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Residential Rehabilitation Application

  1. Town SealResidential Rehabilitation Application
    Please use the interactive online form below to apply for the Town of Brookhaven Residential Rehabilitation Program.

  2. The Town of Brookhaven Residential Rehabilitation Program provides repairs to owner-occupied single-family homes in the Town, thereby stabilizing or increasing home values. Repairs can be made on any part of the home from the chimney to the sanitary system. Driveways, fences and landscaping are not included. Eligibility is determined by total household income and the income guidelines.

    Due to the large number of applicants, it is necessary to complete our application below to be added to our waiting list. Once your name is reached on the waiting list, you will receive an email requesting additional documents (PDF). Once those documents have been received and reviewed for eligibility, you will meet with a member of our staff to complete additional forms and to answer any questions you may have. Learn more about our Residential Rehabilitation Program.

    * indicates a required field

  3. e.g. (555)555-5555
  4. e.g. (555)555-5555
  5. e.g. (555)555-5555
  6. e.g. (555)555-5555
  7. Must meet annual household income guidelines (See table below)
  8. Current with Mortgages & Taxes*
  9. Annual Household Income Guidlines


  10. Does Owner Reside In Home?*
  11. If yes, is there a mortgage on the home?
  12. Life Estate*
  13. Reverse Mortgage*
  14. Please be advised that you must have all valid documents pertaining to home ownership:*

    Check all that apply.

  15. Please confirm you meet our annual household income guidelines - View Now*
  16. Leave This Blank:

  17. This field is not part of the form submission.