2. BEDFORD FIRE DEPARTMENT CUSTOMER OCCUPANCY PORTAL
6. IMPORTANT! PLEASE READ!
   This electronic form is designed for building owners and/or property managers to provide the Bedford Fire Department with accurate contact information and to provide a consistent and easy means of forwarding required inspection reports. If you are not a representative of the building owner or property management company and believe that you have received a letter from the fire department in error, please contact your building owner or property manager and direct them to this form.
8. MULTIPLE PROPERTIES
   If you own or manage multiple properties in Bedford, rather than completing the form multiple times, you can email: a list of your properties, (2) emergency contact names/numbers for each, and associated inspection paperwork to tlavoie@bedfordnh.org.
12. Building Owner or Property Manager Name:*
13. Building Address:*
15. Building Owner or Property Manager Telephone Number:*
16. Building Owner or Property Manager Email Address:*
20. Person Completing Form:*
21. Person Completing Form Email:*
23. Building Owner or Property Manager Emergency Contact Name:*
24. Building Owner or Property Manager Emergency Contact Number:*
26. Building Owner or Property Manager Alternate Contact Name:
27. Building Owner or Property Manager Alternate Contact Number:
31. Have there been any structural modifications since the last inspection?*

    1. YES
    2. NO
32. If YES, please describe modifications:
34. Have any locks changed since the last inspection?*

    1. YES
    2. NO
    3. Multiple Tenants - No Master Keys
35. If YES, create a copy of the new key(s) for installation in the Fire Department lockbox and contact Fire Prevention at (603) 472-3219
36. Have the portable fire extinguishers been serviced in the last year?*

    1. YES
    2. NO
    3. Multiple Tenants - Each Manage Their Own
37. If YES, please upload service record below in the document upload field.
39. Has the Fire Alarm System been serviced in the last year?*

    1. YES
    2. NO
    3. N/A
40. If YES, please upload service record below in the document upload field
41. Has the Sprinkler System been serviced in the last year*

    1. YES
    2. NO
    3. N/A
42. If YES, please upload service record below in the document upload field.
44. Has the commercial hood and suppression system been serviced in the last year?*

    1. YES
    2. NO
    3. N/A
45. If YES, please upload service record below in the document upload field.
46. What is your current hood cleaning frequency?

    1. Monthly
    2. Quarterly
    3. Semi-Annually
    4. Annually
48. Other Comments:
53. FILE UPLOAD PORTAL
56. Fire Extinguisher Documentation
    Upload required FIRE EXTINGUISHER documentation here
57. Fire Alarm Documentation
    Upload required FIRE ALARM documentation here
59. Sprinkler System Documentation
    Upload required SPRINKLER SYSTEM documentation here
60. Kitchen Suppression Documentation
    Upload required KITCHEN SUPPRESSION documentation here
62. Hood Cleaning Documentation
    Upload required HOOD CLEANING documentation here
Leave This Blank:


64. 1. Receive an email copy of this form.
65. Email address

    This field is not part of the form submission.

66. Submit Submit and Print

* indicates a required field