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Manfredi, Richard
ELIZABETH A.NEVILLE,MMC may® Gy Town Hall,53095 Main Road TOWN CLERK � '-� P.O.Box 1179 y a Southold,New York 11971 REGISTRAR OF VITAL STATISTICS ® Fax(631)765-6145 MARRIAGE OFFICER p ®� Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER .�' �P� 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: RICHARD MANFREDI MANFREDI FAMILY CELEBRATION 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 9:OOPM,Saturday, July 30 2016 (Rain Date 9:OOPM,Sunday,July 31,2016 9:OOPM)on Beachfront off of 240 Sunset Path,Southold, New York upon payment of a single fee of$100.00 and subject to the applicant's compliance with the requirements of the Town's Policy regarding the issuance of Fireworks Permits. 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 Seat) Elizabe A. Neville,Southold Town Clerk Suffolk County, New York Date:7/29/2016 THIS PERMIT IS NOT TRANSFERABLE t ' NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL. CONSERVATION Division of Fish and Wildlife,Bureau of Wildlife,Region 1 SUNY@Stony Brook,50 Circle Road,Stony Brook,NY 11790 P:(631)444-03101 F:(631)444-0272 \vww.dec.nygov July 25, 2016 Vanessa Vaz Fireworks by Grucci, Inc. 20 Pinehurst Drive Bellport, NY 11713 Dear Ms. Vaz: The New York State Department of Environmental Conservation has reviewed the fireworks display information for the following show: Name: Manfredi Family Celebration Date: July 30, 2016 Rain Date: July 31, 2016 Location: Beachfront at 240 Sunset Path, Southold, NY Latitude: 410 04' 48.18" N Longitude: 720 27' 0.46" W Based on the information provided, we do not anticipate that the proposed show will cause any adverse impacts to threatened or endangered species. The Fish and Wildlife Service's Guidelines for Managing Fireworks in the Vicinity of Piping Plovers and Seabeach Amaranth of the U.S. Atlantic Coast recommends that the launch site be located a minimum of 3/4 of a mile from the nearest plover area to avoid direct disturbance to nesting plovers. The proposed launch site exceeds the recommended distance and there does not appear to be any threat from indirect impacts. Sincerely, r - Kevin Jennings Wildlife Biologist NEWYORK Department of OPMRtUH fY Environmental Conservation Neville, Elizabeth From: Flatley, Martin Sent: Wednesday,July 27, 2016 4:13 PM To: Neville, Elizabeth Subject: RE: Manfredi Fireworks Permit I'll check tomorrow and get back to you on an access spot, our department uses ATVs to patrol this area for fisherman. Martin Flatley,Chief of Police Southold Town Police Department 41405 State Route 25 Peconic, New York 11958 631-765-3115 From: Neville, Elizabeth Sent:Wednesday,July 27, 2016 4:09 PM To: Flatley, Martin<mflatley@town.southold.ny.us> Subject: FW: Manfredi Fireworks Permit Marty, They are asking you? From: Vanessa Vaz [mailto:vvaz(c cirucci.com] Sent: Wednesday,July 27, 2016 2:19 PM To: Neville, Elizabeth Cc: Edward Rubio Subject: RE: Manfredi Fireworks Permit Ok great, thank you! Is there an access location that Chief Flatley can recommend? I attached the approval from DEC. I believe we spoke about the Coast Guard. Since the display site is on the beach, we did not need to apply for the Marine Event Permit. Respectfully, Vanessa Vaz Logistics Assistant Fireworks by Grucci, Inc. 20 Pinehurst Drive Bellport, New York 11713 p: 631-286-0088 ext. 114 f: 631-286-9036 vvaz(o)grucci.com www.grucci.com 1 Neville, Elizabeth From: Neville, Elizabeth Sent: Wednesday,July 27, 2016 4:09 PM To: Flatley, Martin Subject: FW: Manfredi Fireworks Permit Attachments: DEC Approval.pdf Marty, They are asking you? From: Vanessa Vaz [mailto:vvazCa@grucci.com] Sent: Wednesday, July 27, 2016 2:19 PM To: Neville, Elizabeth Cc: Edward Rubio Subject: RE: Manfredi Fireworks Permit Ok great, thank you! Is there an access location that Chief Flatley can recommend? I attached the approval from DEC. I believe we spoke about the Coast Guard. Since the display site is on the beach, we did not need to apply for the Marine Event Permit. Respectfully, Vanessa Vaz Logistics Assistant Fireworks by Grucci, Inc. 20 Pinehurst Drive Bellport, New York 11713 p: 631-286-0088 ext. 114 f: 631-286-9036 vvaz grucci.com www.grucci.com EXPO 2020 UBAI, UAE TEaTY i Sff - Proud to have been part of the celebration of Q4yZ a the 200th Anniversary of our National Anthem From: Neville, Elizabeth [mailto:E.Neville@town.southold.nv.us] Sent:Wednesday,July 27, 2016 2:01 PM To:Vanessa Vaz<vvaz@grucci.com> Subject: RE: Manfredi Fireworks Permit 1 Good Morning Vanessa, Chief of Police Martin Flatley responded that he has no problem with them using the beach there if they can find an access point without damaging anyone's property or the Town's. Reviewing this file, did you ever receive the NYS DEC or Coast Guard approvals? Please advise. Thank you. Elizabeth A. Neville, MMC Southold Town Clerk&FOIL Officer PO Box 1179 Southold,NY 11971 Tel.631765-1800,Ext.228 Fax 631 765-6145 Cell 631466-6064 From: Vanessa Vaz [mailto:vvaz0)arucci.com] Sent: Wednesday, July 27, 2016 11:35 AM To: Neville, Elizabeth Cc: Edward Rubio Subject: RE: Manfredi Fireworks Permit Importance: High Good morning Ms. Neville, I just wanted to follow up on my email below regarding beach access for the Manfredi fireworks display this Saturday. Thanks again! Respectfully, Vanessa Vaz Logistics Assistant Fireworks by Grucci, Inc. 20 Pinehurst Drive Bellport, New York 11713 p: 631-286-0088 ext. 114 f: 631-286-9036 vvaz(a)grucci.com www.arucci.com EXPO 2020 DUBAI, UAE 0ATE un I3ttst4 wqm_,_.,_,, Proud to have been part of the celebration of Kv STAR at $PKGI.r ec ac2L ar the 200th Anniversary of our National Anthem 2 From:Vanessa Vaz Sent: Friday,July 22, 201611:12 AM To: 'Neville, Elizabeth'<E.Neville @town.southoId.ny.us> Cc: Edward Rubio<erubio@grucci.com> Subject: RE: Manfredi Fireworks Permit Importance: High Good morning Ms. Neville, I have a quick question for you regarding the setup of the fireworks for the Manfredi Family Celebration display on 7/30/16. How would we go about obtaining permission to drive our pickup truck to transport the equipment and product to the display site on the beach? Hand trucks will not be able to be pulled through the sand and it's a bit of a hike to the site. Thank you so much in advance for your help with this! Respectfully, Vanessa Vaz Logistics Assistant Fireworks by Grucci, Inc. 20 Pinehurst Drive Bellport, New York 11713 p: 631-286-0088 ext. 114 f: 631-286-9036 vvazCcbarucci.com www.arucci.com EXPO 2020 UBAt, UAE yA-hY�xCA4TEC.CTYo,f'. � Proud to have been part of the celebration of f " STAR- T, iSPAG,LLC G a L° r the 200th Anniversary of our National Anthem From: Neville, Elizabeth [mailto:E.Neville@town.southold.nv.us] _ Sent: Monday,July 11, 2016 10:37 AM To:Vanessa Vaz<vvaz@grucci.com> Subject: Manfredi Fireworks Permit Good Morning Vanessa, Do you have a letters from the NYS DEC and the Coast Guard on this event? I do have a letter from Edward Rudio to Kevin Jennings, but no response from Mr.Jennings or the Coast Guard. I would like to include it on tomorrow's Town Board agenda for approval. Please advise. 3 Neville, Elizabeth From: Neville, Elizabeth Sent: Tuesday,July 26, 2016 3:36 PM To: Duffy, Bill; Flatley, Martin; Fisher, Robert Cc: Sepenoski,John Subject: FW: Manfredi Fireworks Permit Importance: High Please see question below and send me your comments/recommendation. This location is 240 Sunset Path,Southold on LI Sound. Elizabeth A.Neville, MMC Southold Town Clerk&FOIL Officer PO Box 1179 Southold,NY 11971 Tel.631765-1800,Ext.228 Fax 631765-6145 Cell 631466-6064 From: Vanessa Vaz [mailto:vvaz@grucci.com] Sent: Friday, July 22, 2016 11:08 AM To: Neville, Elizabeth Cc: Edward Rubio Subject: RE: Manfredi Fireworks Permit Importance: High Good morning Ms. Neville, I have a quick question for you regarding the setup of the fireworks for the Manfredi Family Celebration display on 7/30/16. How would we go about obtaining permission to drive our pickup truck to transport the equipment and product to the display site on the beach? Hand trucks will not be able to be pulled through the sand and it's a bit of a hike to the site. Thank you so much in advance for your help with this! Respectfully, Vanessa Vaz Logistics Assistant Fireworks by Grucci, Inc. 20 Pinehurst Drive Bellport, New York 11713 p: 631-286-0088 ext. 114 f: 631-286-9036 vvazCubgrucci.com www.grucci.com 1 EXPO 2020 UBAI,UAE OAT[Crry �3ut.Surf, Proud to have been part of the celebration of � �MOSTAR- 'SQA. Ci�:1G G4 the 200th Anniversary of our National Anthem From: Neville, Elizabeth [mailto:E.Neville@town.southold.ny.us] Sent: Monday,July 11, 2016 10:37 AM To:Vanessa Vaz<vvaz@grucci.com> Subject: Manfredi Fireworks Permit Good Morning Vanessa, Do you have a letters from the NYS DEC and the Coast Guard on this event? I do have a letter from Edward Rudio to Kevin Jennings, but no response from Mr.Jennings or the Coast Guard. I would like to include it on tomorrow's Town Board agenda for approval. Please advise. Elizabeth A.Neville,MMC Southold Town Clerk&FOIL Officer PO Box 1179 Southold,NY 11971 Tel.631765-1800,Ext.228 Fax 631765-6145 Cell 631466-6064 2 Neville, Elizabeth From: Flatley, Martin Sent: Tuesday,July 26,2016 4:18 PM To: Neville, Elizabeth; Duffy, Bill; Fisher, Robert Cc: Sepenoski,John Subject: RE: Manfredi Fireworks Permit I have no problem with them using the beach there if they can find an access point without damaging someone's(of the Town's) property. Please let me know if this is approved, because in this area we will definitely get calls for this type of activity. Martin Flatley,Chief of Police Southold Town Police Department 41405 State Route 25 Peconic, New York 11958 631-765-3115 From: Neville, Elizabeth Sent:Tuesday,July 26, 2016 3:36 PM To: Duffy, Bill<billd@southoldtownny.gov>; Flatley, Martin<mflatlev@town.southold.ny.us>; Fisher, Robert <Robert.Fisher@town.southold.ny.us> Cc:Sepenoski,John<iohnsep@town.southold.ny.us> Subject: FW: Manfredi Fireworks Permit Importance: High Please see question below and send me your comments/recommendation. This location is 240 Sunset Path,Southold on LI Sound. Elizabeth A. Neville, MMC Southold Town Clerk&FOIL Officer PO Box 1179 Southold,NY 1]971 Tel.631 765-1800,Ext.228 Fax 631 765-6145 Cell 631466-6064 From: Vanessa Vaz [mailto:vvaz(a grucci.com] Sent: Friday, July 22, 2016 11:08 AM To: Neville, Elizabeth Cc: Edward Rubio Subject: RE: Manfredi Fireworks Permit Importance: High 1 Good morning Ms. Neville, I have a quick question for you regarding the setup of the fireworks for the Manfredi Family Celebration display on 7/30/16. How would we go about obtaining permission to drive our pickup truck to transport the equipment and product to the display site on the beach? Hand trucks will not be able to be pulled through the sand and it's a bit of a hike to the site. Thank you so much in advance for your help with this! Respectfully, Vanessa Vaz Logistics Assistant Fireworks by Grucci, Inc. 20 Pinehurst Drive Bellport, New York 11713 p: 631-286-0088 ext. 114 f: 631-286-9036 vvaz grucci.com www.grucci.com EXPO 2020 UBAi, UAE0 15 s . Proud to have been part of the celebration of A �r a~:oy 5 S1'AR- SpP1 LEr iiM;4P r + �� a the 200th Anniversary of our National Anthem From: Neville, Elizabeth [mailto:E.Neville@town.southold.nv.us] Sent: Monday,July 11, 2016 