340 Housing Inspections ldress
CHAPTER II STATE SANITARY CODE
Occupant's Name
Jo. of Occupants
Cype of Structure
)wner
Apt. #
# of Dwelling Units 3 # of Stories
-B F M If Habitable Rooms # Bedrooms
Bathroom 410.150
Address of Owner
Regulation
Violations
4ot water between 1200 & 1400
.190
Toilet and seat
.150 A(1)
dash basin
.150 A(2)
Shower or tub
.150 A(3)
Sufficient cold water
.350 A
Floor
.500
Walls
.500
Ceiling
.500
Door
.500
Light
.252 A
Ventilation -
.280 A or B
Plumbing connection & drains -
.350
Kitchen 410.100
Regulation
Violations
Kitchen sink sufficient size
n!n (.� Oi -
Stove and oven
.100 A 2
4 W ,
®Aw . �����e
Space for refrigerator
.100 A(3)
0
2 Outlets (electrical)
.251 B
One electrical light fixture
.251 A
Walls
.500
Ceiling
.500
Floor
.500
Ventilation (window) (mechanical)
.251.6
Cold water (sufficient pressures)
,350 A
Hot water
.190
Windows
.500
Doors -
.500
Screens (door & window)
.551 & .552
Plumbing connection & drains
.350
Living Room
Regulation
Violations
Outlets (2 or one with light)
.251 B
Lighting
.251 A
Walls
.500
` "
Ceiling
.500
44,4 in
Floor
Windows
., 5-00
aitC /
l Y-c-414'4/")
Screens
.551
Locks (windows)
.480 E
Pantry or Dining Room
Regulation
Violations
Outlets (2 or one with light)
.251 B
Lighting
.251 A
Walls
.500
Ceiling
.500
Floor
.500
Window
.500
Screens.
.551
Locks
.480 E
Re eulat ion
Violations
olee.rng ww'.' ,..
1i•htin:
.250 A
ficient natural
or 1
.250 B
;ut ets
1
.251 A
.ht with outlet
Lls
.500
.500
'Ain:
.500
nor
.500
idows
.551
reens
.500
or
there adequate
ace for occupant?
Rliom #2 ■
.400
Sleeping
fficient natural lightin:
1
.250 A
.251 B
outlets or
.251 A
ght with outlet
.500
lls
.500
ilin
.501�aIna
.551
J •
:ndows
:reens
.500
nor
there adequate
for
.400
'ace occupant?
Room #3
Sleeping
natural lighting
.250 A
ufficient
or 1
.251 B
outlets
outlet
.251 A
i•ht with
.500
ails
.500
eilin:
.500
loo r
rindows
.500
.551
screens
.500
)oor
is there adequate
.400
;pace for occupant?
Area & Exit (Interior
Common
illuminated .ro.erl
.253 A & B
Interior area
dindows
.551
Screens
.500
Doors
Ceilin:
.500
.500
Walls
.500
Floors
s
500
.042
Stairwa
Common bathroom clean
Common Area & Exit (Exterior
Chimne
lI
.500
Porches
.500
Foundation
.500
Stairs
.601
Garba:e & rubbish
s
.600
Private wa
and down s.outs
.500
Gutters
Roof
.500
.502
Lead paint
Rnrry lights
.253 B
General
Regulation _ Violations
services ~king and available
heating facilities in good
fir?
680 and 640
water 120° to 1400
ilities vented
ce heater - proper
porary wiring
ctrical service adequate
ects and rodents
lling sanitary
Miscellaneous
.200
700 A F R
190
902
700 R
256
255
550
602 & 457
le next scheduled reinspection is:
I1/2 "4Ttle 1/
c2 .130
Time
a.m.
a.m.
p.m.
