Fillable TOWN OF BROOKHAVEN One Independence Hill, Farmingville, New (Town of Brookhaven)

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TOWN OF BROOKHAVEN One Independence Hill, Farmingville, New (Town of Brookhaven)

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TOWN OF BROOKHAVEN
OFFICE OF THE ASSESSOR
One Independence Hill, Farmingville, New York 11738
Phone: (631) 451-6300 Fax: (631) 451-6379
Edward P. Romaine, Supervisor
Richard P. DeBragga, Assessor
ASSESSMENT ESTIMATE
NAME & ADDRESS TAX MAP # _____________________
______________________________ ITEM # _________________________
______________________________ PHONE # _______________________
______________________________ PHYSICAL ADDRESS_______________
______________________________ _______________________________
____________________________________________________________________________
Provide current survey and/or plans if available.
What is the addition? Describe in detail. (Ex. Living space over basement, crawl, slab?
Attached/detached garage? Dormer(s)? ) If an inground pool, specify vinyl, gunite, etc.
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
What size is the addition? (Use outside dimensions. Give dimensions or square footage).
____________________________________________________________________________
____________________________________________________________________________
Where is the addition located? (Basement, first floor, second floor, etc.)
____________________________________________________________________________
____________________________________________________________________________
What is the estimated cost? If available, attach a copy of contractors estimate.
____________________________________________________________________________
Special features/notes: _________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Sketch: See back of this form. Show outside dimensions. Show main structure if addition is
attached. Estimated assessment will be completed on the back of this form and returned to
you in approximately two weeks.
_________________________________
Signature
ASS
ESSMENT ESTIMATE
F
rom: Land _________________ To: Land ________________________
Full __________________ Full _________________________
Item # _____________________
___________________________________________________________________________________
If there are any questions concerning this assessment estimate only, please call the
Assessor’s Office between 9 am and 4:30 pm on weekdays.
THIS ESTIMATE IS SUBJECT TO FIELD VERIFICATION OF ALL DATA.
THE FIGURES GIVEN IN THIS ESTIMATE ARE GOOD FOR
ONE YEAR FROM DATE OF ESTIMATE.
Thank you.
D
ate: _______________ Assessor: ___________________
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TOWN OF BROOKHAVEN One Independence Hill, Farmingville, New (Town of Brookhaven)

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Completed 2 August 2020

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