HomeMy WebLinkAbout10-10232 CITY OF ZEPHYRHILLS
5335 - 8TH STREET
(813)780 -0020 10232
BUILDING PERMIT
Permit Number: 1 0232 Address: 38116 5TH AV
Permit Type: SPECIAL EVENT ZEPHYRHILLS, FL.
Class of Work: SPECIAL EVENT Township: Range: Book:
Proposed Use: COMMERCIAL Lot(s): Block: Section:
Square Feet: Subdivision: CITY OF ZEPHYRHILLS
Est. Value: Parcel Number:
lmprov. Cost: :77
Date Issued: 3/11/2010 ( t X�l'`e Name: CITY OF ZEPHYRHILLS
Total Fees: 500.00 -7 f `) Address: 38116 5TH AVE
Amount Paid: 500.00 ZEPHYRHILLS, FL. 33542
Date Paid: 3/11/2010 Phone:
Work Desc: SPECIAL EVENT FIRE WORKS SHOW MARCH 13 ,2010 -FEE WAIVED
PYR• N • O L•' 1 IN - - kki 510.00
Cis ( �
- D P INAL
!l /
REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c) when extra inspection
trips are necessary due to any one of the following reasons: a) wrong address b) condemned work resulting
from faulty construction c) repairs or corrections not made when inspections called d) work not ready for
inspection when called e) permit not posted on job site f) plans not at job site g) work not accessible.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permits required from other governmental
entities such as water management, state agencies or federal agencies.
The payment of inspection fees shall be made before any further permits will be issued to the person owning same
"Warning to owner: Your failure to record a notice of commencement may result in your paying twice for
improvements to your property. If you intend to obtain financing, consult with your lender or an attorney
before recording your notice of commencement."
(v‘ &°°' % '4
CONTRACTOR SIGNATURE PERMIT OFFI R
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
' • 513 - 780-0020 City of Zephyrhills Permit Application Fax -813- 780-0021
Building Department
Date Received • i Phone Contact for Permittln. j S 0 ENII — II
Owners Name Christopher Me1e /Pyrotecnirn of Fpwner Phone Number 800 - 854 -4705
Owners Address PO Box 310, New Castle,PA 16103 Owner Phone Number
Fee Simple Titleholder Name' Owner Phone Number
Fee Simple Titleholder Address I �
JOB ADDRESS I Zephyr Park /Take 7.Pph hire's,{: Lb42
SUBDIVISION I I PARCEL (D#I ! T
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED L NEW CONSTR I ADO /ALT [l SIGN n MOVE I I DEMOLISH
INSTALL REPAIR
PROPOSED USE [ SFR 1 I COMM I I OTHER I I
TYPE OF CONSTRUCTION F BLOCK 1 1 FRAME [] STEEL Q OTHER I I
DESCRIPTION OF WORK 5 min. firework display I
BUILDING SIZE I SG FOOTAGE I HEIGHT I
[-] BUILDING $ VALUATION OF TOTAL CONSTRUCTION
1 I ELECTRICAL $ AMP SERVICE I 1 PROGRESS ENERGY f W.R.E.C. �1�,
[ PLUMBING $ . Ar"""e_ dY\ el `� T
A I I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ` Cy r 1 m , ,^ � r
�
V^rf
I I GAS I I ROOFING I I SPECIALTY I OTHER � g � �y> f
FINISHED FLOOR ELEVATIONS I FL000 ZONE AREA 1 IVES [—IN �.-SR
BUILDER COMPANY I
SIGNATURE REGISTERED I Y/ N 1 FEE CURRENF 1 Y/N 1
Address I 1 License # 1 1
ELECTRICIAN COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1
Address' 1 License ( 1
PLUMBER COMPANY I
SIGNATURE REGISTERED I Y/ N I FEE CURRENT I YIN 1
Address 1 License # 1 I
MECHANICAL COMPANY
SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N 1
Address - '- 1 License # I I
OTHER 1 (_ /N...■•••• COMPANY
SIGNATURE REGISTERED I Y/ N I FEE CURRENT 1 Y/N I
Address ( 1 License if 1
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fonns; R -O -W Permit for new construction,
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stomw+ater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster, Site Work Permit for subdivisions/large projects
COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construction.
Minimum len (10) woddng days after submittal date. Required ensile, Construction Plans, Stomlwater Plans w/ Sit Fence installed,
Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. Ail commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
"'PROPERTY SURVEY required for all NEW construction.
Directions: _ .- .._-= -- -.._........
