Type Full Name :
Sign With Hand
Phone # *
Name *
Alarm Company Information
{[CITY]}, {[STATE]} {[ZIP]}
Address *
# of Employees *
Email *
Block *
If so, length of lease
***Payment will NOT be requested until your application has been approved & accepted.***
Please monitor your e-mail for the Payment Request e-mail.
Central Station
Occupancy Load *
City *
Attach any of the following documents as PDF, JPG OR JPEG. Additional documents may be requested after review.
  1. Certificate of Occupancy
  2. Copy of certificate or license issued by State of New Jersey or any governmental agency.
  3. For 501C Organizations: A copy of a valid letter from the IRS verifying the not for profit status and a copy of a current good standing certificate issued by the State of New Jerseyand Good Standing Certificate.
  4. If operation involves any flammable/combustible/hazardous materials: provide MSDS sheets
Involves Flammable/Hazardous Materials? *
Business Details
Type of Ownership *
Application Type *
Do you have an Alarm Company? *
Any changes from previous mercantile use? *
Address *
State *
Late fee of $35 starts on July 1st.
# of Exits *
Types of Alarms Monitored (Select all that apply)
Own or Lease the building? *
Supervisor City *
Require Sprinklers? *
Does alarm reset itself?
Supervisor Name *
Days and Hours of Operation? *
Use the table below to add other Business Owners.
1. If a corporation, give names and addresses of president and secretary
2. If a partnership, give names and addresses of all partners
3. If an LLC, give the name(s) and addresses of the managing member(s)
Status of Last Health Inspection *
Supervisor State *
Title *
Business Name *
NJ State Tax ID # *
All Real Estate Taxes Paid and Current? *
Lot *
Outstanding Zoning/Planning Violations? *
Emergency Contacts Details
Building Owner / Managing Agent of Property Details
Alarm Company
State *
Supervisor ZIP *
State *
Sq. Footage of Lot *
Federal Tax ID # *
Phone # *
Is alarm audible?
Fee Schedule
Last Name *
I (we) hereby certify that I (we) have read this application thoroughly and the information contained herein is true and accurate. I (we) understand that I (we) may not use or occupy the property until inspections are conducted and both Business Certificate of Occupancy and Zoning Certificate are issued for such use/occupancy.

Business Registration Ecode
Phone Number
# of Curb Cuts *
Application Fee
Phone # *
Address *
Date of Last Fire Inspection *
How long will alarm sound before resetting? (Time in Minutes)
Attach your documents
Other Business Details
Applicant Signature *
Business Owner / Applicant Details
Date of Last Health Inspection *
Supervisor Address *
# of Parking Spaces *
Business Description *
City *
First Name *
City *
Phone Number
Square Feet *
Email *
Type of Business *
Status of Last Fire Inspection *