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Home My WebLink AboutPermit Fire Damage Report 1987-06-29t+ /t) / F/e * *ruors I FIRE DAMA.GE REPORT OR ELECTRICAL HAZARD No Dknp€ lilw+rfl No Pqt&frN /,/,+ng r//?.f* TO: - FR0l4: SUBJECT: Building Department Springfield Fire DePartment Structural Damage to Building Address or 'location of buildi ng ILIXT Ol.laf,v Name of o\',ner Type of building o r Dwel ling, Store, l.larehouse, etc.) Estinrated value of building $ 4ooa-o, Estimated loss to building $No oo Date of fire ("- rq'6) Location of damage in build'ing (Roof, !'Jall, Exterior, Inter ior, etc. ) Structural weakness as a result of the fi (Burned rafters, Beams,.lo'ists, etc. ) Additional pertinent information Electrical Hazard hloldr 0ut I ets , etc. ) cc (l,Ji ri no, S i gned DATE: L- l^q.'o.t ^,1 DO NOT WRITE IN THIS SPACE CONTROL EXP. District of Incident ADDRESS 3 OCCUPANTNAME OWNER (kst, FiEt, Ml) (lst" First" MI) 6 PIREREPORTEDBY(lr!t,FiEt,MI) Telephone Muiciprl Alam Syateu Private Alam Syrt m STATE County Radio Verbal No AIam Rc'd 50 to ?0 fet 5 ta 6 st4rE8 REGON FIRE REPORT ;FIRE MARSHAL I (Tie Line) Voicr Signal Mui AIam Not Clasifial Abovc Over ?0 fet NO. Other (List) Automtic ErL Sy8t E D Prc-@nnst h@/tanl only I Pre-onnect hw/hvdrant, smdpipc 49 fEt . ]RE DEPT NO. Hud-laidhor/hydrut,standpipc f! Undetemined Muer Streu Devie I NotClassifiedAbovc in Flisht Behw grd. l€vel Not CLrsiired 13 t 24 sbri6 50 8rcri6 ot mor ., o_o*z a,: =ht-5td It EJ TJ 8>rt. 2 1 5 C)oi,? AFF'E F, i5 Fl EtslJAafr a', Fl. trtr C)o FU l- 15€trl EloF rr 11 o U)rl 14trE F FJ cr) v)€ :0 o,l t{E :D tr,(t) ozF AI.ARM I , OP FIRE SERVICE RESPONDED PERSONNEL 9 TYPEOFSITUATIONFOUND s IO ME-THOD OF EXTINGUISHMENT trE USE M MOBILE PROPERTY 12 ROOM/AREAOFFIREORIGIN E EQUIPMENT nwoLVED INIGNITTON 13 IGNITION FA TOR la OF HEATOF 15 LEVELOFFIREORIGIN '6 vILUE tss StsctuE FiE Outside Stnci ,/vdr ! VehicleFirc ! Bruh,Grm,lava ! r*n, n"uuirtt Self-Ertinguiahed M8ke-shift sidr Portable Ertinguisher l0 to 19 fet 20 to 29 fet 2 sbri6 3 1o a stori"! NUMBEROFfl r D 7 to t2 storia 256 lE BUILDINC AGE (In Yqn) l9 TYPE SEI&3-{ N EXTENT OF DAMAGE CONFINED TO: I Thc ob.iet of origin 2 P.rt of @E or ru of oridn 3 Rem of origiD { Firc-ratad omp. of origia 6 flor of origin 6 Stretun of origir 7 Ertcndcdbcyondltruchrrcof origi! 9 No&rugeof thctypc(N/A) 2l REMARKS WetlrcrCanditionr(optional): I - ,, FoUo* U, Invetigatior Rrqwtcd Y - N f lf ya, vbo will invatiStt Seryie 2,1 Mcmber Rrport SmoLeFlame I 3 1 5 6 7 I 3 1 6 6 7 tr Rtr D trtr D D D tr tr!tr tr eg TIME BACK IN SERVICElrlrDr? ATARM TIME lrt- r{ r7 ARRIVAL TIME lre-r'tt4l.ilb MO DAY 1- rQ I tq t6t1 YEAR DAY OF WEEK ! sun $ uoo flru $ ru Ewd EP'i I srtut ISO CLASS 34t1t411t'l zlP CENSUSTRACT lt0 r.0r2 t 1 DOB (optional) 1,tb - 1011 TELEPHONE DOB (optiond)TELEPHONE 