19 N Maple Avenue, PO Box 516, Millerton, NY 12546
P 518-789-3300 x606, F 518-789-3399
I:\BUILDING DEPT TEMPLATES\Affidavit of Final Cost of Construction.docx (revised 8/2019)
(To be filled out upon completion of the project)
State of New York
County of Dutchess
_________________________________ being duly sworn, deposes and says:
That (s)he is the applicant (or agent of the applicant) named in the Application for Building
Permit # ___________ dated _________________ relating to construction or other work to be
performed on, or in connection with, the premises located as indicated on the application;
That the estimated cost stated in said application of the construction or other work described
therein was $_______________ and that the actual final cost of such construction or other work
was $_______________.
Applicant states that (s)he has examined the approved plans and that to the best of his(her)
knowledge and belief, the structure has been erected in accordance therewith and in accordance
with the applicable provision of the law.
Signature of Applicant/Agent
Sworn to before me this __________ day of __________________, 20____.
Notary Public
NOTE: Cost for the work described in the Application for Building Permit includes the cost of
all the construction and other work done in connection therewith, exclusive of the land. If final
cost is less than the estimated cost stated in the Application for Building Permit, no portion of the
fee paid upon filing of the application will be refunded.)
Filed Cost $_______________
Fee Received $_______________ Additional Fee $_______________
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