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HomeMy WebLinkAbout0102 CENTER STREET - Health 102 Cenlei-Strcct Sewer Acct# 1241 Hyannis t A = 327 -047 'A I i �y Date: �_5Z,7 L6 TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: r F&tn Lu is 3o� ®J� T� BUSINESS LOCATION: ��nA r �T J n is MAILINGADDRESS: 6�,L e, Mail To: TELEPHONE NUMBER: '71)8- 90 Board of Health Town of Barnstable CONTACTPERSON: (l� / �Var, E'efv ic P.O. Box 534 EMERGENCY CONTACT TELEPHONE NUMBER: 79A-&3�E54V_3 Hyannis, MA 02601 TYPEOFBUSINESS: i✓ ,/nn Does your firm store a y of the toxic or hazardous materials listed below, either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: JOUh,7-e, TELEPHONE: �Z, LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antif reeze(for gasoline or coolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid ✓ Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor & furniture strippers Metal polishes hydrochloric acid, other acids) Laundry soil & stain removers Other products not listed which you feel (including bleach may be toxic or hazardous (please list): Spot removers & cleaning fluids V_* (dry cleaners) 6 Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Hazardous Materials Inventory Sheet Checklist Z41,4 Date. j_ Physical Street Address-Check database to ensure it exists Z-- Working Phone Number Actual Amounts -( ie. gas being used to fuel machines, thinner to clean.brushes all count as hazardous materials) Storage Information - location of storage, how long is storage for? If none, note that. Disposal Information -where and who? If none, note that. Applicant Signature understand what is listed.and noted Staff Initial -any questions, know who to ask Vehicle Washing/Rinsing? -provide a vehicle washing policy and explain-it - note that it was given Attach the Business Certificate with your sign off and comments "The inventory form should explain what the business consists of and the procedures they are doing. Notes need to be left to explain what you discussed with them. YOU WISH TO OPEN A BUSINESS? For Your Information:. Business Certificates COST- $30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in the Town (WHICH YOU MUST DO BY M.G.L. - it does not give you permission to operate). You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1'' F1., 367 Main St., Hyannis, MA 02601(Town Hall) and get the Business Certificate that is required by law. z ' { Fill in please: DATE: /<0T/IO APPLICANT'S YOUR NAME: .� BUSINESS YOUR HOME ADDRESS: ' TELEPHONE # Home Telephone.Number: NAME OF NEW BUSINESS A-,)Nj �(I2��TYPE OF BUSINESS IS THIS A YES NO HOME OCCUPATION? Have you been given approval from th building ivision?. YES NO z ADDRESS. F BUSINESS N iil r 1(-e Qi� Owl Y11 U CtkAP/PARCEL NUMBER When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. .This form is intended to assist you in. obtaining the information you may need. You MUST GO TO 2.00 Main St. (corner of Yarmouth Rd. & Main Street) to make sure you have_the appropriate permits and licenses required to legally operate your business in this town. 1, BUILDING COMMISSIONER,, OFFICE This individual has n informe o any permit requirements that pertain to this type of business. Authorized Signatur COMMENTS: 82 n --------------------------- 2. BOARD OF HEALTH This individual has be informe f e er requ• nts that pertain to this type of business. Authorized Sig ture** COMMENTS: MUST COMPLY WITH ALL S REGULATIONS 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has e.n infcded pf the licensing requirements that pertain to this type of business. Auth razed Signature** COMMENTS: � C I (� D IrC.I-e.. S pe r Date: 02 /03 TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAME OF BUSINESS: 1A`'t41N3 1-L S S_�(GQ5 BUSINESS LOCATION: _ C-R 5T INVENTORY MAILINGADDRESS: 1"J'TE9- S7- TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: AA 210rK) F2L1? L I EMERGENCY CONTACT TELEPHONE NUMBER: r 508, 9 IS " 3LI MSDS ON SITE? TYPEOF BUSINESS: anA INFORMATION/RECOMMENDATIONS: Fire District: Waste Transportation: Last shipment of hazardous,waste: Name of Hauler* Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed/Maximum Observed/Maximum Antifreeze (for gasoline or coolant systems) Misc. Corrosive NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil NEW USED Misc. petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Misc. Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt & roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) NEW USED Any other products with "poison" labels Paint &varnish removers, deglossers (including chloroform, formaldehyde, Misc. Flammables hydrochloric acid, other acids) Floor &furniture strippers Other products not listed which you feel Metal polishes may be toxic or hazardous (please list): Laundry soil & stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS YOU WISH TO OPEN A BUSINESS? For Your information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town(which you must do by M.G.L. -it does not give you.permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE.%I?J" Fill in plus APPLICANT'S YOUR NAME/S: G/�IZNl�G101�1 �• FOSS, t- L9 ' BUSINESS YOUR HOM ADDRESS: 3C� C E �°lrC 't`. 6tti1N Sox__)(0 ITA00 NNIS PIA- 0ZG0I { TELEPHONE # Home Telephone Number -114- CAM- -1°l(6-7 NAME OF CORPORATION: CA, N 0 NJ NAME OF NEW BUSINESS G NON G l NV 5 PE OF BUSINESS jjj)yS'h nFirlcF— CL-E ► G-- IS THIS A HOME OCCUPATION? V YES NO ADDRESS OF BUSINESS 5o C.VDA2 ST 15u�r MAP/PARCEL NUMBER �O - N (Assessing) Z oz Z When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 2. BOARD OF HEALTH MUST WMPLY WITH ALL This individual has bee f rmed of the p requ ments that pertain to this type of business. gA7-ARL0IIS MATERIAL S REGULATIONS e-r thorized Signature** MUSt ''-YWITH ALL COMMENTS: .C,%`A�f;. ;IALS RECt.il-PT":; 3. CONSUMER AFFAIRS (LICENSING UTHORITY) This individual has b n inf r1f of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: " i TOWN OF BARNSTABLE Date106/1-3 TOXIC AND HAZARDOUS MATERIALS -ON-SITE INVENTORY NAME OF BUSINESS: (ZAA C. 0106- `5F_R-J(CF,S LL-C, BUSINESS LOCATION: 3� C� ST - INVENTORY MAILING ADDRESS: -�O � �j- TOTAL AMOUNT- TELEPHONE NUMBER: CONTACT PERSON: Gv � (--F A EMERGENCY CONTACT TELEPHO E NUMBER: _7_7L+-q( q-- '� ( MSDS ON SITE? TYPE OF BUSINESS:CL.LW( I& 0<�7((CE KS(q&Xj IN ORMATION/RECOM NDATIONS: Fire District: o DOC` s OIS AL- Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) (MI Miscellaneous Corrosive 10 ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) --Hydraulic fluid(including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products:grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for-engines-and metal -Printing ink Degreasers for driveways&garages Wood preservatives (creosote) Caulk/Grout j Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners i (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers - Windshield wash �V`�1 WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Init' YOU WISH TO OPEN A BUSINESS? For Your Information:. Business Certificates COST $30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME {WHICH YOU MUST DO BY M.G.L. - it does not give you permission to operate). You must first obtain the necessary si natures in the Town at 200 Main St., Hyannis. Take�the completed form to the Town Clerk's Office, 1" FI., 367 Main St., Hyannis, MA 0260(Town Hall this form the Business Certificate that is required by law. all) and get D t DATE: Fill in please: APPLICANT'S YOUR NAME: BUSINESS YOUR HOME ADDRESS: .g.,• , _ � `-' 7 cam..? - 06� , TELEPHONE # Home Telephone Number: NAME OF NEW BUSINESS IS THIS A HOME oCCUPATION? 