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HomeMy WebLinkAbout0163 ESTEY AVENUE - Health 25 Cedar Street Sewer Acct # 2429 Hyannis qnr, IQ-7 n, P t' I i t � e wr t� d, m 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, 1st. FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. � e DATE: Ov \W Fill in please: APPLICANT'S YOUR NAME/S: 77, I E YOUR H ME ADDRESS: �'i✓ Z T. �{i�T -7 � uv G � y 4T M - TELEPHONE # Home Telephone Number NAME OF'CORPORATION: NAME OF NEW:BUSINESS M TYPE'`OF BUSINESS iS THIS A HOMEt)CCUPATION? YES" NO ADDRESS!OF BUSINESS t t MAP/PARCEL NUMBER �� [Assessing) 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 COM*eiRlfor F E This individu d of a y p rm)iAreuirements that pertain.to this type of business. MUST COMPLY WITH HOME OCCUPATION atur- RULES AND REGULATIONS. FAILURE TO FQMMEN I . 2. BOARD OF H TH lV� U VV This individual ha bee�orm of the permit requirements that pertain to this type of business. • N&rV MUST ;,OMPLY WITH ALL Authorized Signature** %1+ARDOI JR NfATF; I.ALS REf !,%I..p:T'r�ln COMMENTS: ` 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: IJ TOWN OF BARNSTABLE Date: TOXIC AND HAZARDOUS MATERIALS ON-SITE NAME OF BUSINESS: iZltl 5-11WV4 BUSINESS LOCATION: . 2- 5T 4. INVENTORY MAILING ADDRESS: rS X- 4 TOTAL AMOUNT: TELEPHONE NUMBER: �-d(f 6(i,,3 �� 5 CONTACT PERSON: Aq-7—ue- EMERGENCY CONTACT TELEPHONE NUMBER: 20P XJ d9ee F MSDS ON SITE? TYPE OF BUSINESS: _/' O' j /�/���- �C.E>v 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 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) Miscellaneous 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 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 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 (including carbon tetrachloride) h ❑ 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 WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINES p0cant's SILnd&W Staff's Initials 9 . Certified Mail#7008 3230 0002 5177 8445 rtKE r Town of Barnstable Regulatory Services BARNS ABLE.. � C 0 O MASK 0 Thomas F. Geiler, Director Public Health Division Thomas McKean, Director 200 Main Street,Hyannis; MA 02601 Office: 508-862-4644 Fax: 508-790-6304 September 28, 2009 Charles Pisacano PO Box 126 Hyannisport, MA 02647 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 25 Cedar Street (Apt#6) Hyannis was inspected on September 28, 2009 by Timothy B O'Connell, R.S., Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of a complaint received by the Town of Barnstable Health Department. The following violations of the State Sanitary Code were observed: 105 CMR 410.550 (B)—Extermination of Insects, Rodents and Skunks. Cockroaches observed within kitchen cabinets. 105 CMR 410.351- Owner's Installation and Maintenance Responsibilities:., Sink within kitchen has .drain that is leaking under cabinets. It was also observed that the refrigerator was also leaking. You are directed to correct the violations listed above within seven (7) days of your receipt of this notice by exterminating cockroaches and by providing report to the Health Division from an extermination company; by fixing leaking refrigerator and sink drain pipe. 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 will result in a fine of$100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Should you have any.questions regarding the above violations, please contact the Town Health Division and ask to speak with the.inspector who performed the inspection. Q:\Order letters\Housing violations/4 suummerside.doc PER ORDER OF TH , BOARD OF HEALTH f L as A. McKean, R.S., CHO Director of Public Health Town of Barnstable Q:\Order letters\Housing violations/4 suummerside.doc HOBBS&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS FORM 30 CI_W BOARD OF H TH CITY/TOWN W DEPARTMENT o ADDRESS GSM SyO�•0� TELEPyqNE tq Ca� Address Occupan (s ✓L_ Floor Apartment No. No.of Occupants No.of Habitable Rooms No.Sleeping Rooms No. dwelling or rooming units No.Storie Name and address of owner Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: av 0 1 ❑ MS ❑ ST ❑ P Waste Line: LIN 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 Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect..