Fillable -COPY OF BUILDING PERMIT -COPY OF FINAL SURVEY (Town of Brookhaven)

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-COPY OF BUILDING PERMIT -COPY OF FINAL SURVEY (Town of Brookhaven)

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Town of Brookhaven REVISED 1/24/2020
Long Island
Please submit photocopies of the following items with your application. (No originals please, as they will not be returned to you)
-COPY OF BUILDING PERMIT
-COPY OF FINAL SURVEY
-COPY OF FINAL PLANS/SITE PLANS
-PHOTO OF FRONT, BACK AND SIDES OF EACH IMPROVEMENT
ONE CERTIFICATE OF ASSESSMENT PER PERMIT. AT LEAST TEN BUSINESS DAYS TO CERTIFY.
THE FOLLOWING MUST BE COMPLETED IN FULL
INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED
APPLICANT NAME:_____________________________________________________
PHONE #:_________________EMAIL______________________________________
PROPERTY ADDRESS:__________________________________________________
BUILDING PERMIT #:___________________________________________________
TYPE OF IMPROVEMENT:______________________________________________
S.C TAX MAP#:____________________________________ITEM#:______________
DISTRICT SECTION BLOCK LOT
TOTAL SQ FT OF ADDITION AND/OR BUILDING:_________________________
MAP NAME:________________________ LOT# _____ SECTION#/UNIT________
MODEL NAME (CONDOMINIUM):_______________________________________
# OF BUILDINGS :________________________ # OF STORIES :______________
EXTERNAL WALL TYPE:_________________ HEATING TYPE:_______________
BASEMENT TYPE (ON GRADE OR BELOW GRADE):_______________________
FULL:___________ PARTIAL:____________ SLAB:__________ CRAWL:________
COMMERCIAL CERTIFICATE OF ASSESSMENT APPLICATION
PLEASE CONTACT THE DEPARTMENT OF ASSESSORS WITH ANY QUESTIONS: (631) 451-6300
Department of the Assessor
Richard P. DeBragga, Assessor
One Independence Hill, Farmingville, NY 11738 · Phone (631) 451-6300 · Fax (631) 451-6379
www.brookhavenny.gov
APPROPRIATE FEE MUST BE SUBMITTED WITH ALL APPLICATIONS: NO CASH PAYMENTS ACCEPTED
PAYABLE TO THE TOWN OF BROOKHAVEN BY CHECK MONEY ORDER
or CREDIT CARD
(CREDIT CARD TRANSACTIONS INCUR A 2.35% CONVENIENCE FEE OR A MINIMUM FEE OF $1.50)
FOR OFFICE USE ONLY
DATE:___________________ FEE: ___________________ CHECK#: _________________ CONTROL#: _________________
BUILDING PERMIT:
☐
FINAL SURVEY:
☐
FINAL PLANS:
☐
PICTURES:
☐
FORM COMPLETED:
☐
PERMIT DESCRIPTION:
__________________________________
__________________ RECEIVING CLERK:____________
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-COPY OF BUILDING PERMIT -COPY OF FINAL SURVEY (Town of Brookhaven)

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Completed 2 August 2020

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