Loading...
35 Cahill Apts Complaints BOARD OF HEALTH CITY HALL COMPLAINT RECORD LP F4rN6 S"r'-cAM N . M�Tro L4MY 2'+ Dash+5' — Time �h/ Co plainant —44 Name of ddress a°L'y�� . � � sr.oa. f� d o / Tels' 1-iTS5/ Nature of Com ain Location o of Prentf Location of Pre ses Owner Address Occupant Taken by—_.-- .___— Referred tos=� / s+ueo rn4r. %L<em r/Referred /Pde to Date of inspection Time INS ECTOR'S RP.JIGET Action Taken Iteuawia Inspector Co /w � Q/ V6� // qIC%/ k�2�C�� Ce-u, Ch4e l,1 Ca Le (as 3- Ire ki.e.04flezgarnee- t . BOARD OF HEALTH CITY HALL COMPLAINT RECORD Name of Complainant Address Nature of Complaint Date Tel. Location of Premises Owner Address Occupant Taken by Referred to Date of inspection ft p Time INSPECTOR'S REPORT _ u/k; •,., .,r 4 ti/k e Action Take. seatais.4 ' LW ! . 1 spe for OPY Date: S-0r--77 (Time: 8,j"scm I Map: Parcel: Name of Complainant: C96yjEl /�v/GES Gon7EZ Address: S/0 09,21.66. %PTS SC Fre0 tsr • Tel: — NATURE OF COMPLAINT: 6moA,VG/Doc. efi dS)4,6 80516/✓% 5)/1/CE P977176//9 LOGE Location: 4i 70 eyt//bG,9GTS - Owner: N HP Address: Tel: Taken bel l Date of Inspection: 5.79.97 ITime:to :co", INSPECTOR'S REPORT: NO NorirFi/se- °pons norr,D CONFInrFP -rJIAi- r>mf 1).447,14O5/Min poa;ear w ti.-4571(Mar CC S)n5 RenR Sri%S - Action Taken r t+a-,7 NN/+ • Inspector Sid tore BOARD OF HEALTH CITY HALL COMPLAINT RECOR PY Date: ,2 q/9S---ITime: PDpim ap: 'Parcel: Name of Complainant: / Address: � y / Te1-38yy13 .fir cis!— so_ - E NA`ST_URE Aft OF COMA PLAINT: p o .do: ak • C' CT'? Q.QJ2 e, 1 . : iviAZ:J i \ Ii ,WSW Address: E a' CO.--a_C - I Tel: Taken by / %_. I Date of Inspection: Z -zs 9f 'Time: M INSPECTOR'S REPORT: w/Pate °MI/Fr-• HEAc of mrur/uc+<c GWA9MED (//OUiriOA/ • -- C6AW1i9c SANi'41&N dfll y/-OO.P , 3 //aces B/evs,muse xio.n c-6 e4)/ . /. 7oro/AG$, CJl6£ rin, e/c St/IC w-4 7/ Dc 4 'r 4I't a/) Ftcb.CS. Sie¢/ rr OM'� et cc - - ,Prom Paoee,s� ,JGer.E✓ns�n9y C✓A PM/ON5 Action Taken: 2q HG2.e /9.0 SSJ✓r 2- 7s-9q /I /Y •wo:- .."'.1::.t if`‘ -.�,�1.-�,,-+"--'p7 ,_,�,.N'y w,� • '_.$ „ -“1-H p I - � BOARD OF HEALTH MEMBERS JOHN T.JOYCE,Chairman ANNE BURES,M.D. CYNTHIA DOURMASHKIN,R.N. PETER J.McERLAIN,Health Agent CITY OF NORTHAMPTON MASSACHUSETTS 01060 OFFICE OF THE BOARD OF HEALTH 210 MAIN STREET 01060 (413)587-1214 ORDER TO CORRECT VIOLATIONS OF CHAPTER II OF THE STATE SANITARY CODE "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AT: #54E Cahill Apartments 35 Fruit Street, Northampton, MA 01060 DATE: February 25, 1998 ORDER ADDRESSED TO: John Skirk COPY 54E Cahill Apts., 35 Fruit Street Northampton, MA 01060 COPIES OF REPORT TO: Northampton Housing Authority 49 Old South Street Northampton, MA 01060 ATTN: Jonathan Hite This is an important legal document. It may effect your rights You may obtain a translation of this form at: Isto � um documento legal muito importante que podera afectar os seus direitos. Podem adquirir uma tradgao deste documento de: Le suivante est un important document legal. II pourrait affectar vos droits. Vous pouvez obtenir une traduction de cette forme a: Questo a un documento legale importante. Potrebbe avere effectto sui suoi diritti. Lei put, ottenere una traduzione di questo modulo a: Este es un documento legal importante. Puede que afecte sus direchos. Ud. Puede adquirir una tradcci6n de esta forma en: To jest wazne legalny dokument. To more miec wplyw na twoje uprawnienia. Mozesz uzyskac tlumaczenie teo dokumentu w ofisie: NORTHAMPTON BOARD OF HEALTH City Hall, 210 Main Street Northampton, MA 01060 Tel #: (413) 587 - 1 214 The Northampton Board of Health has inspected the premises at #54E