Please complete the enclosed application and PRINT clearly.

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Certificate of Occupancy Application Cover Sheet County of Monmouth (732) 872-1224 x215 ph (732) 872-0670 fx www.highlandsborough.org Please complete the enclosed application and PRINT clearly. Return the application by mail: Attn: Code Enforcement Building & Housing Dept. Or email to: DMercado@highlandsborough.org Or fax to: (732) 872-0670 Code Enforcement Hours: Mon. & Wed.: Tues. & Fri.: Thurs.: 8am - 4pm 8:30 a.m. 4:30 p.m. 11:30 a.m. 7:30 p.m. Please note the following information: Certificate of Occupancy Inspections are performed Monday through Friday, during regular business hours, by appointment only. Someone shall be present during inspections to allow access for the inspectors. We do not accept keys to the property. Appointments can be scheduled by phone, email, or in person at the borough office. YOU MUST SUBMIT A FLOOR PLAN FOR EACH DWELLING. The floor plan shall depict the number, dimensions and location of each room in the unit identifying each room, including both its designed and actual use. No space shall be used for sleeping purposes which has not been so designated as a sleeping area on the sketch provided by the own and approved by the Housing Official. UTILITIES MUST BE TURNED ON DURING INSPECTION. Fee Schedule: Certificate of Occupancy Fee $ 50.00 Fire Inspection Fee $ 35.00 Re-Inspection Fee C/O $ 25.00 Re-Inspection of a Re-Inspection of Violations $ 75.00 No Show at Requested Inspection, Re-Inspection Fee (15-minute wait) $ 80.00 No Show Re-Inspection Fee (15-minute wait) $100.00 TCO $ 75.00 Replacement of Lost Inspection Certificate by Applicant $ 10.00 Pre-Inspection Fee $ 10.00 Please do not combine fee payments. Separate checks or cash amounts must be submitted for each fee.

Application for Certificate of Occupancy Fee: C/O $50.00 Fire $35.00 TOTAL FEE $85.00 Certificate # PROPERTY INFORMATION Sale Block # Lot # Rental Street Number of Units Pre-Inspection Total # of Adults Total # of Children # of Bedrooms SELLER / LANDLORD INFORMATION Name Phone Street City State Zip BUYER / TENANT INFORMATION Name Phone Street City State Zip Complete the following information for all occupants including children: NAME GENDER DATE OF BIRTH AGE #1 #2 #3 #4 #5 #6 ALL INFORMATION MUST BE FULLY COMPLETED

Application for Certificate of Occupancy OWNERS CERTIFICATION I, as the landlord/owner/agent of the subject property, agree to keep all areas of the property that are under my control, in a reasonably safe and sanitary condition so as to not endanger the lives or well-being of my tenants or other residents of the. I understand occupancy of this unit before an inspection has been performed and completed is illegal and a violation of borough ordinances and as such, is punishable by municipal summonses. I understand illegal and unsafe living conditions are not acceptable to the borough and I am responsible for such conditions created directly myself. I hereby certify that the information provided is true to the best of my knowledge and I know that if the information provided is willfully wrong that I am subject to a fine. Signature Email Date Phone FOR USE BUILDING DEPARTMENT SECRETARY Amount Paid: Cash: Check# Check# Floor Plan Provided: Yes No Pick Up C/O Mail C/O Email FOR USE CODE ENFORCEMENT OFFICER Approved Signature Date VIOLATIONS 1. 6. 2. 7. 3. 8. 4. 9. 5. 10.

Certificate of Continuing Occupancy, This checklist is to be utilized by residents as a convenience and is to be the definition of codes. The certificate of continued occupancy inspection regarding the conditions of structures and/or appurtenant systems are based solely on interpretive determinations pursuant to visual observations or where applicable, brief operation of subject equipment. The certificate of continued occupancy inspection will include, but is not limited to the following areas: EXTERIOR OF BUILDING 1. Condition of gutters, downspouts, and leaders. 2. Condition of the sidewalks, driveway, apron and handrails. 3. Condition of accessory structures i.e. sheds, fences. 4. All windows and doors in habitable rooms must have screens in good condition. 5. Condition of chimney and flashing. 6. Condition of sliding of structure (paint, brick, stucco finishing). 7. All exterior and interior stair which have four (4) or more risers or more than 30 inches above ground level must have handrails. 8. Grounds around buildings must be free of debris (garbage/rubbish). 9. Provide symbols for address on front of house or mailbox (min 3 high). INTERIOR OF BUILDING 1. Every habitable space shall contain at least two (2) separate receptacles (unless pre-existing). 2. Check for lighting fixtures in hallways, stairways, bathrooms, laundry rooms and furnace rooms. 3. All windows are to operable 4. Smoke detectors required on every story of the dwelling unit, including basement. 5. All broken or crack windows must be replaced. 6. Check all plumbing fixtures for leaks. 7. Check electrical system. GFI (ground fault interrupter switches) are required in kitchen, bathroom(s), and laundry room. 8. Check for excess debris in attic, basement and throughout the house. 9. All interior surface must be in good, clean and sanitary condition. 10. Gas stove and gas dryer mush have shut-off valve behind each appliance. 11. Hot water heater must have approved pressure relief valve and extension 8 from floor. 12. Check all plumbing fixtures for leaks. 13. Check for ventilation in bathrooms. 14. Check stove, must be clean & in proper working condition. 15. Carbon Monoxide Detector with ten (10) feet of each bedroom in every dwelling with gas utility and/or attached garage. 16. An ABC Type Fire Extinguisher, no larger than ten (10) lbs. mounted ten (10) feet away from stone, top of the unit no higher than four (4) feet from the floor. All utilities, gas, water, and electric must be operating for inspection. By issuance of the certificate of continued occupancy, neither the borough nor any of its officers or employees assumes any liability neither expressed nor implied in connection therewith.

Change of Title Request Code Enforcement Department County of Monmouth (732) 872-1224 x215 ph (732) 872-0670 fx www.highlandsborough.org Date: Owner Information Name Street City State Zip Phone Email Property Information Street Block Lot Buyer Information Name Street City State Zip Phone Email I understand that the change of title means the property is being sold as is to the new buyer. I further understand that before any person moves into the building, a complete certificate of continuing Occupancy inspection must be performed and completed by the code enforcement officer. Signature: Date: o Failure to follow these regulations will result in a summons and possible eviction. o There is an inspection checklist attached to the CO application.