MARSHFIELD FIRE DEPARTMENT
GENERAL BUSINESS INFORMATION FORM
BUSINESS NAME: ____________________________________________
STREET ADDRESS: ____________________________________________
TELEPHONE: _____________________ AFTER HOURS _______________
FLOOR LEVEL (IF NOT FIRST FLOOR): _______________
BUSINESS OWNER: ___________________________________________
RESIDENTIAL ADDRESS: _______________________________________
CITY/TOWN: ____________________________ STATE: ____________
ZIP CODE: _________________ PHONE ___________________
MANAGER/2ND CONTACT: _______________________________________
RESIDENTIAL ADDRESS: ________________________________________
CITY/TOWN: _____________________________ STATE: ____________
ZIP CODE: _________________ PHONE ______________________
BUILDING OWNER: _____________________________________________
RESIDENTIAL ADDRESS: _________________________________________
CITY/TOWN: _____________________________ STATE: _____________
ZIP CODE: __________________ PHONE _____________________
FIRE ALARM SYSTEM: _YES NO____ SPRINKLER SYSTEM: _YES NO
CENTRAL STATION NAME: _______________________________________
TELEPHONE #: _______________ AFTER HOURS ___________________
FIRE DEPARTMENT CONNECTION LOCATION: ______________________
DO YOU HAVE A LOCK BOX: _YES NO _ LOCATION _________________
CONTACT PERSONS OR OTHER KEY HOLDERS, IF PROBLEM WITH ALARMS
NAME: ___________________________________________
TELEPHONE: _____________________
NAME: ___________________________________________
TELEPHONE: _____________________
OTHER COMMENTS:
CONTACTS IN CASE OF EMERGENCY
| 
