HomeMy WebLinkAboutMiscellaneous Fire Damage Report 1986-12-26
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FIRE DN1AGE REPORT
OR
ELECTRICAL HAZARD
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DATE:~C. 2 L
i"!8<.
,
TO: Building Department
FROM: Springfield Fire Department
SUBJECT: Structural Damage to Building
Address or location of building 9 J.-S O\YI\"~;c s::t
Name of owner
Type of building \j'-.A..>p\\;,,-,~
(O...s€lling, Store, \~arehouse, etc.)
Estimated value of building S 4/}, 1.)00
Estimated loss to building S SoO
Date of fire \ L - '2 C, _ sCa
Location of damage in building Af+,(.
1'-.) t)r 4, "'; J., .{~ COn:;, x -
0, /V'\ '\.~\.-J
C e "\~'"
(Roof,
0(:' h,.. Ncr-\-\... c.t"\\;,"0'1
Wall, Exterior, Interior, etc.) -
Structural 'lfeakrless as a result of the fire 1(.l.Q.~
~vv',.;t':J;
-\l rU'-' ~ '"
(Burned rafters, Beams, Joists, etc.)
Additional pertinent inrorma tion - I ~,.s
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o'i;: 0"'-.... \-'"'-.e r~\J\"wv... \.
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Electrical Hazard
(V1irinq, Outlets, etc,)
Siqned?Q'-'-~<=- \{"':>I $-- .4;(
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Districtnflncident ~ () ,\ ~ l, \. \ t \c
JAT'.
'2
I MO I OAY I YEAR r
J i).. 2.J~ J 1'1 I~(,I
INCIDENT ADDRESS
92-5 Q('''P'V1f'IL
OCCUPANT NAME Clast., ~nt, Mil
Cv\ P.l'''; c:;. \ O~ ~
BUSINESSOWNER NAME/Last, Fint., MH
DAYOF
WEEK
OWNER NAME I Last, First., Mil
FIRE REPORTED BY /!..ast, Fint. MI)
S4 '" e
~IETHOD OF
ALARM
o Tel~rhooeDirect
o Municipal Alum S~tem
o Privau Alarm S~t~m
_n
County L "'V1~
o Tun 0 Thur o Satu!
o Wod P&. Pri
'ept.Re!lllOndinlt ~O (l'\.i...., ~, e~("l
ALAHM I ARRIVAL TIME I -YIMEBACK 1:-;'
Ol) I SO) 7 L51 '0 01 ~~~EI'C
I CENISUS ~RA1.3 I 31 .3 CLA'sS
DOB (optiooall TELEPHONE
s+
ZIP
11N-M17
L
7'f./-,_<...""O/7
TELEPHONE
I ADDRESS
ADDRESS
DOB{optionall
DOB/optional)
TELEPHONE
ADDRESS
DOB/optiona!l
TELEPHONE
0- Radio
o V~rbal
o No Alarm Rec'd
~911'Ti~Linej
o Voice SiJnal Muni Alarm
o NotClasaifiedAbove
,\1utual Aid lutlnruL~hor lnH!SlLll'ateonlYI
o Received
o Given
o '/A
I ' OF ENGI,ES RESPONDED
o VehieleFire
o Brush. GraM. Leavn
o Trash.Rubbish
('e t II.L (Oft! i,IJ'j~/q..f:;0.1
I MATERIAL FIRST IGNITED WAS MADE OF
Ce..\\", \0'<.<>
15 LE....EL OF fiRE ORIGIN Ili IOto 19ftort CJ -:>u to 49 feet
o Gradelevelto9f~t 0 20to29f~t 0 SOto.O(eet
16 ,,/ Building Cnntenls
VALUE ~OOoo.oo /50',00.00
n :-lU~IBEROF:-;TORIES U :.!st()fIn U ,;tot>stone5
I2llstory D3to4stoties D.tol:?stories
18 BUILDlNGAGE(lnYeanl I BUILDINGSIZEIGmdflrOnlv) rB lOOO.oImsqlt
JOn 0-999 so It 0 s000-9999'!l.ft
19 CONSTRUCTION TYPE D HeavyTimber 0 Unpmttet,St~IBldll
o 5tftl & ("oncrele, J.J hr. J!mt. 0 Pm~t. StfflBlrll 0 PmfKt. MallOnrv Elt. & Wood Int.
E..XTENTOF DA~fAGE CO:-lFINED TO: Flama Smoke DETECTOR PERFORMANCE
I Theohjedorori(in I 0 I 0 OlIn I'I'Klmoforirin-oper.
