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HomeMy WebLinkAbout0092 WINTER STREET - Health 92 Winter Street H: yannis _ A. 3O9 — 184 SEWER q...+..-..,..r:..-.d�_��. .frer�-e d -':�r.. ....:..rYr :_.:w wa+a e:wr..b-.,1+.cu.a... +r•.y.•-:,�y�-r ° e o �I I� j G n y ' L y i f v o fi ° 0 0 Lead Inspection/ isk Assessment Report Page 1 Of Anthony Jakaitis Master Lead Paint Inspector P.O.Box.400, South.Weymouth:,MA 02190 ?R1-331-1:565 St.# Address Apt. 92 Winter St C City Zip Code Hyannis 02601 Number of Rooms in Unit Owner Name: Eric Barsness Property Type: Owner Address: 54 Angus Way Single Family Contact Information: Centerville,MA 02632 Multi Family—1 #Units 7?>—. Client Name if different from owner Condominium III Units Day Care _ Other. Client Address: Key: Lead Column Key: Treatment.Method Column Laundry in Basement? Yes or COV Covered CAP Capped SCR Scraped Finished Space in Basement 7 Yes or 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 Na3S Exp,Date NA Not Accessible VRMR Vinyl/Metal Rep Window INT Intact X•Ray Fluorescence NC No Coaling SFR Storm Frame Removed Model RMD Serial#1462 Tile Tile(testing suggested) DC Dropped!Ceiling Comments I Notes 9.1C- Floor#_,,__,(this is the level within building of unit being inspected) Floor# C C b I • r l l I r I i l r i r r r r I r r r r r r l - �..._d._.....r....-- - i-...i.- ..r_.. i -- • ..y- I I I I 1 i I • r 1 r I r I • 1 I I • l 1 r r r 1 I I 1 r r 1 I • r r t I I I I I r Y r I • I I i ; • 1 -I r • I r • 1 1 t I I I I i 1 I t I I I 1 r • I I • .__�.__f_..i._i. ..f_. _.�•_ •__•---1'--t.._i..�...f..-i_. -'-y--`r- -r- -yam -h --• ♦ .i. B I -r^ I r I I I I wr^. I 1 I 1 I 1 1 I I 1 • I r r T` D I J I r r r r r r I I • • I r I r • I . . I r I i r • r r 1 I • i I I r I r I r I I i I I I r • r 1 r r I I • I r I I I r r ...,..._f....l...t.-.f_. ,...7....f....i.._1..__f._.,. ..r. .f_. I .. I I I I I I • I r r I I I I I r • r r • • r r I r i r ...�._...-.•.._,......- ..y... ...r...y_..r.._y_.y_..e...r-__ _..a...L..J.-.1._.L_-._I._..1-_-i___J... 1 . I • r i I I • I I I . • i I r I r I I r r I 1 I ...,...�..!.._ .5... ._!-.......i....I- a 5-.�.1._.1.. ...T_�_f_.1_...�..... .1...7_...f....I._.,...f..----y---f..�.._ A(Street Side) Start Here A(Street Side) Start Here 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 ✓ -Check off when complete Address verified through LISPS ✓ -Check off when complete Research on Lead-Related History for Address ✓ -Check off when complete www.s1atc,ma.tts/dDhAL1ppp.or 800-532-9571 Inspector Name Anthony.Jakaitis Lic#M 2929 Signature Date 09/30/11. PCAD rev 8/08 i t ADDRESS 92 Winter St.,#C,Hyannis, MA. 02601 Page 2 of-.6- INSPECTION HISTORY INTERIM CONTROL Determination Risk.Assessment Y UrgentPb.Hazards.Inspector Name: Y R.A.Name: Lead Hazards? N Signature ? N Signature Comprehensive Inspector Name Anthony Jakaitis,M 1919 Dust Taken for Risk Initial Inspection Assessment RA Name: d 3 c,I L ( N Signature F Signature Lead Hazards? Visual Portion of p Reins ection for Comp Initial inspector Name: P R.A.Name: .L1c#_____ wlPartial PCAD interim Control F Y Signature Signature N TM L Lead Hazards? Dust Taken for Risk P RA.Name: Lid— Addendum(add.-on Inspector Name: Assessment Reins to Initial Inspection �, F Signature N Signature Lead Hazards? Visual Portion of R.&Name: Lid Reinspection for Addendum as Full interim Control P Signature .Insp. Lost Docs y Inspector Name: I FFT1 I Lj F Lead Hazards? N Signature Dust Taken.for Risk P R.A.Name: ,LIc# Assessment Re' Walk Through for F Signature Ed/Consultation inspector Name: Lic# Signature Risk Assessment Recertification REINSPECTION HISTORY y RA.Name: Lic# Visual Portion of P Ur ent.Pb.Hazards?. N Signature Reocc.Rein lion Inspector Name: F Signature Dust Taken for RA P R.A.Name: Lid Rec_TJertification Visual Portion of F Signature Reocc.Reinspection P Inspector Name: Lic# F Signature POST COMPLIANCE ASSESSMENT DETERMINATIONS _ Dust Taken for P PCAD Inspector Name: Reocc.Reins ection Inspector Name: y F N Signature Signature Lead Hazards? Dust Taken for P Full Inspection Reocc.Reins ection 8 Inspector Name:. LIc# P Actin as PCAD Signatu I I I I y Inspector Name: Signature Dust Taken for Lead Hazards. 9 P Reocc.Reins ection Inspector Name: Lic# Visual Portion of P Inspector Name: Signature PCAD Reins ection Visual Portion of F Signature Final Reinspection 8 Inspector Name. F Dust Taken for P Inspector Name: Signature PCAD Reins ction p F Visual Portion of Signature Final Rein ction. P Inspector Name: -TTJF Signature Dust Taken for PCAD Reins ction P Inspector Name: ,Lic# Dust Taken for Final Rei No Reocc P Inspector Name: F Signature F Signature 't ADDRESS 92 Winter St.,#C,Hyannis,MA 02601 Page 3 odr�— REOCCUPANCY CERTIFICATE HISTORY COMPLIANCE HISTORY(CONT.) Certificate of. Certificate of Reoccupancy Inspector Name Maintained Inspector Name: Com liancc Only after Signature Signature High/Mod Risk No Work=No Dust #rooms rule Work:=7 Dust: Certificate of Certificate of Reoccupancy Inspector Name: LIc# Restored Com liance Inspector Name: Lic# Only after Signature I I I I Signature High/Mod Risk Dust wipes and auth. #rooms rule people Certificate of Inspector Name: Llc# Certificate of Reo� anc Maintained. Inspector Name: Lid Signature Compliance Only after I I I I Signature High/Mod Risk (#rooms rule No Work:=No Dust Work=7 Dust COMPLIANCE HISTORY Certificate of Letter of Full Initial Restored Compliance Inspector Name: Compliance Inspector Name: Lic# No prior history/ Signature Signature No signs of UD Dust.wipes and suth. people Letter of Interim OTHER HISTORY: WAIVERS/UD/EPA RRP Control Inspector Name:_ Approved CLPPP Waiver No prior Comp. Signature CLPPP Insp.Name: Lic# Far ices in I yr. Attach.to Comp Docs Signature Recertification of Approved Interim Control Inspector Name: