Smoke Questionaire and Application Questionaire...QUESTIONAIRE FOR CERTIFICATE OF COMPLIANCE SMOKE...
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PREVENTION THROUGH EDUCATION P: (856) 234-1222 F: (856) 234-4248 E: [email protected] M: 225 North Lenola Road Moorestown, NJ 08057 Division of Fire Prevention Bureau of Fire Prevention www.FirePrevention31.org QUESTIONAIRE FOR CERTIFICATE OF COMPLIANCE SMOKE AND CARBON MONOXIDE DETECTOR Street address of property: Seller or Landlord of property: Year of construction: Buyer or Tenant of property: Date of property transfer: Please read the following items carefully and acknowledge by initialing each item. I understand that any change of ownership or occupancy may not occur prior to a successful inspection and possession of a Certificate of Initial here Smoke Detector and Carbon Monoxide. Furthermore, I understand that if there is any change of ownership or occupancy without the required inspection, the property owner shall be subject to a penalty of not less than $100.00 or more than $2,500.00 per occurrence (N.J.A.C. 5:70-2.3). I understand that a Fire Inspector from Moorestown Fire Prevention will inspect the dwelling during the scheduled time slot. If the Initial here assigned time slot is missed by the applicant or the applicant’s agent, another non- refundable application fee must be paid. I also understand if I do not pass the inspection, I must return to Moorestown Fire Prevention offices and pay a re-inspection fee. I understand that all smoke detectors within the dwelling must be installed and maintained in accordance with NFPA 72. I understand that Initial here all AC powered smoke detectors must be electronically interconnected. I understand that that each level of the dwelling unit is required to have either an AC (electric) or DC (battery powered) smoke detector installed. I understand that the table below provides me with the requirements of the Construction Code regarding the number and type of smoke detectors that are required based on the year the dwelling was built or CO (Certificate of Occupancy) was issued. Pre 1975 1975 – 1977 1977 – 1983 1983 – 1991 1991 - Present DC powered smoke detector on each level, including basement if applicable AC powered smoke detector on uppermost level (DC smoke detector on all other levels) AC powered smoke detector on uppermost and basement level / DC smoke detectors on all other levels AC powered smoke detectors on every level AC powered smoke detector with battery backup on each level and in each sleeping area (bedroom) I understand that if the dwelling is equipped with a low voltage fire alarm system, installed by an alarm company, the fire alarm system Initial here must be tested and approved by a NJ licensed fire alarm contractor prior to the inspection. A copy of the alarm certification provided by the alarm contractor must be presented to the fire inspector at the time of inspection. I understand that a new or recently serviced with an unexpired tag, fully charged and working fire extinguisher with a minimum weight Initial here of 2 ½ pounds and a maximum weight of 10 pounds, and with an ABC rating, must be installed within 10 feet of the kitchen, in the vicinity of an exit, not behind a closed door. I understand that the fire extinguisher shall be mounted, no higher than 5 feet from the floor to the top of the extinguisher, and shall be visible and readily accessible for occupant use. I understand that the Fire Inspector will need access to the electrical panel and that the circuit for the smoke detectors, if applicable, shall Initial here be located and labeled for testing purposes prior to his/her arrival. The homeowner or agent will be responsible for turning the circuit off and on. I understand that if the dwelling has at least one fuel burning appliance, fireplace or garage, a CO (Carbon Monoxide) detector shall be Initial here Installed outside of but within the vicinity of all sleeping areas. CO detectors in bedrooms only will not pass per NFPA 720.
Transcript of Smoke Questionaire and Application Questionaire...QUESTIONAIRE FOR CERTIFICATE OF COMPLIANCE SMOKE...
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.
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:
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
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:
