HomeMy WebLinkAboutComplaint Form 2008-5-30 DRCu LOG IN DATE:
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COMPLETION DATE:
BUILDING DEPARTMENT
VILLAGE OF RYE BROOK
938 KING STREET RYE BROOK,NY 10573
(914) 939-0668
COMPLAINT FORM
DATE: �" 3 f) - D FOR OFFICE USE ONLY
LOCATION: 3 3 k /.+�D� r�6
NEW S.B.L.: A , 2 6— ( -1 OLD S.B. .: �Z CC USE:
OWNER:
Address&Phone:
SOURCE: �� � � � � � � hone ter/Other:
Address&Phone:
COMPLAINT: y r i'0
POSSIBLE VIOLATION:
INSPECTORS LOG
DATE STATUS INSPECTOR