163-22 Exhibit - Fireworks at Montclair Golf Club - 2022.pdf

West Orange Fire Department Fire Prevention Bureau 415 Valley Road, West Orange, New Jersey 07052 (973) 325-4175 Fax (973) 669-1080 fireprev@westorange.org APPLICATION FOR PERMIT The Uniform Fire Code states: “Permits shall be required and obtained from the local enforcing agency for the activities specified in this section, except where they are an integral part of a process or activity by reason of which a use is Tequired to be registered and regulated as a life hazard use. Permits shall at all times be kept in the premises designated therein and shall at all times be kept in the premises designated therein and shall at all times be subject to inspection by the Fire Official.” [N.J.A.C. 5:70-2.7(a)] Applicant Name:_Garden State Fireworks Today's Date: May 16, 2022 Organization/Company/Vendor Name:_Garden State Fireworks Address of Organization/Company/Vendor:. 383 Carlton Road, ,Millington, NJ 07946 Phone No, 908-647-1086 Fax No, 908-647-6258 Emergency Contact No. 908-4641080-Augie Santore Block/Lot No., Registration No. Fed ID No. Location of Activity: Date of Activity:_July 2, 2022; Rain Date July 3, 2022 Time of Activity;_9:00PM-9:30PM The above named applicant hereby requests permission to conduct the following activity at the above indicated location: Fireworks display. Montclair Golf Club Grounds 25 Prospect Ave. West Orange, NJ 07052 For keeping, storage, occupancy, sale, handling or manufacture of the following items: —Fireworks 1.3G UN0335-Shells are pre-loaded, See list of materials enclosed State quantities for each category to be stored or used. State the method of storage and uses. Fireworks are kept on locked truck until loaded into their mortars. | hereby acknowledge that | have read this application, that the information given is correct and that | am the owner, or duly authorized to act on the owner's behalf, and as such hereby agree to comply with the applicable requirements to the Fire Code, Township Ordinance, as well as any specific conditions imposed by the Fire Official. Licey tU fuck Applicat Signature Fire Official Signature Fee Amount Permit Type