Block
Business Location Details
Application Type
Address 2
Important Notice
License Type
Lot
ZIP
10 Reeve Ave
{[CITY]}, {[STATE]} {[ZIP]}
(856) 833-6265
{[AWEBSITE]}
Address
  • Incomplete application will not be processed until all required information is supplied.
  • Please remember to notify us or update any/all emergency contacts if they change throughout the year, as well as any access changes for the (knoxbox) - rapid entry system.
  • Please, do not provide any security system code(s)/information.
  • FOR RENEWAL; deadline is 31st every year, this application must be filled out completely and the renewal fee must all be submitted prior to 1/31. If the application is received after this date or the application is not complete by this date then a $25 late fee will be charged. If the renewal is not completed by 3/1 a court summons will be issued.
City
State
{[PNAME]}
Application
Search for the business address and select it from the drop-down:
  • Business Details
  • Contacts Details
  • Attachments/Certification
Prior use of building:
Phone #
Is there tattooing?
Address 2
Is there an amusement device?
# of Juke Boxes
Total Square Footage of Property
State
# of Amusement Devices
City
Name
Type of Business
Business Details
Is there a car lot?
Is there a fire alarm system?
Is there a laundromat (washer-drying machine)?
Is there a pool table?
Is there juke boxes?
Hours of Operation
Description of proposed business activities:
System Reset Code #/Procedure
Website
Doing Business As (DBA)
Is the address where the business will operate different from the business address?
Is there a laundromat (washer-drying-dry cleaning machine)?
Email
ZIP
# of Pool Tables
Address
Email
Phone #
Please list three (3) employees/contacts who we may call if we need to contact ; who the respective fire departments/officials can contact during normal and/or after hour(s) (24/7) in the event access to the property or owner/manangement is required for emergency personell.
2nd Contact Name
Address
Emergency Contacts Details
City
Address
NOTE: the fire department will access the property with the use of the (knoxbox) - rapid entry system if circumstances warrant, and no emergency contact(s) have responded in a resonable time, dependent upon conditions.
Name
Email
ZIP
List all shareholders, members, partners, directors, officers and registered agent(s) of the applicant.
Fax #
Cell #
State
Fax #
1st Contact Name
Building Owner Details
Phone #
Phone #
SS# or EIN #
3rd Contact Name
State
Phone #
Business Owner Details
Email
Name
City
Email
Additional Owners Details
Cell #
ZIP
Email
Phone #
Type Full Name :
Sign With Hand
I, the applicant, hereby certify that the information supplied herein is true and correct. I further certify that the business for which this application is being submitted complies with all applicable statues and regulations and all applicable ordinances. I understand that violation of any applicable statute, regulation, or ordinance may be grounds for revocation of the Business License for which this application is submitted. I further understand that if any information I have provided in this application is willfully false or misleading, I may be subject to denial of this application or revocation of the License for which this application is submitted.
Business Type Fees
New Business $160.00
Temporary/Seasonal $85.00
Renewal $60.00
Late Fee $25.00
Additional Fees Fees
Zoning $50.00
Car Lot $285.00
CCO $151.00
Laundromat (Washer -Drying Machine) $50.00
Laundromat (Washer-Drying-Dry Cleaning Machine) $100.00
Pool Table $25.00/Each
Tattooing $50.00
Amusement Device $100.00/Each
Juke Boxes $25.00/Each
Please attach everything listed below and any other supporting documents:
  • Valid State issued Driver’s License with photograph or other valid Government-issued Identification with photograph.
  • Proof of authorization to conduct business within the State of New Jersey (A copy of a valid business registration certificate issued by the New Jersey Division of Revenue.)
  • A valid certificate of liability insurance.
Note: Fees will be reviewed and assessed and you will receive an email for for payment via credit card.
Amount Due
Fees
Certification
Applicant Signature
Attachments