21.364 Application for Supervised Display of Fireworks - First Night*)�Department of Fire Services
Commonwealth of Massachusetts
Application/Permit for Supervised Display of Fireworks (FP-027)
This form shall be used as the application and permit for all supervised display of fireworks in the Commonwealth
of Massachusetts.
A copy of this application and required documentation must be submitted to the head of the local fire department
at least twenty (20) days in advance of the proposed date of display as required by 527 CMR 1.00:1.12.8.39.2.2(1).
Required Documentation to be Submitted
M Diagram/site plan showing points where fireworks are to be discharged, location/distance to the
audience, buildings, highways, overhead obstructions, etc. (handwritten maps are not acceptable; Maps
must be Google, Bing, GIs)
M The number and description of the fireworks/pyrotechnics including the diameter of the shells.
A copy of the natural barrier letter from the State Fire Marshal's Office (if applicable).
t FAA, Coast Guard, or other agency approvals/notifications
One copy of this form and required documentation must be forwarded by the Head of the Fire Department to
the State Fire Marshal (by email dfs.licensing@state.ma.us, fax, or mail) not later than five (5) days after receipt
of said application as required by 527 CMR 1.00:1.12.8.39.2.2(4).
Name of Sponsor: Northampton Arts, Inc.
Phone #* 413.587.1069
Address ofSponsor:240 Main St. #1 Northampton, MA. 01060
Location of Display (GPS coordinates): 420 1 9 ' 04.34" N / 720 37 ' 48.61 " W
Nearest GPS Street Address to display set up: 85 Hampton Ave. Northampton, MA. 01060
December 31, 2021 6:15 P.M.
Date of Display: Time of Dlsplay:
1 5-inch tubes
Rain Date. None
Largest Shell Size to be Fired ' Number of Aerial Shells:
Number of Ground Pieces: None Number of Cakes & Max. Diameter 61 Cakes & Strips
This Show Is. Public X Private
Fireworks/Special Effects Company:
Current Users Certificate Number:
Pyrotecnico Fireworks, Inc.
PY-001012
Name of Competent operator: Robert Gutowski
Certificate of Competency #: ry V -004546
Date of Expiration:
Company Supplying Fireworks: (if different from applicant user certificate listed above):
Phone #: 800.854.4705
01 /14/2022
Expiration Date:
12/15/21
Department of Fire Services • P.O. Box 1025,1 State Road, Stow, MA 01775 FP-027 Rev. 1/18
978-567-3375 • FAX 978-567-3199 • www.mass.gov/dfs
Manner and Location of Storage of Fireworks Prior to Display:
On site, in a D.O.T. approved vehicle, secured and placarded
11
CILWA-ad
Signature of Competent Operator:~_ Date: November 2, 2021
Facility Manager - Pyrotecnico Fireworks
l hereby certify that the competent operator named above has my approval and that in my opinion, the display described will be of such
character, so located, discharged or fired as not to be hazardous to property or to endanger any person or persons. (G.L. Chapter 148, 439A)
M There are no changes to the natural barrier approval (no new developments, etc)
Restrictions:
e h. h-.f
Signature of Head of Fire Department:
This permit will expire at midnight on _ J.��r L Z
d tZ
Date: / Z �3 f/?— /
One copy of this form must be forwarded to the State Fire Marshal (electronically, mail or fax) no more than five (5) days
after receipt of said application by the head of the fire department as required by 527 CMR 1.00: 2.22.8.39.2.2 (4).
For Fire Department Use Only
Before the Show
❑ Review DEP advisory on perchlorates
❑ Verify active license and company information at www.mass.eov\dfs (License Lookup)
Day of Show
❑ Pre show site inspection: Establish secured area with a suitable barrier such as snow fencing or
equivalent (caution tape is not sufficient). Natural barriers, as approved by SFMO, have not changed. Secured area must be
established and maintained from the arrival of the fireworks until the completion of the display.
❑ If using racks, determine that the rack placement conforms to the approved site.
❑ Check racks for correct spacing and stability. Check angling of mortars.
❑ If not using racks, determine that mortar tubes are sufficiently buried. Check angling of mortars.
❑ Determine weather and wind conditions just prior to display. If necessary conduct a test shot.
