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2. Office of the Fire Marshal
   Contact the Office of the Fire Marshal
4. Date of Application
   Date of Application
6. Location Where Activity Will Occur
8. Date & Time
   Date & Time

   Date & Time
10. Applicant Name
12. Address
14. City
15. ZIP Code
17. Organization Name
19. Owners Email Address
21. Phone Number
23. The named applicant herby requests permission to conduct the following activity at the indicated location:
25. And for the keeping, storage, occupancy, sale, handling or manufacture of the following items:
27. State quantities for each category to be stored, or used and the method stored or used:
29. Disclaimer
    The Uniform Fire Code States: "Permits shall be required, and obtained from the local enforcing agency for the activities specified in this section, except where they are an integral part of a process or activity by reason of which a use is required to be registered and regulated as a life hazard use. Permits shall at all times be kept in the premises designated therein and shall at all times be subject to inspection by the fire official" [N.J.A.C. S:70-2.7{a)] Pursuant to the New Jersey Uniform Fire Safety Act (1.383,c-383, s.2) and Ni.A.C. 5:70, the Fire Official of the local enforcing agency is required to register and inspect all structures and premises, except single-family and two-family dwellings which are occupied by the holder of the title to the property and dwelling units within two-family and multi-family dwellings, as often as necessary for the purpose of ascertaining and causing to be corrected any conditions liable to the cause of fire, contribute to the spread of fire, interfere with fire operations, endanger life or any violations or intent of this code or any other ordinance affecting fire safety.
31. Applicant Signature

    I hereby acknowledge that I have read this application, that the information given is correct and that I am the owner, or duly authorized to act in the owners behalf and as such hereby agree to comply with the applicable requirements of the fire code as well as any specific conditions imposed by the fire official.

    1. I agree.
33. Electronic Signature
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field