Lic# CLPPP Waiver CLPPP Insp.Name: LIc# Expires 2 yrs from Signature Si nature original Interim Attach to Comp g Control Does Letter of Full Deleading UD/DES Visual Corn fiance inspector Name: Reins ection Inspector Name: Lick_ Signature Signature Dust wipes if No No LOC Issued F Reocc. Certificate of. UD/DES Dust. Maintained Inspector Name: Taken Inspector Name: Lic# Compliance Signature Signature No Work=No Dust No.LOC Issued F Work m 7 Dust UD/DES Dust Taken Inspector Name: Lic# Restored F Certificate of P Com dance Inspector Name: Signature No LOC Issued I I I I i Signature Dust wipes and auth. EPA RRP Visual people And Dust Inspector Name: Lid No LOC Issued and BSignature NO UD F 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 to 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/cm2 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/cm2,or is marked"N/A." • For key to abbreviations like"COV","VB","VR"or"MR","NC","Tide","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/I"circled means that the.surface is a moveable/impacted surface and must be deleaded in its entirety. "SF"circled indicates that there is a storm frame present which requires the blind stop and exterior sill be deleaded.as interior moveable/impacted surfaces. • "AM'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 EXCLUDED The amount of loose paint on a surface as measured,by the head 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 Anthony Jakaitis M2929 9/3012011 Page.-J-5 Inspector(print) Uc# Sig Date Anthony Jakaitis M2929 Risk Assessor(print) Uc# Signature Date Address of Pro ert : 92 Winter Street Apt. C City Hyannis ROOM# SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEA DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ DATE METH DATE METH SURFACE HAZARD H DATE METH DATE METH A B Up Walls 4.3 A/M L N/A Y Window Sill Mil L N/A Y A e Low Walls AIM L N/A Y B Win Apron L N/A Y SLL A a Baseboards 6L NIA Y C Win Casing 7 Vl L NIA Y lCelling Chair Rail A/M L NIA Y D Header Stop 4t11 W A/M L NIA Y Radiatora7- °t. W C*A/M L N/A Y int Stops L NIA Y Floor a A/M 0000 Y in Int Sash -< W AIM L NIA Y AIM L N/A Y 2 Exterior Slil K'k Mfl SF L N/A Y r A/M L N/A Y 3 Part Bead *4 1 Mil L N/A Y C D Door Casing 4qLL NIA Y 4 Blind Stop Mfl SF L NIA Y cu Door Jamb4M L N/A Y Win Ext Sash % 4t, Mlt L NIA Y 34 Threshold AIM L NIA Y Window Sill 'r.'j M/t Q L N/A Y ADoor 6,3 A/M L NIA Y B Win Apron ' S 'ul L N/A Y C D Door Casing a. AIM L N/A Y C Win Casing VM L NJA Y Id.boor Jamb AIM L NIA Y D Header Stop Z MA. A/M L N/A Y 34 Threshold A/M L N/A Y Int Stops Z W Q L NIA Y A B Door AIM L NIA Y 1 Win Int Sash KK M/I A/M L N/A Y C D DoorCasing j A/M L N/A Y Exterior Sill -4N Mti SF L N/A Y 12 Door Jamb NM L N/A Y 3 Part Bead `tt Mll L NIA Y 3 4 Threshold AIM L NIA Y 4 Blind Stop M/I SF L NIA Y A B Door AIM L N/A Y Win Ext Sash %(.4, W1 L NIA Y C D Door Casing AIM L N/A Y A Window Sill M/I —L N/A Y 12 Door Jamb A/M L N/A Y B Win Apron 48 L N/A Y 3 4 Threshold A/M L NIA Y C Win Casing Qvi AW L N/A Y A Closet Door G AIM L N/A Y Header Stop Qg Mil A/M L N/A Y CI Casing " a $ AIM L NIA Y Int Stops 4°j MA JQ L N/A Y C CtosetJamb a A/M L N/A Y 1 Win Int Sash --.(t W AIM L N/A Y D CiosetWalis A/M L N/A Y 2 ExteriorSiil Nk MA SF L NIA Y Cl Baseboard 1 AIM L NIA Y 3 Part Bead -4l Mti L N/A Y 1 Closet Pole AIM L NIA Y 4 Blind Stop W SF L N/A Y 2 Closet Shea A/M L NIA Y Win Ext Sash NO-1MI! L N/A Y 3 CI supports A/M L N/A Y A B Fireplaw A/M L N!A Y 4 Closet Floor" 3 A/M L N/A Y C D Mantle A/M L NIA Y CiosetCeiling AIM L NIA Y Aa c a Win Above 5' AIM L NIA Y COMMENTS/STRUCTURAL DEFECTS: Ceiling Moldin A/M L NIA Y AIM L NIA Y AIM L N/A Y A/M L NIA Y SURFACES:EXCEUDED tJ ces listedin these box--es can a made intact only y a licensed delea er. SID 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 Lt/RA RepRoom,8/08 Anthony Jakaitis M2929 913012011 1 Page Of Inspector(print) Lic# Sig na Date Anthony Jakaitis M2929 Risk Assessor(print) Lic# Signature Date Address of Prooerty: 92 Winter Street Apt, C City . Hyannis HALLWAY: 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 AWN L NA Y A CtosetDoor AIM L N/A Y Low Walls A/M L N/A Y B Cl Casing AIM L N/A Y A s Baseboards (� 89 L NIA Y C Closet Jamb A/M L N/A Y Za A B Chair Rail AIM L NIA Y D Closet Walls A/M L NIA Y AB co Radiator A/M L NIA Y Cl Baseboard A/M L N/A Y rFloor A1M L N/A Y 1 Closet Pole AIM L N/A Y je� Ceiling A/M L NIA Y 2 Closet Shelf A/M L N/A Y Door AIM L N/A Y 3 cisupports AIM L N/A Y C D Door Casing t j 41VI L N/A Y. 4 Closet Floor AIM L NIA Y 12 Door Jamb L N/A Y Ctoset Ceiing AIM L N/A Y 34 Threshold A/M L N/A Y Window Sill MW L N1A Y C B Door A/M L N/A Y B Win Apron $tC A L N/A Y DoorCasing �a L N/A Y C Win Casing `f4 6 L N/A Y 12 Door Jamb L NIA Y D. Header Stop Z,t W AIM L N/A Y 34 Threshold AIM N/A Y IrdStops '(,r MA L N/A Y A B Door A/M L N/A Y 1 Win Int Sash N{MW A/M L N/A Y C D DoorCasing A/M L NIA Y 2 Exterior Sill +( M/i SF L N/A Y 12 Door Jamb A/M L N/A Y 3 Part Bead -It MW L NIA Y 34 Threshold AIM L N/A Y 4 Blind Stop MA SF L N/A Y AB Door A/M L NIA Y Win Ext Sash MW ! N/A Y C D Door Casing AIM L N/A Y A Window Slil MW A/M L NIA Y 12 Door Jamb AIM L N/A Y B Win Apron A/M L NIA Y 3 4 Threshold A/M L N/A Y C Win Casing AIM L NIA Y A B Door AIM L N/A Y D Header Stop MA AIM L NIA Y C D Door Casing A/M L N/A Y Int Stops Mn AIM L N/A Y # Door Jamb A/M L N/A Y 1 Win int Sash MW A/M L NIA Y Threshold A/M L N/A Y 2 Exterior Sill MW SF L NIA Y A Closet Door A/M L N/A Y 3 Part Bead Mil L N/A Y B Cl Casing A/M L N/A Y 4 Blind Stop MA SF L N/A Y C Closet Jamb AIM L N/A Y Win Ext Sash MA L N/A Y D Closet Walls AIM L NIA Y A B C D Win Above 5' MW AWN L NIA Y CI Baseboard A1M L NIA Y A B C D Ceiling Maldin MA Alki L NIA Y 1 Closet Pole AIM L N/A Y MA A/M L N/A Y 2 Closet Shelf . A/M L N/A Y COMMENTS/STRUCTURAL DEFECTS: 3 CI Supports A/M L N/A Y 4 Closet Floor AWN L NIA Y ClosetCeiting AIM 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 SO,IN) DATE METHOD (MORE THAN 288 SO,IN.) DATE METHOD LYRA RepHall,8/08 Anthony Jakaitis M2929 9/3012011 Page-7Of Inspector(print) Lic# Signature Date Anthony Jakaitis M2929 Risk Assessor(print) Lic# Signature Date Address of Propegy: 92 Winter Street Apt. , City Hyannis KITCHEN 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 slaA e Up Walls <&L N/A Y indow Sill W AS L N/A Y A n d Walls A/M L NIA Y B Win Apron �A4 L NIA Y A 8 Baseboards Z A/M L-N/A Y C Win Casing Y,r RAvt L N/A Y a s LL.DiChair Rail AIM L N/A Y D Header Stop 'Ln W AIM L N/A Y c o I Radiator 4 j AIM L N/A Y IM Stops Za W A L N/A Y WFloor AIM L NIA Y 1 Win Int Sash �� WAIM L N/A Y CeilingEE A/M L N/A Y 2 Exterior Sill -44, Mh SF L NIA Y AS Door 6.141 AIM L NIA Y 3 Part Bead -%k% MA L N/A Y Door Casing 4 4 AIM NIA Y, 4 Blind Stop MA SF L N/A Y 12 Door Jamb — G 3 A/M L NIA Y Win Ext Sash MI! L NIA Y 3 4 Threshold AIM L N/A Y !A` Window Sill �4 W W L N/A Y A B Door N/A Y � Win Apron L� 4QM L N/A Y C oor Casing t �• ICUL NIA Y C Win Casing -7,, /GM L NIA Y Door Jamb 'C.1 40k N/A Y D Header Stop %,k M/I AIM L NIA Y 3 4 Threshold AIM L N/A Y Int Stops 't.o Mll Xq L N/A Y A B Door AIM L N/A Y 1 Win Int Sash 41. MA AIM L NIA Y Door Casing Q L NIA Y 2 Exterior Sill 1-, Mll SF L N/A Y Door Jamb %(.L WIN L NIA Y 3 Part Bead -4A tall) L N/A Y 3 4 Threshold A/M L N/A Y 4 Blind Stop MA SF L N/A Y A B Door A/M L NIA Y Win Ext Sash Mil L N/A Y C D Door Casing A/M L NIA Y A B Up Cab Frame d. AIM L N/A Y 12 Dom Jamb AIM L NIA Y Up Cab Door o A/M L N/A Y 34 Threshold A/M L N/A Y Up Cab Walls ct. A/M L N/A Y A Closet Door L?) i L N/A Y 12 Up Cab Shfvs A/M L N/A Y B Cl Casing L NIA Y 34 Supports O. A/M L N/A Y C Closet Jamb t- /b M L NIA Y Low Cab Fram tt AIM L N/A Y Closet Walls A/M L NIA Y A B Low Cab Door A/M L NIA Y Cl Baseboard A/M L N/A Y D Low Cab Walls A/M L N/A Y 1 Closet Pole AIM L N/A Y Low Cab Shly Z. A/M L N/A Y 2 ClosetSheif O A/M L NIA Y 12 Isupports A/M L N/A Y 3 CI Supports O.z AIM L N/A Y 34 Drawers - AIM L N/A Y 4 Closet Floor d 3 AIM L N/A Y o Win Above 5 M/1 A/M L NIA Y Closet Ceding eA AIM L N/A Y W A/M L NIA Y COMMENTS/STRUCTURAL DEFECTS: MA A/M L N/A Y G. S M/I AIM L N/A Y c a set ,M/1 AIM L NIA Y l A/M L N/A Y EXCLUDED SURFACES;Surfaces listed in these boxes can be made intact only by a licensed deleader. SID LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IG IC (MORE THAN 288 SQ.IN.) DATE METHOD (MORE THAN 288 SQ,IN,) DATE METHOD LVRA RepKitchen,8/08 Anthony Jakaitis M2929 W30/2011 Page Of Inspector(print) Lic# Qg`nkme Date Anthony Jakaitis M2929 Risk Assessor (print) Lic# Signature Date Address of Prooerty 92 Winter Street Apt. C- City Hyannis BATHROOM# SIDE LOCATION/ LEAD I, TYPE OF URG IC IC JDELEAJDELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ. DATE METH DATE METH SURFACE HAZARD ttAZ. DATE METH DATE METH A e SLjL Up Walls b 3 A/M L N/A Y Low Cab Fram 0 Z A/M L N/A Y A B low Walls O AIM L N/A Y Low Cab Door Qq AIM L NIA Y A B Baseboards A/M L NIA Y C D Law Cab Walls c 3 A/M L NIA Y krRail A/ML N/A Y Low CabSh 43 AIM L N/A Y ator 6 A/M L N/A Y 12 Supports - AIM L NIA Y A/M L N/A Y 3 4 Drawers AIM L N/A Y ng. A/M L N/A Y A Window Sill a; MA A/M L N/A Y A/M L N/A Y B Win Apron a 3 AIM L N/A Y Casing AIM L NIA Y Win Casing u,l AIM L N/A Y 12 Door Jamb �J A/M L N/A Y D Header Stop u,1 M/I AIM L NIA Y 3 4 Threshold AIM L N/A Y IntStops - 0 2-Mll A/M L N/A Y A B Door A/M L N/A Y 1 Win Int Sash -4r1, MA AIM L NIA Y C D Door Casing A/M L N/A Y 2 Exterior Sill -t,-t MA SF L NIA Y 12 Door Jamb AIM L N/A Y 3 Part Bead '`tt MA L NIA Y 3 4 Threshold AIM L N/A Y 4 Blind Stop MA SF L N/A Y A Closet Door A/M L NIA Y Win Ext Sash Kt� MA L NIA Y B Ci Casing A/ML N/A Y �p Win Above 5' MA AIM L NA Y C Closet Jamb AAN L N/A Y AB AB Ceiling Moldi MA A/M L NA Y D Closet Walls A/M L NIA Y CD Medigne Cab 3 MA AIM L NA Y CI Baseboard AIM L NIA Y A p Wall O/C MA A/M L NA Y 1 Closet Pole A/M L N/A Y M/I A/M L NA Y 2 Closet Shelf AIM L N/A Y MA AIM L NA Y 3 CI Supports A/M L NIA Y M/I A/M L NA Y- 4 CtosetFloor AIM L NIA Y MA A/M L NA Y CWW Ceiling AIM L NIA Y MA AIM L NA Y A B Up Cab Frame AIM L N/A I Y MA AIM L NA Y C D Up Cab Door AIM L N/A Y MA A/M L NA Y UPC Wails A/M L N/A Y MA AIM L NA Y 12 Up Gab Shlvs AIM L N/A Y W A/M L NA Y 14 Supports AIM L N/A Y M/I AIM L NA Y MA AIM L N/A Y M11 AIM L NA Y M/I A/M L N/A Y M/I AIM L NA Y NMI A/M L N/A I Y LMA AIM L NA Y COMMENTS/STRUCTURAL DEFECTS: COMMENTS/STRUCTURAL DEFECTS: 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.1N.) DATE METHOD (MORE THAN 288 SQ,IN.) DATE METHOD LYRA.RepBath,8/08 Anthony Jakaitis M2929 9/30/2011 Page Of j Inspector(print) Lic# Sig Date Anthony Jakaftis M2929 Risk Assessor(print) Lic# Signature Date Address of Property 92 Winter Street Apt. City Hyannis STAIRCASE t,.p4,.j ( ' SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEA DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HA , DATE METH DATE METH. SURFACE HAZARD HAZ DATE METH DATE METH A e Up Walls AIM L NIA .Y A Window Sill W A/M L NIA Y A s Low Walls 03 AIM L NIA Y B Win Apron A/M L NIA Y A e Baseboards bl A/M L NIA Y C Win Casing A/M L N/A Y A 6 Chair Rail f.'T L N/A Y D Header Stop M/I A/M L NIA Y AS CD Radiator A/M L N/A Y Int Stops W AIM L NIA Y Floor AIM L N/A Y 1 Win Int Sash Mfl AIM L N/A Y Ceiling A/M L N/A Y 2 Exterior Sill W SF L NIA Y A B Door A/M L NIA Y 3 Part Bead Mfl L N/A Y Door Casing 6.1 L NIA Y 4 Blind Stop Mn SF L N/A Y 12 Door Jamb 4 L N/A Y Win Ext Sash Mil L N/A Y 34 Threshold 4.24 AIM L NIA Y A Window Sill M/I AIM L N/A Y A B Door 4 1 AIM L N/A Y B Win Apron T AIM L N/A Y C D Door Casing AIM L N/A Y C Win