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement Is required. (A/C upgrades over $5000)
Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized fetter from owner authorizing same
OVER THE COUNTER PERMITTING (Front of Application Only)
Reroofs Sewers Service Upgrades NC Fences (Plot/Survey /Footage)
Driveways -Not over Counter it on public roadways..needs ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed` restrictions'
which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any
applicable deed restrictions.
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or
contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
intended work, they are advised to contact the Pasco County Building Inspection Division— Licensing Section at 727 -847-
8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign
portions of the "contractor Biock' of this application for which they will be responsible. If you, as the owner sign as the
contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges In Pasco
County.
TRANSPORTATION IMPACT /UTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands
that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of
use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89.07 and
90 -07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of
permitting. It Is further understood that Transportation Impact Fees and Resource Recovery Fees must be pald prior to
receiving a "certificate of occupancy or final power release. If the project does not involve a certificate of occupancy or
final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water /Sewer Impact
fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances.
CONSTRUCTION LIEN LAW (Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, t
certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law — Homeowner's
Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. if the applicant is someone
other than the "owner', 1 certify that I have obtained a copy of the above described document and promise in good faith to
deliver It to the "owner prior to commencement.
CONTRACTOR'S /OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work
will be done In compliance with all applicable laws regulating construction, zoning and land development. Application is
hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating
construction, County and City codes, zoning regulations, and land development regulations In the jurisdiction. 1 also
certify that i understand that the regulations of other government agencies may apply to the intended work, and that it is
my responsibility to identify what actions I must take to be in compliance. Such agencies Include but are not limited to:
Department of Environmental Protection - Cypress Bayheads, Wetland Areas and Environmentally Sensitive
Lands, WaterM/astewater Treatment.
Southwest Florida Water Management District - Wells, Cypress Bayheads, Wetland Areas, Altering
Watercourses.
Army Corps of Engineers - Seawalls, Docks, Navigable Waterways.
Department of Health & Rehabilitative Services /Environmental Health Unit - Wells, Wastewater Treatment,
Septic Tanks.
US Environmental Protection Agency- Asbestos abatement.
Federal Aviation Authority- Runways.
I understand that the following restrictions apply to the use of fill:
Use of fill is not allowed in Flood Zone `V" unless expressly permitted.
If the fill material is to be used in Flood Zone "A ", it is understood that a drainage plan addressing a
"compensating volume° will be submitted at time of permitting which is prepared by a professional engineer
licensed by the State of Florida.
tf the fill material is to be used in Flood Zone °A° in connection with a permitted building using stem wall
construction, I certify that fill will be used only to fill the area within the stem wall.
If fill material is to be used in any area, 1 certify that use of such fill will not adversely affect adjacent
properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating
the conditions of the building permit issued under the attached permit application. for lots less than one (1)
acre which are elevated by fill, an engineered drainage plan is required.
1(1 am the AGENT FOR THE OWNER. I promise in good faith to inform the owner of the permitting conditions set forth in
this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work,
plumbing. signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A
permit issued shall be construed to be a license to proceed with the work and not as authority to violate, cancel, alter, or
set aside any provisions of the technical codes, nor shall Issuance of a permit prevent the Building Official from thereafter
requiring a correction of errors in plans, construction or violations of any codes. Every permit Issued shall become Invalid
unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by
the permit is suspended or abandoned for a period of six (6) months after the time the work is commenced. An extension
may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate
justifiable cause for the extension. If work ceases for ninety (90) consecutive days, the job is considered abandoned.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
FLORIDA JURAT (F.S. 117.03) [,,r r� yyJ �ry�t
OWNER OR AGENT i;,rj /1I,�, f(�pl h.1L // i / C fRACTOR
St4scribead and affirmed} before me this Subscribed and sworn to (or affirmed) before me this
VJho istato me or has/have produced Vaho isfare personally known to me or has/have produced
(�
+ / .r� d as identification. as identification.
r i j y /Viw l! r Notary Public Notary Public
Commission No. Commission No.
Name of Notary typed, pointed or stamped Name of Notary typed, printed or stamped
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Marsha Lee Lefebvre, Notary Public
City of New Castle, Lawrence County
My Commission Ex res Ma 1, 2012
41023
NOY /15/2007/THU 04 :59 PM ZEPHYRHILLS BUILDING FAX No, 813 P.002
.
• . •
•
' • •Temporary Sa1es ChecYlicst .
• ` •.City ofZeph '
• _ .5335 8 Street •
• ' .Zephyrhills, Pl. 03542. .