10:37 AM To:Vanessa Vaz<vvaz@grucci.com> Subject: Manfredi Fireworks Permit Good Morning Vanessa, Do you have a letters from the NYS DEC and the Coast Guard on this event? I do have a letter from Edward Rudio to Kevin Jennings, but no response from Mr.Jennings or the Coast Guard. I would like to include it on tomorrow's Town Board agenda for approval. Please advise. Elizabeth A.Neville, MMC Southold Town Clerk&FOIL Officer PO Box 1179 Southold,NY 11971 Tel.631765-1800,Ext.228 Fax 631765-6145 2 Neville, Elizabeth From: Neville, Elizabeth Sent: Monday,July 11, 201610:37 AM To: 'Vanessa Vaz' Subject: Manfredi Fireworks Permit Good Morning Vanessa, Do you have a.letters from the NYS DEC and the Coast Guard on this event? I do have a letter from Edward Rudio to Kevin Jennings, but no response from Mr.Jennings or the Coast Guard. I would like to include it on tomorrow's Town Board agenda for approval. Please advise. Elizabeth A.Neville, MMC Southold Town Clerk&FOIL Officer PO Box 1179 Southold,NY 11971 Tel.631765-1800,Ext.228 Fax 631765-6145 Cell 631466-6064 1 Neville, Elizabeth From: Duffy, Bill Sent: Monday,July 11, 2016 8:41 AM To: Neville, Elizabeth Subject: RE: Emailing: Fireworks Apl Manfredi F_20160624133213 I have no objection -----Original Message----- From: Neville, Elizabeth Sent: Friday,July 08, 2016 12:49 PM To:Spiro, Melissa; Duffy, Bill;Silleck, Mary Subject: FW: Emailing: Fireworks Apl Manfredi F_20160624133213 Please send me your response. Thank you. Betty Neville -----Original Message----- From: Neville, Elizabeth Sent: Friday,June 24,2016 2:35 PM To: Duffy, Bill; Flatley, Martin; Fisher, Robert; Spiro, Melissa Subject: Emailing: Fireworks Apl Manfredi F_20160624133213 Please review and send me your written recommendation. Thank you. Betty Elizabeth A. Neville, MMC Southold Town Clerk& FOIL Officer PO Box 1179 Southold, NY 11971 Tel. 631765-1800, Ext. 228 Fax 631765-6145 Cell 63.1466-6064 Your message is ready to be sent with the following file or link attachments: Fireworks Apl Manfredi F_20160624133213 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. 1 Neville, Elizabeth From: Spiro, Melissa Sent: Monday,July 11, 2016 8:20 AM To: Neville, Elizabeth; Duffy, Bill; Silleck, Mary Subject: RE: Emailing: Fireworks Apl Manfredi F_20160624133213 Hi, Please see my e-mail of June 27th in which I noted that this is not preserved land. Also, in the future,fireworks should be coordinated with John Sepenoski also in regard to whether site is near potential nesting areas. John has suggested that the Town permits are all conditioned upon DEC/USFWS approval if they are near potential nesting areas. -----Original Message----- From: Neville, Elizabeth Sent: Friday,July 08, 201612:49 PM To:Spiro, Melissa <Melissa:S.piro@town.southold.nv.us>; Duffy, Bill<billd@southoldtownny.pov>; Silleck, Mary <marvs@southoldtownny.gov> Subject: FW: Emailing: Fireworks Apl Manfredi F_20160624133213 Please send me your response. Thank you. Betty Neville -----Original Message----- From: Neville, Elizabeth ' Sent: Friday,June 24, 2016 2:35 PM To: Duffy, Bill; Flatley, Martin; Fisher, Robert;Spiro, Melissa Subject: Emailing: Fireworks Apl Manfredi F_20160624133213 Please review and send me your written recommendation. Thank you. Betty Elizabeth A. Neville, MMC Southold Town Clerk& FOIL Officer PO Box 1179 Southold, NY 11971 Tel. 631765-1800, Ext. 228 Fax 631765-6145 Cell 631466-6064 Your message is ready to be sent with the following file or link attachments: Fireworks Apl Manfredi F_20160624133213 1 ELIZABETH A.NEVILLE,MMC �� OGy Town Hall,53095 Main Road TOWN CLERK p P.O.Box 1179 y = Southold,New York 11971 REGISTRAR OF VITAL STATISTICS p - Fax(631)765-6145 MARRIARECORDS OFF MANGE OFFICERAGEMENT OFFICER y�01 .*a0� Telephone n.no 7fork. 0 FREEDOM OF INFORMATION OFFICER sautholdtown.northfork.net J OFFICE OF THE TOWN CLERK 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 as hereinafter specified: DISPLAY IS TO BE SPONSORED BY Manfredi Family Celebration PRINCIPAL OFFICE AT PO Box 1511, Southold, NY 11971 DATE&TIME OF DISPLA 'July 30, 2016 @ approx. 9:00pm EXACT LOCATION•OF DISPLAY Beachfront off of 240 Sunset Path, Southold, NY SUFFOLK COUNTY AX MAP NUMBER FOR SITE RAIN DATE &T 4 ty 31, 2016 @ approx. 9:00pm The following persons are to be in charge of the actual shooting of the fireworks: Name Age Experience Physical Condition Thomas Guida 63 27 years Excellent (Additional names and information may be submitted on an attached sheet Number and type of fireworks is as follows:, Grucci Grand Illuminations-2400 21/2-360 3"-500 Total: Not to exceed 860 Firework Shells and 2400 Illuminations Manner and place of storage of fireworks prior to display: In UN approved boxes in company vehicle. 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. Richard Manfredi FEE: $100 Ngae.Qf Organization See policy-fat' additional information e-mail address: iG�,/k(L039�L�C� ��LLO:� BY Tele No ".ZO' q V\'O Signature of Applicant Date of Application * * * RECEIPT * * * Date: 06/21/16 Receipt#: 207962 Quantity Transactions Reference Subtotal 1 Fireworks 7/30/16 $100.00 Total Paid: $10000 Notes: Payment Type Amount Paid By CK#977 $100.00 Manfredi, Richard Southold Town Clerk's Office 53095 Main Road, PO Box 1179 Southold, NY 11971 �w Name: Manfredi, Richard Po Box 1511 240 Sunset Path Southold, NY 11971 Clerk ID: LYNDAR Internal ID 7/30/16 T 0 R IK Y� f— aT THOMAS J GUIDA CLASS: B NON PROXIMATE AUDIENCE ONLY THIS CARD MUST BE CARRIED WHEN USING PYROT 4NJYC NYS CERTIFICATIONS REQUIRED IN NYC AC�RO CERTIFICATE OF LIABILITY INSURANCEF61812016 DATE(MM/DD/YYYY) 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)mustibe'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 