Application for Licence to act as Licenscd Agency applies for gratt of or renewal of License to act as a Licensed Agencyfor work of providing installation of €quipmeots and mairrterr.rr"i if fireures in any place, building or pan. thereof The particu.lars regarding the I/we certifi that r/we h@;EG,ed;6rac# tnthe department under more.than one name.
Ttlanking you, I Full Name ofthe Applicant ( th caFital lelteia). -ill be a Proprietary Concem or an As2. Whether Licensed Ageocy w +=i+raryry+s. - so.futiou oT p".sori "*n ,s uab.
4 5
6.
a. {upervisory staEgarne, qualifications andadclresses of each.
8 9 freventron and l e satety measures, if any; undertaken and I t) r crrrrrrL.u quarurca'ons ano expe'€nce or the promoter or partners of directors and dealing ll yvur(slop macnlnery, rools and plant -owned by the applicaDt, (location.and and full details to be given).
- site of workshop I 2 been blacklisted in the past by any l3 iyrrcLrisr lrrc apprrcanr nas proouced up to date lncome tax certificate t4 Amount of solvencv "t5 a f"" ofn".
Draft No- Dated. Drawn otr Bank.
16 , urc apprrcarron rs ror renewal or the ex^lrng hcencg rhe detairs in respect of the ricence and t7 Yours faithfully a PARr-rv_Bl cuJARAr GovERNtim$T cAzETTE D(. 19-08_201 4 FOR]VI A2 License to acr as a Licemed Agency for Fire prevention ard rife safety Measures (See rule I l) 246-21 SEAL OF THE OFFICE Place:
Gujarat ( ) Director RAi# Date:Licence is hereby granted or renewed under the provisions ofsub Fire prewenri^- ;-,r r :r^ o_- . , _ _section {l) of section 2g oi the having their registered offtce at ::,::::,:::
for the purposes of the said o"i ;;;",u.,.rtr*il;,,.", ,"-;:measures in relatioD to in class Iocal authority- Subject to the Prevention and L;ie Safelr Measures Rules, 2013, fhe I 28 of.the said Ar, ad rule 20 of the Gujarar .
lici:nce will be valid for a period from, to act as safety Fire ').6-?,2 CUJARA;covERNMENl. ciAZE.r.tE Ex., le-08_2014 [pART_tv_B I,'OR M ,\] (.\i c rrrlc l3) Notice to Licenscd ,{gelrcy for susl)ension or cancellatioD ofLiccnce lo- WHEREAS a Licence to act as a Licensed Agency for the purposes of the Gujarat fire prevJntion and Life SafetSr Measu-es Acg 2013 (Gujarat Act I I of20l3), being a licencc No. dated has been granted or renewed in the name of and the licence so granted or reoewed was subiect to the Provisions ofsection 28 of the said Act and rhe condition!.of licence, s;rccified ir rul€2l of.tlre Gujarat Fire Prevention and Life safety Measules Rules, 2013;
AND WHEREAS it is nohted that you irc guilty of the following acts, namely:_ (.2) AND WHEREAS these acts amount to Now THEREFoRE, in exercise of the p-owers.conferred on me by sub-secrion (l) of section 2g of the said Act(r€ad with sib-section (4) ofsection 28 ofthe said Act), I, hereby call upon you to show cause iD wr itirrg, wittrin i period of30 days from the receipt of ttr is irotice as to why th" licence so granted or renewed . in your favour should not be supended or cancelled- - () Director PAPJ'-rv-Bl GIJJA]iAT GOVERNIVII]NI- (i AZE' r IEI.]X. ] 9.08.201 4 246_23 G' FORI4BT (See suFnrle (l) of rule la) |T'"|T::Y t" ticensed Agencv for compriancerne f rre prevention and l.ife Safety Measures- CERTIFICATE works towards compliancc rrmed other related activitie nder the provisiors of the Chief Fire Officer / Regional Fire Officer / €^ ^-,6^""qr r_ lrc (rtrcer,/ Nominated Ofrcer Signature and .A_ddress of the Licensed Agency.
