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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 This is an important legal document. It may affect your rights. You may obtain a translation of this form at: Isto a urn documento legal muito importante que podera afectar os seus direitos. Podem adquirir uma tradupao deste documento de: Le suivante est un important document legal. II pourrait effecter vos droits. Vous pouvez obtenir une traduction de cette forme a: Questo a un documento legale importante. Potrebbe avere effetto sui suoi diritti. Lei puo ottenere una traduzione di questo modulo a: Este es un documento legal importante. Puede que afecte sus derechos. Ud. Puede adquirir una traduccion de esta forma en: 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 %J. i f I-I ?C i.9 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