293 LAFAYETTE STREET - HOUSING COMPLAINT (2) CITY OF SALEM,MASSACHUSETTS
"Wr BOARD OF HEALTH
KIMBERLEY DRISCOLL 120 WASHINGTON STREET,4"FLOOR
MAYOR TEL.(978)741-1800
FAX(978)745-0343
LARRY RAMDIN,RS/REHS,CHO,CP-FS LRAMDIN(I)SALEM.COM
HEALTH AGENT
COMPLAINT INTAKE FORM
Date: 1 Time: Received By:
Complaint Number: 2327
Complainant
Address: Phone: :
Investigated By: Date:
Property Owner/Occupant Name Telephone #:
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