Casing AIM L N/A Y 12 Door Jamb A/M L N/A Y D Header Stop M/I A/M L NIA Y 34 Threshold A/M L N/A Y IntStops W A/M L N/A Y AB Door AIM l N/A Y 1 Win Int Sash M/I A/M L N/A Y C D Door Casing A/M L NIA Y 2 Exterior Sill W SF L N/A Y 12 Door Jamb AIM L NIA Y 3 Part Bead W L N/A Y 34 Threshold AIM L N/A Y 4 Blind Stop Mli SF L N/A Y A B Door A/M L N/A Y Win Ext Sash Mli L NIA Y C D DoorCasing A/M L N/A Y Newel Pout A/M L NIA Y 12 Door Jamb A/M L N/A Y Railing Cap AIM L N/A Y 34 Threshold A/M L N/A Y Handrail 6 AIM L NIA Y A B Door A/M L N/A Y Balusters AIM L NIA Y C D Door Casing A1M L N/A Y Lower rail A/M L N/A Y # Door Jamb AIM L N/A Y Treads O� A/M L N/A Y Threshold A/M L N/A Y Risers p 3 AIM L N/A Y A Closet Door AIM L N/A Y SMnger A/M L NIA Y B Cl Casing AIM L N/A Y Floor Edge t 4M L N/A Y C Closet Jamb A/M L NIA Y Floor Casing 7.o L N/A Y D Closet Walls A/M L N/A Y . Mll A/M L NIA Y Cl Baseboard AIM L N/A Y COMMENTS 1 STRUCTURAL DEFECTS: 1 Closet Pole AIM L NIA Y 2 Closet Shelf AIM L NIA Y 3 Cr Supports A/M L NIA Y 4 Closet Floor A/M L N/A Y Closet Ceiling A/M 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 SO.IN.) DATE METHOD (MORE THAN 288 SQ.IN.) DATE METHOD LVRA RepStair,8/08 Anthony Jakaitis M2929 913012011 Page 1�bf Inspector(print) Uc# SIg ure Date Anthony Jakaitis M2929 Risk Assessor(print) Lic# Signature Date Address of Property: 92 Winter Street Apt. C. City Hyannis HALLWAY: SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HA . DATE METH DATE METH SURFACE HAZARD HAZ. DATE METH DATE METH A e SIDE Wails 03 A/M L N/A Y A Closet Door AIM L NIA Y A 8 Low Walls A/M 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 A/M L N/A Y A e Chair Rail A/M L N/A Y D Closet Walls AIM L NIA Y AB CD Radiator A/M L N/A Y Cl Baseboard AIM L NIA Y Fly a'%> AIM L N/A Y 1 Closet Pole AIM L N/A Y Ceiling AIM L NIA Y 2 Closet Shelf AIM L N/A Y Door AIM L NIA Y 3 Cl Supports A/M L N/A Y C D Door Casing 7.7 CWX N/A Y 4 Closet Floor A/M L NIA Y 12 Door Jamb L N/A Y Closet Ceiling AIM L N/A Y 34 Threshold AIM L NIA Y A Window Sill W A/M L N/A Y AG Door AIM L NIA Y B Win Apron A/M L NIA Y C D Door Casing `f 4Tt L N/A Yj I C Win Casing AIM L NIA Y 12 Door Jamb &L N/A Y D Header Stop MII AIM L NIA Y 34 Threshold A/M L N/A Y Int Stops Mli AIM L NIA Y A B Door a2. A/M L N/A Y 1 Win Int Sash W AIM L NIA Y Door Casing A/M L N/A Y 2 Exterior Sill M/I SF L N/A Y 12 Door Jamb `s AIM L NIA Y 3 Part Bead MII L N/A Y 34 Threshold A/M L N/A Y 4 Blind Stop Mll SF L NIA Y A B Door A/M L N/A Y Win Ext Sash M/I L N/A Y Door Casing L N/A Y A Window Sill W A/M L NIA Y 12 Door Jamb WL NIA Y B Win Apron A/M L N/A Y 3 4 Threshold AIM L N/A Y C Win Casing AIM L NIA Y A oor 'L L NlA Y D Header Stop M/l A/M L N/A Y C D Door Casing AIM L NIA Y Int Stops W A/M L N/A Y # Door Jamb AIM L NIA Y 1 Win Int Sash W AIM L N/A Y Threshold AIM L N/A Y 2 Exterior Sill M/l SF L N/A Y A Closet Door JA AIM L NIA Y 3 Part Bead M/I L NIA Y B CI Casing AIM L N/A Y 4 IBlind Stop MA SF L NIA Y C Closet Jamb A/M L NIA Y Win Ext Sash Mn L N/A Y D ClosetWal6s AIM L NIA Y AB CD Win Above 5' WA/M L NIA Y Cl Baseboard A/ML NIA Y As C D Ceiling Moldin MUI AIM L NIA Y 1 Closet Pole A/M L NIA Y d df.Z M/1 WL N/A Y 2 IClosetSheff A/M L N/A Y COMMENTS I STRUCTURAL DEFECTS: 3 C!Supports A/M L NIA Y 4 Closet Floorti AIM L N/A Y Closet Cefling A/M L N/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact only b a licensed deleader. SID LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IC !C (MORE THAN 288 SQ.IN.) DATE METHOD (MORE THAN 288 SQ.IN.) DATE METHOD LILRA RepHall,8/08 Anthony Jakaltis M2929 9/3012011 Page Of Inspector(print) lic# Slgn re Da Anthony Jakaitis M2929 Risk Assessor (print) Lick Signature Date Address of Property: 92 Winter Street Apt. City Hyannis EXTERIOR A Side SIDE LOCATION/ LEA 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 Swing CAN L NIA Y Window Sill AIM L N/A Y Comer Boards L N/A -Y A Win Casing AIM' L N/A Y A Lower Tdm L NIA Y Window Sash A/M L N/A I Y Upper Trim L NIA Y Cellar Win Sill AIM L NIA Y WIn Above 5' L N/A Y A Cei Win Sash AIM L NIA Y Polar Move 5 L N/A Y # Cal Win Frame A/M L N/A Y Storm Door 0 X A/M L N/A Y Screen Frame A/M L N/A Y Door <Ofl,N/A Y Cellar Win Sill A AIM L NIA Y Door Casing AIM L NIA Y A Cal Win Sash A/M L WA Y 1 2 Doorjamb AIM L NIA Y # Cel Win Frame AIM L NIA Y 3 4 CAII AIM L NIA Y Screen frame AIM L N/A Y Kickpiate A/M L NIA Y J Cellar Win SIR AIM l N/A Y Storrs Door A/M L N/A Y A Cal Win Sash AN L WA Y Door AIM L NIA Y Call Win F AIM L N/A Y A Door Casing A/M L N/A Y Screen Frame AIM L N/A Y 1 2 Doorjamb AN L N/A Y Caller Win SIR AIM L N/A Y 3 4 Threshold AIM L N/A Y A Cel Win Sash AIM L NIA Y die AIM L NIA Y # Cal Win Frame AIM L N/A Y Dow AIM L NIA Y Screen Frame AIM L NIA Y A DoorCasing A/M L NIA Y Foundation . L N/A Y 1 2 Doorjamb A/M L NIA Y A Bulkhead AIM L N/A Y 3 4 Threshold AIM L NIA Y Fences AIM L N/A Y windowSRl C4.4 A/ML N/A Y Shutters AN L NIA Y A Win Casing A/M L N/A Y Newel post a AIM L N/A Y Window Sash CiL AIM L WA Y Raging Cap o. AIM L N/A Y Windowsill A/M L N/A Y Handrail AIM L NIA Y A Win Casing AIM L N/A Y A Balusters AN L N/A Y Window Sash A/M L N/A Y Lower Rail • AIM L N/A Y Window Sill A/M L NIA Y Treads " AIM L NIA Y A Win Casing A/M L NIA Y Risers AIM L N/A Y Wtndovt Sash A/M L NIA Y Stdrger L A/M L NIA Y A Lamp Post L WA Y I Lattice AIM L N/A Y COMMENTS/STRUCTURAL DEFECTS: Drain Pipes 4") L N/A Y A Elec Conduit L N/A Y OR Fig Pipe L NIA Y L.Overhang Trim AIM L NIA Y Excluded Surfaces:Surfarass 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 11200 ppm for bare soil) SIDE LOCATION MEASURE:LOOSE PAINT IC IC LOCATION AREA MEASUREMENT RESUL RE REMED A (MORE THAN 1440 SO.IN.) DATE METH (Square Feet) (PPM) DATE METH A Play Area A Bare Soo A Comments: A U/RA RepExtk 8/08 