THOUSAND ISLAND PARK CORPORATION
COTTAGE SAFETY CERTIFICATION FORM 1A
This form must be submitted as an original paper document – please print the completed form through signature section, sign it, and have your electrical inspector complete the remaining portion. Upon completion return it to the TIPC office at the address below.
Please submit completed form above to:
Thousand Island Park Corporation
42822 St. Lawrence Avenue Unit #1103
Thousand Island Park, NY 13692