Loading...
43-064 (5) t -htmtkt„44 (� zip of Northampton R n Asssmon etre '� / 'PI?Mk rffire of the ynspoctor of '4�ailbinso _! m rng 7 6 Z ( 3t2Main Street• , Mass,, 0/060ldiag } Northampton, Mass. 01060 \`�, °Err or i u_. ""�- COMPLAINT SHEET How received: Telephone ( ) Complaint No./ r5 p .-._ Personal)Q Date: /0?d79iJ Letter ( ) Time/a L'A.M. _ P.M. Telephone No. .� Complainant's Name: Patricia McElroy Complainant's Address: 40 Dunphy Drive Northampton 7 Complaint received by: -A% tr4 a./ 1 VIOLATIONS OF: O Chapter 44 Zoning Ordinances,City of Northampton ❑ Chapter 802 As Ammended Mass. State Building Code O Sanitary Code, Art.2 Complaint reported against: Name: Vicki Joyce Tot, 586-7065 Address: 48 Dunphy Drive Northampton Location of complaint: Map# 7 Lot it /�L9 Signature of Complanants: Nature of complaint: Tharp is a steady stream of traffic going in and out of the drivaway of tit . , . . . r- • du- t he ow.. _ . r Loss ; - ik._ 1 . ..ty salon husinaca nut of her home . This has been ongoing for at least 5 years that T am aware of. I don' t believe she has either a permit or the proper zoning for this business . This business is in a room within the house, not built onto the home . Investigation:Yes ( )No ( ) Investigated by: 90936 t - ignw/re ,Ga Z9 mrd'±; 'DO rt C*'S _"3 ' r k' I Srb7.J� g- C/cc' I g --roc) .9 oc— G Z cc cm—neck" ��ie doh -G-e . /74(i-7y' nn ?din( - , /--, - ___S-- , , , - L _ A1 n ?din< A — Z S1h, DIVISION OF RHGIS OFFICE OF INVE TIGATION i 617-17-727-74406 Please complete this complaint form as fully as possible. This form must be printed in ink and be legible: COMPLAINT ISSUED BYy, Z 47/4pccwa .,,�� �p_�� / Name: EN �/VY�6je ti rSSiewne C/T7 0r ded247M"ylo� Last Name First Name M.I. Address: 2/2 A7/t" S% %a-$89 /ZYO Number Street Daytime Phone x04477//7.724-011/ ,42111 00 60 City State Zip Code Evening Phone C/T� OF yaf$sn, OA-V Busines Name,Business Address Professional License ft (if applicable) COMPLAINT ISSUED AGAINST: Name: - falfe ycF UiCKfa Last Name First Name M.I. Address: //8 L)CIAJ fit Di°lu,E 4-,R6— Number Street // Daytime Phone No.gWAi ekltdk, A7edli 0/aaa0 City State Zip Code License Number Name, Business Name Address Number Street Daytime Phone City' State Zip Code Professional License Please check the trade or profession that this complaint pertains to: Accountant Psychologist Aesthetician X Hairdresser Architect Health Officer Athletic Trainer Landscape Architect Audiologist/Speech Pathologist Land Surveyor Barber Manicurist Chiropractor Mental Health Counselor Complaint Against School Marriage&Family Therapist Dental Hygienist Nurse Dentist Nursing Home Administrator Drinking Water Plant Operator Occupational Therapist Electrician Occupational Therapist Assistant Electrologists Optician Engineer Optometrist Fire&Burglar Alarm Physician's Assistant Funeral Director Real Estate Appraiser Pharmacist/Pharnacy _ Real Estate Broker/Salesperson Physical Therapist Rehabilitation Counselor Physical Therapist Assistant Respiratory Care Plumber/Gas Fitter Sanitarian Podiatrist Social Worker Radio or Television Technician Veterinarian -Continued on other side- Pleasedien)c�horeasonfm-,rhe ' Breach of contend $s'r� •• ;-Mi presentati L'- 'F Disaupipation Patient neglect Drug oralcoholahuse -- Setmal misconduct Unprofessional or unethical conduct Unable to obtain records c. Failure to fill presaiplionpmperly Un icensed Failure to return a deposit Unsanitary Conditions Inferior work or materials Other: Description of the Complaint: Briefly describe the incidents that led to your complaint and note the times and dates that events occurred. List the names of all individuals involved. SE-F R77-qcw /1 r0 /&9 r 919-#L.T- , Attach additional infomation needed to a plain the details of your complaint Send copies,not the ordinal,of any related documents. You will be sent an acknowledgement letter with the name of the investigator assigned to your case. AUTHORIZATION FOR RELEASE OF RECORDS AND REFERRAL OF COMPLAINT Your signature to this form,or a photocopy thereof,authorizes the Division of Registration to: (I)receive copies of all medical,dental and mental health records relating to your complaint,(2)refer your complaint to appropriate law enforcement authorities to investigate or prosecute your complaint,and(3)conduct a preliminary investigation, Please note that all complaints are investigated to determine their factual basis. The act of filing a complaint does not assure or imply that disciplinary action will necessarily be taken against the licensee. The above information is true, and complete to the best of my lmowledge. //,.//, O// r/4� Yomur tore // > Date .4/4 azz-m5Sigyba5( GTy of.nwf7//A5nO2°"". Mail this form to: Office of Investigations,Division of Registration ti 100 Cambridge Street,15th Floor Boston,MA 02202