Loading...
HomeMy WebLinkAbout2015ELIZABETH A. NEVILLE, MMC 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 www.southoldtownny.gov 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, A PERMIT FOR THE PUBLIC DISPLAY OF FIREWORKS by said organization in accordance with the provisions of Section 405.00 of the Penal Law of the State of New York at 10:00 PM on Saturday, May 23, 2015 (r/d 24`h) on the property of GREENPORT HIGH SCHOOL Athletic Field, north side Front Street and cast 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 ft 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 o e display. Elizabeth A. Neville, Southold Town Clerk Suffolk County, New York (Town Seal) Date: May 19, 2015 THIS PERMIT IS NOT TRANSFERABLE Southold Town Board - Letter Board Meeting of May 19, 2015 gaFra, `RESOLUTION 2015-441 Item # 5.8 ADOPTED DOC ID: 10817 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2015-441 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON MAY 19,2015: RESOLVED that the Town Board of the Town of Southold hereby approves the issuance of a fireworks permit by the Town Clerk's Office to Star Hose Company of the Greenport Fire Department, for a fireworks display on May 23, 2015 (r/d 5/24/15), at Greenport High School's field, Greenport, New York upon the payment of a single fee of $100 and subject to the applicant's compliance with the requirements of the Town's policy regarding the issuance of fireworks permits and subject to the approval of the Town Attorney. Elizabeth A. Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: James Dinizio Jr, Councilman SECONDER: Louisa P. Evans, Justice AYES: Ghosio, Dinizio Jr, Ruland, Doherty, Evans, Russell Generated May 19, 2015 Page 21 ELIZOOIRTll. . NEVILLE, M90 TOWN CLERK REGISTRAR QF VITAL,STATISTICS MARRUGE-OFIkORR:;' RECORD&OF MANAGEMENT OFFICER F _9WOM,QF QpR T own HaH, 0004'$(*.`Itpaa 1p-_O.RQX 1179 90udioiai.'NewYbik 119.71, Telephone(631),705-1890 ,southoldtown.nor,tlifork.rio't': RECEIVE® OFFICE OF TIM TOWN CLEAR" APR 2 1 2015 -TOWN OYSOUTHOLD APPLICATION''__ PERMIT TO jD19 1,AY-F1REW0RXS Southold Town Clerk APPLICATION, IS HEREBY MADE, -pursuant to the provisions of Section 4.0-5-..,.O:of'the Pe-aLaw of the; State ofNew York; for a,pe'nuit-to: display ,,f wprks.,as: hereinafter ,specified D . ISPLAYISTOBE"SP6NSOREi)'OY-.St-ar Hose 4oiap'ahy,- (Greenport. FIX) PRINCIPAL - OFFICE Al24.0 6th Avenue, 'Greenp.ort, NY 11,944 PAT—L&TIMEOE'DISPLAY May 23, 2015 Time;. fo::00- -,pm .EXACT LOCATION,OF DISPLAY '."';Greenport lli�4 School athletic. 'field. SUFFOLK COUNTY, TAX'MAP-NUMMER-POR,SIT RAIN DATE & TIME' 24, '20-15; 0 10:'00: pm T44611fting p6s6hsAtto be yin charge of tht ;ittqiV.shb6t0 i n I g!bfthe :Areworks: Name AgeE�xpeiienep Physicil Condit.1o.ii �ajliaT 1�otterh6s d,bb--.5126/-715 7 year's 'Real-th 'Ek tellent (Additi6'n'-a"I"n''am"e"s'-g-ftd•inf6rm opmaybesub"tted.,bitgnattached sheet- ;Number heet 'N . , f6ftows: wkwIr And type of fii'r'&w*brks is as G Fireworks 2=3 -inch= 424, Cp*ep=6. Mafiber and place of .storage- of jrlrew0ks prior to display Storage at,'Wes;tharnp.ton,Facility. Prmftu4t 401-Ltiet-6d, dloy- of di,splay. Attached horOo andniadd apatt of ioreof is -a' dtagrani bf46Arbunds: on w h be held. t e, display is to Also vffta6hed'']'sa-cerii,fi,c,A,t,o�o,rpolicy ofinsurance coverage: NOTICE Wr.:`ittenpermisston,Wwth"signature:of e,—ro FEE See-pplicy.,10"' additional information Hbsejaomanv (Gr-eenporf FD) Name -of Organization B 4,*gnato 'p_'w INSTAVCTIONS FOR DISPLAY OF' FIREWORKS" Name of body:$ w. 4 9Tks.dis 6Ly. Ponso irig�fir'P p TWO da(p aridAime of,day,at which the fireworks display sto;be_ 'Ih&d. I 'The. exact location plannqdfor t-hellreworks display, including TAX