CONTACT NAME: Britton Gallagher PHCN o •2 - AAic No):216-658-71 01 One Cleveland Center, Floor 30 E-MAIL 1375 East 9th Street ADDRESS: Cleveland OH 44114 INSURERS AFFORDING COVERAGE NAIC# INSURER A: n Ins Co 19437 INSURED INSURERB:Everest National Insurance Company 0120 Fireworks By Grucci Inc. and/or Pyrotechnique INSURERC: By Grucci, Inc and/or Philny Effects, Inc INSURERD: 20 Pinehurst Drive Bellport NY 11713 INSURER E: INSURER F. COVERAGES CERTIFICATE NUMBER:778977536 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 TYPE OF INSURANCE ADD BR POLICY EFF POLICY EXP LIMITS LTR INSR NAND POLICYNUMBER MM/DD MM/DD B GENERAL LIABILITY SIBML00093-161 2/17/2016 2/17/2017 EACH OCCURRENCE $1,000,000 DAMAGE TUR—ENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $500,000 CLAIMS-MADE Fx_1 OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $1,000,000 Liability GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OPAGG $2,000,000 1-1 POLICY X PRO- LOC $ B AUTOMOBILE LIABILITY SIBCA00044-161 2/17/2016 2/17/2017 (Eao accident $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPER D X HIRED AUTOS AMAGE Peracadent $ X AUTOS $ A UMBRELLA LIAB X OCCUR 013136655 2/17/2016 2/17/2017 EACH OCCURRENCE $4,000,000 X EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000 DED X I RETENTION$10,000 $ WORKERS COMPENSATIONWC STATU- OTH- AND EMPLOYERS'LIABILITY YIN I R ANY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A E L EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E L DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement. Date July 30,2016, Rain Date July 31,2016; Location: Beachfront 240 Sunset Path, Southold, NY, Additional Insured(s) Mr.&Ms. Richard Manfredi;Town of Southold, State of New York; CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Richard Manfredi THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. Box 1511 ACCORDANCE WITH THE POLICY PROVISIONS. Southold NY 11971 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 06/08/2016 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 CONTACT NAME: ARS Insurance Agency PHONE FAX 10825 Old Mill Rd AIC, ., Ext: (877)234-4420 (AIC,No): (877)234-4421 Omaha, NE 68154 ADDRIESS: PRODUCER (877)234-4420 CUSTOMER ID# INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA Continental Indemnity Co. 28258 INSURER B. Fireworks By Grucci, Inc. 20 Pinehurst Dr INSURERC Bellport, NY 11713-1573 INSURER D: INSURER E• CTL 1273 1188917 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:' THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR 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 ADD SUB POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER M/DD (MMIDDIYYYY) LIN ITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY ❑❑ DAMAGE TO RENTED $ CLAIMS MADE F7OCCUR MED EXP(any oneperson) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GENT AGGREGATE LIMIT APPLIES PER RD- PRODUCTS-COMP/O GG $ POLICY F1 JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANYAUTO ❑❑ Ea accident $ ALL OWNED AUTOS BODILY INJURY Perperson) $ SCHEDULED AUTOS BODILY INJURY Peracadent $ HIRED AUTOS PROPERTY t DAMAGE ✓ Per acc den $ NON-OWNED AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS MADE ❑❑ AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY O Y ANY PROPRIETOR/PARTNER/EXECUTIVE N Nil 73-474435-01-01 05/27/2016 05/27/2017 E L EACH ACCIDENT $ 1,0 0 0,0 0 0 A OFFICER/MEMBER EXCLUDED' (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach Acord 101,Additional Remarks Schedule,if more space Is required) CERTIFICATE HOLDER CANCELLATION Richard Manfredi SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED P.O. Box 1511 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED Southold, NY 11971 IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE PC937411 ACORD 25 (2009/09) ©1988-2009 ORD CORPORATION. All rights reserved Manfred! Family Celebration - Southold, NY July 30, 2010, - Fireworks by Grucci FIREWORKS BY _.� � "•a AI IN, jq p rel r c � : y . • 1' 210 'I {' �' J Dis la Site • "_ ?�,�, � �'� r, � Max Shell Size 3" ' •fit .'� �';�`�.. s �, r,�t ,P „�,. 210 Fallout Area Recommended 70' / 1" -'-" ,•.�;�';�.. � - �' � Latitude: b 0' 52.5' 105' 157.5' 210' ���''--'• ` �'�s �,��` I I I I I � • � � _ `v ' f�",�� `� 72°27!0.46"W v All Information contained on this document is copyright material and the intellectual property of Fireworks by Grucci Inc. Reproduction and/or circulation without approval of Fireworks by Grucci is prohibited. Rev 1 6/16/16 ****************************************************************************** * I This agreement dated June 6,2016 consisting of two(2)pages is for a 2 Fireworks Performance Contract ----� * 3 Between: ,Fireworks by Grucci, Inc. And: Richard Manfredi * 4 20 Pinehurst Drive P.O. Box 1511 ` * 5 Bellport, NY 11713 Southold,NY 11971 Q 1 * 6 Tel: 631-286-0088 516-220-9220 78 Fax: 9036 * 9 I.AGREEMENT: * 10 Whereas both Fireworks by Grucci, herein referred to as Grucci and Richard Manfredi, herein referred to as * 11 Sponsor agree that Grucci shall pending receipt of all required permits, signed contract and payment'in full, * 12 produce and display fireworks on the beachfront at 240 Sunset Path as follows: *13 * Time of Duration Class of Total Fireworks Or Date Display (minutes) Fireworks Performance Contract * 97_ 71 _-_July_30,2016 _ _ 4—6 min City _ __ _ $7,500.0- _ * Initial here' * 14 1*t * 15 II.SERVICE AGREEMENT: Ar 16 The Total Fireworks Performance contract cost above is quoted fob destination,at site for the fireworks display * 17 and transportation of personnel,equipment and fireworks. Services that need to be provided and paid for by the * 18 . sponsor are as follows: *19 a Section VI.Government Permits and Regulations *20 • Security upon arrival until departure at Discharge Sites and Fallout Areas,including any fencing and/or marine patrol. *21 • Provide direct cell phone or 2-way radio communications to authorize performance time. *22 • Site access,use and detailed clean-up. *23 *24 111.PAYMENT SCHEDULE: *25 Payment of the Total Fireworks Performance Contract for$7,500 shall be paid by sponsor as follows: *26 a) A deposit of$3,750 is due and payable with the return of the signed Fireworks Performance Contract on or *27 before June 15, 2016. t28 b) The balance of$3,750 is due and payable on or before July 15,2016. *329 0 c) A fee of$200.00,plus 1 Y:%interest will be charged to any unpaid balance per month. *31 IV.CREDITING: *32 The sponsor agrees to credit Grucci as "Fireworks by Grucci" in all event programs, invitations, press release, *33 advertising,or promotion copy that is within sponsor's authority. *34 *35 V.RESCHEDULE DATE: *36 In the event the fireworks performance is rescheduled for any reason, Grucci has reserved July 31, 2016 as an *37 inclement weather date in consideration for a 15%fee per day of the Fireworks Performance Contract total plus *38 all out of pocket expenses. These costs shall be paid by the sponsor upon demand.In any event,the sponsor shall * *39 be responsible for full contract price and those related costs as stated above. *40 *41 VI.GOVERNMENT PERMITS AND REGULATIONS *42 Grucci shall file for all necessary permits,licensees and approvals applicable to this contract.However,the sponsor *43 shall be responsible for the payment of all government fees,fire department and police fees,taxes,including but i*r 44 not limited to, sales, use, excise, entertainment, import charges and bonds for such permits, licensees and *45 approvals for the fireworks performance and the activities undertaken pursuant to this Agreement from the *46 appropriate federal,state,and local authorities. *47 * * *AMERICAS FIRST FAMILY OF FIREWORKS *. * Fireworks by Grucci,Inc.=20 Pinehurst Drive=Bellport,NY 11713=Tel:631-286-0088=Fax:631-286-9036 * Page 1 of 2 FPC-Manfredi,Richard-16-07-30 6910/5394 1 *ir�r***********it***1t�t�r**,k**int*sky►ryt,Ryt1t*,ti��k*ytttyt**yt�Ar*tt�*�r*y1n+Mr**�1r�ririt**yt*ytimk�k�k�k****** *48 This Agreement is subject to all federal, state and municipal laws and regulations now in force or which may be *49 enacted before the completion of this Agreement. Should any municipal, state or federal law or ordinance be *150 passed which prohibits or restricts the performance or operation of the fireworks performance described herein, *51 the same shall automatically restrict or limit the fireworks performances described herein accordingly. *52 *53 In the event the federal government or other regulatory authorities restricts or prohibits the use of any firework Jr 54 as setforth herein,preventing Grucci from producing a performance as described above,then in such event,Grucci *55 shall substitute a firework of equivalent entertainment value,such substitution shall not constitute a reduction in *56 the contract price. *57 *58 VII.GENERAL PROVISIONS: *59 a) Neither the Sponsor nor Grucci shall be in default or liable for any type of damages under this Agreement for any ** *60 Force Majeure event. A Force Majeure Event is any such unforeseen act or event this is beyond the reasonable *61 control of a party that prevents the Sponsor or Grucci from performing and is not the fault of the Sponsor or Grucci; *62 and in addition a Force Majeure Event is also defined as war,government intervention, un-navigable waters or ** *63 waterways,strikes,inclement weather,fire,explosions,civil disturbance,act of God or the public enemy,military �* *64 action,terrorist act,unforeseeable or unpreventable lack of materials or equipment. *65 b) Once the contract is signed and the performance is then cancelled by the sponsor for any reason, Grucci shall *66 be paid one Hundred percent(100%)of the total contract price. - ------- ---- -- - -- -- *67 c) Grucci shall not be responsible for any weather or atmospheric conditions that may interfere with the *68 performance or aesthetic quality of the fireworks or the performance. *69 d) This agreement constitutes the entire Agreement between the parties relating to the subject matter hereof, *70 and may not be changed,modified, renewed,or extended except by a written agreement,signed by the party ** *71 against whom enforcement of change,modification,renewal or extension is sought. *72 e) Fireworks by Grucci agrees to procure general liability insurance in the amount of five million dollars and to *73 issue form attached hereto,evidencing such insurance and covering the persons and entities named therein as *74 additional insureds against any claims arising out of the sole negligence of Fireworks by Grucci,Inc.in excess of *75 $2,500.00 per event. *76 f) This agreement shall be interpreted in accordance with and the rights of the parties hereto and shall be *77 determined by,the laws of the State of New York. *78 g) Any and all disputes, controversies, actions, claims, or proceedings arising under, out of, in connection, or *79 relating to the terms of this contract,and amendment thereof, commenced by,between or against any of the *80 parties to this contract shall be commenced and maintained solely in the courts of the State of New York,and *81 by the signing of this contract all parties hereby submit to this same jurisdiction. *82 h) By signing this contract the Sponsor agrees to reimburse Grucci for any and all costs including but not limited 83 to administrative and attorney fees related to any and all disputes, controversies, actions, claims, and/or ** 184 proceedings arising under,out of,in connection,or relating to the terms of this contract. *85 �*86 To validate this contract, it must be signed and returned with 87 /tea Q A - a osit to Grucci on or before ne 1 16. 