{[PNAME]}
Begin typing address and select from the populated dropdown *
Property Type *
If Other
{[CNAME]}
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[PPHONE]}
{[AWEBSITE]}
  • Property
  • Contacts
  • Certification
Zip Code
Block
# of People *
City
Zone
Current License Number (for Renewal)
Lot
# of Rooms *
Application Type *
# of Apartments *
Property Details
Address *
State
Application Cycle *
Type *
City, State, ZIP
Email *
Dealer Address
State
Dealer Name
Property Owner
Address
Type *
Room #
Mailing Address
Email *
Evening Phone #
Heating Details
Phone #
Operator/Manager Information
Phone # *
If Other, enter the contact information below:
City
Name *
New Applicants and new Operator/Manager must be fingerprinted by IdentoGO.
Applicants must successfully pass the background check prior to licensing.
Name *
Daytime Phone # *
Phone # *
Emergency Contact Person Is
State
Name
Enter the following information ONLY if there is a change in partnership or corporate partnership information supplied last year.
ZIP
City
Partnership Information
Emergency Contact
ZIP
Email *
Heating Grade
Type Full Name :
Sign With Hand
Attachments *
Fee Schedule
Occupancy Permit Fee = Number of Rooms x $50

1. A bill, driver’s license or other documents showing that the operator/manager lives at this address must be attached to this application.
2. For Renewal Applications - You must attach the following items:

  • Floor plan of building – only if changes have been made to the floor plan previously submitted
  • Fire Certification
  • Current State Certification
  • Proof that all real estate taxes, sewer, user or connection fees and other municipal liens and charges are currently up-to-date
  • Payment of your application fee ($100.00) and inspection fee ($30.00 per rentable room). The inspection of any apartment is excluded from an inspection fee during the annual Rooming House inspection
  • Current Certificate of Land Use Compliance
  • There will be a reinspection fee of $40 per rentable room, $75 for common areas, and $75 for the exterior of the property.
Certification
Pursuant to §211-6.C – All applications by a natural person, partnership or unincorporated association of natural persons shall be duly sworn to by each of the applicants. An application by a corporation shall be duly sworn to by the president or vice-president of the corporation. All statements in the application shall be deemed material, and any person who knowingly misstates any material fact therein shall be guilty of a crime of the fourth degree pursuant to N.J.S.A. 40:52-10.
Application Fee = $150
Have you ever convicted of a crime involving moral turpitude or any crime under NJ Law licensing or reguation a Rooming or Boarding House? *
Applicant Signature *