❑ All fireworks shall be fired electrically.
Following the Show
❑ A competent operator must ensure a search is made for any unignited shells and related materials Immediately
following the display and at the first available daylight.
❑ Upon completion of the search, a competent operator shall report all findings to the head of the local fire department.
Department of Fire Services • P.O. Box 1025, 1 State Road, Stow, MA 01775 FP-027 Rev. 1/1E
978-567-3375 • FAX 978-567-3199 • www.mass aov/dfs
- ... .. �. ...-.1 � '� �a.$w Ll".' .�k: .s :t �.- �.iy ..� �I;f.°`• :.a, il:6p -E 'ir � :,' .'.{:�w �. .. ,`( "'{ 'i;: .p
1L4L_ "K " CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY)
11/2/2021
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 poliey(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(s).
PRODUCER
Britton -Gallagher and Associates, Inc.
One Cleveland Center, Floor 30
1375 East 9th Street
Cleveland OH 44114
INSURED
Pyrotecnico Flreworks Inc.
P.O. Box 149
299 Wilson Road
New Castle PA 16103
Everest Indemnity Insurance Co.
COVERAGES CERTIFICATE NUMBER: 1775261236 REVISION NU B
M ER,
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.
EISKLTR
TYPE OF INSURANCEADOLSUOR
WVn
POLICY NUMBER
woo EFF
POLICY
DDT
LIMITS
A GENERAL Li41311M
X COMMERCIAL GENERAL LIABILITY
L_ LYMrS MADE NX OCCUR
j
i—
I GENL AGGREGATE LIMIT APPLIES PER
r—
P(X CY I� �o Loc
Y
Y
SISML00091-211
1/14=21
1I M2022
EACH OCCURRENCE
$ 1,000,000
DAMAGE T
GET R ocTE a s
$ S00,000
MED EXP (Any one rson
S
PERSONAL A ADV INJURY
$1.000,000
GENERAL AGGREGATE
S 2.000,000
PRODUCTS-COMP/OPAGG
52,0,000
00
S
13 I AUT MMI E LIABILITY
�—
ANY AUTO
XrxALL OWNED SCHEDULED
AUTOS AUTOS
HIRED AUTOS .. X-- AUTOS
Y
Y
SISCA00141-211
t/14R021
1/14120V
COMBINED SINGLE LIMIT
accident)
BODILY INJURY (Per person)
S
BODILY INJURY (Per accident)
S
PRO Md'TY DAMAGE
S
5
C UMBRELLA LIAR X
X EXCESS L
O UR
CLAIMS MADE
Y
I
Y UXPIC35252-01
1/14/2021
1/14/2022
EACH OCCURRENCE
S 4.000.000
AGGREGATE
$4,000,000
OED PETE noN S
S
WORKERS COMPENSATION
AND EMPLOYERS• L41BILI Y Y / N
AtdYPROPRIETORIPARTNER/EXECUTIVE
OFF6CERAREMSER FXCLUDED9 ❑
(1yy�s �In N)
pE$C� R1PT1ON OF OPERATIONS below +
A
NIA
WC STATU- I JOTH-
TOR ER
E.L.ACHACCIDENT
S
E.L DISEASE - EA EMPLOYE
S
EL DISEASE - POLICY LIMIT I
S
A, Eso Uabd4y92 Y Y S18EX01314-211
1/14/2021 1 1/14/2022
Each U0 Aggragate $5,000,000
Total Umrls 510.000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101. Additional Ranarks Schsd;N If men space in required)
AddibonW Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement.
+ Fireworks Display Date December 31, 2021 / Rain Date None
Location EJ Gore Parking Garage - 85 Hampton Ave. Northampton. MA 01060
Additionally Insured Northampton Arts, Inc- 13 City of Northampton, MA
Northampton Arts, Inc.
Memorial Hall #1
240 Main St
Northampton MA 01060
ACORD 25 (2010105)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHONU'YD REPRESENTATIVE
w lyvo•LV iV M\,Vr%u %,VRr Vr%^ii m. An rlgnrs reservea.
