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HomeMy WebLinkAbout0060 LOUIS STREET - Health 60 Louis S .309-098 Hyannis o a { j LAW OFFICES OFALBERT J..SCHULZ `VVILLIAM CHARLES PLACE 7 PARKER ROAD OSTERVIL:LE; MASSACHUSETTS 02655-2034 TELEPHONE(506)42870950 FACSIMILE(508)420-1536 ALBERT J..SCHULZ MICHAEL F.SCHULZ aschulz@schulzlawoffices.com mschulz@schulzlawoffices.com. July 16, 2009 Susan Nagl,.Esq: South Coastal Counties Legal Services, Inc. 460 West.Main Street. . Hyannis;,Massachusetts 02601 . HAND DELIVERED RE: 60 Louis Street,Apt, 4,MA 02601 Dear Attorney Nagl: I am writing on behalf of my client,.:,Centerville.Village Apartments,with respect to 60 Louis` Street, Apartment 4, Hyannis,MA 02601 (the"property"). ,On February 1,,2009, William Edwards and Belinda Andrade(the"tenants") executed a one year lease for the property. See Exhibit 1. At the time of renting the property,the tenants requested that several items be fixed. 'My client made all requested repairs. Shortly after taking occupancy, the tenants immediately failed to pay rent. On April 21,2000, a 14 Day Notice to Quit.was hand-delivered to the tenants,as well as being sent by certified mail. See Exhibit 2. After receiving the Notice for failure to pay rent, the tenants sent a letter to my client on May 1,2009,acknowledging their failure to pay April 2009 rent and.promising to pay , "asap". See Exhibit 3. To date, April rent remains'unpaid. Between May,1.5, 2009 and.May 22 2009,the tenants illegally parked their vehicle in front of the dumpster at the property. My client attempted to contact them daily to move the car but the tenants did not respond. .On May,22,2009,the tenants were further advised that their rent was in arrears and needed to be brought current., See Exhibit 4. 'Due to the tenants' complete failure to responding to my client's telephone calls,two letters were then delivered to the tenants on May 26, 2009, and June 5, 2009, stating that their vehicle must be moved from in front of the dumpster immediately as they were creating a health hazard at the property and for the other tenants. See Exhibit 5. The June 5; 2009, letter also stated that their rent remained in arrears. See Exhibit 6. . _ - ,. Y i Again,the tenants failed to pay rent on June 1, 2009, and on June 12, 2009, my client hand- delivered and sent by certified mail,a Notice to Quit for failure to pay rent. On that same date; my client received a phone call from.the Town of Barnstable Health Department informing them that a third party was at the property with"a child.: With this information,.not only were the tenants in breach of the lease agreement for not paying rent,but the tenants further breached the lease by subletting to a third party, Raveno Sullivano and her child. Due the numerous breaches of the lease and failure to respond to.my client's telephone calls and. mailings,my client prepared a Summary Process Complaint with an entry date of July 13, 2009. Coincidentally;on July 8, 2009,the tenants sent"a letter to my client stating that certain work had not been performed as requested. See Exhibit 7. :Up6n receipt of the letter on July 9, a call was placed to the tenants stating that although the requested work had never been mentioned before, my client was willing to fix it. An appointment was made for,July 10, 2009,to fix the listed items. Upon speaking with a representative atthe.Town of Barnstable Health Department, it was learned,that someone had requested the Health Department re-inspect the property on July 10, 2009. Not surprisingly, on July.10, 2009, my client received a call from the tenants stating that no one would be home, and rescheduled for Monday, July 13,2009. Interestingly,the tenants were there to let the Health Inspector in on July 10,2009. On July 11, 2009, the.tenants called again to say that.Monday, July 13,2009,would not work to fix the requested items as no one would be home. On July 13, 2009, my client set up an appointment for July 14,2009, at 3 30 p.m.,to fix the requested items. When my client arrived on July 14, 2009,no one.answered the door. A call,was placed to the tenants on July 14, 2009, and'a message was left indicating that someone would be at the property at 10:00 a.m. the next day to fix the items. When my client arrived at the property on July 15,2009 at 10:00 a.m.;the tenants:were present and informed my client,without opening the door, that they would not be. 'permitted to enter. The tenants' actions are untenable. :1 suggest you contact your"client-to discuss the above." I look forward to hearing from you,at your convenience. Very Truly Yours, rhael F. Sc "ulz FS/law:: ICI _ .` -.. . ,. . .. ..' -. _. ' HOSTETTER REALTY PAGE .02 THIS IS A LEGALLY BINDING CONTRACT. IF.NOT UNDERSTOOD,SEEK COMPETENT ADVICE. CAFE COD & ISLANDS ASSOCIATION OF.RLALTOR.S,®INC AEALTOIi° :Lease' Lease)made this let dayof IrebruSTY 200.9_1 By •---Cen.teirvill-a-Vil.],.atge Apartmantt's of_7'701Ul . KntA litro#P, 09-t oXville. NA 02.655, (address) hereinafter called LANDLORD And tea.. Ederards_,k.�el3nd�►_A►x�d.xa�de' of_ herinafler called TENANT. Witnesseth,That the LANDLORD above hereby leases to the TENANT above,the premises located at ARta e,:_! . :60.:hauie $txA9t ;Hyjk ? i ;"Massachusetts (Street Address Hnd Town) COgsisting of(Describe real and personal property) 2 bedroom apartment The term of this]case shall be . ...: ___12 months.:: commencing at trio.Aght _,_. on -2 009 and ending at on _944-44rY..- 3113t. 2.0.10.. . And for such term,the TENANT agrees to pay$: 7 0,;800 0 0, __ _ Said rent shall be payablq in installments of$ __ q O.,,O Q . on the l st,-• _„ day of every month,in advance, so long as this lease is in force and effect. During the lease term,the following charges shall be paid by the LANDLORD or TENANT as checked: L.ANDLOIt.I) TEENANT A. Oil B, Gas C. Electricity ( ) ( ) D. Real Estate Taxes { ) { ) E_ Water : ( x: F. Water Ovet4ges ( x G.Telephone ( ) ( x) H.Trash Removal 1. Lawn Maintenance ( ) ( ) J. Snow Removal ( ) ( ) K. Cable T.V. { ) ( ) L. Condominium Common Area Charges ( ) ( ) The LANDLORD hereby acknowledges receipt from the TENANT$. . 9 0..0. __ as payment of the first month's rent,and the LANDLORD hereby acknowledges receipt from the TENANT$ . __ 9-QQ_ :.. as payment of the last Month's rent(calculated at the same rate as the first month's rent). The TENANT hereby acknowledges receipt of a written Last Month's Rent Receipt with reference to said Iasi month's rent M required by law. And for the heretofore described terra,the TENANT furthcr agrees to pay$ _, 0 (an amount not to exceed one month's rent)as a Security deposit,receipt of which the 1ANDLORD hereby acknowledges;it being understood that said security deposit is not to be construed prepaid:rent,but not shall any damages claimed(if any)be limited(4)the amount,of said security deposit. Said security deposit shall be deposited in escrow as required by law. The TENANT hereby acknowledges receipt of a written statement of conditions with reference to said security deposit as required by law,which statement must be returned to the LANDLORD or his agent within fiflccn days of commencement of tcriartcy. The LANDLORD hereby notifies the TENANT that.'. zl. C. Hoa.tatter .. --Dan.i - .. (name) Of 7701@1. Main Streket,. Oatervillee MA. 02655..... .(Wev,and mailing addrem) is the person who is responsible for the care,maintenance and repair of the heretofore described property. The LANDLORD hereby notifies the TENANT that; . . Laridl.ard nano) Is the person authorized to receive notices of violations of law and to accept service of nroi:45 on behalf of the OWNER. (next page) cv 1.0 This form wAs.OVOOrs4 by DANISL RosTATTall 146"g *.-FORMS. a-tORxs is copyright proteote4 ,We wy not be used by any ether party. - ' HOSTETTER REALTY PAGE 03 Aoy termination under this section shall be., C) without prejudice to any remedies of the LANDLORD which might.otl►erwise be used for[arrears of rent use and occupancy or other breach of any of the said terms,conditions,covenants,obligations or agreements;or. D) without prejudice to any remedies of the TENANT which might.otherwise be authorized and/or required by the applicable laws and Regulations of the Commonwealth of Massachusetts. E) but nothing herein shall be construed as the application of interest or a penalty for the'TENANT'S failure to pay rent until thirty (30)days after such rent shall have been due 14.That the parties agree that in case of any termination of this lease by reason of the default of theTENANT,then at the option of the LANDLORD: A)the T LNANT will forthwith pay to the LANDLORD as damages hereunder'a sum equal to the amount by which the rent and other payments called for hereunder for the remainder of the term. B)the TENANT will furthermore indemnify the LANDL OPD from and against any,loss and damage sustained by reason of any termination caused by die default of,or the breach by,the TENANT. LANDLORD'S damages hereunder shall include,but shall not be limited to, any loss of rents,accrued by unpaid prior to termination;reasonable broker's commission for the rc-letting of the leased premises; advertising costs,the reasonable costs incurred in cleaning and repainting the premises in order to the same;moving and storage. . charges incurred by LANDLORD in moving TENANT'S belOitgings pursu ant to eviction proceedings;legal costs and reasonable attortey's fees incurred by the LANDLORD in collecting any damages hereunder or in obtaining possession of the teased premises by suminary process or otherwise,and to any and all other remedies provided by law. C)the 1.ANDL,ORD may remove the TENANT'S goods or effccks pursuant to a Court Order and the LANDLORD shall not be liable or respota5ible for any loss(rf or damage to TENANT'S ggoods or effects and the LANDLORD'S act of so removing such goods or effects shall be deemed to be the act of and for the account of'TENANT,provided,however,that if the LANDLORD removes the TENANT'S ' goods or effects,he shall comply with all applicable laws,and shall exercise due care in the handling of such goods to the fullest practical extent under the circumstances. 15,That no animals,birds,or pets of any deseription shall be kept in or upon the Leased premises without the LANDLORD'S written consent; and consent so given may be revoked at any time. . . 16.That no surrender or acceptance of surrender of the leased premises shall he valid,unless`so stipulated in writing by the LANDLORD. 17.That the TENANT shall not assign or sublet or permit the leased property or any part thereof to be used by others(except the TENANT named herein,the TENANT'S spouse,children,or guests-fir temporary visits),without the prior written consent of the LANDLORD in each instance. 1f this lease is assigried;or if the leased proppeerty or any part thereof is sublet,or occupied by anyone other than the TIrNANf,the - LANDLORD may,after default by the'1'bNANT,collect rent from the assignee,subtenant or occupant and, the net amount collected to the rent herein reserved. No such assignment,subletting,occupancy,or collection shall be deemed a waiver of this covenant,or the acceptance of the' assignee,subtenant,or occupant as TENANT,or a release of the TENANT from further performance,by the TENANT of the covenants"of this lease. The consent by the LANDLORD to an assignment or subletting shall not be construed to relieve the TENANT from obtaining the consent to writing of the'LANDLORD to any further assignment or subletting. 18.That the waiver of one breach of any term,condition,covenant,obligation,or agreement of this lease shall not be considered to be a waiver of that or any other term,condition,covenant,obligation,or agreement or of any subsequent breach thereof. 19.That if any provision of this lease or portion of such provision or the application.thereof to any person or circumstance is held invalid,the remainder of the lease(or the remainder of such provision)and the application thereof to other persons or circumstances shall not be affected thereby. 20.That the LANDLORD.acknowledges that provisions of applicable law.foibid it LANDLORD from threatening to take or taking reprisals against toy TENANT for seeking to assert his legal rights. 21.'LEAD PAINT: Whenever a child or children under six years of age resides in any.residential premises in which any paint,plaster or other accessible materials contain dangerous levels of lead as defined pursuant to section one hundred and ninety-four,the owner shall remove or cover said paint,plaster or other material so as to make it inaccessible to children under six years of ago,with the provisions of Massachusetts General Laws,Chapter M,Section 197, 22.UREA FORMALDEHYDE INSULATION-UFFI:A LANDLORD of a residential dwelling containing UFF1 shall disclose or cause to be disclosed to all prospective tenants and to all existing tenants the presence of UF'FI in the dwelling_ In the case of a prospective TENANT,a LANDLORD aware of the presence of UFIa l in the dwelling shall make the disclosure before entering into a lease or rental agreement with the TENANT. The disclosure shall be made in writing,'and shall be in the form of the disclosure set forth,in 105 CMR 651.011(3)or as amended and shall be signed by the LANDLORD or its agent as well as by the prospective or existing TENANT. The LANDLORD shall keep a copy or a second original of the signed disclosure as proof of its delivery to the prospective or existing TENANT_ As part of the disclosure,the LANDLORD shall also deliver or cause to be delivered to-the prospective TENANT or existing TENANT at the time of the disclosure the current UF'FI lnforniation Shect developed by and available at the Department:' 23.That the LANDLORD agrees to pay a BROKIEIR'$fee of.. ;.u/aa %of the total rental hereof to upon receipt of the. _ _ rental payment for this lease from the TENANT. OPTIONAL PROVISIONS(Complete or delete if not applicable): 24:That LANDLORa agrees to pay a broker's fee of: - _ n/ %of the total rental on any subsequent rentals of the reel to p to the TENANT,upon receipt of the rental payment from any subsequent rental to the TENANT. 25:In the event of a subsequent sale of the premises to die'TENANT by the LANDLORD during the term of the tenancy or within _ days after the expiration of the tenancy,a BROKER'S fee shall be paid by the LANDLORD based' upon an amount of fee to be reasonably agreed upon between the BROKER and the LANDLORD,but such TENANT/BUYER shall be held harmless as to any dispute and/or litigation between the BROKER and the LANDLORD as to the determination of said.fee. (Sheet 2) Th}0 faizi *.w 0CeRtad by DMILIHOSTETTEIt Uting a-eoms. s->roxxg iY eopyripht praaootod and hey not be Used by say oth.X party. HOSTETTER REALTY PAGE 04 26.Additional Provisions: .Tenanto affit;lume responsibility: for terms at this ,Lease jointly and severally., iN WITNESS WHEREOF,the said parties hereunto set their hands and se n the day a,,,d year firs above)�pn n. LANDLORDS TENANT BROKER The TENANT hereby acknowledges the receipt of all executed copy of this lease from the LANDLORD on , which is within thirty(30)days of the signing of this document by said TENANT TENANT RENT RECEIPT TO: will.i..tttsa: Edwardo A_> elinda. AndraIe RE: Apt.-4.,-._60. Louis_Rtreet, JLIMAO - - - --- -- (Address) (Descrip(ion of I eased premises) l/WC hereby acl.nowledge receipt of knee following.on this '. -let. '°f g'sbruazy_ _ 0 d 9 I, First Month's Rent $ - 9-00.00 2. Last Month's Rent $, .9-110 0 0 LAST MONTH'S RENT Any Landlord or his agent wl' receives,at or prior to the commencement of a tenaricy,rent in advancm for the lest month of tlic tenancy from a tenant or prospective tenant shall give to such tenant or prospective tenant at the tittle of such"advance payinent a receipt indicating the amount of such rent,the date on which it was received,its intended application as rent for the last month of tenancy,the name of the person receiving it and,in the case of an agent,the name of the Landlord for whom the tout is received,and a description ofthe rented or lensed premises,and a statement indicating that the tenant is entitled to interest on. said rent payment at the rate of five percent per year or other such.teaser amount of interest as has been received from the bank where the deposit ttaa been held or in accordance with M.G,L,Ch.186 Section 15B as may be further amended,payable in accordance with the provisions of this clause,and a statorricnt indicating that the tenant should provide the Landlord with a forwarduig address at the terrnination'of the tenancy indicating where such interest may be given or sent.. Any Landlord or his agent who receives said rent in advance for the last month of tenancy shall,beginning with the first day.of tenancy,pay interest at the rate of five percent per year or other such lesser.amount of interest as has been received fromthe bank where the deposit has.been held or in accordance with M,G,L. ii Ch.186 Section 15B as may be furtber emended: Such interest shall be paid over to the tenant each.year as provided in this clause;provided,however,that in the event that the tenancy is terminated before the anniversary date of such tenancy,the tenant shall receive all accrued interest within thirty days of such termination. )ntercat shall fiat accrue for the Isar month for which root was paid in advance. At the cud of each year of tenancy,such Landlord shall give or send to the tenant from whom rent in advance wad collected a statement which shall indicate the attiount payable by such Landlord to the tenant 'rho Landlord shall at u the sense time give or send to such tenant the interest which is due or shall notify the tenant that he story deduct the interest from site rteM rental payment of such taoeut. If, . i rice to deduct interest from the next renta l 'v d id interest due of said notice the c e tenant has not received said alder thirty days trom the ottd of each yuat'of the tenancy,the n payment,the tenant may deduct from his next rent.paymout the interest due. If the Landlord Mils to pay any interest to which the tenant is-then entitled within thirty days after the termination of the tenancy,the tenant upon proof of the sarue in err action against the Landlord shall be awarded damages in an amount equal to three tirnes the amount of interest to which the tenant is eatiticd,together' with court costs and reasonable attorneys fees: If the Landlord transfers_his interest in the dwelling unit,any advance rents received hereunder are to be handled.in aecordance.with Massamhiwctts General - Laws C.196 sec. 15.B(7A). LAN1 09D LANDLORD'S AGENT. Tenant hereby a wowledges receiving a copy of the within relit receipt. Dated: )Receipt .� (tenant). itEv 1/1/93. tos This form was created by DhDRRL rigaxBTraa usirrit •-90Rtra. a-roar® it Copyripbt protaoted dAdl ayy not be vrid by any other yentsy. HOSTETTER REALTY PAGE 05 Tenant Lead Law Notification What lead paint.forms must owners of rental units give to tenants? All tenants who live in units built before 1978 must be given two copies of this Tenant Lead Law Notification and Tenant Certification Form (other side)_If any of the following documents exist for the unit,tenants must also be given a copy of them-dead inspection or risk assessment report,letter of Compliance, or Letter of Interim Control. When do owners have to give tenants these forms? New tenants must be gircrt the forms before entering th rcriml agreement,beginning September 1, 1995. : Current tcnynls mast be giventhc foEms during.the one year.period starting December 1, 1995 at the time of lease rcliewal,or if there is no lease,any time during the year, but no later than December 1, 1996. What is lead poisoning, and how do'children become lead poisoned? - Lc.,i poisoning is x disease.I-cad can rtiakc children,cspccially chose under six years old,r•cr},sick and can cause Learning and bchavior problems. Lead i5 often found in paint on the inside and outside of homcs.The main way.a child can get le,:1 poisoned is from swallo-ing lead paint dust and.chips. A child can also gcc lead from other sources,such as soil and MR[Cr, but these rarely cause lead poisoning by themsich•es,The only Nvay to tell for sure that a child is lead poisoned is to ' linve his or her blood tested. Your doctor,ocher hcalth•care providcr, or Board of Health can do this.A lead poisoned child will"need medical care. A home with lead paint.must be deleaded for a lead poisoned child to get,well. What can you do to prevent lead poisoning?.. Talk to your child's doctor about lead. : •c your child testcd.fo;lead at least once a year until he/shc is four years old. • Ask the owner if your home has been deleaded or call-rhe state Childhood Lead Poisoning Prevention Program (CLPPP) at 1-800=53279571; o:your local Board of Health. Tell the owner if'you have a new baby,or if a stets•child under six years old lines with you. • if your home xvas deleaded, but has peeling paint; tell.and write the owner. If lie/she dues not respond,call C.LPPP or your local Hoard of Health. If your home has not been deleaded,you can do sock, things to reduce temporarily the chances of your child 1.1ecoming lead poisoned. You can clean your home regularly to"wipc up dust and loose paint chips.Use a cleaner. called TSP or an automatic dishwasher detergent high,in p}losphate, or other cleaners made just for cleaning lead dust and chips.The areas to clean most often are v.,indow tc'ells;sills, and floors. wash your child's hands often (particularl) before catino or sleeping)nnj wash your child's toys. 1' member, the only way to permanently lower the risk of your child tctrina lead poisoned is'to ha,�c your home deleaded if it contains lead paint. What does the Lead Law require the owner of your home to do if a child under six years old lives there? An owner of a home bLlilt before 1978 mus;hate thc,home inspcctcd for lead if a child under six years old lives there If lead ha:ar.{s arc found, it must be d^leaded or brought under interini Control. A licensed deleader has to do all removal of all other high•risl:Work.The o:�'nc, o:someone who i�'ocl for him who is not a licensed deleadtr can le<laed 1»int, and , do <erta:r.la,t•risk`ddeadtng 29.E in-erim control work; After the work is done,'thc lead inspector or risk assessor issues a LCitCf Cf ComplianLc or Letter of Interim Control. The ci-xne, must malrc sure there is no peeling pain;anytime after gcuitw a Lace;of Cornpli nce o. Letter of Imcrim Contral. What is Letter of Compliance I:ai p�„u 1,.._a:�ls o tha: the ho nc has been deleaded.The letter is What is a Letter of Interim Control? It is a le�,tl letter th7t says the r:o:k necessary to mklc the hon1e ten:po:arit} Szle froa� lear3 1,azards has been Cone_ or e ye a: but can he renewed d for one m The I-trcr is signc.