M, NUMBER.. The" "ape �experience :and phygical,characieristics,of thCvpe.Tsonls who. are: to do the ,actual 'dischargin 9-0fil"16firOwOrks. Thb,riurfibef and kind, of fireworks to be'discharged.x - The manner and place, of storage, of sach fireworks prior to the display. "showing�ihe point at W., the fireworks are �is, to be: h6ld,h s :A, diagram. of the grounds, 0 g ,1 which the display gs, igbwayisl'arid. other 'lines of Pri cat t6bo',disoharg9d, theJocation of all- b.uif h'" ii ion, the Iffies N res, raine and gr behind whiclxthe Audi will,"N "' A' 'd a location al aph.or.t&Ie'p om mes or other, ioverhead. ObstructiOxis'. Town Clerk�-,may deem` neeessary'to.'Protect.' Su6h :other" information' as - the S'oWkpW:TP gorsorproperty',; isa �,prq pry Wfittenvorrniss,ion..;of the property- owner -,is. required liability , coy, A# indemnity; insurance policy icy vith,, coverage and, indemnity protection .,of, $4,000,00G."00 r ns .01 1 _.ity . . . , ,Verson f6fb6dilyinjury," $1,,000;000.00 pqr accident; .$ 1,0_ 0 000.00: property damage 'The Town. Clerk ,pf the Town of Souffiold rftu§t:havd:thoinsurance; policy in her possessionjgjaa the. fireworks permit- is. issued. The, named insured must',rekd,- TOW -,N, 0IPWV,7HOib. I Applicitibr-Bora, irow' fkstPepermit must; fireworks ' 4(Th6, above instructionsLare, m accordance with the Penal Law, Article 405' Licensing and. of relgtingta fireworks.), ,4co o® CERTIFICATE OF LIABILITY INSURANCE 03/DATE (MMID 25/2015 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 conditio'nit 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). Allied S ectal Insurance Inc. PRODUCER p tyI 10451 Gulf Boulevard. Treasure Island, FL 33706-4814 CONTACT.. - NAME: PHONE FAC AIC. No: E -Mal , ADDRESS: INSURERS 'AFFORDING COVERAGE NAIL # 1-800-237-3355 INSURER A: T.H.E. Insurance Company 12866 INSURED Pyro Engineering, Inc. dba: Bay Fireworks 999 South Oyster Bay Rd., Suite 111 INSURER D INSURER C: INSURER D: INSURER E INSURER F: Bethpage, NY 11714 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- LTR A D TYPE OF INSURANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN . ACCORDANCE WITH THE POLICY' PROVISIONS., ' - POLICY NUMBER POL CY EFF MMIDD POLICY EXP MMIDD OMITS A GENERAL LIABILITYtiPP0101284-05 %� COMMERCIALGENERAL•LIABILITY 02/15!2015 02115/2016 EACH OCCURRENCE $1,000,000 PREMISES (Eaoccurrence)$100,000 MED EXP (Any one person) $ CLAIMS -MADE a OCCUR PERSONAL & ADV INJURY $1,000,000 GENERALAGGREGATE $ GEN'LAGGREGATE LIMIT APPLIES PER : PRODUCTS -COMP/OPAGG $2,Q00,000 $ POL16YF-1 PRO LOC A AUTOMOBILE LIABILITY ANY AUTO CPP0101284-05 02/1512015 02/15/2016 COMBINEDSINGLE LIMIT 1 �OOO,OOO ( accident) BODILY INJURY (Per person) $ BODILY.INJURY (Per accident) $ ' AUTOWNED x SCHEDULED NON -OWNED X HIRED AUTOS X AUTOS - PROPERTY DAMAGE $ .. Per accident)' $ A X UMBRELLA LIAR EXCESsUAB X OCCUR CLAIMS -MADE ECP0010292-05 (VL) 02/15/2015 0211512016 EACH OCCURRENCE $'4,000,000 AGGREGATE $4,000,000 DED RETENTION S. $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICERIMEMBER EXCLUOE07 (Mandatory In NH) DESCRIPTION O OPERATIONS below DESCR H / A WC00006167-001 02115/2015 02/15/2016 WC STATU- DTH - 1 000' 000 E.L. EACH ACCIDENT $ s I E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 A EXCESS LIABILITYIOCCUR ELP0010296-05 (GL) 02/15/2015 02115/2016 EACH OCCURRENCE $9,000,000 AGGREGATE $9,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required) DISPLAY DATE: 05123/15 RAIN DATE: 05/24/15 LOCATION: Greenport HS Athletic Field Greenport NY RE: GENERAL LIABILITY, THE FOLLOWING ARE NAMED AS ADDITIONAL INSURED IN RESPECTS TO THE OPERATION OF THE NAMED INSURED ONLY: Star Hose Company; Greenport Fire Department; Village of Greenport NY; Town of Southold; Suffolk County; Greenport UFSD I Hold Harmless Agreement per contract between the named insurgd and the additional Insured applies. ^ATC L1f%l nrn - P-AIdCFI I:ATInIU Greenport Fire Department p p Thirty (30) Days Notice of Cancellation Applies., SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 240 6th Ave Greenport NY 11944 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN . ACCORDANCE WITH THE POLICY' PROVISIONS., ' - AUTNO EO PRESENIA Cert # "iI V'IV55-ZU7U At;V KU 6VKMVKAIIVN. All rlgras reserveD. ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORD Y 4 ... Rom fi gjLQs.,� lastem.SendmCenter 1104.Columb" , A U-$, 000affeilt, Operatbons Support. -Group 00-110ge p GA 30337 of TrAjf tjil AJV-E2 REQUEST FOR FIREWORKS DISPLAY. 11714 Company Name: ;'PyrQ-En 6iith, Pygbef Rd, -SUR6 1,11 *Beth -NY- gineering J-,, 9,99 page_ Email.Addieg's of Person ReqU'6stiti9 the, how..; joqnne@—bayfirew,'otkgxqm. Event Name! Star Hose ,Company :(,qreenportFD.),20,15 DiMlapy"Datd.- AAyI131015 R- D 00?, May 24, 2015 Display Situtllme: 10:00 PM Duration bf Fireworks Display: 10 minutes Max Hot& ofFireworks: '3`0.0:Feet, d' kajAddress)! City or' Town an state (P4ys NY Latitude 41r06-st3. X" (Ndith)" Longitude: 6,72-22-19W(West,)- List the Closest Publi c Use Airport W 25-Nautica1,'Miles of the Display .if the Fireworks: Will Reach or Exceed 500 -.Ft-,,., `IL-ocation or, Special N&ft; Greenport HS ,)Fie id Moorslane & Monsell TrafilNorth Street .0 Pkag&i�hiai your request to'O GREENPORT UFSD 720 Front Street Greenport, NY 11944 APPLICATIONFOR USE•OF SCHOOL FACILITIES The Administration is responsible for the .use of all school facilities in order that they may consider your request for such use,, kindly complete the followings:- 1. Facilities Use Request: (Or anization), �14 >^i 1'�&SV, requests . the use of � P. � �` FIs !R 1' r jAd at Greenport Publ,ic,schools for the purpose of: on(date), S a1 i`u � ��q S ?3 i 'Ir, at (time) c► rOmay:/I �a/ fs Will activity tie open to o the public? (Circle ne) ` e No Is this a For Profit Organization? (Circle one) , Yes No Admission of 144> JI. ewill 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 roe ncludin Section 414 printed on the reverse side of this application?' ' property rty g Name: _ E:C/ w w eJ `��' �5 ) g b A - ,- .• a Address: ��J lle-CA, k Lvi Nle, �dr� 1Y7 Telephone # `� �7 ' of the person responsible on this occasion. If. 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. $6.4er _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 or4ani?:ation 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:v Date: 7 7 Superintendent: Granted U;TljDeniedA 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." Date: 04/28/15 Quantity 1 Notes: Payment Type CK #1362 Transactions Fireworks *** RECEIPT*** Receipt#: 183617 Reference Subtotal 5/24/15 $100.00 Total Paid: $100.00 Amount Paid By $100.00 Star, Hose Company Co #3 Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 Name: Star, Hose Company Co #3 Greenport Fire Department Po Box 345 240 6th Ave Clerk ID: LYNDAR Internal ID: 5/24/15 Rudder, Lynda From: Flatley, Martin Sent: Tuesday, April 28, 2015 10:50 AM To: Rudder, Lynda Subject: RE: Greenport fire Dept I have no objections to this permit being issued on behalf of the GFD Martin Flatley, Chief of Police Southold Town Police Department 41405 State Route 25 Peconic, New York 11958 631-765-3115 -----Original Message ----- From: Rudder, Lynda Sent: Tuesday, April 28, 2015 9:53 AM To: Doroski, Melanie; Duffy, Bill; Fisher, Robert; Flatley, Martin; Kiely, Stephen; Kruszeski, Frank; Spiro, Melissa Subject: Greenport fire Dept Please provide approval/disapproval 1 Rudder, Lynda From: Doroski, Melanie Sent: Tuesday, April 28, 2015 10:06 AM To: Rudder, Lynda; Duffy, Bill; Fisher, Robert; Flatley, Martin; Kiely, Stephen; Kruszeski, Frank; Spiro, Melissa Subject: RE: Greenport fire Dept Lynda: In Melissa's absence, I have reviewed the Fireworks Permit for Star Hose Company, Greenport Fire Department for 5/23/2015 (RD 5/24/2015). I have also reviewed Melissa's files concerning firework displays at the Greenport High School athletic field. In conclusion, Greenport School is not Town of Southold preserved land. Since this is not preserved land, there is no comment from the Land Preservation Department on this application. Melanie Doroski Sr. Administrative Assistant Land Preservation Department Town of Southold -----Original Message ----- From: Rudder, Lynda Sent: Tuesday, April 28, 2015 9:53 AM To: Doroski, Melanie; Duffy, Bill; Fisher, Robert; Flatley, Martin; Kiely, Stephen; Kruszeski, Frank; Spiro, Melissa Subject: Greenport fire Dept Please provide approval/disapproval Rudder, Lynda From: Fisher, Robert Sent: Tuesday, April 28, 2015 3:57 PM To: Rudder, Lynda Subject: RE: Greenport fire Dept Lynda I have .no problem with this fireworks permit application Robert Fisher Fire Marshall robert.fisher@town.so.uthold.nv.us (631) 765-1802 office (631) 786-9180 cell CONFIDENTIALITY NOTICE: This communication with its .contents may contain confidential and/or legally privileged information. It is solely for the use of the intended recipient(s). Unauthorized interception, review, use or disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy Act. If you are not the intended recipient, please contact the sender and destroy all copies of the communication -----Original Message ----- From: Rudder, Lynda Sent: Tuesday, April 28, 2015 9:53 AM To: Doroski, Melanie; Duffy, Bill; Fisher, Robert; Flatley, Martin; Kiely, Stephen; Kruszeski, Frank; Spiro, Melissa Subject: Greenport fire Dept Please provide approval/disapproval Rudder, Lynda From: Duffy, Bill Sent: Thursday, May 07, 2015 1:28 PM To: Rudder, Lynda Subject: RE: Fireworks Permit I have no objection to the application -----Original Message ----- From: Rudder, Lynda Sent: Thursday, May 07, 2015 10:32 AM To: Duffy, Bill; Kiely, Stephen Cc: Krauza, Lynne Subject: Fireworks Permit On April 28, 2015 1 emailed a fireworks application. I have attached the application again for your convenience. Please provide your approval/disapproval. 1 RESOLUTION 2015-557 ADOPTED DOC ID: 10933 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION NO. 2015-557 WAS ADOPTED AT THE REGULAR MEETING OF THE SOUTHOLD TOWN BOARD ON JUNE 16,2015: RESOLVED that the Town Board of the Town of Southold hereby approves the issuance of a fireworks permit by the Town Clerk's Office to Phenix Hook & Ladder Company # 1 and Relief Hose Company # 2 of the Greenport Fire Department, for a fireworks display on July 4, 2015 and July 5, 2015, at Greenport. High School athletic field, Greenport, New York upon the payment of a fee of $200 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 [UNANIMOUS] MOVER: Jill Doherty, Councilwoman SECONDER: William P. Ruland, Councilman AYES: Ghosio, Dinizio Jr, Ruland,.. Doherty, Evans, Russell El ZARETHA. 