Created by general-english-image-caption-blip on 2025-05-18

a photograph of a document with a list of items for sale

Created by general-english-image-caption-blip-2 on 2025-07-06

a document with the name of the department of public health

Created by gpt-4o-2024-11-20 on 2025-06-13

This image depicts an old inspection form issued by the Board of Health in Haverhill, Massachusetts, specifically for scoring provision stores. It is labeled as "Form 64" and includes structured categories and scores for assessing sanitation and operating practices within stores.

Key Details:

1. Header:

   • The form is from the "Board of Health, Haverhill, Mass."
   • It specifies this is for a "Detailed Score of Provision Stores."
   • At the top left is the seal of Haverhill, Massachusetts, featuring symbols and inscriptions related to the city.

2. Fields for Information:

   • Spaces are provided for the name of the individual or inspected business, address, the type of business, and the inspection date (with the year format ending in '191_' hinting this is from the early 1900s).

3. Evaluation Categories:

   • Two main sections are listed: Equipment and Method, each with multiple subcategories.
   • Points are allocated to "Perfect" (maximum score possible) and "Allowed" (actual score assigned during an inspection).

4. Equipment Section:

   • Factors such as store location, plumbing, ventilation, lighting, ice box conditions, and food product quality are scored.
   • Examples include "Free from contaminating surroundings," "Light screens," and "Covered wagons."

5. Method Section:

   • This section evaluates cleanliness, disposal of food, quality of produce, care for waste products, and transportation methods.
   • Sub-items include "Cleanliness of floors, walls, windows," "Care of product," and "Wrapping."

6. Scoring System:

   • Each section totals to 100 points.
   • Final score is calculated using a formula:
     • Score of Methods multiplied by 2
     • Score of Equipment multiplied by 1
     • Total is divided by 3 for the Final Score.

7. Remarks Section:

   • Space at the bottom is included for comments or additional remarks by the inspector.

8. Inspector Note:

   • The form is signed off by the "Inspector of Meats and Provisions," indicating the health focus of the evaluation process.

This historical document likely represents an early effort at enforcing public health standards in local commerce, highlighting the thorough checks for cleanliness and quality in food and retail environments.

Created by gpt-4o-2024-08-06 on 2025-06-13

This image is a vintage form titled "BOARD OF HEALTH, HAVERHILL, MASS. Detailed Score of Provision Stores." It's a health inspection form for evaluating the condition and hygiene of provision stores. The form is divided into two main sections: "Equipment" and "Method," each with various criteria to be scored.

On the left side, "Equipment" includes criteria such as location, basement, ground floor, plumbing, water closet, sinks, drains, ventilation, windows, doors, light, screens, and ice boxes, with corresponding perfect scores for each item.

On the right side, "Method" covers criteria like cleanliness (floors, walls, ceiling, shelves, windows, etc.), disposal of food, care of product, quality of produce, care of waste products, and transportation. Each criterion has a maximum score that can be allocated based on inspection.

The form includes spaces to fill out the name, address, business, and date, with a formula at the bottom to calculate the final score: the score of methods is multiplied by 2, the score of equipment by 1, and then the total is divided by 3 to get the final score.

There's also a section for remarks and a line designated for the "Inspector of Meats and Provisions." The left corner has a seal or emblem with the text "HAVERHILL MASS 1640 INCORPORATED 1869."

Created by anthropic.claude-3-haiku-20240307-v1:0 on 2025-06-17

This image appears to be a form used by the Board of Health in Haverhill, Massachusetts to conduct a detailed score of a provision store. The form includes sections for evaluating various aspects of the store, such as cleanliness, equipment, and methods used. It provides a detailed scoring system to assess the overall condition and practices of the store. The form seems to be an official document used by health inspectors to ensure compliance with relevant regulations and standards.

Created by us.anthropic.claude-3-5-sonnet-20241022-v2:0 on 2025-06-17

This is a historical inspection form from the Board of Health in Haverhill, Massachusetts. It appears to be Form 64, titled "Detailed Score of Provision Stores." The form includes a detailed scoring system for evaluating various aspects of food provision stores, with two main categories: Equipment and Method.

The form has spaces at the top for recording the business name, address, and date. It features an official seal of Haverhill in the upper right corner.