Date Time
NORTHAMPTON BOARD op HEALTH
_ HOUSING INSPECTION REFERRAL
Referred to
Address
Owner
Date of Referral
Ro Ism pod
-(i ee - k'
RDate
Initial inspection by ---
�4cs1U/le Sotto
Initial inspection report
ac Fu
/4J
e
C tArGe
-• .NORTHAMPTON BOARD 0p HEALTH
HOUSING INSPECTION REFERRAL
Referred to
Address /Aj C�J.°r.--thQC r CC,i r
Owner l C�cet
Date of Referral Q - , S' rs�
~l'rZ cee4 /'/
Initial inspection by RA G, Date ,F44-/g--e7^,
Initial inspection report l i . +Q•t,rU.
-rlAe CP I1raP
Referred by
CHAPTER II STATE SANITARY CODE
) J 7 - ) `/
ress f-bio fS%��d„c kci kg=11t- 6-Ft Occupant's Name nit:l \I'M-1%_ rll e4 I. lN t' 'S,
3 lk of Stories
of Occupants h% Apt. 4 Il e.w ., Ik of Dwelling Units � ,,Z-
e of Structure 'B �
�''J M 4 Habitable Rooms 4 Bedrooms
r>1.2(/ Address of Owner
er ( ��CU�2 P. fiG��
Bathroom 410.150
water between 1200 & 1406
.let and seat
;h basin
,wer or tub
Eficient cold water
Jor
lls
it ing
or
ght
ntilation
umbing connection & drains
Kitchen 410.100
tchen sink sufficient size
:ove and oven
)ace for refrigerator
Outlets (electrical)
ie electrical light fixture
ills
ailing
loor
entilation (window) (mechanical)
old water (sufficient pressures)
of water
indows
loors
,creens (door & window)
'lumbing connection & drains
Living Room
)utlets (2 or one with light)
.fighting
dalls
Ceiling
Floor
Windows
Screens
Locks (windows)
Regulation .
.19Q
.150 A(1)
.150 A(2)
.150 A(3)
.350 A
.500
.500
.500
.500
.252 A
.280 A or B
.350
Regulation
.lpQ A(1)
.100 A(2)
.100 A(3)
Violations
Violations
.251 B
.251 A
.500
.500
.500
.251.6
.3504
.190
.500
.500
.551 & .552
.350
Regulation
1
Violations
.251 B
.251 A
Pantry or Dining Room
Outlets (2 or one with light)
Lighting
Walls
Ceiling
Floor
Window
Screens
Locks
.500
.500
.500
.500
.551
.480 E
Regulation
Violations
.251 B
.251 A
.500
.500
.500
.500
.551
.480E
Al
Regulation
Violations
u.b ..
ficient natural lighting
.250 A
utlets or 1
.251 B
ht with 1 outlet
.251 A
Is
.500
ling
.500
or
.500
dows
.500
eens
.551
r
.500
there adequate
ce for occupant?
.400
Sleeping Room #2
'ficient natural lighting
.250 A
.251 B
cutlets or 1
with outlet
.251 A
;ht
.500
.1s
sling
.500
)or
.500
.500
idows
teens
.551
.500
or
there adequate
for occupant?
.400
ace
Sleeping Room #3
fficient natural lighting
.250 A
or 1
.251 B
outlets
with outlet
.251 A
ght
lls
.500
iling
.500
.500
oor
.500
ndows
.551
Preens
.500
nor
there adequate
for occupant?
.400
,ace
Common Area & Exit (Interior
area illuminated properly
.253 A & B
'tterior
indows
.500
.551
Greens
.500
0075
.500
eiling
.500
ails
loors
.500
tairways
.042
bathroom clean
.151
ommon
Common Area & Exit (Exterior)
'Porches
500
'orches
.500
'oundation
.500
;tairs
.500
;arbage & rubbish
.601
'rivate
.600
ways
;utters and down spouts
.500
toot
.500
.502
.ead paint
?ntry lights
.253 B
Violations
veneLei
1 services working and available
- -
Fon
-
e heating facilities in good
,200
pair?
atat 68
700
A 6
t water 120° to 140°
190
cilities vented
707
ace heater - proper
700
R
mporary wiring
756
ectrical service adequate
755
sects and rodents
550
ttiti
S, J
yelling sanitary
607
b
452
Miscellaneous
Inspector
Date
he next scheduled reinspection is:
Title
a.m.
p.m.
Time
a.m.
p.m.
Date Time
(14494/5
CITY/TOWN
DEPARTMENT
G(.lnk ✓-ti
ADDAES/S
TELEPHONE
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Auto ELVQL EVQ OTIUQVTLRO VOULHO
EYYPO.NO. MnooEL VQ
ennPEQQEL to VOtLLHQ OQS 5LHQLwuata• MUOQCLTE VO
TCQPETE 11ETQ(pPQOr1 QUTOU TOU EYYPQ(POU WtO TO
1 7 t i s v1,-7 7 4
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61.1
�d a l 1-3 =� ,
Q L I 1 J :
(WRITE IN BOARD OF HEALTH ADDRESS AND TELEPHONE NUMBER ABOVEI
ADDRESS:
OCCUPANT: ____ _
NO. DWELLING UNITS:
NO. STORIES:
14p
ARTICLE II
e STATE SANITARY $ODE
nt3
-5c "
-7
NO. 000UPANTS__ __—
__- __ FLOOR: __ ___APT. NO.: __—__--__
-±.2)61-1911_6--144' NO. ROOMING UNITS:
BASEMENT:
TYPE STRUCTURE: —__ FRAME_" B
NO. OF HABITABLE ROOMS:
OWNER: ?1l_ �\ �
ADDRESS:
C 01-,;(!i{- 70
>l'o>c' -1-40\A
1- � G
RICK ;; SEMIDETACHED:__ DETACHED:_—__—_
•L a g7°-- ) -
NO. OF SLEEPING ROOMS:
�L �� f t ( tL&L»lrc �r)
X = VIOLATION
REGULATION
BATHROOM
YES
NO I
3.1A(a) 3.18(a)
Is toilet with seat available? `ca• ILFt 11E'4)
3.1 A(b) 3.18(b)
Is washbasin available?
11 A(c) 3.18(c)
Is shower or bathtub available?
V
f
3.1D 3.2
Are the facilities in a clean, smooth, impervious and sanitary condition?
,
4.1 (9.1 &9.2)
Is cold water for facilities available (witn sufficient quantity l?
5.1 (9.1 &9.2)
Is hot water for facilities available (120 F • 140 F) ?
9.1 & 9.2
Are the facilities properly connected to drain line?
7.3&9.3
Is there at least one light fixture in good repair?
7.4 &9.3
Is there an electrical outlet in good repair at washbasin?
✓
13.1 & 13.1 A
Are the windows in good repair weathertight and fit for the use intended?
13.1
Are the doors in good repair and fit for the use intended?
+-/
13.1 & 13.6
Are the wails in good repair and fit for the use intended?
13.1 & 13.6
Are the floors in good repair and fit for the use intended?
8.1A &8.13
Is there proper ventilation?
13.6
Are the floors and walls of nonabsorbent material?
I.'
14.5
Are the exterior openings properly screened? c� _ ,,� -I Pf„L.11 -
L-
REGULATION
KITCHEN _ 7r) VH (2/ SS,N/ L - 1��
17
Is the room suitable? k. (blti i �., -
2.1(a)
Is sink available and of sufficient size and capacity?
_
41(9.1 &9.2)
Is cold water for the sink available (with sufficient quantity and pressure)? Ck 11L't[1.1 y
5.1 (9.1 &9.21
Is hot water for sink available (120 F - 140 F)?
v
9.1 & 9.2
Is sink properly connected to drain lines?
2.1(b)
Is there a working stove and oven?
