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HomeMy WebLinkAbout2014 o��S�FFO(,�co ELIZABETH A. NEVILLE, MMC �� r/y Town Hall,53095 Main Road TOWN CLERK P.O. Box 1179 CZ C* 2 Southold,New York 11971 REGISTRAR OF VITAL STATISTICS p • Fax(631)765-6145 MARRIAGE OFFICER �� ��' Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER 0.( `1►a www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER 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: East End Seaport and Maritime Foundation Third Street at the Ferry Dock,Greenport,New York 11944 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:OOPM,Saturday, August 30,2014(RAINDATE:I0:OOPM,Sunday,August 31,2014) at Greenport High School Athletic Field, Front Street and Moore's Lane,Greenport, New York 11944; 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 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. (Town Seal) Elizab A. Neville,Southold Town Clerk Suffolk County, New York Date: 8/27/2014 THIS PERMIT IS NOT TRANSFERABLE RESOLUTION 2014-707 ADOPTED DOC ID: 10047 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2014-707 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON AUGUST 26, 2014: RESOLVED that the Town Board of the Town of Southold hereby amends resolution#2014- 679, adopted at the August 12, 2014 regular Town Board meeting to read as follows: RESOLVED that the Town Board of the Town of Southold hereby approves the issuance of a fireworks permit by the Town Clerk to East End Seaport and Maritime Foundation, for a fireworks display on Saturday, August 30, 2014 at 10:00 P.M. (Rain Date: August 31, 2014) at the Greenport High School athletic field, Greenport, upon payment of a fee of$100 and subject to the applicant's compliance with the requirements of the Town's policy regarding the issuance of fireworks permits, as amended, and subject to the approval of the Town Attorney. 0�as4q.0404�& Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: James Dinizio Jr, Councilman SECONDER:Jill Doherty, Councilwoman AYES: Ghosio, Dinizio Jr, Ruland, Doherty, Evans, Russell Neville, Elizabeth From: Neville, Elizabeth Sent: Tuesday,August 26, 2014 10:54 PM To: 'JMOddon@greenportvillage.org' Cc: Rudder, Lynda Subject: Emailing: East Seaport Maritime Fo_20140826214039 Attachments: East Seaport Maritime Fo_20140826214039.pdf Importance: High Hey Jeanmarie, O000ps!! Delete that first e-mail. I sent you the Peconic Landing Fireworks Permit by mistake. Here is the East End Seaport Maritime Foundation's Town Board Resolution and Fireworks Permit. Betty Neville Your message is ready to be sent with the following file or link attachments: East Seaport Maritime Fo_20140826214039 Note:To protect against computer viruses,e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. Neville, Elizabeth From: Neville, Elizabeth Sent: Tuesday,August 26, 201410:54 PM To: 'JMOddon@greenportvillage.org' Cc: Rudder, Lynda Subject: Emailing: East Seaport Maritime Fo_20140826214039 Attachments: East Seaport Maritime Fo_20140826214039.pdf Importance: High Hey Jeanmarie, O000ps!! Delete that first e-mail. I sent you the Peconic Landing Fireworks Permit by mistake. Here is the East End Seaport Maritime Foundation's Town Board Resolution and Fireworks Permit. Betty Neville Your message is ready to be sent with the following file or link attachments: East Seaport Maritime Fo_20140826214039 Note:To protect against computer viruses,e-mail programs may prevent sending or receiving certain types of file attachments. Check your e-mail security settings to determine how attachments are handled. i 00 01 FROM WAQ A.M. OF TIME P.M. PHONE ❑ URGENT AREA CODE NUMBER EXT. ❑ TELEPHONED ❑ CAME TO SEE YOU ❑ RETURNED YOUR CALL � s 7€€kk it, N Board Meeting of August 12, 2014 IN 2014-679 Item # 5.6 'TED DOC ID: 10018 VING RESOLUTION NO. 2014-679 WAS )F THE SOUTHOLD TOWN BOARD ON if Southold hereby approves the issuance of a nd Seaport and Maritime Foundation, for a 4 at 10:00 P.M. at the