HomeMy WebLinkAbout04070034 Application
S:\Code Enforcemem\CODES & ORDINANCES\Temporary Uses\Temporary Use Application.doc
,
- -~:.
i
.
CITY OF CARMEL, INDIANA. DEPARTMENT OF COMMUNITY SERVICES
TEMPORARY USE APPLICATION
DIVISON OF BUILDING AND CODE ENFORCEMENT
INCOMPLETE APPLICATIONS WILL DELAY PERMIT REVIEW.
APPLICANT/OWNER INFORMATION
APPLICANT NAME \-\-ooS~~/' \.\oopJ IK~\oo^, ~,rQ.wc,.b PHONE II: (>11 ) $'1'1-5'1<;(. I
APPLICANTEMAILADDRESS c..\v\~ ,-~'hoo>\.r~~opl. co", FAX II: Cl"n) S'I-G\'1?1b :
ADDRESS OF APPLICANT C,Y-Si E. "3),"~ S>r-. "'lh~)"'iGO\\~ -::t. IV t.t<:').$O
ADDRESS IIV STATE ZIP CODE
PROPERTY OWNER NAME: c.. '" r ';>
ADDRESS OF OWNER I '\S"\
ADDRESS
(o",,\'J
<';'\4" \):<'>-1
\) (".
PHONE II
-:r.h~~"~if.\'>
CJ
nn ) g'n-'~G I
'"'I~ 4(,').]..6:
STATE ZIP CODE
TEMPORARY USE INFORMATION
NAME OF BUSINESS/ORGANIZATION: _\4 l!>O)\ ~."'" \\oof.$ I \(~\'OO"" ~\r4.\-I"'('~J
LOCATIONOFTEMPORARYUSE '-\ 0\ (., \J. OJ (, \.1..; S\.. l "~iI.Njp';\\~~ 4G:>'b~
DATE(S) OF PROPOSED USE '1 _')..-0., ! 'l-c.-O't HOURS OF OPERATION: 9 P-:tI ~ '\PM
DESCRIPTION OF TEMPORARY USE
'""I.k s.\-,,4 ~ O~ OJ;. s<\.--4 o;;Va..wo.1<J
WILL THE TEMPORARY USE BE OUTDOORS' YES or @
WILL THE TEMPORARY USE UTILIZE A TEMPORARY SIGN? @yor NO
ALL TEMPORARY SIGNS ARE PROHIBITED EXCEPT AS PERMITTED BY 925.07'.09,06 SIGNAGE FOR TEMPORARY USES OF THE
CARMEL ZONING ORDINANCE (REGULATIONS OUTLINED ON BACK. TEMPORARY SIGN PERMIT REQUIRED)
IF APPLICATION IS FOR FIREWORK SALES: 't.
(PLEASE REFER TO ADDITIONAL APPLICATION REQUIREMENTS FClltFIREWORKS SALES ON BACK)
WILL THE STRUCTURE BE USED FOR THE SALE OF MORE THAN 500 ILBS OF FIREWORKS' YES or~
DOES THE STRUCTURE ALREADY HAVE A SPRINKLER SYSTEM INSTALLED? YES or@)
HAS THIS STRUCTURE PREVIOUSLY BEEN USED FOR THE SALE OF FIREWORKS? YES or@
CERTIFICATION AND NOTICE OF INTENT TO COMPLY
I hereby certify that I have the authority to make the foregoing application, that the application and plans filed with the a lication are
correct, and that the operation and conduct of the temporary use will conform e e onmg
~~
Signature at Applicant (REQUIR.CD)
OFFICE USE ONLY (DO NOT WRITE IN)
PERMITI/: (J l.f 0 '1 00 "3 b ~ ZONING
APPLICATION REVIEWED BY: Y DATE: ::t ; ~ ;OJf-
REQUIRED INSPECTIONS (call 317/571.2444 to schedule inspections) I.
