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Please note - The forms below may be downloaded, completed, and submitted the following ways:

  • Save electronically or scan, then email to
  • Fax to NDDH at 860-774-1308
  • Mail to NDDH at 69 South Main Street, Unit 4, Brooklyn, CT 06234
  • Forms and payments may be left in our outdoor drop box. Cash payments not accepted.

Some fillable forms may be completed online but still require submission by the above-listed methods.  Forms cannot be directly submitted through our website at this time.


NDDH Ordinances

NDDH Salon Ordinance

NDDH Food Service Ordinance

Annual Permit Packets - Download, print, complete, and submit for your specific permitted business by December 15, 2021 to avoid late fees and penalties. See packet information for new payment options for 2022 permits:

Food Service - For Class I, II, III, IV food service establishments and Caterers. Click here for NDDH Food Ordinance Definitions.

Food Service - Multi / Non-commercial - For multiple class food service establishment (any business with departments that are classified as separate food establishments; and non-commercial function (a function where food is sold or distributed by a person not regularly engaged in the business of selling such food for profit.)

Food Service -Itinerant - For vehicle-mounted, self-contained, mobile food establishments. All Itinerant food vending establishments are required to have a hand-washing sink with hot and cold running water under pressure, holding tank, and mechanical refrigeration.

Bed & Breakfast

Cosmetology, Barbershop Establishment OWNERS - For owners of permitted personal services establishments with employees

Independent Contractors - Cosmetology, Barbershop, Nail Salon, Other - For independent contractors who rent a chair in a permitted cosmetology, barbershop, nail salon or other personal services establishment.

Nail Salon Establishment Owners


Swimming Pools

Note -All Food Service and Miscellaneous permit applications must be accompanied by a completed Emergency Contact Form.

Building, Construction and Property Projects

Use This Form If you want to:
B100a Add a pool, garage, deck or other structure to an existing property.
B100a Brochure Learn more about putting an addition on your property.
B51d Build a new home that will be served by city (public) sewer but will have a private well or if you want to add to an existing property that is served by city (public) sewer but is served by a private well.

Septic Systems

Use This Form If you want to:
Application B and Letter of Consent Install a new septic system, repair an existing septic system, complete a soil test, or have a plan reviewed.
Installer's As-Built Check List Check your work after installing or repairing a septic system.
Sewage Disposal Regulations and Technical Standards for latest revision (web site) Understand the regulations and technical standards that govern the installation of septic systems.
Diagram of Septic System Get a visual idea of what a septic system installation looks like.

Food Service Materials - Click here for NDDH Food Ordinance Definitions

Use This Form If you want to:
Food Service Application Apply for an annual food service permit. This form is used for all food service establishments, including restaurants, food stores, schools, non-profit organizations, and others.
Temporary Food Permits Serve food to the public at an event for a duration of 1 - 14 days.
Itinerant Food Vending Application


Apply for an annual food service permit for a vehicle-mounted, self-contained, mobile food establishment. All Itinerant food vending establishments are required to have a hand-washing sink with hot and cold running water under pressure, holding tank, and mechanical refrigeration. “Pushcarts” are limited to the sale of hot dogs and pre-packaged foods only.
Food Service Ordinances Learn about the local ordinances governing food service.
Food Establishment Permit Application and Plan Review Form with Guidelines Open a new food service establishment, change ownership of an existing food service establishment, or are making major renovations to the kitchen facilities in an existing food service establishment. NOTE - See NDDH 2020 Service Fees for updates that replace 2011 fees listed on page 3 of this guide.
Food Awareness Safety Training Class (FAST) Take a class that provides training in proper food handling techniques. This class is ideal for business owners, volunteers, and new employees working in food service who have not taken the Certified Food Protection Manager course. FAST and CFPM Courses are currently not being offered by NDDH. Click the FAST and CFPM links to the left to see other certification locations and information.
Certified Food Protection Manager Course (CFPM) Become a Certified Food Protection Manager. This is a one day course for Class II, III and IV food service establishments, as required by the Connecticut Public Health Code, 2017 FDA Model Food Code. Class II establishments have until January 1, 2019 to attain CFPM Certification, which is valid for five years. Visit Click Willimantic to enroll.
Simple Ownership Transfer Form When an existing licensed food service establishment changes ownership, the new owner must apply for a new food service license from the health district. Check this form to see if you qualify for a simple transfer of ownership.


Use This Form If you want to:
Bed and Breakfast Application Apply for a required annual registration for a bed and breakfast.
Campground Application Apply for an annual inspection required to permit a campground facility. You may also need to complete a Food Service Application and Swimming Pool Application depending on services offered.
Cosmetology, Barber, Nail Salon Application Apply for a new permit or renewal for nail salons, hair salons, and barbershops. Note - This application is for personal services establishment owners who have employees. Independent Contractors who rent chairs or space from an owner/operator are to fill out the Independent Contractor application listed below.
Day Care Application Apply for a required inspection conducted every two years for a group day care facility licensed by the State of Connecticut.
Hotel Motel Application Apply for an annual permit and inspection for a hotel or motel. You may also need to complete a Food Service Application and Swimming Pool Application depending on services offered.
Independent Contractor Application - Personal Services Applies to cosmetology, barber, nail salon and other trades. An Independent Contractor is a person who engages in an independent trade, business, or profession in which they offer their services to the public. They are generally not employees of a salon or company and perform services under an expressed or implied agreement. Note - This application is not for owner/operators.
Request for Copies of Public Information - (Download, fill and fax, mail or put in outdoor dropbox at NDDH)

Fillable form - Save to computer, complete, re-save and email to

Request copies of public documents on file
Swimming Pool Application Apply for an annual permit and inspection for any public swimming pool located at venues such as town halls, hotels, motels, campgrounds, nursing homes, schools, YMCAs, etc. Note - Swimming_Pool_Application_REV_070820_USED2021this application is not for use by private homeowners seeking to install a pool on their property.
Tick Submission Forms Please note - NDDH does not submit ticks for testing. Residents may submit ticks on their own by using this packet of information, which gives options to submit ticks to the Connecticut Agricultural Experiment Station (CAES) or the Connecticut Veterinary Medical Diagnostic Laboratory (CVMDL).

If a specific form or information you are seeking is not listed here, kindly contact us at (860) 774-7350 or

Please note - the forms and applications above are for health department permitting only. The applicant is responsible for complying with all other state and local laws, regulations, and ordinances required to complete your project.

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