29-346 (2) REMARKS 7 (
NORTHAMPTON FIRE DEPT .
For Incident : 970329 Exposure: 00 DATE: 03/02/97l'TE 1857
CALL FOR A FIRE IN THE BEDROOM AT THE ABOVE LOCATION. E-5 ;
CREW FOUND AN EXTINGUISHED FIRE IN THE BEDROOM. FOUND A ;
SMALL AREA BURNED BY THE BED. THE OWNER STATED HE HEARD A ;
DAUGHTER' S BED. SMALL OWNER UNPLUGGED THE THETABLE
LAMPNEXT
ANDTHAIIRSDRYER
AND EXTINGUISHED THE BURNING AREA ON THE TABLE.
UNABLE TO FIND A CAUSE SO I REQUESTED D.C. DRISCOLL TO
INVESTIGATE THE CAUSE. THE CAUSE WAS FOUND TO BE A
DEFECTIVE LAMP CORD THAT IGNITED DUE TO A SHORT. WHEN THE
CORD IGNITED THE FIRE TRAVELED UP THE CORD TO A STUFFED
ANIMAL THAT WAS PLACED ON THE LAMP CORD.
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USER DEFINED CODES
NORTHAMPTON FIRE DEPT .
t----------------------------------------------------------------------------
:FDID ;INCIDENT NO. ;EXP.NO. ;MO ;DAY ;YEAR ;TIME
;15214 ; 970329 ;00 ;03 ;02 ;97 119 : 57
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1. FIRE/EXPLSION ;2. OVERPRES/RUPT
;BLDG CONTENTS ONLY 11 ;
'----t-------------------------------------
;3. RESCUE/EMS ;4. HAZARD. CONDT
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;5. SERVICE CALL ;6. GOOD INTENT
------------- ---------------------------- -----------------------------------------------'
7. FALSE ALM/CAL :8. NAT DIS/MISC
-------------------------------------------------------- -------------- --------------'
+---------------------------------
;9. HAZMAT LEVEL ;10. WATER USED
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(21 '
0 y` MASSACHUSETTS FIRE INCIDENT REPORT
Department of Public Safety Office of the State Fire Marshal
1010 Commonwealth Avenue Boston, Massachusetts 02215
10 FDID# DEPARTMENT Revised I Delete FORM
A 15214 NORTHAMPTON FIRE DEPT . Report 2 Change FP - 32
Incident# If Exposure Date Dav of Alarm Time Arrival Time Back in Serv.
970329 Fire Only: 0 0 03/02/97 Week: Sunday .l 19 : 5 7 2 0 : 0 1 2 0 : 5 4
Type of Situation Found Ty[e of Action Taken Mutual Aid
B Structure fire 11 Extinguishment 1 1 Rec d
2 Given.
Fixed Property Use (Occupancy) Ignition Factor N\A
C 1-fam dwell year rnd 4 11 Short circuit 54
Correct Address Si Code Census Tract
D 80 AUSTIN CIRCLE 01060 822200
ll Occupant Name (Last,First,Mi) Telephone Room or Apt.
E ( } —
12 Owner Name (Last,First,Mi) Address Telephone
F RODRIGUE , CLAUDE SAME ( 413 ) 586- 5451
13 Method of Alarm from Public Co. Inspection Shift No. Alarms
G 911 7 District E5 B 1
No. Fire Service Personnel No Engroes No. Aerial Apparatus No. Tankers No. Other Vehicles
H Responded 7 Responded 2 Responded Resp. Responded 2
Hazardous Material Yes Substance Special Equipment Used?
Present? X No
20 FIRE Number of Number of Number of Number of
I SERVICE Iniuries Fatalities OTHER Iniuries Fatalities Rescues
Mobile Property Type Vehicle I Yes Estimated Total
J Mobile property type n/a 8 Stolen? 2 X No Dollar Loss 750 . 00
Insurance Co. Total Insurance Claim Paid
ARABELLA INS CO
30 Year Make Model Color License No. VIN#(Serial No.)
40 If Equipment Involved Year Make Model Serial No.
In Ignition LAMP CORD
Complex Area Of Origin Equipment Involved in Ignition
K Dwelling complex 1-2 fmly 4 1 Sleeping rm for :i pers. 2 1 Cord, plug 47
Form of Heat Ignition Form of Material Ignited Type of Material Ignited
L Short-def. insul 23 Toy, game 45 Man-made fabric 7 1
Method of Extinguishment Level of Fire Origin Number of Stories Construction Type
M Make-shift aids 2 Grade to 9' above gr 1 1 story. 1 Unprotected wood frame 8
N
0 Extent of Flame Damage Extent of Smoke Damage Detector Performance Sprinkler Performance
P Part of rm/area of origin 2 Floor of origin 5 No detectors present 8 No equipment present 8
IF SMOKE SPREAD BEYOND Form of Material Generating Most Smoke Type of Material Generating Most Smoke
Q ROOM OF ORIGIN Toy, game 45 Man-made fabric 7 1
WEATHER 30'S CLEAR Avenue of Smoke Travel
R CONDITIONS No significant avenue 8
,ntries contained in this report are intended for the
;ole use of the State Fire Marshal. Estimations and
,valuations made herein represent "most likely" and
MEMBER MAKING REPORT DATE °most probable" cause and effect. Any representation as
to the validity �,r accuracf of reported conditions out-
STEPHEN CORBETT, CAPTAIN 03/02/97 side the State Fire Marsha's office, is neither
intended nor implied.
FIRE MARSHAL
F.M. 1 Yes 2 No