Type Full Name :
Sign With Hand
Number of Bedrooms *
New Occupant Details
{[CITY]}, {[STATE]} {[ZIP]}
Provide details of all new occupants
Designee Details
License Year
Property Owner Details
Designee City State Zip
Type *
By signing below, I the owner certify, swear and affirm, under oath, that the foregoing statements made by me are true. I am aware that if any of the foregoing statements made by me are wilfully false, I am subject to punishment. *
Business Type
Designee Address
Contact Person Details
Address *
Designee Phone
Amount Due:
In accordance with Sections 26-3.5(a), or 26-3.5(b) of the Borough of Belmar Revised General ORdinances, as those Sections may be applicable to this application, I hereby designate the following person to maintain the documents and information required of a property owner and to produce these documents and information to any official or employee of the Borough of Belmar in accordance with a request made pursuant to Section 26-2.8 of the Revised General Ordinances of the Borough of Belmar.
Current water meter reading on file
Designee Email
Fee Schedule

  1. I have obtained a certification (lease or affidavit) in accordance with Borough of Belmar Revised General Ordinances 26-3.5(b)(5)(d), advising of the occupancy limits of the unit, completed by each of the persons who will be tenants of the dwelling unit.

    And, if an "Animal House Bond" pursuant to Ordinance section 26-11 et seq. is in effect on the property in which the dwelling unit is located, Section 4.B must also be compiled with:

  2. I have obtained a certification (lease or affidavit) in accordance with Borough of Belmar Revised General Ordinances 26-3.5(b)(5)(e), advising of the existance of an "Animal House Bond", completed by each of the persons who will be tenants of the dwelling unit.

Email *
Begin typing address and select from the populated dropdown *
2nd Inspection (If initial fails):
NOTE: An inspection will not be scheduled and a Certificate of Inspection and/or License will not be issued if all requirements of the Belmar Ordinances have not been complied with, including but not limited to: payment of taxes, municipal charges and applicable fees, inspection fees, and submission of a floor plan.

WARNING: Please be sure to fill out the application completely. An inspection will not be granted until the form is filled out. INCOMPLETE APPLICATIONS WILL RESULT IN A DELAY IN PROCESSING TIME OF APPROXIMATELY 1 WEEK. NO EXCEPTIONS.
Taxes and water/sewer accounts paid in full
Application Details
Designee Business Name
  1. I have paid in full any and all: Taxes: Water payments, Sewer payments, any other municipal charges, Certificate of Inspection fees, Mercantile License fees, Fire Inspection fees and Tourism fees.

  2. Select One:
Mercantile License Fee:
Closing Date (If Applicable)
Phone #
Property Details
Who should we contact for inspections? *
Designee Full Name
Designating this person to accept service and/or comply with lawful orders of the Borough inspectors or police *
Tourism Fee:
Weekly Rental *
Name *
Address *
Fire Inspection & License:
Animal House paid in full if property has been determined to be an Animal House. List all Animal House properties is located HERE.
Agent Details
Inspection Fee Total
Address 2
Animal House Fee
Finished Basement
Requested Inspection Date
City, State, ZIP *
Specify if any of the following accessory structures exist at this address
3rd Inspection (If 2nd fails):
Phone # *
Phone #
By way of Certification, under oath, in lieu affidavit say that:
  1. I have retained a fully executed copy of any lease agreement executed by all adult persons who will be tenants of the dwelling unit, if a written lease agreement was made.

  2. I have obtained a true and correct copy of the driver's license or, if not available, alternative proof of identification, for each adult tenant.

  3. I have determined that each such adult tenant intends to reside in the dwelling unit for a duration of 175 days or less and as his or her temporary residence, and that he or she maintains a permanent residence elsewhere.

  4. You must have compiled with this paragraph and initial this line if the application is for a Summer Rental Unit that has not undergone changes in the configuration of the unit which would effect the occupancy rate and you have compiled with paragraph 6B. If not the application will be processed, the inspection will occur, however, the Certificate of Inspection and/or the Summer Rental License will not be issued until this section has ben initialed, dated and delivered to the Belmar Dept. of Code Enforcement.
(Please note there is no guarantee re-inspections will be done before Memorial Day weekend).