FDISP-8 Rev. 1/2014
TOWN OF HUDSON – FIRE DEPARTMENT
15 Library Street · Hudson, New Hampshire 03051 · Tel: 603-886-6021 · Fax: 603-594-1164
Business Survey
Dear Business Owner/Manager,
The Hudson Fire Department dispatches emergency personnel and apparatus for both Hudson and
Litchfield. We maintain vital information regarding businesses in our dispatch computers to aid
the two departments in mitigating emergency situations. Please assist us by providing the
information requested below and return this form to the Hudson Fire Department. All data
submitted shall be kept strictly confidential. Thank you for your cooperation in making your
business fire safe.
Business Name: ________________________________________________Date: ____________________
Business Address: _______________________________________________________________________
Business Telephone: _________________________ Website: ____________________________________
Nature of Business: ______________________________________________________________________
Building Owner(s): ______________________________________________________________________
Owner's Address: ________________________________________________________________________
Owner's Telephone: ________________________ Owner’s E-mail Address: ________________________
Is your facility protected by a sprinkler system or fire alarm system?
Sprinkler System Yes____ No____ Fire Alarm System Yes____ No____
If yes, which type of system is it? ___________________________________________________________
If yes, is the fire alarm system connected directly to the Hudson Fire Department?
Master Box/Digital Dialer Number: ____________
Special considerations:
______________________________________________________________________________________
______________________________________________________________________________________
Please list names and telephone numbers of persons to be called in an emergency in the order they
should be called.
First: _____________________ Cell Phone #: ___________ Home Phone #: ___________
Second: ___________________ Cell Phone #: ___________ Home Phone #: ___________
Third: ____________________ Cell Phone #: ___________ Home Phone #: ___________
Fourth: ____________________ Cell Phone #: ___________ Home Phone #: ___________
