North Hanover Township

Office of the Fire Marshal

41 Schoolhouse Road

Wrightstown, NJ 08562

Robert Gancarz

609-758-2522 ext 218

Application for Certificate of Smoke Detector, Carbon Monoxide and Fire Extinguisher Compliance

Property Information:

Block:__________ Lot:__________

Address:_________________________________________________________________________________

Resale:__________ Rental: __________ Date of Closing: _______________________________________

Number of Bedrooms:__________ Number of Stories:__________ Basement : YES NO

Year Constructed: __________

Seller/Owner Information:

Name(s):__________________________________________________________________________________

Current Street Address:______________________________________________________________________

City, State, Zip:____________________________________________Phone #:__________________________

Realtor/Attorney/Agent:____________________________________Phone #:__________________________

(Circle One)

Email: _____________________________________________________________________________________________________

Buyer/Renter Information:

Name(s):__________________________________________________________________________________

Current Street Address:______________________________________________________________________

City, State, Zip:____________________________________________Phone #:__________________________

Realtor/Attorney/Agent:____________________________________Phone #:__________________________

(Circle One)

Email: _____________________________________________________________________________________________________

_________________________________________ _________________________________________

Applicant Name Date Applicant Signature

Please make checks payable to North Hanover Township

Requests received more than 10 business days prior to change of occupant: $35.00. Requests received four to 10 business days prior to the change of occupant: $70.00. Requests received fewer than four business days prior to the change of occupant: $125.00 __________________________________________________________________________________________

FOR OFFICE USE ONLY

Date Application Received:________________ Fee: $ _____________Check #/Cash: _____________ Receipt #: _______

The above referenced property has _______ smoke detectors (all must be checked), on each level of the dwelling including basements but, excluding non-habitable attics and crawl spaces. There are smoke detectors in the immediate vicinity (10 feet) of all sleeping areas. All smoke detectors were found in working order.

The Dwelling is required to have carbon monoxide detector(s) ____Yes ____No

There are _____ carbon monoxide detector(s) in the immediate vicinity of the sleeping area(s) and all were found to be in proper working order.

A 2A:10BC Fire Extinguisher is to be installed within 10ft of the kitchen area see further instruction on reverse side of the application.

Inspector:_________________________________ Certificate #______________________________Date:____________

Certificate Given To:_________________________________________________________________ Date:____________

_{WHERE TO LOCATE ALARMS:}

_{Alarms are to be located on every level of a residence, (basement, first floor, second floor) excluding crawl spaces and unfinished attics, and in every separate}

_{sleeping area, between sleeping areas and living areas such as the kitchen, garage, basement or utility room. In homes with only one sleeping area on one floor,}

_{an alarm is to be placed in the hallway outside each sleeping areas as shown in Figure 1. In single floor homes with two separate sleeping areas, two alarms are}

_{required, outside each sleeping areas as shown in Figure 2. In multi-level homes, alarms are to be located outside sleeping areas and at every finished level of the}

_{home as shown in Figure 3. Basement level alarms are to be located in close proximity to the bottom of basement stairwells as shown in Figure 4.}

_{WHERE NOT TO LOCATE ALARMS:}

_{To avoid false alarms and/or improper operation, avoid installation of smoke alarms in the following areas:}

_{Kitchens-smoke form cooking may cause nuisance alarm.}

_{Bathrooms -excessive steam from a shower may cause a nuisance alarm.}

_{Near forced air ducts-used for heating or air conditioning-air movement may prevent smoke from reaching alarm.}

_{Near furnaces of any type-air and dust movement and normal combustion products may cause a nuisance alarm.}

_{The 4 inch “Dead Air” space where the ceiling meets the wall, as shown in Figure 5.}

_{The peak of an “A” frame type of ceiling-“Dead Air” at the top may prevent smoke form reaching alarm.}

_{FURTHER INFORMATION ON ALARM PLACEMENT:}

_{For further information about alarm placement consult the National Protection Association’s Standard No. 74-1984, titled “Household Fire Warning Equipment.”}

_{This publication may be obtained by writing to the Publication Sales Department, National Fire Protection Association, Batterymarch Park, Quincy, MA. 02269.}

_{CARBON MONOXIDE ALARMS are to be located in every separate sleeping area per NFPA 720 and manufacturer’s recommendations.}

_{WHERE TO LOCATE FIRE EXTINGUISHER:}

_{Within 10 feet of the kitchen and located in the exit or travel path; and is visible and in a readily accessible location. The top of the fire}

_{extinguisher is not more than 5 feet above the floor and is mounted using manufactures hanger or brackets. Minimum size of 2A:10B:C and}

_{weigh no more than 10 pounds, is accompanied with the owners manual or with the proper written instructions. The extinguisher is listed,}

_{labeled, charged and operable. The extinguisher must have been serviced and tagged by a contractor certified by the New Jersey Division of Fire}

_{Safety within the past 12 months or seller must provide a recent proof of purchasing receipt.}