Cahill Apartments 35 Fruit Street, Northampton, MA, 01060 for compliance with Chapter II of the State Sanitary Code. This letter will certify that the inspections revealed violations listed below, which are serious enough as to endanger or materially impair the health, safety, and well-being of the occupants. Under authority of Chapter III, Section 127 of the Massachusetts General Laws, and Chapter II of the State Sanitary Code, you are hereby ordered to make a good faith effort to correct the following violations within TWENTY-FOUR HOURS of the receipt of this order. REGULATION VIOLATION REMEDY 410.352 & Insanitary maintenance of the interior Thoroughly clean up all accumulated 410.505; of dwelling unit which is aggrevated bird droppings and spillage. In the M.G.L. by the presence of three house birds future, maintain said premises in a Chapter 111, flying freely around the premises. clean and sanitary condition through Section 122 Excessive accumulation of droppings, cage litter & birdfood on floors, sills, tables, etc. throughout the apartment. regular cleaning and improved housekeeping within your apartment. Roach infestation and successful extermination being severely hampered by said conditions. Inspection of the premises was made on February 25, 1998 at approximately 10: 55 am. NOTE: Continued unsuccessful attempts to control roach infestation caused by poor sanitation within your apartment will eventually result in the spread of cockroaches to neighboring apartments in the building, which will, in turn, effect the general well-being of all tenants in this dwelling. Your continued failure to correct said violations and improve housekeeping within your apartment may result in more severe legal action to abate said violation, including both orders to permanently remove house birds and I or to start eviction proceedings. If you have any questions regarding this abatement order contact the Board of Health office. Very truly yo David E. Kochan Sanitary Inspector Northampton Board of Health This inspection report is signed and certified under the pains and penalties of perjury. CERTIFIED MAIL# P 082 852 896 BOARD OF HEALTH MEMBERS JOHN T.JOYCE,Chairman ANNE BORES,M.D. CYNTHIA DOURMASHKIN,R.N. PETER J.McERLAIN,Health Agent (413)587-1214 FAX(413)587-1264 CITY OF NORTHAMPTON Northampton Housing Authority ATTN: Jonathan Hite 49 Old South Street Northampton, MA 01060 MASSACHUSETTS 01060 OFFICE OF THE BOARD OF HEALTH COPY 210 MAIN STREET NORTHAMPTON,MA 01060 March 4, 1998 RE: Followuo Inspection of Premises at 54E Cahill Apartments Mr. John Skirk Tenant A followup inspection was made at ME Cahill Apartments today at approximately 11:00 am. I was accompanied by Mr. Garvey, head of NHA maintenance. This reinspection was made to insure correction of the insanitary conditions noted in the Abatement Order(Certified Mail#P 082 852 896)which was sent to Mr. John Skirk on February 25, 1998. The following conditions were noted at the time of reinspection: (1) No change in conditions from the inspection made on 2-25-98. (2) Bird droppings, birdfood and cage litter was noted on most surfaces within this small apartment (floors, carpeting, counters, sills, tables, etc.). (3) The three birds were still loose and roaming freely around the apartment. (4) Several live roaches were noted scurrying across the floor, etc., even though it was during daylight hours. Discussion with Mr. Skirk regarding these conditions seems to be fruitless. It appears that he is oblivious to the fact that the conditions within his apartment not only fuel cockroach harborage but also threaten the