o ELECTRICAL(B&:CE) , IRE DEPARTMENT
CELli: / 7/3' 076l1()~02:fooo
)OPERMIT FEE: $250.00
1 s applicable inspection fees
$75.00 (temporary sign fee)
D PARTMENT OF COMMUNITY SERVICES
ClTYOFCAR~6T~\ ~~ cke:4r171;~/50 _
ii'
TO:
CITY OF CARMEL, DIVISION OF BUILDING AND CODE ENFORCEMENT
CITY OF CARMEL, FIR" DEPARTMENT
; C-\.:" Y"'; S C. ~ ,,,,\0$,,,' ". 'APPLICANT/~(CIRCLE ONE)
\\OOS\.I" ~"'D(?51 \(,,\,o~"" 1tl\N.",w~L NAME OF BUSINESS
l..ln~c" \J. '1(;. \,l, S.\-, ADDRESS OF ACTIVITY
~ )~"'pt:\") 1'"":C..f'J '1tj:.';}.500
~-"'f)~<!>'i
FROM:
DATE:
SUBJECT:
SALE AND/OR STORAGE OF 14 G (CLASS C)* FIREWORKS
Any structure that is used for the storage andior sale of 500 pounds or more (including ,
wrapping and packaging) of 14 G (Class C) fireworks is an H-3 occupancy under the 2003 '
Indiana Building Code (sec 3075) and 2003 Indiana Fire Code (see 202), A sprinkler system
shall be tequired for an H- 3 occupancy and the design shall not be less than that tequited for an
occupancy hazard classification of Extra Hazard 2-
(IBC sec 903.24J, IFC sec 90324J),
*1,4 G (Class C) Fireworks include everything from sparklers and ground spinners to bottle
rockets, roman candles and firecrackers.
An application and plans for the sprinkler system must be submitted to the Indiana State
Department of Fire and Building Services, Plan Review Division and a Construction Design
Release must be received before any sprinkler system can be installed,
The City of Carmel, Division of Building and Code Enforcement will not issue a Certificate of
Occupancy permit until all Indiana State Department of Fire and Building Services releases have
been obtained and a final inspection has been made by the Carmel Fire Department for
occupancy.
As indicated by my notarized signature below, I have been informed of (or am aware of) the
applicable Indiana Building Code and Indiana Fire Code requirements for the storage and/or sale
of I, 4 G (Class C) fireworks within Class I structures.
~~
Signature of Authorized Agent
C\,...'U C<>"'~
Print Name
\.\"O!>\<>.r \\,oops /IL...\oo..... ~\ro-""D.^\e.5
Company Name
C. 'i S l 12. 1:6J-"~ S<\- '
Addre~/A/'" O.~
Notar~
~~te: lr I /M
"'Sl'l-Y:'\ \-~Sq1
Phone Numbet
-:s:..~..J\"h~t'O\(> ,"'I.\J
City, State
.l-\Q~( linVl
County of Residence
My Commission Expires; ~/?-O/ 0,
Ltc. '}$O
Zip
.-
- '
" RYAN A. SUN!:'F.RM./lN
".""" t!OTARY PUBLIC, STAT" OF INDI.\IJA
- ,., .' N..JMSEf1 5D2625
QUALIFIED IN HAMILTON COUNTY
L" COMMISSION EXPIRES 06I2lJ1OfJ
S:\Permits\TEMPORARY ILPs\Fireworks Release Form,doc
NUMBER FW46816
OFFICE OF
FIREWORKS
THE STATE FIRE
CERTIFICATE OF
MARSHAL
COMPLIANCE
2004
1. Pursuant to Ie 22-11-14-5, this Certificate of Compliance is issued to the
fireworks manufacturer, wholesaler, importer, or distributor listed below.
Name CHRIS COMBS/KABOOM FIREWORKS
Address
6445 E 82ND STREET
County
MARION
State
IN
zip
46250
INDIANAPOLIS
City
2. The manufacturer, wholesaler, importer, or distributor to whom this Certificat~ of
Compliance has been issued must provide a certified copy of this Certificate of
Compliance to each Indiana approved fireworks retailer who purchases fireworks
approved for sale at retail under Ie 22-11-14-8 from the holder of this Certificate
of Compliance.
3. Such retailer must POST the certified copy of this Certificate of Compliance i~ a
conspicuous place at each location where fireworks approved for sale at retail under
Ie 22-11-14-18 are offered to the pub1ic.
4. This Certificate of Compliance expires
December 31, 2004.
5. This Certificate of Compliance is not transferable, and may be subject to
revocation by the State Fire Marshal for failure to comply with the laws of the State
of Indiana.
06/22/2004
7?(~z7~~
Date Issued
state Fire Marshal
As the manufacturer, wholesaler, importer, or distributor, or its duly authoriz~d
representative, I hereby certify that this is a true and accurate copy of the
2004 Fireworks Certificate of Compliance issued by the Office of the State Fire
Marshal to the holder listed above.
