Whippany Fire District No. 2

Bureau of Fire Prevention

440 Route 10

Whippany, NJ 07981

Tel: (973) 887-7340

Fax: (973) 887-4559

 

REQUEST FOR TIME EXTENSION

 

Registration Number: _________________________   Original Inspection Date: _________________________

 

Business Name:_______________________________________________________________________________

Business Address:_____________________________________________________________________________

Work which has been abated:___________________________________________________________________

____________________________________________________________________________________________

Work that Remains:___________________________________________________________________________

____________________________________________________________________________________________

Reason why extension is necessary:______________________________________________________________

____________________________________________________________________________________________

Date work will be completed:___________________________________________________________________

 

 

Pursuant to N.J.A.C. 5:70-2.10(d)2., an application for extension of time shall be deemed to be an admission

that the Notice of Violation is factually and procedurally correct and that the violations do or did exist.

 

The following information MUST BE COMPLETED IN ORDER TO BE CONSIDERED, and the information

CAN NOT be the same as the Business Address or phone number, UNLESS the owner lives at the address year round.

 

            Owner’s HOME ADDRESS  _____________________________________________________________

 

            Owner’s HOME CITY, STATE, ZIP ______________________________________________________

 

            Owner’s HOME PHONE NUMBER ______________________________________________________

 

            ___________________________                                          _____________________________________

                        Date                                                                                        Signature of owner or agent

 

          Your request for an extension of time to abate violation(s) at the above location is:

 

          [  ]  GRANTED:  The new date by which compliance is ordered is:_______________________________

 

          [  ]  DENIED:      The time limit originally imposed remains in effect.

 

Failure to correct violations within the time limits set will result in the imposition of penalties

and possibly other enforcement proceedings.

 

         ____________________                                                 _________________________________________

                       Date                                                                                              Inspector Signature

 

                                                  Certification Number: _____________________________

 

 

You shall either fax or mail this extension to our office prior to the scheduled abate date to be considered for

an extension.