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Smoke Detector Installation Request

  1. Franklin County Public Safety

  2. FRANKLIN COUNTY PUBLIC SAFETY WANTS TO ENSURE THAT EVERY HOME IN THE COUNTY HAS A WORKING SMOKE DETECTOR. SMOKE DETECTOR AVAILABILITY IS LIMITED; IF AVAILABLE WE WILL INSTALL THEM IN THE APPROPRIATE AREAS OF YOUR HOME FREE OF CHARGE.

    IF YOU ARE A TENANT IN NEED OF A SMOKE DETECTOR, PLEASE NOTIFY YOUR LANDLORD OF THIS REQUIREMENT AS SOON AS POSSIBLE.

    IF YOU ARE A RESIDENT OF THE TOWN OF ROCKY MOUNT VA, PLEASE CONTACT THE TOWN MANAGERS OFFICE AT 540-483-5243.

    IF YOU, A NEIGHBOR, OR FAMILY MEMBERS ARE WITHOUT SMOKE DETECTORS IN YOUR HOME AND ARE A FRANKLIN COUNTY VA RESIDENT WHO OWNS AND LIVES IN YOUR HOME, COMPLETE THE SMOKE DETECTOR INSTALLATION FORM BELOW.

  3. Do you own your home?*

  4. Office Use Only

    Please do not fill out beyond this point. Franklin County Department of Public Safety will require the resident's signature and date when the install is completed.

  5. Occupant Signature

    ______________________________________________

  6. Occupant Printed Name

    ______________________________________________

  7. Installation Date

    __________________________

  8. Number of Alarms Installed

    ______________________________________________

  9. Installer Signature

    ______________________________________________

  10. Installer Printed Name

    ______________________________________________

  11. Franklin County Department of Public Safety
    1488 Franklin Street
    Rocky Mount, VA 24151
    PHONE: 540-483-3091 • FAX: 540-483-3086

  12. Leave This Blank:

  13. This field is not part of the form submission.