The scoring system is broken down into multiple subcategories:

Under Equipment:

• Store location and surroundings
• Plumbing
• Ventilation
• Care of product
• Ice box specifications

Under Method:

• Store cleanliness
• Food products quality
• Transportation
• Various handling procedures

Each category has specific point values adding up to 100 points each. The final score is calculated using a weighted system where methods are multiplied by 2, equipment by 1, and the total is divided by 3.

The form appears to be from the early 1900s based on its design and formatting, and was likely used by health inspectors to maintain food safety standards in provision stores of that era.

Created by us.meta.llama3-2-11b-instruct-v1:0 on 2025-06-11

The image presents a vintage form titled "BOARD OF HEALTH" with the subtitle "Detailed Score of Provision Stores." The form is dated 1911 and features a logo in the top-left corner, accompanied by the text "Haverhill, Mass." The form is divided into two columns, with the left column listing various store equipment and the right column detailing methods. Each item on the list is assigned a score, ranging from 1 to 10, with perfect scores marked as "Perfect Allowed" and imperfect scores marked as "SCORE." The form also includes a section for the business address, date, and name, as well as a space for remarks.

Key Features:

• Logo: A circular logo in the top-left corner featuring an illustration of a building with a star above it, surrounded by the text "Haverhill" and "Mass."
• Columns: Two columns, one listing store equipment and the other detailing methods, with scores ranging from 1 to 10.
• Scoring System: Perfect scores are marked as "Perfect Allowed," while imperfect scores are marked as "SCORE."
• Business Information: A section for the business address, date, and name.
• Remarks Section: A space for additional comments or notes.

Overall Impression:

The form appears to be a comprehensive assessment tool used by the Board of Health to evaluate the cleanliness and safety of provision stores in Haverhill, Massachusetts. The detailed scoring system and structured format suggest that the form was designed to provide a thorough evaluation of each store's equipment and methods. The inclusion of a remarks section allows inspectors to provide additional comments or notes, which can help to clarify any issues or concerns identified during the inspection.

Created by us.meta.llama3-2-90b-instruct-v1:0 on 2025-06-11

The image depicts a vintage form titled "BOARD OF HEALTH HAVERHILL, MASS." with the subtitle "Detailed Score of Provision Stores." The form is dated 191 and features a seal in the top-left corner bearing the words "HAVERHILL" and "ESTABLISHED 1640 INSTITUTED A CITY 1870."

The form is divided into two main sections: "EQUIPMENT" and "METHOD." Each section contains a list of items, such as "Location," "Store," "Ventilation," and "Ice Box," accompanied by columns labeled "SCORE," "Perfect," "Allowed," and "METHOD." The scores are listed in numerical values, ranging from 2 to 100.

At the bottom of the form, there are spaces for the inspector's remarks and the final score. The background of the form is a light tan color, giving it an aged appearance. Overall, the image presents a historical document that provides insight into the evaluation criteria used by the Board of Health in Haverhill, Massachusetts, during the early 20th century.

Created by amazon.nova-lite-v1:0 on 2025-06-06

The image is a document titled "BOARD OF HEALTH HAVERHILL, MASS." It appears to be a detailed score sheet for provision stores, likely used for health inspections and evaluations. The document is structured with various sections and criteria for assessing the cleanliness, equipment, and methods of the stores.

The document includes a header with the title "BOARD OF HEALTH HAVERHILL, MASS." and a logo with the text "ESTABLISHED 1870, INSTITUTED A CITY 1870." Below the header, there are sections for the store's name, address, business, and date of inspection. The main body of the document is divided into two tables: one for the "SCORE" of the store and one for the "SCORE" of the ice box.

The "SCORE" table for the store includes various criteria such as location, cleanliness, equipment, and methods. Each criterion is rated on a scale, with scores ranging from 1 to 10. The table also includes a section for "Remarks" at the bottom.

The "SCORE" table for the ice box includes criteria such as location, conveniences, ice, drainage, food products quality, protection, wagons, and transportation. Each criterion is also rated on a scale, with scores ranging from 1 to 10. The table includes a section for "Final Score" at the bottom.

The document appears to be a formal evaluation tool used by the Board of Health in Haverhill, Massachusetts, to assess the compliance of provision stores with health and safety standards. The scores and remarks provide a comprehensive assessment of the store's operations and facilities.

Created by amazon.nova-pro-v1:0 on 2025-06-06

The image depicts a document titled "BOARD OF HEALTH HAVERHILL, MASS." It is a detailed score sheet for provision stores, specifically Form 64. The document is dated 191 and includes a logo at the top, representing the town of Haverhill, Massachusetts, with the text "SETTLED 1640, INCORPORATED A CITY 1870."

