TOWNSHIP OF MONTVILLE

FIRE PREVENTION BUREAU - DISTRICT NO. 2

P.O. BOX 353   TOWACO, NEW JERSEY 07082

PHONE (973) 334-4636   ---    FAX (973) 334-5911

www.towacofd.org

APPLICATION FOR CERTIFICATE OF SMOKE DETECTOR, CARBON MONOXIDE ALARM AND FIRE EXTINGUISHER COMPLIANCE

N.J.A.C. 5:70-2.3 (b) Certificate of smoke detector and carbon monoxide alarm and fire extinguisher compliance

Before any Use Group R-3 or R-4 structure is sold, leased, or otherwise made subject to a change of occupancy for residential   purposes, the owner shall obtain a certificate of smoke detector and carbon monoxide alarm compliance (CSDCMAPFEC), evidencing compliance with N.J.A.C. 5:70-4.19, from the appropriate enforcing agency.

FEE REQUIRED FOR INSPECTION CERTIFICATE

N.J.A.C. 5:70-2.9 (d) The application fee for a certificate of smoke detector, carbon monoxide alarm and fire extinguisher compliance (CSDCMAPFEC), as required by N.J.A.C. 5:70-2.3, shall be based upon the amount of time remaining before the change of occupant is expected, as follows:

1. Requests for a CSCDMAPFEC received more than 10 business days prior to the change of occupant: $60.00
2. Requests for a CSDCMAPFEC received four to 10 business days prior to the change of occupant: $90.00
3. Requests for a CSDCMAPFEC received fewer than four business days prior to the change of occupant: $150.00

APPLICANT/AGENT: ___________________________________________________________

ADDRESS: ___________________________________________________________________

TELEPHONE: ________________  ALTERNATE TELEPHONE: ________________ FAX: _______________

PROPERTY INFORMATION

PROPERTY OWNER: ______________________________________________________________

PROPERTY ADDRESS: ____________________________________________________________

PROPERTY IDENTIFICATION -  LOT NUMBER: _______________   BLOCK NUMBER: _______________ 

DATE OF CONSTRUCTION: ___________________              DATE OF CLOSING: ___________________

TYPE OF SMOKE DETECTORS:

¨ BATTERY OPERATED SINGLE STATION    ¨ INTERCONNECTED STATIONS   

¨ FULLY INTEGRATED SYSTEM WITH CONTROL PANEL ¨ CENTRAL STATION AUTOMATIC ALARM

¨ OTHER

LOCATION OF SMOKE DETECTORS:    1. _______________________________________________

Floor Level & Exact Location         2. _______________________________________________

(e.g. First Floor Bedroom)

                                3. ________________________________________________

                                4. ________________________________________________

TYPE AND LOCATION OF CARBON MONOXIDE ALARM:  __________________________________________

LOCATION OF FIRE EXTINGUISHER: ___________________________________________________________

This application form is also available on our web site at http://www.towacofd.org.   For your convenience, you may also submit your application online for faster service.

Please check your smoke detectors and carbon monoxide alarms for placement and functionality before the inspection; fee charges are based on single inspections.  Supplementary inspections will incur additional fees.

If remote monitoring central station services are utilized, please be prepared to notify them of the test when the inspector arrives.

Please complete all required information completely. Certificate of Smoke Detector and Carbon Monoxide Alarm Compliance will be generated from the information provided.

            THE UNDERSIGNED HEREBY REQUESTS THE TOWNSHIP OF MONTVILLE FIRE PREVENTION BUREAU, DISTRICT NO. 2 TO INSPECT THE ABOVE PREMISES FOR COMPLIANCE WITH THE STATE OF NEW JERSEY ADMINISTRATIVE CODE N.J.A.C 5:70-2.3 AND N.J.A.C 5:70-4.19 AND THE TOWNSHIP OF MONTVILLE REVISED ORDINANCE CHAPTER 8.48.  THE UNDERSIGNED ALSO CERTIFIES THE INFORMATION CONTAINED HEREIN IS ACCURATE AND CORRECT.  THE REQUIRED FEE PER INSPECTION MUST BE RECEIVED PRIOR TO ISSUANCE OF A CERTIFICATE.  PLEASE ALLOW ADVANCE NOTICE FOR INSPECTION.

   __________                   _________________________________________________

               DATE                                                 SIGNATURE OF OWNER OR AUTHORIZED AGENT

__________________________________________________________________________________________

 OFFICE USE

DATE OF INSPECTION: ____________________________________
                                                        FEE DUE $_____________

TIME OF INSPECTION: ____________________________________
                                                       CHECK NO. _____________

TIME AT LOCATION:   ____________________________________
                                                            CASH _____________

CERTIFICATE ISSUED:  YES / NO

FIREPRE/CSDCMAPFEC APPLICATION 2/25/2008