AP FM DOCS lailHarnett
Plan Review, Inspection, and Permit Fees
Application Number : 18-sooa4264
$100.00 ElDRB Major Sub Division Prelim Site Plans $ -
$200.00 0 Explosive Material (90 Days) $ -
$100.00 0 Explosive Materials (72 Hours) $ -
$100.00 El Fireworks Public Display $ ioo.00
$50.00 0 Final Inspection $ -
$35.00 +$2.00 per device ❑ Fire Alarm Testing $ -
$35.00 +$2.00 per nozzle ❑ Fixed Fire Suppression $ -
$75.00 ❑ Insecticide Fog/Fumigation $ -
$100.00 0 Pipe Test/UST/AGST $ -
$50.00 0 Plans up to 5000 sq ft $ -
$100.00 ❑ Plans 5001 sq ft to 10,000 sq ft $ -
$150.00 ❑ Plans 10,001 sq ft to 25,000 sq ft $ -
$250.00 0 Plans 25,001 sq ft and over $ -
$35.00 +2.00 per head 0 Sprinkler Certification Test $ -
$50.00 0 Standpipe Testing $ -
$50.00
0 Special Assembly
(ie.amusement buildings,carnivals,fairs) $ -
$75.00 0 Tents/Canopies/Air Supported Structure $ -
$100.00 0 Tank Installation (charge for each tank) $ -
$100.00 ❑ Tank Removal (charge for each tank) $ -
Total Devices/Heads $ -
Total Cost S 100.00
Code Enforcement Official D. Banks Wallace 6/14/2018
r` Harnett
Fire Marshal Division
June 14, 2018
Dan Denning
East Coast Pyrotechnics
Re: Town of Lillington July 4th Fireworks
311 E. Duncan St.
Lillington,NC 27546
Application Number 18-50044264
Mr. Denning,
Thank you for submitting the plans for the July 4th celebration.The plans have been
carefully reviewed by a qualified code enforcement official to examine for compliance
with the North Carolina Fire Prevention Code and all other fire protection regulatory
documents. There are some items that were found during the plan review process that
need to be addressed before a final inspection of the new facility can be given. These
items are outlined and described below.
• Permits
o A permit will be issued for the special assembly that will include the event
as a whole.
o A permit may be issued for other tent areas if the individual tent exceeds
400 square feet or the aggregate area of multiple canopies placed side by
side without a fire break clearance of 12' exceeds 700 square feet.
• Fire Extinguishers
o Portable fire extinguishers shall be provided within a 30-foot(9144 mm)
travel distance of commercial-type cooking equipment. Cooking
equipment involving vegetable or animal oils and fats shall be protected
by a Class K rated portable extinguisher.
o 2A-10B:C fire extinguisher shall be placed at tents/canopies with a travel
distance not to exceed 100' from any fire extinguisher
• 2411.6 Outdoor cooking.
Harnett
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o Outdoor cooking that produces sparks or grease-laden vapors shall not be
performed within 20 feet(6096 mm) from a tent,air-supported,air-
inflated or tensioned membrane structure, temporary membrane structure
or canopy
• 2415 Generators
o Generators and other internal combustion power sources shall be separated
from tents,air-supported, air-inflated or tensioned membrane structures,
temporary membrane structures or canopies by a minimum of 20 feet
(6096 mm)and shall be isolated from contact with the public by fencing,
enclosure or other approved means.
• 2413.3 Refueling.
o Refueling shall be performed in an approved location not less than 20 feet
(6096 mm)from tents,air-supported,air-inflated or tensioned membrane
structures,temporary membrane structures or canopies.
• Permits
o Final inspection will be conducted that day of the event and the permit
will be issued
• 2406.4 Combustible materials.
o Hay, straw, shavings or similar combustible materials shall not be
located within any tent or air-supported structure containing assembly
occupancy, except the materials necessary for the daily feeding and
care of animals. Sawdust and shavings utilized for a public
performance or exhibit shall not be prohibited provided the sawdust
and shavings are kept damp. Combustible materials shall not be
permitted under stands or seats at any time. The areas within and
adjacent to the tent or air-supported structure,shall be maintained clear
of all combustible materials or vegetation that could create a fire
hazard within 20 feet(6096 mm)from the structure. Combustible trash
shall be removed at least once a day from the structure during the
period the structure is occupied by the public.
Thank you again for submitting the plans for the July 4th celebration. Please review the
Harnett
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plans and adhere to any notes and alterations that were made in addition to the original
drawings. These remarks are for the plans that were submitted and its original intent.
These remarks do not apply if the original intent changes or what was submitted on the
above date changes. If you have any questions,please do not hesitate to call this office.
Sincerely,
D. Banks Wallace
Chief Deputy Fire Marshal
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HpRNETlD��RGUDE EC VW1/4 CEV`CES
Application for Plan Rt 1e* Iu )4
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Aprs�'ication p Ig - I V l 4 1.7 M u OFFICR W1/41E
Date Received'. W (13 I I� Ry:
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Name of Project: 10SM& ( f
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Physical Address of Project: J(I E (�ll '
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Plana Submitted By:
Project Phone:
Contact Person/Address: Th11 Detvliel
Contact Email'. ) AY -Dpol\nl1t
' `1) a1 dim� dim� V NA-
Contact Phone: ( _( 041)10 r)- - D�PJ
Contractor's Namellnfo: _Crs4 j
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Contractor's Phone:
• Plans that are submitted will be reviewed as quickly as possible with an average time of review
between 7-10 working days.
• Status checks may be conducted on plan reviews by visiting the website
http:llhteweb.hamett.org/Click2Gov8Pllndex,isp or by calling the Harnett County Central Permitting
Office(910-893-7525,Option#2),or the Hamett County Fire Marshal's Office(910-893-7580).
• Approved plans must be picked up from the Central Permitting Office and all fees paid before any
required inspections can be conducted.
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Fireworks Application
Attached you will find an application fora Fireworks Discharge Permit.This application must be completed
and returned to Central Permitting prior to issuance of the permit. Please slow seven to ten business
days for orocessina.There is a$100.00 permit fee assessed per discharge event?emit fees shall be
paid prior to issuance of Permits. If you have any questions,please feel free to contact us.
Items resulted for permit Issuance:
• Al blanks must be completed on the application.
• Permit holder is required to obtain liability insurance in an amount sufficient to cover the claims of
any person(s)who may be injured or otherwise damaged as a result of the display.The insurance
must name Harnett County as an additional insured and a copy of the Certificate of Insurance
evidencing the coverage must accompany the application.
o Amounts win be debnnined by event
• A detailed site plan indicating the discharge and storage locations as well as distance.
• Manufacturer's technical data sheet of each type of pyrotechnic to be discharged.
Aoalication Index
Section I: Information on the person,group,corporation,association,or entity sponsoring,holding,or
primarily responsible for the event
Section II: Information on the pyrotedmician
Section III: Information on the actual display
Section IV: Public safety information. (Name of fire district where the discharge wil take place,
address of the nearest fire station,and name and address of the nearest medical facility)
Section V: Notarization of the application.(APPLICATION SIGNATURES MUST BE NOTARIZED)
Section VI: Fire Department Comments. (Must be completed by the chief of the local fire department
representing the district where the discharge will take place)
Section VII: For Harnett County Fire Marshal use only
Section VIII: Fireworks Permit Number.
THE COMPLETED FIREWORKS PENNY MUST BE ON SITE DURING THE DISCHARGE OF PYROTECHNICS
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This application must be submitted no later than seven to ten waking days prior to the event to
ensure permit processing.
APPLICANT INFORMATION:
Note:The applicant is the person,group,corporation,association,or other entity sponsoring,holding or
primarily responsible for the event or enterprise for which this permit is requested.
Please type or print
Applicant: &Si COPc67— P*20G EG/+ E cS lI NG
Baling Addren: Pr L> PoK -arci9
Contact Person: Dk1 ben 14l 14
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Contact Erna' n ►4 LDDel Y H I r1-1-.4E442-i74 LJ Nle e l•![7i
Contact Phone: (qia Qb} fifth iXP`Jl L_} -
President or CEO doramocb lf a oa):
la the applicant insured with input to the discharge of flrewmkalpyrotechnics:Yes v No
B covered,specify the source,mount,and coverage period of the insurance:
tun /Tme' ' —c
source: a msi Amount:$
Coverage Period:
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PYROTECHNICIAN INFORMATION:
Note:This is to be completed by the individual who will shoot and/or discharge the fireworks or
pyrotechnics.
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Technician Nana: 2/}-N J s" H 1 14.4-7
Baling Address: 51404 t'
, NC
Contact Email: (���RN 10 l 14 I f-ca FA/ail-KJ ri K
Contact Phone: I7p }93D-S7)(0C-7 ( } -
Bureau of Alcohol,Tobacco and Firearms pm' 4Mlcenee type and number:
Pyrotechnicia s'training and experience:
la the technician insured with respect to the discharge of Breworkslpyrotechnics:Yes No
if covered,specify the source,amount and coverageperiodof the Insurance:
Source: i �(.`.�j ��r1C'12 Amount s
Coverage Period:
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DISPLAY INFORMATION:
Who provided this Information: Applicant: Technician: Both:
Type of display event: Carnival: Exhibition: Fair.