Liccnce No 246 24 GUJARAT GOVERNMENT GA7.t;:r.Ti ux, 19 08 2014 [PART_IV B IORI4 Ir2 (See sub-rule (2) ol rule l4) Six monthly ccrtificates to be Sivefl by the owner or the occupier for compliance of the Fire prevcrtion and life Safefy Measures CER'I'I}-ICATF] Certified that I / we have carried out inspection of thc Fire Prevention and Life Safety Measures installed in the lollowing building or premises, namelyr .
I /We fi;rther certi8/ that these installations in the above mentioned buildings arc maintailed, in good repair .
and efficient conditions during the period , as uoder the provisions of the cujarat Fire Prerl'ention and Life Safety Measures Act, 2013 (Guj.I I of 2013). Th€ details of the inspection of A.
installations carried out by me/us are mentioned in the report app€nded herewith.
Place: Signature and Address of ihe Licensed Agency.
Date: Licence No:
. Chief Fire Offic?r / Regional Fire Officer / Nominated Officer [*Note:- detailed location and postal addresses are to be provided hore].
E PARt'-tv-BJ- GUJARAT GOV}jITNM}jNT GA7-ETTE EX. 19.08-2014 t,ORM BJ /Sce s,rb rrrlu t l) ot rule 15,) Nutiet for lenroyal ofobjccts ol.guods likely to cause the riik offi.e.
246-25 To, Shri Whereas, Oo"-T:-n! has, by notificarion, *li,x,"__ar.*,^11*;;*,"_dljjilTHl;;*,-.".3::fl *",.Notif carionNo.
occupiers or premises or any J hr; ;r p;#;' ;:';,1^:;.":.
*"0 cause.risk.of fire, to take such precautlons as hay: been cause risk of fire, to take srrch reproduced here belou.- precautions as hav: been ----.-. sars Dol lcatioos and as are And whereas, you are thc owner .,r.r.,,hi-- ^. *^ ",_-.
-.-...-..............-.-.- --- rhe said Gor-#,;"e;;;,iil;#- - *"upier of rhe fo[owing premises, wbich fall in the area mentioned in And whereas. on inspcction of_the aforesaid prem l,.st appcnded her.ewith ar,.: such as are likely io ea thesali.ty_ Dt.
unjer sub_section (2) ofsection 22 ot the C I I of 2013) hereby d]r" v* ,r,r*,iJ;,il:;:il safety and submir rhe ,lp.n i, ,*i*iri y"r.
Place;
Date:
NamJand Designation of the Officcr competent to issuenotice ('specifi the periot consideing rhe wgency to remoye the objects and gootts) 246 26 GUJARAT GOVERNMENT GAZETTE EX, 19-08-2014 FORrV Ii4 /See suLrule (2)of ru le t5) Notice to the owner or occupier to comply IPART-rv'-B 'fo, No -_,-_-_.- ...-., , dated issued to you by ..-.-._...--..,,.---,--.__.-.....-,,-.... .,. and ;h;;il;;i;;;,JT#ffJ,:[$:.".j'[1.,*fl1XH;Hruff".,.1;:,J: ji:
d;
And whereas, it is found that vou -have not complied with the iaid notice and have not rcinoved forthwith the ;l'f ""H:.
or goods to i ptace of safety and rh'ef ,,".i;lll;;;;;"* th"t;;;d;i,nl,ri"lli^" *" Now, thereforc, in exercise of the powers conferred Pr€vention and Life Safety Measures Act,20l3 (Gujupon you to submit your say, if any, addressed to the ...:.....................- ....-. as to why rhe said objects or go taking assistance ofa police Oflicer- Signature and Designation of the Officer- Place :.
Date:
'Ib, GU]ARAT COYERNMENT GAZET]E EX. I 9-08.20 I 4 FORIVI 85 . (See rule 16) Scizure ci Detention or Removal Memorandunr Serial No Place from where Seized Particulars of Seized Property Reasons foi Seizure or Detention or Removal() (2) r1) (4) (5) 246-27 or Detention or Shri or M/s Date. and.Time .----.._-. place of Seizure..- .-....-. Removal of objects or goods -g: !]*i* r.:ourry - .:l:: ::: rrrdT,,: ::iUi*::X :,,+d under su b_sec,ion (2) @ ;:*::t#[il"""tr1arat Fire p'",Inrion -JiiE',s"u?fr"ru.**". Acr, 2013 (Guj l l of 2013) for rhe Signature ofthe person froin whom seized- Signature of the panchas
(l) . Signature Name and Designation of the Officer competent to issue noticePlace;
Date:
._ PART_IV Bl
(l)
(2) Notice{s) No.
