Fillable CITY OF WHITE PLAINS DEPARTMENT OF BUILDING 70

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CITY OF WHITE PLAINS DEPARTMENT OF BUILDING 70

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70 Church Street, White Plains, New York 10601
Phone: (914) 422 - 1269 * Fax: (914) 422 - 1471
DEPARTMENT OF BUILDING
CITY OF WHITE PLAINS
BuildingComplaintForm 05/14
http://www.ci.white-plains.ny.us/
Building Complaint Form: To be completed by Complaintant and forwarded (via Email or fax) to Building Department for follow up.
Unit:
Name:
Address:
Site Address:
Phone:
Comment: __________________________________________________________________________________________________
___________________________________________________________________________________________________________
WPBD RESPONSE SECTION:
Reviewed By: ________________________ CEO Name:______________________________ Date:___________________
___________________________________________________________________________________________________________
Date:
COMPLAINT SITE:
Nature of Complaint:
Violation Location: Violation Type:
ISSUE # 1:
ISSUE # 2:
Violation Location:
Violation Location:
Violation Type:
Violation Type:
ISSUE # 3:
Nature of Complaint:
Nature of Complaint:
Specific Instructions for CEO:
SAMPLE VIOLATION LOCATIONS:
Bedroom, Living room, Dining room, Attic,
Basement/Cellar, Front yard, Back yard, Side yard,
Driveway or Garage/Accessory Structure etc.
SAMPLE VIOLATION TYPES:
Work without permits, Over occupancy, Illegal
occupancy, Blocked emergency exits, Illegal storage,
No heat, No hot water, No extermination services or
Property Maintenance Issues etc.
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CITY OF WHITE PLAINS DEPARTMENT OF BUILDING 70

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Completed 17 July 2020

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