1�� TYPE OF BUSINESS YES NO Have you been given approval from th buildingivision? YES NO__ ^ ADDRESS OF BUSINESS 1 Y7 Y-e Ot1r1Yl C ,� (�1AP/PARCEL NUMBER (� { When starting a new business there are several. things must h the Barnstable. This form is intended to assist you in obtaining the.�i�formation in order tyou may o be in oneed. ancYo ItMUSTf ules and regulations of the Town of Yarmouth Rd. & Main .Street) to make sure you have the appropriate permits.and licenses required to legaOYTO Q 00 Mour businain St. ess of town. P y ness in this 1. BUILDING COMMISSIONER'S OFFICE This individual has n informe o any permit requirements that pertain o this type of business. Authorized Signatur COMMENTS: n 2. BOARD OF HEALTH This individual has e informe f e er requ4eq4ents that pertain to this type of business. Authorized Sig ture** COMMENTS: MUST COMPLY WITH ALL LS REGULATIONS 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has e n inf ed f the licensing requirements that pertain to this type of:'business. � p 1 �AuthQnzed Signature** COMMENTS: 1-J + C 1 t J ® V-CA �• --- sop OF mm �M.I"N'r ,r/oz, i N%lam.—� '���.� - - _� -� YOU WISH TO OPEN A BUSINESS? For Your lnfor tion:_ Business Certificates cost $30.00 for 4 years. A Business Certificate 'ONLY REGISTERS THE BUSINESS NAME in town (which you must do by M.G.L.- it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. Fill in please: Date: i APPLICANT'S NAME: YOUR HOME ADDRESS: io 2 cenF e r �k I�ti cane s Yl�r� o G,o 1 ' BUSINESS TELEPHONE # HOME TELELPHONE #: NAME OF CORPORATION: dYa� a FR��I� NAME OF NEW BUSINESS zC i� -1ou5Q �.�,��,� sza��5 TYPE OF BUSINESS c\,Vu�-C" I ►zood ,Park,-y� IS THIS A HOME OCCUPATION? YES NO +�nr-ik Shoff o�Ficea ADDRESS OF BUSINESS I o Z C 54- 4 re :s rn� a�C-10 l MAP/PARCEL NUMBER' (Assessing) Corv,fhe-ck cA - I v� r4- When starting a new business there are several things you must do to be in compliance with the rules and regulations of the Town of Barnstable. This form is to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 2. BOARD OF HEALTH This individua as n informe 4 the requirements that pertain to this type of business. A thorized Signature** COMMENTS:4- Zoo YV WS ,26 1V1 C -v2 -j 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: + if HYANNIS FIRE DEPARTMENT 95 HIGH SCHOOL ROAD EXTENSION HYANNIS, MASS. 02601 Case # Paul David Chisholm CHIEF EMERGENCY:Oeteettd Salle eiG'ed BUSINESS: 775-1300 EMERGENCY: 775-2323 FIRE PREVENTION INSPECTION REPORT PROPERTY OCCUPIED BY:- '�� G.S SE�DLI% C-K- PHONE:-7 7t) LOCATION 4 d Z C ot__� :5T t jw,,!N- R BUSINESS OWNER PHONE: BUILDING OWNER Ue' PHONE: TYPE OF BUILDING CONSTRUCTION HEATING SYSTEM : SPRINKLER SYSTEM YES NO TYPE: PSI: / F.D. CONNECTION LOCATION SHUT-OFF: SERVICE CO PHONE : FIRE ALARM SYSTEM YES NO PANEL_LOCATION: SERVICE CO r PHONE : AUTO/SUPPRESSION SYSTEM YES NO LASr�,__i,SP. : SERVICE CO PHONE FLAMABLE STORAGE , YES NO ` KEY BOX YES NO LOCATION: POWER HYDRANTS (1) _ .,(2,) (3) SPECIAL HAZARDS VIOLATIONS CORRECTION DATE I-Pd -rnnJ�ci K � 15 -c'o� �nJ L �'viti' �rP�s UAA 6 0 �KtSO4J< V 't>Oc"0 . AtA U%A FIRE DEPT. I_.NSPECTOR �� DATE: OCCUPANT ;7x TzG _e' �. �P, �..��•�J' y C� 0r"O=�� C7 PHONE: 6/ _ _ ' EMERGENCY PHONE NUMBERS r 1 PHONE: 2 PHONE: 3 PHONE: WHITE:FIRE DEPT.; CANARY:RE-INSPECT; PINK:PROPERTY Housing complaint investigation David W. Stanton, R.S. Location of complaint: 102 Center Street Apt. B. Hyannis, MA 02601 Francis Sedleicki/Bernard Meaney (tenants) Phone (508) 771-7812 Christos Pissimissis (owner) Date: 05/13/2003 Time 11:00 AM This was a follow up investigation with Cameo Phillips of DSS, Tom McKean of the Town of Barnstable Health, David Stanton of the Town of Barnstable Health, and Lt. Eric Hubler of Hyannis Fire. Listed below are violations and problems observed at said location: -Smoke detector battery loose, fixed by Lt. Eric Hubler -Combustibles stored too close to gas water heater and boiler, corrected by Lt. Eric Hubler. -A lot of clutter present(clothing, rubbish, garbage...) -A chair was blocking the main entrance to the house. -A large amount of dirty dishes with food scraps left throughout house. -A lot of obstructions in pathways to egress. -Room measurements taken as follows: Small bedroom approx. 132 square feet Large bedroom approx. 150 square feet Living room approx. 162 square feet Dining area approx 70 square feet Kitchen area approx 110 square feet Other area approx 28 square feet Total area approx 652 square feet Per 105 CMR 410.400 of the State Sanitary Code, this dwelling may be allowed up to 5 occupants (150 square feet of habitable space for the first occupant, and at least 100 square feet of floor space for each additional occupant) -Photos on file. -Fire Department report on file Town of Barnstable o� _ ,M,„ ABrE : Regulatory Services MA �b 39 6 �•� Thomas F. Geilerf Director prfp�.�A Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 DATE: 03 NUMBER OF PAGES TO FOLLOW: J TO: /)�I A �u be J a V FROM: U✓ S � , PHONE: PHONE: (508)862-4644 FAX PHONE: —7 7S_ 7`/3 5/ FAX PHONE: (508)790-6304 cc: F� NOTES/COMMENTS: OLPI l '�e �/e 'C IT Y Ou �jo'/O U&I A P co Q:MAL=ax Form.doc Town of Barnstable Regulatory Services Thomas F. Geiler,Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 March 6, 2003 Christos Pissimissis (Owner) 11 Ridgewood Avenue Hyannis, MA 02601 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II-MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION The property owned by you located at 102 Center Street, Apartment B, Hyannis, was inspected on March 04, 2003 by David Stanton R.S., Health Inspector for the Town of Barnstable, because of a complaint. The following violations of the State Sanitary Code were observed: 105 CMR 410.351(A): Faceplate is missing for the light switch to the basement bathroom. 105 CMR 410.482: No smoke detector observed in the basement. No smoke detector was observed during investigation. Battery was replaced in living room smoke detector at time of investigation, and worked with new battery. The tenant claims the fire department told them to not use the smoke detector located in the kitchen, outside of a bedroom. After speaking with the Lt. Don Chase, Hyannis Fire Prevention Officer, he stated that you couldn't have a smoke detector in the kitchen, so the tenants' claim was correct. However, Lt. Chase stated that if there is a bedroom off of the kitchen that a smoke detector must be located inside the bedroom, within three (3) feet of the door. No smoke detector was observed in that location either. Hyannis Fire Department was notified. 105 CMR 410.280: The mechanical ventilation in the basement bathroom was inoperable at time of investigation. 