9.3
Is the stove and oven properly connected and vented?
t---
2.2
Are the facilities clean, smooth, impervious. nonabsorbent?
7.2(a)
Is there one light fixture in good repair?
✓�
7.2(b)
Are there two electrical outlets in good repair?
i,----'
7.2(c) -.26 01.1
:.,.
131' Are the windows (if kitchen exceeds 70 sq. ft.) equal to at teat 10%of the floor area?
t....-'-"
13.1 & 13.1A
Are the windows in good repair,weathertight and fit for the use intended?
14.5
Are the exterior openings properly screened?
13.1
Are the doors in good repair and fit for the use intended?
V
13.1
Are the walls in good repair and fit for the use intended?
�--"A
13.1
Are the ceilings in good repair and fit for the use intended?
t_-----
13.1
Are the floors in good repair and fit for the use intended?
(..•4
13.6
Is the floor impervious and easily cleanable?
......-1-
2.1(ct
Is there adequate space and facilities for instaling of Refrigerator? Lam!
8.1A, 8.18(a)
Is there sufficient ventilation? ' -(1ii,C- \ r o.11.1, 'AA l(yyvr�,:.---„u. I I izm
9.3(a) 9.3(b)
Are all owner installed appliances properly installed? / I
1.,
9.4
Are all occupant installed appliances properly installed? _
X■VIOLATION
13.1A
13.1
Are the windows in good repair, weatnertig
Are the walls in good repair and fit for the use intended?
13.1
Are the ceilings in good repair and fit for the use intended?
13.1
Are the floors in good repair and fit for the use intended?
14.5
11 Is there adequate space for the number of occupants?
Are all exterior openings screened?
0
REGULATION
[�-L.L ' �.
LIVING ROOM -'
YES
NO
7.1(a)
Is there sufficient natural light?
/
7.1(b)
Are there two separate electrical outlets in good repair?
i'
7.11W
Is there one outlet and one light fixture in good repair?
8.1A, 8.13(e)
Is there proper ventilation?
13.1A �
Are the windows in good repair, weathertight and fit for the use intended?
V
13.1
Are the walls in good repair and fit for the use intended?
13.1 I
Are the ceilings in good repair and fit for the use intended?
13.1
Are the floors in good repair and ft for the use intended?
14.5
Are all exterior openings screened?
REGULATION
(bv k,12-(7 v,✓
3LcvnJo nbOM a:* 1 (IJ<+Fify)
7.1(a) (
Is there sufficient natural light?
(�
I
7.1(b) I
Are there two separate electrical outlets in good repair?
L'
I
7.1(b)
Is there one outlet and one ent fixture in good repair?
`
8.1A, 8.18(e)
Is there proper ventilation? - 17)(65 ilia�� f" Li"-.
13.1A
Are the windows in good repair, weathert gh and fit for the use intended?
c
13.1
Are the walls in good repair and fit for the use intended?
13.1
Are the ceilings in good repair and fit for the use intended?
13.1
Are the floors in good repair and fit for the use intended? ', h re it,.
14.5
Are all exterior openings screened? V
11
Is there adequate space for the number of occupants?
REGULATION
('.
SLEEPING ROOM --44-7. (identify) I'1 i � Of" (.dd /
//-;
7.1(a)7.1(a) I
Is there sufficient natural light?
i/
7.1161 I
Are there two separate electrical outlets in good repair?
1 1---
7.1161 �
Is there one outlet and one light fixture in good repair?
8.1 A. 8.18(e)
j
�
Is there proper ventilation?
Are the windows in good repair, weathertight and fit for the use intended?
Are the walls in good repair and fi[for the use intended? f i cc � it, /li
2-' �'7� k
Are the ceilings in good repair and fit for the use intended?
,wry
(.v V
13 1A
13.1
13.1
13.1
Are the floors in good repair and fit for the use intended?
