![Page 1: Smoke Questionaire and Application Questionaire...QUESTIONAIRE FOR CERTIFICATE OF COMPLIANCE SMOKE AND CARBON MONOXIDE DETECTOR Street address of property: Seller or Landlord of property:](https://reader034.vdocument.in/reader034/viewer/2022042708/5f3acc639e677f7b107eec66/html5/thumbnails/1.jpg)
PREVENTION THROUGH EDUCATION
P:(856)234-1222F:(856)234-4248E:[email protected]:225NorthLenolaRoadMoorestown,NJ08057Division of Fire Prevention Bureau of Fire Prevention www.FirePrevention31.org
QUESTIONAIREFORCERTIFICATEOFCOMPLIANCESMOKEANDCARBONMONOXIDEDETECTOR
Streetaddressofproperty: SellerorLandlordofproperty: Yearofconstruction: BuyerorTenantofproperty: Dateofpropertytransfer: Pleasereadthefollowingitemscarefullyandacknowledgebyinitialingeachitem. IunderstandthatanychangeofownershiporoccupancymaynotoccurpriortoasuccessfulinspectionandpossessionofaCertificateofInitialhere SmokeDetectorandCarbonMonoxide.Furthermore,Iunderstandthatifthereisanychangeofownershiporoccupancywithoutthe
requiredinspection,thepropertyownershallbesubjecttoapenaltyofnotlessthan$100.00ormorethan$2,500.00peroccurrence(N.J.A.C.5:70-2.3).
IunderstandthataFireInspectorfromMoorestownFirePreventionwillinspectthedwellingduringthescheduledtimeslot.IftheInitialhere assignedtimeslotismissedbytheapplicantortheapplicant’sagent,anothernon-refundableapplicationfeemustbepaid.Ialso
understandifIdonotpasstheinspection,ImustreturntoMoorestownFirePreventionofficesandpayare-inspectionfee.
IunderstandthatallsmokedetectorswithinthedwellingmustbeinstalledandmaintainedinaccordancewithNFPA72.IunderstandthatInitialhere allACpoweredsmokedetectorsmustbeelectronicallyinterconnected.Iunderstandthatthateachlevelofthedwellingunitisrequired
tohaveeitheranAC(electric)orDC(batterypowered)smokedetectorinstalled.IunderstandthatthetablebelowprovidesmewiththerequirementsoftheConstructionCoderegardingthenumberandtypeofsmokedetectorsthatarerequiredbasedontheyearthedwellingwasbuiltorCO(CertificateofOccupancy)wasissued.
Pre19751975–19771977–19831983–19911991-Present
DCpoweredsmokedetectoroneachlevel,includingbasementifapplicableACpoweredsmokedetectoronuppermostlevel(DCsmokedetectoronallotherlevels)ACpoweredsmokedetectoronuppermostandbasementlevel/DCsmokedetectorsonallotherlevelsACpoweredsmokedetectorsoneverylevelACpoweredsmokedetectorwithbatterybackuponeachlevelandineachsleepingarea(bedroom)
Iunderstandthatifthedwellingisequippedwithalowvoltagefirealarmsystem,installedbyanalarmcompany,thefirealarmsystemInitialhere mustbetestedandapprovedbyaNJlicensedfirealarmcontractorpriortotheinspection.Acopyofthealarmcertificationprovidedby
thealarmcontractormustbepresentedtothefireinspectoratthetimeofinspection.
Iunderstandthataneworrecentlyservicedwithanunexpiredtag,fullychargedandworkingfireextinguisherwithaminimumweightInitialhere of2½poundsandamaximumweightof10pounds,andwithanABCrating,mustbeinstalledwithin10feetofthekitchen,inthevicinity
ofanexit,notbehindacloseddoor.Iunderstandthatthefireextinguishershallbemounted,nohigherthan5feetfromthefloortothetopoftheextinguisher,andshallbevisibleandreadilyaccessibleforoccupantuse.
IunderstandthattheFireInspectorwillneedaccesstotheelectricalpanelandthatthecircuitforthesmokedetectors,ifapplicable,shallInitialhere belocatedandlabeledfortestingpurposespriortohis/herarrival.Thehomeowneroragentwillberesponsibleforturningthecircuitoff
andon.
