Devens Fire Department
		182 Jackson Road, Devens MA 01434
			Fire Inspection Report Form			DATE
		Property Name
Address
Master Box #				Location			Tested OK	Y or N
Daytime Phone Number
After hours Phone Number
Primary Contact
		Phone
		Cell
Secondary Contact
		Phone
		Cell
# of Employees per Shift			Shift 1		Shift 2		Shift 3
Building is zoned
Location of Knox Box						Keyes Checked OK		Y or N
Fire Alarm Panel Location
Annunciator Panel Location
Alarm Indicator Light				Location
	Operates when
Central Station Monitored by			master box only
	Phone Number		n/a
Fire Alarm Repair Company
	Phone Number
Is Building Sprinklered				Wet		Dry
		Other
Location of Sprinkler Air Compressor
Location of FD Sprinkler Connection/ Gong
Location of Sprinkler/Fire Pump Room
Antifreeze Sprinkler Location
Sprinkler Maintenance Company
	Phone Number
Locations of O.S. & Y.
Locations of P.I.V.
Devens Fire Department Fire Inspection Report Form								Page 2
Locations of Hydrants
Location of Electrical Room
Location of Boiler Room
How is Boiler Fueled
Type of Fuel (Tank)					Above		Below
	Location of Fuel Tank
Location of Gas Meter
Location of elevator
Does Elevator have Fire Dept. Contol Key
Does Sprinkler have Double Back Flow Device
Type of Construction
Type of Roof
Height of Building
Location of Roof Hatch or Skylights for Rapid Ventilation						N/A
Accessibility to around building
Flammable Storage Location
Types of Flammables
Chemical Storage Location
Types of Chemicals
Building Owner's Name
	Address
	Phone Number
Building Occupant Name
	Address
	Phone Number
Parent Company Name
	Address
	Phone Number
Additional Information
Last Sprinkler Inspection				Last Fire Alarm Test
Devens Fire Department Fire Inspection Report Form								Page 3
Notes:								.
	Owner/Building Occupant has 15 days to submit a written plan of
			Corrective Action to the Fire Chief
Date of Inspection
Inspection Team		Lt.
		FF
		FF
		FF
		FF
		FF
Inspection Officer Signature