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2 � . <br /> PYROTECHNICS PERMIT CHECKLIST--- <br /> Btus Cross/Blue Shield Family Day 2002 <br /> Noah Carolina General Statue 14.413 empowers County Commissioners in the State to Issue <br /> permits for the use of pyrotechnics in connection with shows of all descriptions after satisfactory <br /> evidence te produced to the efhct that the pyrotechnics will be used for the aforementioned <br /> purposes and no others. <br /> The Orange County Commlalonera have adopted a poky which cites the completion of the <br /> following criteria as prarequishe to the Issuance of a pyrotechnics permit. Verification of the <br /> receipt of information will be evidenced by the signature of the appropriate official on this form. <br /> Only after all criteria listed below have been met will the permit be Issued. It should be further <br /> noted that all signatures must be written on the face of the permit in order for the permit to be <br /> valid. Penalties for use of pyrotechnics without a permit are cited In the North Carolina Building <br /> Code,Administration and Enforcement,Volume 1A,Chapter 8.1. <br /> CRITERIA APPROVED BY DATE <br /> 1. LETTER OF REQUEST RECEIVED FROM SPONSORING AGENCY Yes 4-10-02 <br /> 2. FIRE DEPARTMENT CONFIRMED ADEQUATE FIRE PROTECTION YeafTown of Chapel Hip 4-10-02 <br /> MEASURES WILL BE OBSERVED AT EVENT. Fire Department <br /> S. LAW ENFORCEMENT CONFIRMED THAT ADEQUATE MEASURES Yes/Town of Chapel HID 4-10-02 <br /> WILL BE IN PLACE TO ENSURE PUBLIC SAFETY DURING EVENT. <br /> 4. QWUFICATIONSiLICENSE SUBMITTED FOR PYROTECHNIC Approved by Town of 4-10-02 <br /> OPERATOR Chapel Hip Fire Dept. <br /> * SITE LAYOUT SUBMITTED BY THE PYROTECHNIC OPERATOR. Town of Chapel HB Firs 440-02 <br /> DqpL <br /> 8. INVENTORY OF PYROTECHNICS TO BE USED SUBMITTED Wpl be approved by Town 4.10-02 <br /> of Chapel HIP Fire Dept on <br /> day of display <br /> 7. CERTIFICATE OF INSURANCE FOR GENERAL LIABILITY COVERAGE Pam Jones reviewed. 4-10.02 <br /> RECEIVED;MUST INCLUDE COUNTY AS A NAMED INSURED ON THE Names County as <br /> FACE OF THE CERTIFICATE:MINIMUM LIMIT$1,000,000 PER Additional Insured as <br /> PERSONIPER OCCURRENCE. rougkad:aocepabe prnib <br /> 8. LOCATION OF PYROTECHNIC DISPLAY HAS CURRENT FIRE Yes/Town of Chapel HIIL. 4-10-02 <br /> INSPECTION AND IS IN COMPLIANCE WITH THE STANDARD FIRE <br /> PREVENTION CODE,1968,WITH NORTH CAROLINA AMENDMENTS. <br /> 9. SHOW SET UP HAS BEEN APPROVED BY THE FIRE OFFICIAL IN Chapel HUI has approved, 4.10-02 <br /> APPROPRIATE JURISDICTION PRIOR TO THE BEGINNING OF owwrpent upon County <br /> SHOW. I approval <br /> CERTIFICATION RESPONSIBILITIES: <br /> ITEMS 17: ORANGE COUNTY DIRECTOR OF PURCHASING AND CENTRAL SERVICES or ORANGE COUNTY <br /> DIECTOR OF EMERGENCY MANAGEMENT OR DESIGNATE. <br /> ITEM 8 JURISDICTIOWS FiRE OFFICIAL <br /> ITEM 9: ORANGE COUNTY DIRECTOR OF EMERGENCY MANAGEMENT OR DESIGNATE"NOTE: THIS <br /> SIGNATURE CERTIFIES THAT THE FIRE OFFICIAL IN THE APPROPRIATE JURISDICTION HAS MADE <br /> THE SET UP INSPECTION. IT IS NOT INTENDED TO INDICATE THAT THE COUNTY'S EMERGENCY <br /> MANAGEMENT DIRECTOR MUST INSPECT AND APPROVE SET UP PERSONALLY. <br /> FOLLOWING CERTIFICATION OF ITEM 9,PLEASE RETURN THIS FORM TO THE PURCHASING AND <br /> CENTRAL SERVICES DIRECTOR. <br /> Thursday, April 11, 2002 (5).max <br />