Hempstead, NY · Nassau County
Water Service Permit Application
Owners, plumbers, or contractors use this application to request water service from the Town of Hempstead and provide property and service details.
What this form is
This application requests water service and records information about the owner, plumber or contractor, bills-to contact, and facility location. Applicants provide details about the type of use and applicable work, such as service line size, tapping, lawn sprinklers, fire protection, or air conditioning. The form includes an applicant agreement and sections for Town office review and fees.
Who needs it
An owner, plumber, or contractor applying for water service for a facility in the Town of Hempstead should complete this application.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This application is signed and dated without a notary; the signer agrees to the stated water-service terms and no notarized attachment is listed.
How to submit this form
- 1
Download The Application
Download the Water Service Permit Application PDF.
- 2
Complete Applicant And Facility Details
Fill in the applicant, billing, facility location, and applicable water service sections.
- 3
Review And Sign
Review the applicant agreement, then sign and date the application.
- 4
Submit To The Town
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What is the Water Service Permit Application for?
- It is an application for water service that collects applicant, facility, and service details, with sections for applicable work and Town office review.
- Who should complete this application?
- The form identifies the owner and plumber or contractor as applicants and asks for facility and water service information.
- Do I need a notary for the Water Service Permit Application?
- No. The application is signed and dated without a notary. The signer agrees to the stated water-service terms, and no notarized attachment is listed.
- How do I submit the Water Service Permit Application?
- The form names the Department of Water but gives no submission address or delivery instructions. Check the Town website for current contact details.
Need something notarized?
This Water Service Permit Application doesn’t need a notary — but if you have another Hempstead form that does, a commissioned online notary can help.