Westhampton Beach Fire Department
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Help Us, Help You!

Please help us update our Dispatch Computers. We'll only use your information in the event of an emergency which is kept confidential. Having your information or the caretaker's is critical incase we need to gain entry or found the house to have no heat, a water leak, fire or any important issue that could cost you money. This information could save you thousands!

Required   Indicates Required Field
Local Address:
Address Type:
Business Name (if applicable):
Street Address: Required
City: Required
State: Required New York
Zip Code: Required
Homeowner Contact Information:
First Name: Required
Last Name: Required
Mailing Address: Required
Mailing State: Required
Mailing Zip Code: Required
Cell Phone: Required
Home Phone: Required
E-Mail:
In case of Emergency Call:
First Person to Call Name:
First Person to Call Number:
Second Person to Call Name:
Second Person to Call Number:
Contact Title:
Below are questions about your residence or business. This will help us know the important details about your residence. Please fill out what you can, if you would like. Again all information is kept CONFIDENTIAL and will NOT be released.
Any person unable to walk?:
Household Pets?:
Type of Pet, Quantity?:
Medical Oxygen in Use?:
How many bedrooms?:
How many people in the building?:
Fuel for Heat type:
Electric Panel Location:
Electric Backup Generator:
Basement Type:
Elevator?:
Location of Main Water Valve:
Type of Water:
Pool:
Knox-Box:
Driveweay Gate Code:
Hidden Key:
Hidden Key Location:
Any Special Hazards?:
Special Hazards Explained:
Additional Information Needed:
Any Attachments you want to leave:
Add files...
Do you require our feedback?:
If Yes, First/ Last Name:
Telephone Number:
E-Mail Address:
Date/ Time Submitted: 10/19/2018 0250
Thank you for your cooperation and help in this matter.





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Westhampton Beach Fire Department
92 Sunset Ave
P.O. Box 1526
Westhampton Beach NY 11978

Emergency Dial 911
Station Fax: 631-288-5162
E-mail: info@westhamptonbeachfd.org
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