Greenport High of a fee of$100 and subject to the applicant's policy regarding the issuance of fireworks of the Town Attorney. A. Neville 'own Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: James Dinizio Jr, Councilman SECONDER:Louisa P. Evans, Justice %NrN AYES: Dinizio Jr, Ruland, Doherty, Evans, Russell ABSENT: Robert Ghosio Generated August 14, 2014 Page 12 • ' f ELIZABETH A. NEVILI.E,:&MC �\C2 Yv Town Hall,53095 Main Road TOWN CLERK � P.O.Box 1179 Southold,New York 1,971 REGISTRAR OF VITAL STATISTICS ` Fax(631)766-6145 MARRIAGE OFFICER Telephone{631)765 1800 RECORDS OF MANAGEMENT OFFICER �./ '�� southol one(6 1)76 o 1 net FREEDOM OF INFORMATION OFFICER RECEIVED 1Y1a, An • 1(etn\•J h i 4{�J'lFFICD OF TTS TO VIN CLElUl- Ave TOWN OFSOUTHOLD AUG - 1 2014 Gor r np+ PERMIT TO DISPLAY FIREWORKS Southold Town Clerk APPLICATION IS IiEREBY 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 8E SPONSORED BY East End Seaport R. Maritime Foundation PRINCIPAL OFFICE AT Third Street @ the Ferry Dock,_Greenport, NY 1.1944__ DATE& TIME OF DISPLAY _ 8/30/14 Time: 10:00 pm FXk CT LOCATION-OF DISPLAY Greenport High School athletic field SUFFOLK COUNTY TAX MAP NUMBER FOR SITE RAIN DATE cox TI1KE30/14 @ 10:00 pm Rain date: 8/31/14 The following persons are to be in charge of the actual shooting of the fireworks: Nance Age Experience physical Condition Christopher Racioppo dob: _ 5 years + Health: Excellent 9/16/89 assistants: tbd {Additional names and information may be submitted on an attached sheet Number and type of fireworks is as follows: 1.3G Fireworks 2-3 inch— 424. Calces=6. Manner and place of storage of fireworks prior to display: Storage at Westhampton facility. Product delivered day o lsp 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 Pranerty Owner, must be submitted with the Application. East End Seaport & Maritime Foundation FEE: $100 Name ofOrgarizatior. See policy for additional information By Signature of Upplic�anl ���- Date ofApplicati/on �r,'""•a� RESOLUTION 2010-474 revADOPTED DOC ID: 6016 THIS IS TO CERTIFY:' THAT THE FOLLOWING RESOLUTION NO. 2010-474 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JUNE 29,2010: RESOLVED that the Town Board of the Town of Southold hereby adopts the following POLICY regarding the issuance of fireworks permits: 1. The Town may grant a permit for the display of fireworks by municipalities, fair associations, amusement parks,persons or organizations of individuals. Penal Law Section 405.00(2). 2. An 'organization of individuals" is a religious, civic, or comparable organization. Op. Atty. Gen No. 2007-3. 3. Fireworks permits shall indicate that the display must be concluded by 10:00 p.m. if held Sunday-Thursday, 11:00 p.m. if held Friday or Saturday,and there shall be no time restriction if held on July 4. 4. No person shall engage in or allow the manufacture,assembly, storage or display of any fireworks or pyrotechnics display without first obtaining a permit issued by the Town Clerk. A completed application for display of fireworks must be received by the Town Clerk a minimum of 30 days prior to the date of display. The permit application for any fireworks or pyrotechnics display shall be accompanied by the following: a copy of a valid certificate of competency as a pyrotechnician for the individual supervising the firing of the display; Certificate of Insurance naming the Town of Southold as additional insured with coverage limits of$2,000,000 for public liability and$2,000,000 for property damage; Detailed diagram showing location of fireworks discharge and minimum separation distances in accordance with the applicable requirements of Penal Law Section 405(2); XA copy of the contract with fireworks display company; and (e) All applications shall require the approval of the Fire Chief of the District in which the display will take place and the Fire Marshal before being presented for approval by the Town Board. ,eco d CERTIFICATE OF LIABILITY INSURANCE 