24G28 EX.. 19-08 2014 [PART IV.t} Notice(s) No ., .. . . .. . . ..:.
Name of the buiriring or prenrises and Address....
Date and rinte Name and Address ofthe person, in charge and present on the spot Name and Address of rhe panchas_ ResideDt of .-..,,---,. Age .-- --.-.., years- Occupation
(2) Shri/Smi .- ... _...',........,,....,.son/daughter/wife, of _._..,,.....,_...
Resident of-.. . ,-..Age .-..-.- ,.. years- Occupation._.._...-.-..,,..- ,,.._ _ . The Pancharrarna is read over and exprained to us and it is a correct accouut or what w" saw- Signature Name and Designation of the Otficer- Signature ofthe person, in charge of the buildingor premises- GT]JAii-Al' GOVERNMENT GA7-E1-J-}] FOIWI 86 ( See rule lf) .
PANCHANAIII;\ Serial No Place from rvhere Seized Particularb sf Seized Property or objecis or goods Q'rantity Reasons 1br Seizure or -Detenti<in .
_ or Removal' (5)
(l) (2) (3) (4) 3l1fl1,1:ll"; ; a;;" ;; ilX: ;;;l:, ,:
:
, .
llJ *1il:L ,ii IJ' "Jil;;;;e .;'i"oi;i;e .. ...",i,e Xfi:,'r:::::::t ::: ::T::: l..l* above mentioned b'iiai'g '.'p'.,"r'".. il ;,; ;.;:"; ;" .;" J[:]
correct.
.,,.....-_ . seized the following mentioned property which *" .,""i,fy a t"
PART-rv_Bl To, T GOVERNMENT G,.IZE fTE EX- TORMBT (Aee *b-rule (t) of Rule l7) Noiice br cntry and inspectiol i9-08.2014 ' Signature Name and Designation ofthe Officer.
246:29 @ ,, Oy sub-section (l) of scction 24 of t-he I I of20l3) aod sub_rule (l) of rule 25 of urdrt ulrcc nours lrom the time trme, I shall enter and inspect yolr build -- '.-...-__- for the purpose of ascertaining tte id safetyrneasures as required to be provideil by rii riiiler Placc:
Datc:
ts@ GUJARAT GOVERNMENI, GAZEII'I] EX, 19.08-2014 t.oR[I B8 ( See sub rulc(2)ofnrlc i7) Noticc fo A Woman in t[e builrling or.prctliscs tr).tyith(lt_1t]y rclclronr IPART-rv-B " h;;;hrr.......-....-_-- ff, - "'P'.Y or,ot 246-30 To PA R ,.IV B] GUJAR,AT GOVERNMENT GAZT]ITE EX, I9.08.20I4 FORIII 89 ( J.ee rule I8) Inspeclion Report 2- The b.pe* ofoccupancy in the said building or premisbs is as urder,_
(a) Residential O) Educational
(c) Instihrtionlil (O Assenbly
(e) Business (D Mercantile
(g) Ioduskiai
(h) Srorage
(i) , Flazardous Naturc+ of biilding or. premises,_ General Constructional Features [,ow fire risk-cemeqt concrete or bricked_rvall, or Medium fire risk-bricke<t-work and timber, or High fire risk-mqitry tiinber flamed such as timber lleorq timbbr roof, timber_stair-aase, etc_ particulars of lhe building/premises,_
(i) Number ofstoreys and basemenl ifany
(ii) Number of exirs (iiD details ofceiling
2.46--31 .. (a)
(b) a ,rE7 (i") Number ofstair-cases and whether enclosed or opened
(v) Verandah or balconies
(vi) Atticq mezzanine floors, lofls, etc.
(vii) whether prescribed distance in respict of means ofescapes is maintained or not.
f] O." rff:i:
of orher stru*ures wirhin 20 meters all around the buitding and open spaces or approaches Shucfures O North ' (ii) South
(iii) East (i") West
(d) Width of abutting road or street.
Open spaces GUJARAT GOVERNMI.NI- U AZETTE EX,, 19.08.2014 246-32 (.)
