APPLICATION FOR NO OBJECTION CEERTIFICATE FILE NO: SUB: GHMC Fire Prevention Wing Head Office Application for Grant of No Objection Certificate for the Premises No located at ..for Occupancy. A. NAME FO THE APPLICANT 1 Name of the Building Owner: 2 Address of the Premises: 3 Locality: PIN 4 Phone / Mobile No: 5 e-mail B. LOCATION OF THE PROPOSED/ EXISTING SITE 1. Plot No: 2. Survey No: / Village 3 Premises No / Door No: 4 Road: 5 Locality: 6 Mandal: 7. Zone: 8. Circle: 9. Ward No: 10. Ward Name: C. DETAILS OF LICENSED TECHNICAL PERSONNEL / BUILDER (as applicable) 1. Architect Licensed Engineer Structural Engineer ::2:: ::2:: D. DETAILS OF THE PROSED CONSTRUCTION: 1 Site Area (In Sq.Mtrs) 2 Total Built- up) area (in Sq.Mtrs) 3 No. of Floors Sub- Cellar Cellar Ground First Second Third Fourth 4. Use of the Building School Hospital Hotel / Lodge Function Hall Petroleum Pumps Bar & Restaurant Others E. DOCUMENTS SUBMITTED: S. No Document Details Not Required Submitted Not Submitted 1. Application for NOC duly signed by the owners 2. Building Plans (5 Ammonia Prints) duly signed by Owner Architect / Engineer / Surveyor & Structural Engineer, Builder & Fire Contractor. 3. Location (Topographical) Plan: 4. Site Plan (Scale 1: 100) 5. Detailed Drawing of each floor (Scale 1:100) 6. Detailed Drawing of Parking Floors including Terrace Floor Plan (Scale 1:100) 7. Terrace Plan (Scale 1:100) 8 Building Elevation (Scale 1:100) 9. (i) Undertaking on Rs: 100/- stamp paper (As per Form 17) for provisional NOC for school, cinema Halls, Function Halls, Religions Places, which are more than 500 Sq.Mtrs in plot area or 06.Mtrs and above and below 15 Meters height. (ii) Details of 15% Bank Guarantee on the cost of Fire Safety Systems F. FIRE PRECAUTION FEES DETAILS: i) S.B.H, Gunfoundry, Hyderabad. Challan No: Dated Amount ii) GHMC, Head Office, Hyderabad. Challan No: Dated Amount ::3:: ::3:: G. LAND USE: (As per Plan of core area of MCH / Master Plan of Peripheral area /CDA area) 1. Land use in which the site falls as per of Master Plan / Zonal Development Plan. 2. Proposed use of the Building H. All-ROUND OPEN SPACE 1. Plot Area (Net Area) (in. Sq.Mtrs) 2. Height of the proposed building excluding the parking floor Sides Direction (North/South/ East/West) Road width (in Mtrs) Set Back (in Mtrs) Remarks Required Provided Front Rear Side Side 1 Side 2 I. PARKING SPACE (Vide rule 11 & table VI & rule 9.10 (viii) cellar are allowed for plots above 750 Sq.Mtrs only) Area In Sq.Meters Type of Occupancy 1 Sub Cellar 2 Cellar 3 Stilt II OTHER FLOORS DETAILS: 1. Ground 2. First 3. Second 4. Third 5. Fourth 6. Fifth J. STAIRCASES INTERNAL No.S WIDTH EXTERNAL No.S WIDTH ::4:: ::4:: K. FIRE SAFETY MEASURES: Sl. No. ITEMS Required / Proposed Remarks 1. Fire Extinguishers 2. Hose Reel 3 Wet Riser /Down comer 4 Yard Hydrant System 5 Automatic Sprinkler System in Cellar / entire Building 6 Automatic Detection & Alarm System 7 Manually Operated Electrical Alarm System 8 Under Ground Sump 9 Terrace Tank 10 Fire Pump at Ground Level a) Jockey Pump of 180 LPM b) One Electrical & One Diesel Pump of 1620 /2280/2850 LPM. 11 Booster Pump of 900 LPM -- 12 Emergency Lighting with Battery Back up & Auto Glow Exit Signs DECLARATION: I hereby declare that the information provided above is true and correct to the best of my knowledge. I undertake to maintain and keep the Fire Fighting Equipment installed at building in good working condition at all times by regularly servicing and replacing the obsolete equipment and get the staff / Security trained in the usage of the equipment. SIGNATURE OF THE OWNER/MANGEMENT /CORRESPONDENT BANK GUARANTEE BOND 1. In consideration of the President of India (hereinafter called the Government ) having agree to exempt ..(hereinafter called the said owner/Builder) from the demand, under the terms and conditions of an Agreement dated:..made between the Director General of Fire Services, Hyderabad and for providing Fire Safety and Fire Fighting Systems as per National Building Code of India (hereinafter called the said Agreement) of security deposit fro the due fulfillment by the said Owner/Builder of the terms and conditions contained in the said agreement, on productions of a Bank Guarantee of Rs: (Rs in wordsWe, APGUB (hereinafter referred to as the Bank) at the request of (Owner / Builder) do hereby undertake to pay the Director General of Fire Services, an amount not exceeding Rs:.against any loss or damage caused to or suffered or would be caused to or suffered by the Government by reason of any breach by the said owner/Builder of any of the terms of conditions contained in the said Agreement. 2. We A.P.G.V.B do hereby undertake to pay the amount due and payable under this guarantee without any demur, merely on a demeaned from the Government stating that the amount claimed is due by way of loss or damage caused to or would be caused to or suffered by the Government by reasons of breach by the said Owner/Builder of any of the terms or conditions contained in the said Agreement or by reasons of the Owner/Builder failure to perform the said Agreement. Any such demand made on the bank shall be conclusive as regards the amount due and payable by the Bank under this guarantee. 3. We undertake to pay to the Government any money so demanded not withstanding any dispute or disputes raised by the Owner / Builder in any suit or proceeding pending before any court or Tribunal relating thereto our liability under this present being absolute and unequivocal. 