• • Phone r016480.0020/Ii =7g0 -0 021 '
• RRQUIREt O NTS • • •
' t/ .Plot Plan showing setup of location. "
' Notarized fromproperty owner stating their approval. . '
• A"tlanteretardant certificate is TequirecTn. a tent is involved. Inspection is required once tent . • . "
' is erected and prior to opening for business. . .
. Approved certified fire extinguishers per NPPA 10. ' •
• . " No Smgldng Signs must be placed outside entrances.'
' IE there is a wiie fence or chain link fencing must have at least 5 Ft setback from tent and at least
2 exits_ •
M tent has sides, tho sides shah be in. the up position unless there is inclement weather, • '
• • then 2 sides must bein the up position.. • .. • -
• PIRBWORK RBQI)TREMENTS - (in addition to the above) , • . • •
(.....-- of State License. .
• � - Proof of Liability insurance.
, � List of itenas•to be sold at site. •
L - Copy of Drivers License Social Scour' •• • of all personnel dealing
• with the sale of Reworks at the tent ocation. • • •
FEES • •
• . • ' $ 30.00 City Registration. (If Regulated.by.DBPR - Pee is Waived)
• ' X $500.00 - Fireworks fee - Fire Department fee . r.�eo( � F •
• $ 5.00 - Tecnp'ora Sal es. Pee for 1 two days . -
$ 1.00 - Temporary Sales Poo per day for each consecutive day thereafter, not to , •
• : exceed duration of 30 consecutive days and no more than one occurrence • • .
• • • • per calendar year peg Ordhnance #408. •
. S 50,00 - Tent Fee (35.00/BD, 15.00 * /FD) - (*$15.00 waived for Fireworks)
. ' - $ 35.00 E lecteical Fee (if applicable) • ' . . .. - • .
•
' SUBMI I ThD PLAN(S) HAVE BEEN REVIEWED
BY ZEPHYRHILLS/ SHAD OFFICE .
p im er:- • City Date: //
of Zephyrhills � /� � /�
• • Reviewer: • �i?
Applicant: • Pyrotecnico •
Phone Contact: • Marsha LeFebvre — 800 - 854 -4705 • c -' 1 7 - 7 3 7 7 •
•
Address Site: Ze., _ - - . 38116 5th z ve. • Z -., ,'. . 3542
•
Date of Sale: ,3 2010 .
• Ordinance No. 408 dated 1 /26/1987 (for additional requirements) • • .
Zephyrhills Fire Rescue
6907 Dairy Road, Zephyrhills, FL 33542
Fire Marshal Bus (813) 780 -0041
Kerry Barnett Fax (813) 780 -0044
E -mail: kbarnett.c fire.zephyrhills.fl.us
Plan Review #: 10 -022
Project: Founders Day Fireworks Event
Number of Pages: Packet
March 10, 2010
I have received and reviewed the plans for the fireworks show for the 100 year
celebration located at Zephyr Park on 5 Avenue and will allow the project to move
forward. Please note that this review does not eliminate any further requirements as the
project continues moving forward. By receiving permit, contractor acknowledges to
comply with the items listed below. Should anyone have any questions, please do not
hesitate to contact the Fire Marshal's office.
1. Fireworks display shall be in accordance to NFPA 1123 and the remaining
items listed are the main points from the standard.
2. Operator shall be at least 21 years of age.
3. Assistants shall be at least 18 years of age and properly trained. They are
under the direction of the operator.
4. Proper PPE's shall be worn for the event. Long pants, long shirts, eye, ear
and head protection.
5. Event coordinator or fireworks company shall be responsible to section off
around display area and monitor access to only allow those involved with the
fireworks display (set up, operation, inspection).
6. Sidewalks shall be blocked off as indicated on site plan by either event
coordinator or fireworks company.
7. All fireworks shall have proper labeling.
8. Prep area shall be secured from public by minimum of 100 feet.
9. Fireworks company shall inspect all shells following delivery to site to check
for damage.
10. There shall be no smoking within 50 feet of any fireworks.
11. All portions of the electronic ignition devices shall be inspected by the
operator.
12. The electronic ignition devices shall be located at least 75 feet from the
fireworks display.
13. Tents shall not be located in display area.
14. Mortars shall be positioned and spaced so shells are propelled over the fallout
area and to afford protection for the shooter /operator.
15. Mortars and/or racks shall be secured so that they do not reposition during
discharge.
2
16. Floating platform being used for display shall be of sufficient strength and
stability to safely allow display to be fired.
17. Floating platform shall be secured in position so that during the display it
does not become dislodged.
18. Spotters shall be positioned to watch flight and behavior of aerial shells to be
sure they are functioning as intended and shells are not landing outside the
fallout area.