Public Celebration:o' 11 </ Other
the
Pmposed date and time of eventJ UL/ T/1I0 7.OD T
4740
Proposed loationorwe: LItl`tit(-L( )3 t. 311 Ebnicsoot. '
Type and quantity of N•rontalpyrohanlcs to be used and the sequence of the dIsclwgbaMatlng:
5" C ��Ls Feu tL-LPtzucikboems
[?Lose 1 ,2Dx r- 3esh&t k PSK
Estimated duration of the display: do An
o
Specify any safety precautions to be taken:
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PUBLIC SAFETY INFORMATION:
The&Wiry S occur within the following
/ftre district: F--�� L �ram/
Location of the nearest fire station: '7 ✓e-OCk
Meanest medical tuft: [`�I�' -t Lib Mame: C kt- E)s� la —Location: LCA/nc (,71 e--
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CAROLINA
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Applicant Printed Name: ife /—{
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Applicant Signature: lit . Al �
Date: C2 7 f ( ir
STATE OF NORTH CAROLINA
COUNTY OF kJ._
I110.LlJfl2il ifi`4.L(-11(_fti a Notary Public of the County and State aforesaid,do
hereby certify that IQ-X.-IQ-41 h Ili signed and sworn to before me this day.
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Witness my hand and official stamp,this the&day of ,20�v
iaitted. Astklarawl
Notary Public
My Commission Expires: Q/a+1I10/ 8
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FIRE DEPARTMENT COMMENTS:
Note:To be completed by local fire department representing Me district in which the discharge wiY take
place.
Recommendation:Approve: Disapprove:
Chiefs Signature: Dab:
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FOR OFFICE USE ONLY:
NpRNEn COUNN EMERGENCY SERVICES
Fire MaSSts Data Cornmads: CODE COM?U1ARCE
REVIEWEDFOR Co Iw��
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CODECOMPI•IMC
Final Approval: Approved:' 3. OPLA o' Denied:
Conditional approval and*spacial conditions:
Fire Mashes OM*Signature: On
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Fireworks Remit Number: 0 c "14d
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----,d CERTIFICATE OF LIABILITY INSURANCE 5 1M;"'""
THIS CERTIFICATE IS ISSUED AE A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER TMS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFOROEO BY THE POLIGES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER
IMPORTANT: If the areReas holder N an ADDMONAL INSURED,the polcy(tsa)moat be endorsed. N SUBROGATION IS WANED,subject to
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INSURER A:Maxum Indemnity Comoeny 76743
AMMO M URIA•:Riveiport lnsunnre Co
East Coast Pyrotechnics Inc. sauna c:Fverest Indemnity Insurance Co 10851
P O Bat 209 irOJISAoEverest Denali Insurance Company
Catawba SC 29704
INSURER;:
COVERAGES CERTIFICATE NUMBER:2070001023 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
I INDICATED. NOTWTISTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AU.THE TERMS,
EXCLUSIONS MID CONDITIONS OF SUCH P•OOUCIIESS.1 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLUMS.
NLTR S TYPE OF INSURANCE �I1WT POLICY NUMBERI�S�M'WYI IMEpp�YYYI UNITS
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Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement
FIREWORKS DISPLAY:JULY 4,2018
ADDITIONAL INSURED:1)TOWN OF LILLINGTON 2)000NTY OF HARNETT 3)STAFFORD LAND COMPANY, INC EMPLOYEE PROFIT
SHARING PLAN&TRUST
CERTIFICATE HOLDER CANCELLATION
SHOULD ANT OF THE ABOVE OESCMBBO POLICIES BE CANCELLED BEFORE
TOWN OF LILLINGTON THE EXPIRATION DATE TER1OF, NOTICE WILL BE DELIVERED W
PO BOX 296 ACCORDANCE WITH THE POLICY PROWBONs.
LILLINGTON NC 27548
AUTHOR ED REPRESENTATIVE
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ACORD 25(7010/05) The ACORD name and logo are registered maks of ACORD
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Beth Petrich
From: Marshall Parrish <MParrish@lillingtonnc.org>
Sent Wednesday,June 13,2018 11:29 AM
To: Jennifer Brock; Beth Petrich; Lindsey Lucas;Donna Johnson
Subject: Fireworks for 4th of July Town Event
Good Morning,
Zoning is approved for the fireworks display on the 4th of July at 311 East Duncan Street in
Lillington.
Thank you,
Marshall
Marshall Parrish, CZO
Planner and Public Information Officer
Town of Lillington
910-893-0311
This message and any response to this message is being sent on a government e-mail system
and may be subject to monitoring and disclosure to third parties,including law enforcement
personnel.
1