14-r - 3c{ lq TELEPHONEDOB (optioul)ADDRESS DOB (optional) 1c{b - 10u TELEPHONEADDRESS E R€cei"ld ! Givo E Nlr or bvetrgaEAd , OTHER VEHICLES RESPONDED (do not include PA's) . I tor AER]AL APPARATUS RESPONDEDT OF ENGINES RESPONDED L trtr trtr TYPE OF ACTION TAKEN ! Ertinguish Remved Haand Sland Salvagr Not Classifi€d trlOBlLE PROPERTY (Complee line M) LICENSE TSERIAL ' MODELYEARMAKE EQUIPMENT INVOLVED IN IGNITION (Complett Line E) VOLTAGESERIAL 1MODELmKEYEAS FIRST IGNITED:WAS MADEOFFIRST TOTAL .00 Otlrer .mVchicleand Content .@Conr€nts .00 Buildhg .00 .00t.00.00.00.00 5()0,000 sq ft50,000-99,999 sq ft10,000-19.ggJ sq ft1000-4999 8q ft ft BUILDING SIZE (Grnd Ftr OnlY) ft Not Claseifred Above WoodFrrmUnpDtet. Mmnry ErL & Wood Int. Wood Frame Unprctect. Stel Ext. & Wmd Hevy Timber Strel SPRINXLER PERFORMANCE t fl Flq.ipm.nt op.tated Z fl nquip. "ttuua havc opcr.-did not 3 D &uip. pent fiE te .ull to opct. 9 ! Not cluirrcd abovc O E Undet miD€d or not rcPortod 8 [!1,{oequipmntprwnt (N/A) SprirthBContrcUedFin: YES E NO E I of Hadg Opcoed DETECTOR PERFORMANCE trtr D tr Dtr D tr tr I In mm of origin-opa' 2 Not in r@Dof origin-oPer. 3 In m of origio-not opq-fr te 8mrll ,l Not in m of origin-not op.r. frE te small 5 In mD of origi!-not oper. powcr dirennct 6 Not in m of orisi!-not op€r. power dimIt. 7 ln ruo of origin-not oFr' &8d batt€ry 8 Not io rum of origin-trot opcs. d4d b6ttcry g Nod€tEtorprent D l0 Undct4mind Number of Faulitra FiE (, -Lq- 87 DatTitLA/. DatcTitJG F16-tin-rn rR-Aat bt 0thcr /oOLl t,) f] cont. on bacl TlJ*J.O *-ru0''f5 I FIRE DAMA.GE REPORT OR ELECTRICAL HAZARD DATE: TO: FROI4: SUBJECT: Building Department Springfield Fire Department Structural Damage to Building Il) Iiqo, v 1ll v, Address or location of bui'lding Name of ot',ner Type of building Dwel ling, Store, I.larehouse, etc.) Estimated value of building Estimated loss to building $.1 .oo $No oo Date of fire L' l-q'6) Location of damage in bui'lding (Roof, Wall, Exterior, Interior, etc.) (Burned raf ters , Beams, Jo'ists, etc.) Additional pertinent information E'lectri cal Hazard nmu-)r (tli ri nq, 0utl ets , etc. cc Siqned I Structural weakness as a resul t of the f ire {.)oilE DO NOT WRITE IN THIS SPACE CONTTIOL EXP District of Incident ADDRBSS 3 OCCUPANTNAME 1 BUSINESSOWNER (t +rt, Fint, MI) (Lat, FiBt, MI) 6 rIREREPORTEDBY(lst,FiEt,MI) Telephone AINRM Municipal Alam Syatam Privatc Alm System 8 'OFTIRESERVICERESPONDED STATE REGON TIRE NEPORT :FIRE MARSHAL r (Ti€ Line) Vobc Signal Muni Alam Not Clasified Above RE DEPT NO. Hud-laid ho*,/hy&mt, standpipe Mdt€r StEu Devie I NotClusifiedAbove Ilelow rio. l0 Radio Verbal NoAlamRa'd 5 o :89 a:rhFBt5 trl 4t 4' ii>rt{ o 7,? EFEJE FE i5 cE ;H 'a>-r< oo? t- rd.l t5E rrF a'l r<t{E t{a) (r),i C)-lc r5 a1 F lElaozF 9 TYPEOtr'SITUATION ! Vehicle Firc ! Bruh,Grm,Ieava D