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HomeMy WebLinkAbout0576 MAIN STREET (HYANNIS) - Health 576 MAIN STREET Hyannis A 308- 069 -002 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: 06 I 1D13 I I,- Fill in please: APPLICANT'S YOUR NAME/S: l M e ok, C e VEMU.11 R � BUSINESS SS A r�.11e�r t'�dJ d _S YOUR HOME ADDRESS �0 O_VCJ TELEPHONE # Home Telephone Number 6U S I� f I S{Ilf7Rff•G'J ;Bi'ip° NAME OF CORPORATION: NAME OF NEW BUSINESS LUC�-I s C.l P ccTc- o TYPE OF BUSINESS IS THIS A HOME OCCUPATION? ,!S YES NO ADDRESS OF BUSINESS V3 2n i S - LnA MAP/PARCEL NUMBER J1000'3'QQ 02 (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you-may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. &Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: 2. BOARD OF HEALTH This individual h e' i form rmit irrem that pertain to this type of business. Authorized Sig ature** MUST COMPLY UMTH ALL COMMENTS: HAZAR0OUSMATERIALS REGULA IJONS 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature" COMMENTS: TOWN OF BARNSTABLE Date:!J(G1 TOXIC AND HAZARDOUS MATERIALS I T%eJ NAME OF BUSINESS: Lucils C le ncenA fVj BUSINESS LOCATION: - ky-k _0Qb 4jyraM yib-M.4 0o260 INVENTORY MAILING ADDRESS: 11 Q6 Pua.Kcr _ R6 , *1 ct aow/i , P m A o"o�L- TOTAL AMOUNT: TELEPHONE NUMBER: ySb$ _ 36 7 S6 'c16 GV& -775 - 13q-2., CONTACT PERSON: )AkC1 (n gV C-lartU,0 EMERGENCY CONTACT TELEPHONE NUMBER: SDI- 30 -f 60 L- MSDS ON SITE? TYPE OF BUSINESS: INFORMATION/RECOMMENDATIONS: Fire District: i Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW i ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants!, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives(creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes iulendeX Laundry soil &stain removers including bleach) F lcor C/eogv;n 1L of removers &cleaning fluids (dry cleaners) 5�22'12-I (w96 omd, sw't7 fte— 6?pe.qr-L Other cleaning solvents Bug and tar removers Windshield wash P WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applicant's Signature Staff's Initials YOU WISH TO OPEN A► BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1" FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) �•s ,,., O:" DATE: - 26 y Fill in please: APPLICANT'S YOUR NAME/S: �1n BUSINESS YOUR HOME ADDRESS: kan k sq eFT. i!'Fi. TELEPHONE # Home Telephone Number 11�-L1oy-25LY► • r 1�ti.; Earn d�i`�' NAME OF CORPORATION: r4D 55- y5ya �S o�= �/v NAME OF NEW BUSINESS o. TYPE OF BUSINESS IS THIS A HOME OCCUPATI ? YES NO ADDRESS OF BUSINESS a O MAP/PARCEL NUMBER (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Ild. & Mein Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: r` 2. BOARD OF HEALTH This individual ha� en info d f the ermit,requiremants that pertain to this type of business. ' MUST COMPLY WITH ALL Authorized §19nature** HAZARDOUS MATERIALS REGULATIONS COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain.to this type of business. Authorized Signature* COMMENTS; Date: TOWN OF BARNSTABL.E TOXIC AN®' HAZARDOUS MATERIALS KE NAME OF BUSINESS: \ c� 0 gD 0 l BUSINESS LOCATION: S ' 11V�ENTORY MAILING ADDRESS: q,v� St ma TOTAL AMOUNT: TELEPHONE NUMBER: - ^O CONTACT PERSON: v c�S Ir -h�. EMERGENCY CONTAC TELEP: NE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: _�0.n\n �( INFORMATION/RECOMMENDATION : Fire District: Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW' ❑ USED Any other products with "poison" labels (including chloroform, formaldehyde, Paint&varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers !� 1 (including bleach) Spot removers &cleaning fluids (dry cleaners) Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS ;PP cant Signature Staff's Initials YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for,4 years). A business certificate ONLY REGISTERS YOUR NAME in town(which you must do by M.G.L. - it does not give you permission to operate.) ou must ti st obtain the necessary signatLil_('ti On this form at 200 Main St., Hyannis. Take the c:onlpielc,d form to the Town Clerk's Office, 1 st. FI., :36? Main St., Hyannis, MA 02601 (Town Hzill) and get the Business Certificate that is required by lakv. OJ /� i DATE: r _/ ` / Fill in please: APPLICANT'S YOUR NAME/S:r_�Ysc7Y1 BUSINESS YOUR HOME ADDRESS: 5YYl10S� 5oa 3a�A0 Axj an n1l Ma DC9, 's TELEPHONE # Home Telephone Number NAME OF CORPORATION: O e)- L NAME OF NEW BUSINESS 1 TYPE OF BUSINESS. Pn j f1-4'11r Q IS THIS A HOME OCCUPATION? YES NO. ADDRESS OF BUSINESS t4 MAP/PARCEL NUMBER [Assessing). When starting a new business there are several things you must do in order to be in compliance with the rules a qr9atitn)s of�own 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 usiness in s town. 1. BUILDING CO ISSI ER'S OFFICE MUST COMPLY WITH HOME OCCUPATION ` This indivi ual h s e of a y p rmitrequi ements hat pertain to this type of business. RULES AND REGULATIONS. FAILURE TO 44 A i z e ijb)g7np3Ve COMPLY MAY RESULT IN FINES. COMMEN S: J 2. BOARO OF HE TH This individual has een informe of e p rmi r guirements that pertain to this type of business. Authorized Sign re** UST,AMPLY WITH ALL COMMENTS: ✓/SST /—f--1 Z • Lj Lo r.3 c. - ryL_-►2C i�[-L y�"l�Z ;�-�r T/+E►t f.c 6RL 8' VAW A.o sr 1J CM Wy s"f-- 1'*1Ai17Af6 4-as IPAWOJ-r OAI 73#-C PRII A14Y OTh1-eV__lAf6t-cA-'TIU 1 A?'�e •fA-r- ST IC40-r' 3. CONSUMER AFFAIRS (LI NSIN UTHORITY) t�- This individual has be�i infor e of licensing requirements that pertain to this type of business. _ Authorized Signature** _/ COMMENTS: O 4 Q��c I ZI e.,I�'f�S ,s I ��o's � sec ((jv (r r Date: TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-SITE NAME OF BUSINESS: SP "Po hi-mg BUSINESS LOCATION: ' Gt 1 I INVENTORY MAILING ADDRESS: ('1�(V�QJ TOTAL AMOUNT: TELEPHONE NUMBER: CONTACT PERSON: V_MCVS0 0 K)Q-1hG I l Ql EMERGENCY CONTACUmn±rn ELEPHONE NUMBER: 6rjbB D�SnU acl I MSDS ON SITE? TYPE OF BUSINESS: INFORMATION/RECOMMENDATIONS: Fire District: I Waste Transportation: Last shipment of hazardous waste: Name of Hauler: Destination: Waste Product: Licensed? Yes No NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use, storage and disposal of 111 gallons or more a month requires a license from the Public Health Division. LIST OF TOXIC AND HAZARDOUS MATERIALS The board of health and the Public Health Division have determined that the following products exhibit toxic or hazardous characteristics and must be registered regardless of volume. Observed / Maximum Observed / Maximum Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive ❑ NEW ❑ USED Cesspool cleaners Automatic transmisslion fluid Disinfectants Engine and radiator flushes Road salts (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor Oils Pesticides ❑ NEW ❑ USED (insecticides, herbicides, rodenticides) Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers) Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED Miscellaneous petroleum products: grease, Photochemicals (Developer) lubricants, gear