VOS residential fire safety inspection

• ADDRESS

• OWNER:

• TELEPHONE NUMBER

• EMAIL ADDRESS:

• EMERGENCY CONTACT

• DATE OF INSPECTION

  Date

• Prepared by: Joseph Russo VOS Fire Marshal FI address: 103 Broadway Off Island: PO Box 5551 Bay Shore, NY 11706 (631) 583-5566

Exterior of premises

• House number conspicuously posted and viewable from street (VLL 38-16)<br>

  Yes

  No

  N/A

• Functional 100 ' hose with nozzle attached (VLL 25-7D)

  Yes

  No

  N/A

• Long handled shovel readily accessible (VLL 25-7C)

  Yes

  No

  N/A

• Fire hydrants have a 3' cleared circumference of all debris and obstructions if on premises

  Yes

  No

  N/A

• Spark arrestor is satisfactory condition on each chimney (VLL 25-7A)

  Yes

  No

  N/A

• Under brush, reeds and combustibles cleared from building (VLL 25-8)

  Yes

  No

  N/A

• Combustable and flammable liquids stored properly in approved containers with fitted caps (VLL 25-8 & 12)

  Yes

  No

  N/A

Fire Protection and Detection Systems

• Approved, operational fire extinguishers less than three years old on each level of the residence (VLL 25-7B)

  Yes

  No

  N/A

• Is there a fire sprinkler system

  Yes

  No

  N/A

• Is there a fire alarm system

  Yes

  No

  N/A

• Functional smoke detectors in satisfactory condition on all levels of residence and in every sleeping area (VLL 25-15)

  Yes

  No

  N/A

• Carbon monoxide detectors installed if the premises has any appliances, devices or systems the emit carbon monoxide

  Yes

  No

  N/A

Electrical

• Meter pan, junction boxes, breaker panels, and electrical outlets shall be in satisfactory condition free of rust and water damage and have approved covers with no missing components (VLL 25-15)

  Yes

  No

  N/A

• Extension cords shall not be used for permanent wiring (90 days), they will supply only one device and must be plugged into an approved receptacle, power tap, or multiplug adapter. The capacity of the extension cord shall be greater than the rated capacity of the portable appliance it supplies

  Yes

  No

  N/A

• Power strips shall be over current protected, UL listed, and plugged directly into wall outlets

  Yes

  No

  N/A

Housekeeping

• Storage shall be maintained 24" below ceiling in non sprinklered buildings, and 18" in sprinklered buildings

  Yes

  No

  N/A

• Electrical panels, boilers and furnaces shall have a clearance from combustibles (NFPA) (315.2)

  Yes

  No

  N/A

• Egress paths are kept free of debris and obstructions

  Yes

  No

  N/A

• General cleanliness and housekeeping is maintained

  Yes

  No

  N/A

LP gas & Barbecues

• Is there LP gas on the premises

  Yes

  No

  N/A

• Permit #

• Cylinder sizes, use & locations

• LP tanks are level, on a permanent base, not in contact with soil, clear from vegetation, secured properly, not in close proximity to openings or electrical sources, not being stored under a deck or in a building and are in satisfactory condition

  Yes

  No

  N/A

• Is there a barbecue on premises

  Yes

  No

  N/A

• BBQ is properly located away from home and combustibles on a flame resistant base, free of excessive grease, in satisfactory condition with a hose and fire extinguisher within 10'

  Yes

  No

  N/A

• No violations or corrective actions found?

Summary of violations and corrective actions

The violations listed on this report shall be corrected on or before the re inspection date listed below. During this period, the property owner and or business owner continues to be responsible and liable for any damages, injuries or death resulting from these violations.

• Re inspection needed?

  Yes

  No

  N/A

• Re inspection date

  Date

• Follow up notes

Property representative

• Add signature

  Sign