No Yes

Yes No N/A

Yes No N/A

Yes No N/A

New - Payment Requested Payment Received Pending Document Pending Review Approved Pending Inspection In Violation Inspection Scheduled Denied Closed

Cash Check Money Order Fee Exempt No Fee Required

Renewed Not Renewed

New Renewal

Seasonal Annual

No Yes

Yes No

Yes No

Yes No

Yes No

Yes No

Owner of Record Registered Agent of Owner

Yes No

Yes No

Yes No

Gas Heat Fuel Oil Heat Electric N/A

Yes No

Yes No

Important Information

Status

Lead Information

Address

Registration Type

Heating Type *

If this is a Seasonal rental, attach a Parking Diagram. For Annual rentals, attach a Copy of the Signed Tenant Lease. For seasonal rentals please attach list of any agents negotiating the tenancy of the rental.

***All rentals need to provide an insurance declaration***

***Please note:

• Except as provided in subsection b. of this section, the owner of a business or the owner of a rental unit or units shall maintain liability insurance for negligent acts and omissions in an amount of no less than $500,000 for combined property damage and bodily injury to or death of one or more persons in any one accident or occurrence.
• The owner of a multifamily home which is four or fewer units, one of which is owner-occupied, shall maintain liability insurance for negligent acts and omissions in an amount of no less than $300,000 for combined property damage and bodily injury to or death of one or more persons in any one accident or occurrence.

Is Applicant Owner of Record or Agent? *

Janitor Phone

Last Name *

Address *

COUNT Tenants

Schedule Inspection With The Town?

Association Phone #

Attachments *

Rental *

Does the owner state that there have been no prior revocations or suspensions of the license, and there are no pending open complaints awaiting hearing? *

Owner Count

Are there any mortgages on the property? *

Are there any open permits or violations on this property? *

Tenant Count

Details on this agent and/or any other negotiating the tenancy of the rental should be added in the attachment section below in a PDF or Word document.

Application Signature *

Inspection Fee

Additional Phone #

Tenant(s) same as last year?

Do you have a Lead Certification?

Name

Does the owner state that neither the property or the individual applicant, or any entity that the individual applicant has been a member/owner of, has had any prior violations of any Borough ordinance since January 1, 2022 and that there are no pending complaints awaiting a hearing? *

Janitor Name

Bedrooms

If the owner is not residing in Point Pleasant Beach, then the name and address of the agent of the owner of the premises residing in or having an office in Point Pleasant Beach who is authorized to accept mailed service of any notice or order and to comply with the same on behalf of the owner must be provided.

Mailing Address *

Owner Information

Applicant Information

Year Built

Contact Person

Phone #

Emergency Contact Information

Does the owner state that the they are not violating the Zoning Ordinance of Point Pleasant Beach at the property in question? *

Number of Bedrooms

Association Name

Does the owner request waiver of the short-term rental rules for the September 30th to May 15th season?

If requesting a short-term rental waiver, will the owner be actually present and living in Point Pleasant Beach during the period of their request?

Name *

I submit the following information in reference to N.J.S.A 46:8-28 regarding the above referenced property. I certify the information to be true and accurate.

Address 2

Is this person responsible for maintenance or janitorial issues? *

State

Tenant Information

First Name *

Please add owner information here, including if the rental business is owned by a partnership, LLC, Corporation or other business relationship, provide the names of all general partners, registered agents, members, and or corporate offices. All owners must be provided to show 100% ownership.

Oil Provider Address

COUNT Bedrooms

Application Fee

If this is an annual rental application all the tenant information should be filed out below. If this is a seasonal application any tenant information available today should be filled out below. If you have information on new seasonal tenants as the year progress you must email that information to building@pointbeach.org before the tenant occupies the rental. (Tenant names, permeant address, dates of rental.)

Count Owners

Lot

Property Information

Additional Phone #

Heating Information

Enter Street Number and portion of street name (Ex: 123 main) and press Enter to begin search:

If the owner or owners do not reside in Point Pleasant Beach there needs to be an agent of the owner residing in or having an office in Point Pleasant Beach who is authorized to be the emergency contact.

Oil Provider

Does the owner of a multi-unit dwelling request waiver of the short-term rules for the May 15th to September 30th season?

Failure to provide tenant names, permeant address, date of rental prior to all rental dates will result in summons.
When found guilty owner shall be denied from renting any property in which they hold interest for 2 years.

Certification

Is this a resident of Point Pleasant Beach? *

Association Address

Phone #

Phone # *

Phone # *

Mortgage Holder Information

I certify that the information mentioned above is true to my knowledge.

Janitor Address

Balance Remaining

Pursuant to N.J.S.A. § 40A:10A-1 et seq, all landlords and business owners are required to provide an insurance declaration.

**Please be advised an application will be deemed incomplete without the declaration.**

ZIP

Fee Schedule

Block

# of Units in the building

Is this property part of an association (HOA, Condo, Master, Co-Op)? *

City, State, ZIP *

Email *

Property Address *

City

Payment Requirements

Email *

Is this an owner-occupied property? *