oil ❑ NEW ❑ USED Degreasers for engines and metal Printing ink Degreasers for driveways &garages Wood preservatives (creosote) Caulk/Grout Swimming pool chlorine Battery acid (electrolyte)/Batteries Lye or caustic soda Rustproofers w Miscellaneous Combustible Car wash detergents Leather dyes Car waxes and polishes Fertilizers Asphalt& roofing tar PCB's V1 Paints, varnishes, stains, dyes Other chlorinated hydrocarbons, Lacquer thinners (including carbon tetrachloride) ❑ NEW ❑ USED Any other products with "poison" labels (including chloroform,formaldehyde, varnish removers, deglossers hydrochloric acid, other acids) Miscellaneous. Flammables Other products not listed which you feel Floor&furniture strippers may be toxic or hazardous (please list): Metal polishes Laundry soil &stain removers (including bleach) Spot removers&cleaning fluids (dry cleaners) Other cleaning solvents Bug andli tarremovers Windshield wash WHITE COPY-HEALTH DEPARTMENT I CANARY COPY-BUSINESS Applicant's Signature S 's Initia 01/17/2010 11:43 18662530538 STEVE BARNATT PAGE 01/02 �J 0 -0:5 epartment of public Health&Department of Labor C/4 G (, (_OD lay r� kT p NOTIFICATION OF DEJ.EADING WORK �r Ali sections of this form must be completed in order to comply with the notification requirements of M.G.L.C-111§171, 454 CMR 22.00 and 105 CMR 460.000,as most recently amended Contractor performing project Steve Barnatt Acense#DC616 Exp.Date9/17/2010 Lead Paint Inspector Fred Hemmila Date of Inspection9/l/09 Licence d12736 Exp.Date ARMSS OUR PRO Street Address 576 Main Street Apt.Number 11 city H annis 7Jp 02601 Property ownerNelson Brenner ,.__. _Address_Box 226 Sharon,MA 02067 Telephone Number 781=492-6027 Deleading Method![]Wet/Dry Scraping [I Heat Gun 2]Liquid Encapsulant []Demolition []Caustics Replacement (]Covering ❑Other Tf"Odier"selected,plcn%e explain Check one: Dwelling is multi-family Single-family Other Start Date 1/18/2010 Completion Dah, 1/18/2010 When will work be done: AM9 Pm)2 (Specify timer,on site) Weekends?No Project Supertisor Name_Steve Bamatt License#DC616 Exp.Dated/17/2019/ Worker's Compensation Palley Number WCC5008743012009 Carrier_Assoc.Employers Tn case of emergency contsethl/A NO employeSs Tel.i/_( (Contractor's Representative) DELEADINGCONTRACTOR The undersigned hereby states,under the pains and penalties of perjury,that he/sh as read and understood the C monwealth of Mmsachusetts Deleading Regulations,454 CMR 22.00,and the Lead Poisoning ention and Co 1 Reg o 1.05 CMR 460.000,and that the information contained in this notification is true and eorrec bes r n e and le Date_1/8/2010 Sighed Company Name Steve Barnatt dba Altara Construction Addres.9,i6 Cenier_Ske-etaout -DennL%-M 02&EO Telephone Number_508-394-5495 OVER-4 o d -- 1P4L� e7q �� C-o P, 01/17/2010 11:43 18662530538 STEVE BARNATT PAGE 02/02 w Page 2 or 2 � ✓ AG�/'L//`r� a in accordance with Massachoset&(General Laws C.111§197,454 CMR 22.00 and 105 CMR 460,000,notice of the date and method(s)of removal or covering of paint,plaster or other accessible materials containing dangerous levels of lead is to he provided�n must be received by the following agencies,at least. (1.0}days prior to the beginning of deleotdlog. YL/ /l NOTIFICATIONS MAY BE FAXED- c�C1 I. Department of i.abor.Lend progtgem,Division of Occupational Safety 19 Staniford Street,lot Flom',Boston,MA 02114 FAX 617-626-6965 2. Director,Childhood Lend Poisoning Prevention Program Department of Public Health,Donovan Health Building,5 Randolph Street,Canton,MA 02021 FAX:781-774-6700 3. Occupants of dwelling unit 4. All other occupants of the residential premises,if any 5. i ocal Board of Health/tide Enforcement Agency 4_,4 _ G +9 Q - 3azep- 6. Massachusetts Historical Commission (if premises are listed on the State Register of Historic 220 Morrissey Blvd. Places,this notification must he made upon receipt of an Boston,MA 02202 Order to Correct Violations or at least 30 days prior to FAX(617)727-5128 initiating preventive deleading) NOTIFICATIONS SHALL BE COMPLETED IN THEIR ENTIRETY,DATED AND SIGNED-UVCOMPLEIE NOTI(CATIONS WrLL NOT BE ACCEPTED AND WILL BE RETURNED BY THE DEPARTMENT OF LABOR&WORKFORCE DEVELOPMENT- (If owner or unlicensed owner's agent will be performing low risk deleading work,complete the following): Property Owner_N/A Address Telephnne Number__(_)- i certify that I have complied with the training rcquirements of the Commonwealth of Massachusetts Lead Poisoning Prevention and Control Regulations, 105 CMR 460.175,for owner/agent low-rink abatement and containment I further certify that I or my agent will be performing the following low-risk activities (I have circled all that apply): applying liquid encapsulapt capping baseboards removing doors,cabinet doors,shutters applying exterior vinyl siding covering surfaces i J certify that all the information contained in this notification is tru and corn he best o kn ge and b tcf Date_l/8/2010 Signed Revised 12/2007 ce, pro Qj 0 `,. r r M. The Town of Barnstable Health Department F ""ST"` 367 Main Street, Hyannis, MA 02601 riva ,67q. ` Office 508-790-6265 Thomas A. McKean FAX 508-775-3344 Director of Public Health February 8, 1993 Nelson Brenner, T.R.S. Cane Realty Trust P.O. Box 226 Sharon, MA 02067 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CODE II, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION The property owned by you located at Apt. R 576 Rear Main Street was reinspected on February 8, 1993 by Donna Miorandi, Health Inspector for the Town of Barnstable, because of a complaint. The following violations of 105 CMR 410.00, State Sanitary Code II, Minimum Standards of Fitness for Human Habitation were observed: 410.602: Rubber tires and old muffler left on the ground next to the back door. Along with garbage in rear. 410.480: No door handles provided on back door. 410.501: No storm door or storm windows provided in apartment. 410.504: Repaired step located in the shower stall has protruding screw heads. 410.450: Back door is provided with a malfunctioning wooden bolt. Door opens inward. 410.100: Kitchen stove inoperable. One electric burner exhibits evidence of fire. 410.280: No natural or mechanical ventilation in bathroom. 410.482: No smoke detectors. 410.504: Entire one ( 1) room dwelling is carpeted. Carpet contains excessive foreign debris, worn, has holes and is laid over a concrete floor. 