TOMS RIVER BUREAU OF FIRE PREVENTION33 WASHINGTON STREETTOMS RIVER, NJ 08753732-240-5153EMAIL -TRFIREPREVENTION@TRFIRE.ORG

AFFIDAVIT AND CERTIFICATION IN LIEU OF

INSPECTION FOR CERTIFICATE OF SMOKE DETECTOR AND CARBON

MONOXIDE ALARM AND PORTABLE FIRE EXTINGUISHER COMPLIANCE

Dwelling Location: Block: ______________________________ Lot: _______________________________ (not mailing address)

Street: ___________________________________________________________________

Municipality: ___________________________ County: __________________________

*NOTE: ALL BOXES MUST BE CHECKD IN ORDER FOR CERTIFICATION TO BE VALID

[ ] Smoke detector on each level of the dwelling, including basements, excluding attic or crawl space; and

[ ] Smoke detector and carbon monoxide alarm outside each separate sleeping area; and within 10 feet of bedrooms

[ ] All smoke detectors are in working order. [ ] Carbon monoxide alarm(s) in working order

[ ] Fire extinguisher is the correct size, is properly mounted, and is located within 10 feet of the kitchen

This is a ________ story dwelling [ ] with [ ] without a basement.

An inspection shall be conducted by the owner or an authorized representative of the owner. The smoke detectors required above shall be located in accordance with NFIPA 74; the carbon monoxide alarm(s) installed per NFPA-720. All required detectors SHALL be in accordance with attached sheet.

Please mail certificate to: __________________________________________________ Phone #: ___________________________

__________________________________________________

__________________________________________________ Fax #: ______________________________

______________________________ Zip: _______________

Contact person: ______________________________________ Phone #: _____________________ Closing Date: _______________

I do hereby certify that the foregoing statements made by me are true. I am aware that if any of the foregoing statements made by me are willfully false, I will be subject to penalty.

Sworn and subscribed to before me this __________________ day of _______________, 20___________________.

_____________________________________________ ______________________________________________ Notary Signature Applicant Signature

______________________________________________ Printed Name

Note: Payment in the amount of $75.00 made payable to “Toms River Fire Commissioners”. Once issued, a Certificate is not transferable, nor is a fee refundable. If the change of occupant does not occur within 6 months, a new application shall be required. We no longer accept American Express or E-checks.

FOR OFFICE USE ONLY

Team #: __________ Municipal Code: _________________________ Log Number: _______________________ Check Number: _____________________

Updated - 03/2020

EMAIL

Toms River Township Resale Requirements SCHEDULING: Affidavit will be accepted in Lieu of scheduling an appointment during this time. All regulations & applicable laws still need to be followed. Anyone found closing without filing for an affidavit is still susceptible to the $500 fine listed below.It is a violation of the Uniform Fire Code (N.J.A.C. – 5:70-2.3 & N.J.A.C. – 5:70-2.9) & a $500 fine to close without a Certificate of Smoke & Carbon Monoxide Alarm Compliance. Certificates expire 6 months from the date of issuance & must be obtained every time there is a transfer of title (Non-

transferrable); we recommend you schedule as soon as possible to avoid delays. -What is Required?

SMOKE ALARMS: QUESTIONS TO ASK YOURSELF? When was your home built?

• Prior to 1978 – you should have a minimum of battery operated smoke alarms on each level of the home. If you wererequired to upgrade to electric smoke alarms – they must function.

• NOTE: If you have done any alteration or addition to your home, you should have upgraded your alarms.• 1978 – 1983 – Battery alarms were installed in homes on each level.• 1984 – 1990 – Requires interconnected electric (Hard-wired) smoke alarms with battery back-up on each level.• 1991 – Present – Interconnected electric (Hard-wired) smoke alarms with battery back-up in each sleeping room, within

10 feet of each sleeping room door (Outside Room), & each level of the residence including basements.• NOTE: Working smoke alarms for all years are required to be on every level of the residence including basements.

CARBON MONOXIDE ALARMS: A Carbon Monoxide Alarm on each level of your sleeping rooms (within 10 feet of sleeping room doors). Plug in (electric) units can be only used if there is an outlet in the hallway within 10 feet of the sleeping rooms. Currently, battery-operated units are acceptable and can be placed on the wall or ceiling (in accordance with the manufacturer’s Specifications).

FIRE EXTINGUISHER: GUIDELINES according to the NJAC 5:70-4.19 At least one portable (labeled, charged, & operable) fire extinguisher of minimum 2A-10B:C type, no more than 10 pounds, mounted with manufacturer’s bracket within 10 feet of kitchen area & no higher than 5’, located in egress path, & unobstructed from view – Recently purchased receipt or inspection tag from within past 12 months required.

INSPECTION FEES: • (Initial Inspection - $75.00 (PAID PRIOR TO SCHEDULING) - (1st Re-Inspection – FREE) - (2nd / Additional Re-Inspections - $35.00)• (No Show - $75.00)• (Duplicate copy of Certificate - $30.00)• DUE TO HIGH SCHEDLUING DEMAND, PLEASE SUBMIT APPLICATION AT LEAST 2 – 3 WEEKS IN ADVANCE.

Please contact the Toms River Fire Bureau at 732-240-5153 regarding any questions; Updated 03/2020