Form Center

2. Ontario County Emergency 9-1-1
   
   Addressing Division
   
   74 Ontario Street
   
   Canandaigua, NY 14424
4. INSTRUCTIONS:
   Since February 2003 (pursuant to Resolution 413 of 1993), the Ontario County Board of Supervisors designated the County 9-1-1 Center's Addressing Division to approve all proposed names for streets, roads, right-of-ways, apartment complex names, mobile home parks, commercial or industrial plazas, and others, whether public or private, within Ontario County. The Division also assigns road number ranges along proposed streets or roads in compliance with the County-approved number system in use within the municipality. PLEASE COMPLETE ONE FORM PER SUBDIVISION/COMPLEX/PROJECT ALONG WITH A SURVEY MAP OF THE PROPOSED PROJECT AND ROADS. If you do not upload a digital map at this time, you MUST submit a hard copy map to the Addressing Division for completion of the review and approval.
   
   
6. The Addressing Official of the respective municipality where the project is located will assist you in proper completion of this form and will forward it for review at the proper time during the municipal review process. The 9-1-1 Center's Addressing Division will notify both you and the local municipality of its acceptance, denial, or suggested modifications to your name requests within 30 days of receipt of your application and map, along with address range assignments. The Addressing Official will use this information to assign individual address to each lot, dwelling unit, or business within your project.
8. UPLOAD MAP
   If you have a digital map (PDF preferred) for the project, this can be uploaded here.
10. I hereby apply for permission to use the following proposed names:
12. 1.
13. 5.
15. 2.
16. 6.
18. 3.
19. 7.
21. 4.
22. 8.
24. Name of Municipality:*
    -- Select One --City of CanandaiguaCity of GenevaTown of BistolTown of CanadiceTown of CanandaiguaTown of East BloomfieldTown of FarmingtonTown of GenevaTown of GorhamTown of HopewellTown of ManchesterTown of NaplesTown of PhelpsTown of RichmondTown of SenecaTown of South BristolTown of VictorTown of West BloomfieldVillage of BloomfieldVillage of Clifton SpringVillage of ManchesterVillage of NaplesVillage of PhelpsVillage of RushvilleVillage of ShortsvilleVillage of Victor
25. Name of Subdivision/Project:*
27. Tax Map Number:*
28. Name of Applicant:*
30. Mailing Address of Applicant:*
32. Applicant's Telephone*
33. Extension:
35. Municipal Addressing Official:*
37. I understand that this process is intended to protect the integrity of the 911 Emergency Address Records and that the County's determination will be based upon consideration of potential confusion or errors in the dispatching of Emergency Services. Further, I acknowledge that I must notify the County of any changes or discontinuance of approved name(s).
39. Signature of Applicant:
41. Procedural Note: Municipal addressing official presents one copy to applicant, keeps one copy, and forwards two copies to the 9-1-1 Center's Addressing Division which will send one copy back to the addressing official.
Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit Submit and Print

* indicates a required field