Town of

AMHERST

Massachusetts

Phone: (413) 259-3077

AMHERST HEALTH DEPARTMENT, 70 BOLTWOOD WALK, AMHERST, MA 01002 Fax: (413) 259-2404 Website: www.amherstma.gov Email: health@amherstma.gov

NOTICE TO ABATE A NUISANCE

In accordance with Massachusetts General Laws, Chapter 111, Sections 122 125, the Amherst Health Department hereby orders a cleanup of this property within 24 hours or a fine will be charged after 24 hours. If at the expiration of time allowed these conditions have not been remedied, such further action will be taken as the law requires and a fine of no less than $50.00/day and no more than $1000.00/day will be charged. PROPERTY ADDRESS: ___________________________________ DATE: ____________________ REINSPECTION DATE: ______________ TIME: ____________ REINSPECTION TIME: ______

PLEASE NOTE: This is the ONLY WARNING you will receive, a repeated violation will automatically incur a fine, effective immediately. The following violations have been noted at the above mentioned property address: ( ) Trash outside the dumpsters/trash containers ( ) Broken glass ( ) Upholstered furniture ( ) Mattress(es) ( ) Other: ________________________ If you have any questions, please call the Amherst Health Department at 413-259-3077. This abatement order is signed and certified under the pains and penalties of perjury. Inspectors Name: __________________________ Inspectors Signature: ________________________