Anthony Jakaltis M2929 913012011 Page Of Inspector(print) UC# Signs ure Date Anthony Jakaitis M2929 Risk Assessor (print) Lid{ Signature Date Address of Proaerty_ 92 Writer Street Apt G, City Hyannis EXTERIOR B Side SIDE LOCATION/ L TYPE OF URG IC IC DEL DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC .1 DE DELEAD B SURFACE HAZARD H DATE METH DATE METH B SURFACE HAZARD HA DATE METH DATE METH. Skiing L N/A Y Window SIN AN L N/A Y Comer Boards L N/A Y B Win Casing AIM L.WA Y B Lower Trim 4%-1 L N/A Y # Window Sash AIM L NIA Y Upper Trim L NIA Y Cellar Win Sill AIM L N/A Y Win Above 5' L N/A Y B Cal Win Sash AIM L N/A Y Poreh.Above L WA Y N Cal Win Fram AIM L NIA Y Storm Door a. AIM L N/A Y Sr�n Frame AIM L NIA Y Door "j, +I�p L N/A Y Cellar Win$III AIM L NIA Y DowCasing C041 AIM L N/A Y B Cal Win Sash AIM L NIA Y 2 Doorjamb 1.7 IGM L N/A Y lCelWin Fro AIM L N/A Y 3 4 A/ML NIA Y Iscreen Frame AN L NIA Y Kickplate AN L NIA Y CeffarWin Sill AN L NIA Y Storm Door O.t AIM L NIA .Y B Cal Win Sash A/M L N/A Y Door O$ 1 AIM L NIA Y If Get Win Fra AIM L NIA Y Door Casing AIM L N/A Y Sty Frame A/M L NIA Y 1 Doorjamb d. ' A/ML N/A Y Cellar Win SRI A/M L WA Y 3 4 Threshold 'e. A/M L N/A Y B Cal Win Sash AIM L N/A Y "late AIM L NIA -Y Cel Win Fre AIM L N/A Y Door AIM L N/A Y Screen Frame AIM L NIA Y B Door Casing A/M L N/A Y Foundation 04el L NIA Y 1 2 Doorjamb AIM L NIA Y B Bulkhead AIM L NIA Y 3 4 Threshold A/M L NIA Y Fences *Z AIM L NIA Y Window Sill AN L WA Y Shutters AIM L NIA Y B WM Casing AIM L N/A Y Newel post Off- AIM L N/A Y Al Window Sash AIM L N/A Y Ralling Cap a0r AIM L N/A Y Windowsill AIM L NIA Y Handrail 6k( A/M L N/A Y B Win Casing s AIM L NIA Y B Balusters 4R% AIM L N/A Y 1I� Window AAN L NIA Y Lower Rail v.Y AIM L NIA Y Wallow Sill AIM L N/A Y Treads a. AIM L N/A Y B Win Casing A/M L N/A Y Ricers ". A/M L N/A Y # Window Sash A/M L NIA Y Slinger �►. A/M L NIA Y B lamp Post L N/A Y Latke AIM L N/A Y COMMENTS/STRUCTURAL DEFECTS: Drain Pipes a L N/A Y B ElecConduit L N/A I Y Oil�T- . L N/A Y OiAN L NIA 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 B (MORE THAN 1440 SO.IN.) DATE METH (Square Feet) (PPM) DATE METH B PieyArea B I Bare Sod B Comments: B LIRA RepExtB,sros Anthony Jakaitis M2929 913012011 Pagel t Inspector(print) Lic# Sig Date Anthony Jakaltis M2929 Risk Assessor (print) lic# Signature Date Address of Property: 92 Winter Street Apt , City Hyannis EXTERIOR C Side SIDEJ LOCATION/ LEAC TYPE OF URGI IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEA DELEAD C SURFACE HAZARD DATE METH DATE METH C SURFACE HAZARD DATE METH DATE METH Siding L N/A Y Window SNI AIM L NIA Y Comer Boards C04 L N/A Y C Win Casing AIM L N/A Y C Lower Trim L NIA Y # Window Sash AIM L NIA Y Upper Trim L N/A Y Cellar Win Sill AIM L NIA Y Win Above 5' Ca4, L NIA Y C Cal Win Sash A/M L NIA Y Porch Above 5 L N/A Y # Cal Win Fro AIM L NIA Y Slomt Door C3.1 AIM L NIA Y 18creen Frame AIM L NIA Y Door a`t AIM L N/A Y Cellar Win Sill A/M L NIA Y Door Casing A/M L NIA Y C Gel Win Sash AIM L NIA Y 1 2 Door la AIM L WA Y Cal Win FrameAIM L N/A Y 3 4 Threshold AIM L WA Y .$cry Frame AIM L NIA Y KtCl�late AIM L NIA Y Cellar Win SIN AIM L WA Y Storm Door AIM L N/A Y C Cal Win Sash AIM L N/A Y Door AIM L N/A Y Cal Win FrameAIM L NIA Y C Door Cestng AIM L N/A Y Screen Frame AIM L.NIA Y 1 2 Door Jamb AIM N/A Y Cellar WinSMI AIM L NIA Y 3 4 Tore toki AIM L N/A Y C Cal Win Sash AIM L N/A Y Kite A/M L WA Y # Cell Win Frame AIM L N/A Y Door A/M L N/A Y Screen Frame AIM L N/A Y C Door Casing AIM L N/A Y Foundation L NIA Y 1 2 DoorJamb AIM L N/A Y C Bulkhead A/M L WA Y 3 4 Threshold AIM L N/A Y Fences Q. AIM L NIA Y Window Sill AN L WA Y Shutters AIM L WA Y C Mn Casing f► AIM L N/A Y Newel post o U AIM L NIA Y Window Sash AIM L WA Y RaNing Cap o.1L AIM L WA Y Window Sill AIM L WA Y Handrail WA t AIM L NIA Y C Win Caging AIM L NIA. Y C Balusters op AIM L WA Y Window Sash AIM L WA Y Lower Rall .&%A AIM L N/A Y Window S01 AIM 1.N/A Y Treads o. AIM L NIA Y C Win Casing. A/M L WA Y Risers 0.1 AIM L N/A Y # Window Sash A/M L WA Y Wnger QkA AIM L WA Y C Lamp Post L WA Y Lattice A/M L NIA Y COMMENTS/STRUCTURAL DEFECTS: Drain P4m L NIA Y IL C Elec Conduit L WA Y Oil Fill Pipe L WA 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 RESUL REMED REMED C (MORE THAN 1440 SO.IN.) DATE METH (Square Feet) (PPM) DATE METH C Play Area C Bare Soil C Comments: C LYRA RcpE&C,8/08 I ,r Anthony Jakaltis M2929 9130/2011 Page H Of g Inspector(print) Lic# Date Mthony Jakaitls M2929 Risk Assessor (print) LIC# Signature Date Address of Pwerty: 92 Winter Street Apt. City Hyannis EXTERIOR D Side, C SIDE LOCATION/ LEAC TYPE OF URGI IC IC IDELE DELEAD SIDEJ LOCATION! LEAD TYPE OF URG IC IC DELEAD DELEAD D SURFACE HAZARD HAZA DATE METH DATE METH D SURFACE HAZARD DATE METH DATE METH Siding L N/A Y WindowSlil e4" A/M L N/A Y Comer Boards g, L N/A Y D Win Casing AIM L NIA Y D Lower Trim 44-9 L N/A Y #41 Window sash AIM L NIA Y Upper Trim 4.001, L NIA Y Cellar Win.SIR AIM L NIA Y Win Above 6 C L WA Y D Cal Win Sash AIM L NIA Y Porrt Atove 5 L N/A Y Cei Win F AIM L NIA Y Storm Door AIM L NIA Y Screen Frame AIM L NIA Y Door AIM L NIA Y Cellar Win Siff AN L N/A Y D Door casing AIM L NIA. Y D Cal Win Sash AIM L N/A Y 1 2. Doorjamb AIM L NIA Y 4 Cad Win Frame AIM L NIA Y 3 4 Threshold A/M L NIA Y Screen Frame AIM L NIA Y w(plate AIM L N/A Y Cellar Win Sill AIM L WA Y Storm Door AIM L NIA Y D Cal Win Sash AIM L NIA Y Door AIM L N/A Y # Cal Win Frame AIM L WA Y D DoorCaft AIM L NIA Y Sam Frame . AIM L N/A Y 1 2 Door Jamb AIM L WA Y Cellar Win Sill AIM L N/A Y 3 4 Threshold AIM L NIA Y D Cal Win Sash AIM L N/A Y lCdote A/M L N/A Y # Cel Win Fram AIM L N/A Y Door AIM L N/A Y Screen Frame AIM l NIA Y D DoorCasing AIM L NIA Y Foundation p. L N/A Y 1 2 Doorjamb A/M L N/A Y D