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2. Borough of Hawthorne

   Board of Health

   445 Lafayette Avenue, 2nd Floor
   Hawthorne, NJ 07506

   Phyllis Wooldridge, Registrar

   Phone: 973-427-4012 ~ Fax: 973-427-1882

   https://hawthornenj.org/269/Health

4. Name of Applicant*
6. Applicant Address*
8. Applicant Phone Number
9. Applicant Email Address
13. Owner Name*
15. Owner Address
17. Owner Phone Number
18. Owner Email Address
22. Number of Tattooing Rooms
23. Number of Employees
25. Owner, Manager or Person in Charge at the Premises
27. Name
29. Address
31. City
32. State
33. Zip Code
35. Contact Phone Number
36. Email Address
38. NJ Bio-Hazardous Waste Generator License Number

40. Annual Fee: $1,000 - January 1 to December 31 

    Cash or Check only - Checks made payable to: The Borough of Hawthorne

    Please mail or deliver application and fees to the Health Department NO LATER THAN January 31st.  Your license will be mailed to you, Please post in public view. 

    Any questions may be directed to the Registrar at: pwooldridge@hawthornenj.org

    
    

42. Applicant's Certification*

    I certify that I have read and understand the terms, requirements, and restrictions of Chapter 461 of the Borough Code https://ecode360.com/14638782#14638782.  I further certify that the facts set forth in the above application are true.

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