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Address � _---tie\eD VS) Unit
Floor I Apartment No. Max.Occupants No.of Habitable Rooms
No. Sleeping Rooms 3 No..�� '"'`Dwellling(or Rooming Units No.Stories fpi-Name and Address of Owner � 14 " _�-v c '"(�� LP A r‘11-M504.41 f041jv' A.ding Vio.
Type: ❑ nnual easonal 0 Weekly
Inspection: 0 cheduled ❑ for to Occupancy 0 Complaint
Basement: 0 Finished 0 nfinsshed
Detect rs: 0 Smoke(s Not Present 0 Carbon Monoxide Not Present resent
Wall locr ;�5,eiting 45-cc_ Cr7.nwtG,v`t-.5
!— ea g Systen 0 Gas,Oil, Electric,Propane _
le
lumbing ��.-'�''�
ctrical 0 Panel Not Labeled ❑-Panel Labeled
'fety Concerns i`' Sit e-p,mrvt2n'[5
!- Kitchen Stove ectric ❑ Gas r_
2/Appearance of Mold < 1v A(Iw4"16 0.'1 per'`e' i`o
Infestation 0 Rats, Mice,Roaches or Other lone Observed
r~'
" rbage and Rubbish 2 Containers/Covers .lea Clean
xterior Yard 0 xtxtericr of House
Wicks on Doors t'J egress
❑-'S`torm/Screen Door Ooor Closure Windows
..2-kighen
Re ve/Reseal Sealant Base of Shower 0 Top of Tub Base of Tub(Floor) �e �jUy►1Yj�gh TS
General Appearance
Bedroom 0 1 0 2 0 3 0 4 0 5 ❑ 6 1 1
COMMENTS:
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O tc LL,4ley91 J ^�
i'e.,, IA-CA, Reof ct 4 `Q0001-- F12oNT Le—
R t,P tact, p0" e- sc ea. - i r2 4T- Le Bed-sir
C,e t to s re,-t l o ti-r LA.- tov.e.i1.0 (A s - 0,,,-tr- C 0, .4-e a. rse,D oar
26p P i(. D.00(lyt ; -(L c rvz`A.t 4td,t .L1ro - Shd W6t. 45-e- -
1-Qe_tiA I,J artik I ex (,vvek y \lh ...- --Aw U 12--
R�o�tA{t,- 01,4cn , r4 r_ : 044.j-i. (.,0 6✓a_.. Strt --
e,pprcc 1vs0 - A-
L\<ssr✓1 -g1,ab- 1 \ 4,040t1-ce4
A Copy of"Tenants Rights' Has Been Issued 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 authorized inspector(see over).
This inspection Report is Si ne and rtified Under the Pains and Penalties of Perjury. FJl y �f� Q
Title
Inspector - f: 6 6 A.M.
S '/!- Time P.M.
Date A.M.
The next scheduled reinspection .-
Address l/ r�2,on �-s .lc /C.i ? %-
FINDINGS
LOCATION ACTION/ITEM 24 HRS PASS
•FeckQ,ndw. --, 01 4 t-c rl ID o LA-'
14441 w w-/j F�j94:vz. f oo►e,n c, 5 va.0 C r�
1 Rfo+Q. /? e +o-r w_./Repo LAM-- t.r• -5 re to s
`$ 1 icte_e L ao pert o'e_-
s2 AAA-V(1 g.et0 e-1 Foe- Re,i crc �.,n�
tl!fa
NEXT SCHEDULED RE-INSPECTION SO