42 Park Street Ticket 2-4-21 CITY OF SALEM r r r r l
B O A R D O F H E A L T H r r r r
MONTH DAY YEAR ilME CON.R04 vp
LOCATION
NA OF OFFENDER
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DRESS STAT
I hereby acknowledge i of the foregoing citation
X_ Date:
❑Unable to obtain signature of offender y$Date mailed
❑Chapter 40,section 210-General Schedule of fines
❑Regulation 3-Min.Standards of food Establishments State Sanitary Code
❑Regulation 6-Min.Standards of Fitness/Housing 105CMR410
YRegulation 7-Collection,disposal of garbage and refuse 0
E]Regulation 24-Sale of tobacco O
❑Section 2-706-Unauthorized collection of solid waste
❑Section 22-31-General prohibitions for radios,boom boxes,
tape cassettes,disc players,etc.
❑Section 24-9-Throwing,depositing refuse on streets,vacant lots,etc.
❑Section 24-17-Cigarette vending machines
❑Section 38-5-Numbering of buildings,dwellings
❑Other
SIGNA URE OF ENFtLRC S iN
Amount of Fine: ❑Warning ❑$25 $50 El$75
❑$100 ❑$150 ❑$200 ❑$300 ❑Other
You have the following alternatives in this matter within 21 days of the date of this notice:
❑Choose to pay the fine within 21 days of the date of this notice.
Enclose a check or money order payable to the City of Salem and return it in this envelope
or by delivering in hand to the City Clerk's Office,City Hall,93 Washington Street,Salem,
MA 01970.If delivering in hand,please note the hours of City Hall operation;Monday
through Wednesday from 8:00 a.m.to 4:00 p.m.,Thursday from 8:00 a.m.to 7:00 p.m.and
Friday from 8:00 a.m.to 12:00 p.m.
❑Choose to contest this matter within 21 days of the date of this notice and request in writing
a noncriminal hearing.
Enclose a copy of this citation and mail it to the Clerk Magistrate,Salem District Court,65
Washington Street,Salem,MA 01970.The Court will schedule a hearing.
FAILURE TO OBEY THIS NOTICE WITHIN 21 DAYS OF THE DATE OF THIS NOTICE WILL
RESULT IN THE CITY OF SALEM APPLYING FOR THE ISSUANCE OF A CRIMINAL
COMPLAINT AGAINST YOU AND THE DENIAL OR REVOCATION OF ANY CITY OF SALEM
PERMITS OR LICENSES YOU APPLY FOR OR THAT YOU HAVE BEEN GRANTED,
INCLUDING BUILDING PERMITS.
City of Salem,City Clerk's Office,93 Washington Street,Salem,MA 01970
976-745-9595,ext 5610.