Address
Application Type
Begin typing address and select from the populated dropdown
Property Address
City
{[PNAME]}
ZIP
Suite/Unit #
State
Lot
{[ADDR]}
{[CITY]} Fire Prevention, {[STATE]} {[ZIP]}
(973) 266-5520
www.eastorange-nj.gov
Block
  • Business Details
  • Contacts
  • Attachments/Certification
Knox Box Location
Business Type
Assigned Local ID #
Name
Email
Knox Box?
Description of Use/Special Hazards
Phone #
Fax #
Mobile #
Business Details
Tax ID #
If Other, Specify
Address
Business Owner same as
Email
Building Owner Details
Mailing Details same as Business Owner?
Name
City
Night Phone #
Suite/Unit #
State
Email
Mobile #
State
Day Phone #
ZIP
Suite/Unit #
Billing Details
Business Owner Details
Manager/Agent Details
Phone #
Address
State
Phone #
Name
City
Billing Details same as Mailing Details?
Email
City
Mailing Details
Email
State
Suite/Unit #
Night Phone #
Address
Suite/Unit #
Email
ZIP
Suite/Unit #
Name
# of Emergency Contacts Being Provided
Email
Type of Ownership
Day Phone #
Property Owner Details
Purchaser Details
Phone #
Day Phone #
City
Name
Name
Suite/Unit #
Name
Emergency Contact Details
Mobile #
Suite/Unit #
ZIP
Phone #
State
ATTN
Fax #
Name
Federal ID #
Name
2nd Contact Details
Mobile #
Email
Phone #
Email
Federal ID #
3rd Contact Details
Email
Address
Email
Fax #
Phone #
Name
State
City
Email
ATTN
1st Contact Details
Name
ZIP
Tenant/Operator Details
Name
Night Phone #
State
State
ZIP
Building Owner same as Property Owner?
Mobile #
Fax #
Phone #
Address
Address
Suite/Unit #
Fax #
Address
ZIP
ZIP
Fax #
City
Mobile #
City
ZIP
City
Phone #
Address
Type Full Name :
Sign With Hand
Certification
By signing below, I hereby certify that all of the information provided in this application is true and accurate.
Signature
Attachments
Please attach the below and any supporting documents:
  • Contract of sale, affidavit, etc.