The document is divided into two main sections: "EQUIPMENT" and "METHOD." Each section has a table with columns for "Perfect" and "Allowed," and rows for various criteria that are scored.

Under the "EQUIPMENT" section, the criteria include:

• Location (18 points)
• Free from contaminating surroundings (8 points)
• Basement (2 points)
• Ground floor (8 points)
• Plumbing (14 points)
• Water closet (6 points)
• Sinks (4 points)
• Drains (4 points)
• Ventilation (10 points)
• Windows (5 points)
• Ventilators (5 points)
• Light (6 points)
• Screens (10 points)
• Windows (5 points)
• Doors (5 points)
• ICE BOX (12 points)
• Location (12 points)
• Conveniences (4 points)
• Ice (4 points)
• Drainage (4 points)
• Food products quality (10 points)
• Protection (10 points)
• Wagons (10 points)
• Covered (7 points)
• Open (3 points)

Under the "METHOD" section, the criteria include:

• Cleanliness (27 points)
• Floors (5 points)
• Walls (2 points)
• Ceiling (2 points)
• Shelves (2 points)
• Windows (2 points)
• Scales (2 points)
• Blocks (5 points)
• Utensils (2 points)
• Attendants (5 points)
• ICE BOX (12 points)
• Cleanliness (6 points)
• Disposal of food (6 points)
• Care of product (35 points)
• Restored to ice box in hot weather (5 points)
• Enclosed in show cases or closed jars (5 points)
• Under netting in store (5 points)
• Under netting on sidewalk (5 points)
• On platform on sidewalk (5 points)
• Covers for produce in barrels (5 points)
• Covers on boxes (5 points)
• Quality of produce (10 points)
• Freshness (5 points)
• Odor (5 points)
• Care of waste products (6 points)
• Receptacle (3 points)
• Removal (3 points)
• Transportation (10 points)
• Clean vehicle (4 points)
• Covered vehicle (4 points)
• Wrapping (2 points)

The total score for each section is 100 points. The final score is calculated by multiplying the score of methods by 2, the score of equipment by 1, and then dividing the total by 3.

The document also includes a section for remarks and is signed by the Inspector of Meats and Provisions.

Created by gemini-2.0-flash on 2025-06-02

Here's a description of the image:

The image shows a scanned document, specifically a form titled "BOARD OF HEALTH, HAVERHILL, MASS. Detailed Score of Provision Stores." The form is light gray in color and appears to be from the early 20th century (as indicated by the "191" on the document and the item categories). At the top left corner is a seal for the city of Haverhill. Underneath, the form provides spaces for Name, Address, Business, and Date.

The main part of the form is a table used to score the condition of a provision store, divided into two main columns: "EQUIPMENT" and "METHOD." Each column is further divided into "STORE" and "ICE BOX" sections.

Under "EQUIPMENT," the form lists various aspects of the store and ice box such as location, cleanliness, ventilation, lighting, screens, plumbing, and drainage. Next to each item are columns for "Perfect" and "Allowed" scores. The "METHOD" column is organized similarly, with items like cleanliness, care of product, care of waste products, and transportation listed for scoring.

At the bottom, there are instructions for calculating the "FINAL SCORE" by multiplying and dividing scores. There is also a section for "Remarks" and the title of the "Inspector of Meats and Provisions."

Created by gemini-2.0-flash-lite on 2025-06-02

Here is a description of the image:

The image is a vintage document, likely a form used by the Board of Health of Haverhill, Massachusetts, to score and evaluate the condition of provision stores.

Key Features:

• Header: The document features the "Board of Health" logo at the top, with the city name "Haverhill, Mass." beneath it.
• Purpose: It is titled "Detailed Score of Provision Stores," indicating that it was used for inspections and assessments of food stores.
• Structure: The form is divided into sections labeled "Equipment" and "Method," likely assessing different aspects of the store's conditions. Each section has a list of specific criteria with a "perfect" score and an "allowed" score.
• Equipment Section: Includes:
  • Location, cleanliness, plumbing, ventilation, light and other factors associated with the shop's conditions.
• Ice Box Section: Including location, drainage, food quality and more.
• Method Section: Focused on cleanliness of the store's surrounding areas.
• Scoring: There are spaces for entering scores and then performing calculations to arrive at a final score, with multipliers.
• Footer: Includes space for the Inspector of Meats and Provisions.
• Overall Impression: The form is printed on light-colored paper, giving it a somewhat aged and official appearance. The typography is simple and straightforward, reflecting the style of the era.