The ACORD name and logo are registered ntarke of ACORD
Acal?L CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
k___
06/07/2021
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 CONST114JTE 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 pollcy(les) must be endorsed. N 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 certifleate holder In lieu of such endomement(s)
PRODUCER
CONTACT
Applied Risk Services, Inc.
P"OONE' F� _
1D025 Old kill Ad
LAC Ne�E>,� (877) 234-4420 rAm, N(877) 234--4421
Omaha, WE 681S4
EMAIL
AOOREBS:
(877) 234-4420
PRODUCER
CUSTOMERID•
INSURER(S) AFFORDINO_COVER_AGE NAIC
POURED
INSURER Pennsylvania Insurance Co. 21962
Pyratecnico Fireworks, Inc.
INSURER B — — - - - -- -- —
dba Pyrotecnioo---------
PO Box 149
NSURER C
New Castle, PA 16203-0149
INSURER O- _
CTL 1273 1694791
NSURERE.
INSURER F
nc.wwl. nvmocn:
THIS 15 TO CERTIFI THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED NOTWITHSTANDING ANY REOUIREMENT TERRA OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CEi-+Trr1CATE MAY BE ISSUED OR MAN PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS O_F S_ UCH POLICIES.
- LIMITS S"VN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
:IfSJI I IADo gUB POLICY EFF POLICY UP---- —�
LTR � TYPE OFNdWRANCE ' NSR LD POLICY NU IBEA I
i OL�RAL LUMLm
fCOMM"RCIAL GENERAL LIABILITY t_ JI (I
?CLAIMgMADEF7OCCUR
S
'AMA FeORASNCE
Pssm S A+ nlnre
3
$
f I
l�tE� IAnY3n r^ n
I
P�SQLv9L4ARY,.IWSJR:r
s
crENT. AGOAEOATF. LIMIT APLIES PEP Pj
I
GENERALAGGREGArE —
S
DUClT"4E MEA
PRO
UK '
S
s
i AVYOIIoaILE LIABILITY
' M'AUTO I..
+A
COMBINEDSINGLELIMB
$
s_
IALLOWNED AUTOS j'
BOOI�YINJI)RYLPgoersonl
S __
1604FOULEDAUT[A I I
C 1"WPOAUTOz�
flQRUyiNeuRY(pu
►—;
I NON-OWNLO AUTO.
PROPERTY DAMAGE
Per accident —.
S
f
ilalaRELlA UAB-, iOCCUR ;
ISOCCESSUAi r CLAIMS MA 'I
1
����
EACH OCCURRENCE
S
AGGREGATE
_
t�DtM:TI6LL
r iItETENTICM
VADFAERS C 601to"PON
i ANDS MPLOYEAS UABUM 'NI
r'
WC STATU- OTH-
X Ogy uNII
_
A1l> PROPRLROghMflTN-_ y,_-cU7TVE N, A �' I 8 2— 8 7 2 0 9 6— 0 4— 2 6
OmICEi =EItCtUDs'ANIIOeIafyNNNI
06/07/2022
E L. EACH ACCIDENT
S 1, 000, 000
I106/07/2Ml
aSPeCJA1PSIOHSWlan
E-L DISEASE EA EMPLOYEE
f 1,000,000
EL DISEASE POLICY LIMIT
f 1, 000, 000
- I
DESCRIPTIONDFOPERATIONSILOCATIONS VEHICLES (AroichAoordiol A—ftt"wlRemy&AScLedWe,i/annspace 4nquind)
!!CCrrCCLLATC LE Info
Pysuternia10 Ipa rearorka Inc
PO Fi= 149
New Castle, PA 16103
ACORD 25 (2009")
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED
IN ACCORDANCE WITH THE POLICY PROVISIONS.
AVnK>a111iYRtYaLOlMlAIIV 1 —
42533
019W 200'ACORD CORPORATION. All rights m4erved
VERIFICATION CERTIFICATE FOR
INDEFINITE TERM SURETY BOND
THIS IS TO CERTIFY that Bond No. 218SBFX84221ssued by Hartford Fire Insurance Comnanv dated this 1
day of February. 2011, in the amount of Fifteen Thousand Dollars and 00/100 Dollars ($15,000.00), on behalf
ofPrrotecnicu Fireworks Inc. (as Principal), and in favor of The Commonwealth of Massachusetts (as Obligee)
, covers a term which began on the 1 day of February , 2011, and ends only with the cancellation of said bond
or other legal termination thereof; and that the said bond remains in effect, subject to all its agreements,
conditions and limitations.