- Stacks, Flues,Vents,Safeties: rA Kitchen Facilities Sink Bathing,Toilet Facil. Vent., Plunl1b.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: .— E ress 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 INSPECTIO IS IG AND CERTIFIED UNDER, .,TH AINS AND PENALT U INSPECTOR TITLE A.M. DATE TIME �� v P.M. C ) 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 o-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 11, 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 fond 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 1 D5 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(8)and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilitieE 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 de-ects 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 recuired 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, gasfi-ting, 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 413.503(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 410.003 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. i Citizen Web Request Page 1 of 3 j ..ot .0 Ate: ` ;"` 3i. �r ;�:�3:enl ,C WIcconnelt CitizenRequestManagement Ro.,1,0 .z.O sc: :�t.s . re: o k Request Information ..._.._... ....... - ......._..._...._..__... - __......_. __ _..._ _.__...___............_._.._........._.._...._.._......................._.__..._....- ..........................._.........._....... ......................._ _ __ ..........................................__....__..................__....... - .._........................................ RequestID: 27127 Created: 9/24/2009 12:04:27 PM _ . ...................._. Status: Assigned To Staff Assigned To: O'Connell,Timothy Health Office Anonymous: No Request Category: Chapter II : Housing Substandard Routine work: No Estimate: No Date scheduled: _ -- .._._........ .....__._._... __......_...............__.........._......................................................... _ Estimated 10/8/2009 Change Estimated Sep October 2009 Nov Completion Completion Date: Date: Sun Mon Tue Wed Thu Fri Sat 27 28 29 30 1 2 3 4 5 6 7 8 9 10 t18 20 21 22 23 24 27 28 29 3 4 5 6 7 Created By: Wadlington, Ellen Priority: Medium Health Office Citation Numbers: Requestor Information --.._.. ........_..,.__.._..._.._............ ....._.................. ..........._.............._........................_......._......._.__............. ..._................................_........_.___._..............................................._............._............................... . Requestor Request Parcel Number House is infested with Map 327.. Block: 197 Lot 01 cockroaches and mice. Have been in contact with landlord for two years Pa_rcel.._Lookup and nothing has been done.The rodents and roaches are in all units. http://issgl2/IntemalWRS/WRequest.aspx?ID=27127 9/24/2009 Office: 508-778-9777 E-mail: Charliie as urmc ro erdes.com Fax: 508-775-6416 Cell Phone: 508-776-4466 l MCP Pfo er M p ty ana ement P.O.IWX nk Hyannisport,M&.oabo October 7,2009 Kathleen Dean6 6-25 Cedar St. Hyannis,Ma.02601 Kathleen, Thy just prior to meting your unit for roaches I checked the refrigerator and determined the cause of the water collecting in the bottom. The temperature setting for the refrigerator was set at 6 and this setting is too high.A high setting such as this causes the drain to fieeze and thus the water collects in the bottom of the refrigerator.This situation has happened several times before. To verify this I placed a thermometer in the refrigerator and after a short period of time the temperature in i1le refrigerator section was at 32 degrees. As I have explained before to remedy this you must defrost the refrigerator by turning it off and letting it defrost for approximately two(2)days.Then turn it back on and put the temperature coz WI at 3.Using the thermometer that I have left there wait about 12 hours and see what the temperature reads.It should read forty(40)degrees,that is the optimal matting to;;� the food in the refrigerator and not cause the drain to fieeze.If the thermometer ,lower than forty(40)turn the temperature control down just a bit,if it reads higher than forty(40)turn the control up just a bit.By doing this you will prevent the water from accumulating in the bottom of the refrigerator. I I believe this should solve the problem. ou, ,2 es - Box 126 1 Hyannisport,Ma 02647 508-7764466 1 Cc:Health Dept. Office:508-7' 8-9777 E-mail: Charlie incoprooerties.com Fax: 508-775r6416 Cell Phone: 508-776-4466 MCP P ' operty Management P.O.Box M Hyannispork Ma..OM4 October 7,2099 Health Dept. 1 200 Main St. Hyannis,Ma.02601 Attn:ThomaslMcKean Mr.McKean,I Asa=S7, ' to my previous response regarding the complaint filed by Kathleen Deane, 6-25 Hyannis,Ma.please be advised that today,Wednesday, 10/7/09,Fowler Pest Control heated units 2,3,and 6 for roaches.Units 2 and 6 were heated with a spray solution and unit 3 was treated with a bait solution. I will be ananpng with Fowler Pest Control to place these units on a scheduled maintenance program until such time as I can be sure there are no more problems. Also as stated�n my previous letter the leak from the drain plug under the kitchen sink hap has been fixed and I have again addressed the situation with the water collecting in the bottom of he refrigerator.I am enclosing a copy of the letter sent to the tenant outlining what caused the problem and how to maintain the temperature of the refrigerator in order to prevent this from occurring again illet Box 126 I Hyannisport,Ma.02647 508-776-44661 Ce:Kathleen Deane r TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date _ "- O Time: In Out e Owner �it/� Tenant t�-� ► 6 5 Address Address Compliance Remarks or Regulation# Yes X NO Recommendations 2. Kitchen Facilities V 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities Appmved:. 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing. IVA- 18. Driveway Width 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms Number of Vehicles Allowed (max) Number of Persons Allowed (max) Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date _ '- Time: In Out r Owner Tenant Address I I Z �' Address 5 Y 1 Compliance Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities cart --- 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17.Temporary Housing 18, Driveway Width 19. Number of Tenants Observed 0_ /11, PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms o Number of Vehicles Allowed (max) Number of Persons Allowed (max) Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date O Time: In Out e Owner Tenant Address I �" Address 5 Y 1 Compliance Remarks or Regulation# Yes NO Recommendations 2, Kitchen Facilities 3. Bathroom Facilities 4. Water Supply • r - 5. Hot Water Facilities calt 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation ' 9. Installation,and Maintenance of facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing . 18. Driveway Width 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms �— Number of Vehicles Allowed (max) Number of Persons Allowed (max) Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here . TOWN OF.BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date , ( "- O Time: In Out e Owner Tenant Address I Address Complia pce Remarks or Regulation# Yes K NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply Veda �opro _ 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation s: 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal_ 16. Sewage Disposal r,C�^�1� 17. Temporary Housing 18. Driveway Width 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms 0 Number of Vehicles Allowed (max) Number of Persons Allowed (max) Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date y "- O Time: In Out Owner Tenant Address r3-�� I �' Address 5 Compliance Remarks or Regulation# Yes V NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities approved, -C 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing 18. Driveway Width 19. Number of Tenants Observed PART 11 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms Number of Vehicles Allowed (max) Number of Persons Allowed (max) •� }} Person(s) Interviewed _ Inspector If Public Building such as Store or Hotel/Motel specify here FORM 30 �Ih� HOBBS&WARREN'"' THE COMMONWEALTH OF MASSACHUSETTS ,A BOARD OF LTH CITY/TOW a ` - DEPARTME T ADDRESS V L © - ��pp TELEPHONE Address sr Y� ---------- Occupant—_ Floor—Apartment No. � __ No.of Occup�p A No.of Habitable Rooms No.Sleeping Rooms 'T— _ No. dwelling or rooming unitso.Stori Name and address owner 41Wq4^_ - — --- Remarks Reg. Vio. YARD Out Bld s.: Fences: VV Garbage and Rubbish Containers.- Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: 402 \1 Dual Egress:and Obst'n.: -:7—c. ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Li htin : STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: 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: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom —Pantry Den —Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink 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 I GNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PE UR ." INSPECTOR TITLE ((�� DATE :'� TIME _�vw 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 De 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 wit') 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 mairta n 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). (I) 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 s ckness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or;o-he creation or spread of disease. (J) The presence of leadbased paint cn a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning 'revention 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, -seating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standares 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 e'se 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-he release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detecto-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 conditio-) 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 41C.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. I Parcel Detail Page 1 of 3 £ to .. '.s�. 7 Logged in As: Parcel Detail Thursday, Febru Parcel Lookup Parcel Info Parcel ID Developer i j Lot;LOT 1 Location 25 CEDAR STREET I Pri Frontage -I Sec Road Sec; .. Frontage I Village HYANNIS Fire District!HYANNIS Sewer Acct?2429 I Road Index 10259 Interactive Ma _ — AV Owner Info - owner PISA_CA NO, CHARLES & MARGO Co-owner j Streetl I P O BOX 126 I Street2 City HYANNISPORT _ State AMA zip'02647 Country(® Land Info Acres 0.49 Use 4-8 Units MDL-94 Zoning PR Nghbd 0105 I Topography 1 Level I Road Paved ......... Utilities All Public I Location Construction Info Building 1 of 1 YearBelt 1880 SRooY ___,_.__._________.__ Ext Wall D F WOORAME _.. ._ Effect,5504 Roof i - AC NON E Area' Coverl I Type I Int _".. _ __ Bed _,_. ._ .... .. Style Apartments I Wall I Rooms I Model Comercial Ior I Rooms _. Hardwood Bath m Floor 8 Full I I 11 Grade i.Avera e PIUS Heat Total g Type Rooms http://issql/Intranet/propdafa/ParcelDetail.aspx?ID=27634 2/8/2007 Parcel Detail Page 2 of 3 uS K Stories j Heat -- Found- Brick WaIISM $ Fuel ation 9 d t1S " e h1; K. ......_... Permit History Issue Date Purpose Permit# Amount Insp Date Coma 5/1/1985 B27840 $7,500 HY AC 4/1/1985 B27756 $7,500 1/15/1986 12:00:00 AM HY AC 3/1/1985 B27610 $0 1/15/1986 12:00:00 AM HY AC 3/1/1985 627754 $5,000 HY AC Visit History Date Who Purpose 5/7/2002 12:00:00 AM Paul Talbot Meas/Listed ......... Sales History Line Sale Date Owner Book/Page Sale P 1 12/15/2000 PISACANO, CHARLES & MARGO 1 3432/1 1 5 j 2 3/15/1985 MERLESENA ENTERPRISES INC 4435/088 3 10/15/1983 ABRAHANI, MUHAMMAD S ETAL 3887/252 4 5/15/1983 FORD, TR Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parce 1 2006 $398,700 $0 $0 $159,300 2 2005 $178,700 $0 $0 $405,300 3 2004 $149,600 $0 $0 $243,200 4 2003 $203,000 $0 $0 $61,900 5 2002 $203,000 $0 $0 $61,900 6 2001 $203,000 $0 $0 $61,900 7 2000 $170,800 $0 $0 $54,000 8 1999 $170,800 $0 $0 $54,000 9 1998 $170,800 $0 $0 $54,000 10 1997 $211,500 $0 $0 $27,000 11 1996 $211,500 $0 $0 $27,000 http://issql/Intranet/propdata/ParcelDetaii.aspx?ID=27634 2/8/2007 4 Parcel Detail Page 3 of 3 12 105 $211,500 $0 $0 $27,000 13 1994 $307,800 $0 $0 $81,000 14 1993 $307,800 $0 $0 $81,000 15 1992 $298,800 $0 $0 $90,000 ; 16 1991 $317,800 $0 $0 $112,500 17 1990 $317,800 $0 $0 $112,500 ; 18 1989 $317,800 $0 $0 $112,500 19 1988 $197,200 $0 $0 $84,100 20 1987 $197,200 $0 $0 $84,100 21 1986 $81,700 $0 $0 $84,100 ; / Photos http://lssgl/Intranet/propdata/ParcelDetail.asP x?ID=27634 2/8/2007 TOWN OF B RNSTAB E .. Health Division — 200 Main Street - Hyannis; MA 02601 �pF.THE rok Date:FAX U * BARNSPABLE, + MASS. w moo i639. ,gym Number of pages including c er sheet: « AlED MAC A To From: SHARON CROCKER �r Town of Barnstable Health Division Mail tb`. 200 Main Street Phone: .5y y— 2 3 Hyannis, MA 02601 Fax plione: � � ��S' Phone: 508-862-4644 CC: Fax phone: 508-790-6304 REMARKS: ❑ Urgent ❑ For your review ❑ Reply ASAP ❑ Please comment r FORM30 C&w HOBBS&WARREN rm THE COMMONWEALTH OF MASSACHUSETTS t BOARD OF HEALTH CITY/TOVIN, T ' o a n EPAR I ENT ADDRESS (' r,�SAs) gwLf ' ay0 Q TELEPHONE Address Occupant ` nn�GCrzu, Floor Apartme t No. No.of Occupants No.of Habitable Rooms No.Sleeping Rooms 2. No.dwelling or rooming units_✓ No.Stor' s Name and address of owner Remarks Reg. Vio. YARD Out Bld s.: Fences: Garba e and Rubbish Containers: Drainage Infestation Rats or other: c STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: 2n4 ex Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: STRUCTURE INT. Hall,Stairway: ' Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N E ui . 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: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom(1). Bedroom 2 Y Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas, Oil, Elect.: kaQks, Flues,Ve , afeties: Kitchen Facilities Sink e 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 REPOR SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY." lvf�� T���� INSPECTOR `' TITLE DATE J TIME ® � P.M. 94 A.M. THE NEXT SCHEDULED REINSPECTION P.M. T 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 11, 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 wish 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 tre obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which preverts 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 sa�ety. (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, plumbirg 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.E•03(B). (5) Failure to eliminate rodents, cock,oaches, 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 crdered by the Board of Health. I Date To Whom It May Concern: (7�I, , voluntarily grant permission to the Town (Occupant name) of Barnstable Board of Health (Agent or Health Inspector) to inspect my dwelling unit located at in accordance (House#,[Apt\Unit#if appli ble],street, illage) with the Town of Barnstable Code (Chapters 59 and 170) and the State Sanitary Code 4/ (105 CMR 410.000) on` �b� s p _ _}. I hereby authorize and name (Date of inspectiu,,j- _ G 4 CQVO to be my tenant representative for the (Occupant representative) purpose of this inspection. UJC5 PL�CQ VID is an adult person (Occupant representative) designated and duly authorized to act on my behalf and will be accompanying the Town of Barnstable Board of Health for the inspection, granting access to any and all locations (including bedrooms, bathrooms, closets, etc.,) allowing the use of photographs and answering questions. This authorization is only valid for the inspection date specified above, and must be renewed for any future inspection(s.) Occu nts Signature \ to Occupants Representative Signature \ Date Q:\Rental Ordinance\inspection permission 2.doc Town of Barnstable Health Inspector Regulatory Services 8�3o 9 0. Thomas F.Geiler,Director 1:00—2:00 Public Health Division Thomas McKean,Director ;00 Main Street,Hyannis,MA 02601 OfEce: 509462-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT-SEPTIC OUESTIONNAME 1. General Information: Size-of Property: Address: Jr Ma Parcel P Name:D&=_- 2EL&Lo Phone#: orqq6& 2a. How many bedrooms exist at your property now? 2b. Are you planning to add any bedrooms? U If es, how many? 0 Y y 2c. How many bedrooms total are proposed at this property(including the amnesty unit)? 2d. Please include a copy of the.floor plans for the entire prop"- showing the'existing rooms in the home plus the proposed amnesty apartment and/or addition. Please label each room clearly on the plans. 3. Is the dwelling connected to public sewer? YES or NO 000,11"1!1110 'MI M M Offi-d 4. Location of dwelling is, INSIDE or OUTSIDE a Zone of Contribution to public supply wells'? 5. Is the dwelling connected to an ONSI7E 13M or to PUBLIC WATER? r ' 6. Is a disposal works construction permit on gale? YES or NO 6a. If yes,how many bedrooms were approved according to this permit? Bedrooms. 7. Were any building permits obtained for construction of additiopal bedrooms? YES or- NO S. Is there an engineered septic system plan on file at the Health Division? YES 'dr NO Cn a: cl_, 9. Has the septic system been inspected by a DEP certified inspector within the last two years?11 YES or NO FOR OFFICE USE ONLY ? _ 2 The Public Health Division has no objection to �bedrooms at this property. L(29 Special Conditions: sv Signed: bate: 7J= _Q,-Aea1rh/wpfNes/atnw.v1y4p _ T/T 'd 9Z2'ON 1N3Wd0-13A3Q'003/W09 3-19d1SNdUg WUT0:TT S002'9 '130 . THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA y THE COMMONWEALTH OF MASSACHUSETTS OARD OF H - — -- - CITY/To... - F W moxq,isY1n36lzsY nY iaixg ay bnuo3.rt. r a. t7 $nt�rotlo3 9dT r^ Yo ariliawi 843. ri1sgmt to :i9jo..6brx� ., bamse6 gd Marie DE A EN .,,„, 1 i ?11 aEdT b r rt'. u�. a qo _ a Isw boa .s11n9�nq_stf � � s• n fY` ? ' .t t � , s"a•• 'riron a.Y -- ESS, r{1 3o gnigdwtlsc,i brie ,y19 sa o till_ r k&gtrtk lL$Yx91 `A.ns ng" i w ".OIA rfqur�xril p00 Oi,� AM5 2f►t III xa7gg[IJ opti9l bY£dttq' Sri.7 , �? ?art no AJAIV yna r ol�7s. dSi if P c3" #o`a'� �'gatgffi�LP4 usHanNFtr 91t.1a r n yF t 1, fY 1 t Y ti 1' dtYl13 o a Adc��ss t � ti cupant¢�" , f n tYF -an. .+ fi M .f 9 tt ' G ;h 9Z.W,tyx.9' - • � i s. '�• .r. u f ) Flog' 1pa ment o. u 1 a n .rsr, n lsn -wa P �isspi � on—rf2 tta'die 5b r o: �/ No.o«f h?d�tI A_ Por9s_ ��,� aaN�ozlSlee,RSn9t�oot��' sd:ion yam eb No.dweBinglortFoorpjngtunits 1 _ f $3Qrje5 , 6 e:ii7 iosB3r, sbut�et o1 Name a c1 sddress4.ofpwne,, �r l� 1 vn p'wta i n T r� ` '' � ,.�.._�.�.,..��, 9rfy 3r� t�ok:iasxTc�S i xnf xo �tii rpcil4 v o:S nnaxs srtl 3o no s, k.t.do .ls,91c;'3f{1 ,s31fi' Remal�ksa Ton Reg: Vio. YARD Out Bld s.: Fences: . :yebYo`rf5ua.d1iw yt.grrto� a3 b9issal Garbage and Rubbish: , 9TU?•8 lY t2.L Jti'3AJ.C. 71.4>; 79 1:3' t! y dJtlrb "4Jx. QA.l u! :ra Alo:l ' q CL 6h?Af h�'r's: , Insqun-0 _ti.: 1 Ce ifdu a t1i7r t� se+ , ��s , ., w ., [rain�ge' + xo a '" Infestation">Ratsgot 'or other: ' _x ` STRUCTURE EXT. Steps,Stairs, Porches: R x . Qual E ress:r nd Obst'n'' 4,. n •;�` a a ull �� O B 0 F U M AMD 2 qo s,,l/YindQWs•: ar, T93sgrf se3Qita . o T�s srf', a a",e.3a vav xo g atlrr3 Roof + ::SOSI)tJ b'nR (£ijOOi.OI� Gutters, Drains: + ' —Walls: 2f.,� x0 yltaix17�19 9x® 88Y o , ��Zd '8 q '..nB Y2 -72 t 3.w:rs, . .i,.. Foundation: r . t BASEMENT `Gen.5aritation:` �` "� Dampness: . Stairs: A os• a : 03 . xfstYti �; STRUCTURE INT.s1d;j9q(Hall-, Stairway:sg€swsp a.alas il—gin a8 3� $ '9bf�btct. of srirtlali (V Obst'n.: .fft:M-01+s hon (!)(lij02l.USa;�s iiJ f d bs tup x ps rfo23lboo, Hall, Floor,Wall,Ceiling: A X7 J J'tJ k J oU J Y V tG : `.H 'p1U » 55�1 VCl7 U ^..f U d d '1 •J l Half' r ,�.. , r 9. 'flap "F{arl'WtnaowS __.. ` . µ .. ,.... ° HEATING Chithrieys' i Central ❑ Y N E ui Re„air' x `' 's "` gtt�08 p p Q.:.. s w t4 iiro 01 s•`tul.keq Li+' W fYPE: Stacks, Flues;Vents: a PLUMBING: SO' :Ot+l ri uSY��plyfLrn2:(:+� >? z0f 3o znoY¢lvt� a7tf,�kwi�Xg,ao' py 9YulYaT (.I 3 ❑ MS ❑ ST ❑iPasuaD '190Wame Lr n&' �tf:atcldul �sgs lma axh� x� �gtYr��a yara.rxL ei VAST a m a3 9tsHF eL,1 pW`)Ta`R(s)`-&Afg T5hd Vdh zuQa 12a ,y �i? n @���w H • laarl aalsrn� a iELECTRICAL To Tot 1 PAhbl§',"M etai•s,'Ci t3tt rs nob o� o «'� k tti , �,iJ ❑ 110 ❑ 220 Fusing,Grnd.: AMP: n, ,Gen'.Cond. 4istr'b. ox: %" �" ,�d •t i° }Ge Base e. i"r ng Q9a. c 9a`i 461, ::'tom"".1.." i, t . _a� a "2f7i'4 lN�3aftlNlcT b4s, Ventil. Lgtng. Outlets Walls Ceils 'W)nd ooEs Floors Locks d Kitchen xdT s�:agi! ystn 1+ft a j:)!Seta t atlt ti to• `. Bathroom Ta a3��nab9xt a xo. 1r 961:ob's: ,itsorl. 1e ?ltw'.. +'° y'rr 7. • s Pantry . aye $n'T y ee,7;i s! 03 9rn.•essgm Den }j 17t111'ti •!5*, .u!'i 7 *oi R ._ (� bd .7,J.J,>.1 LbJG .Y ylui ti'-g. .. Living Room u: Bedroom 1 y ` Bedroom (2) _- - - _l- V �,$ , ' t fi z.s Bedroom (3Jvo, y� ''o. `sets Maio."na T r Bedroom (4) ofts Hot Water Faeil. b"of7'�q tSc1.•1Tem�Gasj0l iEl&dt mss `i ti'+�, ar,o37 k rtcx r'ic�ot Goa ri:x, 3o nli (ti t _ rsta�lis �IL�S� iif6'f:5iaf�tie�?:sn �� 9r?vcttr ,e '$ :.szcam 7o• sv'x3 •3 Kitchen Facilities Sink '�` N Yancctbfzcsa x noY.7'tbrtos b.tfca Y s StOV� ve , -Bathing, Toilet Facii: jk. ashh si o. nrT bK - .> s ,, P 1.1 n f Infestation _r w: �, ts3wleic R h r., t er ; "' Ili tv� Egress Dual an Obst'n; "r s at?az. General ri ser, rill rfw. rrBuild.ingandstedsf' 4 k" t»�qs•)r;.. XLockszon�lobrsn 3:yV as�tS: � S .�,y �� - t,� ONE bR 099 69 1�IaL E i w H yx 1,Y_1Mlqflklo� � 4YMP/� RT FE G O THOCCUpAE �v t o; t AUTHOR NSPECTOR: Se0: ver) b1f'THIS{IN •ECTION7REPOR W3SidN b_-ANMQERTjhED- NDERTHE�PAINS NDI) « u r 1wk PENAL ES PERJURY" �>` �Ldfil�t� 01d;b ^�''. s � Asa § •�:►s3 INSP96�F f l ' tx �.�# � j• �,f* .t Tea !/ � f.�' �.,'"� y15:15dxfsIsm : o x ins a 7 ^ AD° Fa s A. 3� s>rssCEs. i q s iso tsr` ox1 ;19�7b# t�x' A xo J ' �ti" ter DATE ,," ffr3 n]r as ," 9rf:s THE NEXT SCHEDULED REINSPECTION _ P.M. : w w � a r-..,..�4—w,. ...-p�.,^•,d�-.•yvsY""w. w.r�rr"4• •rsti....s+.� .r•o^"'Tv s'�..-•�'a—c�+ry,+ ,:r.rnt�+•'^,�� ._•� tax { '�v?!` ;x � �` ;y, '"" 3:; �.°`'3' +` + c � a •THE COMMONWEALTH OF NIASSACHUSETTS� �� r BOARD OF, HEALT.1-t� � '" .� ^.:ys�2`s6®__\\ x r '?Y C /�.`�� �r rE;} Fi i {,..•. � 'W ��4 „f, ,r.. ,"�. `� w„�f.•q ` , 1 CITY/TOWN / ., DEPARTMENT y r`.rK� �• �! ADDRESS r TELEPP HONE j Address v '! J 1 1 it z ., t"3 +' .)1t/t/°s� 4 (�ant Occu �, ..✓ •�" :.�.t "1'F f #/ �� � "�'I d J ,,�- g�s, a jt. t ,,,shy$ r.•q - Floor r Apartment N'O' ° No Occupants P y / as r t 01- v # fit Ira No. of Habitable Rooms, _ No Sleeping Rooms .. r No. dwelling or rooming units y+. No. Stones Name and address of!owner �� + <.tr � t r 1• t R 7 Remarksz, Reg Vio ai YARD Out B-I'd gs.:-Fences: Garbage and Rubbish: 4 t •. �: ... Containers:', "'Dr ainage �• Infestation Rats'or"other. :4 'ry 'STRUCTURE EXT. Steps, Stairs, Porches:- Dual E ress:-and,Obst'n.: . _ r ,,r•: ❑ B - F : ❑ M Doors,Windows' ' fa Roof ' --Gutters, Drains: ' Walls: G . r Foundation:. , t: Chimne . BASEMENT 'Gen. Sanitation: ' Dampness: ; Stairs: Lighting: ;, STRUCTURE INT. Hall, S,fairway t Obst'n. Hall, Floor,Wall, Ceiling: ; r. HaliLighting: AY > Hall Windows: z HEATING Chimneys:' " Z Central ❑ Y ❑ N Equip..Repair W ' TYPE: Stacks, Flues,Vents: . a "PLUMBING: Supply Line: 3 .MS ❑ ST 0 P a* Waste Line. ;•::m ^H.W:Tank(s)`Safet ;and Vent(s) • o ELECTRICAL '.Panels,-Meters;C}r.. ❑ 110 .