19. Pressurized water extinguishers shall be located at the display site and with
spotters.
20. After display is shot the electronic firing device shall be switched off and
cables disconnected prior to any work in the display site.
21. The AHJ has the authority to stop the display at any time should a hazardous
condition exists; this includes crowd control, adverse weather and high
winds.
22. The AHJ will give final clearance prior to the display being started.
Inspections Required:
1. Pre -site inspection (at least 1 hour before sunset)
2. Post inspection after display
NOTE: Engine Company will be stationed on roadway in Winters Park directly to the
west of display area. They will be in position half hour before the show.
/ 1:11:11
KERR r FIRE MARSHAL
** *Please be advised this review of plans submitted is a cursory review to assist the contractor in
compliance with applicable fire safety codes. This review is not intended to be a final approval of the
submitted plans. It is the contractor's sole responsibility to ensure that the plans are in complete compliance
with all applicable NFPA codes and local ordinances. In the event that further examination or site
inspection reveals areas of non - compliance, it shall be the contractor's sole responsibility, at their sole
expense to bring those areas in compliance. The City assumes no responsibility for the contractor's failure
to be in compliance with all applicable NFPA codes and local ordinances.
Nov 30 04 12133p Public Relations 913- 703.8109 p.
•
SITE INFORMATION FOR FIREWORKS DISPLAY
Organization sponsoring event: Ze hvrhi t i _
Date and time of production: 3/13/10 - approx. 7:OOPM - 5 Minutes
Location of production; _Zephyr Park /Lake Zephyr, 38116 5th Ave. , Zephyrhills, FL 33542
Nano of main operator: _ Chr Reitargo
Number and ages of all assistants:
Confirmation of License held by operator: See attached
Evidence ofpermitee's insurance carrier: , See attached
Number and types of pyrotechnic devices and materials to be
used: See attached
MSDS for pyrotechnics used: See attached
Extinguishers on site (pressurized water — at least 2): 2
Diagram of where production to be conducted (to include point of firing, fall out radius,
and audience location): See attached
Firing safeguards in place:
• circuit testers no more than 25 mA
• power for firing sources be restricted to batteries or isolated power supplies
• firing systems ensures against accidental firing (2 -step interlock)
• not to be left unattended
• smoking prohibited within 25' of the firing/handling area
• appropriate distance from audience (not less than twice the fallout radius)
• all access points are blocked off into firing/handling area
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City of Zephyrhills - g b o$ r`. 0 M F
_ \ 100th Annual Founders' Day Celebration in < -. x r a
'' , to High level Fireworks Display Site Plan' ' 8 w 4. ' g -5 Id' ^*,,
„ Zephyr Park /Lake Zephyr A ; A
;, `ti _ 38116 5th Avenue a Z l` ( f
PYROTECNICCY Zephyrhills, Florida 33542 a- °
V I, A l, F A M I L Y i 1 R E W O R X 1 • 1889
DEPARTMENT OF JUSTICE
Bureau of Alcohol, Tobacco,
Firearms and Explosives
.K nshttrg, 'V 254Q5
February 25, 2010
Pyrotecnico'Of Florida LLC
30435 Commerce Drive Unit 102 Suites .T & L 540090 :CRR /KCU
San Antonio, FL 335764031
5400
File Number: 1 -FL -00366
Premises Address: 30435 Commerce Drive Unit t02 Suites J & L, San Antonio, Ft; 33576.8031
Dear Sir/Madam:
This letter acknowledges receipt of your timely application to renew your. Federal explosives
license/perntit.
The Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) is not able to process your
application prior to the expiration date of your license /permit. However, Federal law allows you
to continue operations under your current license /permit until such time as ATF completes
processing your application. See 5 U.S.C. § 558. This letter, or as explained below, a follow-up
Letter, will serve as your license /perinit until we complete action OD. your renewal. It is referre
to as a Letter of Authorization (LOA).
Since we have not completed processing your application, you may supply a copy of this letter to
other licensees /permittees, e.g., your distributors, for the next six months (or until we corn y lete"
action on your renewal, if that occurs in less than six months) as evidence of our
licensed/permitted status. If we have not completed processing
within six months of the date of this letter, we will send you another your
et er will also be
valid for six months (or until wo complete action on your renewal, if that occurs in less than six
months). This is of course contingent upon your remaining entitled to continue operations under
your current license /permit.
Please direct questions or concerns regarding this letter to Lydia Otalora at 8 77 - 283 -3352.
Sincerely,
Christopher R. Reeves
Chief, Federal Explosives Licensing Center
ATF web address: www.atf,gov
DS Material Safety Data Sheet
4006
DATE PREPARED: January 18, 2006 11� � • . / riff\ "
N . ICO"
TIT &Ii ft IIIf.04T1 . 1111
From: PYROTECNICO
299 Wilson Rd Telephone Number: 800 - 864 -475 M -F 8AM ---5 PM
New Castle, PA 16101 Emergency : CHEMeTEL INC — 800 -255 -3924 - 241112
FIREWORKS 1.3G un 0335
L section II — Hazardous Ingredients / Identity Information
Contains Pyrotechnic Coin positions that are mixtures of solid oxidizers and fuels that
contained in paper and cardboard containers. No Hazard exist during normal handling
and storage.
OSHA PEL — N/A
ACGIH TLV — N/A
OTHER LIMITS —N /A
Section III -• Physical / Chemical Characteristics
I3oiling Point: - NIA Specific Gravity: - N/A
Vapor Pressure: - N/A Melting Point : - NIA
Vapor Density: - N/A Evaporation Rate: - NIA
Solubility in Water: - N/A
Appearance and Odor: - Pyrotechnic Composition is contained In paper or cardboard casings
that may be shaped as cylinders, balls or tubes. Odor is not apparent.
Section IV -- Fire and Explosion Hazard Data
Flash Point: - N/A Flammable Limits: - N/A
LEL: -N /A UEL: -NIA
Extinguishing Media: Deluge with large quantities of water as quickly as possible by FIRE
HOSE from a PROTECTED location. Materials are self - oxidizing.
Special Fire Fighting Procedures: Do not attempt to fight a fire in the immediate area of 1.3G
Fireworks- EVACUATE THE AREA.
1
2
Section IV — Fire and Explosion Hazard Data Continued
Unusual Fire and Explosion Hazards: Fireworks 1.3G MAY MASS EXPLODE IN A FIRE.
DO NOT ALLOW FIREWORKS TO GET WET- Hazardous Decomposition May Result in a FIRE or
EXPLOSION. EXPLOSION MAY OCCUR IF EXPOSED TO SPARKS OR FLAME.
Section V -- Reactivity Data
Stability: - Stable
Conditions to Avoid: - Open Flames, Sparks, High Temperatures, Friction or Impact.
Incompatibility (Materials to Avoid): - Do Not Allow Fireworks to Get Wet.
Hazardous Decomposition or Byproducts: - Decomposition does not occur under normal
circumstances. Smoke Generated by Fireworks may contain gasses that are irritating to the
eyes or mucous membranes. Prolonged Exposure and Inhalation of smoke may cause shortness
of breath or more serious problems when a chronic respiratory condition exist.
Hazardous Polymerization: Will Not Occur
Conditions to Avoid: - Storage in High Temperatures, Moist or Wet Conditions, Keep away
From Open Flame or Sparks.
Section VI — Health Hazard Data
Route(s) of Entry: - N/A Inhalation: -N /A Skin: - N/A Ingestion: - N/A
Health Hazards (Acute and Chronic) : - NIA
Carcinogenicity: N/A NTP ?: - N/A IARC Monographs ?: -NIA OSHA Regulated: - NO
Signs and Symptoms of Exposure: - Prolonged Exposure to Smoke that is Generated during
Normal use of Fireworks may cause Irritation to Eyes and to Mucous Membranes.
Medical Conditions Generally Aggravated by Exposure: - Eye Sensitivity, Respiratory
Conditions.
Emergency and First Aid Procedure: - EYES Should be flushed with Water. Move to Fresh Air
and avoid additional Inhalation of Smoke.
3
Section VII — Precautions for Safe Handling and Use
Stops to Be Taken in Case Material is Released or Spilled: - If Fireworks are spilled, carefully
pick up the material and place in a Cardboard Carton. Keep OPEN FLAMES and Sparks AWAY
and NO SMOKING.
Waste Disposal Method: - Fireworks that fail to go off should be soaked in a bucket of water and
returned to the source where it was obtained. Dry components or powder should be carefully swept
up and placed in a cardboard container then soaked with water.
Burning of Fireworks Waste must be performed in compliance wilh local and state laws.
Precautions in Handling and Storing: - Keep from OPEN FLAMES, NO SMOKING, AVOID
IMPACT of MATERIALS and CONTAINERS of MATERIALS, STORE FIREWORKS IN A COOL
AND DRY ENVIORMENT. FIREWORKS 1.3G MUST BE STORED AND TRANSPORTED IN
COMPLIANCE WITH FEDERAL, STATE AND LOCAL LAWS.
Other Precautions: - Fireworks 1.3G tin 0335 can cause SERIOUS INJURY or DEATH. They
Should only be Handled by Properly Trained and Qualified Personnel, When Shooting these
Fireworks; PERSONNEL SHOULD WEAR PROPER EYE PROTECTION, HEAD PROTECTION
AND NON - SYNTHETIC CLOTHING.
Section VIII -- Control Measures
Respiratory Protection : N/A
Ventilation: - N/A Local Exhaust: - N/A Special: - N/A
Mechanical: -N /A Other: - N/A
Protective Gloves:- N/A Eye Protection: - When Shooting Fireworks 1.3G
Other Protective Clothing or Equipment: - Protective Head Gear and Non - Synthetic Clothing
when Shooting Fireworks 1.3G,
Work / Hygienic Practices: - Store Fireworks in a Cool Dry and Well Ventilated area. Protect
Against Physical Damage and Moisture. Fireworks should be Isolated from all Heat Sources,
Sparks and Open Flame. No Smoking.
3
AOh Headquarters U.S. locations
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'41 , - il\\ hies CaUlr, PA 1Fi16i 77.1 652 1788
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City of Zephyrhills
100th Annual Founders' Day Celebration
Saturday, March 13, 2010
Lake Zephyr
Product List
High -Level
Size Description Quantity
3.0" Shells 15
2.5" Shells 135
2.5" _ 36 Shot Barrage 1
Low -Level
Size Description Quantity
2.0" 36 Shot Barrage 3
1.0" 8 shot Candle 10
38mm 90 Shot Barrage 1
38mm 49 Shot Barrage 1
33mm 100 Shot Barrage 2
30mm 240 Shot Barrage 1
30mm 7 Shot Barrage 3
' �R OCk LOVQ -Rock 'n Roll energy took center stage at the world's most prestigious fireworks venue LaRonric al
Montreal, Canada. Pyrotecnico's design team developed "Rock Loves... ", a five-act thriller that
...."...---._,.........."...".."_...t.? brought the international crowd to its feet and were awarded the coveted Gold Jupiter.
'Y l± rockfoves.com
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,} : SPRING . ILL, FL 3146104020
r�oa: 03 4 ' 1974 six: M T 6-03
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L720705010156 SAFE DRIVER
Dpet anon M a inotof vehicle Constitutes consent to arty sobriety tem requned by IAA
: Qualifications of Fireworlcs/Pyrotechnics Operators
•
f 1 y- fa ll , ; Please Type or Print In Ink To Fill Out This Form
Name: Chris Reitano
Address: 18405 Normandeau Street
City: Springs Hill State: FL Zip: 34610
Age: 36 Date of Birth: 3 / 9 / 74
Social Security Number: 267 -63 -3577
FLORIDA
XMOi'i+i(License Number: 1 FL00366
List of most current previous shows:
1. City of Ft. Lauderdale, FL Date: 12/31/09
2. City of Boca Raton, FL Date: 12/19/09
3, Coconut Festival, Cape Coral, FL
Date: 11/13 & 11/14,09
4 Vero Beach High School, FL
Date: 10/29 & 10/30,09
S Gator Growl, Univ. of Florida 10/16/09
Date:
Please list below any injuries and amounts of any property damages and location of show
that may have occurred at any previous shows:
i
Signature of Operator: 67,,u_ot
a ,
March 9, 2010
City of Zephyrhills
Attn: Jackie
This is a letter of authorization for Brenda Welcher or Main Street Zephyrhills or Chris
Reitano of Pyrotecnico to pick up the permit for the March 13, 2010 display.
Thank you
Christopher Mele
General Manager
Headquarters U.S. Locations
\\ r' PO. Box 149 Atlanta, GA 877 924 0102
a // z �f/ New Castle, PA 16103 724. 652. 1288 Las Vegas, NV 800 956 7976
/ 9
I1 \ \ Mont g omer y AL 800.255 1199 /1\N\ � into @pyrotecmco.corn
E Y ROT E C N 1 C 0 724. 652. 9555 , New Orleans, LA 800. 783. 2513
V I T A L E E A M I t V F I R E W O R K S • 1 8 8 9 800. 854. 4705 www.pyrotecnico.com Tampa, R 888. 352. 7976
March 9, 2010
City of Zephyrhills
Attn: Jackie
The show on March 13, 2010 will be shot electronically.
Thank you
Christopher Mete
General Manager
Qt o DEPARTMENT OF THE TREASURY - BUREAU OF ALCOHOL, TOBACCO AND FIREARMS
^+ M II 7 1s LICENSE/PERMIT (18 U.S.C. CHAPTER 40, EXPLOSIVES)
`.1. r ` 1 p In accordance with the provisions of Title XI, Organized Crime Control Act of 1970, and the regulations issued thereunder (27
, jr,/ CFR Part 555)you may engage In the activity specified In this license/permit within the limitations of Chapter 40, Title 18, United
4 " stf• States Code and the regulations Issued thereunder, until the expiration date shown. See "WARNING" and "NOTICES" on back.
ta �
Christopher R. Reeves
p �R""'� 8 -PA- 073 -23 -2J -12122
O U
MECT ATF Chief, Federal Explosives ceneing Center (FELL) _ 00E4 conRESvot:oEt:cE Bureau of Alcohol, Tobacco FEYearms and E ! -
To 244 Needy Road '. EXP
Martinsburg, West Virginia 25405 DATE Sept. -mbar 1, 2012
Telephone: 1-877-263.:852 'Fax J X04 -61S 4441 t <-.
NAME - Premfses: Addre '. iNGES? you must notify the F at least 10 days before the mows
PYROTECN)CO ._ _ 299 WILSON,9i,
NEW CASTLE, PA -
TYPE OF LICENSE OR PER iT
23- IMPORTER OF HIGM EXPLOSIVES.
CHIEF, FEDERAL ant* ESUCE1SItG
• •
C rtstapher R. Reeves is =
PURCH • • ING CERTIFICATION MaIII e$t} ng Acldr pltiki 3ES? You must notify the FELC at feast 10 days before the change
1 - : t , - t this ' e copy Of 6 GCenae!permlt
issued 10 • t.. ga g: n the act elffed = S VITALS t R
YOTEGHNIC INDUSTRIES INC
' PYROTECNICO
PO B0X 149 • (SIGNATURE OF LICENSEE/PERt.iI11O) NEW CASTL PA 1 61 03 -01 49
The Iicensee/permiflee named herein shall use a reproduction Qf this
license /permit to assist a transferor of explosives to Verity <ahe Identity
and status of the licenseelpermittee as provided in 27 CFR Part 55 6 ;
The signature on each reproduction must be an ORIGINAL signature.;'
ATF F 5400.14/5400.15, Part 1 (8/89)
CERTIFICATE OF INSURANCE ISSUE DATE
ACORD 03/09r2010
PRODUCER This certificate is issued as a matter of information only and confers no rights
SEIBELS & WILLIAMS, INC. upon the Certificate Holder. This Certificate does not amend, extend or alter the
MCGRIFF,
P.O. Box SEIBELS afforded by the policies below.
Birmingham, AL 35202 COMPANIES AFFORDING COVERAGE
800 - 476 -2211
Company United States Fire Insurance
A
INSURED Company James River Insurance Company
Pyrotecnico of Florida, LLC
P.O. Box 310
New Castle, PA 16103 Company Westchester Surplus Lines Ins
Company See Attachment
Company
E
This is to certify that the policies of insurance described herein have been issued to the Insured named herein for the policy period indicated. Notwithstanding
any requirement, term or condition of 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 all the terms. conditions and exclusions of such policies. Limits shown may have been reduced by paid claims.
CO TYPE OF INSURANCE POLICY NUMBER EFFECTIVE LIMITS OF LIABILITY
LT EXPIRATION
B GENERAL LIABILITY 000292602 01 /1 EACH OCCURRENCE $ 1.000,000
(X) Commercial General Liability /14/2 FIRE DAMAGE S 100,000
❑ aeons Made ®Occurrence MEDICAL EXPENSE $ EXCLUDED
❑ Owners' and Contractors' Protection --
PERS. AND ADVERTISING INJURY $ 1,000,000
® Par Protect Cap $2,000,000 Gen Agg GENERAL AGGREGATE S 5,000,000
General Aggregate Limit apples per PRODUCTS AND COMP. OPER. AGG. $ 2,000,000
® Po'fcy ❑ Protect ❑ Location
A AUTOMOBILE LIABILITY 1337289354 01/14/2010 COMBINED SINGLE LIMIT S 1,000,000
Any Automobeo 01/14/201 BODILY INJURY (Per person) S
❑ All O.med Automobiles
(] SUredu'edAutomob1os BODILY INJURY (Per accident) S
❑ H red Automob^es PROPERTY DAMAGE Per accident} $
❑ Non -avned Automob'es COMPREHENSIVE $1000 deductible
❑ COLLISION $1000 deductible
D WORKERS' COMPENSATION 6FR13UB0668N01409 06/22/2009 WC Statutory Limit I X I Other 1 1
AND EMPLOYERS' LIABILITY EL EACH ACCIDENT S
EL DISEASE (Each employee) S
EL DISEASE (Policy Limit) S
[3 EXCESS LIABILITY 000296262 01/14/2010 EACH OCCURRENCE $ 4,000,000
IL Occurrence ❑Clams Made 01 /14/2011 AGGREGATE $ 4,000,000
C EXCESS UMBRELLA COVERAGE G22054752003 01/14/2010 Excess of Underlying S4, Million $ 5,000.000
01/14/2011 $
$
S
S
Fireworks Display Date: March 13, 2010
Location: Zephyr Park/Lake Zephyr, 38116 5th Ave., Zephyrhills, FL 33542
City of Zehyrhills
The above listed are Additional Insured respects to General Liability policy as required by written contract subject to policy terms, conditions and exclusions.