14.5
Are all exterior openings screened?
v
11
Is there adequate space for the numoer of occupan[s? 2X. t2tiw L
z
REGULATION
ft.(Identify)
SLEEPING ROOM Vic'
7.1(a)
, Is there sufficient natural light?
LF-1
7.1(b)
! Are there two separate electrical outlets in good repair?
c-----I
7.1(b)
Is there one outlet and one fight fixture in good repair?
I �I
8.1A, 8.18(e)
Is there proper ventilation?
L e ^.e^^o v
13.1A
13.1
Are the windows in good repair, weatnertig
Are the walls in good repair and fit for the use intended?
13.1
Are the ceilings in good repair and fit for the use intended?
13.1
Are the floors in good repair and fit for the use intended?
14.5
11 Is there adequate space for the number of occupants?
Are all exterior openings screened?
0
REGULATIONS
COMMON AREA AND EXITS
X=VIOLATIONS
YES I NO
7.5
7.7
13.1A
13.1 B
14.5
13.1
13.1
13.1
15.8 & 15.9
13.1 Are the stairways in good repair and fit for the use intended?
13.3&13.4 Are handrails in good repair and fit for the use intended? r . j
13.5 Are all required balusters or other devices In place?
18.4 Is every entry door of a dwelling unit fitted with a proper lock?
18.3
Does the main entry door of a dwelling close and lock automatically?
18.6 Is the building properly posted with the name of owner?
3.2 Are the common bathroom facilities clean?
12.1 & 12.2 Are there sufficient and properly maintained exits?
Are interior common areas properly illuminated at all times?
Are there operational and sufficient and properly located light switches and fixtures?
Are the windows in good repair, weathertight and fit for the use intended?
Are the doors in good repair. weathertight and fit for the use intended.
Are all doors screened as reouired?
Are the ceilings in good repair and fit for the use intended?
Are the walls in good repair and fit for the use intended?
Are the floors in good reoair and fit for the use intended?
Are all common areas clean?
REGULATIONS
EXTERIOR
v
Are light fixtures and switches properly located?
13.1
13.1
13.1
13.1
13.1
13.3.13.4 & 13.5
13.4
15.4
15.3
15.10
13.1
Is the chimney in good repair?
Are the porches in good repair?
Is the foundation in good repair?
Are the stairs in good repair?
Are the structural elements in good repair?
Are all required hand railings and balusters in place and in good repair?
Are there walls or protective railings as required?
Is the storage of rubbish and garbage proper (occupants)?
Are there sufficient and prooerty located receptacles?
Are the private passageways or rights of way clean and sanitary?
Are the gutters and down spouts in good repair and fit for the use intended?
X■VIOLATIONS
REGULATIONS
GENERAL
YES
NO
10.1
Are all required services are available and working?
6.1
Are the heating facilities in good repair?
6.2
Is heat being supplied at proper terperatures. 68 F - 78 FI?
5.1
Are hot water heating facilities in good repair?
9.3(a)
Are all required facilities properly installed and vented?
6.5
All space heaters in use meet the proper requirements?
7.9
Is there no temporary wiring in use? Location?
7.8
Is the electrical service safe and adequate?
14.1, 14.2 & 14.3 1 The dwelling is free of insect/rodent presence?
157
Is the dwelling unit maintained in a clean and sanitary condition by
the occupants?
REGULATION
OTHER
c i/ 2 et.0 as-:, //ff�';t 7F ./ PL c L'C�F-/
}::(1422------ lb , t / r rnJ - CS R- (-
.r` r" , J tam
ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY
MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL—BEING OF THE OCCUPANT AS
DETERMINED BY REGULATION 29.2 OF THE CODE OR THE AUTHORIZED INSPECTOR.
INSPECTOR
/~ /11 ''
DATE
THE NEXT SCHEDULED REINSPECTION IS
TITLE
TIME
A.M.
P.M.
A.M.
P.M.
DATE TIME