Alarm Ordinance Registration Form - Department Of Police Services
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1Department of Police Services
REG. # ___________________
Three Main Street
(Dept. Use Only)
Newtown, CT 06470 Phone: (203)270-4254
NEW: _____UPDATE: _____
ALARM ORDINANCE REGISTRATION
1. Name
Name of Business (if applicable)
2. Address
3. Billing Address
(ONLY IF DIFFERENT FROM PHYSICAL ADDRESS)
4. Main/Home Telephone
Cell Phone:____________________________
5. Email: _____________________________ Cell Phone: ______
______
Emergency Contacts/Key holders: must have key and alarm code:
6. Name
Phone #’s_________
7. Name_
Phone #’s ____________
_______________________________________
8. Name_______________________________ Phone #’s _____________________________
Alarm Company
9. Alarm/Monitoring Co. Name _________________________Telephone __________________
If an exterior audible device is used in the system, is the system automatically restricted to a maximum
of fifteen (15) minutes? *
<Circle One>
Yes No
Unless required by law, an audible exterior alarm must automatically be restricted to a maximum
of fifteen (15) minutes.”
Pursuant to the provisions of the Town of Newtown Alarm Ordinance on file with the Town Clerk of Newtown and in
consideration for the permission to use an alarm system as defined therein, the undersigned alarm user, as defined therein,
acknowledges full familiarity with said ordinance and certifies the user’s authorization to register the above-identified alarm
device. The undersigned further accepts full responsibility for said device as the alarm user within the terms of said ordinance
and agrees to fulfill all the requirements stated therein. It is the responsibility of the alarm owner to contact Newtown
.
Department of Police Services if there is a change of address
Initial One Time Registration Fee: $25.00: Annual Renewal Fee: $5.00
X______________________ ___________
____________________________
Alarm Owner Signature
DATE
Proper Registration of Alarm Number is Hereby Acknowledged.
Administrator
Please remit payment when returning completed form.
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