Fillable Operating Permit Application (City of Binghamton)

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Operating Permit Application (City of Binghamton)

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The Operating Permit Application (City of Binghamton) form is 2 pages long and contains:

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  • 9 check-boxes
  • 16 other fields

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File type: PDF

U.S.A. forms for City of Binghamton

BROWSE CITY OF BINGHAMTON (NY) FORMS

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Page 1 of 3
Binghamton Fire Bureau
Operating Permit Application
Directions: Complete pages 1and 2 of this application, including any required information on appropriate
Appendices, and return signed application to:
Binghamton Fire Bureau
Office of the Fire Marshal
38 Hawley Street, 3
rd
floor
Binghamton, NY 13901
Fax: (607) 772-7173
If you have any questions, please contact the Office of the Fire Marshal at (607) 772-7123.
Applicant/ Building Information
Applicant’s Name: ______________________________________________________________________________________________________________
Applicant’s Address: ____________________________________________________________________________________________________________
Date of Event: ___________________________________________________________________________________________________________________
Contact Person: ___________________________________________ Telephone: _______________________________________________________
Address of Premises for which Operating Permit is requested: Same as above
Other (specify): ______________________________________________________________________________________________________________
Signature of Applicant
I hereby certify that the foregoing information (and all information in attached sheets, if any) is true and complete.
Signature of Applicant or Authorized Representative Date
Name (and Title, if applicable) of person signing Application (Please print)
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Page 2 of 3
Type of Operating Permit Requested
An Operating Permit is required in order to conduct any activity or to use any class of building listed below.
Please indicate the type(s) of Operating Permit(s) requested by checking each applicable box.
If you require assistance, or would like more information, contact the Office of the Fire Marshal at (607) 772-7123.
Hazardous Materials Storage and Tank Installation/Removal (See Appendix A)– Manufacturing, storing or handling hazardous materials in
quantities exceeding those in Tables 2703.1.1(1), 2703.1.1(2), 2703.1.1(3) or 2703.1.1(4) of the Fire Codes of New York State (see 19NYCRR Part 1225).
Identify the materials and quantities and describe the manner in which the materials will be manufactured, stored or handled. Attach additional sheets if
necessary.
______________________________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________________________
Hazardous Processes and Activities (See Appendix B) – Conducting a hazardous process or activity (including, but not limited to, any commercial or
industrial operation which produces combustible dust as a byproduct, fruit and crop ripening, and waste handling. Describe the process or activity to be
conducted. Attach additional sheets if necessary.
______________________________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________________________
Use of Pyrotechnics in Assembly Occupancies (See Appendix C) – Use of pyrotechnic devices in assembly occupancies. Describe the proposed use.
Attach additional sheets if necessary.
______________________________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________________________
Assembly Occupant Load over 100 persons (See Appendix D) – Use of a building containing one or more areas of public assembly with an occupant
load of 100 persons or more. Describe the proposed use. Attach additional sheets if necessary.
______________________________________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________________________________________________________________
Compressed and Liquefied Petroleum (LP) Flammable Gases (See Appendix E) (E1for LP Exchange Cabinets) – Requirements for the storage, use
and handling of compressed and liquefied petroleum (LP) flammable gases. Complete the form in Appendix E and/or E1 and return it with this application.
Open Burning Permit (See Appendix F) – Requirements for having an open fire must comply with Appendix F as well as City of Binghamton Code of
Ordinances §235-12.
Tent Permit (See Appendix G) – Requirements and prerequisites to erect any tent must comply with Appendix G. Submit sketch with all pertinent
details with this application.
Other (See Appendix H) – Other uses and occupancy classifications determined by the City of Binghamton Fire Marshal’s Office to pose a substantial or
potential hazard to public safety.
Page 3 of 3
For Fire Marshal’s Office use
Inspection Required? YES NO
Inspections Performed? YES NO Date of Inspection _________________________
Tests or Reports required to verify compliance? YES NO
If YES, have tests/reports been received? YES NO
Description: ________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
Application(s) Approved? YES NO
Operating Permit issued by: ________________________________________ Entered in Red Alert by: ____________________________________________
Date Operating Permit issued: ______________________________________ Date Operating Permit expires: ___________________________________
Type of Operating Permit issued: ___________________________________
Conditions of Operating Permit: ____________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________________________________________
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Operating Permit Application (City of Binghamton)

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Completed 2 August 2020

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