Created by us.mistral.pixtral-large-2502-v1:0 on 2025-06-05

The image is a historical document titled "Detailed Score of Provision Stores" from the Board of Health in Haverhill, Massachusetts. It appears to be a form used for inspecting and scoring the sanitation and operational standards of provision stores. Here is a detailed breakdown:

Header Information

• Board of Health: Haverhill, Mass.
• Form Number: 64
• Date: 191 (likely 1910s)

Sections of the Form

1. Identification

• Name: (Blank space for the store's name)
• Address: (Blank space for the store's address)
• Business: (Blank space for the type of business)
• Date: (Blank space for the date of inspection)

2. Scoring Criteria

The form is divided into two main categories: Equipment and Method, each with subcategories that are scored based on their condition or practice.

Equipment

• Store

  • Location: Scored out of 18
  • Free from contaminating surroundings: Scored out of 8
  • Basement: Scored out of 2
  • Ground floor: Scored out of 8
  • Plumbing: Scored out of 14
  • Water closet: Scored out of 6
  • Sinks: Scored out of 4
  • Drains: Scored out of 4
  • Ventilation: Scored out of 10
  • Windows: Scored out of 5
  • Ventilators: Scored out of 5
  • Light: Scored out of 6
  • Screens: Scored out of 10
  • Windows: Scored out of 5
  • Doors: Scored out of 5

• Ice Box

  • Location: Scored out of 12
  • Conveniences: Scored out of 4
  • Ice: Scored out of 4
  • Drainage: Scored out of 4
  • Food products quality: Scored out of 10
  • Protection: Scored out of 10
  • Wagons: Scored out of 10
    • Covered: Scored out of 7
    • Open: Scored out of 3

Method

• Store

  • Cleanliness: Scored out of 27
    • Floors: Scored out of 5
    • Walls: Scored out of 5
    • Ceiling: Scored out of 2
    • Shelves: Scored out of 2
    • Windows: Scored out of 2
    • Scales: Scored out of 2
    • Blocks: Scored out of 5
    • Utensils: Scored out of 5
    • Attendants: Scored out of 5

• Ice Box

  • Cleanliness: Scored out of 12
    • Disposal of food: Scored out of 6
    • Care of product: Scored out of 35
      • Restored to ice box in hot weather: Scored out of 5
      • Enclosed in show cases or closets: Scored out of 5
      • Under netting in store: Scored out of 5
      • Under netting on sidewalk: Scored out of 5
      • On platform on sidewalk: Scored out of 5
      • Covers for produce in barrels: Scored out of 5
      • Covers on boxes: Scored out of 5
  • Quality of goods: Scored out of 10
    • Freshness: Scored out of 5
    • Odor: Scored out of 5
  • Care of waste products: Scored out of 6
    • Receptacle: Scored out of 3
    • Removed: Scored out of 3
  • Transportation: Scored out of 10
    • Clean vehicle: Scored out of 4
    • Covered vehicle: Scored out of 4
    • Wrapping: Scored out of 2

Scoring Calculation

• Score of methods: Multiplied by 2
• Score of equipment: Multiplied by 1
• Total: Divided by 3 to get the Final Score

Additional Information

• Remarks: (Blank space for additional comments)
• Inspector of Meats and Provisions: (Signature or name of the inspector)

This form is a comprehensive tool used to evaluate the hygiene and operational standards of provision stores, ensuring they meet the health and safety regulations of the time.

Created by Qwen/Qwen2.5-VL-7B-Instruct on 2025-07-08

This is an image of a form titled "Board of Health Haverhill, Mass. Detailed Score of Provision Stores," used to assess the conditions of a provision store. The form is structured into several sections that evaluate the store based on various criteria, both for the store itself and for the ice box, a specific section within the store.

