Rensselaer County Bureau of Emergency Services

E-911

Street Number Information Sheet
03/01/94

TOWN: ____________________________________________________
 
OWNER:__________________________________ DATE: ___________
 
Day Phone: __________________________________________________
 
Current Mailing Address: _____________________________________
 
________________________________________________________
 
Previous Land Owner: ___________________________________
 
Subdivision Name: _______________________________________
 
Road: ___________________________________________________
 
Tax Map Number: _________________________________________

---------- Below to be completed by Rensselaer County 911 or Town Official: --------------

Number Assigned: ____________________________________________
 
Post Office: ________________________________________________
 
Fire:______________________________________________________
 
EMS: _____________________________________________________
 
Police: ___________________________________________________

4000 Main Street, Troy, New York, 12181     Phone 518-270-4160     FAX 518-272-4700