(f)
(t)
(2)
(3) Ir'laximum number of occupants, ernployees, visitors_ IPART-IV-B (+Mantion any oftrcse as nay be relevant) Signature Name and designation of the .
Inspecting oIficer, 24G33
PART-IV-ts1 Whereas, after giving you nctice No, GU.TAP.,41 66YERNN,IENT GAreTTE EX, 19.08-2014 FORM BlO lSee sub-rule (l) ofnrJe l9) Nolice regarding inadeqrracies or conlravcrtions regardiDg fire Prevcnrion and life safety measures noticed during inspection To, dated under sub section (l) of section 5 drrect you to of the Guiarat Fire prevention aad Lifc Safety Measures Ac! 2013 (Gujhas or I have inspected tbe iollowing building or prernises, narnely: ,:
ll of2013) &e nominated olficer
(l) a)
(3) I hereby firither direci you to repcrt the compliance in this regard immediatery to the undersigned.
Signature Name and designation of the € B^ and the fire prevention .- therein with reference to the heighr of the building or the natr.rre of rctiriti"" ""-i;; ;;;n .;;:il*, * be provided .promrses or part thereoflrayc been reponed by the norninated officer or are ooticed by me,_
(l)
(2)
(3) 246 34 GU]ARAT GOVERNMENT GAZETTE EX., I9.08.20]4 FORMBII . (See sub_rule (l) oJrute Zi) Nolice for AppbiDtmeot of fiie Safet5r Officer under sectior 12 of abe Act Dat€d:
locatcd (y The Regional Fire Officer br the . Chief.Eire Officer IPART-rv-B Noat -- -]pto.'
Date:
To B PART_tv_BJ GUJARAT GOVERNMEN'| (. i AZETTDEX. 19-08.2014 FOITM IJi 2 {Jr.' s b i l(.(2, (,i I rlL. ) l) (lertiticate ofAppoin{rrrcn t of I,ile Srfety OfficerNo 246-35 Passpon size ' photogcaph of lhe member attesrcd by Rcgional Fire Oficer or the Chicf Fire Oflicer Dated:
C€rtified that Date:
Place:
A son of Shri .......
3 resident of.
In the event of il rvriting, ihe R€gional Fire Officbr or rhc Signatur€ - 2-16-36 GUJARAT GOVERNMENT GAT.ETTE EX;
F'ORM I]I3 . (See sub_rute (l) o/ ruk 2]) F-ire Safety Ccrtificate No- Dated:
IPART-IV ri (name ofthe company / name ofthe owner/occupier) .3:":tlla^:ith rhe firq prevention-and fire safety requirernents in accordance with section lE andverifiedbyrheolficersconcernedof,FireServiceon.............._.-.,..i0""J,r**L.;;;;";;r#:;
lssued.,r . ..,.-___-(name and addresses of the owner or hisrepresentarivc) and that the buirding/prem ises is fit for occupancy with e{rect from for a pe.od of'---- years rn accordance with rures and sutr-ect to compriarce of any specific tuia uy tt"issuing olliccr w Signature (Name anC designation of the authorized signatory). Place.
'Ihe No Objection Certificate issued by . _..,.(reasons to be recorded).
Fire Service_ stand cancelled aird annulleO aue to (Name and designation ofthe authorird signatory) Computer ID-.. - -.._ P.,\Rt tv-Bl 1'cr GTIJARAT GOVIJRNME}J]- G AZT;,1, IE EX. 19.08-?,1) I 4 - FORMBT4 /Sae suLrute (2) of rule 23) ' - A[pticatiou i'o Grant Fi re Safety Certificete 2,i6_f 7 @ Placc:
Date:
Signahrre (Name of the Applicant) Contact details Narne in Full-_. -.,., -. ...,.
Tel. No_ .. -.--_..-..-_....
Srrt,: Application for gart of fire safegr certificate rn rcof building/premises)- ""'spectof .. . '.- --.-.,-at.--,.. . -(acldress Sir This is to inform you thai a frc safety certificate needs to be iss(name of the buildinj rocated "t 'ed in reqcct of--...-.,r,....-.,...........
You are requested bu i Id ing/prem i ses.