-I and dated by a liccnsed lead risk assessor. It i; aged for one year, The ow cr mu_i fully&dead the herb'and get a Letter of.Cou pljance before the end of the second year. w - -._ •:x + HOSTETTER REALTY PAGE 06 Tenan't Certif icatiot Form ' Required Federal Lead Warning Statement: Housing built before 1978 may contain lead•based.paint.Lead from paint,paint chips,and dust can pose health ha ands if not m properly.Lead exposure is especially harmful to young children and pregnant women.Before renting pre-1978 housing,lessors i , disclose the presence of kno�q lead-based paint and/or lead-based paint hazards in the dwelling.Lessees must also receive a fedem approved pamphlet on lead poisoning pres entior.The Massachusetts Tenant Lead Law Notification and Certification Form approved for federal compliance: Owner's Disclosure:.. (a) presence of load-based Paint and/or lead•based'paint hazards(chccl: (i)or(ii)belo%%,): W Known IcaJ-bascd paint and/or lcad•bascd paint hazards arc present in t}ic housing(explain). Owncr/Lessor has no knowledge of icad-based paint and/or lead•bascd point haaards in the housing: (b)ltceordf itnd reports a�'silable to the oWn.er/icssor(Cheek,(i)or(ii) below): {,) _Owner/Lessor has Pro%,ided the tenant with all available records and reports pertaining to lead-based paint and/or lead•based paint hazards in tlic housing(circle documents below). i Lead lnspcction Report Risk Assessment Report Letter of Intecim Control Letter of Compliance (ii).,.,,.^0wrier/1•CSsor has no reports or records pertaining to iead•bascd paint and,ror lead-based paint haiards.in the housing a - Tenant's Acknowledgment(initial)" (c) �cnont has recci�•cd copics.of all documents circled nbot e."(d) Tenant received no documents listed above (e) . ✓lcnanr has reccived the ldassachuseu l'c sriant Lead Law?:oti6cation. Agent's Acknowledgment(initial) (f) Agent has informed the own ur/lessor of the owner's/lcs.sor's obligations under 42 U,S.C.485.2d'and is aware of his/her >. responsibility to ensure compliance. - Certification of Accuracy The following parties have tcvictvCd the information above and cc`rtify, to the best of their knowledge,that.the information the provi is true and ac uratc ' «nc r/Lessor Date Qu ner/Lcssor Da t Tenant Dot Tenant Dab " �atc . Agent fit' Apcnt _ Owner/Managing Agent Information for.Tenant (Please Print): Apr. Name... Street Telephone Number Ctt)'/Tow n Zip . t' I (oa`rier;r^anaeing agent)certify thae I prov idcd the Tenon,Lea I Lau Notification,t Tenant Cectification Fo m and any eN Lea L?'..,dJ u^.c:.S tJ tit^- Ir 73�:.��t L�". ter.1,1:rcruSt1j (0 S,n[gilts CCt6 %Ga.10n. Ths the (alto Vin rca•on The t�:a_iJ,}l ::ai Lead Lit'• 1 r0iliti„yenta!ct3znRtin].iJ r lelu i:n� re,`usin-tore nt to(3milles t ith children or evicting tarn ch liven because of Conta,r the Childhood Lead Poisoning Prctiencicn ['rognm fo. info:r a:ion on the availability of rhis form in oth rlanguages. e Titc Ntassachusccts Depottm^.ntclPublic Health's Childhood Lead I'oning Prevention program(CLP P)has additional infor on, full range of topics relate3 io lrad poisoning prc%-ention, tenants an3 owners rights and responsibiliucs under she Lead Law )tiegula;ions: financial assistance fo.o++ncrs,and Safe dcicadtng and rend-anon work.CLPtP can be reached at 1 S�53L9�71; !tore information is also;lvaibble frogs your lac;il lea:{poisoning pcvcntion program,or your local Board oft(e�hli. Tenant and owner must each keep a completed and signed copy of this form. • ^ _r.r. �`� 'p°--� '•_�Z ___ r- "sue'��<or;-x Y v_� ' �y�`;�i .�`.s::ir� R.r.�l')6-. .-� �^,zet , Tw!=r-�.�:-- _._� �'a.�Jr2,�7�ti•�� .. .. EXHIBIT 2 HOSTETTER REALTY PAGE 02 CENTERVILLE VILLAGE .APARTMENTS 770 BW1 Main Street Osterville, MA 02655 Date: April 21, 2009 To:. William Edwards, Belinda Andrade and all other John Does Premises: Apt. , 601 ouis Street, Hyannis, MA Your rent being in arrears, you are hereby notified to quit and deliver up in- fou.rteen 1.4 days-from recci t of this notice the above described premises. p If you fail to so vacate, I`shall.employ the due course of;law to evict you. J dy cAbee, Agent PROOF OF DELIVERY 1, the undersigned, ;state that:I. have delivered this notice to the.above named tenant(s): - by delivering it in hand to X) by leaving a copy at the premises at ( X ) hy.mailing a,copy of the same by.return receipt requested. - 4Ly Abee, Agent EXHIBIT 3 HOSTETTER REALTY. PAGE 03 WV\o At cc'o Curl -` r c1(LQA /lam. (fit : 111 L '54 1 , 'nn Vl m� ifs h ; CA) C�joi11(�i EXHIBIT 4 HOSTETTER REALTY PAGE 04 CENTERVILLE VILLAGE APARTMENTS 770 Main Street Osteirville, MA 02655 Phone:` (508)428-2828 -Fax: (508)428-1974 NOTICE OF RENT PAYMENT A:RREA.RAGE` Date: May 22, 2009 Property: #i4, 60 Louis Street, Hyannis, MA 02601 Occicpant(s): Willi= .Edwards, ,Belinda Andrade and all other John Does Please be advised that as of this date, your resit is in arrears. Your current arrearage is $1,300-M. Please accept this reminder and I-eii)it aniount due ln1mediately to avoid_ legal intel-ventioti. Thank' I r � __— -- .w:.iA.irk:.'.ICe•t3�IFt1_.^'^^.Y"`'�r::.�. - .......-..:_. EXHIBIT 5 HOSTETTER REALTY PAGE .05 CENTERVILLE VILLAGE APARTMENTS 77091 Main Street Osterville, MA 02655 Tell (.508)428-2828 - Fax; (508)428-1974 i May 26, 2009 To- .William 1,dwards, 13c1inda Andrade and x11 other John Does From: Centerville Village Apartments We have tried to contact you for over a week. You do not answer your phone, return our, messages or open your door. The vehicle you have parked in front of the dumpster prevents.it5 being emptied. It must.be moved IMMEE'DIAT1ELY. The debris collecting in and around the dumpster creates not only rtn eyescire but also a serious health hazard- 'thank you: EXHIBIT 6 HOSTETTER REALTY PAGE 06 CEN:f.E)nVILLI VILLAGE APARTMENTS 170$1 Main Street Osterville; MA 02655 Tel: (508)428-2828 -fiix: (508)428-1974 June 5, 2009 1.'0: William F,Aftrds, Belinda Andrade and all other)ohn Doe' s From: CcrticrvillcVilla�eA.partmcnts ; As you know, parking in front 0f the di rnpster caused problems in the last weeks', Again, you are parked there. This is a violation: Your'car mast be moved IMMI I)IA'1'L;1,Y: Failure to do so will result in towing at your expense. In addition,your rent is.in arrears. Ixgyal intervention will be forthcoming if payment is not made upon receipt of this reminder. 11 hank you. EXHIBIT 7 HOSTETTER REALTY PAGE 09 . vN ,_. fill _ t S Ck a y ..��� C MA Vie. c�0 6XZ5 U-)'i ell OL Joo 1 t s A�- n �lx . 1 - mLLA bcAAZ -t�t �� ex � cke • HOSTETTER REALTY PAGE 10 J C"9- c - �- ti►-� G; - _ PamAq �ws YOU 'WISH TO OPEN A BUSINESS. I For Your Information:. Business certificates (cost$30.00 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.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 [Town Hall) DATE: I' n A 1Z C o N�eS Fill in please: Lfl A. /_l + I IF `� " V,0 APPLICANT'S YOUR NAME: `\ fl BUSINESS Y R HOME ADDRE S: A TELEPHONE # Home Velephone Number NAME OF NEWBUSINESS TYPE OF BUSINESS IS THIS A HOME OCCUPATIO _1 YES O �oU 1 [� m` Have you been given appro al fr m;the building iwsion� YES NO ADDRESS OF BUSINESS MAP%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 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 CO� NER'S OFFICE This individual h e :r"40 ed f ny permit--requirements that pertain to this type of business. �\ Authorized S1jRKture* O MMENTS-1k) t o 2. BOARD OIAHUEALTH This individual has bin informed of the ermit requ ments that pertain to this type of business. '� thorize Sign ture**a COMMENTS: i C s 3, CON UMER AFFAIRS (LICE SING AUTHOR TY) This individual ha , en iinnfo ed of the eq i k uirements that pertain to this type of business. Authorized Signature** COMMENTS: A 4 , 12-0 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 town.(which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1 FL., 367 Main Street, Hyannis, MA 02601 [Town Hall) DATE: I' Fill in please: APPLICANT'S YOUR NAME: l` A L b A RA R CO A OS BUSINESS Y R HOME ADDRE S: 4 CDR M' TELEPHONE # Home Telephone Number NAME OF NEW BUSINESS' TYPE OF BUSINESS IS THIS A HOME. CCUPATIO _YES O f Have you been:given appro;al fr m the buildin ivis�on� YES NO A©DRESS OF BUSINESS a MAPjPARCEL N...UMBER O 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 busiEci s. Authorized Signature �l " 'COM fJ,/ 2. BOARD OF HEALTH �D �J This individual has been informed of the-germit requAments that pertain to this type of business. thorize Sign ture** - COMMENTS: � -�o 3. CON UM ER AFFAIRS [LICENSING AUTHOR TY) This individual ha n infollned of the jiin, quirements that pertain to this type of business. Authorized Signature** COMMENTS: Co , >� • � /�� /l�J�-(/ TOWN OF BARNSTABLE Date: TOXIC AND� HAZARD S MATE LS ON-SITE INVENTORY NAME OF BUSINESS: �pU L-.ot(is S> cJJ"" BUSINESS LOCATION: INVENTORY MAILING ADDRESS: TOTAL AMOUNT: TELEPHONE NUMBER: ©'07I CONTACT PERSON: C;6A�DES sA ���Sit� EMERGENCY CONT TE EP QNE NU B R- MSDS ON SITE? TYPE OF BUSINESS: INFORMATION/@ ECO MENDATI S Fire Dist t: eU -r 1 s 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 O Engine and radiator flushes Road Salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ,k,,-' 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 Pai s, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (inc. carbon tetrachloride) .1/ 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 QMetal polishes may be toxic or hazardous (please list): Laundry soil & stain removers -to- Mu W1W)N-Wf) (including bleach) Spot removers & cleaning fluids (dry cleaners) Other cleaning solvents - Bug and tar removers /p ' Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS l� (� Y' U 0ASH TO OPEN A BUSINESS? For Your Information: Business certificates(cost 30. ars . A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L. - it does not give you permission to op ate.) Business Certificates are available at the Town Clerk's Office, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: A Fill in please: APPLICANT'S YOUR AME: N BUSINESS UR OME A RESS: a Mal Igo TELEPHONE # Ho a Telephone Number S NAME OF NEW BUSINESS E S TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES',-,-< NO.': e rov vis` YM_ADDRESS OF BUSINESS C, MAP/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 200 Main St.-(corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate-yotir business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any'permit require ments that pertain to this type of business. Authorized Signature" COMMENTS: 2. BOARD OF HEALTH This individual has n infor o e p qu ents that pertain to this type of business. orized Signatur " t c COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requ rements that pertain to this type of business. Authorized Signature" COMMENTS: y.. Date: � 1 � TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM l NAMEOFBUSINESS: BUSINESS LOCATION: 1 S MAILINGADDRESS: Mail To: TELEPHONE NUMBER: Board of Health 1 1 Town of Barnstable C0NTACTPERS0N,: "+zC ,° P.O. Box 534 EMERGENCY CONTACT T�LEPHON NUMBER: Hyannis, MA 02601 TYPE OF BUSINESS: Does your firm store any of the toxic 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. Y- If you answer d YES above, please indicate if the materials are stored at a site other than your mailing address: `1 ADDRE$ C�O � 1. S Q ► '�� TELEPHONE 1 LIST OF TOXIC AND HAZARDOUS MATERIALS J 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 A. ��` Quantity Quantity 1 Antifreeze(for gasoline or coolant systems) G Drain cleaners NEW USED Cesspool cleaners �f Automatic transmission fluid Disinfectants y' 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 i Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) Swimming pool chlorine C) Rustproofers Lye or caustic soda t\, Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes ri Asphalt & roofing tar .. Fertilizers TPaints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) t,I Paint& varnish removers, deglossers An other products with "poison" labels • _ y p poison �( � Paint brush cleaners (including chloroform, formaldehyde, CJ Floor& furniture strippers hydrochloric acid, other acids) � Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): Spot removers & cleaning fluids (dry cleaners) t Other cleaning solvents - v' Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS oFtHE r Town of Barnstable Regulatory Services * BARNSPABLE, Thomas F.Geiler,Director y MASS. i639' Public Health Division iOlFp�.�A Thomas McKean,Director p 200 Main Street, Hyannis;MA 02601 •�'� Office: 508-862-4644 0 Fax: 508-790-6304 , June 12, 2009 Daniel Hostetter 7> 770A Main Street Osterville, MA 02655 A lead paint determination was conducted at the home or apartment you own at 60 Louis Street Apt#4, Hyannis, MA. This determination was conducted by Timothy B. O'Connell, R.S., The determination found lead paint in violation of the Lead Law, Massachusetts General Laws, chapter 111, section 197, and the Massachusetts Department of Public Health's (DPH's) Lead Poisoning Prevention and Control Regulations, 105 Code of Massachusetts Regulations (CMR) 460.000. The law requires owners of homes or apartments built before 1978 to have lead paint violations deleaded for full compliance or brought under interim control when a child under six years old lives there. A private risk assessor has to do a risk assessment and give you a lead inspection/risk assessment report before you can go ahead with interim control. A private lead inspector has to do a comprehensive lead inspection and give you a lead inspection report before you can go ahead with deleading for full compliance. If you already have a Letter of Compliance for this property, please complete the last page of the Order to Correct and send it to me within 14 days. The Order that comes with this letter has important information telling you: • what you have to do what deadlines to meet • what documents you have to send to this agency • who can do the necessary work a what the penalties are for not meeting the Order's requirements • what your options are if the property has been previously deleaded. Please call meat this office at (508) 862-4646 as soon as possible to discuss this Order and how to meet it: The following information explains the deleading process, if the property has not been deleaded previously. Hiring a Lead Inspector To help you take the first step—getting a full inspection or risk assessment—a list of lead inspectors is enclosed: We recommend that you check references and make sure that the inspector is still licensed. You can check on the license by calling the state Department of Public BOH Cover Revised 1-05 Page I of 3 Health's Childhood Lead Poisoning Prevention Program (CLPPP) before hiring an inspector. To get a list of risk assessors for interim.control, call CLPPP's central office at 1-800-532-9571. You can also get other helpful materials from CLPPP, including brochures explaining the choices of full compliance deleading and interim control. Again, you can get these by calling CLPPP at the number above or by checking our website, at www.state.ma.us/dph/clppp. Requirements for Doing Deleadik Work High-risk deleading: If you need to or choose to have high-risk deleading work done, such as having lead paint stripped or scraped, you have to hire a deleading contractor. A list of deleading contractors is also enclosed. Just as in the case of inspectors, we recommend you check references and make sure that the deleader is still licensed. You can check on the license by calling the state Division of Occupational Safety,(DOS) at 1-800-425-0004. Moderate-risk deleading: Before you or.your agent can do moderate-risk deleading work, such as removing windows and woodwork, you have to take a course, pass it and get an authorization number from CLPPP. These courses are given by a number of groups and organizations at various places,times and prices. For a list of approved moderate risk training providers, call CLPPP at 1-800-532-9571 or check our website (address above). Remember that you still have to meet the deadlines in the Order. If a course for owners to do moderate-risk deleading is not available at a convenient time or place for you`to meet the deadlines of this Order, you won't be able to do moderate-risk deleading work yourself. You.then have to use other methods to delead, or hire a licensed lead-safe renovation contractor. To get a list of these contractors, or to check their licenses, call DOS at 1-800-425-0004'. Low-risk deleading: Before you or your agent can do only low-risk deleading work, such as covering surfaces, you have to readthe CLPPP low-risk booklet, take a self-corrected exam that you send in to CLPPP, and get an authorization number from CLPPP. If you.want to encapsulate, you must first have a full lead inspection done on the property and then contact CLPPP to go over your inspection report and discuss surfaces that may be good for encapsulation. If encapsulation is a suitable option, you have to read CLPPP's encapsulation booklet, take a self- corrected exam that you send in to CLPPP, and get an authorization number from CLPPP. To get . a free copy of the low-risk booklet, or.ihe encapsulation training.handbook, call CLPPP at 1-800- 532-9571. Interim control work: If you or your agent will be doing other work for interim control, such as structural repairs and cleaning of leaded dust, you have to take safety steps and clean up in the way described in the CLPPP booklet for interim control..To get a copy of this interim control booklet, call CLPPP at the above number: Deleading work has to be carefully done to be safe. To protect the people who live in the home or apartment,you have to,keep them out of the home or apartment, or area being worked on, in these ways: e All people and pets have to be temporarily moved from the home or apartment for the whole time that high- or moderate-risk deleading work is taking place inside the home or apartment. You have to provide the residents with a reasonable alternative place to live for this period. People and pets who have been temporarily moved from their home or apartment can only come back after a licensed private lead inspector or licensed private risk assessor says it is safe for them to return. The inspector or risk assessor does this after reinspecting the home,. BOH Cover Revised 1-05 Page 2of3 including taking dust samples to assure that lead dust levels meet approved standards. This reinspection will be done at least three hours after deleading work is all done. • People and pets have to stay out of the work area while you or your agent does most low-risk deleading work or structural repairs or cleaning of lead dust. They also have to stay out of the work area while there's any deleading work in common areas outside the home or apartment, as long as they have another regular way(not a fire escape) to go in and out of the building. In these cases, people and pets can use the area once the work is done in the area and cleaned up. • People and.pets have to stay out of the home or apartment for the workday while you or your agent apply encapsulants with an airless sprayer. They also have to stay out for the day during deleading in common areas when they do not have another regular way(not a fire escape) to go in and out of the building. When people and pets are out of their home or apartment for the day, it means they can come back to the home or apartment after cleanup at the end of the workday, and don't have to be out overnight: All work for deleading and interim control has to be neatly and properly done, in a professional way, and the home or apartment has to be returned to a.condition that meets the requirements of the State Sanitary Code. Deleaded surfaces cannot be repainted until after they have passed reinspection by a licensed private lead inspector or risk assessor. You have to give written notice about common area.lead paint violations to all other residents of the building. "Notice to Tenants of Lead Paint Hazards" is enclosed for that purpose. You also have to send a copy of the lead inspection report or lead inspection/risk assessment report and any reinspection reports to all mortgagees and lienholders of record. If your property has been previously deleaded, you maybe eligible for a 30-day maintenance period. Please fill out the last page of the Order to Correct and return it to me within 14 days to take advantage of this option. If you have questions about the Department of Public Health's Lead Poisoning Prevention and Control Regulations, you can ask me, or call the CLPPP central office (1-800-532-9571 or 617- 284-8400). If you have questions about the Division of Occupational Safety's (DOS) Deleading Regulations, call the DOS central office (1-800-425-0004 or 617-727-7047). Remember to refer to the at Order for more information about what you have to do. PER R OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable BOH Cover Revised 1-05 Page 3 of 3 F oF1HE r Town of Barnstable Regulatory Services BARNSTABLE, Thomas F.Geiler,Director �$AlE1639. MASS. A Public Health Division Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 June 12, 2009 Daniel Hostetter 770A Main Street Osterville, MA 02655 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 60 Louis Street Apt. 4, Hyannis was inspected on June 12, 2009 by Timothy O'Connell, R.S., Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of a complaint. Be advised that certain portions of this,residential property to be in violation of the State Sanitary Code, 105 Code of Massachusetts Regulations (CMR) 410.750(J). This violation also constitutes a violation of the Lead.Law, Massachusetts General Laws (MGL), chapter 111, section 197, and the Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000.If you already have a Letter of Compliance, please look to the last page of this Order and fill out the appropriate information.. Conditions exist in this residence that may endanger and/or materially impair the-health of the occupants of these premises. DECLARATION OF EMERGENCY The Director of the Massachusetts Department of Public Health Childhood Lead Poisoning Prevention Program declares that the presence'of this violation of the Lead Law and the Regulations for Lead Poisoning Prevention and Control constitutes an emergency pursuant to the Lead Law;MGL chapter 111, section 198 and within the meaning of the Sanitary Code, 105 CMR 400.200(B). CORRECTION OF LEAD VIOLATION(S) The Lead Law, MGL c. 111, §§189A-199B, and the Department of Public Health's Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000, require the owner of a residential premises or,dwelling unit built before 1978 in which a child under the age of six lives have lead BOH OTC Revised 1/05 Page I of 8 paint violations either abated or contained (referred to.as "deleading"),for full compliance or brought under interim control: The steps that you must follow are in the "Order" section. The Lead Law, the Department of Labor and Workforce Development's Deleading Regulations, 454 CMR 22.00, as well as the Regulations for Lead Poisoning Prevention and Control require that residential.deleading work be done by authorized people.The type of authorization will determine the method of deleading that can be done. There are three levels of deleading: High Risk Deleading Only licensed Deleaders can do high risk deleading activities.These activities include scraping, stripping, demolition, and making large amounts of loose paint intact. If this type of work is done on the interior of a unit, then the occupants must be temporarily relocated until the work is complete and has passed a reoccupancy reinspection: Moderate Risk Deleading Moderate risk authorized owners/agents and licensed lead safe renovators can do moderate (and low risk) deleading. These activities include removal and replacement of building components such as windows, and making a small amount of loose paint intact. If this type of work is done on the interior of a unit, then the occupants must be temporarily relocated until the work is complete and has passed a reoccupancy reinspection. Owners interested in becoming trained and authorized to do moderate risk deleading should contact CLPPP for more information. Low Risk Deleading l Low risk authorized owners and agents can do some inirior deleading activities such as covering surfaces with approved coverings and encapsulating approved surfaces. Owners interested in becoming trained and authorized to do low risk deleading should contact CLPPP for more information. These rules on who is authorized to perform what kind of deleading work apply whether the work is being done for full compliance or for interim control. An owner or owner's agent may also make structural repairs, as defined in 105 CMR 460.020, and clean leaded dust, as may be required for interim control. ORDER You are hereby ordered to remedy all violations of MGL c. 111, §197 and 105 CMR 460.000, as identified by a licensed private lead inspector. If you wish to pursue interim control, you must remedy all urgent lead hazards identified by a licensed private risk assessor. Whether you pursue full compliance or interim control, you must correct the relevant violations in accordance with the following schedule: Within sixty (60) days of your. receipt of this Order, you must.provide proof of the following: L. A complete analysis of the property for lead hazards. Proof consists of one of the following: BOH OTC Revised 1/05 PUe 2 of 8 • A comprehensive initial lead inspection report done by a licensed private lead inspector. The inspector must inspect the interior of the unit and the common areas of the unit, including the exterior. • A comprehensive initial lead inspection and risk assessment done by a licensed private inspector who is also licensed as a risk assessor. This is only necessary if you have decided to pursue the option of Interim Control. For more information on the Interim Control program;please contact CLPPP. For previously deleaded properties, a post compliance assessment determination done by a CLPPP code enforcement inspector. If you have a previously complied property and failed to return the last page of this Order within 14 days, then you may no longer be eligible for a maintenance period; however, you must still have the assessment done. Only a CLPPP code enforcement inspector can do this assessment. 