FORM 4 for FIRE
FORM 4
SEE RULE 154 (4)
APPLICATION FOR GRANT OF AMENDMENT OF LICENCE TO POSSESS AND SELL EXPLOSIVES
I_______________________________________on behalf of _________________
________________________________________ apply for grant of a licence, amendment
of Licence No. ___________________ for possession and sale of explosives given below.
(Particulars and enclose other documents as required. )
Replies to be written in the Column
1.Name in which licence is required to be granted (see notes below)
2.Status: individual /company/ Society
3.Age (See notes below)
4.Postal Address
Pin Code No.
Telephone No.
Telegraphic Address
Telex
5.Qualifications & Experience of applicant and the technical personal
employed by him (Give individual details and attach separate sheet if
required)
6.Situation of premises :-
State Maharashtra
Distt. Amravati.
Town or Village
Survey No.
Police Station
Railway Station or Steamer Ghat.
7.Explosive proposed to be possessed and sold.
Name & Description Class Division Quantity At any one time one month
1.
2.
3.
4.
5.
6.
8.Are the premises attached to a factory licensed to manufacture explosives ?
If so please the licence number.
9.Have the premises previously been licensed?
If yes, please give :-
i) Previous licence number
ii) Name and Address of previous licence.
iii) Reasons for cancellation/non renewal of previous licence. Yes/No
10.Has the applicant been convicted under any offence or ordered to a execute any bond under chaper VIII of Code of Criminal Procedure 1973,
during the last 10 years ? If yes please give details.Yes/No
11.(a) Particulars of other licences, if any, under explosive act, 1884 held by the applicant during the last 10 years
(b) Was any license cancelled/not renewed ? Yes/No
(c) If Yes, give details :-
12.Details of amendment proposes/Additional information, if any
I hereby certify that the information given above is correct.
Date:- Signature of applicant
Place :- (Authorised person in case of company)
Full Name _____________________
Address _______________________
Notes :- 1) In case where application is made in the name of a company, the names and address of Directors and Partners and the name, address and
specimen signatures of a persons or person authorised to sign correspondence in respect of licence applied for should be given on a separate sheet and enclosed
with his application form. Any change in the above information should be immediately communicated to the lisensing authority and authority renewing
the licence.
2) Age to be given in case the applicant is an individual.
3) Please attach the following to application:-
a) Site plan of the proposed premises. The plan should be drawn to scale and how full approach read net work to the premises, nearby land marks, and
safety distances from nearest protected works.
b) Plans showing construction details of the building mounds, lighting conducts etc.
4)Delete whichever is not applicable.
1) All explosives on the premises shall be kept in a substantial brick stone or concrete building which is closed and secured so as to prevent
unauthorised persons from having access thereto.
2) The interior of every building and receptacle used for keeping explosives and the shelves and fitting therein shall be so constructed or so
lined and covered as to prevent the exposure of any iron or steel, or the detaching of any grit, iron, steel or similar substance, in such manner as to
come into contact with the explosives. Such interior shelves and fitting shall, so far as is reasonably practicable, be kept free from grit and otherwise clean.
3) The building or receptacle in which explosive is kept must be used only for the keeping of such explosive and for no other purpose whatsoever.
4) Explosives of different descriptions which may be kept under this licence shall be separated by an intervening partition of such substance
and character, or by such intervening space, as will effectually prevent explosion or fire in the one communicating with the other :
Provided that :-
a) Small arms intro-compound and safety fuses belonging to the 1st Division of the 6th (Ammunition) Class may be kept with each other without any
intervening partition or space;
b) The various explosives of the 1st Division 6th (Ammunition) Class may be kept with each other without any intervening partition or space;
and
c) the various explosives of the 7th (Fireworks) Class other than those containing chlorates may be kept with each other without any intervening
partition or space.
5) Any quantity exceeding 2.5 Kgs. of an explosive of the 1st Division of the 6th (Ammunition) Class or of the 2nd Division of the 7th
(Fireworks) Class and other explosives exceeding 0.5 Kg. must be kept in a substantial bag, conister or case made and closed so as to prevent any
explosives from escaping and shall be otherwise packed and marked in accordance with the requirements of rules 8 and 9 of the Explosives Rules, 1983.
6) No oil, paints, matches, lights, any article of a highly flammable or explosive nature or liable to cause fire or explosion or any acids
or similar substances, shall be brought or kept on the licensed premises.
7) No tools, implements, balance, weights etc. made of iron or steel shall be kept at any time in the licensed premises, and no person on
8) the licensed premises shall have any iron or steel in his possession, or attached to or on his boots or shoes.
9) The licensee shall keep records and accounts of all stock of explosives in hand and of all sales in Forms 32 and 33 and shall exhibit his
stock and his books and records to any of the officers authorised under rule 179 of the Explosives Rules whenever such officer may call upon him so to do.
10) All sales of explosives under his licence much be effected on the premises described on the face of the licence.
11) All losses, shortages of stock and thefts of explosives shall be reported without dealy to the police station in whose jurisdiction the licensed
premises are situated and to the licensing authority.
12) Free access to the licensed premises shall be given at all reasonable time to any inspecting or sampling officer and every facilit shall be
afforded to the officer for ascertaining that the provisions of the Act and the Rules and the conditions of this licence are duly observed.
13) To possess and sell from a shop fireworks not exceeding 50 Kgs. Class division 2 Sub-division 2400 kgs. of class7, Division 2, Sub Divisions.
14) The sheds for possession and sale of fireworks shall be at a distance at least 3 metres from each other and 50 meters from any protected
works.
15) The sheds shall not be facing each other.
16) No oil burining lamps, gas lamps or naked lights shall be used in the sheds or within the safty distance of sheds for the purpose of lighting.
Any electrical light if used shall be fixed to the wall or ceilling and should not be suspended by flexible wire switches should be fixed rigidly near the
ceilling and a master switch should be provided for each now of shed.
17) Display of fireworks shall not be allowed within 50 meters of any shed.
18) Licensee shall apply for renual of licence at least one month before the expiry date of the licence.
The following documents (attested) required to be submitted alongwith the
application :-
(1) Residential Proof (Retioning card/Election card) (
(2) Birth Certificate or Leaving Certificate.
(3) Education Proof.
(4) N.O.C. from Muncipal Council/Gram Panchayat.
(5) N.O.C. from Fire Brigade Department.
(6) N.O.C. from Land lord.