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Application For Permit - Burrillville Fire Alarm
Note: This application is only for the radio fire alarm box installation. Any electrical/mechanical permits required must be obtained from the Town of Burrillville, Building Inspectors Office.
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Fire District radio fire alarm box will be installed
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Oakland-Mapleville Fire District
Harrisville Fire District
Nasonville Fire District
Pascoag Fire District
Building Name
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What is the facility called ie. Ocean State Power
Your answer
Building Street Address
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Your answer
Building Contact Name
*
Your answer
Building Contact Phone
*
Your answer
Design/Engineering Firm
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Designer Name
Your answer
Designer Telephone
Your answer
Designer Email
Your answer
Installer Company Name
*
Your answer
Installer Name
*
Your answer
Installer Phone
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Your answer
Installer Mailing Address
*
Your answer
Installer Email Address
*
Your answer
Installer RI License Number
*
Your answer
Radio Box Model
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Verify number of zones required by Fire Marshal before ordering
8MTJ-A-16 Analog 16 Zone
DTX Digital 16 Zone
DTX Digital 4 Zone
Estimated Antenna Cable Length
*
Your answer
Estimated Installation Start Date
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Your answer
Estimated Installation Completion Date
*
Your answer
Comments
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Applicant Name
*
Your answer
Application Date
*
MM
/
DD
/
YYYY
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