Business Name (if applicable)
Agent same as?
Tenant(s) Information
Address
Phone #
Fax #
Please make sure to input all unit(s) information to be able to submit the form.
Are there any other owners/partners?
Address
Fax #
If the record owner is a corporation or LLC, add the names, addresses, phone numbers and email addresses of the registered agent and of the corporate officers.
Email
Property Owner Information (Current)
Full Name
Business Name (if applicable)
Property Manager Information
Address
Fax #
Corporate Information
Buyer same as applicant?
City, State ZIP
Email
Full Name
Emergency contact same as?
Address
City, State ZIP
Buyer Information (New Owner)
Contractor Information
Emergency Contact Information
Email
Business Name (if applicable)
Fax #
Email
Address
City, State ZIP
Applicant same as property owner?
Corporation Name
Phone #
Full Name
Full Name
Phone #
Address
Address
Full Name
Email
Fax #
City, State ZIP
Email
Phone #
Email
Registered agent same as?
Business Name (if applicable)
Registered Agent Name
Phone #
City, State ZIP
City, State ZIP
Property manager same as?
Business Name (if applicable)
Contractor same as?
Fax #
Full Name
Business Name (if applicable)
City, State ZIP
Applicant Information
Fax #
Will the new owner occupy the property?
Add the name, address, and telephone number of the record Owner(s) of the Property. In the case of a partnership, this information shall be provided for all general partners.
Business Name (if applicable)
Agent Information
City, State ZIP
Address
Business Name (if applicable)
Phone #
Phone #
Fax #
Full Name
Property owner is a corporation?
Email
Phone #
I have read and acknowledge the smoke detector and carbon monoxide requirements.
- Landlord Registration (Condos) $25.00
- Rental Registration/Inspection (Single or Duplex properties) $100.00 per unit
- Lead-Safe or Lead-Free Certificate Filing Fee (only required to pay one-time for the certification term – i.e.: 2-years, 3 years for lead-safe or life of the certificate for lead-free) $700.00 per certificate
- Please see Housing Ordinance/CO Ordinance for Commercial CO fee
Applicant Signature
By signing below, I the owner certify that all of the information provided in this application is true and accurate. I certify that this dwelling and all other structures on the property meet the zoning requirements of the {[CNAME]} I attest to the fact that no rubbish/debris/bulk garbage will be left on this property prior to new occupancy. I understand that failure to comply will result in retraction of the {[PNAME]} and a summons will be issued. I understand that this applies to all properties that fall within the {[CNAME]}.
Attachments
Fee Schedule
Preferred Inspection Date
Rental Inspection Times for Scheduling
*NOTE: Rental inspections are NOT required for condominium rentals.
- Tuesdays & Thursdays between 5:00pm – 7:00pm
Housing Inspection Times for Scheduling
- Mondays through Fridays between 11:00am – 2:00pm.
Please note that this is not a confirmed inspection appointment. Once a Township official reviews your request, you will receive an email either confirming the selected inspection date and time or providing alternate available time slots if your requested appointment is unavailable.
Amount Due
Pay Later
If you need to make your payment by mail or in person, our office is located at:Maple Shade Township
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}, {[APHONE]}
Preferred Inspection Date
I acknowledge all open permits must be closed prior to a certificate being issued.
Certification
Please attach the following documents (if applicable):
- Floor Plan
- Rentals Only: Insurance Policy showing $500,000 in liability coverage for non-owner-occupied properties OR $300,000 in liability coverage for owner occupied properties
- Rentals Only: Lead-Safe or Lead-Free Certificate
- State of New Jersey Department of Community Affairs (DCA) Registration Certificate (3 or more units only)
Preferred Delivery Method