410.045: Chronic mold due to chronic dampness throughout dwelling. Much evidence observed on bathroom ceiling. t You are directed to correct these violations within seven (7) days of receipt of this notice. You may request a hearing if written petition requesting same is received by the Board of Health within seven (7) days after the date order is received. However, these violations must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result in a fine of not more than $500. Each separate day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH ' cKean Director of Public Health cc: Dorothy McCue, Tenant To Whom This May Concern: It is my estimation that due to the above existing conditions that this dwelling is unfit for Dorothy McCue to habitate. Her present health problems, asthma and a high risk pregnancy, make this an unsafe dwelling for Ms. McCue. If she and two infants along with her brother were to reside in this dwelling it would not meet the minimum requirements for square footage for occupancy. It is my opinion, Donna Miorandi, Health Inspector for the Town of Barnstable, that it is unsafe for Ms. McCue and/or any other current or future resident to reside at this dwelling. I would request at this time that Ms. McCue move out of this dwelling due to the above cited unsafe, unhealthy conditions. Si cerely, o Q i J Donna Miorandi Health Inspector !�J011�0812010 19:54 18662530538 STEVE BARNATT PAGE 01/02 Department of Public Health&Department of Labor t4, 10 1 NOTII 1CATION OF DELF,ADING WORK All sections of this form must be completed in order to comply with the notification requirements of M.G.L.C.111§197, 454 CMR 22.00 and 105 CMR 460.000,as most recently amended Contractor performing proJtxtStt;Ve Barnett License#DC616 Exp.Date9/17/2010 Lead Paint Inspector Fred Herrimila Date orinspcMion9/1/09 7,icensc#j2736 ,Exp.Date ADDRM OJ,PROZ CT: Street Address 576 Main Street Apt.Number 11 city Hyannis Zip 02601 Property ownerNelson Brenner _ ____Andress-Box 226 Sharon,MA 02067 Telephone Number 781-492-6027 Deleading Method:❑Wet/Dry Scraping ❑Heat Gun Liquid Encapsulant ODemolltion ❑Caustics Replacement OCovering ❑Other If"Other"selected,please explain Check one: Dwelling is multi-famll'y Single-family Othcr Start Date 1/18/2010 Completion Date 1/18/2010 When will work be done: AM9 pM�2 (specify times on Site) Weekends?NO Protect 3uperflsor Name_Steve Bamatt ...... DC616 Exp.Date9/17/2019/ Worker's Compensation Policy Number WCC5008743012009 Carrlet3ssoc.Ernployers In case of emergency contncrN/A No employess Tel. _( . (Contractor's Representative) DIMEADING CONTRA OR The undersigned hereby states,under the pains and penalties of perJury,that be/sh as read and understood the C onwealth of Massachusetts Deleading Regtdatiotts,454 CMR 22.00,and the Lead Poisoning P ention and Co I Rc l0 105 CMR 4G0.000.and that.the information contained In this notification is true and corre t be r e and ief Date-1/8/2010 Signed_ l company Name Steve Bamatt dba Altara Construction Address_183 Center Street S-Qth Dennis. MA 0266.0 Telephone Number_508-394-5495 OVER-it � 01/08/2010 19:54 18662530538 STEVE BARNATT PAGE 02/02 Page 2 of 2 .a In accordance with Massnehusetts',General Laws C.III$197,454 CMR 22.00 and 105 CMR 460.000,notice of the dale and method(s)of taining dangerous levels of lead is to be provided andremoval or covering of paint,plaster or other accessible materials con must be received i by the rollowing agencies,at least=(10)days prior to the beginning of deleading. NO'>;H ICATIONS MAY BE FAXED- I. Department of LaborALead Program,Division of Occupational FAX 617.626-6965 fety 19 Stamford Street,I"Floor,Boston,MA 02114 2, Director,Childhood Lead Poisoning Prevention Program Department of Public Health,Donovan Health Building,5 Randolph Street,Canton,MA 02021 FAX:781-774.6700 3. Occupants of dwelling unit 4. All other occupants of the residential premises,if any 5. Local Board of Health/Code Enforcement Agency _4 Ti Cr 3`"7 6. Massachusetts Historical Commission (if premises are listed on the State Register of Historic 220 Morrissey Blvd. Places,this notification must be made upon receipt of an );oaten,MA 02202 Order to Correct Violations or at least 30 days prior to FAX(617)727-5128 initiating preventive detesting) i NOTQ'ICATiONS SHALL BE COMPLETED Y T��AR,C�N�NT O LABOR&WORK)v'ORCE DE�L'JETE LO NOTIFICATIONS WILL NOT BE ACCEIrm AND WILL BE R t PROIS R(if owner or unlicensed owner's agent will he performing low-risk dclending work,complete the following): TY O Property Owner N/A Address Telephone Number—(—)- I certify that I have complied with the training requirements of the Commonwealth of Massachusetts Lead Poisoning Prevention and Control Regulations,105 CMR 460,175,for ownerlagent low-risk abatement and containment. I further ecrtify that I or my agent will be performing the following low-risk activities (I have circled nil that apply): Pp g ca in• baseboardq removing doors,cabinet doors,shutters applying liquid encapsularIit applying exterior vinyl siding covering surfaces I certify that.all the information contained in this notification is tru and eorre he best o kn ge and b ref Dal0/8/2010 - Signed i Revised 12/2007 I ®SENDER: Complete items 1 and 2 when additional services are desired, and complete items 3 and 4. Put your address in the "RETURN TO" Space on the reverse side. Failure to do this will prevent this card from being returned to you. The return receipt fee will Provide you the name of the Person delivered to and the date of deliver. For additional fees the following services are available. Consult pos"ster for fees and check box'(es)for additional service(s) requested. 1. IS Show to whom delivered*date,and addressee's ldress. 2. ❑ Restricted Delivery T(Extra Aafrge)t t(Extra charge)T 3. Article Addressed to: 4. Article Number 3291130 Mr. Nelson Brenner Type of Service: P.O.Box 226 f'e/J ❑,--,/Registered ❑ Insured Sharon, Ma 026 LJ Certified ❑ COD ❑ Express Mail Always obtain sign�atuL�re— f ddressee � or agent and DAT fE, I,V 5. Si , re—Addressee ressee's Add"res`s(ONL;1h, X requested ar feFe paid 6. Signature—Agent ��' X 7. Date of Delivery t� PS Form 3811, Mar. 1987 * U.S.G.P.O.1987-178-268 DOMESTIC RETURN RECEIPT I �I �I I I UNITED STATES POSTAL SERVICE OFFICIAL BUSINESS SENDER INSTRUCTIONS I � Print your name, address, and ZIP Code in the space below. I. • Complete items 1,2,3, and 4 on F!=SM the reverse. ® • Attach to front of article if space permits, otherwise affix to back , of article. PENALTY FOR PRIVATE 1 • Endorse article "Return Receipt USE,$300 1 Requested"adjacent to number. I I RETURN Print Sender's name,address,and ZIP Code in the space below. TO I I Board of Health I I 367 Main Street I Hyannis, Ma 02601 P 733 291 130 RECEyPT FOR CERTIFIED MAIL NO INSURANCE COVERAGE PROVIDED NOT FOR INTERNATIONAL MAIL (See Reverse) Sent to Mr. Nelson Brenner Street and No. P.O.Box 226 P.O.,State and ZIP Code Postage S Certified Fee 2.00 Special Delivery Fee Restricted Delivery Fee Return Receipt showing to whom and Date Delivered N � Return Receipt showing to whom, Date,and Address of Delivery d TOTAL Postage and Fees S 2•00 Postmark oc Date co E August 3, 1988 0 U. d STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES.(see front) If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving IdRESTRICTED e receipt attached and present the article at a post office service window or hand it to your rural carrier. o extra charge) If you do not want this receipt postmarked,stick the gummed stub to the right of the return address of e article,date,detach and retain the receipt,and mail the article. If you want a return receipt,write the certified mail number and your name and address on a return ceipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space per- its. Otherwise,affix to back of article. Endorse front of article RETURN RECEIPT RECIUESTf,D jacent to the number. If you want delivery`restricted to the addressee,or to an authorized agent of the addressee,endoe DELIVERY on the front of the article. 5. Enter fees for the services requested in-the appropriate spaces on the front of this receipt. If return receipt is requested,check the applicable blocks in item 1 of Form 3811. 6. Save this receipt and present it if you make inquiry. �U.S.G.P.0.1987.178.131 ( illllrM1l111 ( 1 f �~tfi . t, t etfffttl, flf ! ! ' l, 1, t. : t, } THE COMMONWEALTH OVMASSACHUSETTS BOARD OF �HEA TH 7D1 �. 4 CI TOWN A p ' O D h RTMENT IPAIAr --- — -- ADDRESS (A(1Ip O V TELEPHONE 77 6 Address 3 Occupant Floor__ _ Apartment No. No. Occupants _ No. of Habitable Rooms No. Sleeping Rooms p006 No. dwelling or rooming units n ^� Name and address of owner om Remarks. Reg. Vk . YARD Out Bld s.: Fences: ar a can�bis _5 At nt Containers: ' e-ffr-9i_nag_eWAM n es at'ron Rats or other: ) STRUCTURE EXT. Steps, Stairs, Porches: Dual Egress: and Obst'n.: O B ❑ F ❑ M iDoors, Windows: Roof t, Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen. Sanitation: Dampness: Stairs: _ Lighting: STRUCTURE INT. Hall, Stairway: Obst'n.:, Hall, Floor, Wa , Ceiling: J Hall Lighting: Hall Windows: z HEATING Chimneys: z Central ❑ Y ❑ N Equip. Repair Z TYPE: Stacks, Flues,Vents: ` W Cc � PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: m H.W.Tank(s) Safety and Vent(s) o ELECTRICAL Panels, Meters, Cir.: _ ❑ 110 ❑ 220 Fusing, Grnd.: - 0 AMP: Gen. Cond. Distrib. Box: r° Gen. Basement Wiring: DWELLING UNIT Ventil. Lgtng. Ou gets Walls Qeils. Wind. QoorsIFLoors Loc Kitchen PAT-ALi AD[ Bathroom Pantry Den Living Room _ Bedroom (1 Bedroom (2) Bedroom (3) Bedroom (4) r Hot Water Facil. Sup.Ten., Gas,Oil, Elect.: Stacks, Flues Vents Safetie : Kitchen Facilities Sink Stove Bathing, Toilet Facil. Veit., Plumb., Sanit'n.: Wash Basin, Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted: Locks on doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJUIjY"" 0 O INSPECTOR TITLE A. DATE TIME P•M• A.M. THE NEXT SCHEDULED REINSPECTION P.M. i 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of these items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public: Because Chapter II, 105 CMR 410.000 through 410.499 state minimum requirements of fitness for human habitation, any violation has the potential to fall within this category in any given situation but may not do so in every case and therefore cannot be included in this listing. Failure to include shall in no way be construed as.a determination that other E violations may not be found to fall within this category. - Nor shall failure to include affect the duty of the local health official to order repair or correction of .the violations) pursuant to 410 CMR'410.830 through 410.833 nor shall it affect the legal obligation of the person to.whom the order is issued to comply with such order. (A) Failure to provide• i'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 4.10.180 and-410:190 for a'period of 24 hours or ti longer. _ + (B) Failure to provide heat as required by .105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shut-off and/or failure to restore electricity or gas. (D) Failure to supply the electrical facilities required by 105 CMR 410.250(B); 410.251(A), 410.253(A), 410.253(B) and the lighting in common area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage system in operable condition as required by 105 :CMR 410.150(A)(1) and 410.300. _;(G). Failure to provide adequate ekits,' or the obstruction of any exit, passageway'or common area caused by an-object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450 and 410.451. (H) Failure to comply with the security requirements of 105. CMR 410.480(D). _ (I) Failure to comply with any provisions of 105 CMR 410.600 through 410.602 which results in any accumulation of garbage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of lead-based paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regualtions for Lead Poisoning Prevention and Control• 105 CMR 460.000. (K) Roof, foundation;.or,'other structural defects+.that may expose the occupant or anyone else to fire, burns; 'shock, •accident oryother dangers or impairment to health or­dafety. " It (L) Failure to install electrical, plumbing', heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilities as are required by 105 CMR 410.351 and 410.352 so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. k (MA 4Aby-of the following conditions which"re_main uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either operable. (2) failure to provide a washbasin and a shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3) and any defect which renders them inoperable. (3) any defect in the electrical, plumbing, or heating system which makes such system or any part thereof in violation of generally accepted plumbing heating, gas-fitting, or electrical wiring standards that do not create an immediate hazard. . (4) failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A) and 410.503(B). (5) failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (N) Amy other violation of Chapter II not enumerated in 105 CMR 410.750(A) through (M) shall be deemed to be a condition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so. ordered by the board of health. .-�. -. � � _.�_�....., , � =...y.._�. .._..ram. `.�-, ,« ,-•• � rI ` .... f ,. - -- ? THE COMMONWEALTH OF MASSACHUSETTS c7 b BOAR F/ l�H � ,_ - Ci IT N N o vI�ADEe4UMENT ADDRESSlb ]� Address 5 /Y1�lI� Awls - 49,L N(EAfo /L- Z5 Occupant `-� �1 _ ��(j I Floor Apartmeyl� N_o._ pNog. Occupant �_ e �O No. of Habitable Rooms a•j/ No. Slee in Room -f D fC� No. dwelling orrooming units o. r' s �n `7 Name and address A O RD b of owner � _ � 11 � 1T Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish: Containers: Drainage J Infestation Rats or other: STRUCTURE EXT. Steps, Stairs, Porches: Dual Egress: and Obst'n.: ❑ B ❑ F ❑ M Doors, Windows: Roof Gutters, Drains: Walls: Foundation: f Chimney: BASEMENT Gen. Sanitation: Dampness: Stairs: _ Lighting: STRUCTURE INT. Hall, Stairway:. Obst'n.: t Hall, Floor, Wall, Ceiling: ! Hall Lighting: o Hall Windows: ,- z HEATING Chimneys: z Central ❑ Y ❑ N Equip. Repair w TYPE: -Stacks, Flues- Vents:'- a PLUMBING: Supply Line: ; ❑ MS ❑ ST ❑ P m H.W�Tank(s) Safety and Vent(s) / ELECTRICAL Panels, Meters, Cir.: 0 ❑ 110 ❑ 220 /FLsing, Grnd.: AMP: Gen. Cond. Distrib. Box: 0 Gen. Basement Wiring: DWELLING UNIT Kitchen Ventil. Lgtng. Outlets Walls Ceils. Wind. Doors Floors Locks _ Bathroom Pantry Den Living Room Bedroom 1 Bedroom (2) Bedroom (3) Bedroom (4) I Hot Water Facil. Sup.Ten., Gas,Oil, Elect.: _ Stacks Flues Vents Safeties: Kitchen Facilities Sink I ) / Stove Bathing, Toilet Facil. Vent., Plumb., Sanit'n.: Wash Basin, Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: T General Building Posted: r 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 P INS AN PENALT OF PERJURY." INSPECTOR TITLE DATE __ TIME ff P.M. A.THE NEXT SCHEDULED REINSPECTION __ p.M. M. 410.750: Conditions Deemed to Endanger or Impair H1 alth or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions-which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of- these items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public: Because Chapter II, 105 CMR 410.000 through 410.499 state minimum requirements of fitness for human habitation, any violation has the potential to fall within this category in any given situation but may not do so in every case and 'therefore cannot be included in this listing. Failure to include shall in no way be construed as.a determination that other violations may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of the violation(s) pursuant to 410 CMR 410.830 through 410.833 nor shall it affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to •meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shut-off and/or failure to restore electricity or gas. (D) Failure to supply the electrical facilities required by 105 CMR 410.250(B); 410.251(A), 410.253(A), 410.253(B) and the lighting in- common area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage system in operable condition as required by 105 CMR 410.150(A) (1) and 410.300. (G). Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by an object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450 and 410.451. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (I) Failure to comply with any provisions of 105 CMR 410.600 through 410.602 which results in any accumulation of garbage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of lead-based paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regualtions for Lead Poisoning Prevention and Control 105 CMR 460..000. (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or dafety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilities as are required by 105 CMR 410.351 and 410.352 so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. _ 1 4 (M) Any of the following conditions which.remain uncorrected for a period of five or more days following, the notice to or knowledge of the owner of said condition or conditions: (1) lack of akitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either operable. (2) failure to provide a washbasin and a shower or bathtub as required .in 105 CMR 410.150(A)(2) and 410.150(A)(3) and any defect which renders them inoperable. . (3). any defect in the electrical, plumbing, or heating system which makes such system or any part thereof in violation of generally accepted plumbing heating, gas-fitting, or electrical wiring standards that do not create an immediate hazard. (4) failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A) and 410.503(B). (5) failure to eliminate rodents, .cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (N) Amy other violation of Chapter II not enumerated in 105 CMR 410.750(A) through (M) shall be deemed to be a condition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the board of health. �n..s'....-�!."+4,-t�,.,._r ro..t.�.4.r.1,r•Vya i�'4N...a..`-. .a.�L ti ..�-. .. ,.�.^� � �� W ter.^./tis.w..r..��r./�.. -.4'� ir�.+611...�w ur.".+w'`+4Li.�-\-b..� r�v. ...4 +N"�K.w�•• ,,. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � �-� CITY/TOWN h , DEPARTMENT ADDRESS - — °+M 7�,, /A e TELEPHONE /) . Address, - ` © � 20!cupant Floor _ Apartment N ._ - _ No. Occupants No. of Habitable Rooms _ No. Sleeping Rooms No. dwelling or rooming units _ - No. Stories 0 5Name �Y and address of owner 'y _�_ �p�✓O t `�-+� Remarks 1 Reg. Vio. r 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 OF ❑ M Doors,Windows: Roof Gutters, Drains. 4 Walls: Foundation: Chimney: BASEMENT Gen. Sanitation: ,� / ,, Dampness: (!APe � �� �� � �� 77 n�; 0 , Stairs: — d _ Lighting: STRUCTURE [N.M.. Hall, Stairway: /V 14,45 (_S;(-k),b )'1N 605K,' Obst'n.: Hall, Floor, Wall, Ceiling: 1Q.� c AN�_,� Hall Lighting: ,,m e!9 ! > Hall Windows: ,r,pm z HEATING Chimneys: z Central ❑ Y ❑ N Equip. Repair o r W TYPE: < Stacks, Flues,Vents: r �° t►'�� '� "�'"'"'" ,� a PLUMBING: Supply Line: - - - 3 ❑ MS ❑ ST ❑ P Waste Line: m H.W.Tank(s) Safety and Vent(s) ELECTR'CAL Panels, Meters, Cir.: o ❑ 110 ❑ 220 Fusing, Grnd.: AMP: Gen. Cond. Distrib. Box: �° Gen. Basement Wiring: DWELLING UNIT Ventil. Lgtng. Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen .. ' �. a '� -.� -A Bathroom �/ �� � �� � � Pantry Pant 2,Ar� Den 'j ��fy vvwr r=Living RoomBedroom (1) Bedroom (2) �� � �. �: At ����-�V i A.] C �y Waits Bedroom (3) G L i! f// 1 .. r % _. �Y,� /,' !• � / 14 l i Bedroom (4) ���o Hot Water Facil. Su .Ten, Uas,Qil°Efe is Stacks, Flues Vents Safeties: y Kitchen Facilities Sink LeA k Stove #� �.' G - I - I N _MJ� (n4' /° Bathing, Toilet Facil. Vent.701iamb., Sanit'n.:'/ Wash Basin, Shower or Tub:• : () Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: - llaC ►fS General Budding Posted: *� Locks on doors: -•,9 11 I/' �� ` ,/ - r..w'~ .001 ONE OR MORE OF THE VV16CATIONS CH CKED ABOV IE S A COND TIO -WHICH A MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE �V OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY." INSPECTOR P.�if%i.1 (:,� } '. r �T ., 1 • .,.TITLE DATE TIME Of P'M ' J A.M. THE NEXT SCHEDULED REINSPECTION �.i -___ �._ P.M. r 410 750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of these items 'which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.000 through 410.499 state minimum requirements of fitness for human habitation, any violation has the potential to fall within this category in any given situation but may not do so in every case and therefore cannot be included in this listing. Failure to include shall in no way be construed as.a determination that other violations may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of the violation(s) pursuant to 410 CMR 410.830 through 410.833 nor shall it affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shut-off and/or failure to restore electricity or gas. (D) Failure to supply the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253(A), 410.253(B) and the lighting in common area required by 105. CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage system in operable condition as required by 105 CMR 410.150(A)(1) and 410.300. (G). Failure to provide adequate exits,Aorfthe obstruction of any exit, passageway or common area caused by an object, including garbage or trash, which prevents egress in case of an emeggency 105 CMR 410.450 and 410.451. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (I) Failure to comply with any provisions of 105 CMR 410.600 through 410.602 which results in any accumulation of garbage, rubbish, filth or other causes of sickness which may provide-a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of lead-based paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regualtions for Lead Poisoning Prevention and Control 105 CMR 460.000. (K) Roof, foundation, or other structural defects that may expose the occupant-or anyone else to fire,- btirns, shock, accident or other dangers or impairment to health or dafety. ' (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilities as are.required by 105 CMR 410.351 and 4,10.352 so as to expose the occupant or anyone else ,to fire, burns, shack, accident or other danger or' impairment to health or safety. (M) Any of the following conditions wh'ichsremain 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.Lutensils or lack.of a stove and oven or any defect that renders either operable. _ (2),_ failure to provide;a washbasin and a shower or bathtub as required in 105 CMR1410.150(A)(2) and 410.150(A)(3) and any defect which renders them inoperable. (3) any defect in the electrical, plumbing, or heating system which makes such system or any part thereof in violation of generally accepted plumbing heating, gas-fitting, or electrical wiring standards that do not create an immediate hazard. (4) failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or' similar place as required by 105 CMR 410.503(A) and 410.503(B). _ (5) failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (N) Amy other violation of Chapter II not enumerated in 105 CMR 410.750(A) through (M) shall be deemed to be a condition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the board of health. Z 348 659 907 Receipt for Certified Mail No Insurance Coverage Provided Do not use for International Mail (See)jeverse) Sent to Ol t Stre t'a to State Code P.O.1 O Go Postage Certified Fee O � LL Special Delivery Fee a I�esy�Lctgd LDre 1Y�fy—f //T to Whom&Date Delivered / C/ Return Receipi Showing to Whom, Date,and Addressee's Address TOTAL Postage &Fees Postmark or teeV. ` Q STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front). a 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address LA leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier(no extra charge). p) 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return address of the article,date,detach and retain the receipt,and mail the article. L 3. If you want a return receipt,write the certified mail number and your name and address on a return receipt card,Form 3811,and attach it to the front of the article by means of the gummed co ends if space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT 2 REQUESTED adjacent to the number. C 4. If you want delivery restkicted to the addressee,or to an authorized agent of the addressee, y th endorse RESTRICTED DELIVERY on the front of the article. E 0 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If LL return receipt is requested,check the applicable blocks in item 1 of Form 3811. t a 6. Save this receipt and present it if you make inquiry. 105603-93-a-021e Town of Barnstable Health Department law a ` I 367 Main Street, Hyannis, MA 02601 261 Office 508-790-6265 Thomas A. McKean FAX 508-775-3344 Director of Public Health September 1;8, 1996 Nelson Brenner Cane Realty'Trust P.O. Box 20,11 Sharon, MX02067 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.00, STATE SANITARY CODE II MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE, ARTICLE 51 The property,owned by you located at 576 Main Street, Unit 7, Hyannis was inspected on September 12, 1996 by Christina Kuchinski, RS Health Inspector for the Town of Barnstable because of a complaint. The following violations of the Town of Barnstable Rental Ordinance Article 51 and the State Sanitary Code were observed: 410.501: The caulking that had been installed to fill exterior cracks between the storm window frames and the prime window frames throughout the apartment was drying , cracking , and was detached. 410.501: The top window of the window frame in the apartment storage room does not stay up. There is a large air gap at the top of the window. 410.500: The livingroom carpet is very worn and growing mold/mildew. 410.351: The bathroom sink was not secured to the bathroom wall. 410.351: The four burners on the kitchen stove were not working. You are directed to correct the above listed violations within seven (7) days of receipt of this notice. You may request a hearing if written petition requesting same is received by the Board of Health within seven (7) days after the date order is received. However, this violation must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result in a fine of not more than $500. Each separate day's failure to comply with an order shall constitute a separate violation. You are also subject to non criminal citations of$40.00 for the first violation and $15.00 for each additional violation. Tickets will be issued daily until the violations are corrected. PER ORDER OF THE OARD OF HEALTH Thomas A. McKean Director of Public Health cc: Doris Fulcher i Fol o' Sox NOTICE TO ABATE VIOLATIONS OF 105 CMR 410,00, STATE SANITARY CODE II, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE.ARTICLE 51 The property owned by you located at 6-X rywe) % 6414, ' was i pected on y I,y 0/M I/2S health Agent for the Town of Barnstable because of a complaint. The following violations of the Town of Barnstable Rental Ordinance Article 51 and the Sanitary Code II were obs@rved: - ylo. So/ 011) j � I Vic` �� v care cvlO�J SI (M we�•d v� � dnr'y�, c�c�z { � OUq ov4 die -4, (, age C,v 1lle o .! . iS y(01 Sod `71� lI Ur V fareov)" c �� " ylo ems"/ � �orAe, ou are directe�to corre ' scion o n 2 rec ' of o e y You Are ^,directed to correct the remaining above listed violations within seven (7) days of receipt of this notice. You may request a hearing if written petition requesting same is received by the Board of Ilealth within seven (7) days after the date order is received. However, these violations must be corrected regardless of any request for a hearing. Please be advised that failure to comply with an order could result in a fine of not more than $500. Each separate day's failure to comply with an order shall constitute a separate violation. You are also subject to non criminal citations of$40.00 for the first violation and $15.00 for each additional violation. Tickets will be issued daily until the violations are corrected. Enclosed are citation numbers due to violations observed on PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean Director of Public Health Town of Barnstable - SENDER: V ■Complete items 1 and/or 2 for additional services. I also wish to receive the w ■Complete items 3,4a,and 4b. following services(for an ■card Print your name and address on the reverse of this form so that we can return this extra fee): d d ■Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address permit. _d ■write'Return Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery U) r ■The Return Receipt will show to whom the article was delivered and the date delivered. Consult postmaster for fee. a o .S a 3.Article Addressed to: 4a.Article Numbe/rr � w d 711 "go c -1�r 4b.Service Type n ❑J Registered ® Certified/ i as Cn v` // ❑ Express Mail ❑ Insured s 1 N ❑ Retum Receipt for Merchandise ❑ COD a e of Delivery I �° 7 h cc .5Rece' ed B ricftlUa cv 8.Addra a 's Address(Only if requested W o and is paid) Ir d t 0 `o Si na ss o�= T X a N i PS Form 6911, Decembe 1994 Domestic Return Receipt r First-Class Mail UNITED STATES POSTAL SERVICE Postage&Fees Paid uSPS Permit No.G-10 • Print your name, address, and ZIP Code in this box • ff881&tl8pft W TO=of BRM ta618 P.O.Box 534 Hyannis;Massachusli b &W Fax(50)775-3344 (508)790-1621 5 3 FORM3o Hoass&WARREN,INC.NOV.1979.19M THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CITY/TOWN N -�DEPARTMENT, �.. ADDRESS) J- 7 4N SVey ca.� TELEPHONE Address 6 t l `t f i ��e l a-on Occupant Floor Apartment No: '1 'No.of Occupants P p, IsK ap No.of Habitable Rooms No.Sleeping Rooms No.dwelling or rooming units No.Stories, Name andladdress of owner p = NL l V P�J l'1 Pft- ( ' &-a-1 1, f V14 d .�-�ok r ��h �� U�-6(0 7 Remarks Reg. Vlo. YARD Out 13Id s.: Fences: Garbage and Rubbish Containers: t Drainage Infestation Rats or other: STRUCTURE-EX-T. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: t.71 a d Roof 4,6 Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: STRUCTURE INT. Hall,Stairway: ' klmkh n Gv I &JO Cj Obst'n.: r /.�r�'1" C'- e--y v ja Hall, Floor,Wall,Ceiling: ) ,, -4 , • ,/c; 0 Hall Lighting: Hall Windows: / U J HEATING Chimneys: � YI^ t A/ M-617 -S ell_',v Central ❑ Y ❑ N Equip. Repair 4-0 TYPE: Stacks,Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. Sup.Ten.,Gas,Oil, Elect.: Stacks,Flues,Vents,Safeties: Kitchen Facilities Sink Stove .� 1�v�r� CLr-� ►/l. =t t�trWptte,_4 Bathing,Toilet Facil. Vent. Plumb`,Sanit'n.: CJ Wash Basin Shower or Tub: Infestation Rats Mice Roaches or Other: Egress Dual and Obst'n: General Buildina 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 A AUTHORIZED INSPECTOR.(See Over) "THIS INSPECTION REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJURY. /l- 1 INSPECTORJ-4� irLE / ..30 A.M. DATE /P2 TIME / P. r A.M. THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, . shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of these items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter II, 105 CMR 410.000 through 410.499 state minimum requirements of fitness for human habitation, any violation has the potential to fall within this category in any given situation but may not do so in every case and therefore cannot be included in this listing. Failure to include shall in no way be construed as.a determination that other violations may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or j correctionjof the violation(s) pursuant to 410 CMR 410.830 through 410.833 nor shall it affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 OIR 410.201 or improper venting or use,of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shut-off and/or failure to restore electricity or gas. (D) Failure to supply the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253(A), 410.253(B) and the lighting in common area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. .(F) Failure to provide a toilet and maintain a sewage system in operable condition as required by 105 CMR 410.150(A)(1) and 410.300. (GI Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by an object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450 and 410.451. (H) Failure to comply with the security requirements of 105 CMR 41b.480(D). (I) Failure to comply with any provisions of 105 CMR 410.600 through 410.6.02 which results in any accumulation of garbage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of lead-based paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regualtions for Lead Poisoning Prevention and Control 105 CMR 460.000. (B) Roof, foundation, or other structural defects that may expose the occupant .or anyone else to fire, burns, shock, accident or other dangers or impairment to health or dafety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted .plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilities as are required by 105 CMR 410.351 and 410.352 so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either operable. (2) failure to provide a washbasin and a shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3) and any defect which renders them inoperable. (3) any defect in the electrical, plumbing, or heating system which makes such system or any part thereof in violation of generally accepted - plumbing heating,• gas-fitting, or electrical wiring standards that do not create an immediate hazard. W failure to maintain a safe handrail or .protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A) and 410.503(B). (5) . failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (N) Amy other violation of Chapter II not enumerated in 105 CMR 410.750(A) through (M) shall be deemed to be a condition which may endanger 'or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the board of health. V -. I — - LOC&,T10N SEWaC,E PERMIT UO. '� / �, -mow e VILLA E ���t- �✓1 a ,N �t� �� r-- — f7 — — --- — WSTQLLER 5 1J&MF- h,,DDRF-,56Ell R BUILDERS tJ &MF- 4.00RE55 DATE PERNA T ISSUED D ATE COKAPL1 W,3CE ISSUED : �Z � + � �•. - � � ,. M r 'I � % � � ;, �. yOFT raw TOWN OF BARNSTABLE ewQ��e* WATER POLLUTION CONTROL BOARD 31AH3ST48L t P. O. BOX 314 r679 397 MAIN STREET HYANNIS, MASSACHUSETTS 02601 TEL. 775-1 120 March 25, 1977 Mr. John Kelly Board of Health Town of Barnstable Hyannis, Ma. Dear Mr. Kelly: It is my opinion that the property owned by Mr. Franklin off Main Street, Hyannis, cannot be tied to the Town Sewer System at the -- -present time. Respectfully, .e-ec�.w W lliam I. Hallett Superintendent / p c � b, No........ �-..... , Fizz.... ..................... THE COMMONWEALTH OF MASSACHUSETTS BOARD-�OF HEALTH ®D� `.`..... -- ...OF......�-J.-c�h..S.71 bb/.I'd.... Appliration -for Ui_qpuittf Workii C omitrurtiott Prrutit Application is hereby'made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: SS_� .. Gv'A!.. ;I- .......................... - ..~-.....-- ---------------- r Locat"Address r t N Y wner o, Address W e. Installer Address UType of Building Size Lot............................Sq. feet �-, Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------- - - W Design Flow.........................:..................gallons per person per day. Total daily flow----------------------------------------....gallons. WSeptic Tank—Liquid capacity------------gallons Length---------------- Width-----------..... Diameter................ Deptli.._._.-_._----. x Disposal Trench—No_____________________ Width-------------------- Total Length_-_-_____-.--..-___ Total leaching area....................sq: ft. Seepage,Pit No--------------------- Diameter..__--__-__-__-__.__ Depth below inlet.................... Total leaching area......____..____._sq. it. € Z Other Distribution box ( ) Dosing,tank ( ) Percolation. Test Results Performed bY------------- ------------------------------------------------------------ Date-_---•---------------------- -------- a ,a Test Pit No. 1----------------minutes per inch Depth of "Pest Pit-------------------- Depth to ground water._.-.__-.-..-..--.-..._- G4 Test Pit No. 2___________ ___minutes per inch Depth of Test Pit.................... �e th to ground water__..-.___-____---.._ oe ------------ Description of Soil--------------_----- ----• � .. '1�� dk� x � . - -t'.--------------- -- -- -.. i}'i<✓1 �P� ....................... U W ---------------------------------- -----••----•--------- ------------------------------------------------------------------------ 72 U Nature of Rep,irs or Alterations—Answer when a plicable._._--._-_./'_�_�_�.__ � ._.___ ---------------------------------- --------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article NI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Si ne d-- ---- ---- --- ------------------- � 7 /l Date Application Approved BY------ ,----•-- ;�/0�'/• .�-�'l. - ----.........................---------- -----� Date PP cat' n Di a�rlve for the following easons: I-dd—ii I� Date PermitNo......................................................... Issued........................................................ Date 0I Iro....... FEE .......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH %4o-Aft. .............. -------....OF...... ..V ...... ................................................. Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at :s—�6 ................................................................................................ ............................................................................. . .... Locg=' "-Address .&t ..... .......:........ I... ...ON................ ...S............ ...... .......... Y----------------- W caner Address- d. ............................ ....................... Installer Address U Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms-------------------------------------------;Expansion Attic Garbage Grinder ( ) P-I Other—Type of Building ............................ No. of persons............................ Showers Cafeteria ( ) 04 Other fixtures -----------------------------------------------------------------­---- --------- ------------------------------------------------------------------ Design Flow............................................gallons per person per day. Total daily flow.................................... ---gallons. P4 Septic Tunk—Liquid capacity­-­ ----gallons ' Length________________ Width.-__-_.-....._-- Diameter_...-....__._... Depth.__._...__...... Disposal Trench No_--------------------- Width_____-_-__-___----- Total Length--____-__--___-__-. Total leaching area--------------------sq. f t. Seepage Pit No_____________________ Diameter.._...__._.._.;------ Depth below inlet____________________ Total leaching area------------------sq. f t. Z Other Distribution box ( ) Dosing tank (. .), Percolation Test Results Performed by.......................................................................... Date_____-------------------------------.... Test Pit No. I................-niinutespet inch Depth of Test Pit_...._______.._____. Depth to ground water._.-__--_-.-_.---._._. rX4 'Test Pit No. 2---X4-nunutesper inch Depth,of Test Pit...................... kepth to ground water.....................­ .......oie4 I, ....... V;; ...................... ... .. ­ 9 A*- 0 4 ijt Description of Soil----------------------- . ...... -------- ............................................................................. ................ - -- ---- ---------­------ U -------9' ... ..... ------ ---- - - ------------ --- ----- - ---------- -------------­- ------ - Nat Nature o f Rep4irs or A,It go ration s Answe r when U ------------- ......................... ­----------------- ------ -W&OO -ft- ------------------------------ Agrtement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health . Si ed ... ... .................... -- --- --'------- •Si Application Approved By----- - -- ----------------------- ------ - - ..... ---7. Date Application Disapproved for the following reasons:__:------------------------------------------------------------------------------------------------------------- ............................................ .............................................................................................................................................. Date at stued 2"l,........................... ...................-rN,ta ----------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH C�p ......................................... ................................... difiralt V f Tampliatta THIJ IS TQ CERTIFY, Tn t the. lidividudl..Sewige.Disposal System constructed or Repaired by..........4.s.....Q- ------- --- ..A ....,..o x............................................................................................................... I Installer at 40 Z% V ................... ............. ................... ................. .. ---1-47..XV4-4.VY%-A­&-------------------------------------------------------------------- has been installed in accordance with the Provisions of Article XT­6f'-Tl;ie,State Sanitary Code as described in the application for Disposal Works Construction Permit No_________________________________________ dated....._......_.._........__..._.___..____._.__._. . T ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE,,. SYSYE ILL FUNCTION SATISFACTIORY,*,�,z. 4111 DATfr ........ iw nm .. ............ ............. ...... ------------------- THE COMMONWEALTH OF MASSACHUSETTS 'A I ABOARD OF HEALTH ....40... ... ......... 0 F", . ....................... .. No...-- 40.4.Z.."..... FEE......4............... ..Permission-is hereby ranted-- ----------------- �tqb.!Y-------­--------------- ---------------------------------............... to Construct or P an Indi�idual��_... Wage D!;*yosal System wair .... ...... -- --------------------- ---------------- ----------------------------------------- ------------ at No­.t.9----..4...a Street as shown on the application for Disposal Works Construction Per er 0--- - -- ---- ated- - j-�-- 7......... 10--- --- ------------- ........................ ard o Health DATE ..................................... ................ FORM 1255 HOB13S & WARREN. INC.. PUBLISHERS