❑ 220 Fusing, Grnd... ' AMP: Gen. Cond. D.istrib. Box: , o Gen: Basement:W}ring: ; . DWELLING UNIT, s`. Ventil. L'gtng: Outlets Walls ,Cells. ,Wind: Doors Floors'.:Locks1 ^Kltclten .Bathroom 1 . ,•, Y, Ex ,� ;,. .,.,.� } i of Pantry �• r }f Den * Living Room xp . 'Bedroom 1) x Bedroom (2) t 4 Bedroom (3) r Bedroom'(4) Hot Water Facil. = Sup.-Ten., Gas;Oil,xElect:: .•. ^t.• ,• r x' Stacks Flues Vents Safeties` Kitchen Facilities Sink }� ppt " ''Stoveil pp�%' 7 ? Y�Fri i dl } 1 1` s" }`R' `' - Bathing;`Toilet Facil'. Vent., Plurn`b'Sanitn:r, ` "� `"l:"' a/ ' v r,�.,•* r- zT, J 'Was h Basin, Shower or Tub: Infestation Rats, Mice, Roaches,,or;Other: t y l" "n a Egress Dual and Obst'n: General < BuddIngsPOSted: =, 3."-„__ `,' ,:?f #• /` %I 9 f.r`+ ,. ;f� '�.A,.i y.^.. l .Locks on'doors:,i= , spy it" + . ¢ ONE'OR`MORE OF THE`.VIOLATIONS CHECKED ABOVE IS AtCONDITION WHICH,' MAY MATERIALLY IMPAIR THE HEALTH OR'SAFETYfiAND,WELL BEING'OF THE', OCCUPANT. AS DETERMINED BY'105CMR 410 750 OF THE CODE`OR".THE AUTHORIZED INSPECTOR.' (See.. ver) - "THIS INSPECTION'REPORT IS:SIGNED AND CERTIFIED LUNDER THE PAINS AND } PENALTIES OF PERJURY �; n�1 E:'1�•f� 3 � � � ' Ik Y 1' '�- 1.,� Ca' � d .1 k A' F. INSPECTOR fff '+! � J� {,J..os ,}> � r" >4 4, :`' � ��- �;� 1TITLE iA!`M r * DATE ,j- /f / ` T1ME5rP nn� THE NEXT SCHEDULED REINSPECTION PS Ft- �'! s P:M , r 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 these 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 410.000 through 410.499 state minimum requirements of fitness for human habitation, any violation has the potential to fall within this category in any given situation but may not do so in every case and therefore cannot be included in this listing. Failure to include shall in no way be construed as.a determination that other violations 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 the violation(s) pursuant to 410 CMR 410.830 through 410.833 nor shall it 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) Shut-off and/or failure to restore electricity or gas. (D) Failure to supply the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253(A) , 410.253(B) and the lighting in common 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 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 an object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450 and 410.451. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (I) Failure to comply with any provisions of 105 CMR 410.600 through 410.602 which results in any accumulation of garbage, 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 lead-based paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regualtions for Lead Poisoning Prevention and Control 105 CMR 460.000. (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 dafety. (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 facilities 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 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 operable. (2) failure to provide a washbasin and a shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3) and 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, gas-fitting, 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. (N) Amy other violation of Chapter II not enumerated in 105 CMR 410.750(A) through (M) shall be deemed to be a condition 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. LOCATION SEWAGE PERMIT NO. VILLAGE h I N S T A LER'S NAME ADDRESS � D U I L D E R OR OVU ER DATE PERMIT ISSUED 7 - DATE COIr7PliANCE ISSUED0--/7 '17 -- ---- - '/ i', � .,� `�_, � r �., \ o�l� ! �� 0 m " .