well-being of all occupants in Building E. Either through his unwillingness or his inability to take the necessary action needed to abate said violations, present insanitary conditions continue to exist and will continue to worsen as the cockroach infestation gets worse. Left unchecked, the entire building will eventually be adversely effected. I therefore strongly recommend further legal action against this tenant, which would include strict enforcement of your written pet requirements with regard to birds forced removal of said birds from the premises, and, or eviction procedures, if necessary, to alleviate the problem. Whatever course(s)of action you decide to pursue, please contact me should you need any further assistance or corroboration in your endeavor to correct and resolve this problem in a permanent fashion. Sincerely, cc: John Skirk David E. Kochan Sanitary Inspector Northampton Board of Health Date: L5--8)-D0 ITime: 02,'5/3 Map: Parcel: Name of Complainant: 5 /, i,a l Address* Oa y, /J do i - Tel NATURE OF COMPLAINT:/ x, i'. co_ PLtmt r /;w y/7.4.2,U / a, . r ...„-K.4.-/.4.2/ ' ` om / Location: �- I/OQ Owner: ^/T7 /%% 5 0-e-1- Address. Tel:, /_ !/D3C Taken by: ,/ I Date of Inspection: ■_/d/f%J Time:30/90.r -,g INSPECTOR'S REPORT: ^'emu- y. 'riC, '*� �•y;}"i" V —/JD ii// `. Dig'!alPhate$T,,.n '-= -; " frill Taken. N ' Action a-kseg r-- F�''`'`'}�`"`'�� . w Inspector Signature /1/015.4/K5 (5.) oi*'70470 Date: 1-023-D/ ITime: /0;/0 9/7) I Maapp: Name of Complainant 9��7/2tchojete, Teiige -/66 Address: Ceau NATURE mF COMPLAINT: G2- --7n 1201' art d1u /2-4-a - rna� a8`> �i Parcel: Location: Owner: NNF/ 3-coir W N/T[ f0/REa ) Address: I Te15• -4°3O /-z3-o/ ITime: /aorr Taken by: iteac,I Date of locpaetien: INSPECTOR'S REPORT: CemPt4, ' .K' fnitik5 SHE Is 8t/Na NEM55AP a 50 %%IAi SUL cwcc 6 F 'fcErr to LEAP/ - L kblvrra�c-,uclo SHE CdNiACT wEr%E/JA/RVE S enrn1 5621/lcfi ReS1SeN k✓ 6.MfL[, $/,f;SuGpo.,10 /1.6".10# Ns A. A �Fe9is SAF. e ro. Bt gd po5r/� i0 UC)i SEA∎ r fisk€n pre f0 GEi n o✓RnR`,v 5-71/77.6mE■; FRVM. NLR vinsruAN - /-zy-o/ (AttoofrNA S pMst (19ftr o] Action Taken: ,I E lamiyo-vri- / :IDE INTERNATIONAL, INC. 3roce Drive an,32 Oklahoma"73072 U.S.A TEAL SAFETY DATA SHEET 329-5326 MA __ --___--_ ;405) -.-==81 ______________ _----— TRANSPORTATION EMERGENCY 24 HOUR TELEPHONE:(800) 424-9300(CHEMTREC)===============_ ___________________________ sWCIHLCG ==a_= 1.01 glm1(20°C) VOLATILE ORGANIC COMPOUNDS. <0.01% by weight LION I: PRODUCT IDENTIFICATION DUCT NAME: Y MoConTM' OCTANOLIW ATER PARTITION COEFFICIENT: NE EMICAL FAMILY: Mixture of OxYchlorine Compounds EVAPORATION RATE: Comparable m Water SOLUBILITY IN WATER' Complete PA NONYMS: N/A CAS#: None(Mixture) PH CONCENTRATE: 7.50 to 9.00 OTHER DISTINGUISHING CHARACTERISTICS: N/A Fire: 0 Hal [with 0 Reactivity: Ito 4 Special: None _ __________ ___ Fire: 0 Health: 1 Reactivity: 1 =_______ _ _ Product may cause eye and skin irritation FIRE AND EXPLOSIVE HAZARD INFORMATION .ARNDNG STATEMENT: L,4L0. "Ito L Y1tU1 PRODUCT: ErWir_�Cou 03 If duct- c(Pc.n, itnoC0.64/1 :YA REGISTRATION NUMBER: 9804-3 tEVISION DATE: September 2001 gllpgRSEDES. June 1999 _____________as-_____ S CTISN I: HAZARD() INGREDIENTS INGREDIENT[CAS ff OSHA ACGIH . PERCENT PEL TLV STEL OTHER Sodium Chlorite 0.17 NE NE NE E^tent 1975E1421 Minimum Tome 0.1 0.1 03 SARA 313 PPM PPM PPM Chlorine Dioxide [10049-044] TOTAL 0.17 FLASH POINT: None to solution boiling point. Method: N/A FLAMMABLE LIMITS (% By Volume): Lower: N/A Upper: N/A AUTOIGNITION TEMPERATURE: N[E DECOMPOSITION TEMPERATURE' N/E (For dry sodiun chlorite: 180 -200°C) EIRE EXTINGIISIDNG MEDIA: Water unless contraindicated by other material involved in fire. FIRE-FIGHTING EQUIPMENT: Standard protective gear. NE = NOT ESTABLISHED NL = NOT LISTED SPECIAL FIRE-FIGHTING PROCEDURES' Do not allow (C) = IDENTIFIED AS A CARCINOGEN BY OSHA, I%RC,NTP,OR ROTECS EnviroCoe" solutions m evaporate to dryness. UNiU000 FIRE OR EXPLOSIVE HAZARDS: The sodum pursuant to the OSHA Hazard other rra solutions is a strong oxidizer, This document classified prepared(29 CFR 1910.1200). In addition, Communication Standard( 'Hazardous' per this OSHA Standard may be chlorite in dried EnviroCon not classified as which supports combustion. 1l be made available as 1 substances ingredients will = = = fisted. The identity of other ing ___________ pmvidedinthi dad ______ s standard. _____ _____ • PHySICALICHEMICAL DATA SECTION V: REACTIVITY DATA ODOR: Clear liquid with very faint chlorinous APPEARANCE AND odor BOILING POINT: 213°F (1005°C) MELTINGPOINT: N/A VAPOR PRESSURE: 23.7 mm Hg(25t) VAPOR DENSITY: 0.02 kg/m' SECTION II STABILITY: Product is stable. d CONDITIONS TO AVOID: Avoid storing p o troro3ne suduct unn. conditions in which it could evaporate to cry INCOMPATIBLE MATERIALS: Avoid accidentalh), sulk with acids, chlorine compounds,hypochlm and sulfite compounds,phosphoms, organic solvents, and combustible/flammable materials. HAZARDOUS DECOMPOSITION PRODUCTS: Exposure to acids or chlorine compounds can produce chlorine dioxide gas. HAZARDOUS POLYMERIZATION: Does not occur. SECTION VI; HEALTH HAZARD DATA INGESTION: Rat Oral LD (50): 4,360 mg/kg. Ingestion may produce gastric discomfort,nausea,vomiting, and diarrhea. Intake of large INHALATION: Unactivated EnviroCon"" normally has no quantities may produce methemoglobinemia. respiratory effects. If exposure to chlorine dioxide produced from activation occurs, remove victim to fresh air. Contact a physician if respiratory distress continues. INGESTION: DO NOT INDUCE VOMITING. Contact a physician or Poison Control Center immediately. PLEASE NOTE: Above procedures are recommended as emergency first aid preesntions only. They are not intended to replace or supplant the treatment advice of a physician or other authorized health care specialist. FIRST AID SKIN CONTACT: Wash affected area thoroughly with soap water.Remove contaminated clothing and rinse thoroughly wig water before laundering or discard. If irritation occurs seek medical attention. EYE CONTACT: Flush eyes thoroughly with water, making certain eyelids are beld open. If irritation or burning persist, s medical attention. EYE CONTACT: Based on rabbit studies, EnviroConiM has been given an EPA Category III rating as a mild irritant. Exposure can produce slight irritation of conjunctiva, cornea, and eyelid. SKIN CONTACT: Based on rabbit studies,EnviroConlm is listed as 'practically not an irritant". Prolonged exposure may produce localized irritation, contact dermatitis, mild erythema, and edema. SHIN ABSORPTION: Highly unlikely to be absorbed through skin in toxic amounts. Rabbit Acute Dermal LD(50) > 2,020 mg/kg. INHALATION: Acute Inhalation: LC (50) > 5.61 mg/I. Prolonged inhalation of fog or mist containing Ent ireCodt" may be irritating to nose and throat. SYSTEMIC ar(D OTHER EFFECT'S: None known. CHRONIC EXPOSURE EFFECTS: May cause localized irritation to areas exposed to product. MEDICAL CONDITIONS AGGRAVATED BY EXPOSURE: Skin disorders, such as dermal allergies and dermatitis. CARCINOGENICITY: Active ingredients are not listed by ROTECS, OSHA,IARC, or NTP. No evidence to date implicating product as carcinogen or tumor promoter. MUTAGENICITY: Though product active ingredient is a chemical oxidant, no evidence to date for mutagenicity from whole animal or in vitro studies. REPRODUCTIVE EFFECTS: No known effects to date. OTHER HEALTH HAZARDS/HEALTH EFFECTS: None known. SECTION VIII: CONTROL MEASURES/PERSONAL PROTECTION EOUIPMENT VENTILATION: Open air or good room ventilation is normal) adequate for safe use of this product RESPIRATORY PROTECTION: In accordance with OSHA regulations(29 CFR 1910.134 and 29 CFR 1910.1000), fogging or spraying applications may require worker respiratory protection, such as: (I) NIOSH approved air-purifying respirators. EYE PROTECTION: Good manufacturing practice recommends use of chemical safety goggles for all applications involving chemical handling. PROTECTIVE CLOTHING: Good manufacturing practice recommends that, at a minimum, rubber, neoprene,or other chemically impervious gloves be worn for all applications involving chemical handling. OTHER PROTECTIVE MEASURES:Follow label directions. SECTION VII: FIRST AID TARGET ORGANS: Skin, eyes. For chlorine dioxide produced from activation: respiratory tract and exposed mucous membranes. SYMPTOMS OF OVER-EXPOSURE: Skin and eye irritation. Exposure to chlorine dioxide from activation can produce coughing, sor throat, headache, and dizziness. SECTION IX: SPILL LEAK, AND DISPOSAL PROCEDURES SPILL OR LEAK PROCEDURE: Small spills, involving less than 10 gallons, may be flushed to a designated and permitted sewer system with copious amounts of water. Do not discharge this product to storm drains or to any surface or groundwater source unless specifically allowed under a valid NPDES permit. e DISPOSAL PROCEDURE: Small quantities, less than 10 gallons, may be flushed to an authorized and permitted sewer with copious amounts of water. BOARD OF HEALTH CITY HALL COMPLAINT RECORD ctipn Taken: INSPECTOR' REPORT: -pug:d I Cml ii Pnmota tare Check BC!ItYES 1 l Inspector Signature te: //,f//0 'Time: /a-:3a I Map: I Parcel: me of Complainant hik O?i irk dress: SS —'U,v 7� , g ,_ Qi72 NATURE OFCdMPLAINT � � �L/EGG ZG Z ` CC�t % y j _ U. / id-4 /fin�a� ��i � d �y/�� � .�.c�" �LGt �/�C �Jf/�`^' /c 'dation: j // � ,J / d weer: v6'l/!� 7/2/64 z — // ii .�N44/,z,4/ /�'a �r/� ddres Tel: 1 aken by: 'i I Date of Inspectoo : ! I Time: ctipn Taken: INSPECTOR' REPORT: -pug:d I Cml ii Pnmota tare Check BC!ItYES 1 l Inspector Signature ate: L;1 LI Mal ame of omplalnant: tc /i /U2(So ddress: �1�II R(oe /'Y / 4, Tel: cF%-®! NATURE OF COMPLAINT: ,C4.tL� 0,‘ C/011)c., Parcel: .00atlon: )caner: \ddress: taken by: Date of Inspection: Tel: Time: INSPECTOR'S REPORT: ` 4"1-N ie sL ..(ad o g )3o j:ou Gullet Grid tecAcv'&d 110 t% rr' p rvr-t LcRL fiction aken: / „T /1r Nip.011.1.0.1 '- / Inspector Signature Date: WL� � •�.Lf�. Map: Name of Complainant: �An� %= Address: 3 S Location: Owner. Address: /7/6 Taken l) •!am Date of l' enaction: 3ff INS ECTOR'S REP• T: fe-,,;"15te.;4c//4`I'vJ9/ {/ ,`/, . 4 rep4i , %%eve✓S /tip %7 ��� � J 4 / � t�c, Y/�j wee Goiiec 4 Time:/p; e/Ma, Action Taken: (iprrec etrjaaus s, J / eA/, id 44 n ePda/6,BO wr Inspector Signature. S.r e/f aniel Wasiuk rom: Daniel Wasiuk ent: Wednesday, March 09, 2011 11:02 AM o: Ben Wood o: 'jhite @hamphousing.org' object: RE: cahill laundry room food morning Ben, re-inspected the Cahill laundry room today(3/9/11)at approximately 10:15am. A repair technician was on-site in the irocess of repairing the laundry washers. In addition, previous noted unsanitary conditions of the interior area were :orrected. Appropriate cleaning measures were enacted and the entire interior facility area appeared to be