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96 Inspection 2017 Northampton Health Department 212 Main Street Northampton, MA 01060 (413)597-1214 Inspection Form State Sanitary Code 105 CMR 410.000: Chapter II, Minimum Standards of Fitness for Human Habitation Date j Y /7 Time t '3oAi/pm #Occupants f #Children<6 Years Occup nt ame /uG J r'kt"e Phone# Addresser(D . jj City/Town Apt# Owner Name Phone# Owner Address City/Town Zip Code Inspector C i C 5 Title - tie J1 Ts&5Pei r Area or Type of Violation Possible Code ✓if Violation Responsible Description Element Section(s) Observed Party Owner Occupant Exterior, Locks,striker mechanism(4 or more units) 4• 80 Yard& Porch Posting,ID,Exit signs/emergency lights 4• 81,483,484 Handrails,steps,doors,windows,roof-maintenance 500,503 Weather tight elements 501 Rubbish-storage and collection 600,601 Yard maintenance-trash,debris,vegetation 602 Common Maintenance of area 500 Areas& Entry Doors,lights,windows—weather tight,maintenance 501,500 Egress—means,obstructed,safe 450,451,452 Handrails—provided,maintenance 503,500 Interior Lights 254 Halls& Stairs Floor,walls,ceiling-maintenance 500 Railings,stairs 5• 03,500 Doors,windows—weather tight,maintenance 501,500 Kitchen Location(circle): Front Rear Middle Floor Level of Unit Refrigerator,sink,stove,oven-good repair,impervious 100 and smooth Floor,walls,ceiling-maintenance 500 Outlets,lights 251 Windows,screens—weather tight,lock,maintenance, 501,480,500, provided 551 Non-absorbent floor 504 wing room Floor,walls,ceilings S00 Outlets,lights 250 Windows,screens-lock,weather tight,maintenance, 501,480,S00, provided 551 Area or Type of Violation Possible Code +cif Violation Responsible Description Element Section(s) Observed Party Owner Occupant Bedroom Floors,walls,ceiling 500 #1 Outlets,lights 250 Windows,screens—weather tight,locks,maintenance, 501,480, 500, provided 551 Bedroom Floors,walls,ceiling 500 #2 Outlets,lights 250 Windows,screens—weathertight,locks,maintenance, 501,480, 500, provided 551 Bedroom Floors,walls,ceiling 500 113 Outlets,lights 250 Windows,screens—weathertight,locks,maintenance, 501,480, 500, provided 551 Bathroom Sink,shower,tub—impervious,maintenance 150,500 Lights,outlets 250 Ventilation—natural,mechanical 280 Floors,walls,ceiling—maintenance 500,504 asement Maintenance,weathertight 500,501 Lighting 253 Water Fuel Type(circle): Public Private Potable,quantity,pressure 180,354 Responsible for paying MGL ch 186 s 22,metering Hot Water Fuel Type(circle): Natural Gas Oil Electric Other Temp.: °f Location taken: 190 *1101 min-130 max°f Heating Type(circle): Forced Hot Water Forced Hot Air 200,201 Steam Electric No portable units Bathroom °f "Habitable room and every room with toilet,shower, Kitchen °f tub" Living Room °f • Min 68°f 7:OOam-10:S9pm Bedroom 1 °f Min 64°f 11:00-6:59am Bedroom 2 °f • 78 F max in heating season/measure 5 feet wall,5 feet floor Cooper TM99A-UL Digital Thermometer used to take temperature readings Electrical Type(circle): 110 220 Amp: Amperage,temporary wiring,metering 250,255,256,354 Smoke& Required&operational 482 CO Detectors Note:CO detector not needed for all electric! Pests Free of pests/harborage 550 Bedbugs/cockroaches/rodents-evidence 550 Other Referral: 0 Electric ❑ Fire 0 Plumbing 0 Building ❑ Other This inspection report is signed and certified under the pains and penalties of perjury. Inspector Signature Occupant or Occupant's Representative Signature Re-inspection Date Time NOTE: *indicates that this housing inspection has revealed conditions which may endanger or materially impair the health, safety, and well-being of any person(s) occupying the premises Area/Element Code Citation and Description of Violation A - cc 0t\screc, (537...._ n K a ocei c p �'�� (e 'F .bc ; s a i �u4 en ._(:) p�� �� mer (cJ 5c) +);c,, ..4. 'a:P per: U ,„ A)yeki4J-QA lit ) , DAc4 Cli) ef-v-r1(3-)-09 _V-1Q -XI<37 77JPc714-at)‘- cy, °, c7n _raccr042 jeita 0501 lacy Nfi -tp .1 a, az,-,