Business Information

The Wading River Fire District needs the most up to date information in case of emergency at your business. 

Please answer all questions, if a question does not apply to you type N/A.

If any changes were made within your business such as owner, contact number, contact person, alarm code etc, please resubmit this form. 

The information provided is private and will only be seen by the Wading River Fire Department in urgent fire or medical situations. 

Any questions or concerns regarding the information asked please reach out to the Wading River Fire District.

Indicates Required Field

Business Name

Business Address

Owner's Name

Owner's Phone Number

Secondary Contact Name

Secondary Contact Number

Own or Rent Building

Own Rent

Building Owner's Name

Building Owner's Number

Alarm Code and Location

Knoxbox

Yes No

Knoxbox Location

AED

Yes No

AED Location

Additional Information

Date & Time Stamp

10/28/2026 2029

Submit