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Fire Prevention Bureau - Life Hazard Use Registration
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(**) INDICATES DEPT. USE ONLY
Please do not leave any information blank
If you have any questions, please call the Fire Prevention Bureau at (973) 857-4761 or online below
SUBMIT A QUESTION
**Registration Number
FPB USE ONLY
*
Application Date
*
1. Business Name
*
Business Address & Suite(if applicable)
*
Business Phone Number
*
Business E-mail Address
*
Business Ownership Type
Corporation
Individual
Partnership
Cooperative
Government
LLC
2. Individual/Sole Proprietorship - Owner Name(first & last)
*If Individual/Sole Proprietorship, do not complete section 3.
Owner Address, City, State, Zip Code
Owner Phone Number
Owner E-mail Address
3. Other Types of Ownership - Organization/Company Name
*If Other Types of Ownership, do not complete section 2.
Address, City, State, Zip Code
Phone Number
E-mail Address
*
4. Name & Job Title(individual completing application)
*
Phone Number
*
E-mail Address
*
5. Federal Employer ID Number
*
6. Registered Agent Same as Owner?
Yes
No
*If yes, go to section 8.
*
7. Registered Agent - Name
*
Address, City, State, Zip Code
*
Phone Number
*
E-mail Address
*
8. Property Ownership Contact - Name & Job Title
*
Address, City State, Zip Code
*
Phone Number
*
E-mail Address
*
9. Emergency Contact #1 - Name & Job Title
*
Address, City, State, Zip Code
*
Phone Number
*
E-Mail Address
*
10. Emergency Contact #2 - Name & Job Title
*
Address, City, State, Zip Code
*
Phone Number
*
E-Mail Address
BUILDING INFORMATION - COMPLETE ALL SECTIONS
*
1. Pre 1977 Construction
Yes
No
*
2. Block - Lot
*
3. Number of Stories/Levels
*at or above grade
*
4. Number of Stories Below Grade
*example - basement, sub-basement, etc.
*
5. Total Square Footage
*
6. Maximum Occupancy
*
7. Number of Exits
*
8. Grade Height
*
9. Construction Type
Frame
Masonry & Concrete
Masonry & Steel
Exterior Masonry Wall & Frame
Combination
Type 1A - Concrete
Type 1B - Concrete
Type 2A - Steel
Type 2B - Steel
Type 2C - Steel
Type 3A - Masonry & Wood
Type 3B - Masonry & Wood
Type 4 - Heavy Timber
Type 5A - Wood
Type 5B - Wood
*select from drop-down
*
10. Heat Type
Forced Air
Hot Water/Radiator
Radiant
Steam
None
*select from drop-down
*
11. Heat Fuel Source
Electric
Gas
Geothermal
Liquified Natural Gas(LNG)
Liquified Petroleum Gas(LPG)
Oil
Wood
None
*select from drop-down
*
12. Alternate Power Source
None
Solar
Geothermal
Wind
*select from drop-down
*
13. Back-Up Power Source
None
Battery
Emergency Generator
Multiple Grids from Power Company
*select from drop-down
*
14. Emergency Generator Power Devices
Emergency Lights
Exit Lights
Fire Detection System
N/A
*select all that apply
*
15. Number of Roof Hatches
*
16a. Roof Construction
Concrete
Metal
Truss
Wood
N/A
*
16b. Roof Covering
Asphalt Shingles
Asphalt/Tar
Metal
Rubber
Slate
Tile
N/A
*select all that apply
*
16c. Truss Type(if applicable)
N/A
Bowstring
Metal
Steel Bar Joist
Wood
*select from drop-down
*
17. Truss Construction
Yes
No
*
18. Number of Skylights
*
19. Solar Panels
Yes
No
Submit
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