Building Department Complaint Form

CITY OF WHITE PLAINS
DEPARTMENT OF BUILDING

7-11 South Broadway - Suite 100, White Plains, New York 10601
Phone: (914) 422-1269 * Fax: (914) 422-1471

http://www.cityofwhiteplains.com

Building Complaint Form: To be completed by Complaintant and submitted (via Email or fax) to Building Department for follow up.

Date
Name
Address
Phone
Specific Instructions for CEO
	COMPLAINT SITE
Site Address				Unit:
Nature of Complaint
	Issue #1	Violation Location	Type:
Nature of Complaint
	Issue #2	Violation Location	Type:
Nautre of Complaint
	Issue #3	Violation Location	Type: