Certificate Of Inspection - Fire Alarm System - Ocean City Fire Marshal
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1TOWN OF OCEAN CITY - OFFICE OF THE FIRE MARSHAL
P.O. Box 158 Ocean City, MD 21843
Phone # 410-289-8780 Fax # 410-289-8767
CERTIFICATE OF INSPECTION
FIRE ALARM SYSTEM
Annual Certificate of Inspection in Accordance with NFPA 72
Non-Annual Certificate of Inspection in Accordance with NFPA 72
Deficiencies:
YES
NO
Protected Property:
Building Name:________________________________
Exact Physical Address:__________________________________________
Contact Person:________________________________
Bill To:_______________________________________________________
Contact Phone #:_______________________________
Billing Information:_____________________________________________
Fire Alarm Testing Company:
Inspector/Technician:___________________________
Company:_______________________________________________
Phone Number:________________________________
Address:_________________________________________________
Date System Tested:____________________________
_________________________________________________
Fire Alarm License #:___________________________
Fire Alarm System Owner’s Notification:
The owner and/or the owner’s representative of the system was notified on
of all deficiencies?
PRIOR TO TESTING, OCEAN CITY COMMUNICATIONS SHALL BE NOTIFIED!
PHONE # 410-723-6620
(Failure to do so will result in the full provisions of the Town of Ocean City Fire Prevention and Protection Code to be invoked.)
Dispatcher Name/Number:_____________________________
Time:__________________
System Monitoring:
Is this system monitored off site?
Yes
No
Have appropriate authorities been notified prior to testing?
Yes
No
If yes, provide name, location, and phone number of monitoring station:_______________________________________________
_________________________________________________________________________________________________________
Deficiencies Identified During Inspection:
System Out of Service
More than 10% of Initiating Devices Failed
Unprotected Residential Enclosed Corridors
More than 10% of Notification Devices Failed
FACP in Alarm or Trouble
Fire Alarm System Failed to Activate a Fire Protection System or Device
System Monitoring Out of Service
Voice Evacuation System Out Of Service
Other: List Below
Comments / Deficiency Description: (Attach an “Additional Information Form” if more room is needed.)
FOR INTERNAL USE ONLY:
Data Entry Date:__________
FM Assigned:__________
Date FM Assigned:__________
Date Inspected/Contacted:__________
No Deficiencies Found
Deficiencies Verified
QV #:__________
Date of Violation:__________
Date of Compliance:__________
**THIS FORM MUST BE SUBMITTED WITHIN 30 DAYS FROM THE DATE OF INSPECTION TO THE OCEAN CITY FIRE
MARSHALS OFFICE **
Rev. 10/7/2008
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