Left Side: Store Evaluation

• Equipment:

  • Location: 18 points
  • Free from contaminating surroundings: 8 points
  • Basement: 2 points
  • Ground floor: 8 points
  • Plumbing: 14 points (broken down into water closet, sinks, and drains)
  • Ventilation: 10 points (broken down into windows and ventilators)
  • Light: 6 points
  • Screens: 10 points (broken down into windows and doors)
  • Ice Box: 12 points (broken down into conveniences, ice, drainage, food products quality, protection, wagons covered, open)

• Score for Equipment: 100 points

Right Side: Method Evaluation

• Store:

  • Cleanliness: 27 points (broken down into floors, walls, ceiling, shelves, windows, scales, blocks, utensils, and attendants)
  • Ice Box:
    • Cleanliness: 12 points
    • Disposal of food: 6 points
    • Care of product: 35 points (broken down into restored to ice box in hot weather, enclosed in show cases or closed jars, under netting on the sidewalk, on a platform on the sidewalk, covers for produce in barrels, covers on boxes, quality of produce, freshness, odor, care of waste products, receptacle, removal, transportation, clean vehicle, covered vehicle, and wrapping)

• Score for Methods: 100 points

Additional Information

• The form includes space for the name, address, and business of the provision store, as well as a date field (191 is filled in).
• The final score is calculated by taking the score of methods (multiplied by 2) and the score of equipment (multiplied by 1), dividing the sum by 3 to get the final score.
• There is a section for remarks at the bottom.
• The form is signed off by the "Inspector of Meats and Provisions."

This form was used to assess the cleanliness and proper functioning of a provision store, likely to ensure that the food sold was safe for consumption.

Created by Qwen/Qwen2.5-VL-72B-Instruct on 2025-07-08

The image is a form from the Board of Health in Haverhill, Massachusetts, titled "Detailed Score of Provision Stores." It appears to be a standardized inspection form used to evaluate the cleanliness, equipment, and practices of food provisioning stores. The form includes the following sections:

1. Header Information:

   • The form is labeled "Form 64."
   • It includes the text "BOARD OF HEALTH, HAVERHILL, MASS."
   • There is a logo on the left side with the text "HAVERHILL, ESTABLISHED A CITY 1870."
   • Fields for the name, address, business, and date of the inspection are provided.

2. Scoring System:

   • The form is divided into two main columns: "EQUIPMENT" and "METHOD."
   • Each column has sub-columns for "SCORE" and "Perfect Allowed."

3. Equipment Section:

   • This section evaluates various aspects of the store's physical setup and infrastructure.
   • Items listed include:
     • Location (scored out of 18)
     • Free from contaminating surroundings (8)
     • Basement (2)
     • Ground floor (8)
     • Plumbing (14)
     • Water closet (6)
     • Sinks (4)
     • Drains (4)
     • Ventilation (10)
     • Windows (5)
     • Ventilators (5)
     • Light (6)
     • Screens (10)
     • Windows (5)
     • Doors (5)
     • Ice Box (12)
     • Convenience (4)
     • Ice (4)
     • Drainage (4)
     • Food products quality (10)
     • Protection (10)
     • Wagons (10)
     • Covered (7)
     • Open (3)

4. Method Section:

   • This section evaluates the cleanliness and care of the store and its products.
   • Items listed include:
     • Cleanliness (scored out of 27)
     • Floors (5)
     • Walls (2)
     • Ceiling (2)
     • Shelves (2)
     • Windows (2)
     • Scales (2)
     • Blocks (5)
     • Utensils (2)
     • Attendants (5)
     • Ice Box (12)
     • Cleanliness (6)
     • Disposal of food (6)
     • Care of product (35)
     • Restored to ice box in hot weather (5)
     • Enclosed in show cases or closed jars (5)
     • Under netting in store (5)
     • Under netting on sidewalk (5)
     • On platform on sidewalk (5)
     • Covers for produce in barrels (5)
     • Covers on boxes (5)
     • Quality of produce (10)
     • Freshness (5)
     • Odor (5)
     • Care of waste products (6)
     • Receptacle (3)
     • Removal (3)
     • Transportation (10)
     • Clean vehicle (4)
     • Covered vehicle (4)
     • Wrapping (2)

5. Scoring Calculation:

   • The form includes instructions for calculating the final score:
     • Score of methods multiplied by 2.
     • Score of equipment multiplied by 1.
     • Total divided by 3 to get the final score.

6. Remarks Section:

   • A section at the bottom for additional remarks.

7. Inspector Information:

   • The form is signed off by the "Inspector of Meats and Provisions."

The form is designed to ensure that provision stores meet specific health and safety standards, with detailed scores for various aspects of the store's operation and condition.