Nfpa 72, Fire Alarm System Record Of Completion Form
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4FIRE ALARM SYSTEM
RECORD OF COMPLETION
Name of protected property:
Address:
Representative of protected property (name/phone):
Authority having jurisdiction:
Address/telephone number:
1. Type(s) of System or Service
NFPA 72, Chapter 3 — Local
If alarm is transmitted to location(s) off premises, list where received:
NFPA 72, Chapter 3 — Emergency Voice/Alarm Service
Quantity of voice/alarm channels:
Single:
Multiple:
Quantity of speakers installed:
Quantity of speaker zones:
Quantity of telephones or telephone jacks included in system:
NFPA 72, Chapter 6 — Auxillary
Indicate type of connection:
Local energy
Shunt
Parallel telephone
Location of telephone number for receipt of signals:
NFPA 72, Chapter 5 — Remote Station
Alarm:
Supervisory:
NFPA 72, Chapter 5 — Proprietary
If alarms are retransmitted to public fire service communications centers or others, indicate location and
telephone numbers of the organization receiving alarm:
Indicate how alarm is retransmitted:
NFPA 72, Chapter 5 — Central Station
Prime contractor:
Central station location:
Means of transmission of signals from the protected premises to the central station:
McCulloh
Multiplex
One-way radio
Digital alarm communicator
Two-way radio
Others
Means of transmission of alarms to the public fire service communications center:
(a)
(b)
System location:
(NFPA Record of Completion 1 of 4)
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