HomeMy WebLinkAboutHood Violation - Miscellaneous - 7/15/2019 I(6 Ved p r lxtt to nGX.c. 148A and 527 Clot 100W. .� f�� � 5
DATE IS541ED DEPARTMENT IS51bING NOTICE ISSISELL D BY: D OF FIRE DEPARTMENT(OR DESIGNEE FIRE CODE ENFORCEMENT OFFICER(PRINT NAME( OFFICER 1.D.NUMBER
a� i A h/0 gel�g��® ❑ STATE FBRE MAF2SHAL(OPi DESIGNEE)
NAME aF FFENDER(LAST) $d A�di v Sd •9a' �CCC � v -- � ( ) AA�
} ADDRESS 'CITYfTom a E Tip CODE
DATE PF VI 7I N TIME A LOCATION OF ViDIAT ON jINCLUDE 0,ST CITY,-.0wri STATE .ZIP CODE
Atve4k, PIP IV o It
VIOLATIONs(S). Fire Code, 527 CMR 1,00 (Code of MaSwebuseft Regulations Only) Check One, ado specific conditions to ba corrected
[3 Continuing conditions to be corrected within 24 hours
0'Warnings of violation(s)only M Conditions to be corrected within days
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"Violation(s)527 CM R I.00 VescOption ca Condition:
Dqg!��ta�rr Assessment
e-L&14IViA/b jAL PA C, (S
Seca J' �e N
Sec.
Report Attached 13 Yes o — --- 'dotal Amount Due.' a o
This is a 21111 or subsequent offense Date(s)of prior O aVlse(s)._- � —
OFFICER CERTIFICATION: I certify that i and atF$hadzed to issue this Massachusetts Fire Code Violation Notice in accordance with the provisions of
'R.—G.L. cc, 9 8A. I further certify that(check arse):
0 1 have delivered a copy of this violation to the offender,or the offender's agent at the thee;and place of the violation
Signature of offender or agent of the offender upon receipt:
NaMee _ _ Date:---
0 Check here if offender refused delivery(Note:`vVhoever upon the request,of any local Or state cede enforcement officer refuses to state his/her name and
address shall be punished by a fine of not more than$200.00( .G.L.C.148A)
3 have mailed a Copy of this violation notice to the offender at the offender's last known address.
C 1 have delivered a copy of dais�diolation at the offender's last known address. am 0 -get s::
Address cif wiling or delivery: ��� �, ei 4 j,
1A Die
MAKE PAYMENT OR REQUESTAN APPEAL TO.' —
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(PInACF LABEL HERE) S