8 Cabot Street Complaint 10-5-2018 Wn
( � CITY OF SALEM MASSACHUSETTS
BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4Ty FLOOR
MAYOR TEL.(978)741-1800
FAx(978)745-0343
LARRY RAMDIN,RS/REHS,CHO,CP-FS LRAMDIN[a'SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: Time: ._ Received By:!)
Complaint Number: 2281
Complainant )'
Address: 'R } Phone: q� --.2
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Investigated By: _ Date:
Property Owner/Occupant Name Telephone #: