Fire Prevention Request for Extension

(**) INDICATES DEPT. USE ONLY

Pursuant to N.J.A.C. 5:70-2.10(d)2, an application for extension of time shall be deemed to be an admission that the Notice of Violation is factually and procedurally correct and that the violations do or did exist. The following information MUST BE COMPLETED IN ORDER TO BE CONSIDERED, and the information CAN NOT be the same as the Business Address or phone number, UNLESS the owner lives at the address year round.
FPB Use Only
FPB Use Only
FPB Use Only
FPB Use Only
FPB Use Only
FPB Use Only
FPB Use Only