Download Application for Fire Licence for Industries, other Establishments

West Bengal Form No. 393 Z (14) WEBSITE VERSION APPLICATION FORM Under .Section 15 of the West Bengal Fire Services Act, 1950 (West. Bengal Act XVIII of 1950) as subsequently amended, read with Government Notification No. 813/F2E-101/63 dt. 23.2.65 under Section 23(1) of the Act To The Collector, Fire Licence Section Writers' Buildings Main Block, Top Floor Western Side Kolkata-700 001 Sir, Under the provisions of Section 15 of the West Bengal Fire Services Act, 1950 (West Bengal Act XVIII of 1950), as subsequently amended. I/We beg to apply for new/renewal License for my/our warehouse/workshop described below, for the period of one year .with effect from the.................. A plan (duplicate) of the warehouse/workshop drawn to the scale of one metre to a centimetre, is annexed herewith. Yours faithfully, ( BLOCK LETTERS) Signature in full : Name in full : Address In full : Present : Permanent : Date : Number and date of last License issued, if. any:, 1.Ward No.................... .................................,I.A. Area. 2.Premises No.. . . . . .. . . . . . . . . . . .. . . . . .. . . . . .. . . . . .. . . . . . . . . . . .. . . . . .. . . ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... .. ... .. ... .. ... .. ... .. ... .. ... .. ... .. ... .. ... .. ... .. ... .. ... .. ... .. .. 3.Description of the warehouse/workshop. . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . . . ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... .. . ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... .. . ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... .. Downloaded from www.barrackpore.gov.in, the official website of Barrackpore Sub-Division ( 2 ) 4.Name and maximum quantity of the, article or each of the articles to be stored, pressed or kept. ............. .. ... .. ... .. ... .. ... .. ... .. ... .. ... .. ... .. ... .. 5.Description of buildings . . . . . . . . . . .. . . . . . . . . . . .. . . . . .. . . . . . . . . . . .. . . . . . . . . . .. . . . . .. . . . . . . . . . . .. . . . . .. . . . . ... . . . . .. . . . . . . . . . . .. . . . . .. . . . . .. . . ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... . 6.Name of owner ofthe building or place. . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. 7.Name of occupiers with their office address . . .. . . . . .. . . . . . . . . . . .. . . . . .. . . . . .. ................................................................. 8.Annual municipal value of the warehouse/workshop or annual value as assessed by the Collector . . . .. . .. .. . . . . . . . . . . .. . . . . . . . . . . .. . . . . .. . . . . . . . . . . .. . . . . . . . . 9.Description of structure and nature of occupancy with immediate 20 feet all round of the proposed warehouse/workshop.. ..... ..... ..... ..... ..... ..... ..... ... 10.Name of the Insurance Company, if the premises be insured . . . .. . . . . .. . . . . .. . . . . . ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... . 11.Exact number of water/sand bucket and extinguishers provided on, site and each indicated, onplans, . . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . . .. . . . 12. Total floor area of the warehouse/workshop (each floor separately) . . . . . . . . . . . . . . . . . ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... . 13.State water­ (i) Sprinklerisinstalled................................................. (ii) Hydrant system is installed; if so, give capacity of pump in gallons per minute and normalworking pressure and number of hydrants fitted . . . . . . . . . .. . . . . . . . . . . .. . . . . . ... ........... .................................................... (iii) Distance of nearest open water ( i. e. river or tank ) with access details and proximate area and depth . . . .. . . . . .. ... . . . . . . . . .. . . . . .. . . . . .. . . . . .. . . . . . . . . . . .. . . . ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... ..... . Downloaded from www.barrackpore.gov.in, the official website of Barrackpore Sub-Division