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HomeMy WebLinkAboutSpecial Inspection Fire Damage Report 1995-10-8 -=c . . ~ ~\ ~l~ FD-16 srers </25. FIRE DAMAGE REPORT OR ELECTRICAL HAL~RD DATE: (O!O<5ICf\ " . if TO: Bu i 1 ding Depa rtrnent '. FRO~1: Springfield Fire Department .SUBJECT: Structural Damage to Building Address or 1 ocati on of bU,il ding Name of O\'mer C:nv"1 ]2..e<t.J I :Type of building o-C.-kr.:L ~'iJll,~\'/)'1 ( Dwell i11g , "ior 0 . C.:.> ,,-., t>'\e.;-Cc, l '/ <.- '> ~jy ~~CF~ frl{MJl Warehouse, etc.) Store, . Estimated value of building $ .Estimated loss to building $ Date of fire l () I (?':5 1'1 c:;- Location of damage in building ~ i'O,v_n', , ( Rc4,;- s.fc, ..,~ !../" " . l2..cz<1.r de} ,.<,/0') '> h:u'i'\' t, '" It I rA,H-cI-{ {,'vv,( ,-CLVdr l( ~<; ~...,.., I;,i'l' '2. ,..Jt{eJo~- 'b {'-e-'lf- ,g{ !:>v; Ic:V~, (Roof, Wall, Exteriof, Interior, etc.) .~ ~,~....- ,5vrAeJ r~f~-Kr<; , (Burned rafters, 5<"iKJ' ~ ~'1 c1. 4 V~~,,-) ~."2..,A 'S;~ '7 +I'i Structural weakness as a result of the fire B 1 ' .. earns, ,-,01 S :..S , etc. ) Additional pertinent information . Electrical 'Hazard . Ovel\.'\.lA'~ I,)/-.,t'\ b.,J~~...{ r ,./ir-i:) . ried'f'OlCLA.. ~W,,'.tz,.I"'S {CAr VH~' .c{,?ir"laj""~ vir-i'j C{l<;.;." (Wlrlng, Outlets, etc.) '. D'.I cc: '/ Lv (ly{ () 10- iO- Cf5 Signed~lIl ;t~l f . \./ ,lJil(J-vLtJ-f