10711712014 THIS CERMRrATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CENTFIGATE HOLDER.THIS CERTFICIITE DOES NOT AFFIRMATNEL.Y OR NEGATNELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICES BELOW. THIS CEtTTFr ATE OF MISURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUNG IINSURER(316 AUTHORIZED REPRESgTTATNE OR PRODUCER,AND THE CERTIFICTE HOLDER. IMPORTANT: Q the c I'll rA- holder is an ADDITIONAL.INSURW,the panh►(be)mast be endorsed. N SUBROGATION IS WANED,md*d to Vw farms and candMiorrs of the palay.oertairr poiais racy n qWm an eudorawmnt A afatament on this c IMT, I doss not on d rights to the -m lift efe ILolder In Neu Of such andarsmandloA PRODUM Allied Spechft Insuranrx,Inc. 10461 Gtdf Bordelrard FM Treasure isiand,FL 33706.4814 1402:17.3355 AuraCW*VPAW HMO NNLNLBtA:T.H.E.btstNamx ConVanY 12866 aSURED Pyro Engineering,Inc. NISURERe: dba:Bay Fireworks Nva: NISURE lD 999 South Oyster Bay Rd.,Suite 111 ofox RH:: BeStpage,NY 11714 RnW MF- COVERAGES CERT94CATE NUMOM REVISION NWS THIS IS TO CERWY THAT THE POLKAS OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAKED ABOVE FOR THE POLICY PERIOD INDICATED NOTWRHISTAHIOM ANY REST.TERM OR CONDITION OF MIY CONTRACT OR OTHER DOCUMENT 111TH RESPECT TO VWHICHH THIS CERTIRQKTE MAY BE ISSUED OR MAY PERTAIN.THE eBINiANCE AFFORDED BY THE POLICIES DESCRIBED MEN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POS.LMYTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMIS. N� TVPEOFNNNLANCE POLIt:YraNB®L LNa7a A ""' ' N 000,000 CPP0101294-84 4M4 05MAI is O=W-m +cE t1, X CeraMCIAL OEM R L LLL urY $100,000 LxAae4 mE Q OCCUR MEDEW =wp� $ pmsowLaAD wmw $1,000.Q00 6ENEWLAaGRE6ATE $ 6Bn.AL,RE"TEUWrMWUMPBt PROODUCrs-CorLP/OPAee $2,000,000 Poicy PRo- LAc $ Lur A ALLr°r10� upin 1f' CPPOID1284-84 4 WM40MS ,000.000 qOD LYHJ"w f%rpww* $ ANv ALRO x Au BODLY""wo%raa'1 0 $ arm ix H OMAURN x NON47INED $ AUm L NSFAM A LIAR X OCCUR 05M4I2014 NR41MS EACH OCCURRENCE $ 000,000 A t .P0010�292-04(VL) Ham CLARISMeoe ALi 117E $4,000000 RELENT ms $ vLL:_ oT►e A AND e OVERVUAMLUY YIN 44166W 4n"s E.L.EACNAcaDENr ER $1,000.000 oTFLCF .M pi 161 MLUD®n NIAJ E.LO -EADV $1,000,000 N ����OPFRATM]NS4.Mir E1.ONlEABE-POL1CYLeef 51.000000 A ExcEss uABNJT1fx)ccuR ELP0010296.04(GL) MM4 105M42"S JEAM OCCUR$11,aDoAN AGGREGATE$11ANN000 DESCI!?LDNOFOPNRMLCNCILOCA7=nlVOYCIE$_ m-11AC0RDj*%A&MpwWft - 1 dwdul%r�ape lm4 PHw DATE:SSI30M4 RAMI DATE INIMM4 LOCATION:Gr*w*wt H e A9116 a FUtd,GreenportNY RAL LIABILITY,THE FOLLOWING ARE NAMED AS ADDITIONAL MSD IN RESPECTS TO THE OPERATION OF THE NAMED INSURED stEndSeaportSI- 'll Le Feumk m.VLMageefGriee*W%TownofSoudwKSepti#County; enGreportUFSD. hvdess Agr*@nm*Par Cantr*d betwear the ruened insured and the addltia"kwAumd spp%& CERTIFICATE HOLDER CANCELLAT10N Thirty(30)Days Notice of Cancellation Applies. East End Seaport 9.Nwith- Foundation SHOULD ANY OF THE ABOVE DESCRB®FIDIJ et BE CANCELLED NEFORE Third Street Q the Ferry DOCK THE E>PNIATION DATE THEREOF. NaTICE YMJ- BE DBZA9= IN ACCORDANCE VKM THE POLN:Y PROVISIONS. Greenport NY 11044 AurR w /j Cert#1735 0 11188 2010 ACOJO CORPORATION. AM rigfrts re:nrved. ACORD 25[2010x00) The ACORD mane arrd Logo are regi m l 'norks of ACORD °;. � � �. R -R RACIOPPO - .... LAS: A "PLAY i µ w dARD.. MUSBE CARRIED v tN"YROTECHNICS 40, 0. TIFICATIONS REQUiRED IN NYC America's World Class Fireworks Leader Display Date:August 30, 2014 FIREWORKS DISPLAY AGREEMENT AGREEMENT made May 30,2014 by and between Pyro Engineering, Inc., whose address is 999 South Oyster Bay Road,Suite 111, Bethpage, NY 11714 (hereinafter"PEI');and East End Seaport&Maritime Foundation,Third Street @the Ferry Dock, Greenport,NY 11944 (hereinafter"SPONSOR'). WHEREAS,PEI designs,produces,and conducts fireworks displays;and WHEREAS,SPONSOR wishes to engage PEI to design,produce and perform a fireworks display on the terms and conditions hereinafter set forth; NOW,THEREFORE,in consideration of the terms,conditions and covenants hereinafter set forth,the parties hereto do mutually agree as follows: 1.FIREWORKS DISPLAY: On, August 30,2014 (hereinafter"the Display Date").PEI shall provide the fireworks and equipment for the display at the Fireworks Display location.The display will be under the supervision of a PEI trained technician.it is agreed that PEI shall be the sole fireworks supplier and producer for the event contracted for herein. (Note: The actual start and stop time of the display will be determined by the governmental authorities having jurisdiction over the display). ALTERNATE DATE: August 31, 2014 2. COST AND PAYMENTS: FIREWORKS DISPLAY PRICE: The total(Fireworks Display Pnce lus all other applicable charges)sum shall be due and payable as follows: a.The sum of� Due and Payable on Night of August 30,2014 Please Note: SPONSOR is responsible for the payment of all governmental fees and taxes, including, but not limited to, sales, use,excise,license,permit,entertainment,or other fees,taxes or surcharges Imposed or otherwise applied to this exhibition. Also, please see Section 16(c)below. 3. POSTPONEMENT/RESCHEDULING:If the display of the fireworks is postponed/rescheduled by reason of inclement weather or by determination by the governmental authority having jurisdiction,or for any other reason beyond the control of PEI,same shall be re- scheduled to the Alternate Date set forth above. In the event a postponement/rescheduling is necessary due to inclement weather or by determination by the governmental authority having jurisdiction,or for any other reason beyond the control of PEI a postponement/rescheduling fee will be based on the table below. Description I %of Fireworks Display Price Additional Costs If notified by 12:01 AM on 08/29/14 1 5% Any 3rd P rty Vendor Expenses If notified after 12:01 AM on 08/30/14 1 15% Any 31d Party Vendor Expenses Once Bay Fireworks Techs Arrive on Site 20% 11 ny 31d Party Vendor Expenses Any request made by SPONSOR for rescheduling/canceling shall be directed to help@bayfireworks_com or by phone(516)233- 4132. It is understood and agreed that PEI shall have no obligation to reschedule a display except as required by inclement weather or reasons beyond the control of PEI. 4. SPONSOR'S AGENT.Mr.Ken White CELL PHONE:: � T shall be designated as SPONSOR'S agent to whom all questions and inquiries shall be relayed. Sponsor's agent shall be the only agent of SPONSOR authorized to make decisions on behalf of SPONSOR or to request rescheduling of the fireworks display on the part of SPONSOR. Plewa initial each page. Initial here: /<«-) Sponsor s, xy� 6 l r i II ItY}t � L g i YZ r�lia n a3. � 4 Eastern Service Center 1701 Columbia Ave. U.S.Department Operations Support Group College Park,GA 30337 of Transportation AJV-E2 REQUEST FOR FIREWORKS DISPLAY 5/30/14 Company Name: Pyro Engineering- 999 South Oyster Rd, Suite 111 - Bethpage,NY 11714 Email Address of Person Requesting the Show: joannena bavfireworks.com Event Name: Eastend Seaport Maritime Museum Display Date: August 30,2014 Rain Date: August 31,2014 Display Start Time: 10 PM Duration of Fireworks Display: 8 minutes Max Height of Fireworks: 300 Feet City or Town and State (Physical Address): Greenport,NY Latitude: 41-06-19 N(North) Longitude:072-22-20 W (West) List the Closest Public Use Airport Within 25 Nautical Miles of the Display if the Fireworks Will Reach or Exceed 500 Ft. :Mattituck Airport=10 miles Location or Special Notes: Greenport HS Athletic Field Front St.