REQUEST FOR CRIMINAL COMPLAINT
FOR STATE SANITARY CODE VIOLATIONS

To any Justice or Clerk-Magistrate of the                 Housing
Court:
_________________________________________________________________
on behalf of the Commonwealth, on oath complains that:

_________________________________________________________________
was and is the owner of residential premises located at 

________________________________________________________________;

On ____________________________, 200___, a representative of the 
____________________________________________________Program
inspected the said premises and determined that the dwelling did
not comply with the provisions of Article II of the State Sanitary
Code, 105 C.M.R., §410.000;

On _____________________________, 200___, pursuant to §410.832 -
833 of the Code, the defendant was served with a written order to
comply;

On  _____________________________,  200___,  and  from  day  to  day
thereafter the defendant has failed to comply with the order, each
such day being a separate offense and a separate and distinct count
of this Complaint;

all in violation of State Sanitary Code, 105 C.M.R., §410.910-920,
and the public health law, Gen.L. c. 111, §127A, and the defendant
did so willfully, intentionally, recklessly or repeatedly.

__________________________
Date:

______________________________
Complainant:

Assigned for hearing on _____________________,200__, at _________
o’clock.

On hearing (Complainant)(Defendant)(both parties)(neither party),
I  find  no  probable  cause  for  the  Complaint.    Process  shall  not
issue. 

On hearing (Complainant)(Defendant)(both parties)(neither party),
and Complainant having sworn or affirmed that the Complaint is true
upon  information  and  belief,  I  find  probable  cause,  and  order
summons to issue returnable _______________________________.

______________________
Date:

___________________________________
Clerk-Magistrate