The Certificate Holder is named as Additional Insured with respect to General Liability as required by written contract subject to policy terms, conditions, and
exclusions.
CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF
ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
Authorized Representative
Main Street Zephyrhilis
5224 7th Street }
Zephyrhilis, FL 33542
Page 1 of 2 Certificate l0 a LPLGWYOF
ADDITIONAL INFORMATION ISSUE DATE
03/09/2010
PRODUCER CERTIFICATE HOLDER
MCGRIFF, SEIBELS & WILLIAMS, INC. Main Street Zephyrhills
P.O. Box 10265 5224 7th Street
Birmingham, AL 35202 Zephyrhills, FL 33542
800 -476 -2211
INSURED
Pyrotecnico of Florida, LLC
P.O. Box 310
New Castle, PA 16103
workers Compensation and Employers Liability
** *Proof of Insurance Only * * **
Insurance Carrier: Travlers Insurance Company, issued through:
Florida Workers Compensation Joint Underwrting Association, Inc.
2420 Lakemont Ave. Sutie 100; Orlando, FL 32814
States Insured: Florida
Policy Number: 6FR13UB0668N01409
Policy Period: 6/22/2009 to 6/22/2010
Employers Liability Limits:
Bodily Injury by Accident $1,000,000 each accident
Bodily Injury by Disease $1,000,000 policy limit
bodily Injury by Disease $1,000,000 each employee
Pay: 2 of
Certificate 10# LPLGWYQF
Jacquelint. 3oges
From: Kerry Barnett
Sent: Monday, March 01, 2010 4:05 PM
To: Marsha LeFebvre
Cc: Jacqueline Boges; Bobbie Swetland
Subject: RE: FW's
Marsha,
It is but it will be waived. The City is a sponsor of the 100 year celebration. I copied the building dept on this as well.
Kerry Barnett
Fire Marshal
6907 Dairy Rd
Zephyrhills, FL. 33545
(813) 780 -0041
CELL: (813) 813-714-6326 f5" From: Marsha LeFebvre [ vre @pyrotecnico.com]
Sent: Monday, March 01, 2010 3:59 PM
To: Kerry Barnett
Subject: RE: FW's
Is the fee still $500?
From: Kerry Barnett [ mailto :kbarnett@fire.zephyrhills.fl.us]
Sent: Monday, March 01, 2010 3:55 PM
To: Marsha LeFebvre
Subject: RE: FW's
Marsha,
I have spoken with Chris and we walked the site. I am just waiting on the submittal for the review.
Kerry Barnett
Fire Marshal
6907 Dairy Rd
Zephyrhills, FL. 33545
(813) 780 -0041 -
CELL: (813) 813 - 714 -6326
From: Marsha LeFebvre [ mailto :mlefebvre @pyrotecnico.com]
Sent: Monday, March 01, 2010 3:43 PM
To: Kerry Barnett
Subject: FW's
Kerry, we ar planning on doing a show on March 13 at Zephyrhills Park. Chris Reitano said he contacted someone
from th €fire ., ' pt. However, he is
Off sick today and we can't confirm this. Can you let me know if you were informed of this show? 1 am awaiting the
product list from Chris but I have
Everything else ready for the application.
Thank you
Marsha LeFebvre
Show Coordinator
Pyrotecnico- New Castle
P.O. Box 1 9
New Castle PA 16103
800 - 854 - 4705 -Toll Free
724 - 652 - 1288 -Fax
www.pyrotecnico.com
www.rockloves.com
PYROT CNICO
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LOU'S
'7Th v"v" [� \]T CNICO-
P 4 R L E C � I O-
special fx*
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