Applications, Forms, Permits & Documents

Required Notice to Health Department for In Person and Catered Events with attendance above the State's social gathering limits

Applications, Forms, Checklists & Fee Schedule

  1. Application for a Permit to Operate (PDF)
  2. Bathing Beach Safety Plan Checklist (PDF)
  3. Environmental Health FOIL Request Form (DOC)
  4. Executive Order 4 of 2018 - Compliance Certification Project Information Sheet and Certification
  5. Fee Schedule for Permits and Other Applications as of January 1, 2017 (PDF)
  1. Notice of Intent to Construct, Enlarge, or Convert, for Occupancy - Instructions and Application (PDF)
  2. Report on Operation of Swimming Pool (PDF)
  3. Swimming Pool Safety Plan Checklist (PDF)
  4. Workers Compensation Requirement (PDF)

Children's Camps

  1. Children's Camp Written Plan Checklist (PDF)
  2. NYS Children's Camps Fact Sheet - Bunk Bed Guardrail Requirements (PDF)
  1. NYS Sanitary Code Subpart 7-2 - Children's Camps (PDF)

Engineering Plan Submissions

  1. Backflow Prevention Device Checklist (PDF)
  2. Engineering Report for Swimming Pool Plans (DOH-1309) (PDF)
  3. NYS Appendix 5-B Standards for Water Wells (PDF)
  4. NYS Appendix 5-D Special Requirements for Wells Serving Public Water Systems (PDF)
  5. OCHD Design Policy and Standards - Appendix 75-A and Design Handbook (PDF)
  6. Realty Subdivision Application (PDF)
  1. Realty Subdivision Checklist (PDF)
  2. Sewage Disposal System Application (PDF)
  3. Sewage Disposal System Checklist (PDF)
  4. Soil Mitigation Requirements (PDF)
  5. Water System Improvement Application (PDF)
  6. Water System Improvement Checklist (Mains, Pumps, and Tanks) (PDF)

First Aid & Water Safety

  1. 2013 Sex Offender Registry Fact Sheet (PDF)
  2. 2016 Epinephrine Auto-Injector Program Certification (PDF)
  3. 2017 Camp Trip Swimming Safety Certifications (PDF)
  4. 2017 Certifications for Children's Camp Aquatic Director (PDF)
  5. 2017 Certifications for Level III Aquatic Staff (PDF)
  6. 2017 CPR (PDF)
  7. 2017 CPR Certifications for Level III and IV Aquatic Staff (PDF)
  1. 2017 Fact Sheets Memo (PDF)
  2. 2017 First Aid Certification for Children's Camp Staff (PDF)
  3. 2017 Learn-to-Swim Acceptable Programs (PDF)
  4. 2017 Lifeguard Certifications (PDF)
  5. 2017 Progressive Swimming Instructor (PDF)
  6. 2017 Swimming Pool Operator Acceptable Courses (PDF)
  7. Swimming Pool Safety Plan Checklist (PDF)

Public Water Systems

  1. Application for Approval of a Chlorinator Installation (PDF)
  2. Lead and Copper Sampling Plan (XLS)
  1. NYS Appendix 5-D - Special Requirements for Wells Serving Public Water Services (PDF)
  2. Policy and Application for Design and Approval of an Ultraviolet Disinfection System Installation (PDF)