Bulkhead 0.4 AIM L N/A Y 3 4 iThreftid A/M L N/A Y Fences A. AIM L N/A Y Window Sig AIM L N/A Y Shutters AIM L N/A Y D Qwn Casing A/M L N/A Y Newel post AIM L NIA Y Window Sash AIM L WA Y Raging Cap AIM L NIA Y Window Sill AIM L N/A Y Handrail AIM L NIA Y D Wtn Casing 4WA/M L NIA Y D Balusters AIM L NIA Y Window Sash AIM L N/A Y Lower Rall AIM L NIA Y Window S61 `A AIM L N/A Y Treads G AIM L N/A Y D 4ft Casing A/M L N/A Y Risers O AIM L NIA Y At Window Sash OAAfti AIM L N/A Y Stringer , Q AIM L N/A Y 0 ILamp Post L N/Al Y Lattice AIM L WA Y COMMENTS/STRUCTURAL DEFECTS: Drain Pipes C L N/A Y D EleC Condult L NIA Y Oil Fill Pipe L NIA Y Overhang TM AIM L N/A Y Excluded Surfaces:Surfaces listed in this box can be made Son Test Results intact only by a licensed deleader (Must be less than 400 ppm for play area 11200 ppm for bare soil) ISIDE LOCATION MEASURE:LOOSE PAINT IC IC LOCATION AREA MEASUREMENT RESUL REMED RIMED D (MORE THAN 1440 SO.IN.) DATE METH (Square Feet) (PPM) DATE METH D Flay Area. D Bare Soil D Comments: D LYRA RepExtD.8/08 I f ' Anthony Jakaitis M2929 9/3012011 Page i5Of inspector(pr(nt) Lic# Si Date Anthony Jakaitis I11112929 Risk.Assessor(print) Llc# Signature Date Address of Prperty: 92 Winter Street Apt City Hyannis GARAGE SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEA OELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELF_AD A SURFACE HAZARD HAZ DATE METH DATE METH C SURFACE HAZARD HA DATE METH DATE METH Siding L N/A Y Siding cA4 AIM L N/A Y A Comer Boards 44"t L N/A Y C Comer Boards as A/M L N/A Y LowerTdm e— L N/A Y Lowertdm 4pq L N/A Y Upper Trim L N/A Y Upper Trim der L N/A Y Door O�Q N/A Y Door AN L N/Al Y A Door Casing C 4- AIM L N/A Y C Door Casing AIM L N/A Y DoorJarrb "111 A1M L N/A Y DoorJamb AIM L NIA Y Threshold Y 1 A/M L N/A Y Threshold AIM L N/A Y Window Sill AIM L N/A Y jWndow Sill AIM L NIA Y A Win Casing A/M L N/A Y C Ift Casing <114 A/M L N/A Y Wm Sash AIM L N/A Y Wn Sash OL AN L N/A Y A Foundation L NIA Y C lFoundation L N/A Y COMMENTS I STRUCTURAL DEFECTS: a f,�.y COMMENTS/STRUCTURAL DEFECTS: Csl - (.• c t+- EXCLUDED SURFACES:Sdrfaces 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 A (MORE THAN 1440 SQ..IN.) DATE METHOD C (MORE THAN 1440 SQ.IN.) DATE METHOD A NC A A SIDEJ LOCATION/ LEAD TYPE OF URG IC IC DELEAq DREAD SIDE LOCATION/ LEAD TYPE OF URG IC IC JDELEAqDREAD B SURFACE HAZARD HAZ DATE METH DATE METH D SURFACE HAZARD H DATE METH DATE METH Siding77 L N/A Y Siding L N/A Y B Comer Boards 44 . L NIA Y 'D Comer Boards L NIA Y LowerTdm L N/A Y Lower Trim 04 L N/A Y UpperTrim L N/A Y UpWTrim c L N/A Y Door AIM L NIA Y Door AIM L NIA Y B Door Casing A/M L NIA Y D Door Casing A/M L N/A Y Door Jamb A/M L NIA Y Door Jamb AIM L NIA Y Threshold AIM L N/A Y ThreshoW A/M L N/A Y Window SIII AIM L NIA Y AIM L N/A Y B Win Casing A/M L N/A Y D Wm Casing A/M L N/A Y Win Sash A/M L N/A Y Wm Sash AIM L N/A Y B Foundation L WA Y D Foundation L NIA Y —9 COMMENTS/STRUCTURAL DEFECTS: COMMENTS/STRUCTURAL DEFECTS: EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact o ly by a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IC IC B (MORE THAN 1440 SQ.IN.) DATE METHOD D (MORE THAN 1440 SQ.IN.) DATE METHOD B D B D B D LYRA Repoarage,8/08 I -master, Leadfaint 1imspector (781,)331-1565 Eric Barsness 54 Attu Way Centerville,ILA 02632 Recertxf c�tafln l�ate< :bate of issue: 11/1712El1.1 Finall Expiation Date. Tate cif> xpiratioh-1.14.7/20 2 �` (Cannot bc'rhore than 2.yrs alloi.date'of .Dear Erie Barsuess, This letter is to certify that on:Novcm�ber l7�20-1l,i,perftiri►b a Risk assessment o[ X Risk assesssr�entrespectaan of your pr€ipert'located at inter St. Apartment=316U. and relevant cbnii on.areas, in. the City or'Town of yams fir,cornpl anm tffa�i�qu�Tq ep s;of ii es�rn eon"I. On that; date.T found that: There were no urgent.lead ba=ds'- T.hee.appropz dtely�i �thofi or train'kd':people+correctted,the urgent lea hhz'artls��ideni fted,ih. the.risk assessment report pe.rfa on. O 30/2011 I found the.property.meets the regiremerts fc iiterruiull:under th .�vissacliusttseeral. Laws;Cb4pto I 11,8eetion.197 and 105'CMR 460.000,Rdgulat ons for Lea d F'sissining 'Prevention�and Control. This Lettei of Interim,Comet may be rezieived.once;fir:an adrtzs�nal tsnewyear period,upon reinspect 6wand recordf cation'by a licensed risk assessor._By tbe,end bf thc.ortgi one-yeas period,or;zf the letter is recertified;by the ead of�e sac,'vn+T:�ear,�aeka;use#ts:faw rega rep you to obtain a Letter of ull,.Deleading�Compli ce'for this preperiy 1= L&er of to�Cal-and Rjv r. tgim mv8-4 � Page l Ot-3 Address; 92 Winter Sti,#fir HYAnnis.,MA,. L2601 This;property and relevant common-aireas shalUrema n in.complistise with the requirements of interim control only ssJoug.as#here continues,to f't n6 urgentlead .Hazards,and as long as cover-ings,including.encapsulants,foirin nn eMetive h'arrierbvi e'r le id pot or other leaded_materials: cornplete risk;assessmont,and`or risk assessment re nspection report is attacbed'to this letter and lists all ofthe,s facos,that,bave been cometed. for interim control. To the best'of my knoWledge the cost of ibe deleading-work performed for interim-control and. that would,also be require.f+or full;delving coiplianc �s , SQ1;0 ' Sincerely, Risk s axe r License plumber, Anthony) ti s R292 i ]Receiratioa��tate��# , I I pe formed a risk assessro nt recertiicaiion reinspection pn�On,-this tit 1fciund that. D There-were no urgent load hazards The appropriately authorized or trained;people corrected:the urgent lead Hazards identified in. r the rsk.assessmcnt recertcation rort- rfarmeaza I found the property meets the requirMe�ts for interim comrol:under the Massachusetts'General' Laws,Chapter.1:11, S6c6o"n 191 and 105 C'IR 460 00.0`Regulationsifor Lead I'oisonirig Prevention and_ControL I recertify this Letter of Interim Control, all its provisions apply.for ibe recertified`time period Ihave c9mpleted at the°top of the Est page oftliis Utter:of lnterirn Control,.. I ReOr cation Risk.Assessor and Licedse Number R 2929 Slaotzld you have any questions atieut this Ieftr,ca11 the L1epen °cof I?rblic FleaJtih ae 1- Db�53 -957I: I I,., Later of tfileeirei Cor trd and Reeertiflution fi v 9-09 page 2¢d3 Address. 92 'Winter St..-,#C,IlVann s,MA- Insnection.and Dele"na Hi4te for Interim Control: Initial Inspeetiou done on a9/30/2011 by Antlaon�J tis tic.,� N12929 Risk Assessment done on 091301201 . by.•An ony;Ial t:s laic #R 29 9 Reoccupancy Reinspectian,if needed,done on,:; by Lice Final.Risk Assessment Reinspection done;on: 11 17/2,01.1, by An#ho#Y akaifls Uc, R 9,29' Recerdficati.on Risk Assessment Rei spect'ion done on.-by Lic.,# 1 Final Risk Assessment-Recertification Re aspect,on done on: _by Lic', Deleading GonEtactor Clean Surface Deleadi /Mark Bianco : Licehse, : D 001055, Delcading',irrethods: Rig F1einolition Pgwer sarsdm . Caustics Heat gun ,Rebkkeratdnt Covering; Liquid encapsulation Dt � Work was-done in the following morns:piease:refer to his re +it Work was done.on the following.tylaes of'c mponents Il sere€er to inspection report. '7/ZOY1 Finish Date: 1/17/2011 Cost 150.60 Start Date., 1,1, - i t Lead-safe:renovator: Lich._ Moderate risk owner/agent<Auth.: � Deloading Mctho.ds: Replacement baking�ntaet (iriter�or} /l ciitg tntaet(triter orb: Covering Liqui&1encapsulation `Work was donkin thct followi* 'roams:Flease,refer to inspiDctaon report Mork was done on.the following types.caf components: Plcase.:refer'io.insp; ctian report. Start-Date:-Finish Date_host: (Doesn't Include Owner"s Labor.) Low-risk ownerla'&iat ' Aulhofizat on ;: I�eleading methods" Covering, Liquid encapsglation. Capping basebaazds Replacemeht. (ONLY doors,cabinet doors shutters,shelve$rn t affike ,diwwers,w nanvas can hinges) Work was done in—the following rod iis: Ple a refer to insp tiara repnrt Work-Vas done on the fo€sw ,qfomF gero ion.reporkI irI St rt..Date:�/�/_- Finish Date:�1�/ Gast: $ (Doesn'tinclude Owner's,Lab I 1- licttTrof lnttce�'Gt atrdt©ad,kcrratifir400 H g,z 3 of.3 f 3 w n Iv-sit'Iv-sit's Re00 tt En-Wronmental H=ards services,L.L.G." 7,469 Whfteplhe Rd Richmond;VA 232,37 j !SOP'Prt',Nurnber " 11-11-02634; �'eieph6t1a3:8QQ�347:4a1o% Client, Anth ony"d fe=aitis � Received Date!. 1912�"12G71 RO.Box 400 Arrel Date> :.11t2112.,011 South Weymouth,MA-02-190 epcirted DAN 11121,20,'1"1 f .Najcct)TestAdd : 92 Winter St.#0,,,HY6nn1 .; Collection Date 11/17 01 j fN ber 1t rr$ . Labo`ratoryAesults L-ab Sample Ctisnt Sample Gottoctic►n Looglovi Surface Tatal,Pb Wlp' Area oncerAMOOn Nariati* Number, Number 1:1-11-62634- 1 KITCHEN � FL 001 . . -I)263�t K1TOH N :{ Bf 10 0i0133, <9 1"1-11-02634 ;3' Ct MEdvvW 00 0 o 03 „ j 11-11-02634- coo 1 FL, <1UX �1p 004 I 11�11-p2s34- � €�c�t�r 1t S -0 0 0,7 � 005 11-t1=t)26 4- ROOM! YUW 15:10';0 "0'616 <26 006 11-11-t}2f34- 7 BLANK 1 00 - { 9 E e H } I 4:. Pa 1 of, 2 P fi z j EnvirOhr en al # Iv s,r L: .0 I Client Numbers 22-2289 Report l`�uMb-r. i1-11- 2G3�1. Praject(TresttAddress- 92 Winter'St.,'#C;Hyannis Lab Sample Client Sample wlection Location Surface Total Pb Wjpe,Area Concentration Narrative Number Number to g W) ID. Method: EPA`SVVM'700Q8 Accreditation.#; wed By:A Reutattt+ red'Sgnatory. r i baborah.,Brkt:. "OC Clerk The Federal lead guidelines for dust cfearance.levels by wipe,satriplingr Floor%(FL)-40.ugly,Interior WhdoW.SIlls(SL)=250 uVftz,Window Webs(WW)-400 uWff. The Reporting i imlt(ILL)4s,10.0 4 Total Pb. Reported'nEasults are,not cotr�ed for field blanks. Dust wipe area and results are.ccict�Iated'based oneasureiatients deterrrliraed bV-tb .elien#. Al internal quality control requirements associated with this batch ire met,'unfess, thnrwjse noted. s 11 The coed h6n ofthe samples analyzed was otxWtaWp up="lot per.labord",proteecl unlsss 61herWise noted pre the repay#:rtasaiti represent the anWysls of.semptes submf�ted.by the.GtenL&empre:lpgOn,d cr3Rtlad,€�8r etc,,'vu�s Piavfded h'y tMo clot#..rt Its reported above In ugrrtx sin cxiufated based on urea supplled by ttse'cl�enL tr the not dCn rbofi wttteln,tha rasuli 3or a faetd btenk ft due to trco fact that the dtoht dip not include'a tuetd hlark wlUa Uaelt serriles. Ek1S iipJp resartts d not roet blpn9r.epoa. !is ray #®hilt` not be repmd�urad except Ili full,WILW the v,�ten coareenl of tFro1E++r�ironmeti# I Na and e L L C;.calrfcrmra` floe 2 1' NY FLAP#11714, fead , ( . -- Legend ug=rnsOWram ug . m€crogromspper squora fuot . P6" rrtL rh lrifater fN—s,quere r I I I r I y a page 2 of 2 I G ,...—.. w .. .. ., � . ._ -02634 'ENS 111111I1 �11NIIIII�Ill Lead' s ate: Labor`' tori sChain-of-Custody " _1 i2 r , Envira►nmental. azar4 Spt*es,LLC: ,4E rec ap s�� r� VA pz co, cis M AnthonyJaka cis PO.€BOX 400 south Wernout�.MA 02190 aMC= _ eia�rfSascet�ap: c ,6 7=529-1 781-331.1659 pbMtoect200'Q@yrahbo. m .N - 2 ®i rr�. ter Aar.: 92 Wnter'fit. c rss�i�t mix. Hyannis I nthbi�i JAalt,s �11 9 c�� �t _. Y �+�t�o�x�ia>>rar�:- _ t�rider�umti� •'Eta a _ .Ua=WW A � a. ��a_ r� Y7, Y �. F1 * a =ice :Q" 1"�wd" ' lje € _ DN D LT -tiff 'RA, -.moo � �> R, -m4bam R _1* Bt DAM ,+ _ ram" six M cue.XT LTFBX Rlltmt .;; r, s fps w Val uM. c,rr DW iihii�oiil or, FL e _ lczvgir 11 X,i e . 