105 CMR 410.500: Basement ceilings are loose with cracks. You are directed to correct the violations regarding smoke detectors (410.482) within 24 hours of this order letter by ensuring there are operable smoke detectors provided throughout the dwelling in accordance with the state fire code. You are also directed to correct all the other violations listed above within thirty (30) days of your receipt of this notice, by installing a faceplate for the light switch, by replacing Q:Health/Order letters/Housing violations/pissimissis.doc :LL or repairing the mechanical ventilation in the basement bathroom and by replacing or repairing the damaged ceiling in the basement. You may request a hearing before the Board of Health if written petition requesting same is received within ten(10) days after the date the order is served. Non-compliance could result in a fine of up to $500.00. Each day's failure to comply with an order shall constitute a separate violation. PER ORDER OF HE BOARD OF HEALTH Thomas A. cKean, R.S. Director of Public Health Town of Barnstable CC: Francis Sedleicki, Tenant Bernard Meaney, Tenant Laura Samuels, DSS Q:HeaWOrder letters/Housing violations/pissimissis.doc Town of Barnstable Regulatory Services t�1 Thomas F. Geiler, Director Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 March 6, 2003 Francis Sedleicki (Tenant) Bernard Meaney (Tenant) 102 Center Street Apartment B Hyannis, MA 02601 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II-MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION The property rented by you at 102 Center Street,Apartment B, Hyannis, was inspected on March 04, 2003 by David Stanton R.S., Health Inspector for the Town of Barnstable, because of a complaint. The following violations of the State Sanitary Code were observed: 105 CMR 410.451: Egress Obstructions. Exits and/or passageways blocked with clothing and other articles. 105 CMR 410.452: Safe Condition.' All means of egress are not being maintained in a safe, operable condition at all times. 105 CMR 410.602(b): Maintenance of areas Free from Garbage and Rubbish. Occupant of dwelling is not maintaining a clean and sanitary condition that part of the dwelling they exclusively occupy and control. You are directed to correct the violations within thirty (30) days of your receipt of this-notice, by removing the articles obstructing the exits and passageways, by maintaining the dwelling in a clean and sanitary condition. You may request a hearing before the Board of Health if written petition requesting same is received within ten(10) days after the date the order is served. Q:Health/Order letters/Housing violations/sedleicki.doc Non-compliance could result in a fine of up to $500.00. Each day's failure to comply with an order shall constitute a separate violation. IVThe Building Department has been notified in regards to the bedroom in the basement. No Emergency egress from the sleeping room was observed during the inspection. PER ORDER OF T BOARD OF HEALTH Thomas A. McKean, R.S. Director of Public Health Town of Barnstable CC: Christos Pissimissis (Owner) Laura Samuels, DSS Tom Perry, Building Commissioner Q:Health/Order letters/Housing violations/sedleicki.doc TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair BOARD OF HEALTH satisfactory 2. Printers 3.Auto Body Shops r ( ` , Fn unsatisfactory- 4.Manufacturers COMPANY �T" �1�� (see"Orders") 5. Retail Stores 6.Fuel Suppliers ADDRESS q r W'C' Class: 7.Miscellaneous c1c71S QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS IN OUT IN OUT IN OUT #&gallons Age�Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: DISPOSAL/RECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply Town Sewer ublic VQ O On-site OPrivate 3. Indoor Floor Drains YES N0V__ O Holding tank:MDC O Catch basin/Dry well - O On-site system 4. Outdoor Surface drains:YES NO LORDERS: O Holding tank:MDC A,;n . [ � O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destnation Waste Product YES INO 1. 2. „ Person(s) Interviewed Inspector Date a \Ultl(1i. dbVl'((Qj\id`� I11ytt �r'7 cC4<_ rn F'Y� FR,ANCES HATEM-SIEDLE H USING CHOICE VOUCP'"R OGRAM INSPECTION CHECKLIST 102 CENTER STREET APT Q PHONE NO PLICATION No. -" >L1 ---- HYANNIS MA 02601 PHONE No. DATE of PEcno � 3i r r rc yr uvz�rei,t Ivry (J Audit (J Inmal [I Special ❑ Annual LAST INSPECTOR: INFORMATION UNIT fl Number of Children HOUSING TYPE UNIT VO I OOLV028601 in family with (Check as appropriate) GRADE Elevated Blood Level __ CHRISTO PISSIMISS jTATE ZIP CODE FAMILY COMP MALE F ALE ❑ Manufactured HomeA ❑1 RIDGEWOOD AVE ADULTS O Single Family Detached eNE NO. ❑ Duplex or Two FamilyHYANNIS r _ �S_--19y MINORS , W-3 Family House C-'f' MA 02601 C] Row House or Town House D ❑ CHILDREN ❑ Low Rise:3 or 4 Stories (UNDER 6) including Garden Apartment rr! _ ❑ High Rise:5 or more stories Y • ' FAMILY SUBSIDY SIZE: ❑ Multi Family • P ❑ Pass Repair ❑ Staff Dal d No.of rooms used for sleeping LOC ❑ YES NO ❑ Inconclusive ❑ Maint. (or could be used it unit is vacant) BUILDING PER�IT ❑ YES CVNO (� INSPECTION ITEM 1.LIVING ROOM PASS F INCL. COMME T DATE PASSED 1.1 Living Room Present 1.2 Electricity 1.3_ Electrical Hazards i 1.4 Security/Heating Elem. 1.5 Window Condition,Screens 1.6 Ceiling Condition 1.7 Wall Condition 1.8 Floor Condition ITEM 2.KITCHEN PASS FAIL INCL CO M PADATE SSED 2.1 Kitchen Area Present 2.2 Electricity ✓ 2.3 Electrical Hazards 2.4 Security/Heating Elem. 2.5 Window.Condition.Screens'! 2.6 Ceiling Condition' 2.7- Wall Condition 2.8 Floor Condition - _ 2.9 Stove or range with oven Elec/ s 2.10 Refrigerator 2.11 Kitchen sink 2.12 Kitchen space for storage&prep 2.13 Ventilation ITEM 3.BATHROOM PASS FAIL FINCL COMMENT DATE PASSED 3.1 Bathroom Present 3.2 Electricity 3.3 Electrical Hazards 3.4 Security/Heating Elem. 3.5 Window Condition,Screens 3.6 Ceiling Condition 3.7 Wall Condition 3.8 Floor Condition r 3.9 Flush Toilet in enclosed room in unit 3.10 Fixed washbasin or lavatory in unit 3.11 Tub or Shower in unit 3.12 Bathroom ventilation 4 OTHER ROOMS USED --- - ITEM L DATE FOR LIVING.&HALLS PASS FAIL INC COMMENT __.. .. _ .. a_..._. .._.. _PASSED 4.1 Room Code' ;�`Room Location (Chec a), 2jRi Center/Left.__._ (Check.One) p.Front/Cent ear. Floor Level ---- 4.2 Electricit /litu ination - 4.3 Electrical Hazards 4.4 Window Condition t 4.5 Security/Heating Elem. fn 4.6 Ceilin Condition ZO 4.7 Wall Condition H 4.8 Floor Condition U 4.9 Natural Light W 'ROOM CODES: t=Bedroom or an other room used for sleeping(regardless of� Y p 9(eg type of room) 3=Second Living Room.Family Room,Den,Playroom,TV ROOM 5=Additional Bathroom' 7=Garage 9=Other 2=Dining Room,or Dining Area 4=Entrance Halls,Corridors,Halls,Staircases 6=Attic 8=Laundry White Copy for Agency-Yellow Copy for Landlord-Pink Copy for Tenant- I ITEM 4. OTHER ROOMS USED wes N�__.I IN -- --- _ K FOR LIVING& HALLS PASS _= :ONL COMMEN' AP FINAL IN[ ATE 1 4.1 Room Code' [J Room Location Chec ❑ RI hVCente Check One ❑ FronVCenter _ _Floor Level � 4.2 Elect ricit /Illumination 4.3 Electrical Hazards ,l { 4.4 Security -- i 4 5 Window Condition -- � 46 Ceiling Condition - 4.7 Wall Condition ---- -- 4.8 Floor Condition / 4.9 Natural Li ht -- I 4.1 Room Code' = Room Location (r1KCk One) ❑ Right/Center/Left (Check One) ❑ Front/Center/Rear _Floor Level 42 Electricity/Illumination 4.3 Electrical Hazards 4A Security i 4.5 Window Condition 4.6 Ceiling Condition 4.7 Wall Condition 4.8 Floor Condition 4.9 Natural Light 4.1 Room Code' = Room Location (Check One) ❑ enter/Left (Check One) ❑ Front/Cente ar_Floor Level 4.2 Electricity/Illumination 4.3 Electrical Hazards 4.4 Security 4.5 Window Condition 4.6 Ceiling Condition - 4.7 Wall Condition 4.8 Floor Condition 'ROOM CODES: t=Bedroom or any other room used for sleeping(regardless of type room) 3=$eoaltl Living Room.Family Room.Den.Playroom.TV ROOM 5=Additional Bathroom 7=Garage 9=Other 2=Dm�ng Boom.or Dining area 4=Entrance Hans.Corridors.Halls,Staircases 6=Anic 8=Laundry ITEM 5.ALL SECONDARY ROOMS YES NO IN.