3ti'EVILLE, MMC TOWN CLERH REGISTRAR OF VITAL STA'T'ISTICS MARRIAGE OFFICER. RECORDS OF M31NAGEMENT OFFICER FRE+EDOAlOFLN- FORIIATIONOFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, l e%ifYork 11971 Fax (631) 765-6145 Telephone (631) 765-1500 southoldtown.northfork.net OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD APPLICATION PERMIT TO DISPLAY FIRENVORKS 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: Relief Ho. s e DISPLAY IS TO BE SPONSORED BY Phenix Hook & Ladder Co. #1 & Co'. ` `##2 . PRINCIPAL OFFICE AT 3rd Street Greenport, NY 11944 PC) �dk Sg DATE & TIME OF DISPLAY July 4, 2015 @ PM EXACT LOCATIOii-OF DISPLAYGreenport High -School Athletic Field. SUFFOLK COUNTY TAX MAP NUMBER FOR SITE RAIN DATE & TrIME TBD @ PM The following persons are to be in charge of the actual shooting of the fireworks: Name Age Experience Physical Condition Joseph Carpanzano 46 10+ Years Excellent (Additional names and information may be submitted on an attached sheet Number and type of fireworks is as follows: Approximately (434) 3" - 5" Aerial shells & (890) Cakes. Manner and place of storage of fireworks prior to display: In a NYS Licensed Magazine @ Legion Fireworks Co., Inc. 10 Legion Lane Wappingers Falls, NY. 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. la`IJ.%� SaF f1. Se bJ FEE. $100 f e of Organization See �policY 4or additional information By Signature of Applicant O1 Date ot Application F,i IZARETII A. N'EVILLE, MMC 'OWI CLERK REGISTRAR OF VITAI, STATISTICS MARRIAGE OFFICER RECORDS OF MXNAGnIENT OFFICER. FREEDOM OF P3F01MATION OFFICER Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 13.971 Fax (631) 765-6145 Telephone (631) 765-1800 �outltoldtown.norEhforI:.net OFFICE OF THE TOWN CIXRK TOWN OF SOUTHOLD APPLICATION PERMIT' TO DISPLAY FIR AVORKS APPLICATION 1S 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: Relief Ho. se DISPLAY IS TO BE SPONSORED BY Phenix Hook & Ladder Co. #1 & Co=.' -'#2 . PRINCIPAL OFFICE AT 3rd Street Greenport, NY 11944 P0. DA'L'E & TIME OF DISPLAY July 5, 2015 @ PM EXACT LOCATION -OF DISPLAI`Greenport High -School Athletic Field. SUFFOLK COUN'T'Y TAX MAP NUMBER FOR SITE RAIN BATE & TIM1E TBD @ PM The following persons are to be in charge of the actual shooting of the fireworks: Name Joseph Carpanzano Age Experience Physical Condition 46 10+ Years ' Excellent (Additional names and information may be submitted on an attached sheet Number and type of fireworks is as follows: Approximately (374).3" - 5" Aerial Shells & (780) Cakes. Manner and place of storage of fireworks prior to display: In a NYS Licensed Magazine @ Legion Fireworks Co., Inc. 10 Legion Lane Wappingers Falls, NY. 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. ides (� FEE, $100T�? a of Ora ization See policy for additional information 13y Signature of Applicant , g ds— Date of Application 10 ACC)R" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDONYYY) 4/29/2015 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(ies) 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). PRODUCERNTA CT NAME: PHcoN o Ext :216-658-7100 FAX No) -216-658-71 01 Britton Gallagher One Cleveland Center, Floor 30 1375 East 9th Street E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # Cleveland OH 44114 INSURER A Is Surplus Ins Company 26620 DAMAGE TO RENTED PREMISES Ea occurrence $500,000 INSURED INSURERB:Everest National Insurance Company 0120 INSURER C : Legion Fireworks Co., Inc. INSURER D: 10 Legion Lane Wappingers Falls NY 12590 INSURER E INSURER F AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS COVERAGES CERTIFICATE NUMBER: 1292461055 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 LTR TYPE OF INSURANCE ADDL INSR BR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MMIDD LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE KI OCCUR SIBML00116-151 /15/2015 /15/2016 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $500,000 MED EXP (Any one person) $ PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE 1 $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- LOC PRODUCTS-COMPIOP AGG $2,000,000 $ B AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS S18CA00056-151 /15/2015 /15/2016 COMB We accident $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Per accident A X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE EAU731294 /15/2015 /15/2016 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A WC STATLIMU- OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Date of Display: 7/4/2015. Location of Display: Greenport 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. TC LIAr ni=n CAtd( r -I 1 AT1AN U 19SS-2UIU ACUKU GUKPUKA I ION. All rights reservea. