Yes No

Yes No

Renewed Not Renewed

New In Review Payment Requested Paid Approved Issued Denied Expired Renewed

No Yes

New Renewal Location Change

AL AK AZ AR CA CO CT DE FL HI ID IL IA KS KY ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY AS DC FM GU MH MP PW PR VI

Own Lease

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Yes No

Phone # *

Name *

Vending/Lottery Machine(s)

Type of Sign

Address *

Boat Slips

Central Station

Email

Does alarm reset itself?

Emergency Contact Details (Up to 3, 1 Required)

Email *

Fire

Last Name

Block

***Payment will NOT be requested until your application has been approved & accepted.***
Please monitor your e-mail for the Payment Request e-mail.
***Please DO NOT SUBMIT DUPLICATE REQUESTS.***

Pinball Machine(s)

Multi-Room Cabins or Trailers

If "Lease", length of lease?

First Name

How long will alarm sound before resetting? (Time in Minutes)

Tennis/Squash/Handball/Paddleball Courts

Alarm Company Information

Ice Machines

Email

Inspection

Business Location

Application Type *

Rooms (Hotels/Motels)

Email

No of units

Is alarm audible?

Will You Be Installing a Sign? *

Address *

An inspection must be completed by the department of Construction and Code Enforcement before this application can be approved. The inspection fee is $250 payable by cash or check to City of Somers Point. This fee is separate of the Mercantile License / Business Registration fee. Please send the inspection fee to: 741 Shore Rd, Somers Point, NJ 08244 (include GovPilot Reference # with payment).

Seats (Restaurant)

Lot

If “Yes”, state the previous business (if known)

Phone #

Own or Lease the building? *

Last Name *

Size of the Sign (SQFT)

Block

City *

ZIP

Panic/Hold-up

Temperature

Supervisor Name *

Was the Property Previously Occupied? *

Bowling Alleys

Owner name

Title *

Business Name *

Attach your documents

Title

Email *

Person to be contacted to setup inspections?

Email

Phone # *

Phone Number

Lot

Last Name

Building Owner Details

Flood

Installation Company

Property address

State

State *

Other

An inspection must be completed by the department of Construction and Code Enforcement annually before this application can be approved. Please contact 609-927-9088 ext 142 to set up the inspections.

Movie Theater Projectors

Electrical Transmissions

Burglary

Washers/Dryers/Laundromat

Phone Number

Taxi Cabs

Phone # *

Lock Box code

Last Name *

I (we) hereby certify that I (we) have read this application thoroughly and the information contained herein is true and accurate.

Mercantile Registration Ecode.

Baths, Saunas, Pools

The following Application Fee shall apply to this Business Type

Phone #

Will signage be added or any alterations made to existing signage?

Phone # *

Business Type *

Address *

Rental Owner Email

Certification

Types of Alarms Monitored (Select all that apply)

Garages & Parking Lots

Title

Single Room Cabins or Trailers

Other Business Details

Applicant Signature *

If you have any of the following, please select and list how many:

Business Owner Details

Inteded Use

First Name *

Description of Business *

Phone #

Building occupied

First Name *

City *

Gas Pumps

1. CCO
2. Certificate of Insurance
3. Restaurants must attach their County Board of Health Certificate. Please upload attachments as PDF, JPG, or JPEG

Short-Term Rental

Will there be any alterations/construction?

Title

Pool Table, Music, Video Games, Auto. Slot Machines, etc.

Email *

ZIP *

Medical

Phone #

First Name