Do I need a notary for the well permit application?

No. The application has a signature and date line but no notary block. The listed attachments and later well completion documents are not described as requiring notarization.

How do I submit the well permit application?

Submit it to the Town of Mount Hope Building Department at 1706 Route 211 West, Otisville, NY 10963. The form lists (845) 386-9949.

What information and attachments does the application ask for?

It asks for property, owner, and well driller information, including the driller’s DEC registration number. It lists insurance documents, a site plan, and detailed drawings as required materials.

What must be submitted after the well work is complete?

The form says to submit a copy of the well driller’s log and laboratory report to the Building Inspector for review and approval.

Mount Hope, NY · Orange County

No notary required

Application for Well Permit

Property owners and other applicants use this application to request a Mount Hope well permit and provide property and well driller information.

What this form is

Use this application to request a well permit from the Mount Hope Building Inspector before starting well work. It asks for the property location, owner and driller details, and the well driller’s DEC registration number. The form also lists insurance documents, a site plan, and detailed drawings as required materials; after work, the well driller’s log and laboratory report must be submitted for review.

Who needs it

Property owners or their agents, lessees, and well drillers applying for a well permit in Mount Hope need this application.

How to submit it

Submit the application to the Town of Mount Hope Building Department, 1706 Route 211 West, Otisville, NY 10963. The form lists (845) 386-9949 as the department phone number.

About notarization

This application is signed and dated without a notary; the listed insurance documents, site plan, drawings, driller’s log, and laboratory report are not described as notarized.

How to submit this form

1
Download The Application
Download the Application for Well Permit PDF.
2
Complete The Application
Enter the property location, owner details, well driller information, and the requested permit and property identifiers.
3
Gather Required Materials
Include the insurance documents, site plan, and detailed drawings listed on the form.
4
Submit To The Building Department
Submit the application to the Town of Mount Hope Building Department at 1706 Route 211 West, Otisville, NY 10963.

Frequently asked questions

Do I need a notary for the well permit application?: No. The application has a signature and date line but no notary block. The listed attachments and later well completion documents are not described as requiring notarization.
How do I submit the well permit application?: Submit it to the Town of Mount Hope Building Department at 1706 Route 211 West, Otisville, NY 10963. The form lists (845) 386-9949.
What information and attachments does the application ask for?: It asks for property, owner, and well driller information, including the driller’s DEC registration number. It lists insurance documents, a site plan, and detailed drawings as required materials.
What must be submitted after the well work is complete?: The form says to submit a copy of the well driller’s log and laboratory report to the Building Inspector for review and approval.

Need something notarized?

This Application for Well Permit doesn’t need a notary — but if you have another Mount Hope form that does, a commissioned online notary can help.