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TOWN OF BROOKHAVEN OFFICE OF THE ASSESSOR One (Town of Brookhaven)

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TOWN OF BROOKHAVEN
OFFICE OF THE ASSESSOR
One Independence Hill, Farmingville, New York 11738
P
hone: (631) 451-6300 Fax: (631) 451-6379
Ed
ward P. Romaine, Supervisor
Richard P. DeBragga, Assessor
Assessment Estimate for Apportionment/Consolidation
N
ame & Mailing Address Tax Map #s _____________________________
______________________________ _____________________________
______________________________ Item #’s _____________________________
_______________________________ ______________________________
Physical Address
________________________________________
________________________________________
________________________________________
Phone # ________________________________
Please provide as much detail as possible and provide a current survey.
Is this estimate for a consolidation _____ or an apportionment _____?
For each parcel please indicate:
Tax map # ______________________ Dimensions _________________ Acreage _________
Tax map # ______________________ Dimensions _________________ Acreage _________
Tax map # ______________________ Dimensions _________________ Acreage _________
What will be the acreage & dimensions of the new parcel(s)? Please indicate on the survey.
______________________________________________________________________________
______________________________________________________________________________
If this is for a consolidation, are all deeds in EXACTLY the same name? ______
*If not, all deeds need to be in exactly the same name before consolidation can be completed.
Any additional information _____________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
S
ignature __________________________________________
Assessment Estimate
From: Land ________________ To: Land ________________________
Total _________________ Total _______________________
Item #: _______________________
________________________________________________________________________________
If there are any questions concerning this estimate form only, please call the Assessor’s Office
between the hours of 9 am and 4:30 pm Monday through Friday.
THIS ESTIMATE IS SUBJECT TO FIELD VERIFICATION OF ALL DATA.
THE FIGURES GIVEN IN THIS ESTIMATE ARE GOOD FOR ONE YEAR FROM THE DATE OF ESTIMATE.
Date: _____________________________
Assessor: ___________________________
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TOWN OF BROOKHAVEN OFFICE OF THE ASSESSOR One (Town of Brookhaven)

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Completed 2 August 2020

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