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Fillable Printable Affidavit of Detetors' Installation

Fillable Printable Affidavit of Detetors' Installation

Affidavit of Detetors' Installation

Affidavit of Detetors' Installation

MAYOR
Michael Esmay
TRUSTEE &
DEPUTY
MAYOR
Kar en T ara pat a
TRUSTEES
Ja m e s Ande rson
Vincent S. Morgan
Peter Malcolm
VILLAGE OF UPPER NYACK
328 NORTH BROADWAY
UPPER NYACK, NEW YORK 10960 *
*INCORPORATED 1872 *
Tel. 8 45-358- 0084 FAX, 845- 358-07 41
uppernyack@ optonline. net
www.uppernyack-ny.us
Village Clerk
Carol G.Brotherhood
Village Treasurer
Barry MacCartney
VILLAGE ATTO RNEY
Robert P. Lewis
AFFIDAVIT OF COMPLIANCE ROCKLAND
COUNTY SANITARY CODE §13.34 AND §13.35. S MOKE A ND
CARBON MONOXIDE ALARM INSTALLATION
I am an owner of the property described herein:
Tax designation:
Address:
Upper Nyack, NY 10960
County of Rockland
State of New York
I attest that at the time of transfer, all sleeping areas and access hallways have smoke
detector (s) and carbon monoxide detector (s) installed in accordance with the above
law.
Owner / Transferor
L.S.
STATE OF NEW YORK }
COUNTY OF ROCKLAND } SS.:
Sworn to before m e this
day of
20
Notary Public Seal
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