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Phenix Hook & Ladder Co. #1 & Relief Hose Co. #2 ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 58 3rd Street Greenport NY 11944 AUTHORIZED REPRESENTATIVE U 19SS-2UIU ACUKU GUKPUKA I ION. All rights reservea. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/3/2015 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(ies) 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 Britton Gallagherarc°N One Cleveland Center, Floor 30 1375 East 9th Street CONTACT NAME: o :216-658-7100 C No). -216-658-71 01 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # Cleveland OH 44.114 INSURER A;Axis Surplus Ins Company 6620 EACH OCCURRENCE $1,000,000 INSURED INSURER B :Everest National Insurance Company 0120 INSURER C: Legion Fireworks Co., Inc. 10 Legion Lane Wappingers Falls NY 12590 INSURER D: INSURER E INSURER F: B COVERAGES CERTIFICATE NUMBER: 300475392 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 LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD POLICY EXP MM/DD LIMITS B GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY' CLAIMS -MADE 1XI OCCUR AUTHORIZED REPRESENTATIVE S18MLOOI16-151 /15/2015 /15/2016 EACH OCCURRENCE $1,000,000 DAMAGE ( RENTED PREMISESS Ea occurrence) $500,000 MED EXP (Any one person) $ PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO- LOC PRODUCTS -COMP/OP AGG $2,000,000 $ B AUTOMOBILE X X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOSNON-OX AUTOSW"ED S18CA00058-151 /15/2015 /15/2016 7MBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ (P.'. e� t) MAGE $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE EAU731294 /15/2015 /15/2016 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 DED I I RETENTION $ $ WORKERS COMPENSATIONIMC AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A STATU- OTH- Y L T E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMri 1 $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) Date of Display: 7/5/2015. Location of Display: Greenport High School 720 Front Street Greenport, NY 11944.- 1944.Additionally Insured: Certificate Holder, Town of Southold, Village of Greenport, Greenport Public Schools, and Greenport Fire Department. Additionally CERTIFICATE HOLDER CANCELLATION ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Phenix Hook & Ladder Co. #1 & Relief Hose Co. #2 ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 58 3rd Street Greenport NY 11944 AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD '4g; zJ It. ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 To: Bill Duffy, Town Attorney / b-� Martin Flatley, Southold Town Police Chief Robert Fisher, Fire Inspector Melissa Spiro, Land Preservation Coordinator From: Bonnie Doroski Dated: June 4, 2015 Re: Fireworks Application of Phenix Hook & Ladder Relief Hose Number of Pages (including cover): 7 COMMENTS: Transmitted herewith is an application for Fireworks Permit for Phenix Hook and Ladder Relief Hose Greenport, for July 4 and 5. Please advise if you have any objections to this permit being issued. Thank you Doroski, Bonnie From: Doroski, Bonnie Sent: Thursday, June 04, 2015 4:14 PM To: Duffy, Bill; Fisher, Robert; Flatley, Martin; Spiro, Melissa Cc: Blasko, Regina; Doroski, Melanie; Krauza, Lynne Subject: Emailing: fireworks app