- RNAL NO. Rooms not used for Living) PASS FAIL CONC COMMENT APPROV. 5.1 NONE Go to Part 6 INIT1AUDATE 5.2 Security 5.3 Electrical Hazards ?then Potentially Hazardous 5.4 Features to an of these Rooms ITEM 6.BUILDING EXTERIOR YES NO IN.- FINALNO. PASS FAIL CONC APPRov. 6.1 Condition of Foundation ATE JI 6.2 Condition of Stairs,Rails,and Porches 6.3 Condition of Roof and Gutters 6.4 Condition of Exterior Surfaces 6-6 Condition of Chimney 6.7 Manufactured Homes:Tie Downs 6.8 Manufactured Homes:Smoke Detectors --]� 1 42= ITEM HEATING&PLUMBING YES NO IN.- N0. PASS FAIL CONC COMMENT APPPROV. INTMUDATE 7.1 Adequacy of Heating Equipment 7.2 Safety of Heating of Equipment 7.3 Ventilation/Cooling 7.4 Water Heater Gas/Elec!Oil 7.5 Approvable Water Supply 7.6 Plumbing 7.7 Sewer Connection ITEM 8.GENERAL HEALTH YES NO IN.- FINAL No. AND SAFETY PASS FAIL CONC APPROV. BImAMATE 8.1 Access to Unit _ 8.2 Lead Paint,LOC ❑ Not Applicabl 8.3 Evidence of Infestation 8.4 Garbage and Debris 8.5 1 Refuse Disposal 8.6 Interior Stairs and Common Halls 8.7 Other Interior Hazards 8.8 Elevators of Appl' ble 8.9 Interior Air ouality 8.10 Site and Neighborhood Conditions 8.11 Entry Door Security C�-fdOfApplicable 9.1 Heating System Type ❑ Gas ❑ Oil ❑ Electric ❑ Other ITEM YES NO. PASS FA CONC COMMENT AP`R`o. .353 Asbestos Material MmauoATE .482 Smoke Detectors This inspection has been performed to determine compliance unde t e HU CD Section 8 Programs.While some of the inspection requirements may be similar or identical to provisions of the(coal codes this Inspection does not certify compliance with said codes.In all instances,it is the Owner's responsibility to maintailproperty to meet all applicable state and local codes and a tenant's right to request an ins ectio b the local c forcement agency. Pany Present at Inspection In. ctor Signa rc Dale V� Datc Da-_ic��e Stanton, David From: Anne Robertson [arobertson@haconcapecod.org] Sent: Tuesday, March 25, 2003 11:02 AM To: Stanton, David; 'Lynne Perry' Subject: RE: Housing inspection, 102 Center Street, Apt. B. Hyannis. Mr. Stanton, I faxed this to you last week on the 19th. It was faxed at 2:21 p.m. and the report showed that 3 pages were successfully sent. Guess report is wrong and I will refax today sometime. I had to request Ms. Siedlicki's permission per our Technical Advisor and tenant O.K. 'd that it be faxed. Thank You, Anne Robertson Program Representative Housing Assistance Corporation Ph. (508) 771-5400 Fax (508 775-7434 ext. 249 -----Original Message----- From: Stanton, David [mailto: ] Sent: Monday, March 24, 2003 2:02 PM To: hac@haconcapecod.org Subject: Housing inspection, 102 Center Street, Apt. B. Hyannis. Could I please get a copy of the most recent Section 8 housing inspection report for 102 Center Street, Apt. B, Hyannis. The Tenant for this property is Francis Sedleicki, and the landlord is Christos Pissimissis. I faxed a request for this information last week, and did not receive a response. Thank You, David W. Stanton, R.S. Health Inspector Town of Barnstable Ph. (508) 862-4647 Fax (508) 790-6304 1 RESIDENTIAL LEASE FOR LOFT, APARTMENT OR PRIVATE RESIDENCE THIS LEASE is made on the 1 day of jJ 21-P The Landlord hereby agrees to lease to the Tenant,and the Tenant hereby agrees to lease from the Landlord,the Leased Premises described below pursuant to the terms and conditions.specified herein: LANDLORD: � 7 TES ��SS/!'YJ�P IENANT(S): f"Q�nA'NG � A L �,SIF Address: �� 1/ Address: l0d c1�1— reE7g a �011/ K.4 "LS ace ) 1. Leased Premises. The Leased Premises are those premises described as: �. 8���'P1O �S � �/ 1�/YID /QDO�T / Grl�/✓G��'I ��BrJ�;I 2. Term. Term of the Lease all be for a term of year(s)begin ping on the day ofA�t��®e and ending on Midnight of the day of ,�!'a� If Tenant remains in possessi n of the Leased Premises with the consent of the Landlord of r the le a expiration date stated above,this Lease will be converted to a month- to-month Lease and each party shall have the right to terminate the Lease by giving at least one month's prior written notice to the other party. 3. Rent. The monthly rental amount for the Leased Premises is$1!! =per month. The rent payment must be paid by the_/ day of each month at the Landlord's address listed above. The first month's rent is to be paid when Tenant signs this lease. Landlord need not give notice to Tenant regarding Tenant's obligation to pay rent. 4. Security Deposit. Upon Tenant's execution of this Lease, Tenant shall make a security deposit of$ to Landlord in order to ensure that Tenant complies with all terms and conditions of the Lease. If Tenant fully complies, Landlord will return the security deposit within r— week(s)after the date Tenant delivers possession of the Leased .. Premises to Landlord. If Tenant does not fully comply with the terms of the Lease,Landlord may use the security to pay amounts owed by Tenant,including damages. 5. Default/Abandonment. If Tenant defaults in the payment of rent or any other term or condition of this Lease,Landlord may give Tenant written notice to cure such default. If Tenant fails to cure such default within I LL days of receiving notice,Landlord may elect to terminate the Lease,re-enter the Leased Premises and remove the Te ant,all other occupants and their possessions and any costs incurred by Landlord in enforcing these rights shall be deemed additional rent. . If Tenant abandons or vacates the Leased Premises during the Term of this Lease,Landlord may elect to re-enter the premises, without liability for prosecution or owing damages to Tenant,and,at Landlord's option,relet the Leased Premises. If Landlord elects not to relet the Leased Premises,Tenant shall be liable for the remainder of the rent due under the Lease until its expiration. If Landlord relets the Leased Premises but is unable to relet the Leased Premises for as much rent as would have been paid by Tenant during the period between Tenant's abandonment and the end of the Term,Tenant shall be liable to Landlord for the difference. Landlord may also dispose of any property left by Tenant after abandonment without liability and apply the proceeds to reduce such difference. 6. Occupants. The Leased Premises shall be occupied by the following persons only: q Z No other persons shall occupy the Leased premises without the advance written consent of the Landlord. The authorized occupants may,only use the Leased Premises for residential purposes and may not utilize the premises for commercial or busi- ness purposes. 7. Repairs. Tenant must take good care of the Leased Premises and all equipment and fixtures contained therein. Tenant is responsible and liable for all repairs,replacements and damages caused by or required as a result of any acts or neglect of Tenant,Occupants,invitees or guests. If Tenant fails to make a needed repair or replacement,Landlord may do it and add the expenses to the rent. 8. Partial or Total Destruction of Leased Premises. If the Leased Premises are partially damaged or completely destroyed by a fire or other occurrence that is not caused by Tenant's negligence or willful act(or the negligence of Tenant's family, agent or guest),Landlord may elect to: (1)repair or rebuild the Leased premises during the period of untenantability and abate the rent proportionally for.this period;or(2)not repair or rebuild the Leased Premises,terminate the Lease and prorate the rent up to the time of the damage. 