FORM OF General Information to be accompanied with the checklist FIRE DEPT.,

General Information to be accompanied with the checklist
Annexure-I to Circular Memo.Rc.No.5880/E1/2002, dt 28.9.2004.
A.P.FIRE AND EMERGENCY SERVICES DEPARTMENT
General Information to be obtained from owners/occupiers of
HIGH RISE BUILDINGS TO ENSURE SAFETY OF INMATES
Sno Item Particulars to be furnished by marking() Check Points
1 Name and address of Owner/Occupier and telephone No’s
2 Location and Address of the Building
3 Area of Site(in sq.mtrs)
4Type of Occupancy
5 Height of the Building from abutting road level to terrace (in mtrs.)
6 No. of Floors with Height(in mtrs)
7Approximate No. of inhabitants/Occupants
8Total Builtup area of the Building
9Details of No. of Blocks with heights and interdistance
10Means of Escape
a) No. of Internal Staircases
b) No. of External Staircases
c) Width of Internal Staircase
d) Width of External Staircase
11Whether No. of Internal Staircases provided comply with requirements of NBC of India(1 No. for every 22.5 mtrs. Travel distance)
Yes No NA
Sno Item Particulars to be furnished by marking() Check Points
12 Whether No. of External Staircases provided comply with requirement of NBC of India(Minimum 1) Yes No NA
13 Whether Width of the Internal Staircases complies to requirement of NBC of India
Occupancy Min Width
Residential 1mtr
Assembly & 2 mtrs
Institutional(Hospitals)
All Other Buildings 1.5 mtrs Yes No NA
14 Whether the min. width of External staircase i.e 1mtr as per NBC is provided Yes No NA
15 Whether Refuge Rooms (Between 24 meters to 39 mtrs height) is provided Yes No
16 Whether Fire Tower (above 24 meters height) is provided Yes No NA
17 Whether Fire Lift (545 kg Capacity) is provided Yes No NA
18 Details of Basement
Whether Min. 01 Entry is Provided. Yes No
Whether Min 01 Exit is Provided. Yes No
Whether Staircase
width(1.5 meters) is mentioned Yes No NA
19 Details of Terrace
a)Whether Overhead tank for fire fighting is provided Yes No
b) Whether Roof Exits provided Yes No NA

Sno Item Particulars to be furnished by marking() Check Points
c) Whether Booster Pump provided Yes No NA
d) Whether Cat walk to
neighbouring Building provided Yes No NA
20 Open spaces provided all around the building (As per Regulation 10 of M.S.B.Regulations, 1981) in mtrs Min Open spaces required are:
15 mtrs and above - 6 mtrs,
16 mtrs - 6.4 mtrs
19 mtrs - 7.4 mtrs
22 mtrs - 8.4 mtrs
25 mtrs - 9.4 mtrs
25 mtrs to 30 mtrs - 10 mtrs
North
East
West
South
21Whether Open Space in the North complies to M.S.B.R., 1981 Yes No
22 Whether Open Space in the East Complies to M.S.B.R., 1981 Yes
23 Whether Open Space in the South Complies to M.S.B.R., 1981 Yes No
24Whether Open Space in the West Complies to M.S.B.R., 1981 Yes No
25Whether width of street abutting the Building(Clause 4.6 of part III) Residential(12 meters) is available
a) Residential 12 mtrs/Commercial/Mercantile upto 1000 sq.mtrs. Above 1000 sq mtrs 12 mtrs – 18 mtrs Yes No
Sno Item Particulars to be furnished by marking() Check Points
26 Whether means of access to premises (as per Part III 4.6 of N.B.C. 4.5 meters) (4.5 mtrs. One Minimum) is provided Yes No
27Fire Detection System(As per clause 7:10:2 Table 20)
Whether Smoke detection system provided Yes No NA
Whether Heat detection system provided Yes No NA
Whether Gas flooding system provided Yes No NA
28 Fire Alarm System(As per Clause 7:10:2 Table 20 of Part iv of N.B.C)
a) Whether Manually operated electrical alarm system provided Yes No
b)Whether automatic (24 meters above) alarm detection system provided Yes NO NA
c) Whether 01 manual Call point for 22.5 mtrs. Travel distance provided Point Yes No
c)
for
29 Whether Wet Riser – cum Down Comer (As per Clause 7.10.2. Table 20 of Part IV of N.B.C) is provided (One for every 1000 sq mtrs Built up area) Yes No
30 Whether Open space around the building is leveled Yes No
31 Whether Exit from premises (4.5 meters one Minimum) is provided Yes No
Sno Item Particulars to be furnished by marking() Check Points
32 Whether Automatic Fire fighting System(As per Clause 7.10.2 Table 20 of part IV of N.B.C) Sprinkler system is provided in Basement/Cellar? Yes No
33 Whether Underground Static Water Tank (As per Part IV Clause 7.10.6 Table 20 of N.B.C of India) (01 Lakh liters capacity) provided Yes No
34 Whether Fire Service inlet One – 4 way Provided Yes NO
35 Whether Courtyard Hydrants (As per part IV clause 7.10.2 Table 20 of N.B.C. of India) are provided? Yes No NA
36 Whether Fire pumps as per Part IV Clause 7.10.6 Table 20 of N.B.C of India are provided
a) One Electrical Main Pump Yes No
b) One Diesel Main Pump Yes No
c) One Electrical Jockey Pump Yes No
37 Transformers (As per Part IV Appendix D-1 1.16 of N.B.C. of India) fire protection
a)Whether 45 liters Foam Trolley is provided Yes No NA
b)Whether Fencing around transformer is provided? Yes No NA
c)Whether Soak pit is provided Yes No NA
38 Whether Lightning protection (As per Part IV Appendix D-3 of N.B.C of India(One) provided
Yes No
39 Whether Control Room (As per Part IV Appendix D-3 of N.B.C of India (One) is provided
Yes No NA
Sno Item Particulars to be furnished by marking() Check Points
40Whether the Hydraulic Platform can be moved all around the building Yes No
41 Whether minimum required fire safety measures as prescribed in Table 20 of NBC to this type of occupancy and height are provided? Yes No
Date :
Place: (Signature)
Owner/Management