5 Daniels Street Court #2 Inspection Form 6-1-2021 No,
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CITY OF SALEM, MASSACHUSETTS
RESIDENTIAL RENTAL INSPECTION FOR
Pro a address: S � q
Number of units at address: Does the property owner live at this address? YES Unit: 1' O
Name of property owner.-
Abechp-
Mailing,address of property owner: Z 2 ��' �
Telephone number of property owner: _ � 1� " �J��'►" ����
Unit number for all units at this address subiect to inspection by the Massachusetts Hoitsim Finance Agency,
Metropolitan Housing Assistance Program,the De artment of Housing and Urban Development,or the Salem
Housing Authority (list all applicable unit numbers at this address):
4 2—
Dates within last the 12 months when the Salem Police Department responded to a earl for sery ice at this address:
Has there been a disorderly house citation Pram the Salem Police for this address within the last three years?
YES NO
Unit number for all units at this address that have had a sanitary or building aide violation within the last three
years: ��]L
Chit number for all units at this address that are rented out for fourteen or fewer days in the last 12 months:
N O P E
Executed by owner on this � day of tM
Signature of owner:.