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HomeMy WebLinkAboutMiscellaneous Fire Damage Report 1983-11-15 ~' \", " -~ .' . FD-16 < ,- {/ ,'-I <3:') _r6J_ . --' I.. BOdf)~ FIRE DAMAGE REPORT OR ELECTRICAL HAZARD DATE: //-/:,-- '6) TO: Building Department FROM: Springfield Fire Department SUBJECT: litnvtllril 1 n.ma!je ,'" B_ il.:.ffig /(01'Ot./ c..J()ccJ sfoue Address or location of building ~8:3i( n17:U',.. s-f' Name of QI.mer K "ll. J Cl::u:/~ Po 0 15 Type of building ,eonc/'ek block (Dwelling, Store, Warehouse, etc.) Estimated value of building $ Estimated loss to building $ Date of fire /J- /$"-.8'3 >f Location of damage in building (Roof, Wall, Exterior, Interior, etc.) Structural weakness as a result of the fire (Burned rafters, Beams, Joists, etc.) . Additional pertinent information ref(ul"&<' J) e NYIl'if- 1')(' re J+'O<Ji.I a. ( . Electrical Hazard (Wiring, Outlets, etc.) cc: ,~/~A':"-' c;:/ Signed I 'tt- ..,e..,--I- L2~ (' ~ ~v ...... ......L. ',- ......... '-"_ ..Jl.-\..I.c.. '.JL' Vn.......~_'V.l t'u~L. I~LlI..JHl ", '. ... .. -un :ci)"-rRO~ I:XP, OFFICE :F STATE FIItE :\IAItI\L F\'ILi\i:I'D'It:~O' ,),."' ,\ " - NO NO J ..\ t. .' . I Date" line and Locali:~'n-~rE~cr::~~~yAlaTl~.. or Inc'i:fent T - --. -- ~: ~~~~:::fDI~~;;;1 ~f;~':; ~~~ :{-~ <; r,counIY. ~, ~- 7.ipl.S?;i;;~~:'I_ R;~Ondingc:05~~ ~::;:;, f-~i5~ 3, Date of Alarm: Mo,. -1-1-- Day'..J.X... Yr,' iLl.- Day 01 Week'11IC...... ~Iour 01 Day'C!:i!.:iI- How Reported. I)" ,I" '11.' ^ 4. Na.:ne at Occupant/or Business ~ame Kl:tJl..oc:ldc U"loc:./tt; Telephone }lo. ~. Where was O(:CUP~ at time ot inCident Property Operating:- Yes x.- ~o_ 5. Name at Owner ..J Clrl1f"i l) (6~, ('... Address Telephone No. 1'. rued Property Use. Property Complex - Moblle Property. \I-'.mlly Cl......ULn,C. 1.I...r... 00." ~~l. I~t.. "C.I tMulU-u.se lX'e\.lP&l'lC7'1 {Auto. R.R. c.r. mooLl. AoIne, etc.1 , ' ..' I ' ~- (,i L Type ot Situation Found. ~_ __~__~~PIO&l~~~~.1 ~~..!.!:~_.~"!"~,~ Utl.uth"'r:'~~~" ~tc,_l S.-n.:'/{<2.. Type of Action Take"' ,5 ;' h t./t' ~'r;c{o:ti ~..., 1r.J[UtlIUllh~ ftre, Iny~'tJcufon, ~'cu~, ftrll lid. ..,.ahd~. eU:,) . A. o:\IOI3lLE PROPERTY I1'FOIOIA T10:-l ~!odcI Seri::!.! :"-la, License No. & State I Fire Protecti';;" andControl-r---'-'" Year Make 9. No. at Companies: Engine.;L. Aerial- I Tanker- 10. No. ot ~len: Paid. 1/ Volunteer- Sleepers- . 11. Time trom Alarm to Agent ..1.pplication. Method of I:. No. ot Fire Streams Used: Booster- 1 \-Z... 13. Amount ot Hose Used: 11.'1". 2':-1". 14.' ~o. oC Precannects Used; 11:-2". 2~". 15. ~1utual Aid:. Given _ Receiyed _ Name ot other Dept~, Used 16. Time Back in Ser;ice OJc~L Total Time..?5-"li Tt)tal Aooaratus TiJ"':'ie ~5.1.jl-1'. SaIYilge/Re5c~e. Other- No. Men on 1st Er.gine ~ No. :'1en at Fire Scene.LL-- Extinguishment. 21h". "2- Master Streams. J"' :-io. ~"1d Size at Ladde:co Other- Total ~1anhours jt:J..;- """1 _ .;:''-c;-U~ C...,' , , .::' :,.:' :. ~":':,- '. ' .' '- . -.--.-.-------- -' , '. ,:,-.;~;) ItJ':: :'i::::i.:::' q~:. 22. 35. ~.'~'-:~ ",~ i~ ~N Er,~E:;',:E:t\lCf ~<ESIC;~l... C":'L.L SM::::::r ~ :':;-.3,]) :'TiACt-:=:D... :: )'PL;. : :.~ L~K!DSJT \,j:,r:<;<EC A3JVE (/:::'" ,,, /VI c 1-< c- ),) b""ldi" r. :>:~L......!t'J ACT!:JN It-KEN (i!~b): s-i-o..:p S.-Y"IL>/{p Ca,.,...,,.......... I." c., (:'.... C. .Y\ iiJI7'(t./ ,. ,c)c.:Jd A3S I 5T t.J"KE G 1 VEi.J : R;::CEIVED, . :.'''E OF OTHER AGENCY: R=TURt.J~T' ="!C'r';'UT=. "'=S V 'J~ '- ___ _'";.,~ _._'.... ~ i.....' ::.y ,,\'-iC:'~: ALAR:.~ TR;<J"JSi.~ITTAL D::LA.YED:_YES --.lC---!-.JCl; IF YES. WHY? ',','~S 3UIL.DII'JG PRGTE':TED BY DETECTG;?57 YES _NO TYPE: ACT:',;:'TED:_YES ~~8: IF NO. WHY? , "EOUIPMENT YEAR Ir.JFCRr-1ATIQl\l (If a.;:-;;'~' ~::!-::.bZe); f.1AKE r.IOOEL SERI.AL . VOLTAGE (If eny) FOLLOW-UP INVESTIGATION RECLEST ~lADE Te, 8."i/1';'7 DATE, J /- IS- 7'3 bv/'l- By WHOM, y?o.-.--.~ How =;mLES TED: 1,,- 17;!," (Cse t;j~c..b~:]'k ()~ .:'C~lm . /'or ac.;:~t.-:;:..or..::.L 7..1:':C:Y~,'7:ztt.cn.) SIG'~ED 5Y/ '/ ~ TITLE: r:- -a. n-f- . - <>'j' 0,\ TE: 11- J" - ':J