F:e$ 246 33 GUJARAI' GOVi|I{NMENT CI A7,ETTE EX., I9-03-2O I 4 FORNI tlt 5 (See sub-rute (2) ofrtie 26) Certilicate for coDrpliance of Fire preyention and Life Safety MeasureslPAR',r'-rv B Tilc details ofthc ,}or-t and rerated activities which I or we have executcd or performed are m€niioned;;list apppnded berewith Place : Sigoa[re and Address of the Fire Safety Olficer.
. 6 Date : Licence No Signature ofthe occupier and the owner [+Note.- For achbui Description and Location of Ruildiug orprcmises Ccrtified that I have execrrted the works towards compliance in relation to Firc prevenrio. ard [,ifeSafety Mcasures to be providccl atrtl perfbrrrned other rclated activities req.ired to be c.rriecl .,,,. ;rt;;,;following buiHing or prcmises, as requirerl undcr rhc provisions ofthe Gujarat riir.c prevc,tion arrd l_ifeSafety Measurrs Ac! 2013 (Cuj. of ZO ij).
PAI(I'-IV-BJ cuJARAl COvt. r( NMET J f i, nz t ; r ret ry. t 9_08-2014 I.'oR}I C I /See ruie ,lg) l:orrn of Dechi:ttiorr By Un.<.tor ( )f A perrrlal 246-39 Declaration By Erector Of pandal Under Section 27 OfThe Acf of tho ercctor of pandal) _having @ do hereby declare that the paodal erected at meters by ....-......... .,... . . ,n.,",".i",i,"-.," ,, r,""" *,;; ";J?#-T__, ...... . _ . _ r;
Fire prevaniaion e 40 of the Gujarat erection ofpandal that the bomplete Arso' it 's decrared that no $.orag/u. pe of the flammabre liquid or gases is dom in the pandar and thatelectrical wiring has been done in conformity with Indian Electricity Rules by authorized persons_ I, also, decrare that folowing kain€d rrre fighting staff shall remain on duty during the occupancy of thepandal:- l " ' ...:.........
2 .. . ........... ...
E^ (Signature oferector of panrlal) 3 246-40 CUJARC.T GOVERNMENT G AZE1'TE EX., I 9 -08-2C1 4 FORM C2 (See sub-rule (2) rute 29 & sub rule (8) rule 3l) Seizurc Orde r IPART-rv-B Hff1i"..:::orr has t,een received from the autirolised 0.. .rr,"..'i"* :#,"H:.T"1:":::::::::;;;;;ffiffi:ii,i,.llT,i"l,Jiil_,,m;:"1i::,"j:::or temprory structure, shamiyara or rcnr or mandap or pard.l "-","d:;"o'";:f or occirpied byyou, or building WHEREAS you have failed to carrv o,,, ,t . ^,r.* ^..,-^ -- -, .
- " "'* " wuuPtco oyJou' 27 ofthe cujaiat Fi." p,"r.nt.;,3#:j[-":^1".t::'*" "uthori::d officer under sub-secrion (l) of section :3:::.:1:i."r,",.oaan"iJi;;;ili,:::TilT;l;ffi ;:fi T,:ilIAIID wEnREAs you have failed to make nepresentation under sub '- "'""!
Fire Prevantaion ano u"rs"r"tvi"r 2013 /crri a^, rr ^..^r.\ 'section (2) of sectrbn 27 ofthe cujarat:Jf:"* ."d Lier sarery Aci. 20,, (d;;;; ;ffi fi* ."".,t3;ffiT r?ffJTf ,l:,#;
Date & Tirne Case No.
___-__ arc not found satisfactory.
NOW THEREFORX I, (n11e - or the Authoriry) =".f LTfl)ITIll:l"l::'."".'"":-;,oj1,'"*'",;",,ilH;:]j;::J"ffi-HIil.';iijj*:#l::1".:*;;;;;.;T"".:# j jl;Hj:Hl:lHH1H encroachrnent ofthethe following goodVobjects for the reasons srated against cach.
(Signature of Authority) Name and Designation and address of the Owner/occupier of the building or premises or To t.
2.
3.