gfd_20150604151206 Attachments: fireworks app gfd_20150604151206.pdf Please review this fireworks application and let me know your decision regarding it at your earliest convenience. Thank you. Bonnie J. Doroski Deputy Town Clerk Your message is ready to be sent with the following file or link attachments: fireworks app gfd_20150604151206 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. Doroski, Bonnie From: Flatley, Martin Sent: Thursday, June 04, 2015 4:31 PM To: Doroski, Bonnie Subject: RE: Emailing: fireworks app gfd_20150604151206 I have no objections to these firework displays being conducted. Martin Flatley, Chief of Police Southold Town Police Department 41405 State Route 25 Peconic, New York 11958 631-765-3115 -----Original Message ----- From: Doroski, Bonnie Sent: Thursday, June 04, 2015 4:14 PM To: Duffy, Bill; Fisher, Robert; Flatley, Martin; Spiro, Melissa Cc: Blasko, Regina; Doroski, Melanie; Krauza, Lynne Subject: Emailing: fireworks app gfd_20150604151206 Please review this fireworks application and let me know your decision regarding it at your earliest convenience. Thank you. Bonnie J. Doroski Deputy Town Clerk Your message is ready to be sent with the following file or link attachments: fireworks app gfd_20150604151206 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. Doroski, Bonnie From: Spiro, Melissa Sent: Friday, June 05, 2015 8:48 AM To: Doroski, Bonnie; Duffy, Bill; Fisher, Robert; Flatley, Martin Cc: Blasko, Regina; Doroski, Melanie; Krauza, Lynne Subject: RE: Emailing: fireworks app gfd_20150604151206 This is not preserved land. -----Original Message ----- From: Doroski, Bonnie Sent: Thursday, June 04, 2015 4:14 PM To: Duffy, Bill; Fisher, Robert; Flatley, Martin; Spiro, Melissa Cc: Blasko, Regina; Doroski, Melanie; Krauza, Lynne Subject: Emailing: fireworks app gfd_20150604151206 Please review this fireworks application and let me know your decision regarding it at your earliest convenience. Thank you. Bonnie J. Doroski Deputy Town Clerk Your message is ready to be sent with the following file or link attachments: fireworks app gfd_20150604151206 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. Doroski, Bonnie From: Duffy, Bill Sent: Friday, June 05, 2015 8:55 AM To: Doroski, Bonnie; Fisher, Robert; Flatley, Martin; Spiro, Melissa Cc: Blasko, Regina; Doroski, Melanie; Krauza, Lynne Subject: RE: Emailing: fireworks app gfd_20150604151206 Hi Bonnie, I have an objection. Penal law section 405.00 (2) (a) states that an application for a fireworks display shall set forth the name of the person actually in charge of the display, who shall possess a valid certificate of competence as a pyrotechnician. I did not see the certificate of competence as a pyrotechnician for Joseph Carpanzano, only a copy of his driver's license. If a certificate of competence as a pyrotechnician is provided, I would have no objection to the application. Please feel free to call me with any questions regarding the foregoing. Thanks, M -----Original Message ----- From: Doroski, Bonnie Sent: Thursday, June 04, 2015 4:14 PM To: Duffy, Bill; Fisher, Robert; Flatley, Martin; Spiro, Melissa Cc: Blasko, Regina; Doroski, Melanie; Krauza, Lynne Subject: Emailing: fireworks app gfd_20150604151206 Please review this fireworks application and let me know your decision regarding it at your earliest convenience. Thank you. Bonnie J. Doroski Deputy Town Clerk Your message is ready to be sent with the following file or link attachments: fireworks app gfd_20150604151206 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. ELIZABETH A. NEVILLE TOWN CLERK REGISTRAR OF VITAL STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD TRANSMITTAL To: Bill Duffy, Town Attorney