Request Smoke Detectors Form

IMPORTANT

To be eligible for smoke detectors you must live in Beverly City or in Edgewater Park Township in a one- to two-family house that is owner-occupied. There is a limit of 3 units per residence.

If you live in a rental and your landlord does not have working smoke detectors in the unit, that is a violation of the Beverly City and Edgewater Park Township Municipal Code requirements. Those requirements state that property owners need to “maintain all fire protection and smoke detection equipment for the premises.”

First Name *

Last Name *

Street Address *

Apartment, suite, etc

Beverly City or Edgewater Park Twp. ? *Town?

Daytime Telephone *

Evening Telephone *

Email Address

Own ? Rent ? *

Landlord/Agent Name *

Landlord/Agent Telephone *

Are There Special Needs, Impaired Hearing ?

How Many Smoke Detectors Are Not Working? *

What Floors Need A Smoke Detector? *

Select Best Installation Day(s)

When Is Best Time For Installation?

Hours

Minutes

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