9. Alterations. Tenant must obtain Landlord's prior written consent to paint or wallpaper the Leased Premises or to install any paneling,flooring,partitions,railings or make any other alterations. Tenant must not alter the plumbing,ventilation,air- conditioning,heating or electric systems. All the alterations,installations and improvements shall become property of the Landlord when completed and paid for,and shall be surrendered as part of the Leased Premises at the end of the term. Landlord is not required to pay for any of the work performed under this section unless,Landlord has agreed to pay as indicat- ed in the prior written consent,required by this paragraph. 10. Maintenance of Leased Premises. Tenant shall,at tenant's expense,maintain the premises in a clean and sanitary condi- tion at all times. At the end of the term,Tenant will leave the Leased Premises clean and in good condition,with the excep- tion of ordinary wear and tear. Tenant shall remove all Tenant's belongings and surrender all keys to Landlord upon the expi- ration of the Lease. 11. Assignment/Subletting Restrictions. Tenant may not assign this agreement or sublet the Leased Premises without the prior written consent of the Landlord. Any assignment,sublease or other purported license to use the Leased Premises by Tenant without the Landlord's consent shall be void and shall(at Landlord's option)terminate this Lease. II IIIII IIII II I II I III REDIFORM®1o310 967 0 77925 10310 9 01993 Rediform 12. Utilities/Services. Tenant is responsible for the payment of all utilities and services,except for the following: which shall be paid by Landlord. 13, Landlord's Right to Enter. Landlord may,at reasonable times,enter the Leased Premises to inspect it,to make repairs or alterations,and to show it to potential buyers,lenders or tenants. 14. Pets. Tenant may not bring or keep pets in the Leased Premises without the prior written consent of Landlord. 15. Laws and Regulations. Tenant must,at Tenant's expense,comply with all laws,regulations,ordinances and regwre- ments of all municipal,state and federal authorities that are effective during the term of the lease agreement,pertaining to the use of the premises. Tenant must not do anything that increases the Landlord's insurance premium. 16. Legal Fees. If Landlord is successful in a legal action or proceeding between Landlord and Tenant relating to the non- payment of rent or recovery of possession of the Leased Premises,Landlord may,to the extent legally available,recover rea- sonable legal fees and costs from Tenant. 17. Inspection Prior to Occupancy. Tenant has inspected the Leased Premises and agrees that the Leased Premises,and all improvements,are in good,habitable condition as of the date of this lease. 18. Subordination. This Lease,and the Tenant's leasehold interest,is and shall be subordinate,subject and inferior to any and all liens and encumbrances now and thereafter placed on the Leased Premises by Landlord,any and all extensions of such liens and encumbrances and all advances paid under such liens and encumbrances. 19. Quiet Enjoyment. If Tenant promptly pays the rent and obeys all of the terms of this lease,the Tenant may remain in and use the Leased Premises without interference by Landlord. X Binding Obligations and Entire Agreement. This lease agreement is binding on Landlord and Tenant and those that lawfully succeed to their rights or take their place. Tenant and Landlord have both read this lease and affirm that this lease contains the entire and only agreement between the parties. 21. Joint and Several Obligation. If more than one person executes this Lease as a Tenant,the obligations of all Tenants shall be joint and several with each Tenant assuming full liability for the obligations under this Agreement. 22. Additional Terms and Conditions Agreed to by Both Parties: -- - This-lease-is effective when Landlord delivers a copy signed by all parties to the Tenant. The parties have signed this agree- ment in duplicate the day and year written above. Landlord 6plfL.a to ' Authorized Agent) (Tenant) (Tenant) Read the instructions and other important information on the package. When using this form you will be acting as your own attorney since Rediform, its advisors and retailers do not render legal advice or services. Rediform, its advisors and retailers assume no liability for loss or damage resulting from the use of this form. C/I V %Iliam A Minn Adpsunq c(D.9 ffne" INSURANCE ADJUSTERS 626 FALL RIVER AVENUE,SEEKONK,MASSACHUSETTS 02771-5417/(508)336-3160 FAX(508)336-3161 August 17, 1999 Hyannis Bldg. Inspector Hyannis Fire Dept. 367 Main Street 95 High School Ext. Hyannis, MA 02601 Hyannis, MA 02601 Hyannis Board of Health PO Box 534 Hyannis, MA 02601 RE: INSURED: Chrstos-&_Stamatella Pissimisses LOSS LOCUS: C10-2-C-enter St. , DATE OF LOSS: 8/5/99 TYPE OF LOSS: Vandalism ADJUSTER FILE: 99-000817 Gentlemen: Claim has been made involving loss, damage or destruction of the captioned property, which may either exceed $1,000.00 or cause Massachusetts General Laws Chapter 143, Section 6, to be appli- cable. If any notice under Massachusetts General Laws Chapter 139, Section 38, is appropriate, please direct it to the writer's atten- tion, including a reference to the captioned insured, loss locus, date of loss and adjuster file. 1. a � 0 A-- TITLE:0 On this date I caused copies of this notice to be sent to the above addresses by first class mail. c aIIG� NATURE -- - -- ------ AND DATE 7 FIMEr, Town of Barnstable Department of Health, Safety, and Environmental Services BAMSTA13M + 1' ,0� Public Health Division p'fDfA°�A P.O. Box 534, Hyannis MA 02601 Office: 508-8624644 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health July 22, 1999 Christos Pissimissis 102 Center Street Hyannis, MA 02601 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CODE II, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE,ARTICLE 51 The property owned by you located at 102 Center Street, Hyannis, was inspected on June 21, 1999 by Glen Harrington, R.S. Health Inspector for the Town of Barnstable, because of a complaint. The following violations of 105 CMR 410.00, State Sanitary Code II, Minimum Standards of Fitness for Human Habitation were observed: 410.100A(2): Heating element on top of stove was inoperable. 410.351: Hole observed in wall in main room. 410.351: Refrigerator observed to be leaking. 410.351: Sink drain was blocked due to plumbing problem. 410.351: Wash basin was removed. Hole left in wall. 410.482: Smoke alarams inoperable. 410.501: No storm windows in kitchen bathroom and living rooms. 410.550 B Numerous fruit flies and house flies observed throughout apartment. 410.601: Trash observed on the ground at rear of apartment. You are directed to correct the violation of 410.100, 410.351, 410.482 and 410.601 within twenty-four (24) hours of receipt of this notice. You are also directed to correct the remaining above listed violations within seven (7) days of receipt of this notice. You may request a hearing if written petition requesting same is received by the Board of Health within seven (7) days after the date order is received. However, these violations must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result in a fine of not more than $500. Each separate day's failure to comply with an order shall constitute a separate violation. PER ORDER OF T BOARD OF HEALTH Thomas A. McKean Director of Public Health cc: Hal White Building Dept. I Jo INC.. o The Town of Barnstable Health Department 367 Main Street, Hyannis, MA 02601 rua AY►' Office 508-790-6265 Thomas A. McKean FAX 50b-JW344 t 1 Director of Public Health �.viSfnS Pi SS �iw< rSS%! S+awa� z(c,t-F`j NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00 STATE SANITARY CODE II, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION The property owned by you located at (c Z C�4-�1— J as inspected on 6 Z i, 1� , 199� by* Cte-c-, 1-la-+���hsfc;,. 62, S, Health Inspector for the Town of Barnstable, because of a complaint. The following violations of 105 CMR 410.00, State Sanitary Code II, Minimum Standards of Fitness for Human Habitation were observed: for GK 2 u(o, 1001}(2) A4.ec . 2UA,v,e, 4 S-{�v.e l �S 1..'�- An..c,( U�.,..•{�-(G..���� w 2.r2 n c'�`c-G(� Ll !O t 7 S O 3�� � : SLL,%k dro,Lv, CN0.S )aLGc6P4 d4,e frD � lt.LnlO1N� �ra (rJ(X��7 q [O. /oo , 410. 7,il,gio, 43Z ctti.r g10, 60I You are directed to correct e violation within twenty- D 1167 p four (24) hours of receipt of this notice. You are also directed to corre `f'1� Y ewe e�i�r'ng viola O(Z within -S- da of receipt of this notice., You may request a hearing if written petition requesting same is received by the Board of Health within seven (7) days after the date order is received. However, these violations must be corrected regardless of any request for a hearing. Please .be advised that failure to comply with an order could result in a fine of not more than $500. Each separate day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health y FORM30 �hw HOBas&WARREN'"' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CITY/TOWN --- W b DEPARTMENT ° ADDRESS J- C-------'=` /---- TELEPHONE / Address Z G�-�. Sfre.>z`�; ur Occupant_T►vy( (,t't� F _ Floor Apartment No. G No. of Occupants-1___ No. of Habitable Rooms_ No.Sleeping Rooms__(_----_ No. dwelling or rooming units_ No.Stories. Name and address of owner C Lv iJ dZ7 S YARD Remarks Reg. Vio. Out Bld s.: Fences: Garbage and Rubbish .-C-5 I, ad re o, C Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Ste s,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: ./f/�o S t4,v1 i<<f c vlr Roof ' Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: STRUCTURE INT. Hall,Stairwa p-8-- � �O� Obst'n.: S f Hall, Floor,Wall,Ceiling: ko(t (.:C, ( Iq 6--f,i Hall Lighting: Hall Windows: HEATING ,� Chimne s: ' Central OY ❑ N Equip. Repair TYPE: a w Stacks, Flues,Vents: PLUMBING: Su I Line: ❑ MS ❑ ST ❑ P Waste Line: cTtw-fin H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen. Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT vk( Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks C1 a Kitchen o� SW Bathroom Pantry Den Living Room aSS Bedroom 1 Bedroom 2 Bedroom(3) Bedroom 4 Hot Water Facil. Sup.Ten. a Oil, Elect.: v Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink aZ v 14 A.- Stove .-dcav— E Qt ln Bathing,Toilet Facil. Vent!, Plumb.,Sanit'n.: (Ai" i, rH ircti,� � N ael„J- b e_4 z> Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n:; General Building Posted Locks on Doors: .44 ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS'A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIE OF PERJU Y " /� INSPECTOR- � TITLE "7 [y"t t ✓ .� DATE TIME '3 —_— P.M THE NEXT SCHEDULED REINSPECTION A.M. N P.M. f Health Complaints 21-Jun-99 Time: 1:50:00 PM Date: 6/21/99 Complaint Number: 1912 Referred To: GLEN HARRINGTON Taken By: K.S. Complaint Type: CHAPTER II HOUSING Article X Detail: UNSANITARY CONDITIONS Business Name: Number: 102 Street: Center St. 7> 2*" Village: HYANNIS Assessors Map-Parce Complaint Description: There is no plumbing in the house, and trash all over the place. Actions Taken/Results: Investigation Date: Investigation Time: � z'r/ /c/ 1 i> s" Health Complaints 2Wun-99 Time: 1:50:00 PM Date: 6/21/99 Complaint Number: 1912 Referred To: GLEN HARRINGTON Taken By: K.S. Complaint Type: CHAPTER II HOUSING Article X Detail: UNSANITARY CONDITIONS Business Name: Number: 102 Street: Center St. 7 Village: HYANNIS Assessors Map-Parce • � Complaint Description: There is no plumbing in the house, and trash all over the place. Actions Taken/Results: Investigation Date: Investigation Time: Dy cw it Caring Calvin Several religions To THE today can look to Reformationist MILLENNIUM John Calvin for their beginnings. In 1536, the Frenchman Calvin published the first edition of his 17 Institutes of the Christian Religion, a volume that espoused Calvin's THURSDAY near-total reliance on the Bible as the word of God. Also a scholar, theologian, and human- ist, Calvin moved to Geneva in 1541, where he helped formulate a new constitution, a municipal school system, and supported special care for the poor, hospi- tals, and new industries. 198 Di\ys TO THE MILLENNILINI__ >: `::;> t+'? ?y { s< {}tit "' skt '€2t:` Y22ttS` t'Y '<YM1;; YYi t`ss ;; ?YY?'`` t2t''` t22`} ?>;rs,<'kiii ` >•>r>rsssrss.>'' ti !xtyk ` �327047 :: .............. .. ........................................... ............................:::.: ..0024158 «>:+> �,,yy�}��Ct���.'�.y•.••,.hv... oil Kii ......v.......v....... .:::::::::n::�:::::::::.vvw:::::::::::.::w:w:::.::;...•••::::•::v:::•:::::::::::::•.:::;:••.v:::.;.....��.. ...Fvvvvw::::::::::::::::::::::;;...................:::::::vv:v::::::::.::...... :::::•..:::::.::::::: CLL{:::Lv'tiii;:v':::::L::::::i::LLvt;:::;:v':::::ii::v':v':{. ::::: ::::::::::::.:......:::::::::::::::::::::::::......................... :::.vY: �,}{yy..�,�y .:::::•:v:•.::::•.vh:::::::::::::::•:::::;:L•:::::::;::3:::. .00 ti�vvyi}•y%•i k t}j:j: titi4: •i:::{L:::::v:;•.v:::::::•::::::v::.:::•::.:::::::is:•.h::::::::Lttt3:i;ii;•ii:tt`• v.�.::: «:•.�:.vw::.w:::nv}:•i:•ii:vY,y,, ................................................................................... �:::::::::::::::::::::;:::{:.}}•+,{:.....•'•::.........?'::::::::::::.... . V.4 ii., ;L:?>.G:•: YiYY......:rrr::: uuuUfrr:G:•i tii::i v<itii::ii::`+v `i. ..........•.. y. « PISSIMI SSIS CHRISTOS �•011 ����yy, 2 STAMATELA P ISSIMISSIS 0000• 1928 .:::<:•:;:<:::;::•:::;.:•>::::::..::.;:.«;.:..<;.:::.::.;::;:<;:::::;::::.;;:;:::.:::... 102 CENTER T ER ST. :::•:.:•.>.:•.:....::•.::.:.:.:.:•.>.:::..•v.:v,..:.:.::.:.:..:.:•.v.vvvv.v:.... ... NIS HYAN ........... > , ` .:.: ..«....:.. .. .: :.:00 ...vvvvv::::> •.:. ......,...,::•:::::::.:.::::•:::::::::•:::.:v:v:v:v:,:,:,:.:.:....:.•:...:.v:.v:.v:.:v:.•v;:v:.<vv:v.<vv:vv:vv:v::v::v..vv::v:::::::::.:•v.::v.•v::.:::„::.::•:<:::�.:�::::::::::<..::. 000000'''' :::.::.:::.:::::.:::::::.::::.::::::. «:•.:v::;;.;•::::::::::::.:iiii:?`{ :':::':�:tt<<"' � '' .; .:::::::.�:::::::::::..•:::::::::::::::.:;:.:f�:ie#f�i�'�':;'::. .............. «:.:::::::::.:,vvvv:::.:•::.�:::•.::::::::::::::::::::::....,,:.:.:.,�::.v..... ..................... ..................................... ::::::•::::::::. ..... ........ ........ .........:..:::::::::::.::::::::vvv:.vvvv»v>,vv,;.vv.;•:::•>:;:::: .......................�:v.v.. ................vvvv,,.....vvvv........vvvv........v..v.vvv..................................,v,.v..............v,.,•.�:::•>:•:: `tt'OOOO t>IM1M1iPISSIMISSIS CH'RISTOS 5161107 E�1 »? 2200 1:02:::: {:4i .:CENTER STREET "':fSEf#r#iiiait:;; 'v#+31#1t ; 0045 :tE< 9C¥s. 271 :. . ..:....... .................................... r.::• HY SPR S •. 