Certificate Fee: $50.00 INSP-67 - Rev. 3/2015
TOWN OF HUDSON
FIRE DEPARTMENT - INSPECTIONAL SERVICES DIVISION
12 School Street · Hudson, New Hampshire 03051 · Tel: 603-886-6005 · Fax: 603-594-1142
Smoke Detector Inspection Certificate
Installation Address: ________________________________________________________________________
Business Name (if applicable): ______________________________________________________________
Type of Occupancy: Residential
Commercial/Industrial
Property Owner: _____________________________________________________________________________
Mailing Address:_____________________________________________________________________________
Daytime Phone #: ___________________________ Cell Phone #: __________________________________
Email: ______________________________________________________________________________________
The smoke detectors installed at the above listed address have been inspected and were
found to be in compliance at the time of the inspection, with the provisions of the State
of New Hampshire Fire Code, Part SAF-C 6018.
_____________________________________________ _________________________
Signature of Inspector Inspection Date
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