&Moores Lane Please email your request to: 9-ATO-ESA-OSG-firewo rks Ca)-faa.q ov * * * RECEIPT * * * Date: 08/01/14 Receipt#: 176027 Quantity Transactions Reference Subtotal 1 Fireworks 8/30/14 $100.00 Total Paid: $100.00 Notes: Payment Type Amount Paid By CK# $100.00 East, End Seaport& Marine Fdn. Name: East, End Seaport& Marine Fdn. P.o. Box 624 Greenport, NY 11944 Clerk ID: LYNDAR Internal ID:8/30/14 Rudder, Lynda From: Martin Finnegan Forward Sent: Friday, August 01, 2014 11:49 AM To: Rudder, Lynda Subject: Re: Emailing:fireworks_20140801095536.pdf Looks ok to me. Sent from my Whone > On Aug 1, 2014, at 10:56 AM, "Rudder, Lynda" <Ivnda.rudder@town.southold.nv.us>wrote: > Please approve/disapprove the attached. ><fireworks_20140801095536.pdf> 1 Rudder, Lynda From: Flatley, Martin Sent: Friday, August 01, 2014 12:29 PM To: Rudder, Lynda; Doroski, Melanie; Finnegan, Martin; Fisher, Robert; Kiely, Stephen; Kruszeski, Frank; Spiro, Melissa Subject: RE: Emailing: fireworks_20140801095536.pdf I have no objections to this fireworks display taking place. Martin Flatley Chief of Police Southold Town Police Department 41405 State Rt. 25 Peconic, N.Y. 11958 631-765-3115 -----Original Message----- From: Rudder, Lynda Sent: Friday, August 01, 2014 10:57 AM To: Doroski, Melanie; Finnegan, Martin; Fisher, Robert; Flatley, Martin; Kiely, Stephen; Kruszeski, Frank; Spiro, Melissa Subject: Emailing:fireworks_20140801095536.pdf Please approve/disapprove the attached. 1 Rudder, Lynda From: Doroski, Melanie Sent: Friday, August 01, 2014 1:25 PM To: Rudder, Lynda; Finnegan, Martin; Fisher, Robert; Flatley, Martin; Kiely, Stephen; Kruszeski, Frank; Spiro, Melissa Subject: RE: Emailing:fireworks_20140801095536.pdf I have reviewed the applications for Fireworks Permits for: East End Seaport & Maritime Foundation 8/30/14 (RD 8/31/14), at the Greenport High School Athletic Field. Greenport School is not Town of Southold preserved land. Since this is not preserved land, the LPC has no comment on this application. -----Original Message----- From: Rudder, Lynda Sent: Friday, August 01, 2014 10:57 AM To: Doroski, Melanie; Finnegan, Martin; Fisher, Robert; Flatley, Martin; Kiely, Stephen; Kruszeski, Frank; Spiro, Melissa Subject: Emailing: fireworks_20140801095536.pdf Please approve/disapprove the attached. 1 CHIEF HARRY BREESE (631)477-9801 STATION 1 1sT ASST.CHIEF WAYNE MILLER (631)477-8261 STATION 2 2ND ASST.CHIEFJEFFREY L.WEINGART (631)477-1943-CHIEFS OFFICE CHAPLAIN C. KUMJIAN (631)477-4012-FAX TREAS/SECRETARY J. KALIN THIRD STREET• P.O. BOX 58 GREENPORT, NY 11944 Email:gfdfire@optonline.net I t www.greenportfd.org Organized 1845 RECEIVED AUG - 4 2014 Southold Town Clerk August 2, 2014 To whom it may concern; The Greenport Fire Department is aware that the East End Seaport & Marine Foundation will be holding a fireworks display on Saturday, August 30" with a rain date of Sunday, August 315 at 10:00 pm in conjunction with their carnival fundraiser. We will have apparatus on hand to stand by during this event. Res ectfully yours; G� Harry Breese Chief of Department " - GREENPORT UFSDg '`� J � a RECEIVED 720 Front Street J41-1 P J Greenport, NY 11944 / �/ 1� AUG - 4 2014 APPLICATION FOR USE'OF SCHOOL FACILITIES S0uARi!dr@*n is responsible for the use of all school facilities in order that they may consider your request for such use, kindly complete the following: 1. Facilities Use Request: (Organization), �14GG�reennort requests the use of�� �� Public Schools for the purpose of: .SAgai fe on(date), o.' a u ' / at(time) Will activity be open to the public? (Circle one) Yes. No Is this a For Profit Organization?(Circle one) Yes (00 Admission of A-10 A f C /� will be charged; proceeds will be used for L e � Zt'/►l�i,4„� ,�L(C, Does applicant agree to submit financial records for examination upon requests? .E 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? 50',e.V Name : �1 �. 1J,!/rl eef /���� Address: Zgf a c�! Telephone# 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 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 A. 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 observe the regulations and that we, individually, and as an organization,will assume all financial 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 for loss of any kind in connection herewith. Applicant Signed: Date:. Superintende t: Grante De,.ied Date: Specific Details of Use: EXCERPTS 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."