HomeMy WebLinkAbout24 Sioux Road Rental InspectionTHE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF YARMOUTH
1 ,146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664-4451
Telephone (508) 398-2231 , Ex| 1240 - Fax (508)398-2365
eaa,"s'-2].--9-iwt-____________Unit
Floor-----LApartment No.-Max. Occupants No. of Habitable Rooms
No. Sleeping Rooms No. Dwelling or Rooming Units-No. Stories L
Name and Address of Own C 'Ba <3,2 I I ba Ll Vo{
Type: ! Annual Seasona klv
lnspect on eduled n P ior to Occupancy E Complaint
Basement: U Finished nfinished
D rs tr Smoke$) Not Present ! Carbon Monoxide Not Present
oor d/ce;'rino,,-System: Z Gas. Orl, Electric, Propane
ff{,.""n
eating
Qdturgting
w{yartcat
f/Safetv Con
! Panel Not Labeled
cerns
Panel Labeled
D{itihen Stove ! Electric
{Appearance ol Mold
firtestation ! Rats ce, Roaches or Other
d/containers/covers
Gas
tr{ie ouservea
{NeacteanGarbage and Rubbish
B-txterior Yard
E-ldcks on ooors
of House
Door !-/oor Clos ur" Buwindo*"
hen
tr Remove/Reseal Sealant Base ot Shower D Top ofTub ! Base of Tub (Flood
General Appearance
Bedroom !1 tr2 !3 D4 !5 n6
COMMENTS: r \fafle- q; V1,o,,.r"5-( , \
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! A Copy of "Tenants Rights' Has Been lssued to Tenant.
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 105CMR 410.750 of the code or the auihorized inspector (see over).
This i Report is and Certified Under the Pains and Penallies ol Perjury.
lnspector Tltle yhas,al DtsO<c'o r<
Date {-p-ze
The next scheduled reinspection 5
Time
'--7
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A= R c q,<-z-s:;-c i-,PM
PM
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