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Nys doh 3915 2010 form-2026

The document is an application form from the New York State Department of Health for a permit to operate various types of facilities, including food services, recreational areas, and temporary residences. It outlines general instructions for completing the application, specifies required sections (A, B, G, & H), and provides detailed information on facility and operator requirements. The form includes sections for facility information, operator details, insurance compliance, and necessary signatures to ensure adherence to health regulations.

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Click ‘Get Form’ to open the nys doh 3915 2010 form in the editor.
Begin with Section A: Facility Information. Fill in your facility's name, address, and contact details. Specify the capacity based on your establishment type, such as seating for food services or maximum occupancy for camps.
Indicate the facility status as either profit or nonprofit and select the appropriate facility type from the provided list. Ensure you check all applicable days of operation and enter expected opening and closing dates.
Move to Section B: Operator/Owner Information. Enter the legal operator's name, address, and contact information. If applicable, provide details about the owner if different from the operator.
Complete Sections C through G as necessary based on your establishment type, ensuring all required documentation is attached for compliance.
Finally, sign Section H to validate your application. Make sure to print your name, title, and date before submitting.

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Versions	Form popularity	Fillable & printable
2011	4.9 Satisfied (51 Votes)
2010	4.1 Satisfied (46 Votes)

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