Iunderstandthatifthedwellinghasatleastonefuelburningappliance,fireplaceorgarage,aCO(CarbonMonoxide)detectorshallbeInitialhere Installedoutsideofbutwithinthevicinityofallsleepingareas.COdetectorsinbedroomsonlywillnotpassperNFPA720.
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PREVENTION THROUGH EDUCATION
P:(856)234-1222F:(856)234-4248E:[email protected]:225NorthLenolaRoadMoorestown,NJ08057Division of Fire Prevention Bureau of Fire Prevention www.FirePrevention31.org
IunderstandtheFireInspectorwillalsocheckthevisibilityandreadabilityofthehousenumbersonthedwellingtoverifytheyarevisibleInitialhere andreadablefromthestreetintheeventofanemergency.ThehousenumbersmustbepermanentlyaffixedtothehouseinArabic
numbers,approximately3incheshighand1inchwide.Iunderstandthathousenumbersmayneedtobelargerthan3-inchx1-inchinordertobevisiblefromthestreet.Brassandotherbrightmetallicnumeralsmustbeplacedonadarkorcontrastingbackground.Thenumbersshallnotbehiddenbytrees,shrubsordecorativetrim.
IunderstandthattheabovelisteditemsaretobecompletedBEFOREtheFireInspectorarrives,asher/shecannotinstallorrepairitems.InInitialhere theeventthatafailureoccurs,anewappointmentmustbemadeandpaidforpriortore-inspection.Ialsounderstandthepersonmeeting theinspectormustbe18yearsofage,orolder. PrintName:
Date:
Sign:
Pointofcontactforinspection: Phone:
AppointmentDate: AppointmentTime:
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PREVENTION THROUGH EDUCATION
P:(856)234-1222F:(856)234-4248E:[email protected]:225NorthLenolaRoadMoorestown,NJ08057Division of Fire Prevention Bureau of Fire Prevention www.FirePrevention31.org
SmokeDetectors:Smokedetectorsaretobelocatedoneverylevelofadwelling.Inhomeswithonlyonesleepingareaoronefloor,adetectorshallbeinstalledinthehallwayoutsidethebedrooms.Inonestorydwellingswithseparatesleepingareas,asmokedetectorisrequiredoutsideeachsleepingarea.Inmulti-leveldwellings,smokeddetectorsshallbelocatedoutsidethesleepingareasandateverylevelofthedwelling.Asmokedetectorisrequiredtobeinstalledatthebottomofbasementstairwellsandtopofwalk-upatticstairwells,ifapplicable.
FireExtinguisher:
• ABCType• Minimumweight2½pounds/Maximumweight10pounds
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PREVENTION THROUGH EDUCATION
P:(856)234-1222F:(856)234-4248E:[email protected]:225NorthLenolaRoadMoorestown,NJ08057Division of Fire Prevention Bureau of Fire Prevention www.FirePrevention31.org
APPLICATIONFORCERTIFICATEOFCOMPLIANCESMOKEANDCARBONMONOXIDEDETECTOR
ThefeeforissuanceofaCertificateofComplianceis$25.00.Thefeeincreasesto$35.00iftheapplicationissubmittedwithin5daysofinspection.Thefeemustaccompanythisapplication.Checkshouldbemadepayableto:MoorestownFirePrevention.Pleasesubmitacopyofthecontractofsaleorleaseagreementwiththisapplication.DateofApplication: DateofSettlement: AddressforInspection: RequestorName: Address: City: State: Zip: DaytimePhone: Emailaddress: Youarethe: ☐Owner☐Buyer/Lessee☐Agent BuyerorLesseeName: Address: City: State: Zip: PreferredmethodofdeliveryfortheCertificateofCompliance:☐Mail ☐Fax ☐EmailEmailAddress: Fax: IherebyacknowledgethatIhavereadthisapplication,thattheinformationgiveniscorrect,AndthatIamtheownerordulyauthorizedtoactintheowner’sbehalf.Signature: PrintedName: