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TOWNSHIP OF JACKSON DIVISION OF CONSTRUCTION INSPECTIONS 65 CONNOR BLVD, JACKSON, NJ 08527 (732) 928-1200 EXT 1205 FAX (732) 928-7861

ROOF-MOUNTED PHOTOVOLTAIC SYSTEMS LOCAL FIRE OFFICIAL DOCUMENT

PURSUANT TO:

5:23-4.5. Municipal enforcing agencies-administrative and enforcement. 52:270-203. Enforcement of act by enforcing agencies; reports, data and information; fees; inspections; certification of fire inspections. SPECIFICALLY SECTION:

5:23-4.5(h)xx. Within 10 business days of issuance, provided written notice to the lire official for the municipality7 appointed pursuant to N.J.S.A. 52:270-203 of all permits issued for installations of roof-mounted photovoltaic systems.

Contracting Agency:

Business Name: ___

Address: ___

Business Number: ___

Date of Installation: ___

Property Owner:

Block: ___ Lot: ___

Name: ___

Address: ___

Rec. By: ___

Date: ___