Signed, sealed and dated* (enter below) Hartford Fire Insurance Company
02/01f2021
BY: 1 Y ,
MiAc W. Edwards.11
Attorney -in -Fact
2/1/2021-211/2022
*Use current or renewal date.
1 ' _J3• - - `t 1a= a .t , . t. - x. r . z r - _ • . ,. .. >•a .' «,.L ".' ..
r
Direct /nquhles(Clalms to:
THE HARTFORD
POWER OF ATTORNEY BONnectic
One Hartford Plaza
Hartford, Connecticut 08155
Bond.Clelmegilthehariford,com
call: 888-280-3488 orfax: 860-767.5835
KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Name: MCaRIFF INSURANCE SERVICES INC
Agency Code: 21- 2 5 n n a
0 Hartford Fire Insurance Company, a corporation duly organized under the laws of the State of Connecticut
0 Hartford Casualty Insurance Company, a corporation duly organized under the laws of the State of Indiana
0 Hartford Accident and Indemnity Company, a corporation duly organized under the laws of the State of Connecticut
Q Hartford Underwriters Insurance Company, a corporation duly organized under the laws of the State of Connecticut
L_J Twin City Fire Insurance Company, a corporation duly organized under the laws ofthe State of Indiana
O Hartford Insurance Company of Illinois, a corporation duly organized under the laws of the State of Illinois
Hartford Insurance Company of the Midwest, a corporation duly organized under the laws of the State of Indiana
Hartford Irrsurenee Company of the Southeast, a corporation duly organized under the laws of the State of Florida
having their home office in Hartford, Connecticut, (hereinafter collectively referred to as the 'Companies") do hereby make, constitute
uplothearnountof Unlimited
Christopher C. Gardner of Union MS, R.E. Daniels, Shelby E. Daniels of Pensacola,
FL, Robert Read Davis of Atlanta GA, Robert M. Verdin of Metairie, LA, Anna
Childress, Mark W. Edwards II, Alisa B. Ferris, Robert R. Freel, Richard H.
Mitchell, William M. Smith, Jeffrey M. Wilson of BIRMINGHAM, Alabama
their true and lawful Attomey(s)-in-Fact, each In their separate capacity If more than one is named above, to sign its name as surety(les) only as
delineated above by ®, and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written Instruments In the
nature thereof, on behalf of the Companies In their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and
executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
In VWtness Whereof, and as authorized by a Resolution of the Board of Directors of the Companies on May 23. 2016 the Companies
have Mused these presents to be signed by Its Assistant Vice President and Its corporate seals to be hereto affixed, duly attested by its Assistant
Secretary. Further, pursuant to Resolution of the Board of Directors of the Companies, the Companies hereby unambiguously affirm that they are
and will be bound by any mechanically applied signatures applied to this Power of Attorney.
s � : Sµw.ru41G Z io a f �""a � � raurula • ,„mew
r p -I Itez � • F . p � A
E rf j � :\Munlrl„ � 4•uN1► JD70 J 3 ID7o � D 1979
Shelby Wiggins, Assistant Secretary Joelle L. LePlerre, Assistant Vice President
STATE OF FLORIDA
ss. Lake Mary
COUNTY OF SEMINOLE
On this 13th day of February, 2020, before me personally came Joelle LaPlerre, to me known, who being by me duly swom, did depose and say:
that (s)he resides In Seminole County, State of Florida; that (s)he Is the Assistant Vice President of the Companies, the corporations described In and which
executed the above Instrument; that (s)he knows the seals of the said corporations; that the seals of Ixed to the said Instrument are such corporate seals;
that they were so affixed by authority of the Boards of Directors of said corporations and that (s)he signed his/her name thereto by like authority.
••7�,F�' Jnmca Noelle Ciccone
My Canarnksion OFF029702
EVires June 20. 2021
1, the undersigned, Assistant Vice President of the Companies, DO HEREBY CERTIFY that the above and foregoing is a true and correct
copy of the Power of Attorney executed by said Companies, which is still In full force effective as of February 1, 2021
Signed and sealed In Lake Mary, Florida.
Itn, Yq
�r�l...uvri a iO�r •� t i �..r..,��� � raw
f:\��t•t;+�� � �••I•M• ; lD7o la lD7o I •
• IUM �I • ,• • hl,r 1 4uu `� .
_ , r
r.
Keith D. Dozols, Assistant Vice President
Northampton Arts, Inc.
oT t 211231 Northampton Arts, Inc.
PYROTECHICO DIRECTORY
Role
R+tiswM6
t-ihail
Mobile #
office #
Purchasing
Nucerino, lee A
Nucerino@pyrotecnico.com
724.813.01 14
724.923.6613
Sales Coordinator
Killingsworth, Mary M
mkillingsworth@pyrotecnico.com
1 724.730.7037
724.923.6607
Show Producer
Raynor, Eugene G
603.321.0605
603.532.9323
Facility
Speeney, Tom
tspeeney@pyrotecnico.com
603.721.2700
800.458.4656
Equipment
Adam Nickerson
adom.nickerson@pyrotecnico.com
724.651.3443
Logistics
Tim Kunkel
tkunkel@pyrotecnico.com
1724.730.3969
724.923.6615
11/2/21.4:13 PM
mediami (3264X2448)
0/dj cm �Gr., W�
FW-004546
Fireworks Certificate of Competency
Robert J
448 Florf
Florence
State Fire Marshal
ski
Expiration Date
12115/2021
1. AA
Northampton Arts, Inc.
211231 Northampton Arts, Inc.
SHELL /FINALE COUNT TOTALS
Show Date 12/31/2021 / Display Duration: 8 - 10
minutes minutes
Sales Order SO-C42226 / Work Order WO-3205
oftup C"Y
CAKE STR 26
IGNITERS 60
MODULAR STRIP STR 24
.1 A
Northampton Arts, Inc.
of w1cu 211231 Northampton Arts, Inc,
SHELL /FINALE COUNT TOTALS
Show Date 12/31/2021 / Display Duration: 8-10 minutes
Sales Order SO-C42226 / Work Order WO-4078
GMVP C"
- None - 9
IGNITERS 42
a, o
V
W
.�
,^o^
=J
C
E
ce
Q
V/
LU
Z
o
w
O
•-
V)
E
z
Z
Wu
o
�'••
3
1
`
co
d
o�
Z
o�
•-
CA
Q
coo
�
�
3
a
0
C�
Lu
O
44
M�
y
ri
Z
•—
V
Q
V
V)
N
al
Y.it
N
�0
O
y
W
cv)
a=
Q
O
�
O
W
v,
LL
V )
Z
UQ
u
u�o
u
Wne
�ne
�=)W
F
m
�
C4
w
oe
O
N
N
Q
Q
Z
Z
Z
f�a
N
N
N
N
N
N
N
N
N
N
(I1
CI
N
m
CO
CO
a
o
N
N
N
N
N
N
N
N
N
N
N
N
N
m
m
CO
O
W
ac
s
W
z
z
0
IL
a5��
u
3
0
�3
Q
oz
W
x
3
3
W
Q
3
a
u
3
Q
oz
g
mDWW�sw"��oZ�
}
O
a
W
m
O
a
W
ce
J
a
a
o
}
z
�
3
O
W
z
Z
z
0
�d��wWW0w
Y
u
ce
u
z
g LLI
m
o
W
t-
m
o
u
ou
W
o
N
3
a
3
m
W
o=
N
W
c�
Z
0
a
oce
r
a
m
x
Z
nc
0""
x
3
~
a
3
0
CCad
~
o
ae
0
3LLO
0
u
�
m
W
a
W
3
m
co
i
m�
a
0
x
W
�,
u
,u-,
�--
In
i-
to
I--
In
F-
to
r-
w
in
r
to
F
On
r
w
r-
to
►-
4n
r•
VI
r
v]
-
oc
Ln
nc
On
On
On
h
tnf
"
h
h
CO.
CO.
