Lake Grove, NY · Suffolk County
Disabled/Handicapped Parking Permit Application
This application is for residents seeking a permanent or temporary disabled parking permit, including new applicants and people renewing or replacing a permit.
What this form is
The application requests a disabled or handicapped parking permit and includes sections for the applicant and an authorized medical professional. The instructions cover new, renewal, and replacement permits, and explain which identity and residency documents to provide. Medical professionals provide a diagnosis and certify the applicant’s disability; the form lists different certification requirements for temporary and permanent disabilities.
Who needs it
Residents applying for a new, renewed, or replacement disabled parking permit complete Part I, and an authorized medical professional completes Part II when required.
How to submit it
Return the completed application in person or by mail to Brookhaven Town Clerk, One Independence Hill, Farmingville, NY 11738; include a stamped, self-addressed legal-size envelope. Fax copies are not accepted.
About notarization
This application is signed without a notary; for a lost or stolen permit, the instructions separately require a signed sworn affidavit that must be notarized.
How to submit this form
- 1
Download The Application
Download the disabled or handicapped parking permit application PDF.
- 2
Complete Part I
Fill out and sign Part I, providing your physical address if your mail is delivered to a P.O. Box.
- 3
Gather Required Documents
Provide identification and address proof if needed. For a renewal, return the expiring permit; have an authorized medical professional complete Part II.
- 4
Submit The Application
Return the application in person or by mail to Brookhaven Town Clerk at the address on the form. Fax copies are not accepted.
Frequently asked questions
- Who completes the disabled parking permit application?
- The applicant completes Part I. Part II is completed by an authorized medical professional, with certification requirements depending on whether the disability is temporary or permanent.
- What documents should I provide with the application?
- Bring a driver’s license or non-driver ID. If it does not show your current physical address, the instructions list a utility bill, bank statement, or credit card statement as address proof.
- Do I need a notary for the disabled parking permit application?
- No. The application itself is signed without a notary. For a lost or stolen permit, the instructions separately require a signed sworn affidavit that must be notarized.
- How do I submit the disabled parking permit application?
- Return it in person or by mail to Brookhaven Town Clerk, One Independence Hill, Farmingville, NY 11738. Include a stamped, self-addressed legal-size envelope; fax copies are not accepted.
Need something notarized?
This Disabled/Handicapped Parking Permit Application doesn’t need a notary — but if you have another Lake Grove form that does, a commissioned online notary can help.