Borough of Roselle Park

110 East 1Vestfield A venue
Roselle Park, New Jersey ono<±-zos3
PHONE: (908) 245-2721 FAX: (908)298-9718
CONSTRUCTION DEPARTiviENT Fee for Change of Use Certificate of Occupancy $60.00
ACTION
l8J CERTIFICATE OF OCCUPANCY
0 CERTIFICATE OF CONTINUED OCCUPANCY
0 LEAD ABATElY.IENT CERTIFICATE OF
0 TEiVIPORARY CERTIFICATE OF OCCUPANCY
USE __ . __ .BOARDAPPROVAL: '
COST. tCK.tt/CASH CERTIFICATE#:
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IF YOU ARE REQUESTING A TElYIPORARY CERTIFICATE OF OCCUPANCY,
PLEASE EXPLAIN "YVHY:
-----------------------------------------
DESCRIPTION OF BL!SINESS (FROM!rGJ:- . . : r./ :
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--I hereby the all statements are true. Any false
Issuance of this Certificate of Occupancy.
SIGNED. ,1; /
/ ,} OvVNER AGENT
lJVSPECTJOJVS: PASS/FAIL
0 BUILDING 0 ELECTRIC 0 PLUiviBING
D FIRE
I
of Roselle Park
110 East ltVestfield A venue
Roselle Park, New Jersey ono4-zos3
PHONE: (908) 245-2721 FA.X: (908)298-9718
CONSTRUCTION DEPAR.TiviElvl' Fee for Change of Use Certificate of Occupancy $60.00
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BUSINESS CERTIFICATE OF OCCtJPANCY
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BLOCK: .j :..· ::. LOT: /
---
WORK SITE LOCATION: c:-Cj> cc, s-g
OWNER OF PROPERTY: !i c-cci 9%5
HOME ADDRESS: 2 I 7 /.;:' c: H:: /t a 1 2 ,; 4
Eas· ·. f:-' e. 5 V:JI/ :red . ll/f/1 e PHONE: '? t J'- 5" t ? -;' ;--:?'
iVNER OF BUSINESS: ;; .Pti ;.? J)1,r:nd'f1S- Jon1o ;/}
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ACTION
lZJ CERTIFICATE OF L.tSE
0 CERTIFICATE OF CONTIN1JED OCCUPANCY
0 LEAD ABATEIY.IENT CERTIFICATE OF CLEARtillCE
0 TEIV?ORARY CERTIFICATE OF OCCUPAJ.'rCY
USE GROUP: CURRENT BOARDAPPROVAL: ,
COST: --. CERTIFICATE#: {
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IF YOU ARE REQUESTING A TEMPORARY CERTIFICATE OF OCCUPAL"\TCY,
PLEASE EXPLAIN vVHY:
----------------------------------------
-
DESCRIPTION OF BUSINESS

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-I hereby attest y{a:1to the best pf my knoivledge, all statements are true. Any false

of issuance of this Certificate of Occupancy.
SIGNED. )i>-?;?- ,;.-(_r .;:, J;. ;_<::.. :...
/ ._,;1 o-vVNE'R AGENT

D PLIDvffiiNG 0 FIRE
Borough of Roselle Park
110 East ·westfield Avenue
Roselle Park, New Jersey ono4-2083
PHONE: (908) 245-2721 F.A:X: (908)298-9718
CONSTRUCTION DEPlillTiviEJ:vl' Fee for Change of Use Certificate of Occupancy $60.00
ACTION
rz1 CERTIFICATE OF OCCUP AL'fCY
0 CERTIDCATE OF CONTINUED OCCUPAATY
0 LEAD ABATElYIENT CERTIFICATE OF CLEAR4..l'fCE
D TElY.IPOR..ffi.Y CERTIFICATE OF OCCUPAL'fCY
USE GROUP:
_ ____;BOARD APPROVAL:
CERTIFICATE#: (W:·f-tLf\·SD
COST:
----
IF YOU ARE REQUESTING A TENIPORARY CERTIFICATE OF OCCUPAL"l"CY,
PLEASE EXPLAIN 'WHY:
----------------------------------
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....:..--"' : ·,
--I hereby attest tn?:1to the best of my kno£viedge, all statements are true. Any false
informati.ont? issuance of this Certificate of Occupancy.
SIGNED. ,1 ;t-·v1....
1
·"' /., 7Jl._0-7
/ /J 0'1 1 TER AGENT .
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t/ II Uk?YYC$r
liVSPECTJOJVS: PASS/FAIL
0 BUILDING D ELECTRJC 0 PLUNIBING D FIRE
Borough of Roselle Park
110 East 'tVestfield A venue
Roselle Park, New Jersey ono4-zos3
PHONE: (908) 245-2721 FAX: (908)298-9718
CONSTRUCTION DEPiiRTiYI£1-.iT Fee for ChLmge of Use Certificate of Occupancy $60.00
ACTJON
t8J CERTIFICATE OF OCCUP Al'fCY
0 CERTIDCATE OF CONTINuED OCCUPANCY
0 LEAD iillATElY.IENT CERTIFICATE OF CLEAR<\NCE
0 TElVIPORARY CERTIDCATE OF OCCUPANCY
USE GROUP: CURRENT
COST: -- --C-ERTIFICATE#:
. - . . -
IF YOU ARE REQUESTING A TEi\1PORARY CERTIFICATE OF OCCUPANCY,
-----------------------------------
DESCRIPTION OF .. ;c:···:;-/ ·::·
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all true. Any false

of Issuance ofth1s Certificate of Occupancy.
SIGNED: ;,-v'-?;?-v(_, /-r ';/llLG.-;;;-
/ /j AGENT
v /
/, ·.
lJVSPECTJOJVS: PASS/FAIL
0 BUILDING 0 ELECTRlC [3-PLUl'vffirNG
D FIRE
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