HomeMy WebLinkAboutComplaint 6/13/25 TOWN OF YARMOUTH
Health Department
1146 Route 28, South Yarmouth, MA 02664
508-398-2231 ext. 1246 Fax 508-398-0836
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JUN 13 2025 COMPLAINT FORM
BUILDING DEPENT
°Y ARTM Today's Date:
Type of Complaint: Rental Food Hazardous Materials General
This is a formal request for enforcement of an alleged violation. The following are facts in the case:
Property Address of Alleged Violation: 6,410 (k' �e)a DC ._2/I 1{ i b-A7 f
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Property Owners Name(s):
Property Owners Mailing Address:
Description of Complaint: 8 0 s S 3 n U 4. A 'dl
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Date (s)of Alleged Violation(s): � (k / / f rtj ( 1-,d
Name- Peron(s): $ t C/ u 1 l/ - A S2)(jJ12
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,eo o. Health Department
o :_ _ 1146 Route 28, South Yarmouth, MA 02664
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508-398-2231 ext. 1246 Fax 508-398-0836
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Complaint Form Instructions
➢ Please be aware, when you fill out a Request for Enforcement you are filing a formal
written complaint
➢ Read the Request for Enforcement form carefully and fill out the Request for
Enforcement form completely
➢ Multiple complaints pertaining to different addresses require a form for each complaint
➢ Multiple complaints pertaining to the same address can use one complaint form
➢ Sign and forward the original Request for Enforcement form to the Health Department
(copies are not accepted)
Please Note:
➢ Request for Enforcement forms that are incomplete will be treated as anonymous
complaints and will be investigated at the Assistant Health Director's discretion.
➢ Complaints that are phoned in to the Health Department will be treated as anonymous
complaints and will be investigated at the Assistant Health Director's discretion