HomeMy WebLinkAboutComplaint Form 2008-9-8 13R LOG IN DATE:
� y��,`� •;�� 'C' COMPL ON UA
r"
.
19p2
BUILDING DEPARTMENT ASSIGNED TO:
VILLAGE OF RYE BROOK
938 KING STREET RYE BROOK,NY 10573
(914) 939-0668 ASSIGNEDBY:
G
COMPLAINT FORM
RECEIVED BY: +
DATE: D FOR OFFICE USE ONLY
LOCATION: ��i(.�/l/��J /G�C ' `✓L��
NEW S.B.L.: OLD S.B.L.: USE:
OWNER: 1 fTOrr 11
Address&Phone:_ 00l.[{?tvy 'cog
Qe- 0 Y V�
SOURCE: Ya ILf Phone/Letter/Other: U
Address&Phone:
COMPLAINT: Pon l W a L L
POSSIBLE VIOLATION:
INSPECTORS LOG
IPA STATUS IN PECTOR