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911
Non Emergency
516-440-2300
BROOKVILLE POLICE DEPARTMENT
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Alarm permit application
Today's Date
(Required)
Application Type:
(Required)
New Permit
Renew Existing Permit
Village:
(Required)
Brookville
Cove Neck
Matinecock
Mill Neck
Occupancy Type:
(Required)
Own
Rent
Alarm Type
(Required)
Central Station
Siren/ Exterior Bell
Central Station Name:
Central Station Phone#
Alarm Physical Location
(Required)
Address (location of alarm)
(Required)
Street Address
Address Line 2
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Owner Name (DO NOT USE TRUST/LLC NAME)
(Required)
First
Last
Owner Home Phone
(Required)
Owner Cell Phone
(Required)
Owner Email
(Required)
Renter Name
First
Last
Renter Home Phone
Renter Cell Phone
Renter Email
Married
(Required)
Yes
No
Spouse name
Children?
(Required)
Yes
No
How Many Children
(1) Emergency Contact
(Required)
First
Last
Emergency #
(Required)
Key Holder
(Required)
Yes
No
(2) Emergency Contact
First
Last
Emergency #
Key Holder
Yes
No
Occupation
Business Name
Business Address
Street Address
City
State
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Dogs?
(Required)
Yes
No
How Many
Please enter a number from
0
to
100
.
Dog Breed
Household help?
Yes
No
Resides at residence?
Yes
No
Household Help Name
First
Last
Owns firearms?
(Required)
Yes
No
Pistols permit #:
County of issue
Permit type
Firearm Type:
Pistol
Rifle
Description
Firearm TypeL
Pistol
Rifle
Description
Firearm Type:
Pistol
Rifle
Description
Miscellaneous info:
Alarm Permit Application Fee
(Required)
$50.00 (New Application)
$20.00 (Renewal Application)
Consent
(Required)
I have read and agree with the Terms of Agreement and the associated fee for the alarm permit application.
TERMS OF AGREEMENT
IT IS UNDERSTOOD AND AGREED BY THE UNDERSIGNED THAT:
1. The alarm system is considered only as a convenience to the permit holder or authorized occupant and an operational aid to the police.
2. The police shall not be held liable for any failure to respond to an alarm.
3. This application is subject to the approval of the Chief of Police and may be revoked by the Chief of Police.
4. The permit holder shall allow inspection of the alarm system by an authorized representative of the police.
5. If the alarm is activated and the permit holder or authorized occupant is absent from the premises protected by the alarm, the police shall be permitted to enter the premises without incurring any liability for the purpose of:
a. searching for intruders
b. extinguishing fires
c. making necessary adjustments to the alarm
system.
6. The applicant agrees to designate a friend, neighbor, relative or other person to hold and have available for the police, a key to the premises and a key or code lo the alarm system.
7. All outside audible alarm systems shall have an automatic cut-off set for not more than fifteen (15) minutes.
8. Dialer type alarm systems must send NOMORE THAN TWO messages upon activation and shall be programmed to dial a Police Department approved telephone number for alarm system. Under no circumstances shall any alarm system be programmed to dial (911) or (516- 440-2300).
9. Has an audible signal which can be clearly heard in all portions of the protected structure when the alarm system is automatically activated, except for a silent, panic or hold-up activation.
10. The alarm system contains a 30 second time lapse between initial activation of the alarm system and transmission of the alarm signal to the Police Department or Central Alarm Station with an abort feature or alternate means of canceling the alarm signal within the 30 second period. An abort feature shall not be required for devices specifically designed to enable an alarm user to intentionally activate the alarm system.
11. The approval of the Police Department as to the suitability and quality of all devices, equipment and hardware and the approval of the Underwriters Laboratories.
12. Contains such other technical features or requirements as shall be provided in the rules and regulations governing alarm systems.
13. The applicant hereby acknowledges that.
a. He /She has read or is familiar with the Village General Ordinance regarding alarm systems.
b. He /She shall be responsible to pay all charges for false alarms.
c. The alarm system must be installed by a LICENSED INDIVIDUAL OR FIRM.
d. An Alarm User Permit MUST accompany this application when submitted to the Police Department.
14. An Alarm Installation Permit MUST accompany this application when submitted to the Police Department
THE FAILURE OF ANY ALARM USER TO OBTAIN A PERMIT AS REQUIRED CONSTITUTES A VIOLATION AS DEFINED IN THE VILLAGE ORDINANCE. AN ALARM USER SHALL MEAN ANY PERSON WHO OWNS, RENTS OR OTHERWISE OCCUPIES PREMISES ON WHICH AN ALARM SYSTEM IS OWNED, OPERATED, USED OR MAINTAINED.
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