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Block
Application Type
{[PNAME]}
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Address
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
Lot
  • Contacts
  • Description of Property
  • Attachments/Certification
Will you be using a Third Party Company for the results?
ZIP
Email
Phone #
# of Rental Units
License #
City
Address
Phone #
State
ZIP
Name
City
Year Built
Property Type
City
Applicant Information
Address
Email
Email
Name
Property Owner Information
Phone #
State
Contractor Information
ZIP
Name
Address
State
Basement
Bedrooms
1st Floor
Occupants of Unit #1
Kitchens
Occupants of Unit #2
Unit Information
3rd Floor
Bathrooms
Description of Property
2nd Floor
Type Full Name :
Sign With Hand
Certification
If you are unclear of your selections, please call 201-387-4055 ext 4151 before proceeding.
DEADLINE FOR INSPECTION IS June 1, AFTER WHICH TIME, FINES WILL BE ASSESSED.
Signature
Attach supporting documents, if any.
Application Fee
State Fee
DEADLINE FOR REGISTRATION IS February 15, AFTER WHICH TIME, FINES MAY BE ASSESSED.
NOTE: IF PAYING ONLINE, ONCE IN THE PAYMENT SCREEN DO NOT HIT THE 'BACK' BUTTON.
Inspection Information
Attachments
Is the owner or lessor using a Borough Certified Visual Assessment Official for the Visual Assessment?

The fees are as follows and made payable to the Borough’s Building Department: 

If the owner or lessor uses a Borough Certified Visual Lead Assessment Official for the Visual Assessment, the periodic visual assessment fee is as follows:

  • Fee for dwelling with single unit: $100
  • Fee for any additional unit in a dwelling: $50
  • New Jersey Division of Community Affairs inspection fee per unit: $20

If the owner or lessor does not use a Borough Certified Visual Lead Assessment Official for the Visual Assessment, the administrative fee for processing the independent periodic visual assessment is as follows:

  • Fee for dwelling with single unit: $50
  • Fee for any additional unit in a dwelling: $25
  • New Jersey Division of Community Affairs inspection fee per unit: $20 
Fee Schedule
I hereby declare and affirm that I am the legal owner or authorized agent of the legal owner of this property, and that all information on this form is complete and accurate to the best of my knowledge.

I, the legal owner or authorized agent of the legal owner of this property, understand that failure to comply with state, county, and local ordinances regarding residential rental dwelling units will result in legal action, which can include but is not limited to Notices of Violation, summons to Municipal Court, property liens, and other penalties.