HomeMy WebLinkAboutFD Referral Form 2003-6-8 0bIl7j12003 14:07 9149393834 PORT CHESTER F=RE DE PAGE 01
VILLAGE OF RIVE BROOK
BUILDING & ENGINEERING DEPARTMENT
938 KING STREET
RYE BROOK.,NEW YORK 10573
PHONE(914)939-0663 FAX(914)939-5801
REFERRAL FORM
TO: All Departments
FROM: Michael J. Izro, Acting Building Inspector
On your tour of duty, if any of the following conditions are observed,please note the
location and refer it to the appropriate department.
1. Any form of alteration work, exterior or interior(this includes plumbing electrical
work-and construction materials, etc...).
2. If you enter a dwelling observe if there is illegal occupancy(e.g., overcrowding,
more than normal cooking facilities).
3. Sidewalk obstruction: (e.g,, containers to collect debris).
4. '.4ew occupancy: store,business,etc..., that may not have obtained a permit.
5. Other: (Describe condition):
Referred To:
1. POLICE DEPT. 4. RECREATION DEPT.
2. )e_BMDING DEPT. 5. OTHER
3. PUBLIC WORKS
Date: (6- o -3 Location: I-71, I:u .j [�it� ►a�.
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Referred By: �• ��a R a r
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