Smoke Detector Certification

● THE ONLINE APPLICATION FOR INSPECTION MUST BE COMPLETED AT WWW.MTFP1.COM AND BEFORE FILLING OUT THIS FORM!!

● The Fire Official has approved the temporary use of this Self-Inspection Affidavit.
● Contact Bureau to verify instructions for Self-Inspections and payment information.
● Complete the informantion below to acknowledge full compliance of information provided on this page.
● Retain the email for your records

Address of Residence Self Inspection was completed on*

Street Address only.

E-mail Address*

Confirmation Email (copy of this completed Affadavit / Self Inspection will be sent to this email )

Owner / Representatives Name*

First NameLast Name

ALL applicable boxes MUST BE CHECKED in order for certification to be valid*

An inspection shall be conducted by the owner or an authorized representative of the owner. The Fire Inspector will advise during the scheduling as to what requirements are needed for the smoke, carbon and fire extinguisher locations as per the specific residence.
The property owner or their representative has conducted this inspection and attests that: The required smoke alarms are located in accordance with NFPA -72. All smoke alarms are listed in accordance with ANSI/UL-217, Carbon Monoxide alarms are installed in accordance with UL-2034 and NFPA 720.

I do hereby certify that the foregoing statements made by me are true. I have read and fully understand the contents below. I am aware that if any of the foregoing statements made by me are willfully false, I will be subject to penalty.

Initials *

COMPLIANCE GUIDELINES

1. Smoke detectors and carbon monoxide detectors must be within ten (10) feet of any bedroom.

2. For floors that do not have bedrooms, there must be at least one (1) smoke detector on each floor. Both finished and unfinished basements require a smoke detector. If you have an unfinished attic, you do not need a smoke detector in the attic area.

3. To determine the age of your detector, look at the date of manufacture on the back of the unit. If the smoke detector has a manufacture date that is more than 10 years old or has no date visible, you must replace the unit to pass the inspection. If the carbon monoxide detector has a manufacture date that is more than 7 years old or has no date visible, you must replace the unit to pass the inspection. If you have a combination smoke/carbon monoxide detector, and it has a manufacture date that is more than 10 years old or has no date visible, you must replace the unit to pass the inspection.

4. If you have a hard-wired smoke detector system that needs to be replaced, it must be replaced with a hard-wired smoke detector. You cannot install a battery-powered smoke detector in place of a hard-wired smoke detector.

5. When replacing any battery-powered smoke detectors, the replacement battery-powered smoke detector must have a factory installed, sealed, and maintenance free 10-year battery.

6. Fire extinguishers must have a minimum rating of 2A:10B:C. Fire extinguishers must be mounted on a wall on the way out of the kitchen utilizing the bracket supplied with the extinguisher. The extinguisher should be mounted at waist level, but no higher than 5 feet from the floor and visible (not in a closet or cabinet). The Fire Inspector scheduling the inspection will advise the best location to be mounted.

7. A receipt must be left with the extinguisher showing that the extinguisher was purchased less than one year ago. If the receipt is older than one year, the extinguisher must be replaced with a new unit or a NJ State licensed contractor inspection tag can be substituted for the receipt as long as it has been issued within 12 months prior to the sale of the residence.

Affidavit / Self Inspection