HomeMy WebLinkAbout0095 OLD EAST OSTERVILLE ROAD - Health (2) 93 Old East Osterville �
Osterville
Ti!, A= 145-021
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MRVP #
Assessors office (1st Floor)
Assessor's Map and Parcel #
Building Department (4.th Floor) / 1 -2 —6 -d
Zoning
INSPECTION FEE $coo.00
RE-INSPECTION FEE $15.00 .
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Request- For A Housing Inspection For Certification Under the
MA Rental Voucher Program
Your Name IC g ::&AA
Affiliation (Circle One) Owner Real Estate Agent Tenant
Your Addressag' C 1,12
Telephone Number (Day) C (25 3/7 (QW r) (Night) Sj W p
Address of Rroperty Where Inspection is Pequested,
Unit/Apt.# fit `- �Qy1/� � �Q IJR�QXI�TQ C �
Name of Owner
Address � � or-) on y+ a/( Wi l ( e A
Mailing Address (if different) U -A
Telephone Number (Day) (Night)
Will there be any children under the age of si 6) who will
be occupying the rental unit? (circle one) es No
Was the dwelling constructed prior to 1979?
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FOR OFFICE USE ONLY:
Certification
The dwelling, dwelling unit, or rooming unit located at
was inspected on
by Health
Inspector for the Town of Barnstable and was found to be in
compliance with the provisions contained within 105 CMR
410.00, State Sanitary Code II: Minimum Standards of Fitness
for Human Habitation. However, this certification does not
include a determination as to whether this unit contains any
lead paint because under 760 CMR 49.02 Massachusetts Rental
Voucher Program, a separate lead paint inspection must be
conducted.
Inspector's Signature
Date v
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TOWN BARNSTABLE ���G
BOARD OF HEALTH '� �� � -��✓�
ARTICLE 11:MINIMUM STANDARDS FOR HUMAN HABITATIO7
Date
Owner iB�100-Sr- Tenant i/ B
Address -. 4 9 ��L��� ddress � =
-
Compliance Remarks or
Regulation Yes No Recommendations
2. Kitchen Facilities P
3. Bathroom Facilities
4. Water Supplyl� v,
5. Hot Water Facilities
6. Heating Facilities T
7. Lighting and Electrical Facilities vs
8. Ventilation
9. Installation and Maintenance of Facilities (,
10. Curtailment of Service rj
11. Space and Use
12. Exits
13. Installation and Maintenance of Structural
Elements N
14. Insects and Rodents
15. Garbage and Rubbish Storage and Disposal
16. Sewage Disposal
�.Jt/ .✓_ram' .
17. Temporary Housing
PART II
37. Placarding of Condemned Dwelling;
Removal of Occupants; Demolition
Person(s) Interviewe Inspect4
I
If Public Building as Store or Hotel/Motel specify here
Hoses Q WARREN.INC.
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