Bureau of Fire Prevention
Borough of Berlin
P.O. Box 226 - Berlin, NJ  08009
Telephone 856-767-6839
 
APPLICATION
FIRE SAFETY PERMIT
 
Date of Application:  
 
 APPLICANT
Name:  
 		 Address:
Telephone No.:  
 		  
 LOCATION  OF PERMIT REQUEST
Name of structure, building, premises:  
 		 Proposed date:
Address:  
 		 Telephone:
 
The above named applicant hereby requests permission to conduct the following activity at the indicated location:
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And for the keeping, storage, occupancy, sale, handling, use of, or manufacture of the following:
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(State Quantities for each category to be stored or used)
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DIAGRAM (IF NECESSARY)
 
 
 
 
 
 


 
 
 
 
 
 
 
 
 
 
 


 
 
 
 
 

THE UNIFORM FIRE CODE STATES:
"It shall be unlawful to engage in any business activity involving the handling, storage or use of hazardous substances, materials or devices or to maintain, store or handle materials; to conduct processes which produce conditions hazardous to life or property; to install equipment used in connection with such activities; or to establish a place or assembly without first obtaining a permit from the fire official." (N.J.A.C. 5.70-2.7(A))
 

NOTE:  Each individual act requires a separate permit.  You should consult your local Fire Official for the number and types of permits required and for information on fees.
 

I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION.  THAT THE INFORMATION GIVEN IS CORRECT AND THAT I AM THE OWNER OR DULY AUTHORIZED TO ACT IN THE OWNER'S BEHALF AND AS SUCH HEREBY AGREE TO COMPLY WITH THE APPLICABLE REQUIREMENTS OF THE FIRE CODE AS WELL AS SPECIFIC CONDITIONS IMPOSED BY THE FIRE OFFICIAL.
 
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 Signed                                                                           Title                                                       Date