(Name pandal).
st, No- Place frorn *t "r"- to G seized rer;'.,,iy Reasons tu. sdiiEI dctention &-{i9 Part;culars of obie"ti oig,r,rdsio seized PARI_rv_Bl I Name and address ofOtvner/cccupier 2- Name and address ofthe person present 3- Narne and Address ofthe panchas:
A. a) Shri/Smt b) Slo-D/o:lV//o.
c) Resident of d) Age ([ears) GUJARAT GOVERNMENT GAZEI-IE EX. I g.O8-2014 IT()RNI C3 (See sub rule (2) rule 29) Paochnenr:t Case No- Place 246 41 We, the above Panchas are this day. .....-.......-_ _- .'_-"rfl"d Uy Shri,lSmt.
Dale Time *i,i:"j lt ":l:f:eizing ofcertain objects or foods c) a) 0 s) h) Occupation Shri/Snrt S/o,D/o.AVlo.
Resident of Age (Ycars) i) Occupation Place _ _to from address ofthe building/prem iseVpanda I whichwere possessed a,d exposed ilthe p."',sevfiildi./p"ni;#;ilff#i::,j'fl,Jir:ilifl:l'Jn'n'J*,, ,,"nt.n",t ou.;""tvgoo* rrr, i"r, *" t""td'lJ;T.:""'":l*"'{ln-T^o_t:t*r.rion of the officir) ."ir"a t* f.ir"*-irg sl.
No- Place from where Quantity R"rsors fo. s"irraa a-rrddetention Received the copy ofparrchnarra- Signature of ttc owner/occupier Signature of panchas:
GUJARA'| GOVERNMEN'I' GAZETTE EX., I 9-08-2014 FOII]VI C4 (See sub rule (3) ofr e 29 & sub-rale (9) ofrule jt) Notice for Claiming of Seized Goods :
IPART-rv_B 246-42 WHEREAS certain objects,/goods ryere scized (date) from premises located.at case Noon of(address the premises) in dated under section 27 of (Signaturc) Name Designatign Dated:
PIace:
dated vide panchnama No.
the Act WJEREAS ths said objects/goods are now lying at the premises).
NOW THEREFORE I-----_(name) (Designation) having office,.<, 1116 vurLc ::. ,.^,. ,, do hereby call_unon you to remove the said objectVgoods on any ;orkrng day between _IIrs ro Hrs within days atat your risk and cost failing which it shall be presumed thal you donl intend [o clairn ihc.said objectsftoods anit rhe sirme shall be disposed off by way ot public aucrion under the provision of suLsection (8) of section 27 of the Gujarat Fire Prcvantaion and Life Safcty Act, 2013 (Guj_ Act I I of20l3), withour any further notice_
PART IV-IJI No- NOTICE WHEREAS a sum ofRs_ _-- towards the deploymert of the F-ire Sewici is due to be paid by you- CT].IARAT GOVERNMENT G AZE]TEEX, I 9.08 2OI4 FORM C5 (.!ee rule j0) NOW T}IEREI.'ORE, I ?46-43 Date:
(Designatiou) callupon you to pay thc :-aid iruoLrnt rvithin days rhrougir bank draft pa),able to Dir""to., Cu1"."rState Frre Service payablc at _Ganrihinagar_ € Signature () Director, Gujarat State Fire Service - :
@^ 24G44 (]UJAI{.\'I (i()VLRNMINI. (it\ZF]t-ff) F.X , I9 08-20I4 FOITNI C6 (S'ee sub rule (2) of r ule 3l ) NOl'ICE OIIIiIC-IC o}- SURDIVISIONAL 1VI,.\GISTRATE Date:
(name) IPART_rv_r] Nolo, wHEREAS a report has been rcceived irom the Director, Grrarat state Fire service under su6seciion {6) ofsection 27 0f the Act regarding removar of emroachment or objects r goods causing a risk of rrre or (Designation) call upon you to show cause within under suLsection (6) of section 27 of the ,aict- (days) from rEc€ipt of this notjce Signature Sub-Divisional
PART.TV-BJ GUJARA'T CJoVJ,'IINMENT GAZETTE EX, IIORM C7 (&:e sLrt>nrle (3) of rule 3l ) I q-oE 7() I -1 No.
