Application for one and two family dwellings
Certification of Smoke Detector and Carbon Monoxide Alarm Compliance

Fees
10 + business days= $50.00, 4-10 business days= $70.00, fewer than four business days= $125.00 Reinspection fee= $50.00

Date: ______________________


Seller / Landlord Name: ______________________________________________________________________

Address:

______________________________________________________________________


_______________________________________________________________________


Seller / Landlord phone: _______________________________________________________________________


Property Location: _______________________________________________________________________
(Wildwood Crest, N J 08260)



Block: __________________ Lot: __________________


Buyers Name: _________________________________________________________________________


Buyers Address: _______________________________________________________________________

_________________________________________________________________________

___________________________________________________________________________



I, ______________________________, certify that I am the owner or authorized representative of the dwelling at the above referenced location and request a smoke detector / carbon monoxide inspection.


Inspection date / time requested:__________________________________________________________


Requirements:

1.) Detectors must be installed and in working order and located on each level of the dwelling, including 
Basement; excluding attic and crawl space and within 10 feet of each sleeping area.

2.) Type 2-A: 10-B:C Fire extinguisher must be tagged for the current year and located in each 
Kitchen. Fire extinguishers must be easily visible to the inspector.

This is a ____________ story building ( ) with ( ) without a basement

Contact Information for a Completed Certification:

Name / Agent:_______________________________________________________________________________


Address: __________________________________________________Phone: ___________________________


( ) call above for pickup ( ) mail to above

Fees pursuant to 2006 ordinance # 996, effective 3/20/2006.