Martin Flatley, Chief of Police Melissa Spiro, Land Preservation Coordinator Bob Fisher, Fire Marshal From: Bonnie Doroski Dated: June 9, 2015 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (631) 765-6145 Telephone (631) 765-1800 Re: Additional Information regarding Fireworks Application of Phenix Hook & Ladder Relief, Greenport Number of Pages (including cover): 2 If total transmittal is not received, please call 631-765-1800. COMMENTS: Original transmittal did not include the Pyrotechnician Certificate of Competence. f N 10 A Legion. Lane, Wappingers Falls, N.Y.- 12590- 845-831-8328.. . Shooter: Joe Carpanzano Cell Phone #: (914) 260-7698 60b04CE�ONLY h '0 60b04CE�ONLY FROM : LEGION FIREWORKS Co Inc PHONE NO. Jun. 09 2015 09:16AM P1 Legion Fireworks Coff Inc. 10 Legion Lane V' Wappingers Falls 4` NY e` 12590 Phone (845)831-8328 0. Fax (945)838-3476 FAX COVER SHEET TO: Bonnie, Town of Southold FROM: Deanna Theiss, Adm. Asst. RE: Certificate of Competency for Shooter DATE_ June 9, 2015 RECIPIENT FAX #: 1-631-765-6145 Number of pages including cover: 2 Dear Bonnie, Please find the following documents the firework displays gbovA?toll.hr�. mP-Aoy-pw 5ton5. Thank you, Deanna Administrative Assistant Doroski, Bonnie From: Duffy, Bill Sent: Tuesday, June 09, 2015 10:47 AM To: Doroski, Bonnie Subject: RE: Emailing: fireworks additional inf 20150609092724 I am good. -----Original Message ----- From: Doroski, Bonnie Sent: Tuesday, June 09, 2015 10:32 AM To: Duffy, Bill; Fisher, Robert; Flatley, Martin; Spiro, Melissa Cc: Blasko, Regina Subject: Emailing: fireworks additional inf_20150609092724 I know that some of you have responded to the original email I had sent regarding this application but the Town Attorney pointed out that this certificate was missing from the application packet. Please let me know if you require any other information. Thank you. Bonnie J. Doroski Deputy Town Clerk Your message is ready to be sent with the following file or link attachments: fireworks additional inf 20150609092724 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. Doroski, Bonnie From: Fisher, Robert Sent: Friday, June 12, 2015 8:31 AM To: Doroski, Bonnie Subject: RE: Fireworks permit Bonnie I have no problems with the fireworks permit for the Greenport Fire Department. From: Doroski, Bonnie Sent: Thursday, June 11, 2015 9:00 AM To: Fisher, Robert Subject: Fireworks permit Hi Bob, I was just wondering if you have had a chance to review the application for the Greenport Fire Departments request for fireworks? If you need me to resend the application, just let me know. Thanks, Bonnie ELIZABETH A. NEVILLE, MMC 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) 765-1.800 www. southoldtownny. gov 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: Phenix Hook & Ladder Co. #1 & Relief Hose Co. #2 3`d Street Greenport, N Y Greenport High School Athletic Field 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 Greenport High School Athletic Field on Sunday, July 5th, 2015 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) Elizabeth A. Neville, Southold Town Clerk Suffolk County, New York Date: 6/18/15 THIS PERMIT IS NOT TRANSFERAB ELIZABETH A. NEVILLE, MMC 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 www.southoldtownny.gov 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: Phenix Hook & Ladder Co. #1 & Relief Hose Co. #2 3`d Street Greenport, N Y Greenport High School Athletic Field 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 Greenport High School Athletic Field on Saturday. July 4`h 2015 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) Elizabeth A. Neville, Southold Town Clerk Suffolk County, New York Date: 6/18/15 THIS PERMIT IS NOT TRANSFERABLE