2 Partofroomorareaoforirin 2 0 20 D:? Notinroomofori~-oper.
:1 Roomo(orilfin 3 it J 0 D:l InrmoforiR'in-nOIOper-firetoosmaU
2Q .. Fire.ratedcor:np.ororiPn 4 0 .. 0 ~ 4 NotinnnoloriJin-lH)toper,liretnoamall
5 Flooroforigin 5 0 50 0 5 lnroomofori~-notoper.powet'd~nneet
6 StlUCtureoforirin 6 0 6 ~ 0 6 Not in rm 01 ol'irin-nutopt'r, powerdiKun,
EJ:tended beyond stNCture()(orilrin 0 0 0 Inroor:no{orilrin-nutoper.deaclbatU"ry
o 8 NOlinronmolorijfin-l'IOtoPt'r.deadb.ttery
o 9 Nodetectorpre:vnt 010 Undetermined
8 , OF FIRE SERVICE PERSONNEL
RESPONDED
-3
9 TYPE OF SITUATION FOUND
3. Strocture Fire
o Outside SIn.LCt. w/value
to METHOD OF 0 Selr.EJ:tinruished
EXTINGUISH~IENT 0 Make.shiftaids
0 PortahleEltinlUish~r
II '0 PROPERTY lJSIo:
,--,,=-\ \'..J '7
M MOBILE I YEAR I MAKE
PROPERTY
-'2 ROOM/AREA OF FIRE ORIGIN
A-1+;c
E EQUIPME~T ,"YEAR I MAKE
INVOLVED
IN IGNITION
13 IGNITION FACTOR
Jr
,e J~i ,,,-J I~
14 fORM OF Ht:ATOF IG:-.iITION
LOSS
~-vo .00
9 Nodamaceoflhel)1)elN/Al
21 REMARKS WealherConditionl/optionaH:
22 Follnw Up Invnliplion &-quested
,JL
Y
2J ~umberollnjurin
Fires,.rvi~
~ber Mllkin~ He~n
~ '
I-< ",_ . \, '
:?S AdaitifloollnlOnnatiun by
'Cue"''':
oJ
814-440-10 fR-84j
I' OF AERIAL A?PARATUS RESPONDED
o OtherlLi..tI
I * OTHER \'EHICl.&.., RESPONDED
(do not include PA'II
I TYPE OF ACTION TAKEN
~ Euinruish 0 Removed Hazard
o Invntication 0 Stand By
o Hand.Laid hOle/hydrant. standplp.o
o ~laslerSIr?am Device
o NntClallilledAhove
o Salv.It'
o NlJlClaUlfled
o Und.trrmined
o Autumatic Elt. SysUm
{2I...Pr?conneethose/tankonly
o Pr?cunntet hose/hydrant, sLandpipt'
I PHOP~HTY CO~IPL!::X (llapplieabl"
I M~DEL
I ,\IORII.Io: PROPERTY l(umplele line Ml
SERIAL,
I LICENSE II
EQUIP~ENT I:-.iVOLVED 1:-: IGNITION cCur:nplete Line EI
MODEL
I SERJALI
I VOLTAGE
~''''
f'('\' V: C,-<5 C; 'I"e.
IIT~IRST IGNITED:
l,.,,;, ~ ""- \ Ar \; 0 '^
U R.lowrro,levrl
o NfllClanified
Othf'r
TOTAL
.5:S "000
U Over70ftoet
o Ohjel:a in Fliltht
o IJndelumined
Vf'hicle and CflnUnts
,.,
,00
,00
~,..oo .tlO
,00
,00
U 1:ltn-.!4Iturin
o 25to49,torin
LJ &0 storIes ur more
U JO,UOO.19.999sqft U 5O.000.99,999~ft
o 20()(l(l.J9<A9....ir 0 10lIOOO.oI99.999soft
o t.:nprurtet, ~1asonry ElL & Wood Int, (El: Unprotected Wood frame
o Pl'lItecled Wood Frame 0 :-Int C!usI(iPd Abuvf'
SPRI~KLER PI-:RFORMANCIo:
10 EquipmentoperalPd
o Equip. shnuld h.lVlI uper,-did nol
;1 0 Equip. present lire loulmall woper,
9 0 NOI cLulili.d above
o 0 Undf'lerminedflrnotr~p"rted
S 0 Nflequipmenlp~nUN/AI
o 500.000 ~ ft
Sprinkl~,. Controlled Fire:
YES 0 NoD
,0
101 Hnda Qpened
o coni. on Mek
If ~-n, who wiD in\.eslicate
Other
~umberoIFallllit;ell
Fin.Se,,'icf'
O,h.r
Titl
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Title
Dale
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