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UNITED STATES POSTAL SERVICE
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Print your name, address, and ZIP Code in this box •
BOARD OF N�'At1'N
27000M
NOR1H ANDOVER MA 0184
a }
AORTH f
F
HEALTH DEPAR
RECEIVED
I OF NORTH ANDO1
kLTH DEPAPTLAMM
Comp laint/Investigation Intake Report - Taken by:
Date of Report: — 3 /C�,
Category/Type of Complaint:
Name of Person Reporting:
01
Time:
Address/Location of Incident:
I
Phone Number:
/ C Phone Number:
Name of Alleged Violator:
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Immediate corrective action to be taken: �^ j
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To be Investigated by:
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Title: i Date Scheduled for Investigation:
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Date Submitted for Data Entry: Date
Entered:
When Your Acting Pro-Se. Your The Boss And Control The Cosec
tsj
Elaine Dallaire-Donegan
Freelance Paralegal
r;
Business Office
10 Walker Road., Suite #2
North Andover, Massachusetts, 01845
978-387-6135
Elainelegal@yahoo.com
Town of North Andover
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES
WILLIAM J. SCOTT
Director
(978)688-9531
DATE: October 8,1999
27 Charles Street
North Andover, Massachusetts 01845
LETTER OF COMPLIANCE
TO OWNER OF RECORD PROPERTY LOCATION
V"1��to a 'rye
A
95SACHUSE��y
Fax(978)688-9542
Flather Bay Realty Unit 3
Lloyd Wajda ' Bldg. 14 Walker Rd
JRQ Realty Trust, LJW Realty Trust, SP2nd Trust North Andover, MA
102 Butternut Lane 01845
Methuen, MA 01844
A Health Department ORDER LETTER dated August 31, 1999 was issued to you as
owner of record of the property listed above citing violations of the State Sanitary Code,
105 CMR 410.000, Minimum Standards of Fitness for Human Habitation. A re -inspection
of the property on October 8, 1999 indicated that all violations noted on the order have
been corrected.
A copy of this letter is being sent to the person(s) who made the complaint. If the
complainant has any questions or comments concerning this determination of compliance,
the Board of Health must be contacted within ten (10) days of the receipt of this letter.
Sincerely
u aan Y. Ford
Health Inspector
Cc: Kelly Walsh
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
Date
8/30/99Complaint
Complaint#
74
Complaintant
Kelly Walsh
Addresss
Phone#
14 Walker Road Unit 3
557.9411
.Action Complaintant talked to everyone and people
suggested that she should call the Health
Owner of Property [Flather Bay Realty f Dept.
Owner's Address 102 Butternut Lane
Methuen
Phone#
OL Sent ❑
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WILLIAM J. SCOTT
Director
(978) 688-9531
Town of North Andover
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES
27 Charles Street
North Andover, Massachusetts 01845
NORTH ANDOVER BOARD OF HEALTH
ORDER
Issued under the provisions of the State Sanitary Code, Chapter II, Minimum
Standards of Fitness for Human Habitation, 105 CMR 410.000.
Date; August 31, 1999
Fax(978)688-9542
TO: Property Location:
Flather Bay Realty Unit 3
Lloyd Wajda Bldg. 14 Walker Rd
JRQ Realty Trust, LJW Realty Trust, SP2nd Trust North Andover, MA
102 Butternut Lane 01845
Methuen, MA 01844
North Andover Health Department personnel made an authorized
inspection of the property at the above address on August 31, 1999.
This inspection revealed violations of certain regulations of the State
Sanitary Code, Chapter II, as listed on the attached Violation Form. You are
hereby ORDERED to correct these violations within the time allotted on the
enclosed form. Failure to comply within the allotted time period may result in a
criminal complaint against you in the Lawrence District Court and may result in
an assessment of a fine.
You have the right to request a hearing before the Board of Health if you
feel this order should be modified or withdrawn. A request for said hearing must
be made in writing and received by the Health Department within seven (7) days
from the receipt of this order. At said hearing you will be given an opportunity to
be heard and to present witness and documentary evidence as to why this order
should be modified or withdrawn. All affected parties will be informed of the date,
time and place of the hearing and of their right to inspect and copy all records
concerning the matter to be heard. An attorney may represent you. You also
have the right to inspect and obtain copies of all relevant records concerning the
matter to be heard.
9j6san Ford
Health Inspector
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530
HEALTH 688-9540 PLANNING 688-9535
4
VIOLATIONS TO BE CORRECTED NO LATER THAN TEN (10) DAYS FROM
RECEIPT OF THIS ORDER LETTER:
VIOLATION REGULATION REINSPECTION
1) Bathroom window does not stay open 410.501
- Windows must open and close easily
Replace or repair the window so that it opens
and closes easily and is not a hazard
2) Kitchen — Dishwasher door falls freely. 410.351
Appears to have a spring missing
- all owner -installed equipment shall be
maintained free from hazards
Repair door of dishwasher
3) Bathroom wall tiles observed loose. 410.504(8)
Wall behindtiles under the window area spongy
when pressed on.
- The walls up to a height of 72 inches of a shower
area shall be constructed of a durable material,
covered by a smooth, nonabsorbent material
and kept in a watertight condition.
Remove tiles and repair the wall areas in disrepair.
Make area nonabsorbent.
