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Get NY FC-1414 - Nassau County 2001-2024

NASSAU COUNTY FIRE COMMISSION EDWARD P. MANGANO COUNTY EXECUTIVE OFFICE OF THE FIRE MARSHAL 1194 PROSPECT AVENUE WESTBURY NEW YORK 11590 THOMAS E* TILLEY FIRE MARSHAL 516-579-9900 MAKE CHECK PAYABLE TO TREASURER COUNTY OF NASSAU APPLICATION FOR FIRE ALARM PERMIT New TYPE OF APPLICATION Amendment ALARM SYSTEM LOCATION Residential 1 or 2 Family Mecantile Industrial Public Assembly Address Multiple Residence Office Name Storage Post Office Village Closest Intersections 1 Institutional Educational Facility Special Information Guard Dogs Directions Hazardous Materials Invalids etc* CENTRAL STATION INFORMATION Phone City St Zip ALARM INSTALLER INFORMATION FM No* NYS Unique ID No* NYS Unique ID Expiration Date System Installation System Maintenance System Inspection INSTALLING COMPANY CERTIFICATION I NYS license Qualifier Title of NYS Licensed Company Name Signature Date Certify that the above proposed or existing system does or will comply with all Nassau County New York State and Local Ordinances codes and regulations. I also certify that before installing the above system all required plans and fees have been submitted to the Fire Marshal and a set of the approved plans are on site of the installation* I also certify that a copy of this permit application will be conspicuously affixed at the fire alarm control panel or its propsed location at the premises prior to commencing of and during installation of any part of the system* Receipt No* Check No* FD No* Location ID No* FC-1414. 9/80 REV.11/98 FOA No* FD Name No Charge FD Alarm No* Permit No* Verified By FAP ID No*.

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