r*t, Rubbi"tt E Other(Liso ! Autoutic Ert. Systcm I Pre-connrct he/tank only fl Pre'mnnect hw/hvdrant, sundPiPe 49 fet E soozor*t E-tr ME-THOD OF EXTINGUISHMENT Structure FiE Outside Struct. w/valw D S€[-Ertingui6hd E.t) ! Undetemined I t II : i : t I ; r tl USE M MOBILE PROPERfi I2 ROOM/AREAOFFIREORIGIN E EQUIPMENT IT.ivOLVED IN IGNITION I3 IGNITION FACTOR l4 OF HEAT OF 15 LEVELOF'FIREORIGIN Make-shift aids Portable Extinguisher l0 to l9 fet 20tD29 tet Over 70 fet Obje{s ir Flieht Not Clasified Grade t6 VALUE LOSS 17 NUMBEROF abn6 El r 3 to 4 Btoris 1S BUILDINGAGE(lnYan) 19 CONSTRUCTIONTYPE 3-4 20 D(TENT OF DAMAGE CONFINED TO: I Th€objectoforiSin 2 Part of rcm or m of origin 3 Rmm of origin { Fire-ratad ooP. of origin 5 Flor of origin 6 Structw of origir ? ErtendedbeyondstrucbEof origir g No,trrugeof thc type (N/A) 2l REMARKS Wether Cpndition8 (optionsl): 22 Follow UP InvetiSrtioD Reqwtad Y- N f fya,whowillinvcstigEt' 23 of lnjuriee Seryie 24 Member R€pon 25 Infomtion SmokeFleme I 3 1 6 6 trtr D tr!tr tr sg D &tr D tr D tr TIME BACX IN tt SERVICETrorr) ALARM TIMEDAY )-t4 Et* Ewd E su. Ern YEAR Mon Thw fl SrtutDAY OF WEEX t'ltb MO ISO CLASS 34t114t1t'| ZIP CENSUS TRACT Ir0 t.0r2 t I lrlb-'loll TELEPHONEDOB (optronal) 14l - 3e{ lq TELEPHONEDOB (optional) DOB (optioml)TELEPHONEADDRESS 1qL - 1ou TELEPHONEDOB (optional)ADDRESS I neeived I Givu fl Nle or # OTHER VEHICLES RESPONDED (do not rnclude PA'e) tt # OF AERIAL APPARATUS RESPONDED# OF ENGINES RESPONDED 2- ! Remved Hurd Stand 'I-YPE OF ACTION TAXEN Ertinguish Salvage Not Classified (CompleE hne M) #SERIAL #MAKE EQUIPMENT INVOLVED IN TGNITION (Complete Line E) VOLTAGESERIAL #MODEL IGNITED:WAS MADEOFFIRST TOTAL .00.00VehicleandConten* .*Cnnt4nts .00.00 .00t.00.00.00 50 6@n6 or morebsbries13 b 24 storia to 49 8tori67to l2st ri6 5O0,0O0 8q ftEO,0o0-99,999 Eq ft10,000-19.999 6q ft1000-4999 sq ft ftBUILDING SIZE (Grnd Flr OnlY) ft Unprctcctcd Wood Frare Clasified Above IJnprotct. Mmnry Ert. & Wmd Int Frame Unprolrct. Slel BIdg & Wood Heq.- Timber t E Equipmentoperated z D Equip. shoutd haveoper.-did not 3 E Fhuip. pre*nt fir tm 8roll to oper' g ! Not cluihed above o ! UndeterminedornotrePortld E Ek1',lo equipmntPrent (N/A) SprinlrtenContrclledFire: t6 g NO D SPRINXI,ER PERFORMANCEDETECTOR PERFORMANCEu Etr tr trtrtril tr I In mm of origin -oPer,2 Not in r@m of origin -oPer' 3 In m of origin-not oper-frc te Emall ,l Not in m of origin-not oper- fir too small 5 ln ruo of ori8io-not oper. poeer dimonect 6 Not in m of origin-not oper. power dieon' 7 In mm of origin-not op€t. &ad battery 8 Not i! mm of origin- not oper' d€'d battery 9 No det{torpwnt f} l0 Undet€mined Number of Fatrliti6 Fire DatA Titlc Fld-adn-10 lR-R4l Other E cont. on back ARNIVAL TIME t r1- r''l r4I rl r{ r7llqt6ti MODELYEAR Other ,1-o.ooABuilding Ll lr) ..r .t i9. .00 ^11 2