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AFFIDAVIT OF COMPLIANCE WITH SMOKE DETECTOR AND
CARBON MONOXIDE DETECTOR REQUIREMENTS
CARBON MONOXIDE DETECTOR REQUIREMENTS
FOR ONE AND TWO FAMILY DWELLINGS
STATE OF NEW YORK_____)
) ss.:
COUNTRY OF ____________)
The undersigned, being duly sworn, deposes and says under the penalty of perjury that:
1. I am the grantor of the reel property or of the cooperative corporation owning real property located at:
_______________, New York (the "Premises");
___Street Address
2. The Premises is a one or two family dwelling, or a cooperative apartment or condominium unit used as a residence;
3. Installed in the Premises is an approved and operational carbon monoxide detecting device in compliance with subdivision 5-a of Section 378 of the Executive Law of the State of New York.
4. Installed in the Premises is an approved and operational single station smoke detecting alarm device in compliance with subdivision 5 of Section 378 of the Executive law of the State of New York.
5. These statements are made with the knowledge that a willfully false representation is unlawful and is punishable as a crime under article 210 of the Penal Law of the State of New York.
6. The word “grantor” shall be construed to read in the plural whenever the sense of this affidavit so requires.
_________________________________________________ ____________________________
Sworn to before me this __ day of ____________,____
____________________________
Notary Public