Fillable Printable Affidavit of Smoke Alarm and Carbon Monoxide Alarm Installation

Affidavit of Smoke Alarm and Carbon Monoxide Alarm Installation

STATE OF NEWYORK

AFFIDAVIT OF COM PLIANCE OF SMOKE ALARM & CARBON

MONOXIDE ALARM INSTALLATION

IN ONE AND TWO FAMILY HOME

State of New York )

SS:

County of Orange )

1 (I) (WE) are the transferors (s) of the property described herein, and attest that the

property at the time of transfer has installed on its premises an operable single or

multiple stati on smoke alarm s and single or multiple carbon monox ide alarm s.

2. The property is a (one) (two) family dwelling located at:

Address:_________________________________________________________

Town: _____________________ County:____________________________

State: _____________________ Zip: ________________________________

3 (I) (WE) make this affidavit in accorda nce w ith Se c tion 373 subdivision 5 of the

Executive Law,

Transferor: ____________________________L.S.

Transferor______________________________L.S.

Sworn to before me this___ day

of __________________, 20__ _

Notary Public