Signature
Title
Date
NUMBER FW468J.6
OFFICE OF
FIREWORKS
THE STATE FIR~
CERTIFICATE OF
MARSHAL
COMPLIANCE
2004
1. Pursuant to IC 22-11-14-5, this Certificate of Compliance is issued to the
fireworks manufacturer, wholesaler, importer, or distributor listed below.
Name CHRIS COMBS/KABOOM FIREWORKS
Address
6445 E 82ND STREET
INDIANAPOLIS
City
County
MARION
IN
State
Zip
46250
2. The manufacturer, wholesaler, ~orter, or distributor to whom this Certificate of
Compliance has been issued must provide a certified copy of this Certificate of
Compliance to each Indiana approved fireworks retailer who purchases fireworks
approved for sale at retail under IC 22-11-14-8 from the holder of this Certificate
of Compliance.
3. Such retailer must POST the certified copy of this Certificate of Complianca in a
conspicuous place at each location where fireworks approved for sale at retail under
Ie 22-11-14-18 are offered to the public.
4. This Certificate of Compliance expires
December 31, 2004.
5. Thie Certificate of Compliance is not transferable, and may be subject to
revocation by the State Fire Marshal for failure to comply with the laws of the state
of I.ndiana.
06/22/2004
~<1 ~->~r;.~<-/
Date Issued
State Fire Marshal
As the manufacturer, wholesaler, importer, or distributor, or its duly authorized
representative, I hereby certify that this is a true and accurate copy of the
2004 Fireworks Certificate of Compliance issued by the Office of the State Fire
Marshal to the holder listed above.
Signature ~ ~
Title
0""Nr
Date
<>") ~ ~O't
) <- ->
~-
~ ~, "----.........._-
- n
2 rl!) F-W
(j)~
x. d.j
..c. ^ ;x-
;:- -
-r> j:
r
o<)r 1- ::n VI
~~ f, t:
;>( ~
x ...t:r ~
,C.
r
-1l
,
-;:(\ l ,
~
8');'{ \ t_<...J]
0 0 \
; , .,
1)
r'I VI cD-J
~
-"
?' p: ):-r Y
-
\
~, ~
-9)..
~o
~
AlA-IIi)
~Q;}4/;r--
/
/
I
)1'7'51fT S-
f
,
/
,
/
/
/
) \; :>
~-
~ ~" ---,-~--.
,
," 2 f)!) EW
(j:) ~
>< c()
..c. - 'X
;: -
-() j::
r
~ -.:n VI
C0, f, [
x: ~
x .L-" ~
..c
"
:J
;I l
E
g\... '{ \ t....;]
0 0 \
~ '1
1)
~ VI enJ
~
.A
T' (r ".r: ,.. y
-
\
9, 00 ~
'X r "9)..
,.f:-/ ~o
--11 ~
,
AlA-I III l,-
~CZJ41(-
,^
.
/
.'
/
/
.'
.'
/
.'
/
/
1~'~4 Ib~~~14~b4 ASSUC1ArED AGENCIES PAGE 01/01
CERTIFICATE OF LIABILITY INSURANCE ' I o~;iM~
~RooUC~R (76$)529-31)30 FAX' (765) 521-456<1 THI8 CERTIFICATIi IS ISSUED AS A MATTER OF INFORMATION
As i d A i ' I ONLY ANP CONFERS NO RIGHTS UPON THE CERTIFICATE
sac ate . gene eo, nc. HOLDER. THIS CERTIFICATE DOES NOT AM6N.D,EXTEN!l.D.R.
'17005, Memoria' Drive ALT&RTHE COVERAGE AFFORDED BY THE POL'CIES B'" 0'"', '
P.p. Box 470
New Castl., IN 47362
'NSU". "H"oosi er Hoops Basketba", Inc.