51SL wea , 3 _Del�.adin,g Invoice Please completely and clearly fill out.apptopriatt.infqrrnatio Name(prttitj: iw� x��t � ° Comppy. Address . .', z " � .., s. imp cock. Address of cleleadirtg work::. �t eade { d her6by'attest"that all deleading activities� : d.clean up> : done_;in acc+nrdance w ith,the Department of Labor Worki'prce DevelopmenVs'regulations 454 C,,MR 22.00 and jhe';.Chj*ldh6od leaf Poikoning Prevention I'rvgc�p regulations, 105 CRIP 460MO, Signature ., - ---- --� Date 1./;.11 only c tnplete section reflecting ArtaVr author,,iz Ct o"n,/I cen. e.Status. Deteading.Contracmr. /,n 42k,4- l Deleading methods; cr Demolition Po- er sa'nd Ing Caustics Heat gun Replacement Covering Liquid enicapsulatton Other r Work was done in the following rPorns ,��}� � O'tc Pry %- f « Work was'done,on the follovring_tyPes of components: Start Date ,�I/� Fib kh Dare.; l 1, Gpst: Lead-safe renovator: E f,lcense , l Moderate risk.owncragent: Attltorirtcpla. Moderate.Risk,Deleading M0bcrds'; P:epiacieMe t MAing intact (interiar) M:akirig intact(exteriori' Coveri' Liq' t id:enca;psulation. 6pping'baseboards Work was,.dor :in the following rooms, Work was dorwon the following types>of°:compenentss I , ' Start Date: l I Finish Date: 1 J Cost:'S.; ( ). 1 Llocfn I:n�etudt;{)w�lsr'sLst�pr Low-risk owner/agent/ Aethorization-Ai l Low Risk Deleading rn et hods Liquid encapsulation Capping baseboards R_eplsccm nt(doors,catrirrat doors.. ht nais.shelves not"affixed.drativcrs wrndowsbh hinst:O Work was done.in the following rooms:' Work'was done on the'r llowing"types,'of comper,nt nts Start Dale: I. It21'Sh rite: f � cost S: _ (9acsn`t IkWdi wnv Lab t) , r {, i Nov 16 2011 11 : 32AM HP LRSERJET FAX p. 1 CLEAN SURFACE DELEADING� : NC . 203 Essex St. (781) 340-0816 Weymouth, MA 0218$ FACSIMILE COVER SHEET DATE: , Nov. 16, 2011 TO: Director, Asbestos & Lead Program (617) 626-6965 Director, Childhood Lead Poisoning Prevention Program (781) 774-6700 Board of Health, Town of Barnstable (508) 790-6304 FROM: Mark S. Bianco RE: Notification of Deleading. Work _ 92 Winter St. , Apt. _ C,"-Hyannis, MA PAGES : 3 WAIVER..#NWL 11008 Nov 16 2011 11 : 35AM HP LASERJET FAX P. 1 CLEAN SURFACE DELEADING r, INC . 203 Essex St. (781) 340-0816 Weymouth, MA 02188 FACSIMILE COVER SHEET DATE: Nov.. 16, 2011 TO: Director, Asbestos 6 Lead Program (617) 626-6965 Director, Childhood Lead Poisoning Prevention Program (781) 774-6700 Board of Health, Town of Barnstable (508) 790-6304 FROM: Mark S. Bianco RE: Notification of Deleading Work 92 Winter St. , Apt. C, Hyannis, MA PAGES: 3 WAIVER #NWL 11008 Nov 16 2011 11 : 35AM HP LASERJET FAX p. 2 -4 WAIVER#NWL 11008 COMMONWEALTH OF MASSACHUSETTS Department of Labor& Industries and Department of Public Health NOTIFICATION OF DELEADING WORK All sections of this form must be completed in order to comply with the notification requirements of M.G.L.Ch. l 11, § 197, 454 CMR 22.00 and 105 CMR 460.000 as most recently amended File Number: (AGENCY USE) Contractor performing project Mark S. Bianco License#DC 001055 Lead Paint Inspector Anthony Jakaitis License #M2929 Date of Inspection 9/30/11 If low-risk deleading work is being performed,complete the following line: Property Owner: N/A __. Agent. Address of Project Building Name (if any) Floor 2 Street Address 92 Winter St. Apt.No. C City Hyannis Zip 02601 Deleading Method: t/Dry Scrapin Heat Gun Caustics Liquid Encapsulant ovenng Demolition Replacement Other If"Other" selected,please explain Check One: Dwelling is multi-family X Single family Start date 11/17111 Completion date 11117/11 When will work be done: A.M. X P.M. Weekends Project Supervisor's mane Mark Bianco License# DC001055 Property Owner. Eric Barsness Address 54 Angus WU City Cen 'lle State MA Zip 02632 Telephone (508)958-6838 In case of emergency contact Mark Bianco Phone: day (617)340-0816 evening_ (781)340-0544 (over) Nov 113 2011 11 : 35RM HP LRSERJET FRX P. 3 Page 2 of 2 fn accordsocewith Massachusetts General Laws C.111 11197,04 CMR 22.00 and 105 CMR 460.000,notice of the date and method(s)of emovai or covering of paint,plaster or other accessible materials containing dangerous levels of lead is to be provided and must be received by the following agencies,at least TEN (10)days prior to the beginning of deleading; NOTIFICATIONS MAY BE FAXED. L 1, Department of Labor,Lead ProBatn,Division of Occupational Safety . 19 Staniford Street,l"Floor,Boston,KA 02114 FAX:617-626-6965 4, 2. Director,Childhood Lad Poisoning Prevention Program Department of Public Health,Donovan Health Building,S Randolph Street,Canton,MA 02021 FAX: 781-7746700 3. Occupants of dwelling unit 4. All other occupants of the residential premises,If any 3. Local Board of Health/Code Enforcement Agency 6. Massachusetts Historical Commission (if premises.are listed on the State Register of Historic 2220 Nfomissey Blvd. Places,this notification must be 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-INCOMPLETE NOTIFICATIONS WILL NOT BE ACCEPTED AND wILL BE RETURNED BY THE DEPARTi17ENT OF LABOR&WORKFORCE DEVELOPMENT. PROPERTY OWNER(If owner or unlicensed owner's agent will be performing low-risk deleading work,complete the following): Property Owner Agent(s) Address Telephone Number (_--}- i certify that 1 have complied with the training requirements of the Commonwealth of Massachusetts Lead Poisoning Prevention and Control Regulations. 105 CMR 460.175,for owner/agent low-risk abatement and containment, I further certify that I or my agent will be perfom►ing the following low-risk activities (1 have circled all that apply): applying liquid emcapsulant capping baseboards removing doors,cabinet doors,shutters applying exterior vinyl siding covering surfaces I certify that the ation contained in this notification istrue and correct to the of my knowAge and belief, Date Signed Revised 12/2007 t 1� 77� i Anthony Jakatls � Invoice Master I:eact.In*tar � E PO BOX 400 Dat- Invoice# . South Weymout , l IA-.02190 itzzno�i 1154 (781)33l-1565 t I Bill To � Eric Harsnesy 54 Angus W4, Crutervitle,MA 92632 i t { P,O Fla: `farms Projc! Quant[ty I� sc3pUisn` Rats: Arnotist: 1 Lcad Re�nsiiecion(laierim'Canfmt)-S2 WiDIgiSt.,#C.}(y=is Ito ' l Ill7tt# 215^Qq 2 �0� i r 1 I f Total $245:oa