HomeMy WebLinkAbout300 BI #5A001TOWN OFYARMOUTH
Burglar & Fire Alarm
User lnformation Card
Alarm Type:
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Burglar
Fire
Addr€ss ol Alarm:
(lndud€ cornplels direclions
so tllat polioefirE cen loc8te
& rEpond promplv)
Phone Number:
Business Name:
(if applic€ble)
Name of owngr or p€rson in
cllarge ol premises:
Tslephone Number:
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Addross of p€rsoo in cha€e
of premlses:q.nQ-
Czr 57 6 t1tro
(oYer)
Narng. addrgss and t€1.# ot
s€cond perEon authorizgd
to rBspood lo orl€rgoncy atlocation ol alarm:
Q ro(B-l'n )<qfNamg
Addross 9 e_
rer., .5 O t ?32- 73q9
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7R * -Yto- lzt9
A*l/f.*4"^4-,7l 425
Signature Date
(For s€olrily FrrpGes, ttis csrd strcold b6 lltungd lo Ul€ appropdato agsq tsi€d boios, oi$sI h pe6on ir r sealed oft€lope.)
For BUBGI-AF ajarm: YAFMOUH POI.JCE DEP FIMENT For F|RE starmr: y BMoI.JTH FIRE DEmRTI|ENT
or{E 8R D ESTCKSON tV y s6 otD MA|N STEEEI
WEST YARI'OUIH, MA @673 SOUIH YARMOI,Ifi, MA (p66'
Alarm Co.:
Phono,
Sp€cial Comments: