Nassau County Traffic Management

Lane Closure Notification Form

Thisform is NOT required for shoulder closures..
This is NOT a lane closure permit application. A road closure permit must be approved prior to closing any lanes on a County roadway. Contact permit at (516) 571-6740 or 1194 Prospect Avenue, Westbury.

Please provide the information requested below:

Approved Road Closure Permit Number:
Name of Company/Municipality:
Contact Name:
Address:
City:
Zip:
Contact Phone:	Ext:
Contact Email:
Date(s) Closed From:	To:
Time Closed From:	:
Time Closed To:	: (check for 24hr Closure)
Road to be Closed:
Hamlet:
From Cross Street:
To Cross Street:
Direction of Traffic:	(closest applicable)
Number of Lanes Closed:
Reason for Closure:
Nassau County Traffic Management PLEASE COMPLETE THIS FORM AND SUBMIT NO LATER THAN 3PM ONE DAY PRIOR TO CLOSURE. WEEKDAY CLOSURES FROM 7:00 AM TO 9:00 AM OR 4:00 PM TO 6:00 PM WILL NOT BE PERMITTED. Nassau County Traffic Management 1194 Prospect Ave Westbury, New York 11590 Phone: (516) 571-6992 Fax: (516) 571-6882 Email: trafficmanagement@nassaucountyny.gov