in an adequate sanitary manner. Any further questions, please contact me. thanks, Daniel Wasiuk Health Inspector Northampton Health Department dwa sink C'^^^hamotonma orf; office: 413-587-1339 From Ben Wood Sent: Tuesday, March 08, 2011 3:50 PM To: Javeria Mir; Daniel Wasiuk Subject FW: cahill laundry room Hi, unless you already wrote them up I don't think it is necessary to write formal orders unless they do not take care of the problem.Check in with Jon tomorrow (wed.) or do a quick stop-by.Thanks. Ben From Northampton Housing [mailto:jhite @hamphousin9.org] Sent: Tuesday, March 08, 2011 9:10 AM To: Ben Wood Subject: Re: cahill laundry room Ben- You mentioned you were having an email problem. This arrived sometime after 6:25 PM, when I logged off last night. Anyway, we have a washing machine that has a blown seal, and a tenant with a blown gasket. We got word of the former yesterday and called it in for service. We've known of the latter for years, which is why I blew my gasket. What a complete waste of you guys time. Jon On 3/7/11 10:34 AM, "Ben Wood" <bwood @northamotonma cov> wrote: Good morning, I was wondering when these calls were going to come in. We received a call this morning about flooding in cahill laundry room. Are you aware of this?Thank you. 1 in Wood, MPH rector, Northampton Health Department .2 Main Street, Municipal Building )rthampton, MA 01060 .rect Line: 413-587-1213 eneral Office: 413-587-1214 3x: 413-587-1221 mail: bwood©northamotonma.gov lo://www.northamptonmamov/healthdept 2 BOARD OF HEALTH MEMBERS ONNA C.SALLOOM,CHAIR SUZANNE SMITH,M.D. JOANNE LEVIN,M.D. enjamin Wood,MPH,Director a Abbott,RN,Public Health Nurse tniel Wasiuk,Health Inspector ,mund Smith,Health Inspector Heather McBride,Clerk CITY OF NORTHAMPTON MASSACHUSETTS 01060 OFFICE OF THE BOARD OF HEALTH (413)587-1214 FAX(413)587-1221 212 MAIN STREET NORTHAMPTON,MA 01060 NOTICE TO ABATE A NUISANCE DATE: 9-14-2011 ADDRESS Cahill Apartments-Northampton Housing Authority 49 Old South Street, Northampton MA i owner of Cahill Apartments, 35 Fruit Street, Northampton MA u are hereby notified to take action to remedy the conditions named below within DAYS of the service of this notice, according to Massachusetts General Laws,Chapter 111, actions 122-125 ESCRIPTION: • Mattress, broken upholstered furniture, old carpeting, loose cardboard allowed to accumulate around dumpster. at the expiration of time allowed these conditions have not been remedied, or are not in the -ocess of being remedied,such further action will be taken as the law requires and a fine of 1000.00 for each offense may be charged. By order of the Northampton Board of Health This abatement order is signed and certified under the pains and penalties of perjury. Edmund Smith, Health Inspector Northampton Health Department /� Gt �Q `� � ,^ r`t 9-trU - eo7n,a �[�-C.tgi'� d j'n /61e j�G�c s' a" ✓ra e:l ne of Co plainant: dress: NATURE OF COMPLAINT:`) on S 3�(\wl 1:z. uArce 1 c.Nc\ In lick 10)2Q-\ k V1G` < < a,c ) h '��1 h-) ocation: )wner: \ddress' Taken Date of Inspection: INSPECTOR'S REPORT' piaw r • 9 hv IRGy E, 1Nrit c cd 0-A./pee/0-A./pee/Zit./ if, M/2svE . o.yree r!/ " /ME - MA-re-155 m-G C4-4i n J,7, c A//CE' 'nen c --9torF fl 6tdJr>4�, Total#of Inspections: Orders Issued?: Date of Final Inspection: Notice of Compliance?: Inspector Signature 1 ir, r tET �� "12) 5h€ j BOARD OF HEALTH i >'` CITY HALL COMPLAINT RECORD Date: i; k! i Taken by: INCL Date of Inspection: 7 -tors Time: a : Ci - Aft rm.* Total#of Inspections: Date of Final Inspection Chock Box YES Orders Issued?: Notice of Compliance?: Inspector Signature