CODE ENFORCEMENT COMPLAINT

Fill out this form if you have a specific complaint regarding code enforcement within the Town of Clay, NY.

Type of Complaint

Choose the type of code violation which best describes your concern.
Brief Description of the Complaint
Address of Complaint Address of Complaint
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
CONTACT INFORMATION

This is the description of your section break.
Name Name First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Email
Issues Code Enforcement can NOT Address:

- Emergency situations Dial 911
- Disputes between neighbors. (i.e., Civil Matters)
- Standing dead trees and/or trees hanging over property
- BLACK MOLD
Compliance

- If any building/premises is in violation of any code, rule or regulation notice will be served by either posting on the property, regular mail, or personal service.
- Failure to comply within the given time frame will result in issuance of an official Notice and Order and or an appearance ticket.
- The Town may also have the necessary work performed to correct said violations and billed to the property owner.
*Under NYS Bail reform laws all complainant information is required to be disclosed, I understand that any false statements made in this complaint may be punishable under Section: 175.30 and or section 210.45 of the Penal Law
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.

CODE ENFORCEMENT COMPLAINT

CODE ENFORCEMENT COMPLAINT

CONTACT INFORMATION

Issues Code Enforcement can NOT Address:

Compliance

*Under NYS Bail reform laws all complainant information is required to be disclosed, I understand that any false statements made in this complaint may be punishable under Section: 175.30 and or section 210.45 of the Penal Law