Sector Long Island Sound Housing Work Request

Complete this form to send a Housing Work Request.
Submited By:
Housing Area:
House No:
Work Phone:
Home Phone:

Complete description of service/work.

Can you or a family member complete this work if materials are provided?
Yes No
If you checked YES, what materials are needed? (Materials can be picked up for selfhelp every Thursday from 1-3pm at the engineering building.) None
If you are unable to complete the work and your request is approved. Do you authorize a housing maintenance representative to enter your home and complete the work?
Yes No

By submitting this form you are agreeing to the information you provied and signing this document.

Notice: Priority will be determined by the Engineering Staff.
   Priority One: Emergency Repairs should be completed within 24 hours.
   Priority Two: Will be completed within 15 days.
   Priority Three: Will be completed within 30 days.

If your work request is not completed by the time indicated here, please contact the Housing Maintenance Office at (203) 468-4482. Each request will be evaluated and given priority based on the following: Personal Safety, Impact and Potential Damage to Gov't Property.

FOR AFTER HOURS EMERGENCIES:
CALL 203-410-3844 OR 203-468-4404 OPS CENTER

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Last Modified 5/8/2013

Security Levels

Sector Long Island Sound Housing Work Request