Application for Permit

IMPORTANT

The New Jersey Uniform Fire Code (N.J.A.C. 5:70-2.7(a) states: Permits shall be required and obtained from the local enforcement agency for the activities specified in this section, except where they are an integral part of a process or activity by reason of which the 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.

Date of Application (mm/dd/yyyy) *

Location of Event *

Date(s) of Event *

Time(s) of Event *

Applicant Name *

Organization Name *

Street Address *

Email Address

Daytime Telephone *

Emergency Telephone *

Fax Machine Telephone

Registration #

The above named applicant hereby requests permission to conduct the following activity at the above indicated location. *0 / 180

And for the keeping, storage, occupancy, sale, handling or manufacture of the following (include quantities for each category to be stored, or used and the method stored or used. *0 / 180

List appliances to be used *

Are Fire Suppression Systems available ? Yes or No *

If Yes, Last Date of Inspection

Are Fire Extinguishers on location (ABC and/or Class K) ? Yes or No *

If Yes, Last Date of Inspection

IMPORTANT - There are five types of permits. Click the following link for Permit Types and Fees

Permit Types and Fees

Fee Amount (Payable to Cinnaminson Fire District #1) *

USD

Select Permit Type *

I hereby acknowledge that I have read this application, that the information is correct, and that I am the owner, or duly authorized to act in the owner's 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. *0 / 180

By: Fire Marshal - Lt. Jesse Nickum

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