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Instructions

The Board of Health will approve the application & issue a license after a satisfactory health inspection. Contact Northwest Bergen Regional Health Commission at 201-445-7217 Monday thru Friday from 8:30am to 4:00pm to schedule an inspection prior to opening establishment.

Per Board of Health Ordinance #2021-01 the following fees are established. All annual fees are due no later than March 1ˢᵗ of each calendar year. Any fee not received by this date will be considered late and subject to a late fee equal to 50% of the annual license fee. The operator and the employees must observe all applicable codes, ordinances, rules & regulations of the Montvale Board of Health & New Jersey State Department of Health. The establishment will be subject to periodic health inspections by Northwest Bergen Regional Health Commission. If mailing, include the Copy of the Application & payment to:

Borough of Montvale
Board of Health
12 DePiero Drive
Montvale, NJ 07645

Does Your Establishment Have a Grease Trap?
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Date of last Inspection
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  • Establishment Details
  • Owner Details
  • Grease Trap Details
  • Food Handlers
  • Attachments
  • Fees & Certification
Phone #
Seating Capacity
Lot
Establishment Type
City
If Other
Address
Registration Type
ZIP
State
Description
Is The Establishment a Non-Profit?
Establishment Details
Establishment Name
Address 2
Business Sq.ft.
Block
Email
Email
City
Emergency Contact Details
First Name
Email
Is Building Owner Same as Business Owner?
City, State, ZIP
State
Phone #
First Name
Business Owner Details
Phone #
Last Name
Address
Building Owner Details
ZIP
Phone #
Last Name
Last Name
First Name
Address
Email
Grease Trap Details
Capacity (in gallons)
Make
ZIP
N/A
Name
Disposal Facility License #
Device Type
Name
Flow Rate (gallons per minute)
Phone #
License #
Cleaning/Inspection Company Details
License #
Plumber Details
State
Inspection and Cleaning Date
Phone #
Model
Additives
Location(s)
N/A
Address
City
City, State, ZIP
Disposal Facility Name
Address
Please provide name(s) of person(s) who attended Food Handlers Training Course and date of certification.
Food Handlers Details
- Please Attach Latest Grease Trap Inspection Report.
- Please Attach Certificate of Insurance
Attachments
Type Full Name :
Sign With Hand
In making this application, I or we, agree to comply with all of the ordinances of the Borough of Montvale, and the law of the State of New Jersey, covering such establishment. It is further understood that, I or we, will surrender licenses, if granted, to the Borough of Montvale on demand. Expiration date is December 31st of each year. When there is a change in ownership or discontinuance of business, this license must be surrendered to this office.
Certification
Application Fee
Type Fee
Bakery $250
Convenience Store $400
Delicatessen $275
Misc. Retail Food Establishment $500
Mobile Ice Cream $200
Nursery School or Daycare $300
Agricultural Market or Farm stand $300
Candy Counters (Pre-packaged candy/goods) $100
Dairy Products Dispensing Truck $75
Restaurant (1 to 50 seating capacity) $400
Restaurant (Over 50 seating capacity) $800
Supermarket (under 50,000 sq.ft.) $1000
Supermarket (Over 50,000 sq.ft.) $2000
Late Fee Starting from March 1ˢᵗ of the Licensing Year 50% of The Application Fee
Late Fee
Fee Schedule
Applicant Signature