6/24/16 * * Richard ManfreO 6ate Felix James Grucci(Phil) Date * President/CEO *88 *89 91 RECEIVED *92 Congratulation,you have just purchased the finest fireworks performance available In the world. * JUN Z 4 * Southold Town Clerk ,*k *'AMERICAS FIRST FAMILY OF FIREWORKS * * Fireworks by Grucci,Inc.=20 Pinehurst Drive-Bellport,NY 11713=Tel.631-286-0088=Fax.631-286-9036 * Page 2 of 2 FPC-Manfredi,Richard-16-07-30 6910/5394 CHIEF OF DEPARTMENT r r James H.Rich III 1$04la,lb 'irr 'ryart=nt PO.Box`1469 SECRETARY FIRST ASSISTANT CHIEF Craig Goldsmith 55135 Main Road Teresa L.Rich Southold,New York 11971 SECOND ASSISTANT CHIEF (631) 765-3385 • Fax (631) 765-5009 TREASURER Peggy Killian Chiefs' (631) 765-1240 Ronald Butkovich RECEIVES; Dear Elizabeth Neville, June 23 2016 Southold Town Clerk JUN 2 3 2016 Southold Towle :ler I am writing this letter to let you know I have discussed and reviewed Mr Richard Manfredi application to have a fireworks display on July 30, 2016. We grant permission for this event to take place and feel all necessary compliance with the Chiefs of the Southold Fire Department have been meet. Thank you any further questions please feel free to call me at 631926-3970 Sincerely, Craig GoldsAAmith 1"Asst. Chief Southold Fire Department 4,//9 � Neville, Elizabeth From: Neville, Elizabeth Sent: Tuesday,July 05, 201611:10 AM To: Fisher, Robert Subject: RE: Fireworks Apl Manfredi F_20160624133213 Tracking: Recipient Delivery Fisher,Robert Delivered:7/5/201611:10 AM Thank you, Bob! -----Original Message----- From: Fisher, Robert Sent:Tuesday,July 05,2016 9:27 AM To: Neville, Elizabeth Subject: Fireworks Apl Manfredi F_20160624133213 Betty I have no reservations about this fireworks show. Bob Robert Fisher Fire Marshall,Town of Southold robert.fisher@town.southold.ny.us (W) 631-765-1802-(C) 631-786-9180 PRIVILEGED AND CONFIDENTIAL COMMUNICATION CONFIDENTIALITY NOTICE:This electronic mail transmission is intended only for the use of the individual or entity to which it is addressed and may contain confidential information belonging to the sender which is protected by privilege. If you are not the intended recipient,you are hereby notified that any disclosure, copying, distribution,or the taking of any action in reliance on the contents of this information is strictly prohibited. If you have received this transmission in error, please notify the sender immediately by e-mail and delete the original message. -----Original Message----- From: Neville, Elizabeth Sent: Friday,June 24,2016 2:35 PM To: Duffy, Bill<billd@southoldtownny.gov>; Flatley, Martin<mflatlev@town.southold.nv.us>; Fisher, Robert <Robert.Fisher@town.southold.nv.us>;Spiro, Melissa<Melissa.Spiro@town.southold.nv.us> Subject: Emailing: Fireworks Apl Manfredi F_20160624133213 Please review and send me your written recommendation. Thank you. Betty Elizabeth A. Neville, MMC Southold Town Clerk& FOIL Officer PO Box 1179 i Neville, Elizabeth From: Flatley, Martin Sent: Friday,June 24, 2016 4:04 PM To: Neville, Elizabeth; Duffy, Bill; Fisher, Robert;Spiro, Melissa Subject: RE: Emailing: Fireworks Apl Manfredi F_20160624133213 I have no objections to this application being approved Martin Flatley,Chief of Police Southold Town Police Department 41405 State Route 25 Peconic, New York 11958 631-765-3115 -----Original Message----- From: Neville, Elizabeth Sent: Friday,June 24, 2016 2:35 PM To: Duffy, Bill<billd@southoldtownnv.gov>; Flatley, Martin<mflatlev@town.southold.ny.us>; Fisher, Robert <Robert.Fisher@town.southold.nv.us>; Spiro, Melissa<Melissa.Spiro@town.southold.nv.us> Subject: Emailing: Fireworks Apl Manfredi F_20160624133213 Please review and send me your written recommendation. Thank you. Betty Elizabeth A. Neville, MMC Southold Town Clerk& FOIL Officer PO Box 1179 Southold, NY 11971 Tel. 631765-1800, Ext. 228 Fax 631765-6145 Cell 631466-6064 Your message is ready to be sent with the following file or link attachments: Fireworks Apl Manfredi F_20160624133213 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 Neville, Elizabeth From: Neville, Elizabeth Sent: Friday,June 24, 2016 2:35 PM To: Duffy, Bill; Ffatte , , isher, Robert;Spiro, Melissa Subject: Emailing: Fireworks Apl Manfredi F_20160624133213 Attachments: Fireworks Apl Manfredi F_20160624133213.pdf Please review and send me your written recommendation. Thank you. Betty Elizabeth A. Neville, MMC Southold Town Clerk& FOIL Officer PO Box 1179 Southold, NY 11971 Tel. 631765-1800, Ext. 228 Fax 631765-6145 Cell 631466-6064 Your message is ready to be sent with the following file or link attachments: Fireworks Apl Manfredi F_20160624133213 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. 1 June 16,2016 TO: Kevin Jennings COMPANY: Bird Conservation Biologist NYS DEC Region 1 50 Circle Road SUNY Stony Brook Stony Brook,NY 11790 PHONE: 631-444-0308 FAX: 631-444-0272 EMAIL: Kevin-lennings@dec.ny.goovv FROM: Edward Rubio TOTAL PAGES: 2 Dear Mr.Jennings: Below please find display information for a coming contracted fireworks display with our site plan for this event attached. EVENT: Manfredi Family Celebration LOCATION: Beachfront at 240 Sunset Path,Southold,NY LATITUDE: 41'448.18"N LONGITUDE:72°27'0.46"W DATE: July 30,2016 RAIN DATE: July 31,2016 TIME: Approx. 