4) Name of owner not posted 410.481
- The owner of a dwelling which is rented for
residential use, who does not reside therein,
shall post a notice made of durable
material, not less that 20 square inches in
size, bearing his name, address and phone number.
Post owner information
Cc: Tenant
NORTH ANDOVER HEALTH DEPARTMENT
120 Main Street • North Andover, MA 01845
Telephone (508) 682-6483, Ext. 32
Housing Inspection Report
COMPLAINT #.
COMPLAINANT
ADDRESS OF PREMISES
°
OCCUPANT �
OWNER!
OWNER'S ADDRESS 12�> 7 /S
DATE OF INSPECTION .P /�� �g`q HOUR j
ROOMS/VIOLATION:
4
D
Form #HIR -1 Action Press 885-7000
r�
Date 8/30/99 Complaint
Complaint# 74
Complaintant Kelly Walsh
Addresss
Phone# 14 Walker Road Unit 3
557.9411
jcqty
Owner of Property Flather Bay Realty i
Owner's Address I
102 Butternut Lane
Methuen
Phone#
Broken window -has to put a stick in the
window to hold it up. Talked to the
Association and was told that was not
allowed but the owner says it is.
Dishwasher spring is gone also. Notified
they want to sell the unit,unable to sell
and wants to raise rent
Complaintant talked to everyone and people
suggested that she should call the Health
Dept.
OL Sent ❑
I
Town of North Andover
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES
27 Charles Street
North Andover, Massachusetts 01845
COMPLAINTS
Date:
Complaintant:
Address: Tel. # v�
ed. 12
Z -L4 113
Complaint Against:
Property Owner:
r
Address: / l9� � Tel.#
l.J21�f.%i✓�� LLC ,�,
,ra 14L�
NORTH ANDOVER BUILDING DEPARTMENT
400 Osgood Street
Tel: 978-688-9545
Fax: 978-688=9542
BUSINESS FORM FOR TOWN CLERK
DATE:
-
F
NAME: M; �e-
�t
ADDRESS- lY GJa&P�
ZONING DISTRICT:
A[b00�- K at- CL\\ ,Nj' S t4&K..,
TYPE OF BUSINESS: C'C' �I (' �{ SP l !/ fC t�' LIZ %V Ccohyu4er-
BUILDING
LAYOUT PROVID
AVAILABLE PARKING SPACES: N IA
ZONING BY LAW USAGE: YES NO
c
INSPECTOR SIGNATURE
Revised 11.5.04
BUSINESS FORM FOR TOWN CLERK
9304 Date.Z/�.L�
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that ...4 . , . ... .... .. .. .
has permission to perform ...�. � Q.
plumbing in the bu'ldings of .. . ,l//' ..f lour /Xe
i
at .....t� .1��aJ .. �.. ............... Korth Andov r, Mass.
Fee. Lic. No.,,-' . .. . .............
t— PLUMBING NSPECTOR
Check # ✓3-U
.f
VS.
TYPE QR
PRINT
CLEARLY
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
CITY1 /V,at)MA DATE PERMIT f#
dovcd-
JOBSITEADDRESS I L- w0tj c 1 kj_ I OWNER'S NAMEJMCadoi,� vow (��1
O�VNI R ADDRESS walk �a „ TEL "U
IFAX
OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL
NEW. RENOVATION: REPLACEMENT: PIANS SUBMITTED: YES NOI j r
FIXTURES Z FLOOR-
BSM
1
2
3
4
5 6
7
tl
9
10
11
12
13
14
BATHTUB
CROSS CONNECTION DEVICE
DEDICATED SPEGIALWASTE SYSTEM
DEDICATED GASIOIUSAND SYSTEM
DEDICATED GREASE SYSTEM
E
DEDICATED GRAY WATER SYSTEM
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER
I
DRINI<INGFOUNTAITJ
- -
FOOD DISPOSERI
.._._.._'
FLOOR [AREA DRAIN
-
- -
INTERCEPTOR (INTERIOR)
KITCHEN SINK
LAVATORY
i
ROOF DRAIN
SHOWER STALL
SERVICE IMOP SINK
i
TOILET
URINAL
WASHING MACHINE CONNECTION
-
_
WATER HEATER ALL TYPES
WATER PIPING
OTHER _
-
-
----
- --
-- --
it
—
--
INSURANCE COVERAGE: - -- •__ ._. _ __ ?
I have a current liabilit ihsilratice poiiq.or its substantial equiValetn which meets the regttiremeots of MGL Ch. 142. YES � 1 1 NO j
IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE.BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY I OTHER TYPE OF INDEMNITY j BOND ), I
OWNER'S fNSURANCE :WAIVER: I am aware that the licensee.does not have the insurance coverage required by Chapter142 of the
Massachusetts General Laws, and thatmy signature en this permit application waives this requirehient.
_ CHECKONEONLY: OWNER ( AGENT
SIONATURE OF OWNER OR AGENT
I heiebp cerlifyihat all of the details and infomiallon I have Submitted or entered regaidingahis application are true a accurate t 1h a of my knoertedge
and that all! plumbing work and installations performed under the permit issued 'for this application will be inconipli ce to aU P di,
i nt , -vision of the
Massachusetts State Plumbing Code and Chapt, 142 of the General Laws.
PLUMBER'S NAME I. ` 01 W c LICENSE # 13o7obiGNAI URE
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