Author: Linda Colangelo

Northeast District Department of Health

69 South Main Street, Unit 4, Brooklyn, CT 06234
Phone: (860) 774-7350 / Fax (860) 774-1308 / www.nddh.org

An Important Notice Regarding Your Permit

Permit Fee
$155.00

To: Outdoor Swimming Pool Owners
From: The Northeast District Department of Health Date: March 15, 2024
Subject: 2024 Swimming Pool Permit Renewal

The Swimming Pool permit issued to your establishment by the Northeast District Department of Health (NDDH) has expired and must be updated on a yearly basis.

Please return the following to this office by Monday, April 15, 2024:
A completed Swimming Pool Application. You may access the application forms and can make payment online at www.nddh.org/formspermits. If you do not have computer access, you may complete the form at our office.
Pay the application fee.

We are eager to assist you in complying with the State of Connecticut public health regulations. Upon receipt of all completed documentation, a permit will be issued for your establishment. Please be sure to provide us with a valid e-mail address, as we will be sending permits electronically.

All completed documentation must be received by Monday, April 15, 2024. All documents are due before your opening date if you plan on opening your establishment before April 15, 2024. The establishment will be charged a late fee of $90 if documentation is received after April 15, 2024. In addition, a penalty fee of $12 per NDDH business day with a maximum of $120 shall be assessed for each day late from April 29^th through May 10^th inclusive.

Annual inspections will be conducted throughout the year. Please be aware a re-inspection fee of $120 will be charged for a failed inspection.

If you have any questions, please feel free to contact us. We look forward to working with you. Sincerely,

Melissa Nichols Finance Manager

Subsurface Soil Fees	Board Approved 04/13/2023
Soil Testing
New Construction/Repair	$240.00
Additional Soil Testing	$125.00 per hr
Plan Reviews
Residential-New | $170.00
Residential-Repair | $140.00
Commercial (New/Repair) | $250.00
Subdivision | $155.00 per lot

Additional Reviews
2^nd Review

$120.00

Additional Reviews | $140.00 each
Septic Permits
Residential (New/Repair)	$340.00
Commercial (New/Repair)	$550.00
Tank Replacement/Sewer Line	$140.00
Water Treatment	$205.00
Simple Ownership Transfer Fee-Permit to Construct  $ 80.00
Other Subsurface Soil Service Fees

Well Permits | $185.00
B100a-Change in Use-SIMPLE | $ 75.00
B100a-Change in Use-COMPLEX | $ 110.00
B51d | $ 75.00 per lot
Site Not Ready for Testing | $160.00
Finals- 3^rd & Subsequent Inspections | $205.00
Standpipe monitoring | $125.00 per visit
Permit, Registration and Inspection Fees
Bed & Breakfast | $ 50.00
Hotel/Motel | $140.00
Day Care | $150.00
Group Home | $150.00
Cosmetology/Barbershop | $140.00
Independent Contractor | $125.00
Simple Location Transfer Fee-Independent Contractor | $ 40.00
Nail Salon Permit (4 chairs or less) | $145.00
(5 chairs or more) | $165.00
Campground | $165.00
Pool | $155.00
Lead | $225.00 per case
Miscellaneous Services Fees
Consultation	$ 90.00 per hr
Re-Inspection Fee	$120.00
Late Fee	$ 90.00
Penalty Fee	$ 12.00/NDDH bus. day/max. $120 Rabies Specimen Transport	$165.00 (rate subject to change) Photocopies	$	0.50
Technical Standard Booklet	$ 15.00 Tick Submission Fee (postage/mailer only)	$	8.00
A $40.00 non-refundable processing fee will be charged for all requested refunds and returned checks in addition to applicable bank charges.

Sanitarian Approved Initial:	 Date: 	
Emailed:	

Northeast District Department of Health
69 South Main Street, Unit 4,
Brooklyn, CT 06234
Phone – (860) 774-7350 / Fax - (860) 774-1308
www.nddh.org	email@nddh.org

SWIMMING POOL APPLICATION

SELECT STYLE:	 INDOOR	 OUTDOOR
OWNERS NAME: 	

BUSINESS NAME: 	
PHYSICAL LOCATION: 	

MAILING ADDRESS: 	
BUSINESS PHONE: 	BILLING EMAIL: 	

CONTACT PERSON: 	CONTACT PHONE: 	
WATER SUPPLY:	WELL 		MUNICIPAL 	

DIMENSIONS:	LENGTH 	WIDTH 	DEPTH	SLOPED DEPTH RANGE 	
RECIRCULATING INLETS: 	OUTLETS / MAIN DRAINS: 	

CIRCULATING PUMP: 	RATING: 	GPM
FLOW GUAGE: 	SCALE: 	TO 	GPM

HAIR CATCHER: 	FILTER: 	MODEL: 	
FILTER TYPE:	SAND	 D.E.	 CARTRIDGE		SIGHT GLASS:	YES	NO MAKE UP WATER PLACE OF INTRODUCTION: 						
CHEMICAL FEED:	MANUAL	 AUTO

CHLORINATOR: 	MODEL# 	CAPICITY:	GPD
TEST EQUIPMENT: 	

FILTER BACKWASH DISPOSAL: 	
COMPLIANCE DOCUMENTS PROVIDED TO NDDH REGARDING VIRGINIA GRAEME BAKER ACT: YES	NO SKETCH OF POOL:

SIGNATURE: 		DATE: 	

NDDH Use Only |
Date: 	Fee: 	Check # | CC | E-Check | Cash | Receipt #
Date: 	Fee: 	Check # | CC | E-Check | Cash | Receipt #
Rev. 111121

Northeast District Department of Health

69 South Main Street, Unit 4, Brooklyn, CT 06234
860-774-7350 / Fax 860-774-1308	www.nddh.org

***EMERGENCY CONTACT INFORMATION***
Water Interruption • Power Outage • Fire • Flood • Contamination • Natural and Man-made Disasters
There are a number of emergencies that can interrupt your establishment. To protect the public, the Northeast District Department of Health (NDDH) must be able to quickly contact decision-makers for your business/organization to provide appropriate guidance. Check our website for regular updates that impact your establishment at https://www.nddh.org.
NDDH will conduct periodic tests of our Emergency Notification Systems. You may receive messages by phone, text, fax, or email. Please complete the information below, being sure to fill all fields accurately:
Today’s Date: 	

Business/Org Name: 			 Business Address: 			  City: 	 State: 	 Zip: 		
Emergency Contact Name and Title: 			 24/7 Contact #: 		Cell Number: 				 Work Phone: 	Fax Number: 			 Email Address: 				

Alternate Emergency Contact Name and Title: 		 Cell Phone: 	Fax Number: 	 Work Phone: 	 Home Phone: 	  Email Address: 				
Is water for your business establishment/organization supplied by:
	Well		Community Water System

NDDH USE ONLY:

Updated - EHS Database: 	 Excel Data Sheet:		Initials: 	

Businesses with multiple locations: Please complete a separate form for each location.

REVISED 12/16/21