1516 ING STREET !: The Town of Barnstable y rN[roe . •J = Health Department ru,""'TLn ' 367 Main Street, Hyannis, MA 02601 Office 508-790-6265 Thomas A. McKean' FAX 50b-JW344 fy i 719Director of Public Health t!�a-.,,,vim, i, 14 o z 6,n I NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CODE II, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION The property owned by you located at (0 7- w-as inspected on 6 a'�va- Z I Ir , 1991 bye C(ee- fo-,,, 62. S. Health Inspector for the Town of Barnstable, because, of a complaint. The following violations of 105 CMR 410:00, State Sanitary Code II, Minimum Standards of Fitness for Human Habitation were observed: los'Gvc 2 C1[0, l.yo4(2)° /�ek �'^�I 12(R.w.e/,� r." �'r e7 .3 fo v-e S-�7e5 11Sl { �lM0( Ve1r. t0- fT Wt 1Y74 �i �n �✓vl c4vN L( LOQ�oTZV matey '(0 la-t �2at �sGCv� )o 1v c 4,4 0&-e `b qtO. /00 , 410. 3S7(/gjv,49rZ "4101601 u You are directed to correct violationa/�within twenty- four (24) hours of receipt of this notice. // `` You are also directed to corre ewza_� iez5 v o la-7. )O(Z within 5�12�V-� !dta ;jof receipt of this notice.. You may request a hearing if written petition requesting same is received by the Board of Health within seven (7) days after the date order is received. However, these violations must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result in a fine of not more than $500. Each separate day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health d Qp o N m P T o � � C r FORM30 HAW HOBBS&WARREN'"" THE COMMONWEALTH OF MASSACHUSETTS �� BOARD OF HEALTH 13 CIITTY`//T�O W N tl DEPARTMENT ADDRESS 1^/ / U(p.�, TELEPHONE Address L 0 7- G � -�1ri">e� aqt"`a Occupant_ /t - Floor Apartment No. C No.of Occupants No. of Habitable Rooms If No.Sleeping Rooms No. dwelling or rooming units No.Stories Name and address of owner f qzo S Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish -" 1... re-o'-, ri'( C> Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: /t40 S' (wvl C3h .YET 017z v D Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: 0-0-- 6LAI(' Obst'n.: S 54&ztla ` Hall, Floor,Wall,Ceiling: koQ C,., C� Hall Lighting: Hall Windows: e a ix Y, HEATING Chimneys: Central ❑ ❑ N Equip. Repair TYPE: t"d Stacks, Flues,Vents: PLUMBING: Supply Line: i ❑ MS ❑ ST ❑ P Waste Line: vz.-vA H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT �7k( Ventil. L to Outlets Walls Ceils. Wind. Doors Floors Locks a o Kitchen Bathroom .>c— Pantry Den Living Room aSS 2 Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten. a Oil, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink 1710, v►v+ t Stove #-v60— 13 Ce o%aA.,,-f- By e."— 1#4-14 >q Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: &tr_: k /oaf►h C✓ A609b ' �t Wash Basin,Shower or Tub:_ &-k[ Infestation Rats, Mice,Roaches or Other: 3'sd Egress Dual and Obst'n: ,6V a Q ��S 4J C General Building Posted _.tom {� Locks on Doors: . I i ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIE OF PERJU Y " �,, / INSPECTOR � TITLE �1Ot r 61vv _ M. DATE / 0 TIME P.M A.M. THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation,any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in tiis listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.'830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold,to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting-in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the cbstruction of any exit, passageway or common area caused by any object, including garbage or trash,which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. J The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public ( ) P P 9 9 P Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered,crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of'a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2)and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. Form 10 COMMONWEALTH OF MASSACHUSETTS THE TRIAL COURT SUMMARY PROCESS SUMMONS AND COMPLAINT Department Docket No. G Division Entry Date ss. THIS IS A COURT NOTICE OF A PROCEEDING TO EVICT YOU-PLEASE READ IT CAREFULLY IMPORTANTE:ESTE DOCUMENTO ES UNA NOTICIA DE UNA CORTE,RESPECTO A PROCEDIENTES PARA DESALOJARLE ADDRESS: 41 CITY: // i1/;✓L�_ZIP: Q You are hereby summoned to appear before the Judge of the Court P at the time and lace listed below:. _ DAY: T UCS01C'\ DATE: J V� I t g S TIME: r 3QG,>� COURT LOCATION: If n Sf4 b IP Sf r c f ROOM: to answer the complaint of- LANDLORD/OWNER: 1 %2_.1 f"/ ( M /S Q 1 STREET: j_L_( ' l �.J�7� e���7 1� CITY: 19-�'4a/.z'z J ZIP: 0a26d I that you occupy the premises at f7'9- .p ?� �' x( being within the judicial district of this court, unlawfully and against the right of said Landlord/Owner because - ZO and further, that$ rent is owed according to the following account: JO%EPH J. RADON ACCOUNT ANNEXED First or Administrative Justice Clerk -Magistrate Signature of Ptaintiff or Attorney Addms of Plaintifrs Attornev 7 7 -7y Date of Signature of Plaintiff or rney Telephone Number of Pa intifror Attorney NOTICE TO OCCUPANTS: At the hearing on you(or your attorney)must appear in person to present your defense.You(or your attorney)must also file a written answer to this complaint.(Answer form 2 is available in the clerk's office.)You must file(deliver or mail)the answer with the court clerk and serve(deliver or M mail)a copy on the landlord(or landlord's attorney)at the address shown above.The an er must to re d by the court clerk and received by the landlord(or the landlord's attorney) no later than Monday sI U 2 l/� before the hearing date. IF YOU DO NOT FILE AND SERVE.AN ANSWER,OR IF YOU DO NOT DEFEND AT THE TIME OF THE HEARING, JUDGMENT MAY BE ENTERED AGAINST YOU FOR POSSESSION AND THE RENT AS REQUESTED IN THIS COMPLAINT. NOTIFICATION PARA LAS-PERSONAS DE HABLA HISPANA: SI USTED NO PUEDE LEER INGLES TENGA ESTE DOCUMENTO LEGAL TRADUCIDO CUANTO ANTES. s Form 10 (continued) To the Sheriffs of our several Counties, or their Deputies, or any Constable of any City or Town within said Commonwealth, GREETINGS: We command you to summon the within named tenant/occupant to appear as herein ordered. WITNESS, JOSEPH J. REARDON Firs[or A in rat 19, tntry Date Clerk-Magistrate OFFICER'S RETURN ss City/Town -- .- Harp — t C Barnstable County Sheriff's Department c � 6, 1999 at 4:30 P.M. , t I hereby certify and return that on July to I served the within S ummary Process Summons otaoccupants, the within named defendant Haro hereof ld tin& y her hand to him at 102 by delivering an attestgYis, MA. - Center Street, Apt. C► ann Fees: $ :;? Brad. Parker, Deputy Sheriff P.O. Box 614, Centerville, MA 02632 NOTICE TO LANDLORD/OWNER: Fees: Service Have the Officer complete and return above.Service must be made on the defendant no.later than the seventh day Copy Travel and not earlier than the thirtieth day before the Monday Use of Car entry day. This form must be filed in court no later than the close of business on the scheduled Monday entry day. L& U Mailing $ In appropriate cases, proper evidence of notice to quit must be provided this court upon the filing of this com- plaint. See Rule 2(d).According to Rule 2(c),the hear- ing date is the second Thursday (or Friday or Monday in some courts)after the entry day. TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: Z Prq IS- o Mail To: BUSINESS LOCATION: /o 5 J_AI, IN's Board of Health MAILING ADDRESS: 5-A e" ry Town of Barnstable P.O. Box 534 TELEPHONE NUMBER: °7 7 f FL 3 : Hyannis, MA 02601 CONTACT PERSON: &Ci-iwrFe-2 EMERGENCY CONTACT TELEPHONE NUMBER: `` 7 1 6k 1 Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities totalling, at any time, more than 50 gallonsliquid volume or 25 pounds dry weight? YES X NO ^ This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- stics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants ® rodenticides) Degreasers for engines and metal c X— Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes , Jewelry cleaners Asphalt & roofing tar . Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chlorofor formaldeh de P ( g Y Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business �U),6,e— w® 144Z,- WA�.G iq401-ep �i TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS rM 3fo Class: 7.Miscellaneous (US QUANTITIES AND STORAGE (IN=indoors; OUT=outdoors) MAJOR MAT ,. , IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (13) :. Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers ©miscellaneous: ro x C� rJ V DISPOSAIJR.ECLAMATION REMARKS: 1. §anitary Sewage 2. ter Supply V I D00S AS-1 1140 Town Sewer ublic Couig GV0619 fi On-site Private ' t >� �- 3. Indoor Floor Drains YES N0�( ° O Holding tank:MDC 7K O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO ORDERS: Q Holding tank: MDC O Catch basin/Dry well O On-site system 5.Waste Transporter Name of Hauler Destination Waste Product YES INQ 1. 2. Person (s) Interviewed Inspec or *Dat FORM30 �I1W HOBBSB WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH gam^14bu- CITY/TO W N F DE ARTMENT _lay-U-46 �. ADDRESS TELEPHONE Address _ _ Occupant . Floor Apartment No. .No.of Occupants No. of Habitable Rooms ` No.Sleeping Rooms---y- K'� No. dwelling or rooming units--No.Stories S/`^ _ 1 I I t/ 1 Name and address of owner _ I Ii(D�G l°� Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: h }C 1 Dual Egress:and Obst'n.: 4-141 ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: J J Foundation: Chimney: o BASEMENT Gen.Sanitation: ° Dampness: N - Stairs: Li htin : STRUCTURE INT. Hall,Stairway: 0. Obst'n.: Hall, Floor,Wall,Ceilin Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: ILU Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Woors FI s Locks Kitchen Bathroom PantryI Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.: i Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink Stove (01 , Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY." INSPECTOR TITLE A.M. DATE TIME P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises.This listing is composed of those items which are deemed to always have the po-ential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II. 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) .Failure to provide a supply of water suff cient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water.. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the o:)struction of any exit, passageway or common area caused by any object, including garbage or trash,which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requ rements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 103 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else tc fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. 1 (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfiting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or p-otective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroacres, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. • .,. .. .,- �. .-.r.., , . .•„ ..`..-. .v—rw•t\..v^ v..,.. Yw....vw--....,.ti.,.....�n.� .r+......r""ti.-^•cd..s�'r-s ... -.. .-,�.rr�..r _.-...,-... ....n. ..-..,1 E.r' .,,, ,ti.1+r FORM 30 ClW HOBBSB WARREN'M THE COMMONWEALTH OF MASSACHUSETTS BOARD /OF HEALTH CITY/TOWN DE ARTMENT ca^OV ADDRESS �M N' My 1 � I TELEPHONE Address __ _______.__ Occupant_ _ Floor Apartment No. ____ No-Qf Occupants_ No. of Habitable Rooms ram- _No.Sleeping'Rooms No. dwelling or rooming units __ No.Stories__ �� 1 Name and address of owner Ar^t , Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: I STRUCTURE EXT. Steps,Stairs, Porches: v-5) Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: r4 L-- Walls. �J0' Foundation: Chimney: � A fo BASEMENT Gen.Sanitation: Dampness: loll ' t J 1� �j Stairs: I"� Li htin �k ,ilv n. _ STRUCTURE INT. Hall,Stairway: r\ �'� h \� 01, " u v%,- Obst'n.: Hall, Floor,Wall, Ceiling: r Hall Lighting: / l Hall Windows: i J , x HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: "�. If " H.W.Tanks Safety and Vents ELECTRICAL Panels, Meters,Cir.: �, l ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT \1 r Ventil. L to . Outlets Walls Ceils. Wind. Doors F_I ers Locks Kitchen `® Bathroom Pantry Den Living Room (� ` Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 �' ,tA , Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: ^ it Stacks, Flues,Vents,Safeties: O.0 Kitchen Facilities Sink �° Iv( Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY." INSPECTOR TITLE A.M. DATE TIME P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the heaith, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. .. .-._.a-a_.,....-..-.^vr-�.-•.,...-.�v�......,,.,`,�,�•.r-.--.::.�-..�..,.h,...n,._y..�+.-.,-.v..ray.-,.,.rrW.+^.-,.....ter--^s•.-*.•-....*r--:...'ti-v__..--. --.^... -,r-..c-....r-r-�.��.-.--w._z,�,�-.-.�..�:. r:..-,r•. -ZaM `FORM FI�W HOBBSBWARRENrn THE COMMONWEALTH OF MASSACHUSETTS � B� C� BOARD OF HEALTH ` ;�(n i`n t `L•FAtaf I CITY/TOWN W r o DEPARTMENT Apir c � � ' ADDRESS GSM vW ITS �/f f TELEPHONE Address —_ ___—.--___-- -- -- --------Occupant- -. - Floor _Apartment No.___ ___ -_ No..of Occupants--- No. of Habitable Rooms— `. No.Sleeping`Rooms No. dwelling or rooming units .-____ No.Stories Name and address of owner__ t Remarks Reg. Vio. YARD Out Bld s.: Fences: a , 7.2 Garbage and Rubbish p t Containers: l✓' -- Drainage Infestation Rats or other: 1 STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress: and Obst'n.: _� ❑ B ❑ F ❑ M Doors,Windows: Roof f'� Gutters, Drains: r l Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: i L/ ✓' Dampness: Stairs: Li htin : ', , ,'r .27 . STRUCTURE INT. Hall,Stairway: Obst'n.: �.. Hall, Floor,Wall,Ceiling: Hall Lighting: ` Hall Windows: `• ( .2 HEATING Chimneys: ; ' „ i € \ ? Central ❑ Y ❑ N E ui . Repair TYPE: Stacks, Flues,Vents: •�'" PLUMBING: Supply Line: [ t ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ' ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen. Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. \Doors Floors Locks Kitchen , ` " Bathroom Pantry Den Living Room ,u Bedroom 1 i Bedroom 2 tf , Bedroom 3 ., Bedroom 4 F x„1 Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.: Arl Stacks, Flues,Vents,Safeties: ,0, Kitchen Facilities Sink i (J .I ` Stove ' Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: 101-144 fi Wash Basin,Shower or Tub: `f Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: rF. General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY." INSPECTOR TITLE A.M. DATE TIME P.M. A.M. THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the heaith, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the pe-son to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance wi--h 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish,filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 root enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health.