11 ( I t1~1 ~l::H::I4
~
INSUR&RS AFFORDING COVERAGE
lN3u~A: ",nove" Insurance
, INSUReR.. Cit1~8ns Insurance Group
NAle;, ,
000000 i
6457 E. 82nd ,St.
:Indi anapo 1i s " ,IN 46250-0000
INSUR&R c:~
IN8UR~R 0:
IN&URER E:
, ,
. THe PO~ICle8 OF INSURANC~ ~ISTED a~,ow HAVE aEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDIN'
ANY REQUIREMENT, TERM OR CONDITION OF'ANY CONTRACT OR OTHER DOCUMENTWITH RESPECT TO WHICH THIS CERTIFICATe tAAY 65 ISSUED OR
MAY PERTAIN, THe INSURANCE AFF'OROeC 8Y THE: POLICIES DES:::Rlaj:D HEREIN IS SUBJEc..T TO ALL tH.~ il!R:MS, EXCLUSIONS AND, CONDITIONS OF SUCH
.POllCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCE!) BY PAID CLAIMS. . ~ ' '
I~ T'YPE Oil JNIURANCIi , ,OUCY NUMBeR . EFP!r.TIV& POL N IJMITS I
.. ~",",IW. U""rTY . ,07W 6868157-07 01/01/2004 .01 01/2005 EACH OOCU"",,"CI $ 10000001
,)C .CO~CIA"L GeNEML LIAElILtTY ' DAMAGE: TO RCN1l:C $ ~ SOOO(
_ ~ CLAIMS MADE [!:]. OCCUR MCD C17 (Anyon. pemnj I 500(
....SONAl.. AOV 'NJU"" $ 100000C
GIiNIiRAL AGGREGATE $ 200000C
PAO()u~ - CO,;!P/OP AGO I 100000(
A
A
~LAGCR!~,UMfT AP~8 iteR:
I POLICY I I ~~g I IlOC '
~\TTOMOBIJ.I Ul\B1U'rY
L A~ AUTO
~ All. OWN'\!!O AUTOS
~ SCH!:OUL.!O AUTOS
~ HIRED AUTO'
~ NON..owN~ AUTOS
AHW"6773543-070i/Ol/2004 01/01/2005
OOMBlNED SINGLE I.IMlT
(fa aden\)'
$
WDIl. Y INJURY
(~r pwaon)
$
50000<
BOOIl Y INJURV
(PI!ll&CCkl≪Q
.
" '
PROPERTY OAMAGC $:
(P.,."r;dlWtt)
NAAAlJIC UADILITY
H ,ANY A1J'ro'
WK 033 61 65 05/0172003
$
$
AGG $
$
$
$
.$
, $
05/01/2004 ~.
!.L EACH ACClDIiNT -:- I
OJlolI!R T11AN
....UTOONLY:
AlJTO ONLY. eA ACCIDENT
""ACC
,
, ' . . '
~ceSS/UMBRI!Ll:A LIABIlITY
W OCCUR 0 CLAIMS ~
h ~DUOnBl.'
,H~T10N $
WOIUaDtS OOMPI!NSATIDN AND
IIIPLDYIiR8'IJAIIILITY
8 AHV PllOPA/5TOM'ARTNERlEXeOUTIVE
Of'"1"'1CeRIMl:MDm ExCLUCI:D?
~~I~~.Jt~~~NS llIllow
_Ell
EACH OCCURRENCE
AGGRE!:GATE
E.LOISEASE.EAEMPLOYE $
E.L, OleEASE.. poucv LIMIT .
100 0001
100,0001
500.001
, '.
c.scRlPTION 0' OP&RATIONII LOCATIONSJ VIDIICU81 mtCl.USf0N8 .&0061) D'l' IiND0R8it't1INT ISPEctAL, PROVI&IONII
~ichigan store at Michigan and 96th St.. retail and ohowroom display, hoops. swings, misc.
~acreat;onal items, seasonal items, and,etc.
City of Carmel
J$ssee
Carmel. IN
.
ACORD 25 (2001/08) FAX: (317) 571-2499
" ._._u
ISHOUI.o AtfY OP THe ABOve DUCftl8l!!!O poucres Be CANC!l.UD BefCCiRR THE
EXPIRATION OATaT~BRGO', THB TUlMO INSURl"~ WIll. ENDfA.~ TO MAIL
~_ .DAYII WRITTl1N NOTICB TO TMB C&RTlFlCATI! HOLDIfR HAltBD to THIf LEFT,
SUi FAILURE TO MAA.. GUC1i Nonc; 8MAl-L IMPOC& NO OBLIGATION OR UABlUTY
0" a;...,......1'ro UII...u "HIINeUIlItD ITa AO;l!HTlt OR A!PIU!II!NTATlVE!S.
AUTHORtZSD RBPRIiII!HTATIVI ~----.. I?rJ
Everett Co'e/LKH ~- "'-!. ~
CACORD CORPORATION 1988