- Declararion by the prontL)ter r;1 thc or g:rnizer or the owrrer or the occup icr ot per rri isr:.r Date:
wmREAS, the undersign promoter or the o.ganizer or rhe owner or the occupier of permiscs are intendingto use the premises bearing R.S,No,/C_S.No./proper! No_uamely:- rvPurur rrt'- having the postcl address.
ffiH;-^,]lTi##:l:,ff::,::.12]_o^i::":,T 27 of the Gujart Fire prevenrarion ana r_ir. sea,,ylMgasrrcs Act, 2013 (Gu-i. I I of 2013) we declare to have made rltvcnlaron and l-il-e se&trq' section (l) ofsectio,27.
rv rrdYs rltaoc measures as prescrl ied io tbe trndcr sub- The aforesaid premisqs shall.be open for irspection to the authorised blficer to access the .o..u.t.o-l ondadcquacy of the measures.
24646 GUJARAT GOVERNMENT GAZETTE EX,, 19-08.2014 FORM C8 . (.5'e€ sub-rule (3) olrule j t) Permissiorr 10 grant use ol.telnperory str uctut-e [PART_rv_B Date :
-located to be used for the following pur-pose To, s^ No.
WHEREAS the building/premises bearing No- Wtierca, tle promoter or the organizer or thc bwner or the occupier of permises have submitted thedeclarnbn dated undpr sub_rule (3) df rule 3l in form .C, The inspection for the aforesaid premisses is carried out on dated h\, -.,+r yrv,rrrr.uJ rJ LzrrrrEu our on oarcd _ by authorisedofficer.
.., . The permission is granted to use. the premises for the aforesaid fir.pos" fror, ,lrt" rodate with the foliowing conditiors.
' Signature . .Aulorised Officer PARt-_tv_Bl GUJhRAT GOVERNMENTGAZET_TE EX t9_08 2014 l.olxv c9 (.Sr.' rirl,,-r.ulc i l0),,t,ule 3l &s1b rulc(lyot rulc tr,1 FORI'l olj .\ ppE.\t, .t.O .I.HE APPELL/\TE AUTII()Rn y .-.......-of2c.
746-41 rcsident of @ Appeal No
6. Relief claiEed.
3, FeeofRs.5fi)0/:hasbqeripaidvidereceiptNo....,.._.-__-,................_....dared_ _...1. Appeal is wittrin time.
'-.: ] No other A;pear or any matter rerating to tbe subject rnattei of tiriS appeat is pending in S igDature of Authorized representatiye, if arty.
Signature ofAppellant {g Appellant:
Si., The Appellant respecffirlly shorveth as under:
2- Grouud ofAppeal.
24648 GUJARA'I' GOVERNMEN'| GAZEI']'E EX., FOR\{ DT (See sutsrule (2) of rule 4l) r 9.08-2014 IPART-IV-B Current date- Fire Report Number.
Form of Fire Report Opr.ational jurisdiction of Fire Station.
Information received from- Name of the caller.
Phme number of the caller- Full address ofthe incident place.
Eafe ofreceipt ofcall- Time ofreceipt ofcall.
' Tinie of departure from Fire Station.
Appoximate distance from Fire Station- Tiue ofarrival at Fire Scene.
Nature of call.
,Dale of leaving from fire scene.
Tirne ofleaving from fire scene.
_ $p ofoccupancy Ocorpaacy details in case ofothers- Category offire- Type ofbuilding Buildiag details in case ofothers_ Details of affected area.
;
a' _ Details if injury.
Details of dearh(s)_ @-^ Divisional Fire Officer I PA\]Jl/+J Tq The Officer-In <tiargg Place:
-Date:
(*Mention any ofthese as may be relevant) 246_49 Sub- ..--- *n, -- Si., r race/building/part thereof bean-ng N.,_. ..--- rocaled ati am.to state ' ' of the Guja --_ dared d^ jd;#ace or bu rdiirg or p..
f':1H y::::*'T,F il"T;iffi ';;: :?::",;::iff !E7 ,*,,.i,?ilf":iiilx:;:j, ,f:,ffi;d{,;,ffi:{..1;1:ii1 rernoved themselves-fror they stiil c,ntin,"'iijl' tr.l, -0,u., In th.e event of non_.b_ F sion or rn occupation iherec ,nd.,.;gn"d ;;;:,::,T,:l1c or rhe orrrer so rnadc un, suppty of etecrriciry ".
,"1 ::lt:
subscclion , ri", ',i" ,^';'*t sub seclion (l) of the saia secrion 26, the watcr lo such *plac. o. bril supply of *ttt'' ""it't^.."'n"t"!tn 26 to direct the authorirv re As r hc person s,, o**,",.'1,-il;
ffi ;:il:'fi :,ff J"{ "[f '*''""'* **r'""ffi i i;
not removed rhcmserves "li?i".LTi,l,,llL".l'fr:1":::-,:lt ionerr +prace or buiriing o. pn., rhcr eor huve direct.the authorities ex"cut"a ro aii"o,n;;#;ffi:".11e ts a non-compliance thereof and I, thererbre, buirding or part rhcreor. comprianp",, ;;;;";;i;;;ff:,f|I,il;rT::;;;:H:,1" ,",0 ,o*." ;l Signature Name and designation ofthe officer_ I I ll 5l') To, 'f he O fficer In-charge' Sub. - * Place/bu ild inglpart rheret occupation thereofln the evenr of non-compliance of the order so nade under sub-section (l) of the said section 26, the undersigned in cmpowered under sub section (2) of thc said section 26 to direct any policc oflicer, having jur isdiction in the atea, to remove such pcrsons ironr *uclr -pface or buildingorpart thereofanrl srrch police officer shall comply with such directiol- S ir, I am to state Oat bY an ord Gujarat Fire Prevention and and directed the Persons in remove thernselves forthwith from such *place or building or part thereof as due to inadequacy of frc prevention and life safety measures, tt'" "o"altion of such place or building to ,h" p"r.o.," oi p-p"rty therein. These persons have lrowever not removed t or building or part the-r-of io compiiance of the order so made and they still co in Tire abovementioned *place, buirding or part the.eof is sitrrate<r within yo,r area ofjurisdiction- As the persons in possession or in. occrrpation of the abovenientioned *place or building or part thereof havenot removed themserves as directed by the said ordet tbere is a non-compriarre thereof and I, therer-orgdirect you to remove such persons from sucri *prace or buirding or part thermf and sear the +prace orbuilding or pait 6ereof as required under sub-secrion (3) ofsectiJr 26 _of thesaid Act- Complian": ;;;behalfmay please be reported to me immediately.
Place;
Date:
(*Mertion any offfbse as may be ieleyant) Signature Name and designation ofihe officer.
BE (See sub-rulc (l ) of nric 43 ) oraler to to renrovc persons fr"tj t";;;t''"cc'/brrildirg to police of{icer in-cltargtr' [PART-Iv-B ^ -t. Pr\ITT-IV.RI (iI,JARA,I C;CVIJRNMENT GAZETTEEX.IS.OS 2OI.I ,,,16 5I IroRM D4 (See rule 45) Order to l)eliver possession Fighting No- Fiqrripnrent or properlr No. Date:
-__. ljor thc purposes of fire fighting operations, or as the case [tlry be,during the ongoing fire 0ghring opelatiors rt the ,r_,r* Or,rr, or premrses, namely nder sub.section (l) ofsection l3 of tle,ll of 2013), read with rule 59 of rhe er the possessioner the possession , the sai vr ,,rut r;rty to tne undsrs ofthis order and after fi releascd from requisition soon ai may be, l_ '2.
Place Tn, ) :
:
e Director/ Chief Fire Officer/Fire Officer GIJJARAT GOvERl.'IivtENt GAZDrcE EX., 19_08 201,r FoRlr D5 ( See rule 46 ) Rcport of Damage Caused to pr emises or propefty by Fire OIIrcer Opcrations, Name of the lrire Station:
IPART-IV_B during Fire !-ightirg and Rescue, Date and time ofcall received- Fire report No. aad date- Name and Address ofthe prernises where fire occurred-:- Description of p,roperty involved- Name ard Address of the premises to which damage causeG__ Nature and extent ofpoperry b which damage caused.- Description ad d€tairs oFdamagti ca,sed to the premises or property in tbe course offire fightingand rescue operations-
(8) Reasons for breaking or pulling dorvn the structures, ifany_ io) CIainrof the amount, ifany.made bythe party_ (i 0) Name and Designation ofthe officer of the authority designated under sub-rtrre (2) of rure 24-
(l)
(2)
(3)
(4)
(5) (.6)
(1) (l I ) I{emarksa . ( l2) Submittcd through By order and in the flame ofthe Govemor ofcujarat, CovEnNMENT CENTR TL PEEss, caN-DEtnacAf,.
NEELA MUNSHI,