P
P
P
N
�
u'
N
N
N
N
N
N
N
N
N
N
N
w
OC
m
e
in
V)
In
oe
oc
N
tn
r
{n
W
w
w
w
w
W
w
IX
W
w
to
w
W
W
W
w
In
V.
u
QQle
U
%Qe
U
Q]QC
V
YQQ
U
YQQ
NQe
hQe
tQo
QYQ
lQe
YQQ
O
O
O
Z
o
o
o
o
o
o
o
0
0
0
0
0
0
-
m
m
m
m
m
m
m
m
m
Olga
m
m
N
N
N
N
('N
N
N
N
N
N
N
N
N
in
cq
c']
V
C
V)
W
(V)
W
Z
w
O
cn
Z
w
0
V
Z
z
Q
0
W
w
0
t—
Q
V)
Ce
_O
Cie
Cl-
Cie
D
O
� /
V I
Ll-
Q
(n
_I
E
O O
r �
co O
= 3
o
O
o
0
a3
CL
N
C4
r V
N ,
� O
N y
T �
L
r O
� N
to
� h
m
Z
V
10
V
V
'0
V
N
-0
-0
d
v
c
m
N
0
w
-CI
LLJ
.
0WLUo
�
oc
W
_w
ain
�
v
O
}
W
0
m
ce
O
C
a
m
m
N
V
o
U
o
O
h
U
Iw
L
a
iR
Y
>
h
Z
Y
U
p
Z
U
w
c
a
wrj
3?
m
3
d I
aj
ce
1--
Z
0
0
0
0
0
0
0
0
0
0
m
m
m
m
m
m
m
m
m
N
N
N
N
N
N
N
N
N
\,
I
N
O
1% .. - 1 .{
0
U.S. Department Eastern Service Center 1701 Columbia Ave.
of Transportation
IREWOR
operations Support Group College Park, GA 30337
AJV-E2
DISPLAY NOTIFICATION
Company Name: Pyrotecnico Fireworks, Inc
Email Address of Person Submitting Request:
rf I owe rs @ py rote c n i co . c o rn
Cell Phone Number for On -Site Technician:
800.854.4705
Event Name: Northampton Arts, Inc - NYE Display
Display Date:
December 31, 2021 Rain Date: none
Display Start Time: 6:15 P.M.
Duration of Fireworks Display: 15 - 18 minutes
Max Height of Fireworks: 1 00'AGL
Address, City and State:
85 Hampton Ave. Northampton, MA. 01060
Latitude: 420 19' 04.34" N (North) Longitude: 720 37' 48.61 " W (West)
List the Closest Public Use Airport Within 5 Nautical Miles of the Display if the Fireworks Will Reach or
Exceed 500 Ft. Not Appiicabie
Special
Please email your request to:
9-ATO-ESA-OSG-Fireworks@faa.sov
m
m
o
FT
�
rn
c
m
m
U
C
N U
W m
C
c
U
7
m
(n
`
\
�
=
0
U >.
O
U N
U
I
h
L Q
CAp
_
0
(� }
U
'=a
c
lu
v C
N
O
c
c
C
M
4\l
r
0 O
3 �
p
_L
ui
LL C..
N
G O) d
C
2 It —
m
oUx.O
A'o-
Im
s
a3i
w
aaz
.0
L
co
L
LL
d
0
v
0
rn
fn
E
m
a�
r
N
U
0
y
w
t�0
N
a�
di
U
N
0.
N
7
O
7
CL
U
N
c
(;
0
a
gOa Wax o/ cqi xv CJe/X4scce6
Permit to Transport Fireworks
TF-004053
This is to certify that in accordance with all Massachusetts laws and regulations a
Permit to Transport Fireworks Is hereby issued to:
Expiration Date: 07/25/2022 Restrictions or Secondary License Type:
Pyrotecnlco Fireworks, Inc.
PO Box 149
New Castle PA 16103
ajati;;
Post in a conspicuous place. Verify the status of this Certificate at www.mass.gov/dfs
Permit to Transport Fireworks
Pyrotecnlco Fireworks, Inc.
PO Box 149
New Castle PA 16103
State Fire Marshal
TF-004053
Expiration Date: 07/25/2022
Restrictions or Secondary License Type: