Bloomingburg, NY · Sullivan County
Well Permit Application
The Village of Bloomingburg well permit application is for property owners applying to drill a new well, replace a pump, or redrill an existing well.
What this form is
Use this application to request a Village of Bloomingburg permit for well drilling, pump replacement, or redrilling an existing well. It asks for the property location and tax map details, work description, property use, and contact and insurance information for the well driller and plumber or pump installer. The form lists a fee of $150 for residential work and $250 for commercial work, payable when filing.
Who needs it
Property owners proposing well work in Bloomingburg should complete this application, including the listed driller and installer information.
How to submit it
The form lists the Village of Bloomingburg at 13 North Road, P.O. Box 341, Bloomingburg, New York 12721. It says the permit fee is paid on filing.
About notarization
This application is signed and dated without a notary; the included DEC completion report has an electronic signature affirmation under penalty of perjury.
How to submit this form
- 1
Download The Application
Download the Village of Bloomingburg well permit application.
- 2
Complete The Application
Provide the owner and property details, describe the well work, and enter the requested driller and installer information.
- 3
Check The Listed Fee
The form lists a $150 residential fee and a $250 commercial fee, payable on filing.
- 4
File With The Village
The form lists the Village at 13 North Road, P.O. Box 341, Bloomingburg, New York 12721.
Frequently asked questions
- Do I need a notary for the Well Permit Application?
- No. The application is signed and dated without a notary. The included DEC completion report has an electronic signature affirmation under penalty of perjury.
- Who uses the Bloomingburg well permit application?
- Property owners seeking a permit for a new well, pump replacement, or redrilling an existing well use this application. It requests information about the property and the well driller and installer.
- How do I submit the Well Permit Application?
- The form lists the Village of Bloomingburg at 13 North Road, P.O. Box 341, Bloomingburg, New York 12721, and says the permit fee is paid on filing.
Need something notarized?
This Well Permit Application doesn’t need a notary — but if you have another Bloomingburg form that does, a commissioned online notary can help.