HomeMy WebLinkAboutComplaint Form 52219 TOW .41 .• OUTH �n
1146 Route 28 g.. . �' ►,uth, MA 02664 MAY 22 2019
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508-398-223 <,* 'Y3 4'' . 08-398-0836 L011.
Office of I.i; .•.:1 .- 2 missioner
MATTACM &SE /�
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COMPLAINT FORM
Date: .--- I - - ( 9
Type of Complaint: Building Zoning General y e�f"-�ac
This is a formal request for enforcement of an alleged violation. The following are facts in the case:
Property Address of Alleged Violation: � C� - C
Property Owners Name (s): A CA n ( cam Q i 'rex-- 8 ^Property Owners Mailing Address: `3
Description of Complaint:
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Date (s) of Alleged Violation (s): ZG ( & `
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Name (s) of Person(s): Q
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The following information is required. Failure to provide your name, address,
and telephone number will result in the Inspector of Buildings/ Zoning
Enforcement Officer to process the complaint at his/her discretion. (PLEASE
PRINT)
Complainant Name: \ _ f -�
Address of Complainant: 1 4, 72 and (� 7 [ -e\''-11- c C `2 6 7 .�
Telephone Number: $ oS— 3 a - Zug 3 Email Address: k 0+-v is i I c-1,(44
Preferred Method of Contact(check one): Telephone: v Email: L-
I am basing my allegations on the above facts. I understand that as the complainant, in the event the Building
Commissioner is personally unable to bring the matter in to compliance, I may be required to attend legal
proceedings to enforce the regulation referenced above in a court of law. Pursuant to the above allegations I am
requesting an investigation and enforcement if applicable.
Signature of Complainant: r\ LA: let,7
I Prefer to Remain Anonymous: [ ] (check box)