9:00 PM DURATION: 4—6 minutes We would appreciate your assistance in getting a notice out to the Coast Guard ASAP with copy to us of your agency having no objections to this site being used. Thank you for your help and cooperation in this matter. Sincerely, Edward Rubio Logistics Manager Fireworks by Grucci,Inc. CELL: 516-658-4486 Fireworks by Grucci,Inc. Office#: (631) 286-0088 20 Pinehurst Drive Fax#: (631) 286-9036 Bellport,NY 11713 E-nufl:.erubio(@gmcci.com THE FIRST FAMILY OF FIREWORKS June 16,2016 As per the document N.F.P.A. 1123-2000 Code for'Fireworks Display and,the Town of Southold regulations,the following information is provided. Sponsor/Client Name: Manfredi Family Celebration Location and Date of Fireworks Display: Beachfront off 240 Sunset Path, Southold,NY July 30,2016—Rain Date July 31,2016 @ Approximately 9:00 PM Chief Pyrotechnician: Health: Age: Years Experience: Tom Guida Excellent 63 27 Product: Not to Exceed 860 Firework Shells and 2400 Illuminations 1.3G&1AG explosives, UN0335, Maximum Aerial Shell Diameter= 3 inches. Storage will be at secured safety zone in D.O.T. approved fiberboard containers #UN-4G, and stored in company vehicle approved for this purpose. Fireworks by Grucci complies with all requirements of the NFPA 1123 and The Town of Southold. The above information is submitted and verified by: i Edward Rubio Logistics Manager (631) 286-0088—Phone (631) 286-9036—Fax (516) 658-4486 - Cell Fireworks by Grucci,Inc. Office#: (631) 286-0088 20 Pinehurst Drive Fax#: .(631) 286-9036 Bellport,NY 11713 E-mail: erubiona,gracci.com THE FIRST FAMILY OF FIREWORKS June 16,2016 I 1 DISPLAY: Manfredi Family Celebration FROM: Edward Rubio Re: July 30,2016 Fireworks Displays / Rain Date:July 31,2016 SHELL SIZE NOT TO EXCEED 3" SHELL SIZE: QUANTITY IN PCS. Grucci Grand Illuminations - 2400 2'/2 - 360 3" - 500 4" - N/A 5" - N/A 6" - N/A 8" - N/A 10" - N/A 12" - N/A 24" - N/A Grucci Grand Illuminations = Gerbs,Mines,SPX,Comets,Roman Candles Water Falls,Strobe Pots Storage will be at secured safety zone in D.O.T. approved fiberboard containers #UN-4G, and stored in company vehicle approved for this purpose. Total:Not to exceed 860 Firework Shells and 2400 Illuminations Type: Fireworks UN0335 (Display Fireworks) (Explosive 1.3G) Fireworks UN0336 (Special Effects) (Explosive 1.4G) Thank You, Edward Rubio Logistics Manager Fireworks by Grucci,Inc. Cell: 516-658-4486 Fireworks by Grucci,Inc. Office #: (631) 286-0088 20 Pinehurst Drive Fax#: (631) 286-9036 Bellport,NY 11713 E-mail:erubiona�grucci.com THE FIRST FAMILY OF FIREWORKS June 16,2016 h Richard Manfredi 240 Sunset Path Southold,NY 11971 Cell: 516-220-9220 t Email: richard391@gmail.com Dear Mr.Manfredi: Please find attached hereto for the Manfredi Family Celebration fireworks display scheduled for July 30,2016 with a Rain Date of July 31,2016 at 9:00 PM the following: 1) Letter to Town of Southold Clerk's Office 2) Town of Southold Permit to Display Fireworks Application 3) Insurance Certificate 4) Site Plan 5) Chief Pyrotechnician's Data Form 6) Chief Pyrotechnician's NYS Certificate of Fitness 7) Pyrotechnic Product Count 8) FAA Notification Letter 9) U.S.Fish&Wildlife Notification 10) DEC Notification Please sign the enclosed application and forward to the Town of Southold along check for $100 made out to the Town of Southold to: Elizabeth Neville,Town Clerk Town of Southold 53095 Route 25 Southold,NY 11971 Thank you for your help in this matter and if you should have any questions please call. (Sincerely, Edward Rubio Logistics Manager Fireworks by Grucci,Inc. Cell: 516-658-4486 Fireworks by Grucci,Inc. Office#: (631) 286-0088 20 Pinehurst Drive Fax#: (631) 286-9036 Bellport,NY 11713 E-mail:info@grucci.com THE FIRST FAMILY OF FIREWORKS June 16,2016 TO: Mr. Steve Papa �/1 COMPANY: U.S. Fish&Wildlife Service E-MAIL: steve papakfws.gov PHONE: 631-776-1404 x 201 FAX: 631-776-1405 FROM: Edward Rubio TOTAL PAGES: 3 ' Dear Mr.Papa: Attached please find site map anis the plover protection plan for the fireworks display noted below: EVENT: Manfredi Family Celebration LOCATION: Beachfront at 240 Sunset Path,Southold,NY LATITUDE: 41'448.18"N LONGITUDE:72°27'0.46"W DATE: July 30,2016 RAIN DATE: July 31,2016 TIME: Approx. 9:00 PM DURATION: 4—6 minutes r We would appreciate your assistance in getting a notice out to the Coast Guard with copy to us of your agency having no objections to this site being used. Thank you for your help and cooperation in this matter. Sincerely, Edward Rubio Logistics Manager Fireworks by Grucci,Inc. Cell: 516-658-4486 Fireworks by Grucci,Inc. Office#: (631) 286-0088 20 Pinehurst Drive Fax#: (631) 286-9036 Bellport,NY 11713 E-mail:info@grucci.com THE FIRST FAMILY OF FIREWORKS Attachment,I �� _ :Ea`s`ter6 Service Center' 1701 Columbia-Ave. U:S.,Department Operations SupportGroup' College fark,GA 30337 of Transportation AJV;E2 RE!Q�.IEST FSR FIREWR 01 5 DISPLAY Company Name: Fireworks by Grucci Effi.4Address of Person Submittimgitequest: waz@gruCCi.Com Event Nanie: Manfredi Family Celebration Display Date: July 30, 2016 Rain,Date:. , July 31,_2016 Display-Start Time: 9:00 PM Duration ofFirewdkk!t Display: 4 - 6 minutes M#Height'ofFirew6-ift 3" max with height of 300' City•or.Town;and;State,(PhysicalAddress): Beachfront off 240 Sunset Path, Southold,NY 11957 Latitude: 410 448.18" ' (N6rth)_ Longitude: _ -72°270.46" (We's't) PstAp C w4,Public,Use-Airport Within-25 Nautical_Miles of the;Display if-the'F reworks Will Reacli:or Exceed`500 Ft., Spechal.Nptes: J - ( ;iUse ��ulua t;utti',Uc si.iuptln[aaual i;he vork i'rnu�duv es:S'ui U,SU W 12/6/20.13 June 16,2016 I� Elizabeth Neville,Town Clerk / Town of Southold 53095 Route 25 Southold,NY 11971 Phone: 631-765-1800 Fax: 631-765-6145 Email: e.neville@town.southold.ny.us CC:lynda.rudder@town.southold.ny.us Dear Ms. Neville: Please