Greenport. At this time I am giving my permission for these fireworks displays to take place. I am also with the understanding that in the event of rain on either date listed above that two rain dates have been requested. They are Thursday July the Fifth and Sunday July the Eighth. Our department will provide fire protection for these events. Sincerely yours, Chief Greenport Fire Department RECEIVED JUN 2 5 201~ Southold Town Clerk To: From: Re: Date: Linda Cooper Peter Harris Fireworks Information June 25, 2012 Hi Linda: Here are the documents that you have requested pertaining to the two fireworks displays for the Greenport Fire Department for July the Fourth and July the Seventh. I have enclosed the two signed contracts, Greenport High School approval application, and the photo I D's of the two gentlemen that will be performing the display. New York State only requires that one person be certified and that person is ( Chris DeRobertis ) I have enclosed his photo I D of his Pyrotechnician certificate of Competence. If you have any other questions please contact me. Pete GREENPORT UFSD 720 Front Street Greenport, NY I 1944 APPLICATION FOR USE OF SCHOOL FACILITIES The Administration is responsible for the use of all school facilities in order that they may consider your 1. Fa cilities Use. Request: (0 r§apizaJ;J,o n), ,~.~Z~ t. /~ requests the use of/~/g~.,c:-/~,~//~/~'/:~'~,-~.~, ~'~'~ $ at Greenport Pubic Schools for the purpose of: on(date), , I.~.l./ ~ ~vt~ ~.~/ J'/~.t at (time) ,~/-~/~/J¢ ~,'4/<~ ~j/~l~/! ~2~,,,/~..t...~,j~,~ WflYactigity be open to ~he'ls~51ic ? (Circle one) (~ Nd Is this a For Profit Organization? (Circle one)(~) No Admission of /'~'O/q./~ will be charged; proceeds will be used for Does applicant agree to submit financial records for examination upon requests? Does applicant agree to conform to the regulations of the Board of Education and all laws regulating to the use of school property including Section 414 printed on the reverse side of this application? ~7~ Name: ~O ~.e£ ~.¢'~[~ r., ,'z / Telephone # ~/z'~'-~-~/¢17 -L'~///~-~'~-.~/S--~'~j of the person responsible on this occasion. 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 Greenport 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-day guarantee notice of cancellation. The user agrees to indemnify the district for any applicable deductibles. III. Rules Governing Use of Facilities No smoking is allowed in the building or on the grounds. The organization using the facility is responsible for enforcement. For Profit Organization Auditorium $150 per hour-- hour(s) X rate = Custodial $40 per hour Monday - Friday = hour(s) X rate = Custodial $60 per hour Saturday & Sunday = hour(s) X rate = Technical (sound & lights) $60 per hour = hour(s) X rate = This all must be paid seven days in advance and is not refundable unless the district receives notification of cancellation at least 48 hours in advance. V. I agree on behalf of the above-mentioned organization that all members and guests will obse~vethe re~u!at!o~s-an~th-=t we, !ndividuaHy, and_as~a~ nrg~n!zatio~wUI ~um~ aJLfJnancial responsibility for any and all damages done to the Greenport School property during the above- indicated period of use. We also agree that our organization will at all times hereafter indemnify the above-named school against any loss, damage or expense of any kind, which said school may sustain or incur because of the use of the above-mentioned building by our organization, and we further will hold said school harmless.~'~f any kind in c~rf~ection herewith. Superintendent:~/' ~,' ,~enied Specific Details of Use: i / EXCERPT5 FROM SECTION 414 OF THE EDUCATION LAW "... The Board of Education of each district may.., permit the use of the school house and rooms therein, and the grounds and other property of the district, when not in use for school purposes, for any of the following purposes: 1. For the purpose of instruction in any branch of education, learning or the arts. 2 For holding social, civic and recreational meetings and entertainments, and other issues pertaining to the welfare of the community; but such meetings, entertainment and uses shall be non- exclusive and shall be open to the general public. 3 For meetings, entertainments and occasions where admission fees are charged, when the proceeds thereof are to be expended for an educational or charitable purpose; but such use shall not be permitted if such meetings, entertainments and occasions are under the exclusive control, and the said proceeds are to be applied for the benefit of society, association or organizations of veterans of the military, naval and marine service of the United States and organizations of volunteer firemen." 05/~$/20~2 ~OE ~3=23 ~AX Legion Fireworks Co,, ln¢, I0 e~ie~l Lasso x~'~l~i~*gel~ t:~tl~ NY I~gO Page 1 of 1 Cooper, Linda From: Cooper, Linda Sent: Thursday, June 21, 2012 12:13 PM To: Harris, Peter Cc: Sinramm, Joan Subject: GFD Fireworks permit Tracking: Recipient Harris, Peter Sinramm, ]oan Read Read: 6/21/2012 1:51 PM Hi Pete, I got the OK from Bob Fisher for the fireworks permit. Once I have received: 1. Copy of the contract with the fireworks display company, 2. Certificates for the pyrotechnicians 3. GHS approval 4. GFD Fire Chief's written approval I can send the permit over to you. L/ada ,7.. ~ooper Deputy Town Clerk Town of Southold 631-765-1800 L~fe may not be the party we hoped for, but as long as we are here, we might as well dancer The difference between try and triumph is a little "umph"! 6/21/2012