HomeMy WebLinkAbout22 Television Inspection ReportTHE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF YARMOUTH
1 146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664.4451
Telephone {508) 398-2231 , Ext. 1240 - Fax (508) 398-2365
Address ZL
Floor
Type: I Annual E Seaso
lnspectioni D Scheduled
Unit
No. Steeping Rooms -3 No. Dwetting or Roomi
Name and Address ol O 6l
Aparlment No. Max Occupants
g\
b tlo. ot x"n,tabte Ftooms 5
Units
-
No. Sfoues I
rng
t
Vo
Weekly
to Occupancy
nal
{,tiat ! Complaint
BasTent: tr Frnished ! UnrinlsneO-frhdL
Det/ctors: E Srnoke(/) Not Present ! Carbon Monox;de Not Present
{vull,sntoo, arlqtm
feating System: '{eas. O,l.Etectric. Propane
dilu otns
f '"",n"", f Panel Not Labeled &anel Labelea
#,"""n,
E Safety Concerns /
f Kitchen Stove dErectric tr Gas
! Appearance of Mold ,/
E lnfestation C Bats, M,ce, Roaches or Olher fitone Observed
G,/@rbage and Rtbbish / dco^taine.s/Covers d erea Cleaa
4xtenv Yard L,/tdrio, or House
/lo"t . on ooo., ffif""
E/$torm/Screen Door N/Door Ctosure D Windows
y'*n"n"n
n Remove/Fleseal Sealant Base of Shower n Top of Tub D Base of Tub (Floor)
Il cenerar Appearan."-TErn C'i C
Bedroom !1 !2 3 tr4 tr5 !6
See xrnles
ote >
A e
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a A Copy ot "Tenants Rights' Has Been lssued to Tenant.
One or more ol the violations checked above is a condition which may malerially impair the health or safety and well-bEing of the occupant as
determined by 105CN,lR 410.750 of the code or the authorized inspector (see over).
This ins on Repo ned and Certified Under the Pains and Penalties ot Perjury
lnspector
Date
The ne s eduled reinspection
o 4_Tifle
Time
PM
A,M
PM
I
I
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