find attached hereto for the Manfredi Family Celebration fireworks display scheduled for July 30,2016 with a Rain Date of July 31,2016 at 9:00 PM the following: 1) Town of Southold Permit to Display Fireworks Application 2) Check for$100.00 for Permit Fee 3) Insurance Certificate 4) Site Plan 5) Chief Pyrotechnician's Data Form 6) Chief Pyrotechnician's NYS Certificate of Fitness 7) Pyrotechnic Product Count 8) FAA Notification Letter 9) U.S.Fish&Wildlife Notification 10) DEC Notification 11) Contract with Sponsor 12) Letter to Sponsor Thank you for your help in this matter and if you should have any questions please call. Sincerely, Edward Rubio Logistics Manager Fireworks by Grucci,Inc. Cell: 516-658-4486 Fireworks by Grucci,Inc. Office#: (631) 286-0088 20 Pinehurst Drive Fax#: (631) 286-9036 Bellport,NY 11713 E-mail:info@grucci.com THE FIRST FAMILY OF FIREWORKS �© RESOLUTION 2010-474 ADOPTED 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) a copy of a valid certificate of competency as a pyrotechnician for the individual supervising the firing of the display; (b) 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; (c) Detailed diagram showing location of fireworks discharge and minimum separation distances in accordance with the applicable requirements of Penal Law Section 405(2); (d) A 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. Resolution 2010-474 Board Meeting of June 29, 2010 5. All applications for a fireworks permit shall be subject to an application fee in an amount of$100.00,together with a processing fee in an amount to be determined by the Town Board to cover the Town's costs for monitoring and enforcing compliance with the Penal Law. 4 �a T , Elizabeth A.Neville Southold Town Clerk RESULT: ADOPTED [UNANIMOUS] MOVER: Albert Krupski Jr., Councilman SECONDER:Vincent Orlando, Councilman AYES: Ruland, Orlando, Talbot,Krupski Jr., Russell ABSENT: Louisa P. Evans Updated: 6/30/2010 10:43 AM by Lynda Rudder Page 2 Attachment 1 ?a alp Eastern Service Center 1701 Coluinbia Ave. U.S.Department, Operations Support Group doilege Nark,GA 30337 of Transportation AJV-E2 FI AT DIS-PEA Company Name: . Fireworks by Grucci Email Address of Pprson,Submitting Request: vvaz@grucci.com Event Name:—Man redi Family Celebration Display Date: July 30, 2016 Rain Date: July 31, 2016 Display Start;Time: 9:00 PM Duration of Fireworks Display:' 4 - 6 minutes Max height of Fireworks 3" max with height of 300' City or Town,and State(Physical Address): Beachfront off 240 Sunset Path, Southold,NY 11957 Latitude: 41' 4'48.18" (North) Longitude: 72027'0.46" (West) List the Closest Public Use Airport Within 25•Nautical Miles of the Display if the Fireworks Will Reach or Exceed 500 Ft. Special?Motes: i. ,, .,., � a.:r.. ..t<,c x..'»=a-.)�7 .is:.;t al di . J:L..>sl; E ,..Cuts.,Ci•e .,r,.7oJ s.f,... f .i.Vb it!.. :., 12'6/2013 June 16,2016 DISPLAY: Manfredi Family Celebration FROM: Edward Rubio Re: July 30,2016 Fireworks Displays / Rain Date:July 31,2016 SHELL SIZE NOT TO EXCEED 3" SHELL SIZE: QUANTITY IN PCS. Grucci Grand Illuminations - 2400 2'/2 - 360 3" - 500 4" - N/A 5" - N/A 6" - N/A 8" - N/A 10" - N/A 12" - N/A 24" - N/A Grucci Grand Illuminations = Gerbs,Mines, SPX, Comets,Roman Candles Water Falls,Strobe Pots Storage will be at secured safety zone in D.O.T. approved fiberboard containers #UN-4G, and stored in company vehicle approved for this purpose. Total: Not to exceed 860 Firework Shells and 2400 Illuminations Type: Fireworks L N0335 (Display Fireworks) (Explosive 1.3G) Fireworks UN0336 (Special Effects) (Explosive 1.4G) Thank You, �) Edward Rubio Logistics Manager Fireworks by Grucci,Inc. Cell: 516-658-4486 Fireworks by Grucci,Inc. Office#: (631) 286-0088 20 Pinehurst Drive Fax #: (631) 286-9036 Bellport,NY 11713 E-mail-eiubio@glucci.com THE FIRST FAMILY OF FIREWORKS �®�uFFot,�co ELIZABETH A.NEVILLE,MMC �y� r/y Town Hall,53095 Main Road TOWN CLERK P.O.Box 1179 coo 9t Southold,New York 11971 REGISTRAR OF VITAL STATISTICS We ® Fax(631)765-6145 MARRIAGE OFFICER Telephone(631)765-1800 RECORDS MANAGEMENT OFFICER ®.l �►a www.southoldtownny.gov FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD To: William Duffy, Town Attorney /Chief Flatley, Southold Town Police Department Robert Fisher, Fire Inspector Melissa Spiro, Land Preservation From: Elizabeth A.Neville Town C rk Dated: June 24, 2016 Re: Fireworks Application of Manfredi Family Celebration Transmitted herewith is an application for Fireworks by Grucci Fireworks for the Manfredi Family Celebration on private beach off 240 Sunset Path, Southold, New York at 9:OOPM on,July 30, 2016 (Rain date: 9:00 PM July 31, 2016 Please advise if you have any objections to a permit being issued. Thank you. June 16,2016 �r TO: Mr. Steve Papa COMPANY: U.S. Fish &Wildlife Service E-MAIL: steve papa a,fws.gov PHONE: 631-776-1404 x 201 FAX: 631-776-1405 FROM: Edward Rubio TOTAL PAGES: 3 Dear Mr.Papa: Attached please find site map and the plover protection plan for the fireworks display noted below: EVENT: Manfredi Family Celebration LOCATION: Beachfront at 240 Sunset Path, Southold,NY LATITUDE: 41°448.18"N LONGITUDE:72°27'0.46"W DATE: July 30,2016 RAIN DATE: July 31,2016 TIME: Approx. 9:00 PM DURATION: 4—6 minutes We would appreciate your assistance in getting a notice out to the Coast Guard with copy to us of your agency having no objections to this site being used. Thank you for your help and cooperation in this matter. Sincerely, ) l Edward Rubio Logistics Manager Fireworks by Grucci,Inc. Cell: 516-658-4486 Fireworks by Grucci,Inc. Office#: (631) 286-0088 20 Pinehurst Drive Fax #: (631) 286-9036 Bellport,NY 11713 E-mail•info@grucci.com THE FIRST FAMILY OF FIREWORKS