2. An.established deleading plan for who will be deleading and when the work will be done. Proof consists of at least one of the following: • A contract with a licensed deleader, licensed lead-safe renovator, or low risk authorized agent. To check on the license for deleaders and lead safe renovators, contact the Division of Occupational Safety at(617).727-.7047. To check on the authorization for 'low risk agents, such as vinyl siders or carpet layers, contact CLPPP at 800-532-9571. 1. • If you or your agent will be doing the work, a copy of the authorization letter and a completed."Documentation of Training to be an Authorized Owner/Agent And Intention to Comply with the Order to Correct" form verifying that all work will be done within required timelines (see 90 day and 120 day requirements). This form is included in this package. . Contracts with licensed/authorized people as well as an authorized owner or agent's completed "Documentation of Training to bean Authorized Owner/Agent And Intention to Comply with the Order, to Correct"must also specify that the unit will meet acceptable lead dust levels under 10.5 CMR 460.170, as determined by the licensed lead inspector or risk assessor's dust wipe sampling. Should any of the dust samples fail to meet acceptable standards, the last authorized person who performed high- or moderate-risk work will be required to reclean the entire unit until all dust samples meet acceptable levels. If a low or moderate risk authorized person did the deleading and dust samples fail three times, a licensed deleader will be required to reclean the entire unit until all dust samples meet acceptable levels. Within ninety (90) days of your receipt of this Order, you must provide proof that the following work was completed anj reinspected (including passing dust wipes if required): 1. All high and moderate risk deleading on the interior of the unit must be done and must have passed reinspection, including dust wipes. BOH OTC Revised 1/05' Page 3 of 8 f Please note that if high or moderate risk activities will be done on the interior, then encapsulation cannot be done.until after all of this high and moderate risk work has been reinspected and passed dust wipes. 2. Removal and replacement of doors, if chosen as the method of deleading, must be done and have passed reinspection. 3. Loose surfaces in the interior of the unit must have been made intact by the appropriately authorized person; been covered, or otherwise deleaded and reinspected. This includes loose surfaces being prepared for encapsulation(but DO NOT encapsulate these surfaces until after a successful reoccupancy reinspection):Making paint intact on the interior of a unit requires. dust wipes at the reinspection. There cannot be any loose paint in the unit by the ninetieth day. 4. For those owners pursuing the Interim Control option, rules 1- 3 still apply; however only "urgent" lead hazards are required to be corrected. In addition, all required safeguards and structural repairs relevant to the interior of the unit must be complete and have passed reinspection and dust wipes, if required. Proof of this work consists of a copy of a reinspection report from a licensed lead inspector or risk assessor and copies of passing dust wipe results, if dust wipes were required. Copies of these documents must be provided to this agency by the 90`h day. Within one hundred and twenty (120) days of your receipt of this Order, you must provide proof that the following work was completed and reinspected (including passing dust wipes if required): 1. Any low risk activities on the interior of the unit that were not done by the 901h day deadline must be complete. This includes encapsulation of interior surfaces that were previously made intact. 2. All required deleading in the interior common areas and on the exterior is done and has been reinspected, including passing dust wipes if they were required. 3. For those owners pursuing the Interim Control option, all of the "urgent" lead hazards must be corrected on the interior, common areas, and the exterior. Also, all required safeguards and structural repairs relevant to the interior common areas and the exterior must be complete and have passed reinspection. For Interim Control, a final set of dust wipes is required to be taken at the final reinspection. Proof of this work consists of a copy of a reinspection report from a licensed lead inspector or risk assessor, copies of passing dust wipe results, and a copy of a compliance document. Copies of these documents must be provided to this agency by the 120`h day. PROSECUTION AND CIVIL PUNITIVE DAMAGES Failure to comply with any of the deadlines set out above will require this agency to initiate criminal or civil proceedings against you within seven(7) business days. Compliance with this Order will be determined by this agency's receipt of the appropriate documents within the BOH OTC Revised 1/05 Page 4 of 8 specified deadlines. Documents should be sent to my attention at 200 Main Street Hyannis,MA 02601. Inspection documents required by the 60th day deadline. One of the following: ❑ Initial Lead Inspection report by a licensed private lead inspector; ❑ Inspection report and risk assessment report by a licensed private risk assessor; ❑ Post Compliance Assessment Determination done by a CLPPP code enforcement inspector. Deleading documents required by the 60th day deadline. At least one of the following, although there may be a combination of documents: ❑ A contract with a licensed.deleader, licensed lead-safe renovator, or low risk authorized agent; ❑ A copy of an owner/agent authorization letter from CLPPP and a completed "Documentation of Training to be an Authorized Owner/Agent And Intention to Comply with the Order to Correct;" ❑ If you or your agent will only be doing structural repairs and lead-dust cleaning for interim control, a signed written statement attesting that this work will be completed in accordance with the required timelines. Documents required by the 90th day deadline: ❑ A Letter of Lead Paint (Re)'occupancy(Re)inspection Certification issued by a licensed lead inspector or risk assessor, in cases where high-.or moderate-risk deleading work occurred, requiring occupants to.be.relocated,from the unit for the duration of the work; ❑ Copies of results of all dust samples taken by the licensed lead inspector or risk assessor, and copies of all reinspection report(s) issued by a licensed lead inspector or licensed risk assessor; Documents required by the 120th day deadline. Only one of the following: ❑ A Letter of Full Deleading Compliance issued by a licensed private lead inspector. ❑ A Letter of Interim Control issued by a licensed private risk assessor. ❑ For previously deleaded properties, a Certification of Restored Compliance (an addendum to the original letter of compliance) issued by a CLPPP code enforcement inspector. A copy of the deleading notification(s) must be sent to this agency at least ten (10) days before the start of any deleading, no matter who is performing the work, and whether it is for full compliance or interim control. BOH OTC Revised I/05 Page 5 of 8 The law provides penalties of up to $500 for each day of noncompliance. In addition, you may become liable for civil punitive damages equal to three times any actual damages for failure to comply with this order if a child becomes poisoned. CORRECTION OF VIOLATION BY CODE ENFORCEMENT AGENCY If within the time periods stipulated above this residential property is not brought into full compliance or interim control, this agency may contract with an authorized person or authorized persons to correct the violation(s) and obtain a Letter of Full Deleading Compliance or a Letter of Interim Control, and bill the owner, or initiate court action to reimburse itself. RIGHT TO A HEARING You may request a hearing pursuant to 105 CMR 460.900 of the Regulations for.Lead Poisoning Prevention and Control, in conjunction with the procedures of 105 CMR 400.200(B), the Sanitary Code provision for hearings in emergency public health matters. As already noted, the aforementioned violation constitutes an emergency. (See "Declaration of Emergency" section.) As such, you may request a hearing only if you have complied with this Order. The hearing will be provided within p ten days of your request. This agency shall issue a written decision within seven days after the hearing. FEDERAL REGULATIONS Some feder al financial assistance programs require additional environmental investigation. If i you are planning on or have applied for a federal loan program, please contact me as soon as possible in order to discuss further requirements. Please have the name of the loan program and the local agency administering the program when you call. '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 pet 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 t. speak with the inspector who performed the inspection. P ORD OF T E BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable BOH OTC Revised 1105 Page 6 of 8 If your property already has a letter of compliance, you must fill out this form and return it to me within 14 days. Please include copies of ALL your lead- related paper work for this address. I will review the paper work for this address and contact you to schedule a post compliance assessment determination: Upon this review and a site visit, you may be eligible for a 30-day maintenance period; during which you may be able to fix the hazards yourself and your letter of compliance remains valid. Failure to return this form to me within 14 days may disqualify you from this option, requiring you to follow all of the rules and timelines outlined in this Order To Correct Violations. Only a CLPPP code enforcement inspector can do the required inspection work for previously complied properties. The inspection and reinspection services are provided for free. Please complete and return this form immediately in order to take full advantage of this 30-day maintenance period. Please print clearly: NAME: DATE: . ADDRESS: I ,r ZIP CODE TELEPHONE NUMBER: O ADDRESS OF THE.PROPERTY CITED: ZIP CODE: OCCUPANT(S)NAME: OCCUPANT'S TELEPHONE NUMBER: ( ) Please check off which documents you have attached to this form:. ❑ Lead Inspection Report f ❑ Risk Assessment Report ❑ Letter'of Full Initial Inspection Compliance ❑ Letter of Abatement Compliance ❑ Letter of Full Deleading Compliance ❑ Letter of Interim Control ❑. Certificate of Maintained Compliance BOH OTC Revised 1/05 Page 7 of 8 ❑ Certificate of Restored Compliance Other: ` is is an impormnt notice. [6as'.have it translated. Estee urn av rsv impota r, Quexra manda�-lo rmduzir_ Este es uun aviso importan Sire thandarlo u`aducir. SAY LAZ` BAST 'I`HC31' G A, TRON cle-ci est irnp}artant ��uillez farms traclu re. AA 4 HPOZOXH, AYTO EINAI IRMANTIKO. T AA 'AKA , METAq)PAITE Questo e un 'avviso i;mportante. Si pre adi fario tradurre BOH OTC Revised I/05 Page 8 of 8 oFIME r Town of Barnstable Regulatory.Services > MRMtABLE, 9 MASS. g Thomas F.•Geiler, Director .i639 �0 AIEo Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 LEAD DETERMINATION REPORT FORM Date of Determination: 01 Inspector: o�tl 6' C d tvive License #: 71 Method Used: Sodium Sulfide Expiration date: X-Ray Fluorescence Model: Serial #: Property Address: Apt. # Description of Property: J Single family /✓ Multi-family #units ''� Garage Fence Other structures Age of Property: Pre-1978 Post-1978 Occupant: f2� Occupants under six ye r of age: Lice ill ya wo DOB: t o '�d DOB: DO Occupant's Telephone: o yDSC� Property Owner(s): Owner's Address: . 0 2 Vitl2 Owner's Telephone: Lead Hazards found? Yes No An X-ray fluorescence reading greater than 1.0 mg/cm2 or a gray or black reaction to sodium sulfide indicates a dangerous level of lead and constitutes a positive determination. Deleading should not be undertaken based on this report. A licensed lead inspector must do a full inspection in order for you to qualify for a Compliance Letter. Deleading of lead painted surfaces must be performed by an appropriately authorized person, including a licensed deleading contractor, a licensed lead-safe renovator, and an owner/agent who is trained to perform specific work as required under the Lead Law. Contact the Childhood Lead Poisoning Prevention Program for additional information regarding deleading and training. 1. BOH Determ Form . Revised ]-05 Page l of 2 LOCATION SOURCE Pb 1. Child's bedroom Window parting bead/exterior sill area Ne 2. Child's bedroom Window sill Po 5 3. Living room Window parting bead/exterior sill area 4. Kitchen Window parting bead/exterior sill area 5. Interior Flaking paint 6. Exterior Flaking paint 7. Exterior Cellar window units 8. Exterior Window sills below 5' 9. Exterior Main entry door casing 10. Interior Outside corner of baseboard 11. Kitchen or Bathroom Chair rail 12. Bathroom Window sill 13. Exterior 14. Interior hallway (common area) Stair tre d or s ringer 15. Interior hallway (common area) Balusters 16. Interior hallway (common area) Door casing I 17. Porch Stair tread or riser 18. Porch Railing cap 19. Porch _ Balusters 20. Porch Support columns(<6" diameter or square) 21. Porch Staircase stringer 22. Exterior Bulkhead 23. Garage/Outbuilding Door casing or jamb 24. Interior Closet door or baseboard(uncapped) 25. Interior Cabinet door, shelf, or wall BOH Determ Form - Revised 1-05 Page 2 of 2 Y j The Commonwealth of Massachusetts µ Executive Office of Health and Human Services , Department of Public Health Center for Environmental Health Childhood Lead Poisoning Prevention Program MITT ROMNEY 250 Washington Street, 7th floor GOVERNOR Boston, MA 02108-4619 KERRY HEALEY 800-532-9571 LIEUTENANT GOVERNOR RONALD PRESTON SECRETARY CHRISTINE C. FERGUSON COMMISSIONER DISCLAIMER CONCERNING LEAD DETERMINATION REPORT The information contained in this report concerning the presence of lead paint does not constitute a comprehensive lead inspection. The surfaces tested represent only a portion of those surfaces that would be tested to determine whether the premises are in compliance with the Massachusetts Lead Poisoning Prevention Law(Massachusetts General Laws, chapter 111, sections 189A through 199B). Serious lead poisoning hazards are created when materials containing lead paint are disturbed, unless proper safety guidelines are followed. Therefore,Massachusetts's law requires that: A licensed deleader must do all high risk deleading,°such as scraping or the use of caustics. Property owners,their unlicensed agents, and licensed lead-safe renovators may do some deleading activities without a deleader's license. Before they do so,though, owners,their agents, and lead-safe renovators must become trained and receive authorization to perform these activities. Owners and their agents should contact the Childhood Lead Poisoning Prevention Program for more information on the specific activities they may perform and on how to become trained and authorized to.perform these deleading activities. Lead-safe renovators are licensed by the Division of Occupational Safety(DOS) and should contact them for training and authorization requirements. Letters of Full Compliance will be withheld if unauthorized deleading has occurred. Any renovating or rehabilitation,of premises containing dangerous levels of lead paint must be done in compliance with the procedures set forth in the Deleading Regulations issued by the Division of Occupational Safety(454 Code of Massachusetts Regulations 22.11),including sealing off the work area from adjacent areas, and performing a thorough clean-up. Any deleading work done on the basis of this report will not qualify the property owner for a state income tax credit,nor will the cost of such deleading be reimbursable under any state loan or grant program. In order to qualify for such programs,the premises must first be.subject to a comprehensive lead paint inspection. If a child under six resides in this dwelling,the property,owner may'face criminal or civil liabilities unless all lead paint violations have been corrected. This lead report cannot assure that the property owner has met his or her obligations under the law. It is unlawful for rental property owners to use the presence of lead as the basis for discrimination against tenants or potential tenants with young children. Disclaimer Revised 1-05 Page l of l a � The Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Public Health Center for Environmental Health Childhood Lead Poisoning Prevention Program MITT ROMN250 Washington Street, 7th GOVERNORERNOR floor KERRY HEALEY Boston, MA 02108 LIEUTENANT GOVERNOR (800) 532-9571 RONALD PRESTON SECRETARY CHRISTINE C. FERGUSON COMMISSIONER RESIDENTIAL DELEADING ADVISORY The process of removing or covering lead paint hazards, commonly called deleading, can be . dangerous if it is not done properly. That's why the Lead Law(Massachusetts General Laws chapter 111, sections 189A through 199B),the Regulations,for Lead Poisoning Prevention and Control (105 Code.of Massachusetts Regulations 460.000)and the Deleading Regulations (454 CMR 22.00)have rules for how deleading is done in homes and apartments. These rules say who can do the work, safety steps that have to be taken while the work is done,how to clean up after the work and how the work is finally approved. These rules are enforced by the Department of Public Health's Childhood Lead Poisoning Prevention Program(CLPPP),the Division of Occupational Safety (DOS) and local boards of health. Who can do deleading work Under these laws, only a licensed deleading contractor can do high-risk work, such as scraping or stripping lead paint,repairing more than a small amount of chipping or peeling lead paint so it can be repainted, and demolishing lead-painted building parts. Besides deleaders,property owners and their agents who take a one-day course can do moderate-risk deleading work, such as removing windows, woodwork, and just about any surface of a house, as well as repairing small amounts of chipping and peeling lead paint so it can be repainted.Lead-safe renovators trained and licensed by DOS may also be hired to do moderate-risk deleading work.Finally,low-risk deleading work can be done by all the people who can do high-or moderate-risk deleading work, and also owners and their agents, including contractors,who just complete the CLPPP low-risk booklet(and/or encapsulant booklet). Low-risk deleading means covering surfaces, applying encapsulants, capping baseboards,removing doors, cabinet• doors and shutters, and applying exterior siding.Property owners and their agents may also do structural repairs and lead-dust cleaning for interim control: Staying out of the home or parts of the home during deleading To protect the people who live in the home or apartment being deleaded,the law also has rules about making sure they stay out of the.home or apartment, or the area being worked on, in these ways • All people and pets have to be temporarily moved from the.home or apartment for the whole time that high-or moderate-risk deleading work is taking place inside the home or apartment. The owner has to provide residents with a reasonable alternative place to live for this time. Property owners and residents should refer to the CLPPP document, "Notice to Property Owners and Tenants: Tenants' Rights,Responsibilities,and Remedies"for more information on alternative housing during deleading.. • People and pets have to stay out of the work area while most low-risk deleading work, structural repairs or cleaning of lead dust, is taking place. They also have to stay out of the work area when deleading work of any kind is taking place in common areas outside the home or apartment, as Residential Deleading Advisory Revised I=05 Pa I of l U long as they have anotherregular way(not a fire escape)to go in and out of the building. In these cases,people and pets can use the area once cleanup is completed after all the work in the area is done. • People and pets have to stay,out of the home or apartment for the day while coverings are put over a surface with peeling, chipping or cracking lead paint or plaster, and during applying of encapsulants with an airless sprayer. They also have to stay out for the day during deleading of common areas when they do not have another regular way(not a fire escape)to go in and out of the building. When people and pets are out of their home or apartment.for the day, it means they can come back to the home or apartment after cleanup at the end of the workday, and don't have to be out overnight. It is very important that people whose home or apartment is being deleaded think carefully about what they will need during the time they are away from home, and take it with them.No one can return to a home or apartment while deleading that requires them to be out is still taking place, and has not been properly cleaned up. Property owners and residents must take deleading safety rules seriously and cooperate fully to make sure everyone is protected.No one should interfere with the work being done safely. Getting ready for deleading to begin People who live in a home or apartment in which any kind of deleading work is going to be taking place have to get written notice at least 10 days before the start of this work. This applies also to other residents of a building, if any deleading work will take place in common areas. Before deleading work begins, all household possessions of every type should be removed or stored in plastic bags in non- work areas. Closets and cabinets to be deleaded must be emptied. As a last resort, large furniture and belongings not removed from the work area should be.put in plastic bags and left in the center of the room,where they will be covered with heavy plastic by the person doing the deleading. The reason for this is to protect everything in the home or apartment from lead dust contamination. Belongings must also be protected before an owner or agent performs low-risk.deleading work, or other work that may be required for interim control,but the precautions are not as. extensive for this type of work. In general, it is recommended that furniture and belongings be moved outside the work area, or covered with thick plastic and sealed with duct tape,before low-risk deleading begins: Cleanup after deleading and returning home A final cleanup will be done at least two hours after all the interior high- or moderate-risk deleading work is done. This delay is to make sure that fine lead dust will settle out of the air and be removed in the final cleanup. People and pets who were temporarily moved to alternative housing can return only after a lead inspector or risk assessor says that the home is safe. The inspector decides this after doing a reoccupancy reinspection,which includes an analysis of lead dust levels within the home. Residents should leave a phone number where they can be reached so that the inspector or risk assessor can call them and.let them know when it is safe to return home. If the property owner or agent is going to be doing low-risk deleading work or other work for interim control after the residents return home,they will be taking some safety steps for this, as described in the CLPPP low-risk booklet. They will also be doing a cleanup when they are done with the low-risk work. An inspector or risk assessor will return at the completion of all the work and do a reinspection to check the owner's or agent's work. Temporary ways to protect children from.lead poisoning. Children exposed to lead paint hazards are at risk of becoming lead poisoned. This disease can affect every part of a young child's developing body; and in particular, can seriously and permanently Residential Oeleading Advisory Revised 1-05 of Z - - . 6 hurt the brain, kidneys and nervous system. Even at lower levels of exposure, lead can cause children to have learning and behavioral problems. The best and only permanent way to protect children from lead poisoning is deleading. But even before that process begins, there are some important steps that can be taken to protect young children from lead poisoning. Your lead inspector's or risk assessor's advice should be carefully followed because he or she knows your child's home. As part of their normal behavior, young children place things in their mouths, especially toys and their own fingers. If there are lead paint chips and dust in your home,they may be picked up by your child's fingers, as well as by toys, foods and pacifiers that fall on the floor, and end up in your child's mouth. It is especially important to wash your child's toys and to keep your child's hands clean, particularly before meals and at bedtime. Areas of peeling or chipping lead paint and dust should be cleaned. Wet wiping with paper towels and a general household detergent is best. Do not use your household vacuum cleaner to clean up paint chips,because this will only send fine lead dust into the air. Windows, windowsills and the floors under windows in particular are often areas from which children can get exposed to lead. Sills should be cleaned regularly if paint dust or flakes collect there. If windows are in poor condition, the best thing to do may be to keep the lower sash closed and open only the upper sash for ventilation. (This also protects your child from accidentally falling from the window.) Contact paper may be applied to areas of peeling paint on . windowsills, walls or other surfaces as a temporary measure. Sometimes furniture can be moved to block children from deteriorating paint or plaster. If deteriorating paint or plaster is in the child's bedroom, use another room as the child's room, if possible. Think of those parts of the home where your child spends most of his or her time, and try to keep there as I clean as you can before your home is deleaded. Lead paint can also get into soil. If the outside of your home has chipping or peeling paint, do not let your child play in the soil closest to the house. Be careful to wipe your shoes off on a mat before walking into your house, so you don't track in soil from these areas. Follow the advice of your lead inspector or risk assessor about soil on the property. For more information about how the deleading process works, and how to protect your children from lead poisoning, call the toll-free CLPPP information line, at 1(800) 532-9571. Residential Deleading Advisory Revised 1-05 The Commonwealth of Massachusetts Executive Office of Health and Human Services a 4W' Department of Public Health ImI I IWt Center for Environmental Health Childhood Lead Poisoning Prevention Program 250 Washington Street, 7t" floor Boston, MA 02108 MITT ROMNEY (800) 532-9571 GOVERNOR KERRY HEALEY LIEUTENANT GOVERNOR RONALD PRESTON SECRETARY p CHRISTINE C. FERGUSON COMMISSIONER NOTICE TO PROPERTY OWNERS AND TENANTS: TENANT'S RIGHTS AND RESPONSIBILITIES Violations I Lead paint violations under the Lead Law and the state Sanitary Code have been found in the home or apartment listed in the attached documents. These violations maybe a danger to the health of the people living in the home or apartment. Children younger than six years old are at the most risk of being lead poisoned. Lead can damage a child's growing brain and other parts of the body. Even small amounts of lead can harm a child. The owner of this home or apartment is responsible for removing or covering the lead violations. (This is called deleading.) Legal Rights and Responsibilities For these lead violations to be deleaded as quickly and safely as possible, it helps if both the owner and the tenant cooperate with each other. It is important that tenants and owners know their rights under state law. Because the laws are not simple, tenants may need to get legal help and/or legal advice before trying to use the rights found below. (1) Temporary Housing. (Massachusetts General Laws chapter 111, section 197) Tenants and their pets must be temporarily moved out of the home or apartment for the whole time that high-risk or moderate-risk deleading work is taking place inside the. home or apartment. They cannot return until that work is done, the unit is cleaned up and a licensed.lead inspector finds that the home or apartment is safe. The owner and tenants have to agree on a plan for temporary housing. If the tenants choose to move in with family or friends they do not have to pay rent to their landlord while they are out of their home. If they do not so.choose, the owner finds the temporary housing and offers.it to the tenant. The Law requires that owners pay any charges for the temporary housing the.owner offers, and that tenants continue to pay their full normal rent during the time they live.in the temporary housing. The temporary housing must be one that "does not cause undue economic or personal hardship to the tenant."If the temporary housing chosen by the owner would not cause a hardship, and the tenant still Tenants'Rights Revised 1-05 Page I of 3 refuses to accept it, then the tenant has to find and arrange for his or her own temporary housing during deleading. In this case, the tenant doesn't have to pay rent for the days he or she is not at home,but has to pay the cost of the temporary housing he or she has chosen. In this case, the owner has to pay the tenant any amount by which the cost of the temporary housing first chosen by the owner is more than the rent for that period. No matter where the tenant stays,the owner must pay reasonable moving costs. Tenants are advised to get legal help if they cannot agree with the owner on a plan. (2) Protection from Retaliatory Rent Increase or Eviction. A property owner may not evict a tenant, or increase the rent or refuse to renew the lease of a tenant in retaliation(getting even) for the tenant reporting a suspected lead paint violation to a code enforcement agency such as the local board of health. If the rent is raised, or tenants get an eviction notice or their lease is not renewed within six months after the tenants called the board of health or got their home deleaded, a court can automatically find that the owner took this action in retaliation unless the owner can show clear evidence that he or she had other reasons, unrelated to the violations. An eviction based on not paying the rent is not retaliatory. Property owners who are found to have threatened or taken actions against tenants for exercising rights under the Lead Law are liable for damages under M.G.L. c. 186, s. 18 and M.G.L. c. 93A. A tenant who believes that the owner has retaliated against him or her because of lead violations may also file a complaint with the Massachusetts Commission Against Discrimination (MCAD). (3) Rent Withholding. (Massachusetts General Laws chapter 239, section 8A) Tenants have a basic obligation to pay rent for their home or apartment to the owner. . But, if lead violations are not being deleaded,tenants may have a right to hold back their rent payments. Tenants may take this step only if they were up to date in their rent at the time the owner was notified of the lead paint violations, and they did not begin withholding until this point. Owners have the right to go to court to evict tenants for not paying rent. To fully protect themselves against attempted evictions, tenants withholding rent for Lead Law violations may need to place withheld rent money in an escrow (separate savings) account, or may be ordered to do so by the court. If these conditions are met, tenants may not be evicted for not paying rent or for any other violation that is not the tenants' fault. Owners have the right.to enter the tenants' home or apartment, if possible by appointment,but in any case in emergencies, to inspect for lead violations and to have them repaired. Tenants have a responsibility to cooperate with owners and allow all necessary access to their home or apartment for repairs. Tenants who do not cooperate with this right of entry may be subject to eviction. If rent was withheld, the court may order that all or part of the withheld rent be paid to the owner after the violations are deleaded. (4) Abatement of Rent or Damages. Even when the rent withholding statute does not apply, tenants may be able to have their rent reduced or get back rent they have already paid, if their home or apartment has Lead Law violations. The landlord always has a duty to provide housing that meets basic housing standards. A tenant can bring a court action for breach of this "implied warranty". Tenants'Rights Revised 1-05 Page 2 of 3 2 (5) "Rent Receivership". (Massachusetts General Laws, chapter 111, sections 127C - 127J) This law allows tenants, the state Childhood Lead Poisoning Prevention Program or the local board of health to ask the court to find that Lead Law violations exist, and to allow rent to be paid into court rather than to the owner,*to pay for necessary repairs. (6) Owner Liability: Compensatory and Punitive Damages. (Massachusetts General Laws chapter 111, section 199) The owner of a home or, apartment built before 1978 is liable for damages to a child underage six who becomes lead poisoned as a result of the owner's failure to comply with.the Lead Law and regulations. The owner of such home or apartment who is notified through an Order to Correct Violations or Order to Restore Interim Control Measures of lead violations, and who willfully fails to correct the violations, in accordance with the Lead Law and Regulations, is also subject to punitive damages, which are triple the actual damages found. NOTE: All the information presented above is only a summary of the law. Before you decide to withhold your rent or take any other legal action, it is advisable that you consult an attorney. If you can not afford to consult an attorney,you should contact the nearest Legal Services office. Repainting Violations of the Lead Law are also violations of the state Sanitary Code. Surfaces from which lead paint or other coatings have been removed have to be repainted under 105 CMR 410.020 of the state Sanitary Code. Deleaded surfaces have to be sealed and made easy to clean. Deleaded surfaces can only be repainted after the surfaces have been reinspected while bare and approved by a licensed lead inspector. Tenants may want to contact the owner if the required repainting is not done. If the owner does not respond, tenants should call the local board of health. Tenants'Rights Revised 1-05 Page of 3 �� a — = The Commonwealth of Massachusetts Executive.Office of Health and Human Services t Department of Public Health ' Center for Environmental Health MITT ROMNEY Childhood Lead Poisoning Prevention Program GOVERNOR 250 Washington Street, 7t" floor KERRY HEALEY Boston, MA 02108 LIEUTENANT GOVERNOR (800) 532-9571 RONALD PRESTON SECRETARY CHRISTINE C. FERGUSON COMMISSIONER NOTICE TO TENANTS OF LEAD PAINT HAZARDS Lead in violation of the Lead Law (Massachusetts General Laws, chapter 111, sections 189A-199B) and the state Department of Public Health's Regulations for Lead Poisoning Prevention and Control.(105 Code of Massachusetts Regulations 460.000) has been found in apartment in this building. Children exposed to lead hazards are at risk of becoming -lead poisoned. This disease can affect all parts of a young child's developing body, and in particular, can seriously and permanently hurt the brain, kidneys and nervous system. Even at lower levels of exposure, lead can cause children to have learning and behavioral problems. If you have a child under six years of age, it is important that he or she be regularly tested for lead poisoning, as the law requires. If your child has not been tested recently, you should ask your child's doctor or health care provider to test him or her. If you don't have a regular health care provider, you can call your local board of health, or the state Childhood Lead Poisoning Prevention Program(CLPPP), at 1-800-532-9571, to find out where you can get your child tested for lead for,free. Lead poisoning can only be detected by such testing. Since lead violations have been found in an apartment in this building, it is quite possible that your unit may have lead violations too. If you have a child under six years of age, you should ask the owner of your building about having your apartment inspected for lead paint. You can call your local board of health to check for lead (ask for a lead determination), or call CLPPP at 1-800-532-9571 for further advice. It is against state law for property owners to discriminate against tenants with children because of dead paint hazards in their apartment. If deleading of apartment will also include deleading of common hallways, staircases and porches of your building, you will get a written notice 10 days before any deleading will begin. While the deleading is being done, everyone must keep out of the areas being worked on. You have to use another way to go in and out of your building during this time. If your apartment is on the same floor and is in the work area as a common area in which deleading is being done, the person or persons doing the deleading work will protect your apartment too. They will be temporarily covering your doorway with thick plastic sheeting and taping it down with masking tape, so that fine lead dust can't be blown in, around, or under your door. If they have not properly covered areas to protect them from lead dust and debris from the " deleading work,tell the owner of your building or call the state Division of Occupational Safety (DOS) at 1-800-425-0004, or CLPPP at 1-800-532-9571. If you don't have an alternative way of Tenant Hazards I-05 Revised 1-05 getting in and out of your building, talk to the owner of your building, or the person or people doing the deleading, and coordinate the work. Check your windowsills and doorways for any V'isible dust after deleading. Lead dust can be cleaned up with paper towels and a mixture of regular household detergent and water. If you notice lead dust from deleading in your apartment, tell the person doing the deleading, and the owner of your building. Deleading work that is done the right way should not result in lead contamination of your building. However, if you notice any lead,paint dust or debris that has not been properly cleaned up at the end of the workday, tell the owner of your building. You can also call DOS at 1-800- 425-0004 or CLPPP at 1-800-532-9571 or the local health department. Tenant Hazards 1-05 Revised 1-05 1 Town of Barnstable Regulatory Services _ Thomas F. Geiler,Director BARNSTABLE, '6 Public Health Division prFb`" Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office:. 508-862-4644 Fax: 508-790-6304 REQUEST FOR DETERMINATION OF LEAD HAZARDS AND ENFORCEMENT OF THE LEAD LAW , Date: �' 20 request the. Department print name of occupant of Public Health to inspect my residence.or dwelling u it for lead paint. The address of this residence or unit: tD 6 Street and Apartment Number Massachusetts. City or Town Zip code The telephone number to reach me there is: ) 3 G � Phone Number The child (ren)under the age of six (6) years who reside(s) in this household is/are: Name Was the residence built before '1978? Yes No I understand that the lead determination requested may include all rooms of the dwelling unit or residential premises, common areas, porches and accessible exterior areas, as well as other buildings within the property lines. I further understand that if there is a child under six (6) years of age in residence, and the determination hereby requested identifies lead hazards in violation of Massachusetts 1 General Laws, chapter 111, section 197, and Regulations for Lead Poisoning Prevention and Control, 105 Code of Massachusetts Regulations 460.110 and .750, such violations must be either deleaded for full compliance, or the unit must be brought under interim control, at the property owner's expense. The property owner must correct all violations, whether for full compliance or interim control, within 120 days of the receipt of an Order to Correct Violations. The property owner must also submit within 60 days of the receipt of such an Order, a copy of.a signed contract with a licensed deleader, if one will be necessary for the required work. If the owner or his/her agent is,going to perform owner/agent deleading work, the owner must also submit a special form within 60 days. If the owner fails to comply with the Order to Correct Violations, the Health Department shall initiate judicial proceedings against the owner to enforce the Order. The Massachusetts Department of Public Health's Childhood Lead Poisoning Prevention Program conducts random audits of inspections conducted by private inspectors and risk assessments conducted by private risk assessors following lead determinations. Such monitoring is performed to assure the quality of services being provided to the public. By requesting this determination, you agree to allow CLPPP access to your residential premises or dwelling unit after the initial determination and prior to your returning once any deleading,whether for full compliance or interim control, is completed. Not all private inspections or private risk assessments will be audited, so you may not hear from CLPPP requesting access fo hes dditional visits. ignatLR of Occupant 2 s1 C 4; Lead Inspection / Risk Assessment Report P 20 e 1 Of Lead Paint Inspect►ons. by, Fred. Hemmila a9 — 16 Quaker Road, East Sandwich, MA 02537-1027 ETel. 08-888-8378 In Mass: 800-286-8378 FAX 508-888-8397 :fred lead(c-oco m cast.net Website:www.fredhemmila.com St.# Address Apt. ❑❑Z101 aoo❑a❑oa®o�❑❑❑a❑❑❑❑❑ ❑❑❑❑� City Zip Code ®�®®®�0❑❑❑❑❑❑❑❑❑❑ 00©1oJ0 Number of Rooms In Unit Owner Name: P: t/f-L4+14 i�VIt,L V1 ' API-5 Number Property Type: Owner Address: 170A MkrAJ St' "T D S7c-tAGLE me ea(; Single Family Contact Information: Multi Family-k- #Units Client Name if different from owner): Condominium_ #Units_ Client Address: Day Care _ Other: Key: Lead Column Key: Delead/IC Method Column Laundry itl Basement? YeS r N COV Covered CAP Capped SCR Scraped Finished Space in Basement? Yes or o VB Vinyl Baseboard COV Covered DIP Dipped MET Metal ENC Encapsulated REM Removed VR Vinyl Rep.Window. MI Made Intact REP Replaced Testing Method Used: MR Metal Rep.Window PRE Prepared for Enc REV Reversed Na2S Exp.Date NA Not Accessible VR/MR Vinyl/Metal Rep Window INT Intact X-Ray Fluorescence NC No Coating SFR Storm Frame Removed l R Serial# I?s� Tile Tile(testing suggested) � Mode Component Does not Exist —�-- DC Dropped Ceiling Comments/Notes Floor#_(this Is the level within building of unit being inspected) Floor# C b C b ,• r2 , -- ,• . k -- - . '. ' B C'...,___ ..a...; _I_._a_.. . -" a -; ........... - . N A(Street Side) Start Here A(Street Side) Start ! Pb(lead)equal to or greater than 1.0 mg/cm2 with x-ra fluorescence or positive with Na2S is Dangerous. (� XRF Calibration Recorded in Log Book V ✓ -Check off when complete Address verified through USPS ✓ -Check off when complete Research on Lead-Related History for Address I/ ✓ -Check off when complete www.state.ma.us/di)li/clon or 800-532-957I Inspector Name FREDERIC 7 REMMILA LiC# 1136 Signature lfmckuc, Awtak Date LI/RA rev 8/08 ADDRESS: 60 LpV15 Sif2cc�7 `f; i4yhw/✓15 0,-)-6a 1 Page 2 of � INSPECTION HISTORY INTERIM CONTROL Determination Risk Assessment Y Inspector Name: ,Lic# RN R.A.Name: Lic#Signature Lead Hazards? Ur ent Pb.Hazards? Signature Comprehensive Initial Ins ection Inspector Name:�� LIC# Dust Taken for Risk Y Assessment R.A.Name: ,Lic#, Signature [Fq Lead Hazards? Signature Visual Portion of Com Initial P R.A.Name: ,Lic# p Inspector Name: ,LIC# Reinspecuon for w/Partial PCAD FN Interim Control Signature Signature -TT Lead Hazards? Dust Taken for Risk R.A.Name: L'Ic#_ Addendum(add-un Inspector Name: ,LIC# Assessment Reins . P to Initial Inspection) ,, F Signature N Signature Lead Hazard? Visual Portion of _ Reinspection,for R.A.Name: ,LIC#_ Addendum as Full Interim Control P Ins .(Lost Do:s) Inspector Name: ,Lic# �] Signature r F Lead Hazards? Signature Dust Taken for Risk P R.A.Name: ,L'Ic#__— Assessment Reins . Walk Through for F Signature Ed/Consultation Inspector Name: Lic# Signature Risk Assessment Recertification REINSPECTION HISTORY y R.A.Name: ,lic# Visual Portion of Reocc.Reins ec ion P Inspector Name: ,LIc# Urgent Pb.Hazards? N Signature F Signature Dust Taken for RA PI R.A.Name: ,Lic#__ Recertification Visual Portion of FSignature Reocc. Reins action P Inspector Name: ,LIC# -- F Signature POST COMPLIANCE ASSESSMENT DETERMINATIONS Dust Taken for p PCAD ENI Inspector Name: Lic#—_ Reocc. Reins txtion Inspector Name: ,Llc# F Signature — Signature Lead Hazards? Dust Taken for on P Full Inspection Reocc. Reins ecti Inspector Name: ,LIC# s F Actin as PCAD Signature Y Inspector Name: Lic#___ Dust Taken for Lead Hazards? N Signature Reocc. Reins ection P Inspector Name: ,LIC# 9F Visual Portion of P Inspector Name: Lic#i_ Signature PCAD Reins action F 9Signature Visual Portion of — Final Reins ection P Inspector Name: ,LIC# F Dust Taken for r Signature PCAD Reins ection F Inspector Name: ,Lic#__ _ F Visual Portion of P Signature Final Reins ection F Inspector Name: ,Lic# _ Signature Dust Taken for PCAD Reins ection P Inspector Name: ,Lic# Dust Taken for Final Reins .(No Rcrocc Inspector Name: ,Lic# F Signature _ Signature ADDRESS: (oQ koyfs sf?zaT, 0-14, PWAlo e uq Page 3 of 9e) REOCCUPANCY CERTIFICATE HISTORY COMPLIANCE HISTORY (CONT.) Certificate of Certificate of Reoccu anc Inspector Name: ,LIc# Maintained Inspector Name: Lic#—__ Compliance Only after Signature Signature ` High/Mod Risk No Work—No Dust (#rooms rule Work=7 Dust Certificate of Reoccupai�cy Certificate of Inspector Name: ,LIc# Restored Compliance Inspector Name: ,Lic#`_ Only after Signature 9 Si nature _ High/Mod Risk Dust wipes and auth. #rooms rule people Certificate of Inspector Name: Lic# Reoccu anc � Certificate of Maintained Inspector Name: ,Lic# Signature Compliance Only after High/Mod Risk Signature #rooms rule No Work=No Dust Work=7 Dust COMPLIANCE HISTORY Certificate of Letter of Full Initial Restored Compliance Inspector Name: ,Lic# Compliance Inspector Name: ,Lic#___ Si nature No prior history/ Signature Dust wipes and auth. g No signs of UD people Letter of Interim OTHER HISTORY: WAIVERSIUD Control Inspector Name: ,Lic# Approved CLPPP Waiver No prior comp. Signature Inspector Name: ,Lic#�_ Expires in I •r' Attach to Comp Signature Docs — Recertification of Interim Control Inspector Name: ,L•Ic# Approved CLPPP Waiver Inspector Name: ,Lic#—_ Expires 2 yrs from Signature Signature original Interim Attach to Comp — Control Docs Letter of Full Deleading Inspector Name: ,Lic# UD/DES Visual Compliance Reins ection Inspector Name: ,Llc#__ Signature I I Signature _ Dust wipes if No No LOC Issued F Reocc. Certificate of UD/DES Dust Maintained Inspector Name: ,Lic# Taken Inspector Name: ,Lic#___ Com liance Signature RF Signature No Work--No Dust No LOC Issued Work=7 Dust UD/DES Dust Certificate of Taken F Inspector Name: ,Lic#_._ Restored Compliance Inspector Name: ,Lic# Signature _ No LOC Issued Signature UD/DES Final Dust wipes and auth. people Reins ection Inspector Name: Lic#_— Signature No LOC Issued F •— Page 4 of EXPLANATION OF LEAD INSPECTION/RISK ASSESSMENT REPORT FORM COLUMNS This page provides general information needed to understand the lead inspection/risk assessment report. However,you should speak with the inspector/risk assessor before you start to do any work on your home. SIDE Refers to A,B, C,or D side of the building or room. See the diagram on the cover sheet.The"A"side of the building or room is the side facing the street that gives the property its address(usually,it is the front of the building). Keeping your back to this street, from the"A"side move clockwise to the`B"side on your left,the"C" side opposite you, and the"D"side t pp y o the right. Numbering is from left to right. LOCATION/ Refers to the building component(s)being tested. Some surfaces may be made up of more than one part. For SURFACE example,"Baseboard"may refer to four separate pieces of wood(one on each wall),but is still considered one surface. LEAD The actual lead result. Each surface tested must have a result recorded in the"Lead"column. • A number shows that the surface was tested with an XRF analyzer. A number(or average number)equal to or greater than 1.0 mg/cmZ is a dangerous level of lead. • A"pos"or'neg"shows that the surface was tested with sodium sulfide."Pos"means that there is a dangerous level of lead. • "N/A"means that the inspector was not able to test the surface. Unless the owner can get a sample to test, the inspector must assume the surface contains lead and require it to be deleaded, if necessary. • "MET"or"MR"means that a metal surface was not tested and only needs to be intact, even if it is a leaded surface. However,metal handrails,metal window sills,and metal railing caps,need to be deleaded if they test equal to or greater than 1.0 mg/cmZ,or is marked"N/A." • For key to abbreviations like"COV","VB","VR"or"MR","NC","Tile","DC",see the cover page. • When a component box is slashed and there are test results above and below the diagonal line,the result on the "bottom"represents results below 5 ft. and the"top"result indicates the test result above 5 ft. TYPE OF Not all lead paint must be deleaded.This column tells you IF and WHY a surface needs deleading.The deleading HAZARD standards below may not apply for Interim Controls. Speak to your risk assessor for more information. • "M/1"circled means that the surface is a moveable/impacted surface and must be deleaded in its entirety. • "SF"circled indicates that there is a stonn frame present which requires the blind stop and exterior sill be deleaded as interior moveable/impacted surfaces. • "A/M"circled means that the surface is"accessible mouthable"and must be deleaded to a minimum of five feet high, four inches in from the edge or comer. • "L"circled means that the surface is loose and must,at minimum,be made intact. • If more than one choice is circled, the rules for deleading may change depending upon what method of deleading you choose. Speak to the inspector for more information. • "N/A"means the inspector was unable to determine if the surface was a lead hazard.The person doing the deleading must check this surface and follow all the rules for deleading. Speak to the inspector for more information. • If nothing is circled in the column,then it is likely the surface does not need deleading. Speak to the inspector for more information. Remember,this does not mean the entire surface is lead free, it just does not require deleading in its current condition. URG HAZ? This column is only completed during a risk assessment. A risk assessment is an evaluation of a home's suitability for Interim Control. Only a licensed risk assessor can do a risk assessment,not all inspectors are risk assessors. If"Y"is circled,then this surface is considered an"Urgent Lead Hazard"and some type of deleading work is required to qualify for Interim Control. IC DATE The date the licensed risk assessor determines the surface meets the standards for Interim Control. IC METH The deleading method or structural repair done to qualify the surface for Interim Control. Refer to the deleading codes key on the cover page. DELEAD The date that the lead inspector reinspects the surface and finds that it has been successfully brought back into DATE compliance. DELEAD The method used to bring a surface into full compliance. Refer to codes in the Key on the cover page of the PCAD METH I EXCLUDED The amount of loose paint on a surface as measured by the lead inspector."N/A"means that the inspector was not SURFACES able to measure the loose paint,but has determined it is more than the cut-off for moderate risk making intact. LIRA Exp.8/08 HEW ILA o�7J(o Page Of Inspector(print) Lic# Signature Date 60 Louis St., #4, Hyannis 02601 Risk Assessor(print) June 26, 2009 Date Address of Pr ert : City: ROOM# SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH A B Up Walls A/M L N/A Y Window Sil MA A/M L N/A Y A B Low Walls AIM L N/A Y B Win Apron Fo La v AIM L NIA Y g Baseboards AIM L N/A Y C Win Casin " A/M L N/A Y Chair Rail � A/M L N/A Y D Header Stop M/I AIM L N/A Y Radiator AIM L N/A Y Int Stops M/I AIM L NIA Y Floor AIM L N/A Y 1 Win Int Sash MA AIM L N/A Y Ceiling A/M L N/A Y 2 Exterior Sill M/I SF L N/A Y A B Door AMI L /A Y 3 Part Bead MA L N/A Y D Door Casing AIM L N/A Y 4 Blind Stop M/I SF /A Y 2 Door Jamb AIM L N/A Y Win Ext Sash M/I L N/A Y 3 4 Threshold AIM L N/A Y A Window Sill �. M/I AIM L N/A Y A B Door A/M L N/A Y CB)Win Apron AIM L NIA Y oor Casing A/M L N/A Y C Win Casing AIM L N/A Y 1 Door Jamb A/M L N/A Y D Header Stop M/I AIM L N/A Y 3 4 Threshold AIM L N/A Y Int Stops M/I AIM L N/A Y A B Door A/M L N/A Y 1 Win Int Sash M/I A/M L N/A Y C D Door Casing A/M L N/A Y 2 Exterior Sill A SF L NIA Y 12 Door Jamb AIM L N/A Y 3 Part Bead M/I L N/A Y 34 Threshold A/M L N/A Y 4 Blind Stop M/I SF L A Y A B Door A/M L N/A Y Win Ext Sash M/1 L N/A Y C D Door Casing AIM L N/A Y A Window Sill M/I A/M L N/A Y _ 12 Door Jamb A/M L N/A Y B Win Apron A/M L NIA Y 34 Threshold AIM L N/A Y C Win Casing A/M L N/A Y A Closet Door AIM L N/A Y D Header Stop M/I AIM L N/A Y B Cl Casing A/M L N/A Y Int Stops M/I A/M L N/A Y C Closet Jamb AIM L N/A Y 1 Win Int Sash M/I A/M L N/A Y D Closet Walls AIM L N/A Y 2 Exterior Sill M/I SF L N/A Y Cl Baseboard AIM L N/A Y 3 Part Bead M/I L NIA Y 1 Closet Pole AIM L N/A Y 4 Blind Stop M/I SF L N/A Y 2 Closet Shelf AIM L N/A Y Win Ext Sash M/I L N/A Y 3 Cl Supports AIM L N/A Y AB Fireplace AIM 1 N/A Y 4 Closet Floor A/M L NIA Y CD Mantle AIM L N/A Y AB Closet Ceiling AIM L N/A Y c D Win Above 5' AIM L N/A Y COMMENTS/STRUCTURAL DEFECTS: Ceiling Moldin A/M L N/A Y AIM L NIA Y AIM L N/A Y AIM L N/A Y EXCLUDED SURFACES: u aces listed In these boxes.can be made Intact only 5y a licensed da leader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IC IC (MORE THAN 288 SQ.IN.) DATE METHOD (MORE THAN 288 SO.IN DATE METHOD r . CIE M►LJ4a7J� Page `P Of Inspector(print) Lic# Signature Date 60 Louis St., #4, Hyannis 02601 Risk Assessor(print) June 26, 2009 Date Address of Property: City: ROOM#—� SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH A B Up Walls A/M L N/A Y A Window Silk— 0. M/I AIM L N/A Y A B Low Walls O A/M L N/A Y B' Win Apron 00 AIM L N/A Y A B Baseboards AIM L N/A Y C Win Casing 01 A/M L N/A Y A B Chair Rail A/M L N/A Y D Header Stop U MA AIM L N/A Y ABGo Radiator M AIM L NIA Y Int Stops M/I AIM L N/A Y ID FloorDT- AIM L NIA Y Win Int Sash M/I L N/A Y Ceiling AIM L N/A Y 2 Exterior Sill A SF L /A Y Door AIM L N1A Y 3 Part Bead 7 A N/A Y Door Casing AIM L N/A Y 4 Blind Stop A SF It. N/A Y 12 Door Jamb A1M L N/A Y Win Ext Sash / L N/A Y 34 Threshold A/M L N/A Y A Window Sill M/I AIM L N/A Y A B Door AAvI L NIA Y � Win Apron AAd L N/A Y. C Door Casing A/M L.N/A Y C' Win Casing �.3 AIM L N/A Y 2 Door Jamb AIM L N/A Y D .Header Sto M/I A/M L N/A Y 3 4 Threshold AIM L N/A Y Int Stops MA AIM L N/A .Y A B Door AIM L N/A Y 1 Win Int Sash Q M/1 A/M L N/A Y Door Casing L AIM L N/A Y II'Lp' Exterior Sill A S L /A Y 1 1 Door Jamb— AIM L N/A Y 1111113 Part Bead � MA L IA Y 34 Threshold AIM L N/A Y 4 Blind Stop M/I S L /A Y A B.Door A/M L N/A Y lWin Ext Sash MI N/A Y C D Door Casing AIM L N/A Y A Window Sill. M/I A/M L N/A Y 12 Door Jamb AIM L N/A Y B Win Apron A/M L NIA Y 34 Threshold AIM L N/A Y C Win Casing AIM L N/A Y A Closet Door AIM L N/A Y D Header Stop M11 AIM L NIA Y B CI Casing AIM L N/A Y Int Stops MA AIM L N/A Y G Closet Jamb AIM L N/A Y i Win Int Sash MA A/M L N/A Y Closet Walls A1M L N/A Y 2 Exterior Sill, M/I SF L NIA Y Cl Baseboard A/M L N/A Y 3 Part Bead M/I L N/A Y 1 Closet Pole AIM L N/A Y 4 Blind Stop MA SF L N/A Y 2 Closet shelf AIM L N/ALY WinESASash MA L N/A Y 3 CI Supports— AfM L N/A A B Fireplace AIM L N/A Y' 4 Closet Floor QAIM L N/A C D Mantle AIM L N/A Y /� AB Closet Ceiling iJ A/M L N/A CID Win Above 5' AIM L NIA Y COMMENTS/STRUCTURAL DEFECTS: 0,Ceiling Moldin AIM L N/A Y AIM L N/A Y AIM L N/A Y A/M L N/A Y _:J EXCLUDED SURFACES:Surfaces Iste In these boxen can be made Intact only ry a licenseg7e ea der. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IC IC (MORE THAN 288 SQ.IN.) DATE METHOD (MORE THAN 288 SQ.IN.) DATE METHOD i Page Y Of Inspector(print) Lic# Signature IV Date 60 Louis St., #4, Hyannis 02601 Risk Assessor(print) June 26, 2009 Date Address of Property: City: KITCHEN F LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ. DATE METH DATE METH Up Walls AI L N/A Y A Window Sill 0. MA AIM L N/A Y Low Walls L NlA Y Win Apron A/M L N/A Y 71 A B Baseboards AIM L N/A Y C Win Casing M L /A Y A B Chair Rail A/M L N/A Y D Header Stop C M/I AIM l NIA Y AB CD Radiator M. AIM L N/A Y I Stops A I L N/A Y Floor A/M L N/A Y 11 t Win Int Sash A L N/A Y Ceiling A/M L N/A Y lZJ Exterior Sill MA SF N/A Y A Door AIM L N/A Y 3 Part Bead MA NIA Y D Door Casing AIM L N/A Y 4 Blind Stop fl M/jffk I L N/A Y 12 Door Jamb AM L N/A Y lWin Ext Sash M L NIA Y 34 Threshold AIM L N/A Y A Window Sill A AIM NIA Y fDoorA B Door VO�: AIM L NIA Y Win Apron d ! AM L N/A Y C Door Casing AIM L NIA Y Win Casing Avl N/A Y 1 2 Jamb AIM L NIA Y D Header Stop A L N/A Y 3 4 Threshold AIM L NIA Y \ Int Stops MA L NIA Y A B Door A/M L N/A Y 1 Win Int Sash MA I A/V L N/A Y Door Casing AIM L N/A Y Exterior Sill> MA F L N/A Y 1 2 Door Jamb AIM L N/A Y q Part Bead MA L /A Y 34 Threshold AIM L N/A Y 4 MI S I L PIA Y A B Door A/M L N/A Y Win Ext Sash O I N/A Y Door Casing MIL N/A Y A R Up Cab Frame 00 AIM L N/A Y 1 Door Jamb LAIL N/A Y p Cab Door A/M L N/A Y 34 Threshold OVI L N/A Y Up Cab Walls A/M L NIA Y A Closet Door AIM L NIA Y 12 Up Cab Shlvs AIM L N/A Y B Cl Casing AIM L N/A Y 34 Supports 0. AIM L N/A Y C Closet Jamb A/M L N/A Y Low Cab Fram A/M L N/A Y D Closet Walls AIM L N/A Y A B Low Cab Door AIM L N/A Y Cl Baseboard AIM L NIA Y �6 ow Cab Walt A/M L N/A Y 1 Closet Pole j AIM L N/A Y Low Cab ShIvs AIM L N/A Y 2 Closet Shelf AIM L N/A Y 12 Supports V,, AIM L N/A Y 3 Cl Supports A/M L NIA Y 34 Drawers AIM L N/A Y 4 Closet Floor AIM L NIA Y AB o Win Above 5' MA A/M L NIA Y Closet Ceiling A/M L NIA Y k V Loi M/I A/M L NIA Y COMMENTS I STRU URAL DEFECTS: MA NM L /A Y M/1 A/M L N/A Y MA A/M L N/A Y MA A/M L N/A I Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact only by a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDEJ LOCATION MEASURE:LOOSE PAINT IC IC (MORE THAN 288 SO.IN.) DATE METHOD (MORE THAN 288 SO.IN.) DATE METHOD & P/1 �oZ73` (g page' of Inspector(print) Lic If Signature Date 60 Louis St., #4, Hyannis 02601 Risk Assessor (print) June 26, 2009 Date Address of Pro ert : City: BATHROOM ff SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ?1 DATE METH DATE METH A B Up Walls A/M L N/A Y Low Cab Fram A/M L N/A Y A B Low Walls AIM L N/A Y AB Low Cab Door AN L N/A Y A B Baseboards J A/M L N/A Y CD Low Cab Walls AIM L N/A Y A B Chair Rail AAd L N/A Y Low Cab Shtvs AIM L N/A Y AB co Radiator A/M L N/A Y 12 Supports A/M L N/A Y Floor AIM L N/A Y 34 Drawers A/M L N/A Y Ceiling A/M L N/A Y Window Sill M/I AIM L NIA Y A B Door A/M L N/A Y FN Win Apron AIM L N/A Y oor Casing AIM L NIA Y Win Casing AIM L N/A Y 1 DoorJamb O AIM L N/A Y Header Stop MA AIM L N/A Y 34 Threshold A/M L N/A Y Int Stops M/1 A/M L N/A Y A B Door 41A/M L N/A Y 1 Win Int Sash M/I A/M L N/A Y C D Door Casing A/M L N/A Y 2 Exterior Sill M/I SF L N/A Y 12 Door Jamb A/M L N/A Y 3 Part Bead M/I L N/A Y 34 Threshold A/M L N/A Y 4 1 Blind Stop MA SF L N/A Y A Closet Door j AIM L N/A Y. Win Ext Sash M/I L N/A Y B CI Casing AIM L N/A Y ABc o Win Above 5' MA AIM L NA Y AB C Closet Jamb AAd L NIA Y CD Ceiling Moldin MA AIM L NA Y AB D Closet Walls A/M L N/A Y CD Medicine Cab MA AIM L NA Y AB Cl Baseboard A1M L N/A Y CD Wall O/C MA A/M L NA Y 1 Closet Pole A/M L N/A Y S{�,f% (� MA AIM L NA Y 2 Closet Shelf A/M L N/A Y MA AAd L NA Y 3 CI Supports AIM L N/A Y M/I AIM L NA Y 4 Closet Floor A/M L NIA Y• MA A/M L NA Y 11o,eng AAd L N/A YM/l A/M L NA Y e A/M L N/A Y MA AAd L NA Y C D r A/M L N/A Y MA AIM L NA Y s AIM L N/A Y MA AIM L NA Y 12 s AfM L N/A Y MA AIM L NA Y 34 AIM L N/A Y M/I AIM L NA Y M/I A/M L N/A Y MA AIM L NA Y M/I A/M L N/A Y MA AAd L NA Y MA A/M L N/A Y M/I A/M L NA Y COMMENTS I STRUCTURAL DEFECTS: COMMENTS I STRUCTURAL DEFECTS: tEXCLUDED SURFACES:Surfaces;listed in these boxes can be made intact only by a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDEJ LOCATION MEASURE:LOOSE PAINT IC IC (MORE THAN 288 SO.IN.) DATE METHOD (MORE THAN 288 SO.IN.) DATE METHOD ff Fie Apollm Page t_I OfW Inspector(print) r It Sianature Date Risk Assessor(print) 60 Louis St., #4, Hyannis 02601 June 26, 2009 Date Address of Pro ert : City: HALLWAY:Interior #XIPATIor Common Hallway: Front Rear Floor#_ SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDEJ LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH SLL A B Up Walls AIM L N/A Y A Closet Door AIM L N/A Y A B Low Walls— A/M L N/A Y B Cl Casing A/M L N/A Y A B Baseboards Q. AIM L N/A Y C Closet Jamb AIM L NIA Y A Chair Rail A!M L N/A Y D Closet Walls A/M L N/A Y A c D Radiator AIM L N/A Y Cl Baseboard A/M L N/A Y ID Floor A/M L N/A Y 1 Closet Pole AIM L N/A Y Ceiling AIM L N/A Y 2 Closet Shell AIM L N/A Y Door AIM L N/A Y 3 Cl Supports AIM L NIA Y Door Casing O. A/M L NIA Y 4 Closet Floor AIM L N/A Y 12 1 Door Jamb A/M L N/A Y Closet Ceiling A/M L N/A Y 3 4 iThreshold AIM L N/A Y A Window Sill M/I AIM L N/A Y B boor A/M L N/A Y B Win Apron A/M L N/A Y C D Door Casing A/M L N/A Y C Win Casing A/M L N/A Y 12 Door Jamb AIM L N/A Y D Header Stop M/I A/M L N/A Y 34 Threshold A/M L NIA Y Int Slops I M/I A/M L N/A Y A B Door A/M L N/A Y 1 Win Int Sash M/I AIM L N/A -Y R2 Door Casing A/M L N/A Y 2 Exterior Sill M/I SF L N/A Y Door Jamb AMA L N/A Y 3 Pail Bead M/I L N/A Y 34 Threshold A/M L N/A Y 4 Blind Stop M11 SF L N/A Y ZD Door AIM L N/A Y Win Ext Sash M/I L NIA Y oor Casing AIM L N/A Y A Window Sill JIMA A/M L N/A Y 12 Door Jamb A/M L N/A Y B Win Apron AIM L N/A Y 34 Threshold AIM L NIA Y C Win Casing A/M L NIA Y A B Door A/M L N/A Y D Header Slop I IM/I A/M L N/A Y C D Door Casing AIM L N/A Y Int Stops I IMM AIM L NIA Y # Door Jamb AIM L N/A Y 1 Win Int Sash M/I AIM L N/A Y Threshold A/M L N/A Y 2 Exterior Sill M/I SF L N/A Y A Closjb r AIM L N/A Y 3 Part Bead M/I L N/A Y B Cl CA/M L N/A Y 4 Blind Slop M/I SF L N/A Y C Closb A/M L N/A Y Win Ext Sash M/1 L N/A Y GD Closls AIM L N/A Y A B Win Above 5' MA AIM L N/A Y AB Cl Brd A/M L NIA Y c o Ceiling Moldin MA AIM L NIA Y 1 Clos A/M L N/A Y Mll A/M L N/A Y 2 Closll AIM L N/A Y COMMENTS/STRUCTURAL DEFECTS: 3 Cl S �• AIM L N/A Y 4 Closr AIM L N/A Y Closing AIM L N/A I Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact only by a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IC IC (MORE THAN 288 SO.IN.) DATE METHOD (MORE THAN 288 SO.IN.) DATE METHOD ICED 96Hf1 t1'A ..t /i c Page.L 01- Inspector(print) Lic N Signature Dale 60 Louis St., #4, Hyannis 02601 Risk Assessor(print) June 26, 2009 Dale Address of Property: „.. . city: STAIRCASE �` TO 2A[0 4 SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH A e Up Walls O O AIM L N/A Y Window Sill M/I AIM L N/A Y A e Low Walls AIM L N/A Y B Win Apron AIM L NIA Y Ae Baseboards A/M L N/A Y C Win Casing AINI L NIA Y A e Chair Rail A/M L N/A Y D Header Stop M/I AIM L N/A Y AB C o Radiator A/M L N/A Y Int Stops M/I AIM L N/A Y Floor A/M L N/A Y 1 Win Inl Sash (� M/I AIM L NIA Y :. Ceiling 0% AIM L N/A Y 2 Exterior Sill q. M/I SF L NIA Y A Door A/M L NIA Y 3 Part Bead M/I L NIA Y C D Door Casing AIM L NIA Y 4 Blind Slop M/I SF L NIA Y 12 Door Jamb A/ L /A Y Win Exl Sash M/I L N/A Y 34 Threshold l A/M L N/A Y A . Window Sill M/I A/M L NIA Y B Door*i, AIM L NIA Y B Win Apron AIM L N/A Y C Door Casing AIM L N/A Y C Win Casing A/M L N/A Y 12 Door Jamb Q AIM L N/A Y D Header Slop MA AIM L N/A Y 34 Threshold 0- AIM L N/A Y Int Stops M/I AIM L NIA Y A B Door A/M L N/A Y 1 Win Int Sash M/1 A/NI L N/A Y C oor Casing Z A/M-t N/A Y 2 Exterior Sill M/1 SF L NIA Y 1 Door Jamb (�: AIM L N/A Y 3 Part Bead M/I L NIA Y 34 Threshold A/M L N/A Y 4 Blind Stop M/I SF L N/A Y A Door '� A/M L N/A Y Win Ext Sash M/I L N/A Y D Door Casing AIM L NIA Y Newel Post t;7 A/M L N/A Y 12 Door Jamb AIM L N/A Y Railing Cap (� A/M L NIA Y 34 Threshold L /A Y Handrail A/M L NIA Y B oor• AIM L N/A Y Balusters Q AIM L N/A Y C Door Casing AIM L N/A Y Lower rail AIM L NIA Y N Door Jamb A/M L N/A Y Treads A/M L NIA Y Threshold AIM L N/A Y nisers a A/M L N/A Y A �� (�. A/M L N/A Y Stringer AIM L N/A Y B V&ip c 15 ( AIM L N/A Y Floor Edge AIM L N/A Y C r�,J � (J. A(M L N/A Y ray Floor Casing AIM L N/A Y D r�I �J AIM L N/A Y M/I A/M L N/A Y Cl Baseboard AIM L N/A Y COMMENTS/STRUCTURAL DEFECTS: 1 Closet Pole AIM L NIA Y 2 Closet Shell A/M L N/A Y 3 CI Supports AIM L NIA Y 4 Closet Floor AIM L N/A Y Closel Ceiling A/M L NIA Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact only by a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDEJ LOCATION MEASURE:LOOSE PAINT IC IC (MORE THAN 288 SO.IN.) DATE METHOD (MORE THAN 288 SO.IN.) DATE METHOD i Pagei3 Of Z� Inspector(print) Lic# Signature Date 60 Louis St., #4, Hyannis 02601 Risk Assessor(print) June 26 2009 Date , Address of Property: it HALLWAY:Interior #_ or Common Hallway: Front Rear loor#V SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD I SIDEJ LOCATION/ LEAD TYPE OF URG IC I IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH A B Up Walls AIM L N/A Y A Closet Door 4 A/M L N/A Y A e Low Walls AIM L N/A Y B Cl Casing A/M L N/A Y A B Baseboards A/M L N/A Y C Closet Jamb AIM L N/A Y A B Chair Rail A/M L N/A Y D Closet Walls AIM L N/A Y AB CD Radiator A/M L N/A Y CI Baseboard AIM L N/A Y Floor A/M L N/A Y 1 Closet Pole A/M L N/A Y Ceiling AIM L N/A Y 2 Closet Shelf NM L N/A Y B Door o AIM L N/A Y 3 Cl Supports A/M L N/A Y D Door Casing AIM L N/A Y 4 Closet Floor A/M L N/A Y 1 Door Jamb �. AN L N/A Y Closet Ceiling A/M L NIA Y 3 4 Threshold AIM L N/A Y A Window Sill M/I AIM L N/A Y B Door AIM L NIA Y B Win Apron AIM L N/A Y C Door Casing A/M L N/A Y C Win Casing A/M L N/A Y 4 Door Jamb A/M L N/A Y D Header Stop M/I AIM L N/A Y 34 Threshold A/M L N/A Y Int Stops M/I AIM L N/A Y A B Door�i AN L N/A Y 1 Win Int Sash M/I AIM L N/A Y Door Casing AIM L N/A Y 2 Exterior Sill MA SF L N/A Y 2 Door Jamb AI L N/A Y 3 Part Bead MA L N/A Y 34 Threshold Q 4) AIM L N/A Y 4 Blind Stop M/1 SF L N/A Y A B Door AIM L N/A Y Win Ext Sash M/I L N/A Y FDoEor asingAIM L N/A Y A Window Sill M/I AIM L N/A Y 12 Jamb AIM L N/A Y B Win Apron AIM L N/A Y 34 Threshold AIM L NIA Y C Win Casing AIM L N/A Y A B IDAIM L N/A Y D Header Stop M/I AIM L N/A Y b AIM L N/A Y Int Stops M/I A/M L NIA Y # A/M L N/A Y 1 Win Int Sash MA AIM L N/A Y AIM L N/A Y 2 Exterior Sill M/I SF L N/A Y A A/M L N/A Y 3 Part Bead M/I L N/A Y B AN L N/A Y 4 Blind Stop M/I SF L N/A Y C V' AIM L N/A Y Win Ext Sash M/I L N/A Y AB AIM L N/A YcDWin Above 5' M/I NM L N/A Y AB CI Baseboard KM L NIA I Y CD Ceiling Moldin MA AIM L N/A Y 1 Closet Pole AIM L N/A Y MA AIM L N/A Y 2 Closet Shelf AIM L N/A Y COMMENTS/STRUCTURAL DEFECTS: 3 ClSupports A/M L N/A Y 4 jCloset Floor AIM L N/A Y Closet Ceiling AN L N/A Y EXCLUDED SURFACES:Surfaces listed in these boxes Can be made intact only by a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IC IC (MORE THAN 288 SQ.IN.) DATE METHOD (MORE THAN 288 SQ.IN.) DATE METHOD ICED f{ 1r1 r�i9 (,3` Page' 01 R Inspector(print) a Signalure Date 60 Louis St., #4, Hyannis 02601 Risk Assessor(print) June 26, 2009 Date Address of Pro ert : it : STAIRCASE �i `v eAlL 2—X0 r" Wyt— SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH ne Up Walls NM NIA Y A Window Sill �.(�M/I A/M L N/A Y A B Low Walls A/M L N/A Y B Win Apron AIM L NIA Y A B Baseboards 0. NM L N/A Y C Win Casing U AIM L NIA Y A B Chair Rail AIM L N/A Y D Header Stop .1 MA A/M L NIA Y AB f' Go Radiator NM L N/A Y Int Stops 0 0 M/I NM L N/A Y yj.Floor AN L NIA Y 1 Win Int Sash M/ AIM L NIA Y , Ceiling AIM L N/A Y 2 Exterior Sill / SF L NIA Y A Door A/M L N/A Y 3 Part Bead / IL N/A Y C Door Casing— j AMFt N/A Y 4 Blind Stop U M/ SF IL N/A Y 102 'Door Jamb AIM L N/A Y Win Ext Sash .l M jl NIA Y 3 4 Threshold AN L N/A Y A Window Sill ' A NM 'L NIA Y Ag Door AN L N/A Y B Win Apron AIM IL N/A Y C Door Casing AIM L N/A Y C Win Casing Z A/M !L N/A Y i Door Jamb A/M L N/A Y D Header Slop Q MA AIM IL N/A Y 3 4 Threshold A/M L N/A Y Int Slops (�.� M/I AIM I'L N/A Y A B Doors AIM L N/A Y 1 Win Int Sash Z AlA/M iL NIA Y Door Casing AN L NIA Y 2 Exterior Sill AlSF IL N/A Y 1 Door Jamb AIM L N/A Y 3 Part Bead AlIL NIA Y 3 4 Threshold A/M L N/A Y 4 Blind Stop A SF IL N/A Y A B Doo (� A/M L N/A Y Win Ext Sash I it N/A Y CG Door Casing—U• AIM L N/A Y Newel Post 0 AIM iL NIA Y 2 Door Jamb"' AN L N/A Y Railing Cap 00 AIM !L N/A Y 34 Threshold AN L N/A Y Handrail C), AIM IL N/A Y A B Door AIM L N/A Y Balusters AIM IL N/A Y Door Casin AA�I L NIA Y Lower rail AN 'L N/A Y ff Door Jamb AIM L N/A Y Treads AIM iL NIA Y Threshold A/M L N/A Y Risers AIM jL N/A Y A Closet Door AN L N/A Y Stringer NM 'L N/A Y B Cl Casing A/M L N/A Y Floor Edge AIM L NIA Y C Closet Jamb A/M L N/A Y y Floor Casing AIM L N/A Y D Closet Walls AIM L N/A Y MA ARd L NIA Y Cl Baseboard A/M L N/A Y COMMENTS/STRUCTURAL DEFECTS: 1 Closet Pole A/M L N/A Y 2 Closet Shelf A/M L N/A Y 3 Cl Supports A/M L N/A Y 4 Closet Floor AIM L N/A Y Closet Ceiling NM L N/A Y EXCLUDED SURFACES:Surlaces listed in these boxes can be made intact only by a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IC IC (MORE THAN 288 SO.IN.) DATE METHOD (MORE THAN 288 SO.IN.) DATE METHOD 04a FRo -A a73L L. page 5 Of Inspectorr(print) Lic# Signalur Date Risk Assessor(print) 60 Louis St., #4, Hyannis 02601 Date Address of Property: June 26, 2009 BASEMENT/LAUNDRY AREA SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDEJ LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH A B Walls D AIM L N/A Y AB rn Pipes JI AIM L NIA Y AB rD Walls AIM L N/A Y A e CD Sink A/M L N/A Y AB Walls A/M L N/A Y AB Drainpipe A/M L N/A Y AB Walls A/M L N/A Y A B Serviceboard AIM L N/A Y AB CD 113aseboards A/M L N/A Y A B Shelves AIM L N/A Y AB C D Chair rails A!.M.L_NA Y C D Supports AIM L N/A Y Floor A/M L NIA Y A B Shelves A/M L N/A Y Ceiling AIM L N/A Y C D Supports AIM L N/A Y AB C D lChimney ( A/M L N/A Y A B lShelves AIM L N/A Y AB co Support Colu AIM L /A Y C D Supports A/M L N/A Y Door 6�j r AIM L N/A Y Window frame M/1 AIM L N/A Y D Door Casing A/M L N/A Y Window Sash M/I A/M L N/A Y 12 Door Jamb AIM L N/A Y Exterior Sill MA AIM L NIA Y 34 Threshold 1— AIM L N/A Y 1 Part Bead M/I A/M L N/A Y AB Door N/A Y 3 4 Win Ext Sash M/1 A/M L N/A Y C Door Casing A/M L N/A Y Window frame M/I AIM L N/A Y 2 Door Jamb N/A Y A B Window Sash MA AN L N/A Y 34 Threshold L N/A Y C D Exterior Sill M/I AIM L N/A Y 6B NJamb . N/A Y 12 Part Bead Mn AIM L N/A Y C D AIM L N/A Y 3 4 Win Ext Sash MA A/M L N/A Y 12 /A Y Window frame M/I A/M L N/A Y 34 A/M L N/A Y A B Window Sash M/I NM L N/A Y AB C D Cabinets A/M L NIA Y C.D Exterior Sill M/I A/M L N/A Y A B Benches A/M L N/A Y 12 Part Bead M/I AIM L N/A Y C D Supports A/M L N/A Y 34 Win Ext Sash tul/l AIM L N/A Y A 'OIL—jg' L /A Y Window frame MA AIM L N/A Y " Cft11 A/M L N/A Y A B Window Sash M/1 AIM L N/A Y C h JA410* N/A Y C D Exterior Sill MA A/M L N/A Y D fWla4 0 AIM L N/A Y 12 Part Bead M/I AIM L N/A Y Cl Baseboard AIM L N/A Y 34 Win Ext Sash M/I A/M L NIA Y 1 Closet Pole AIM L N/A Y Newel Posts AIM L N/A Y 2 Closet Shelf AIM L N/A Y A B Handrail A/M L N/A Y 3 CI Supports AIM L N/A Y C D Balusters A/M L N/A Y 4 Closet Floor A/M L N/A Y 12 Lower rail AIM L NIA Y Closet Ceiling A/M L N/A Y 34 Treads A/M L N/A Y Comm ents tructural Defects Risers AIM L NIA Y Stringer lj KM L N/A Y All co L NIA Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact only by a ensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDEJ LOCATION MEASURE:LOOSE PAINT IC IC (MORE THAN 288 SO.IN.) DATE METHOD (MORE THAN 288 S0.IN.) DATE METHOD Inspector(print) Lic# Signature V Date 60 Louis St., #4, Hyannis 02601 Risk Assessor (print) June 26, 2009 Date Address of Property: -- — City EXTERIOR A Side SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD A SURFACE HAZARD HAZ? DATE METH DATE METH A SURFACE HAZARD HAZ? DATE METH DATE METH Siding L N/A Y Window Sill AIM L N/A Y Comer Boards L N/A Y A Win Casing A/M L N/A Y A Lower Trim L N/A Y # Window Sash A/M L N/A Y Upper Trim (—L)N/A Y Cellar Win Sill A/M L N/A Y Win Above 5' 114 L N/A Y A Cel Win Sash A/M L N/A Y Porch Above 5' L N/A Y # Cel Win Frame A/M L N/A Y Storm Door A/M L N/A Y Screen Frame. AIM L N/A Y Door AIM L N/A Y Cellar Win Sill AIM L N/A Y A Door Casing L /A Y A Cel Win Sash AIM L N/A Y 1 2 Door Jamb /A Y # Cel Win Frame A/M L N/A Y 3 4 Threshold M /A Y Screen Frame A/M L N/A Y Kickplate L /A Y Cellar Win Sill A/M L N/A Y Storm Door A/M L N/A Y A Cel Win Sash A/M L N/A Y Door A/M L N/A Y # Cel Win Frame A/M L N/A Y A Door Casing JA/M L N/A Y Screen Frame A/M L N/A Y 1 2 Door Jamb AIM L N/A Y Cellar Win Sill A/M L NIA Y 3 4 IThreshold I AIM L N/A Y A Cel Win Sash A/M L N/A Y Kickplate A/M L N/A Y # Cel Win Frame AIM L N/A Y Door A/M L N/A Y Screen Frame A/M L N/A Y A Door Casing A/M L WA Y Foundation L N/A Y 1 2 Door Jamb AIM L N/A Y A Bulkhead A/M L N/A . Y 3 4 Threshold AIM L N/A Y Fences A/M L N/A Y tZ Window Sill L N/A Y Shutters A/M L N/A Y A Win Casing A/M L N/A Y Newel post A/M L N/A Y #. Window Sash /A Y Railing Cap AIM L N/A Y Window Sill N/A Y Handrail AIM L'N/A Y A Win Casing AIM L N/A Y A Balusters A/M L N/A Y # Window Sash '1 A/M L /A Y. Lower Rail AIM L N/A Y Window Sill A/M L N/A Y [�?l�°Z A/M L N/A Y A Win Casing AIM L N/A Y pj'r3 A/M L N/A Y # Window Sash A/M L N/A Y S i t2.r` A/M L N/A Y A Lamp Post L N/A Y Lattice AIM L N/A Y COMMENTS/STRUCTURAL DEFECTS: S'A L45 L N/A Y A Elec Conduit L N/A Y Oil Fill Pipe L N/A Y Overhang Trim A/M L N/A Y Excluded Surfaces:Surfaces listed in this box can be made Soil Test Results intact only by a licensed deleader (Must be less than 400 ppm for play area/1200 ppm for bare soil) SIDE LOCATION MEASURE:LOOSE PAINT IC IC LOCATION AREA MEASUREMENT RESULT REMED REMED A (MORE THAN 1440 SO.IN.) DATE METH (Square Feet) (PPM) DATE METH A Play Area A Bare soil A Comments: A LYRA RepExtA,8/08 r 'f Leo Aim ti I LA: G Page 1 Of Inspector(print) I ir.it Signature 1V Date 60 Louis St., #4, Hyannis 02601 Risk Assessor (print) June 26, 2009 Date Address of Property: City EXTERIOR B Side SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDEJ LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD B SURFACE HAZARD HAZ? DATE METH DATE METH B SURFACE HAZAR HAZ? DATE METH DATEI METH Siding V L N/A Y Window Sill A/M L N/A Y Comer Boards If L N/A Y B Win Casing Q L N/A Y B Lower Trim L N/A Y # ( Window Sash L)N/A Y Upper THm L N/A Y Cellar Win Sill AIM N/A Y Win Above 5' L N/A Y B Cel Win Sash I AIM L PIA Y Porch Above 5'�' L N/A Y # Cel Win Fram A/M /A Y Storm Door AIM L N/A Y Screen Frame /. AN—L N/A Y Door 6.4, A/M N/A Y Cellar Win Sill L N/A Y B Door Casin AIM L /A Y B Cel Win Sash A/M L N/A Y 1 2 Door Jamb A/M N/A Y #7 Gel Win Frame N/A Y 3 4 Threshold AIM L N/A Y _ Screen Frame AIM L N/A Y ft—1 late A/M L N/A Y Cellar Win Sill A/M L /A Y Storm Door AIM L N/A Y B Cel Win Sash . A/M L /A Y Door ,,� A/M L N/A Y #-7 Cel Win Fram M N/A Y B Door Casing 06AIM L N/A Y J —Screen-Tame A/M L N/A Y 1 2 Door Jamb W. AIM L N/A Y Cellar Win Sill A/M L /A Y 3 4 Threshold AIM L N/A Y B Cel Win Sash A/M L /A Y Kickplate AIM L N/A Y #( Cel Win Frame N/A Y Door Ajj 0 A/M L N/A Y Screen Frame A/M L N/A Y B Door Casing" A/M L N/A Y Foundation L N/A Y 1 2 Door Jamb A/M L N/A Y B Bulkhead A/M L N/A Y 3 4 Threshold A/M L N/A Y Fences A/M L N/A Y Window Sill AIM L N/A Y Shutters AIM L N/A Y B Win Casing A/ L N/A Y �Gl, '{�75t�L_ N/A Y # Window Sash OI N/A Y V +C/fy;rJ A/M N/A Y Window Sill 09 AIM N/A Y k� r� 5ASit Y B Win Casing KKV N/A Y B Balusters A/M L N/A Y #`l,Window Sash AIM N/A Y Lower Rail A/M L N/A Y Window Sill A/M L N/A Y Treads A/M L NIA Y B Win Casing L N/A Y Risers A/M L N/A Y # Window Sash L N/A Y Stringer AIM L N/A Y B Lamp Post L N/A Y Lattice A/M L N/A Y COMMENTS/STRUCTURAL DEFECTS: ijiO4 L N/A Y B aF L N/A Y L N/A Y Overhang Tri A/M L N/A I Y Excluded Surfaces:Surfaces listed in this box can be made Soil Test Results intact only'by a licensed deleader (Must be less than 400 ppm for play area/1200 ppm for bare soil) SIDE LOCATION MEASURE:LOOSE PAINT IC IC LOCATION AREA MEASUREMENT RESULI REMED REMED A (MORE THAN 1440 SQ.IN.) DATE METH (Square Feet) (PPM) DATE METH A Play Area A Bare soil A Comments: A LURA RepExtB,8/08 Q d2fd ILA *-2 5o Page Of Inspector(print) Lic# Signature Date 60 Louis St., #4, Hyannis 02601 Risk Assessor (print) June 26, 2009 Date Address of Property: City: EXTERIOR C Side SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD C SURFACE HAZARD HAZ? DATE METH DATE METH C SURFACE HAZARD HAZ? DATE METH DATE METH Siding L N/A Y Window Sill A/M L N/A Y Corner Boards L N/A Y C Win Casing A/M L N/A Y C Lower Trim L N/A Y # lWindow Sash A/M L N/A Y Upper Trim N/A Y Cellar Win Sill AIM L N/A Y Win Above 5' N/A Y C Cel Win Sash AIM L N/A Y Porch Above 5' L N/A Y # Gel Win Frame A/M L N/A Y Storm Door A/M L N/A Y Screen Frame AIM L N/A Y Door A/M Ll N/A Y Cellar Win Sill A/M L N/A Y C Door Casing L /A Y C Cel Win Sash A/M L N/A Y 1 2 Door Jamb AIM L' /A Y # Cel Win Frame A/M L N/A Y 3 4 Threshold AIM N/A Y Screen Frame A/M L N/A Y KicWate WL N/A Y Cellar Win Sill A/M L N/A Y Storm Door AIM L N/A Y C Cel Win Sash AIM L N/A Y Door A/M L N/A Y # Cel Win Frame A/M L N/A Y C Door Casing A/M L NIA Y Screen Frame A/M L N/A Y 1 2 Door Jamb AIM L N/A Y Cellar Win Sill A/M L N/A Y 3 4 Threshold A/M L N/A Y C Cel Win Sash AIM L N/A Y Kicliplate A/M L N/A Y # Cel Win Frame A/M L N/A Y Door AIM L N/A Y Screen Frame AIM L N/A Y C Door Casing AIM L N/A Y Foundation 0 L N/A Y 1 2 Door Jamb AIM L NIA Y C Bulkhead AIM L N/A Y 3 4 Threshold AIM L N/A Y Fences AIM L N/A Y �\ Window Sill A/M L N/A Y Shutters AIM L N/A Y C Win Casing �j' A/M L N/A Y Newel post AIM L N/A Y # Window Sash A/M(L)N/A Y Railing Cap AIM L N/A Y Window Sill L N/A Y Handrail AIM L N/A Y C Win Casing L N/A Y C Balusters AIM L N/A Y # Window Sash AIM L N/A Y Lower Rail AIM L N/A Y Window Sill AIM L N/A Y Treads AIM L N/A Y C Win Casing A/M L N/A Y Risers A/M L N/A Y # Window Sash A/M L N/A Y Stringer AIM L N/A Y C Lamp Post L N/A Y Lattice AIM L N/A Y COMMENTS/STRUCTURAL DEFECTS: Drain Pipes L N/A Y C Elec Conduit L N/A Y Oil Fill Pipe L NIA Y Overhang Trim AIM L N/A Y Excluded Surfaces:Surfaces listed in this box can be made Soil Test Results intact only by a licensed deleader (Must be less than 400 ppm for play area/1200 ppm for bare soil) SIDE LOCATION MEASURE:LOOSE PAINT IC IC LOCATION AREA MEASUREMENT RESUL REMED REMED A (MORE THAN 1440 SO,IN.) DATE METH (Square Feet) (PPM)l DATE METH A Play Area A Bare soil A j Comments: A LURA RepExtC,8/08 11A A 736 L Page=f Of Inspector(print) Lic# Sionature Date 60 Louis St., #4, Hyannis 02601 Risk Assessor (print) June 26, 2009 Date Address of Property: City: EXTERIOR D Side P11 [ 0 ;— SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDEJ LOCATION I LEAD TYPE OF URG IC IC DELEAD DELEAD D SURFACE HAZARD HAZ? DATE METH DATE METH D SURFACE HAZARD HAZ? DATE METH DATE METH Siding L N/A Y Window Sill141 AMY L N/A Y Comer Boards L N/A Y D Win Casing NIA Y D Lower Trim L N/A Y # (0 Window SashVk A/M L N/A Y Upper Trim N/A Y Cellar Win Sill 1 [AIM'IL N/A Y Win Above 5' N/A Y D Cel Win Sash I AIM I L N/A Y Porch Above 5'/' L N/A Y # F Cel Win Frame kA/yf L N/A Y Storm Door A/M L N/A Y l Screen Frame A/M L N/A Y Door AIM L N/A Y Cellar Win Sill .0 1 kMjL N/A Y D Door Casing A/M L N/A Y D Cel Win Sash A/M L N/A Y 1 2 Door Jamb A/M L N/A Y #0 Cel Win Fram A/ L N/A Y 3 4 Threshold AIM L N/A Y � Screen Frame A/M L N/A Y Kickplate AIM L N/A Y Cellar Win Sill L N/A Y Storm Door A/M L N/A Y D Cel Win Sash A/M L N/A Y Door AIM L N/A Y # Cel Win Fram S. L N/A Y D Door Casing A/M L N/A Y Screen Frame A/M L N/A Y 1 2 Door Jamb A/M L N/A Y Cellar Win Sill L N/A Y 3 4 Threshold A/M L N/A Y D Cel Win Sash AIM L N/A Y Kickplate A/M L N/A Y # Cel Win Fram L N/A Y Door AIM L NIA Y t Screen Frame A/M L N/A Y D Door Casing A/M L N/A Y Foundation L N/A Y 1 2 Door Jamb AIM L N/A Y D Bulkhead A/M L N/A Y 3 4 Threshold AIM L N/A Y Fences AIM L N/A Y Window Sill A/M L N/A Y Shutters A/M L N/A Y Win Casing &YNN/A Y Newel post A/M L N/A Y # Window Sas N/A Y Railing Cap A/M L N/A Y Window Sill Q: A/M L N/A Y Handrail A/M L N/A Y D Win Casing OViD N/A Y D Balusters AIM L N/A Y !I Window Sash A/M L N/A Y Lower Rail A/M L N/A Y �L Window Sill A/ N/A Y Treads AIM L N/A Y D Win Casing A4 L N/A Y Risers A/M L N/A Y #j Window Sas A/ N/A Y Stringer AN L N/A Y D Lamp Post L N/A Y Lattice AN L N/A Y COMMENTS/STRUCTURAL DEFECTS: Drain Pipes 60 L N/A Y D Elec Conduit L N/A Y Oil Fill Pipe L N/A Y Overhang Trim A/M L N/A Y Excluded Surfaces:Surfaces listed in this box can be made Soil Test Results intact only by a licensed deleader (Must be less than 400 ppm for play area/1200 ppm for bare soil) SIDE LOCATION MEASURE:LOOSE PAINT IC IC LOCATION AREA MEASUREMENT RESULTREMED REMED A (MORE THAN 1440 SQ.IN.) DATE METH (Square Feet) (PPM) DATE METH A Play Area A Bare soil A Comments: A LURA RepExtD,8/08 Page,-�,OOf'- Inspector(print) lac# Signature Date 60 Louis St., #4, Hyannis 02601 Risk Assessor (print) June 26, 2009 Date Address of Property: ... . City: EXTERIOR D Side (,d t>� ;_ a. 0 SIDE LOCATION/ LEAD TYPE OF URG 16 IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD D SURFACE HAZARD HAZ? DATE METH DATE METH D SURFACE HAZARD HAZ? DATE METH DATE METH Siding L N/A Y Window Sill AIM L N/A Y Comer Boards L N/A Y D Win Casing AIM L N/A Y D Lower Trim L N/A Y # Window Sash AIM L N/A Y Upper Trim L N/A Y Cellar Win Sill AIM L N/A Y Win Above 5' L N/A Y D Gel Win Sash AIM L N/A Y Porch Above 5' L N/A Y # Cel Win Frame AIM L N/A Y Storm Door AIM L N/A Y Screen Fram AIM L N/A Y Door AIM L N/A Y Cellar Win Sill AIM L N/A Y D Door Casing AIM L N/A Y D Cel Win Sash AIM L N/A Y 1 2 Door Jamb AIM L N/A Y # Cel Win Frame AIM L N/A Y 3 4 Threshold AIM L N/A Y Screen Frame AIM L N/A Y Kickplate I A/M L N/A Y Cellar Win Sill j AIM L N/A Y Storm Door A/M L N/A Y D Cel Win Sash AIM L N/A Y Door AIM L N/A Y # Cel Win Frame AIM L N/A Y D Door Casing AIM L N/A Y Screen Frame AIM L N/A Y 1 2 Door Jamb AIM L N/A Y Cellar Win Sill AIM L N/A Y 3 4 Threshold AIM L N/A Y D Cel Win Sash AIM L N/A Y Kickplate AIM L N/A Y # Cel Win Frame AIM L N/A Y Door AIM L N/A Y Screen Frame AIM L N/A Y D Door Casing A/M L N/A Y Foundation L N/A Y 1 2 Door Jamb AIM L N/A Y D Bulkhead AIM L N/A Y 3 4 Threshold AIM L N/A Y Fences AIM L N/A Y )CZ Window Sill AIM L N/A Y Shutters AIM L N/A Y D Win Casing L /A Y Newel post AIM L N/A Y # Window Sa °' A/ L /A Y Railing Cap AIM L N/A Y Window Sill AIM L N/A Y Handrail A/M L N/A Y D Win Casing N/A Y D Balusters AIM L N/A Y # 0 Window Sash AIM L N/A Y Lower Rail AIM L N/A Y Window Sill AIM L N/A Y Treads A/M L N/A Y D Win Casing A/M L N/A Y Risers AIM L N/A Y # Window Sash A/M L N/A Y Stringer AIM L N/A Y D Lamp Post 7 L N/A Y Lattice AIM L N/A Y COMMENTS/STRUCTURAL DEFECTS: Drain Pipes L N/A Y D Elec Conduit L N/A Y Oil Fill Pipe L N/A Y Overhang Trim AIM L N/A Y Excluded Surfaces:Surfaces listed in this box can be made Soil Test Results intact only by a licensed deleader (Must be less than 400 ppm for play area/1200 ppm for bare soil) SIDE LOCATION MEASURE:LOOSE PAINT IC IC LOCATION AREA MEASUREMENT RESUL REMED REMED A (MORE THAN 1440 SO,IN.) DATE METH (Square Feet) (PPM) DATE METH A Play Area A Bare soil A Comments: A ` LYRA RepExtD,8/08 The Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Public Health Center for Environmental Health Childhood Lead Poisoning Prevention Program MITT ROMNEY 250 Washington Street, 7th floor GOVERNOR KERRY HEALEY Boston, MA 02108 LIEUTENANT GOVERNOR 800-5532-9571 RONALD PRESTON SECRETARY CHRISTINE C. FERGUSON COMMISSIONER Documentation of Tr-ainin2 to be an Authorized Owner/Agent And Intention to Comply with the Order to Correct Please complete this form and mail it to the code inspector enforcing the case. His or her address is included in the Order to Correct. the owner, or I, the (print owner's name) owner's agent (fill in one), (print agent's name) do attest to the fact that I have complied with the owner/agent deleading training prerequisites of 105 CMR 460.000, the Lead Poisoning Prevention Regulations, and passed an exam to qualify for and perform specific abatement and containment work. I further attest to the fact that I will complete the abatement and containment work that I will perform in compliance with 105 CMR 460.000, the Lead Poisoning Prevention Regulations, and within the deadlines stipulated in the Order to Correct Violation(s). Finally, I attest that I will not exceed the scope of my low-risk authorization/moderate risk authorization (circle appropriate level of authorization). Signature of Owner or Agent Authorization Number (Address of unit where work will be performed) li Name of Code Enforcement Lead Inspector: Doc of Training 1-05 Page 1 of 1 k 07/23/2009 05:58 508-428-1974 HOSTETTER REALTY PAGE 01 HOSTETTER REALTY 770A Main Street Osterville, MA 02655 Phone: (508) 428-2828 Fax: (508) 428.1974 @Fax: From: Date: Pages: �, including this page � . -7 �. � U 07/23/2009 05:58 508-428-1974 HOSTETTER REALTY PAGE 02 r NIgF�:x-:Stephen Barnatt (150842819r4) Steve F1cr.iutP Allora Constwuct:cr, Inc. 163 Center Street •Souih Dennis, MA 02660 tel; 508-39A,5A95 Fax: 1,866-253-0538 stove.6arna"Vmac.corn 4eleading Contractor DC616-HIC 101927 -CS. U&S August 3, 2009 Hostetter Realty 770-A Main Street Osteraille, MA 02655 Re, Proposal, leac9 paint abatement at 60 Louis Street, Apartment 4, Hyannis. MA. ! hereby propose to%jMish the labor and materials necessary for the completion of deleadW4 at 60 Louis Street Apartment#4 and commcn interior areas and exterior to include; Gammon anq_L=rjgL&UL-' J� Remove two pair of affected 'window sash. Replace with white vinyl insulated replacement style window units with low-e insulation, half screens, tilt sash and grids to match existing style. -Remove nine cellar window units. Replace with white vinyl insulated hopper style cellar window units. -Remove rear common egress door unit and cellar door unit at bottom of celiar bulk head. Replace with fiberglass insulated door unit with aluminum thresholds. Existing lock set will be reused on rear egress, new lock Set will be provided for cellar door. -Remove affected exterior door unit at top of cellar bulk head. Rebuild with primed pine to fit existing rough opening. -Scrape and finish sand front entry door jambs, casings, side flies -Scrape and finish sand interior door jambs and door thresholds as required. -Cover affected 90% wall corners in hall 'mays with pine moulding. Lead hoini <bwsment-Lend Sate Renuvnrion Restoruric,n•Vointing-Corpentry•Atlriirions-WlndaYs 07/23/2009 05:58 508-428-1974 HOSTETTER REALTY PAGE 03 r,:,vl)PaY zplephen Barnatt j15084281UN) •• - --- -Remove approximately 11 affected,support posts in cellar. Repiace with pressure treated 44 posts. ;rape all affected loose paint on upper trim (rakes,soitit, fascia, and frieze boards), window sills,window casings to make paint fully intact and ready for priming and finish painting. 1 -Remove nine pair of affected window sash, Replace with white vinyl Insulated replacement style window units with low-e insulation, half screens, tilt sash and grits to match existing style. -Cover blind stops at two exterior windows .nth white alurninum trim. I -Remove affected interior door casings. Replace with primed pine of same dimensions. -Remove affected window casings and window stops. Repiace with primed and clear pine tc match existing. Scrape and finish sand and replace areas of kitchen built in ironing closet as needed. - -Coven affected 90% wall corners in kitchen MJth pine moulding.. -Perform ongoing and final HEPA vacuuming of all common work areas and Apartment 4. -Wash all work areas with a lead specitec detergent. All work is guaranteed to pass a compliance inspection and lead bust wipe sampling as performed by lead inspector Fred Hemmila. ;associated fees are at the owner's additional expense and paid directly to the lead inspector, 07/23/2009 05:58 508-428-1974 HOSTETTER REALTY PAGE 04 n,,My FaX-81ephen Barnau �1 DU541M i P4) 1-vw rJ)va-V,0 Lt, All work is guaranteed to be completed in a timely and professional mariner in accordance with current industry standards for the sum of $18,700,00. Respectfully, .��:� r ,f�rtrriitrr Steve 6amatt Deleading Contractor Construction Supervisor Home Improvement Contractor Notes: -Apartment#4 may NOT be occupied at an time during deleading. The Apart y P Y tenants and all tenant belongings must be removed from the apartment. -Apartment#4 may NOT be occupied until the lead paint inspector has approved all work and received satisfactory results of lead dust wipes, -Apartments 1. and 3 may be occupied during deleading of Apartment #4. -An egress plan must be determined for Apartments 1, 2, and 3 while common exterior areas at being deleaded. -The deleader must have access to the inteeor windows of Apartments 1, 2, and 3 as they will be covered with plastic sheeting during the day time hours when exterior scraping is being performed. The window wells and sills of these windows will be vacuumed and wiped. -Two weeks should be allowed for work in Apartment#4 and cellar. -Two additional weeks should be allowed for exterior work. FORM 30 Caw HOBBS&WARREN TM THE COMMONWEALTH OF MASSACHUSETTS BOARDF HEA TH d CITY/TOWN }� o W C ly✓_� D PARTMENT ADDRESS M yvey`0 TELEPHONE Address _Occupant ' 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 f / �� V Remark 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: 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 LI(O -7 6 —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: V"�! 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 PERJ Y ` INSPECTOR—^ TITLE 1 A.M. DATE TIME P.M. A.M. THE NEXT SCHEDULED REINSPECTION ► / P.M. t � f 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 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.-N00 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 dispo3al 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. - r The Commonwealth of Massachusetts Executive Office of Health and Human Services -- Department of Public Health �r Bureau of Environmental Health Childhood Lead Poisoning Prevention Program DEVAL L. PATRICK 250 Washington Street, Boston, MA 02108-4619 GOVERNOR * (U00) 532-9571 TIMOTHY P.MURRAY LIEUTENANT GOVERNOR JUDYANN BIGBY,MD SECRETARY JOHN AUERBACH COMMISSIONER May 6, 2009 Raven Sullivano Parent/Guardian of Vincent Sullivan, , 60 Louis St Hyannis MA 02601 Dear Parent or Guardian: I am a Public Health Nursing Advisor for the Massachusetts Childhood Lead Poisoning Prevention Program. One aspect of our program is to offer education to families on the prevention of childhood lead poisoning, and to inform parents when their child should return for a lead test. When a child has a lead test in Massachusetts,the results are reported to the Massachusetts Childhood Lead Poisoning Prevention Program. Vincent's i-nost recent lead test was done on 4/21/2009 and the result was 31.0 µg/dL,which is elevated. The Centers for Disease Control& Prevention recommends that a child with a blood lead level above 20 µg/dL have a repeat venous blood test in 1 month. It is important that you contact your child's health care provider to schedule a repeat lead test. r Enclosed, you will find educational materials about lead poisoning. These materials will provide you with important information on how to reduce your child's lead exposure. You can also go to our website at www.state.ma.us/dph/clppp/clppp.ht . If you have any questions aboui childhood lead poisoning or would like to speak with me directly,please feel free to call me at 7.NI 7 & Sincerely, Maureen Foley, RN Public Health Nursing Advisor Childhood Lead Poisoning Prevention Program cc: Enclosures Health;Care Provider f ' RUN ON C-Lab PAGE 1 05/13/09 - 0401 5 Industrial Dr. Mashpee, MA 02649 NETPRT PRE (800) 750-8378 (508) 539-6100 For: VICTOR J CILLIS MD Mne: CILV 100 INDEPENDENCE DRIVE, HYANNIS, MA 02601 NAME: SULLIVANO,VINCENT ANGEL DOB: 10/20/07 AGE: lY 06M MRI# 6856833 LOC: CLAB ADDRESS: 418 BEARSES WAY,HYANNIS,MA 02601 302-983-0565 CELL Spec #: 0508:RL00138R Coll: 05/08/09-1642 Reg MD: CILLIS MD,VICTOR J CC MDs: Ordered: LEAD WHOLE BLD I Test Result Flag Reference > LEAD WHOLE BLD 13 H Desirable <10 ug/dL MAY **. This result has been repeated`. for confirmation. MAY - Performed/referred by Mayo Medical Lab, 200 First St.SW, Rochester,MN 55905 i y ---- _ I . ** FINAL REPORT ** ** END OF REPORT' ** Med Dir: Ramon Blanco M.D. 05-13-2009 08:28 VICTOR CILLIS 5087758673 PAGE1 emu.:as�;a� a rya a�av t rrSCJl.1 tIF I IVIV 11VF'ORMATION 0YAi,Nanre STREET SULLIVAN VINCENT 05-13-2009 IF YOU HAVE ANY QUESTIONS ABOUT YOUR NITS.MA - www.cus.com 418 BEARSES UTAY Prscbr:CILIIS,VICTOR MEDICATION,PLEASE CONTACT YOUR PHARMACIST: HYANNIS,MA 02601-C 00 Refills: 0 MCADAM,BOB,RPh. Ph:508.957-2614 IC FEhHOUS SULF75 MGI0.6 ML DQUA UUALITEST - TAKE 1.6ML 40MG ELEMENTAL IRON)BY MOUTH This is a PALE YELLOW,DROPS. DAILY FOR 4 EEKS IRON SUPPLEMENTS-ORAL COMMON BRAND NAME(S):Feosol,Ferin-Sol WARNING: Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children younger than 6 years.Keep this product out of reach of children.If overdose does occur,seek immediate medical attention or call a poison control center. USES: This medication is an iron supplement used to treat or prevent low blood levels of iron(e.g.,for anemia or during pregnancy).Iron is an important mineral that the body needs to produce red blood cells and keep you in good health. HOW TO USE: Follow all directions on the product package,or take as directed by your doctor.Do not take more than the recommended dosage.If you are uncertain about any of the information, t consult your doctor or pharmacist.This medication is best taken on an empty stomach 1 hour before or 2 hours after meals.Take with a full glass of water(8 ounces or 240 milliliters)unless your, doctor directs you otherwise.If stomach s I s.Do not upset occurs,you may take this medication with food.Avoid taking antacids,dairy products,tea,or coffee within 2 hours before or after this medication crush,chew,or break the tablet or capsule.Doing so . Y because they will decrease its effectivenesie down for 30 minutes after taking this medication.If you are taking a time-release tablet or capsule,it must be swallowed whole.Do not N o can destroy the long action of the drug and may increase side effects.If you are taking chewable tablets,chew the medication thoroughly,then . o swallow.If you have a liquid form,carefully measure out your dose using a medication-measuring device,mix it in a glass of water or juice,and drink the mixture through a straw to prevent staining a the teeth.If your liquid form is to be given by dropper,the dose may be placed well back on the tongue and followed with water or juice.If your liquid form is a suspension,shake the.bottle well o before each dose.Take this medication regularly in order to get the most benefit from it.To help you remember,take it at the same timels)each day.effects persist or worsen,contact your doctor or pharmacist promptly.it o e EFFECTS: Constipation,diarrhea,stomach cramps, upset stomach may occur.These effects are usually temporary and may disappear as your body adjusts to this medication.If any of these a a =_ffeon may cause your stools to turn black,an effect that is not harmful.If your doctor has prescribed this drug,remember that Y N Ir or she has judged that the benefit to you is greater than the risk of side effects.Many people using this medication do not have serious side effects.A very serious allergic reaction to this rare.However,seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction:rash,itching/swelling(especially of the faceltonguelthroat), L Q ;eve >evere dizziness,trouble breathing.This is not a complete list of possible side effects.If you notice other effects not listed above,contact your doctor or pharmacist.Call your doctor for nedicai advice about side effects.In the US,you may report side effects to the Food and Drug Administration(FDA)at 1-800-FDA-1088.In Canada,you may report side effects to Health Canada at G866.234-2345. M. PRECAUTIONS: Before taking this medication,tell your doctor or pharmacist if you are allergic to it;or to tartrazine;or if you have any other allergies.This medication should not be used if -s o 0 ,ou have certain medical conditions.Before taking this medication,consult your doctor or pharmacist if you have:iron overload disorder(e.g.,hemochromatosis,hemosiderosis).Before taking this o nedication,tell your doctor or pharmacist your medical history,especially of:uselabuse of alcohol,liver problems,stomachlintestinal problems(e.g.,ulcer,colitis).If your brand of iron :upplement also contains folic acid,be sure to tell your doctor or pharmacist if you have vitamin B12 deficiency(pernicious anemia)before taking it.Folic acid may falsely improve certain 3horatory tests for vitamin B12 deficiency without actually treating this anemia.Untreated vitamin B12 deficiency may result in serious nerve problems(e.g.,peripheral neuropathy symptoms such as umbnesslpain/tingling sensations).Consult your doctor or pharmacist for details.Chewable tablets of this medicine may contain aspartame.If you have phenylketonuria(PKU)or any other condition hat requires you to restrict your intake of aspartame(or phenylalanine),consult your doctor or pharmacist about using this drug safely.Liquid preparations of this product may contain sugar and/or Icohol-Caution is advised if you have diabetes,alcohol dependence,or liver disease.Ask your doctor or pharmacist about using this product safely.During pregnancy,this medication should be used o o my when clearly needed.Discuss the risks and benefits with your doctor.This medication passes into breast milk.Consult your doctor before breast-feeding. t RUG INTERACTIONS: Your healthcare professionals le.g.,doctor or pharmacist)may already be aware of any possible drug interactions and may be monitoring you for them.Do not start,stop or specially:certain an ��D hinge the dosage any medicine before checking with them first.Before taking this medication,tell our doctor or pharmacist of all prescription and nonprescription/herbal products you may use, antibiotics(e.g.,penicillamine,chloramphenicol,quinolones such as ciprofloxacinlnorfloxacin),bisphosphonates le.g.,alendronate),levodopa,methyldopa,thyroid replacement rugs le.g.,levothyroxine).Avoid taking this medication at the same time as antacids or tetracycline antibiotics.Wait at least 2 hours between taking this medication and an antacid or ltracycllne.If your brand of iron also contains folic acid,be sure to tell your doctor or pharmacist if you take certain anti-seizure drugs(e.g.,hydantoins such as phenytoin).This medication 1 lay interfere with certain laboratory tests(e.g.,fecal occult blood tests),possibly causing false test results.Make sure laboratory personnel and all your doctors know you use this drug.This 3cument does not contain all possible interactions.Therefore,before using this product,tell your doctor or pharmacist of all the products you use.Keep a list of all your medications with you, QL id share the list with your doctor and pharmacist. IERDOSE: If overdose is suspected,contact your local poison control center or emergency room immediately.US residents should call the US National Poison Hotline at 1-800-222-1222.Canada c~ -silents should call a provincial poison control center.Symptoms of overdose may include:stomach pain,nausea,vomiting,diarrhea. ~ )TES: If your doctor has prescribed this medication,do not share it with others.Laboratory and/or medical tests(e.g.,complete blood count)may be performed periodically to monitor your o ogress or check for side effects.Consult your doctor for more details.This medication is not a substitute for a proper diet.It is important to maintain a well-balanced diet.Foods rich in iron o ciude red meats(especially liver),fish,beans,dried fruit,and iron-fortifiedlenriched cereals and bread. j ISSED DOSE: If you are taking this product on a prescribed schedule and miss a dose,take it as soon as you remember.If it is near the time for the next dose,skip the missed dose and resume h f mr usual dosing schedule.Do not double the dose to catch up. ORAGE: Store at room temperature between 59 86 degrees F(15-30 degrees C)away from light and moisture.Do not freeze liquid forms of this medication.Do not store in the bathroom.Keep 2 medicines away from children and pets.Do not flush medications down the toilet pour them into a drain unless instructed to do so or .Properly discard this product when it is expired or no longer o 0 eded.Consult your pharmacist or local waste disposal company for more details about how to safely discard your product. cc Z-1 gEE /� N �79 v a o� ��m \.♦ Ll w OODQO .�m yTOmC' j�s �-- to co C� r- 7a7 cm 7D n rn CNmC NO W 2 0to oo _C fp0 C +o m 3aC D0=C, otrimvw T KZ OM CD ,Y •Y '. O 0 -I k. ...._ ....,f m W Coo ta.2 N 1 Qa..+ O .Zcn n M m CA SIR tr = FO co, to m �• W O S v O A) 0 ti � n tr �• cc t _ o ° I p p it p 3 tyr) K o o O Eft W N oo K ­t 'C3 O C, o m sn fn C" O r,o o rn aw� O o �� C) �n N• m o� t o S4. !CD �, , yrs� � �o � I � y 05/20/2009 01:50 508-428-1974 HOSTETTER REALTY PAGE 01 I I CK KCAL I T 770A Main Street Osterville, MA 02655 Phone: (608) 420-0644 X Fax: (608) 428.1974 @Fax: From: c ez` Date: y-O� Pages: 7 , Including this page 05/20/2009 01:50 508-428-1974 HOSTETTER REALTY PAGE 02 THIS IS A LEGALLY BINDING CONTRACT. IF NOT UNDERSTOOD,SEEK COMPETENT ADVICE. CAPE COD & ISLANDS ASSOCIATION OF REALTORS,®INC. REALTORg Lease .LeaSe,made this 1st day of. Fa,bruasy _.- , 2009.., 02 By Centarvilket ..Village Apartmante of .T70H1 XAiA S%Talt, Oe.tervi110,.. XX .( M.25. (name) hereinafter called LANDLORD And .... .ftPat... Edw^rde rE aelinda Andrade of 2.94_.Sea. Street., De=iaport., MA (ad d dres-rts-. , (name) s) hcrenafter called TENANT. withesseth,That the LANDLORD above hereby leases to the TENANT above,the premises located at 60 Louie. .S.troot Hyannis„.... _...... . Massachusetts (sheet Address and Town) consisting of(Describe real and personal property) 2 bedroom apartment The term of this lease shall be 12 IItOniri®. ,commencing at _ _._ midnight. , __ „ on FeDrusry,,, let ,- , ...2.009, and ending at „ . .._..Atift,ight__ on .__ January_,. 31et _ .20.10-.. And for such term,the TENANT agues to pay S 10-,,.800.0.0 __ ___ . - Said rent shall be payable in installments of S :-._ . .9 0.0.0 0 on the _ 1st - day of every month,in advance, so long as this lease is in force and effect. During the lease term,the following charges shall be paid by the LANDLORD or TENANT as checked- LANDLORD TENANT ( ) A. Oil ( ) ( X j B. Gas ( ) C. Electricity ( ) ) D. Real Estate Taxes C ) E. Water ( x ) ( ) F. Water Overages ( x ) ) G. 'Telephone ( ) ( X) H. Trash Removal ( ) ( ) 1. Lawn Maintenance ( ) ( ) J. Snow Removal ( )K. Cable T.V. C ) X L. Condominium Common Area Charges ( ) ) 'The LANDLORD hereby acknowledges receipt from the TENANT S - -Soo __.. as payment of the first month's rent,and the LANDLORD hereby acknowledges receipt from the TENANT S 9_Q0 as payment of the last month's rent(calculated at the same rate as the first month's rent). The TENANT hereby acknowledges receipt of a written Last Month's Rent Receipt with reference to said last month's rent as required by law. And for the heretofore described term.the TENANT further agrees to pay$ 0_.. (an amount not to exceed one month's rent)as a security deposit,receipt of which the LANDLORD hereby acknowledges;it being understood that said security deposit is not to be construed prepaid rent,but nor shall any damages claimed(if any)be limited to the amount of said security deposit. Said security deposit shall be deposited in escrow as required by law, The TENANT hereby acknowledges receipt of a written statement of conditions with reference to said security deposit as required by law,which statement must be returned to the LANDLORD or his agent within fifteen days of commencement of tenancy. The LANDLORD hereby notifies the TENANT that Dani.pl_C. Hoet®tter_ name) of 770B1 main street, oet®rville, !SA 02655 _ ...(w�and mailing ad&v") .. m��neae� is the person who is responsible for the care,maintenance and repair of the heretofore described property. The LANDLORD hereby notifies the TENANT that .. .. Landlord is the person authorized to receive notices of violations of law and to accept service of proc�ss on behalf of the OWNER. (next page) ACV 1.0 .. This terM wag negated by DMIRL aOaTITTII wing a-401tt5. a-VoRMs to copyright protected god may not be aped by gay other party. �Y 05/20/2009 01:50 508-428-1974 HOSTETTER REALTY PAGE 03 The parties hereto,in consideration of these presents,agree as follows: 1.That no more than_ _ two . (2). _. _ ;_ Persons will occupy said premises. 2.That no alteration,addition,or improvement to the leased property shall be made by the TENANT without the written consent of the LANDLORD. Any alteration,addition,or improvement made by the TENANT after such consent shall have been given,and any fixtures installed as part thereof.,shall at the LANDLORD'S option become the property of the LANDLORD upon the expiration or other earlier termination of this lease;provided,however,that the LANDLORD shall have the right to require the TENANT to remove such fixtures at the TENANT'S cost upon such termination of this lease. 3.That the TENANT shall maintain the leased premises in a clean condition and;the TENANT will be responsible for all damage,breakage, waste,and/or loss to the premises,except normal went and tear and unavoidable casualty which may result from occupancy;and upon termination of this lease the TENANT will leave the premises in the same general and good and habitable condition as found upon entry. 4,"That the LANDLORD agrees to supply fixtures and household furnishings,equi�mcnt of other personal property only as specifically described within this agreement,and/or in accordance with the statement of conditions to be incorporated by reference herein- S.That the words"LANDLORD"and"TENANT'as used herein shall include their respective heirs,executors,administrators,successors representatives,assigns,and/or agents. If more than one party signs as TENANT hereunder,the agreements heroin of the TENANT shall be the joint and several obligations of each such parry. 6.That so as unfit fore LANDLORD and TENANT uman habitation that these presen that should the ts shall thereby be ended,with remises be fund to thed e fire or other TENANT for any rent`term unus d to become 6A.Subject to the conditions of paragraph six(6),the LANDLORD agrees that should the premises acquire a condition which amounts to a violation of law which may endanger or materially impair the health+safetY,or well-being of the TENANT,or become unfit for human habitation;upon proper notice to or discovery by the LANDLORD thereof,the rent or a just portion thereof according to the nature and extent of the condition shall be suspended or abated until the condition is remedied,if such a remedy is reasonably possible during the least term; provided,however,that said condition or violation of law was not caused by the TENANT or others lawfully upon said premises. If such a remedy is not reasonably possible,during the lease term the LANDLORD shall so notify the TENANT within thirty days after proper notice to or discovery by the LANDLORD of said condition;.and after such notice to the TENANT by the LANDLORD either party may terminate the lease by written notice to the other party. 6B.That the LANDLORD and TENANT further agree that should the premises be taken for any purpose by the exercise of the power of eminent domain that these presents shall thereby be ended with refund to the TENANT for any rent term unused,and that the TENANT does hereby assign to the LANDLORD any and all claims and demands for damages on account of any such taking or for compensation for anything lawfully done by a proper public authority in pursuance of such a taking. 7.That the TENANT agrees that it shall be the TENANT'S obligation to insure the TENANT'S personal property and the keeping of said personal property shall be at the sole risk of the TENANT. B.That the TENANT agrees to indemnify and hold the LANDLORD harmless from any and all liability,loss or damage arising ftom an nuisance made or suffered on the leased premises by the TENANT,or the TENANT'S family,guests,licensees,and or invitees,to and from any negligence.or illegal or improper conduct of any of said persons. Neither the TENANT or any of the heretofore described persons shall or suffer offensive use of the leased remises,not commit or permit any nuisance to exist thereon,nor cause damage to the leased make P premises,nor create any substantial interference with rights,comfort,safety or enjoyment of the LANDLORD or other occupants of the same or any other apartment,not make any use whatsoever thereof other than as and for a private residence. 9.That the TENANT agrees that no articles of personal property shall be placed in common areas. 10.That any notice by either parry to the other shall be in writing and shall be deemed to be duly given only if delivered personally or mailed by registered or certified mail,addressed to the TENANT at the building in which the leased property is located and to the LANDLORD at the address noted on this lease.unless either party has notified the other party in writing of a change of address for the purpose of notice. 11.That during the lease terns the LANDLORD will keep and maintain the leased premises in such good repair,order and condition as the same are at the commencement hereof,reasonable wear and tear and damage by unavoidable casualty excepted. And the LANDLORD shall make all repairs,changes,alterations,and additions which may be required by any laws,ordinances,orders,or regulations of any public authorities havin jurisdiction over the leased property except that the TENANT shall make all such repairs,changes,alterations,and additions required because off rat any use made of the leased property by the TENANT other than the proper and lawful use as a private residence,or because of any unlawful action or any negligence of the TENANT or any breach or default by the TENANT under this lease. 12_That TENANT agrees to allow the LANDLORD to enter and view the premises,both inside and.outside: A)to inspect the premises; B)to make repairs thereto; C)to show the same to a prospective TENANT or PURCHASER; D)pursuant to a Court Order;and E)to protect the premises if it appears that said premises have been abandoned by the TENANT; F) to inspect,within the last 30 days of the tenancy or after either party has given notice to the other of intention to terminate the tenancy,the premises for the pwpose of determining the amount of damage,if any,to the premises which would be cause for deduction from any security deposit held by the LANDLORD pursuant to law. 13,That if the TF.,NANT defaults,breaches and/or otherwise fails to comply as regards any of the terms,conditions,covenants,obligations,or agreements,expressed herein or implied hereunder,the LANDLORD,without necessity or requirement of matting any entry may terminate this lease by: A)a seven(7)days written notice to the TENANT to vacate said premises in can of any breach except only for nonpayment of rear,or R) a fourteen(14)day written notice to the TENANT to vacate leased premises upon the neglect or refusal of the TENANT to pay the rent as herein provided. (Continued on Sheet 2) SLi• leap was aceated by DMXJM a097rrM tuin9 6-90M- 6-POW 10 aagyrlght pratseten smA coy not be -Asad by aqy eth6r party- I 05/20/2009 01:50 508-428-1974 HOSTETTER REALTY PAGE 04 Any termination under this section shall be: C) without prejudice to any remedies of the LANDLORD which might otherwise be used for arrests of rent use and occupancy of other breach of any of the said terns,conditions,covenants,obligations or agreements•or D) withoutprejudice to any remedies of the TENANT which might otherwise be authorized and/or required by the applicable laws and Regulations of the Commonwealth of Massachusetts. E) but nothing herein shall be construed as the application of interest or a penalty for the TENANT'S failure to pay rent until thirty (30)days after such rent shall have been due. 14.That the_parties agree that in case of any termination of this lase by reason of the default of theTENANT,that at the option of the LANDLORD: A)the TENANT will forthwith pay to the LANDLORD as damages hereunder a sum equal to the amount by which the rent and other payments called for hereunder for the remainder of the term. 13)the TENANT will furthermore indemnify the LANDLORD from and against any loss and damage sustained by reason of any termination caused by the default of,or the breach by,the TENANT. LANDLORD'S damages hereunder shall include,but shall not be limited to, any loss of rents,accrued by unpaid prior to termination;reasonable broker's commission for the re-letting of the leased premises; advertising costs;the reasonable costs incurred in cleaning and repainting the premises in order to re-let the same;moving and storage charges incurred by LANDLORD in moving TENANT'S belongings pursuant to eviction proceedings;legal costs and reasonable attorney's fees incurred by the LANDLORD in collecting any damages hereunder or in obtaining possession of the leased premises by summary process or otherwise,and to any and all other remedies provided by law. C)the LANDLORD may remove the TENANT'S goods or effects pursuant to a Court Order and the LANDLORD shall not be liable or nspotnsible for any loss of or damage to TENANT'S goods or effects and the LANDLORD'S act of so removing such goods or effects shall be decttted to be the act of and for the account of TENANT,provided,however,that if the LANDLORD removes the TENANT'S goods or effects,he shall comply with all applicable laws,and shall exercise due care in the handling of such goods to the fullest practical extent under the circumstances. 15.That no animals,birds,or pets of any description shall be kept in or upon the leased premises without the LANDLORD'S written consent; acid consent so given may be revoked at any time. 16.That no surrender or acceptance of surrender of the leased premises shall be valid,unless so stipulated in writing by the LANDLORD. 17.That the TENANT*ball not assign or sublet or permit the leased property or any part thereof to be used by others(except the TENANT named herein„the TENANT'S spouse,children,or guests for temporary visits),without the prior written consent of the LANDLORD in each instance_ If this lease is assigned,or if the leased property or any part thereof is sublet,or occupied by anyone other than the TENANT,the LANDLORD may,after default by the TENANT,collect rent from the assignee,subtenant,or occupant and apply the net amount collected to the 4 rent herein reserved. No such assignment,subletting,occupancy,or collection shall be deemed a waiver of this covenant,or the acceptance of the assignee,subtenant,or occupant as TENANT,or a release of the TENANT from further performance by the TENANT of the covenants of this lease. The consent by the LANDLORD to an assignment or subletting shall not be construed to relieve the TENANT from obtaining the consent in writing of the LANDLORD to any fuuther assignment or subletting. 19_That the waiver of one breach of say term,condition,covenant,obligation,or agreement of this lease shall not be considered to be a waiver of that or any other term,condition,covenant,obligation,or agreement or of any subsequent breech thereof. 19_That if any provision of ibis lease or portion of such provision or the application thereof to any person or circumstance is held invalid,the remainder of the lease(or the remainder of such provision)and the application thereof to other persons or circumstances shall not be affected thereby. 20.That the LANDLORD acknowledge s.that provisions of applicable law forbid a LANDLORD from threatening to take or taking reprisals against any TENANT for seeking to assert his legal rights. 21.LEAD PAINT: Whenever a child or children under six years of age resides in any residential premises in which any paint plagw or other accessible materials contain dangerous levels of lead as defined pursuant to section one hundred and ninety-four,the owner shall remove or cover said paint,plaster or other material so as to make it inaccessible to children under six years of age,with the provisions of Massachusetts General Laws,Chapter iTi,Section 197. 22.UREA FORMALDEHYDE INSULATION-UFFI:A LANDLORD of a residential dwelling containing UFFI shall disclose or cause to be disclosed to all prospective tenants and to all existing tenants the presence of UFFI in the dwelling. In the case of a prospective TENANT,a LANDLORD aware of the presence of UFFI in the dwelling shall make the disclosure before entering into a lease or rental agreement with the TENANT. The disclosure shall be made in writing,and shall be in the form of the disclosure set forth in 105 CMR 651.011(3)or as amended and shall be signed by the LANDLORD or its agent as well as by the prospective or existing TENANT. The LANDLORD shall keep a copy or a second original of the signed disclosure as proof of its delivery to the prospective or existing TENANT. As part of the disclosure,the LANDLORD shall also deliver or cause to be delivered to the prospective TENANT or existing TENANT at the time of the disclosure the current UFFi information Sheet developed by and available at the Department 23.That the LANDLORD agrees to pay a BROKER'S fee of..._ .ala _ %of the total rental hereof to - upon receipt of the __ . rental payment for this lease from the TENANT. OPTIONAL PROVISIONS(Complete or delete if not applicable): 24.That LANDLORD agrees to pay a broker's fee of _.. of a . .._. %of the total rental on any subsequent rentals of the premises to the TENANT,upon receipt of the rental payment from any subsequent rental to the TENANT. 25.In the event of a subsequent sale of the premises to the TENANT by the LANDLORD during the term of the tenancy or within days after the expiration of the tenancy,a BROKER'S fee shall be paid by the LANDLORD based upon an amount of fee to be reasonably agreed upon between the BROKER and the LANDLORD,but such TENANT/BUYER shall be held harmless as to any dispute and/or litigation between the BROKER and the LANDLORD as to the determination of said fee. (Sheet 2) Shi■ loan Want Created W A> XJM 808S"n UNinp •-VORa6. 6-40RMB is aopyrtgnt protected and may not be used by &W ether party. f 05/20/2009 01:50 508-428-1974 HOSTETTER REALTY PAGE 05 • 26.Additional Provisions: Tenants assume responsibility for terms of this Lease jointly and severally. IN WITNESS WHEREOF,the said parties hereunto set their hands and n the day year firs above 3�p.tte o- LANDLORD TENANT BROILER The TENANT hereby acknowledges the receipt of an executed copy of.this lease from the LANDLORD on - ---- , which is within thirty(30)days of the signing of this document by said TENANT TENANT RENT RECEIPT TO: Mill.i_am 1901v_arde.. & BO.l�,nda_ Aa4r440- RE: __ Art...!L 60. Louis. S.,treet.. . (Tenant) , --- . _Hyaaais _ ► . . . .. -.._ (Address) (Description of Leased Premlrer) 4 I/We hereby acknowledge receipt of the following on this _ . 1st..... .. day Of _._ rembr cry..__ __ , _200 9 . ! 1- First Month's Rent $ :.._ RQ.Q.0 0 __ _ . _.. . __. . . . •-- - 9.Q0.0 2. Last Mot1th's Rent $ _ _ .. . . . . __. _.... ... LAST MONTH'S RENT Any Landlord or his agent who receives,at or prior to the commencement of a tenancy,rent in advance for the last month of the tenancy from a tenant or prospective tenant shall give to such tewt or prospective tenant at the time of such advance payment a receipt indicating the amount of such rent the date on which it was received its intended application as tent 1br the last month of tenancy,the name of the person receiving it and,in the case of an agent,the name of the Landlord for whom the rent is receive k and a description of the rented or leased premises,and a statement indicating tear the tenant is entitled to interest on said rent payment at the rate of five percent per year or other such lesser amount of interest as has been received from the bank where the deposit het been held or in accordance with M.G.L.Ch.186 Section 158 as may be finther amended,payable in accordance with the provisions ofthis clause,and a statement indicating that the tenant should provide the Landlord with a forwarding address at the termination of the tenancy indicating where such interest may be given or sent. Any Landlord or his agent who receives said rent in advance for the last month of tenancy shall,beginning with the first day of tenancy,pay interest at the rate of five percent per year or other such lesser amount of interest as has been received from the bank when the deposit has been held or in accordance with M.G.L. Ch,186 Section 158 as may be further amended. Such interest shall be paid over to the tenant each year as provided in this clause:provided,however,that in the event that the tenancy is terminated befm the amtiversary dare of such tenancy,the tenant shall receive all accrued interest within thirty days of such termination. Interest shall not accrue for the last month for which rem was paid in advance. At the end of each year of tenancy,each Landlord shall give or sand to the tenant from whom rent in advance was collected a statement which shall indicate the amount payable by such Landlord to the tenant. The Landlord shall at the same time give or send to such tenant the interest which is due or shall notify the mom that he may deduct the interest from the nod NOW psymeat of such tenant. It after thirty days from the end of each year of the tenancy,the tenant has not received said interest due or said notice to deduct the interest from the next rental payment,the tenant may deduct from his next rent payment the interest due. If the Landlord fails to pay any interest to which the tenant is them entitled within thirty days after the termination of the tenancy,the tenant upon proof of the same in an action against the Landlord shall be awarded damages in an amount equal to three times the amount of interest to which the tenant is entitled,together with court costs and reasonable attorneys fees. if the Landlord transfers his interest in the dwelling unit,any advance tents received hereunder We to be handled in accordance with Massachusetts Gerhenl Laws C.186 sec. 15B(7A). LANDLORD LANDLORD'S AGENT Tenant hereby acknowledges receiving a copy of the within rent receipt. Dated: Receipt (Tenant) REV. 1/1193 805 Zhis form was created by MN137: aeaTITTtnt using •-Moore. 0-POaa6 la Copyright protected and asy not be used by any other party. 05/20/2009 01:50 508-428-1974 HOSTETTER REALTY PAGE 06 Tenant Lead Law Notification ad pa int forms must owners of rental units give to tenants? What le p e b d La�vNotificatton and given CwO copies of this Tenant Lea All tenants who live in units built before 1976 must g Tenant Certification Form (other side).If any of the following documents exist for the unit,tenants must also be given a copy of them: lead inspection or risk assessment report,Letter of Compliance, or Letter of Interim Control. When do owners have to give tenants these forms? Nc%r tenants must be f;ivccs tl,c forms before entering the rental agreement, beginning September 1, 199�. Current tcn�nts must be given the forms Burin; the one year period starting Dccernbcr 1, 1995 at the time of lease- Current renev:•al,or if there is 110 lease, an;• 'in' during the year,but no later than l)cccmber 1, 1996, What is lead poisoning, and how do children become lead poisoned? - Lc,;i poisoning is a disease. Lead can make children,especially those under six years old,verl'sick and can cause learning and behavior problems. Lead is often found in paint on the. inside and outside of homes.The main way a child can get Ica,` poiso,ed is from s��'allowino lead paint dust and chips. A chilli can also get lead from ocher sources,such as soil and %vatcr, but these rarely cause lead poisoning by themsch-cs.The only way to tell for sure that a child is lead poisoned is to havc his or her blood tested. Your doctor, other health care provider, or Board of Health can do this.A lead poisoned child will heed medical care.A home with lead paint must be deleaded for a lead poisoned child to get�ti'ell. What can you do to prevent lead poisoning? Talk to your child's doctor about lead. liar e your child tested fo;Icad at least oncc a year until he/she is four years old. Ask the Owner if your borne l,a;been deleaded or call the state Childhood Lead Poisoning Prevention Program (CLPPP) at 1-800-532.9571, o: your local board of Health. Tell the Owner if you have n nc%�- baby,or if a new child under six years old lives"'ith you, s peeling paint, tell and verite the owner. 1f he/she does not respond, If your home, %vas deleaded,but ha call CLPPP or Your local Board of Health. gas to reduce temporarily the chant �es of your child - 1f your home has not been deleaded,you can do some thin becoming lead poisoned. You can clean your home regularly to wipe up dust and loose paint chips.Use a cleaner dus called TSP or an automatic disli�vasher detergent high in phosphate, o;other cleaners made`hands oftenust for `ng ( anti u arl and chips.The arras to clean most often are sti•indo��•wells,sills, and floors. wash your child's P _r _ sleeping)and gash your child's toys. Remember, the only way to permanently to%ver the risk of your I_��,o.c casino or_Icep�no) . y child gcttino lead poisonai is to hatic }our home deleaded if it contains lead paint. What does the Lead Law require the owner of your home to do if a child under six years olt lives there? An o«vncr of a home built befo-c 1978 mus:have the home inspected for lead if a child under six)ea;sold lives there- [f local hn:a;,is are found, it mus;be d:lcaded or brought under interim control. A licensed deleader has to do all removal of leaded paint, and all other hioll,nsk %vo:k.The o•.�-nec o;someone �ti-ho«-o:ks For him %%ho is not 2 licensed deleadtr can do cerm:r, lox-risk delcading and intarini control wo-k. After the work is d,ne, the lead inspector or risk assessor issues a Letter orCompliance or Leyte,or l,terini Control. The o'xncr roust makc sure there is no peeling pain;anytime after grain;a Letter of Compliance o, Lcue:or lntc, Control. What is a Letter of Compliance? It is , le;.: lctccr tnat :1ys ci-ht; Lhn: th:;, t.:= no I,ad print h• t:a.-Js o: tha: the home has been deleaded The letter is signet a-,d dt_ed I^� a What is a Letter of Interim Control? It is n `coal Icctcr that says the o;: necessa,y to make the home rcmpo;- ril% s-Afe from lead hazards has lccn done. TIZe I;ctcr is signe t and dated by a licensed lead risk assessor. It is good for one year, but can be renewed for one more ye,; The o%k'ncr muse fully delead the ho;nc and get n Letter of Comp linnee before chc end of the second year. • Q i Tenant Certification Form Required Federal lead Warning Statement Housing built before 1976 may contain Iead•baseo paing t.Lead from paint,children dr and pregnant i.�omennt n..�Be orre renting re-1978 housing,lessors properly.Lead exposure is especially harmful to yo and dust jan P05C health hazards if not n ung disclose the presence of known lead-based paint and/orlead-based a Massachusetts Tenant ards lLeade law lNotilicationand Cectib a'tionorm approved pamphlet on lead poisoning prevention.Th approved for federal compliance. '-`� approved pampn►ct approved for federal compliance. IL Owner's Disclosure (a) Presel\cc of Icad•based paint and/or lead-based paint hazards(checl. (i or(ii)belo\\•): S lain cic and/or lead-based paint harards are resent i (i) Known,lead based pai n die housin (exp )• ii 01\nerJLcs�or has no knowledge of lead-based paint and/or lead-based Paint harards In the housing. I (b)Records and reports-i"Itilablc to the o\:•ner/lessor(Check(i)or(ii) below): (',) O\':nerl Lessor has provided the tenant with all available records and reports pertaining to Iead•bascd paint and/or lead-based paint hazards in Elie housing(circle documents below). Lead I nspcction Report Risk Assessment Report Letter of Interim Control Letter of Compliance (ii) Owner/Lcssoc has no reports or records pertaining to Irad•based paint and/or lead-based paint hazards in the housir. Tenant's Acknowledgment(initial) (c) nant has received copies of all documents circled above.(d) �Tenant,has received no documents listed above. (e) Fenant has received the Massachusetts Tenant Lead Law Notification. Agent's Acknowledgment(initial) (f) Agent)vas informed the owner/lessor of the owner's/lessor's obligations under 42 U.S,C.4832d and is aware of his/her responsibility to ensure compliance. Certification of Accuracy \ v' w information above and certify, to the best of their knowledge,that the Information th The following ar parties have rc Ic cd the Info ,p t ) B pro%-i is true and ae urate. w ner/Lessor Date Owner/Lessor Dj TenanE Dick, -Tenant Da Agent Datc Agent Da Owner/Managing Agent Information for Tenant(Please Print). Name Street Apt. CiE)•/"rbwn Zip Telephone Nurnber I (owned managing a;enc)certify this 1 provided the Tenant Lea:( Law Notification!Tenant Ceccification Form a:\d aay e> Lead La:,'eocu ncra5 W the t•::17.1:.EU,Lh-, CC0,M:FC.Wed to s7Qn 6:F eerti lea.ion, The tcn+n;g.ivc the follo•.\•irr rca:aa I h: f�`.assl,h'_seccs Levi Lawpooh:bis rcncal e:s:riminrion, inclui,n:refijsing to rent-(a families wich children or e\'icring ram v,,i;h ch;l i':en kecaws:of Itad rl:n- Contact the Childnaai Lead Poisoning Prevcncion Ptosram far info: r., inn on the availability of this form in ocher languages, The `lassachuserts Depo;cment of Public Health's Childhood Lead roisoning Prevention Program(CLPPP) has additional infor on a full rtnge of topics relared to lead poisoning prevention, tenants And owners rights and responsibilities under the Lead La- Reoula;ions, fin,neial msisEance for owners,and szfc dcicad\ng and renovinion%York.CLPPP can be reached of 1-", -532-9571• More informntion is also available from your local Icad poisoning prevention program,or your local Board oft{elleh. Tenant and owner must each keep a completed and signed copy of this form _. -�'..C�.1V�:.I�tF):\L.. .\i1rAS�l7.�!Fle..�lh6-,..._- ... ,- :Tr'-�.. :+1'i.�.o.. _._ .. •:�?=�r:i-o� JUDGMENT �® CAB A�61�'�F���� DOCKET NUMBER Trial Court of Massachusetts ` ��i f�6 1t r"1 4 �® 200925S0001173 District Court Department FOR POSSESSION AND RENT Summary Process Session CASE NAME CENTERVILLE VILLAGE APARTMENTS'vs BELINDA ANDRADE PLAINTIFF(S)WHO ARE PARTIES TO THIS JUDGMENT- CURRENT COURT P01 CENTERVILLE VILLAGE APARTMENTS Barnstable District Court Main Street P.O. Box 427 ., ^ 'fit i,�'1.4ypca. � fi;.. } 1 },• y Barnstable, MA 02630-042.7 ��^^^ (508)375-6600 ` a, DEFENDANT(S)'WHO ARE PARTIES TO,THIS JUDGMENT---- D01'BELINDA ANDRADE Jt � ++<-+ = WHEN YOU MUST ROOM/SESSION APPEAR PARTY TO WHOM THIS COPY OF JUDGMENT IS ISSUED FURTHER ORDERS OF THE COURT P01 CENTERVILLE VILLAGE APARTMENTS Joint& Several with William Edwards, 770B1 MAIN ST. Executions shall issue on 8/18/09 OSTERVILLE, MA 02655 ATTORNEY FOR PARTY TO WHOM THIS COPY OF JUDGMENT IS ISSUED SUBJECT PREMISESrj, I r " 60 Louis'St Apt#4Hyanrns, ._ MA 02601JUDGIIAENT'FOWPLAINTIFF(S) FOR.POSSESSION AND RENT'' t On the above action, after trial by a judge, the issues having been duly tried or heard, and a finding or verdict having been-- duly rendered, IT IS ORDERED AND ADJUDGED by the Court( Riley, Hon. William J. )that the Plaintiff(s)na�rT ed above recover of the-Defendants)named above possession of the subject premises shown above and, for unpaid rat; use and occupation, the "Judgment.Total"shown:below plus such other costs as may be taxed pursivant to law, with po&dgment interest thereon pursuant to G.L.c. 235,§8:at the"Annual Interest Rate"shown below from the"Date Jqdgmeg Entered" shown below until the date of payment: — _ ::NOTICE.OF ENTRY OF JUDGMENT Pursuant to Mass: R.'Civ P.54; 58, 77(d)and 79(a)and Uniform Summary Process Rule 10(d), this Judgment-has been entered on the docket on the"Date Judgment Entered"shown below, and this notice is being sent to all parties Attached are any rulings of,law, or any findings of fact and rulings of law, which may have been made by the CoUlwpurs nt to Mass. R..Civ. P. 52(c)orrn x r 1. Date of Breach,,Demand or Complaint 7/13/2009 2. Date Judgment Entered 8/7/2009 3. Number of Days of Prejudgment Interest'(Line 2-Line 1) 25 4. Annual interest Rate,of 12.00%/365 = Daily,Interest Rate 0.032877% 5. Single Damages $2,700.00 6. Prejudgment Interest (lines 3x4x5) $22.19 7. Double or-Treble Damages Awarded by Court (where+authorized by lane)- � $0.00 8. Costs Filing fee.& Surcharge $195.00 9. Attorney Fees.Awerded`by Court(where authorized.by law) , $0.00 10: Other Costs Awarded by Court $72.50 I 11:JUDGMENT TOTAL PAYABLE TO PLAINTIFF(S) (lines 5+6+7+8+9+10) $2,989.69 DATE JUDGMENT ENTERED I CLERK-MAGISTRATE/ASST.CL % 8/7/2009 jt r Robe,,E. Powero Daterrime Printed:0&07/2009 10:10 AM FORM NO. ` Cleric I 1 JUDGMENTENT FOR PLAINT'FF(S) DOCKETNUMBER Trial Court of Massachusetts � �El I ry 200925S0001173 District Court Department R POSSESSION AND RENT Summary Process Session ENTERVILLE VILLAGE APARTMENTS vs. BELINDA ANDRADE O ARE PARTIES TO THIS JUDGMENT CURRENT COURT P01 CENTERVILLE VILLAGE APARTMENTS Barnstable District Court Main Street P.O. Box 427 Barnstable, MA 02630-0427 (508)375-6600 DEFENDANT(S)WHO ARE PARTIES TO THIS JUDGMENT ; D02 WILLIAM EDWARDS ��- WHEN YOU , MUST ROOWSESSION APPEAR PARTY TO WHOM THIS COPY OF JUDGMENT IS ISSUED FURTHER ORDERS OF THE COURT P01 CENTERVILLE VILLAGE APARTMENTS Joint&Several with Belinda Andrade. 770B1. MAIN ST. Executions shall issue on 8/18/09 OSTERVILLE, MA 02655 ATTORNEY FOR PARTY TO WHOM THIS COPY OF JUDGMENT IS ISSUED SUBJECT PREMISES 60 Louis St. Apt#4 Hyannis,MA.02601 JUDGMENT FOR PLAINTIFF(S) FOR POSSESSION AND RENT On the above action after default the issues havingbeen duly tried or heard and a finding or verdict having been duly Y 9 9 Y rendered, IT IS ORDERED AND ADJUDGED by the Court( Riley, Hon.William J. )that the Plaintiff(s)named above, recover of the Defendant(s)named above possession of the subject premises shown above and,for unpaid rent, use and occupation, the"Judgment Total"shown below plus such other costs as may be taxed pursuant to law,with postjudgment ' interest thereon pursuant to G.L. c. 235,§8 at the-"Annual Interest Rate"shown below from the"Date Judgment Entered" shown below until.the date of payment. NOTICE OF ENTRY OF JUDGMENT Pursuant to Mass. R. Civ P. 54, 58, 77(d)and 79(a)and Uniform Summary Process Rule 10(d), this Judgment has been entered on the docket on the"Date Judgment Entered"shown below, and this notice is being sent to all parties. Attached are any rulings of law, or any findings of fact and rulings of law,which may have been made by the Court pursuant to Mass. R. Civ.P. 52(c)or 64A(c): z u. 1. Date of Breach, Demand or Complaint" omplaint 7/13/2009 2. Date Judgment Entered 8/7/2009 3. Number of Days,of Prejudgment Interest (Line 2'-Line 1) 25 4. Annual Interest Rate of .12.00%0/'365 = Daily,Interest Rate . 0.032877% 5. Single Damages - $2,700.00 6. Prejudgment Interest (lines 3x4x5) $22.19, 7. Double or Treble Damages Awarded by Court (where authorized bylaw) $0-.00 8. Costs Filing fee & Surcharge -$195.00 9. Attorney Fees Awarded by Court(where authorized by law) $0;00 10 Other Costs Awarded by Court $72.50 11.JUDGMENT TOTAL PAYABLE TO PLAINTIFF(S)" (lines 5+6+7+8+9+10) $2,989.69 DATE JUDGMENT ENTERED CLERK-MAGISTRATE/ASST.CL e //h 817/2009 monerl C Date/Time Printed:08/07/2009 10:09 AM Clerk M.Rads i rata FORM NO. .. .. a CIVIL'DOCKET V SUMMARY PROCESS NOTICE OF JUDGMENT I PLAINTIFF VS. DEFENDANT I . Plaintiff's Attorney/Prose Trial Court of Massachusetts f not rep- District. Court Department -esented by First Barnstable Division Attorney,use 02630 Plaintiff's Barnstable, Ma,s — " ADDRESS , ouI eSV - - - - PLAINTIFF'ADDRESS - Defendant's-Attorney/Prose f not rep- Fsented by ,ttorney,use , defendant's " DEFE:: NDANT'S ADDRESS address 'ADDRESS Property -APt:n - Address v TO THE ABOVE NAMED PARTIES The box marked below shows the action of the court on the Summary Process action brought against you. On L' "� 2 L default after hearing ❑ by agreement_ The Court found judgment in favor of th Plaintiff. / EPossession as of (� " e 1 Execution not to issue until — 19, h' For Rent due in'the sum of [� For costs'due in the sum of [ZI For use and occupation in the sum of -11 ed' 14 s'/ [_] For damages (waste) in the sum of C� d- Other conditions- ���n� % •�.; ;t,�ia �9r, z,/��<-- f �•����o - ci/� �,�.. []. The Court.;foundfd:g.ment.r ..favor o.f th defendant.(This,means.'th,at_.the.defendant.do�s not.have_to, vacate the".premises. ❑ The Court dismissed`th claim. ❑ Other: 61 Plaintiff DATE Defendant Judge i ❑ Sianed•agreement on file. NOTICE TO THE DEFENDANT ' If the Court has found against you, and has ordered possession, you are required (unless otherwise'ordered by the Cour ) to vacate the premises by the date stated. If you should fail to do so,you may be forcibly evicted.. I All payments of Rent, Cost or.Darnages,are to be made directly to the plaintiff or to his attorney unless otherwise ordered by.the Cour. f The defendant may,within ten (10)days after the date of t;s Judgment ,appeal the Court's decision upon postir a bond, unless waived. If the defendant wishes to appeal, he or she should contact the Clerk-Magistrzte of the"above iiam`ea l Court for assistance, a tenant remaioina`in.possession at theAJ,'ne of appeal maybe required to post.bond as determined by Court. nnT�TF-Si uSTED NO Sf,BE LEER lNGL S, OBTENGA UNA T Fv,DUCOIOi .