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Mount
Kisco Police Department |
Alarm Permit Application |
| Permit Number | Leave Blank |
| Annual Fee | Leave Blank |
| Paid | Leave Blank |
| Date | Leave Blank |
| Commercial Property | Fill in name, address, suite and/or apartment number, and phone number. |
| Private Residence | Fill in name, address, suite and/or apartment number, and phone number. |
| Emergency Name | Fill in at least 1 emergency contact (you can specify up to 5 contacts). First name listed should be the primary key holder. Fill in this section as accurately and completely as possible. |
| Alarm Installation | If the alarms was installed by an alarm company, fill in the company name, address, and telephone number. If the alarm was installed by a private individual or homeowner please note such this section. |
| Alarm Type | B - Burglar F - Fire H - Holdup Any other type of alarm please be specific, i.e.; Medical Alert, Panic, Gas, Freeze, etc. |
| Hazardous Material | Please advise type of material and location. |
| Fire District | Leave Blank |
| Comments | Any information you may feel be important for responding emergency personnel. |
Please Note: If there are any changes during the year that might affect the information you have provided, it is your responsibility to notify the Mount Kisco Police Department as soon as possible so that the changes may be reflected in our computer system.