HomeMy WebLinkAboutComplaint Form 2014-1-31 LOG IN DATE:
BUILDING DEPARTMENT
VILIAUF OF RYE BROOD COMPLETION DATE:
938 KiNG'STREET RYE BROOK,NY 10573
(.914.) -0668 AssiGNED TO:
ASSIGNED
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COMPLAINT :
COMPLAINT FORM
RECEIVED BY:
—FDA
DATE: FOR OFFICE USE ONLY
LOCATION: :] l�� eV.�, Ayc rl�u ` _
NEW S.B.L.: 135. I - OLD S.B.L.: USE:
OWNER: [ LJI ZZIiC �D
Address&Phone:
SOURCE: (f l/ Y Phone/Letter/Other:
Address&Phone:
COMPLAINT: r)-e w rY1 DO YGt. al S-e r V1 c e 0 le-
a.e, rs «n�sa ice
POSSIBLE VIOLATION:
INSPECTORS LOG
DATE STATUS INSPECTOR