Residential Smoke Inspection Affidavit

Residential Smoke Inspection Affidavit Residential Smoke Inspection Affidavit

Application for Self-Inspection Certification of Smoke Alarms, Carbon Monoxide Alarm and Fire Extinguisher Compliance

To conduct a self-inspection, the seller must test the smoke alarms and confirm that all smoke alarms, carbon monoxide alarms, and the fire extinguisher are all in working order and are in the proper locations according to the guidelines listed.  This form must be completed in its’ entirety for affidavit to be processed.  Please email firemarshal@mlfd.org if you have any questions prior to submitting this form.

If there are two separate residences on the property that are being sold or rented (i.e. a cottage or garage apartment), a separate application and fee is required for each dwelling unit.

A letter will be e-mailed to you for closing.

Affidavit Fee is $50 and is payable online after submitting this form.

INSPECTION ITEMS

Before continuing with this form, be sure to check that all items were inspected following guidelines set forth below:

Smoke Alarm Requirements:

Smoke Alarm Requirements based on Residential Dwellings Year of Construction

  • Pre 1975 DC powered Smoke Alarms on each level including the basement (if applicable)
  • 1975 – 1977 AC powered Smoke Alarm on uppermost level (DC smoke alarms on all other levels)
  • 1977 – 1983 AC powered Smoke Alarm on uppermost and basement level (electrically interconnected) (DC smoke alarms on all other levels)
  • 1983 – 1991 AC powered Smoke Alarms on every level (electrically interconnected)
  • 1991 – Present AC powered Smoke Alarms with battery backup on each level and in each sleeping area (bedroom) (electrically interconnected)

The smoke alarms required in (a) above shall be located and maintained in accordance with NFPA 72.

All smoke alarms must be less than 10 years old as per Mt Laurel Township Local Ordinance 1985-12, Chapter 81, Section 81-24.

Carbon Monoxide Alarm Requirements:

Carbon monoxide alarms shall be installed in all dwelling units in buildings in one- and two-family or attached single-family dwellings, except for units in buildings that do not contain a fuel-burning device or have an attached garage, as follows:

  • Single station carbon monoxide alarms shall be installed and maintained in the immediate vicinity of the sleeping area(s).
  • Carbon monoxide alarms may be battery-operated, hard-wired or of the plug-in type and shall be listed and labeled in accordance with UL-2034 and shall be installed in accordance with the requirements of this section and NFPA-720.

Fire Extinguisher Requirements:

A portable fire extinguisher shall be installed in accordance with the following:

  • The fire extinguisher shall be within 10 feet of the kitchen and located in the path of egress;
  • The fire extinguisher shall be readily accessible and not obstructed from view;
  • The fire extinguisher shall be mounted using the manufacturer’s hanging bracket so the operating instructions are clearly visible;
  • The fire extinguisher shall be an approved listed and labeled type with a minimum rating of 2-A:10-B:C and no more than 10 pounds
  • The owner’s manual or written operation instructions shall be provided during the inspection and left for the new occupant.
  • The fire extinguisher shall be serviced and tagged by a certified Division of Fire Safety contractor within the past 12 months or the seller must have a receipt for a recently purchased extinguisher
  • The top of the extinguisher shall not be more than five feet above the floor.

Local Ordinance Requirements:

  • There must be a visible house/unit number on the property for emergency responders.
  • All electrical panels must be identified and properly labeled.

Affidavit

PROPERTY INFORMATION





INSPECTION CONTACT INFORMATION

CERTIFICATIONS

BY CHECKING EACH OF THE CHECKBOXES BELOW, I CERTIFY THAT I HAVE PHYSICALLY INSPECTED THE FOLLOWING ITEMS ON THE ABOVE DATE

STATEMENT OF AFFIRMATION

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