4. The payment so made by us under this bond shall be a valid discharge of our liability for payment there under and the Owner / Builder shall have no claim against us for making such payment. 5. We, A.P.G.V.B further agree that the guarantee herein contained shall remain in full force and effect during the period that would be taken for the performance of the said Agreement and that it shall continue to be enforceable till all the dues of the Government under or by virtue of the said Agreement have been fully paid and its claims satisfied or discharges or till the Director General of Fire Services certifies that the terms and conditions of the said Agreement have been fully and properly carried out by the said Owner/Builder and accordingly discharges this guarantee. 6. We A.P.G.V.B further agree with the Government the Government shall have the Fullest liberty without our consist and without affecting in any manner our obligations hereunder to very any of the terms and conditions of the said Agreement or to extend time of performance by the said Owner / Builder from time to time or to postpone for any time or from time to time any of the power exercisable by the Government against the said owner/Builder and to forbear or enforce any of the terms and conditions relating to the said agreement and we shall not be relieved from our liability by reason of any such variations or extensions being granted to the said Owner / Builder or for any forbearance,, act or omission on the part of the Government or any indulgence by the Government to the said Owner/Builder or by any such matter or thing whatsoever which under the law relating to sureties would, but for this provision, have effect of so relieving us. ::2:: ::2:: 7. This Guarantee will not be discharged due to the change in the constitution of the Bank or the Owner/Builder. 8. We A.P.G.V.B lastly undertake not to revoke this guarantee during its currency except with the pervious consent of the Government in writing. 9. Notwithstanding anything contained herein. i) Our liability under this bank guarantee shall not exceed Rs: (Rupees in word:.. ii) This bank guarantee shall be valid up to iii) We are liable to pay the guaranteed amount or any part thereof under this bank guarantee only and only if a written calm or demanded is served upon us on or before . (Date of expiry of guarantee).
FORM 17 {See the rule 15(1) d} Undertaking on Rs:100/- stamp Paper format UNDERTAKING This letter of Undertaking is executed by: ____________________________________________________________________________ ____________________________________________________________________________ ___________________________________________________________________ in favour of the Director General, Fire and Emergency Services, BRKR Govt., Officers / Complex, Tank Bund Road, Hyderabad 500063. 1. We say that we are promoters and Developers Builders of the Multi-storied Building at___________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ 2. We say that as stipulated by you we will provide all Fire Safety as per National building Code and Multi-Storied Building Regulations, 1981 in the above Multi- Storied Building and prepared the estimated of Rs:______________________ towards the provision of all Fire Fighting Systems and submit he estimate in original along with the general information and checklist /on fire safety measures for approval. 3. We undertaking to incur an expenditure of Rs:_____________________ for providing Fire Safety arrangements as per details furnished in the above estimate. 4. We undertaking to furnish Bank Guarantee for 15% of the total estimated cost of safety systems as above in favour of Director General of Fire Services, obtained from any nationalized bank for a period of 5 years guaranteeing to provide all fire fighting systems as per National Building Code and maintain them in good working conditions around the clock. 5. We agree that the above bank Guarantee can be invoked by Director General of Fire Service at any time in the event of non-provision or non-maintenance of fire fighting system in our Multi-storied Building as per National Building Code or in event of Non-compliance of any other Fire Safety Measure suggested in the provision No- Objection Certificate. 6. We also agree that the provision No-Objection Certificate shall be issued by the Director General of Fire Services for the construction of Multi-Storied Building only after furnishing the above Bank Guarantee by us. 7. We say that as stipulated by you we will undertake to impart training to 40% of the occupants and employees working at Building in Fire Prevention and Fire Fighting at with in 6 months from the date of occupant. 8. We undertaking to maintain and keep the Fire Fighting equipments installed at Building _____________________________________________________________ ____________________________________________________________________ _____________________________________________________________ in good working conditions at all times by regularly and replacing the obsolete equipment. Place: Signature of the Builder / Promoter / Developer Date: Name Designation: Telangana Fire Services State Training School, Vattinagulapally, Hyderabad Address for Correspondence: Contact Telephone Number: