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HomeMy WebLinkAboutMiscellaneous - 18 ROYAL CREST DRIVE 4/30/2018 (2)m Date.a�Ao ................ .1265!; Commonwealth of Massachusetts Official Use 0 _ Department of Fire Services Permit No. Occupancy and Fee Checked , BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEMEPRINTINMKOP, TYPE.ALLMFORMATION) Date: AuaU_5 ;(6, I Ll City or Town of. NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 'S ® Q Q U 0-1 e,f -'e- s Owner or Tenant /-� N► % C 0 Owner's Address bu t tel l r1 N Is this permit in conjunction with a building permit? Yes ❑ No Telephone No. (Check Appropriate Box) Purpose of Building Utility Authorization No. - Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Overhead ❑ Undgrd ❑, Overhead ❑ Undgrd ❑ No. of Meters No. of Meters Location and Nature of Proposed Electrical Work: CkecK &.g_ k.tcre ( (.E nn e_g_4-tc sl `S 11,4 8aS4_06o-_,rck eledr6 e. )-ko_+ , Vnc voI6.q 4.6{rr,4ostaJ-5 p_n& 0_Ar(_gi4 brect-ke-r a Pee-Aivicj 'f" h --e S e- ti n 14 ' Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Cell: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑In- ❑ rnd. grnd. o. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number - - " Tons ................."***-J----* KW .......... No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No, of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated 'Value of Electrical Work: 300 : ®6 (When required by municipal policy.) Work to Start: a (a le I 1 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE El BOND ❑ OTHER ❑ (Specify:) I certify, under tlzepain wand penalties/of,n erjury, that the information on this application is true and complete. FIRM NAME: D A i �.. l Pr Y l til mac% +2_ i C LIC. NO.: X41 S 7Cl q Licensee:"Dwi@ 1 PA Vl Ag -1 e— Signature o_.,P tte,_� LIC. NO.: 3 1850E_ (If applicable enter "exempt" in the license number line.) Bus. Tel. No.-- Address: M 0 R 11` S4-- WCL -1 KlCk1M il"1 P- 0-AU Alt. Tel. No.: -504- *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE: $ SignatureturaTelephone No. AML The Commonwealth of li2assachusetts - ,, Department ofIndustrial Aiccidents Office of Investigations 600 Washington Street Boston, MA 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legib (�ly Name (Business/Organization/Individual): bA1y\ IL ` 1� Address: Lot © 1 `t-.. City/State/Zip:t M ®a 1 Phone#: Are you an employer? Check the appropriate box: 1. ❑ " I am a employer with 1 4. El am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a solo proprietor or partner- listed on the attached sheet. ship and'have no employees These sub -contractors have working forme in any capacity. workers' comp, insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ 1 am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, §1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11. ❑ Plumbing repairs or additions 12.0 Roofrepairs 13.❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. i -Homeowners who submit this affidavit indicating they ate doing all work and then hire outside contractors must submit anew affidavit indicating such. tContractors that checkthis box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. lam an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name; Policy # or Self -ins. Lie. #:W CL ` 00 ExpirationDate: Job Site Address:, 5 % �� Cc-� cy-<s q-- 1D r City/State/Zip: 14, �,tJ () Ok).,C K Vii -A G 1 g 4 S Attach a copy of the workers' compensation -policy declaration page (showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one=year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certo under the pains and penalties ofperjury that the information provided above is true and correct. JP> A) Phone #: Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other - - - Contact Person: Phone #: /t�,e)o asCLc.<3© 7 ® AC" " CERTIFICATE OF LIABILITY( INSURANCE DATE(MMIDD/YYYY) TYPE OF INSURANCE 8/26/14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERAIPICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER James O'Connell Insurance AgenPHONE 572 Boston Rd Unit 7 Billerica, MA 01821 CONTACT NAME: LESLIE HANNON FAX (978) 667-0587 (978) 667-6150 AIC, No: ADDRESS: JIMINS@OCONNELLINS.COM INSURE S AFFORDING COVERAGE NAIC # INSURERA:Merchants INSURED I NSU RER B : A . I . M . Insurance INSURERC: DANIEL P VITALE ELECTRIC INSURER D: 190 DALE ST INSURER E: WALTHAM, MA 02451 INSURER F: AUTOMOBILE LIABILITY ANYAUTO ALLOWNED SCHEDULED AUTOS AUTOS NON -OWNED HIREDAUTOS _ AUTOS COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxI OCCUR BOP9098053 9/12/14 9/12/15 EACH OCCURRENCE $ 1,000,000 DAMAGETPREMISESORENTED a occurrence) $ 500,000 MED EXP (Anyone person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GENERALAGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRO LOC rx-1 POLICY JE PRODUCTS - COMP/OPAGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANYAUTO ALLOWNED SCHEDULED AUTOS AUTOS NON -OWNED HIREDAUTOS _ AUTOS COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE $ Peraccident UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTNE Y / N OFFICE R/MEMBEREXCLUDED? (Mandatory in NH) If yyes, describe under DESCRIPTIONOFOPERATIONS below N/A WCC5006538012009 10/11/13 10/11/14 X WC STATU- O1Y I=TH- E.L. EACH ACG DENT $ 100,000 , E.L. DISEASE -EA EMPLOYEE $ 100,000 E.L. DISEASE -POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ELECTRICAL WORK CERTIFICATE HOLDER CANCELLATION © 1988-2010 AtORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The AC ORD name and logo are registered marks of ACORD Phone: Fax: E -Mail: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TOWN OF NORTH ANDOVER MA ACCORDANCE WITH THE POLICY PROVISIONS. 120 MAIN ST AUTHORIZED REPRESENTATIVE NORTH ANDOVER, MA 01845 LESLIE HANNON © 1988-2010 AtORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The AC ORD name and logo are registered marks of ACORD Phone: Fax: E -Mail: 9951 Date...... ....................... TOWN OF NORTH ANDOVER I've PERMIT FOR WIRING This certifies that ............. I -IC- ....................... : ........................................................ has permission to perform .......... ...................... wiring in the building of ......... RIO ................................................................. ......... a... ,North Andover, Mass. at ..!!0 ... P .... A �4'— �. A ed Fee ...1. ............... .... . . ....... .............. ...... . Lic.No.1.8y.77/y .... C�;4c?,A)Ll!i-EPE- �C---r-OR- - �� Check # 6 Lq� 7 `w (fommonweal/h o f Madjac4ueei% Official Use Only c� cc77 C� Permit No. Apartment ol._%ire Serviced Occupancy and Fee Checked y BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: March 4. 2011 City or Town of: North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 50 Royal CreSt Drive Building # Za Owner or Tenant Royal Crest Apartments Telephone No. 978-681-1822 Owner's Address 50 Royal Crest Drive North Andover. MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Commercial - Apartment BUIldiingsUtility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ New Service Amps / Volts Overhead ❑ Undgrd ❑ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Install 6 Gell Packs! No. of Meters No. of Meters ('mmnlotinn nftho fnUnwino tnhlo mm; ho wnivorl by tho tncnorinr of Wira , No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- ❑ rnd. rnd. o. o Emergency Lighting Batte[y Units 6 No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pum Totals Number Tons KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of WaterKms, Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or E uivalent OTHER: Attach additional detail if desired, or as required by the Inspector of 6Vires. Estimated Value of Electrical Work: $ 600,00 (When required by municipal policy.) Work to Start: 03/04/2011 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: LIC. NO.: A10737 Licensee: Michael J. Parziale Signature a I" , LIC. NO.: E20269 (If applicable, enter "exempt" in the license number line.) U Bus. Tel. No.: 781-322-9344 Address: 50 Branch Street Malden, MA 02148 Alt. Tel. No.: 781-322-3100 *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. SS CO 001021 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's a ent. Owner/Agent Signature Telephone No. PERMIT FEE. $ 125.00 z H w o � � y 0 W N Y U N 3 - = �� c 3 E'i A C cd O >O E .4 O O a O ce on Y E a o o ti 3 a doo a o vT�. 00 V E E R. F -d O U � ons N � � ° w o 00 > •ti � c Q kn C Q S o 0 S 3 O is v, Q ° E 3 ^O y CLC Q .C+ a� �[ C s Q `a d O u v b d F F v1 a o t o •• x ❑ E t o O CO N .'•' W 3 00 y^ U � 3 U Cl N O•E� �.0 L CYvOi 7 t- 42 Oo s. sdn s C. v bA - a 3 S E °o c v 0 o S Ec vdi to V" g AS a A N x �o'es M o aria x 3 E o a*14 E y YL0.6 w v sE�o 00 Q aci c a� a 0,,. tEd C°'d E S boa c p 3S U G. t y >, W« E "O" x N V O O A Cd U 4. O 0- z r.0 E O U O C y �j p 0 -0 O O cd �O Y o 3 v Q y00ot Y E o d cd C O a> E •• >d N O o pp Hy Er E8- o Y Y = 3y� `d a H U r� m O Z O x O M a u a y o nT E o y o o s `° u y.� cd C N C A cd �d O C ' aS >+ cOd O y a0i aci cCdp y C d • ° C y owp 6E -F y u 14 os° w d 3k >' :� • C E ^o o «+ ++ u m U d A U C7 a A U U W %/ s o � � y 0 N � � y 0 4 V U C N C O 0 a �U .0 7 N ? j m J N N N O N O N 7C �I IIrA C. RS 4P 00 ti U FA � T R N y U C V O - Z O 2 o f v E rn V y 'C O � L O 3 d o ti � 0 •o � °' E 3a� _ E _? o M O O rn so°n 0 3 s E A° y at�oYO�.__ cd ❑ X' � cO 7 T ^ E C O y U a E o C cu U av"0 Ny o is 3� � tl 1.3i v ie 00 a°i bu 8 x $ 0 0 0 a Y c a o E >.> m 3 5 0 N 5 a c o o to food_ cd y e Yd C T= 4. N 21 � v s O o --" ti y p: b' Q 0 ,E, sto op y•5 E E 5 o"nr w 300, O A4 �� =a�b — v* N L yo d 75 w PL c .--�N iM7 E•'L' 7 0b U 3 Q, 0 0 4P 00 ti U FA 0 0 ca z a3+ Lex. d o 0 0 ca z a3+ Lex. ti ti V A U 4, Eo T It. U ti N, _A E H w re C ui 0 0 S 0 CIO U ci N O a 0 0.4 rN� � CO°' a �° d Y o N 3 C x p o too E a) t c N > y 00 °' � E 5 b•�.e u ca L y o U o :E2 LC E x C d 4.= O C � N N O ° 3 oo �" 3 = "" s N 0 „ 0r0U E g &F-•� 01 o °.E xl. U y il; ot,c 7t C E (D 'Eu Gr V �+ N H C fl C EO n U OgUG C ��.1 A N i � � o � a � � •oo � a `ti° x Ep U3Er °cs � d a cq 3° 5 't7 b U O >y M E O U L1 a°i E o a E O C o o Y a ^� u E a i ow E :: d 85 oo 'C E>> o 3 t c o w y o FC U ti •G' U 'b iO C C R Q Ci ��y/ .�+ ca ❑ o EE ro ca .. y .E U C O an •V•i r W � O C chi b x U�� � chi y 0 � y •O � a a' W�� C O O � � � Lz Y c x w o o> c^ OQ cd v •� 'r b ° 3 cCi 13 a� " p 00 O N x N Q H • • ,y c>a c>a y ° ai cCd 3 E eC N oA W O E Eco D o o U E 2� o °o O � pl • y � � O L1 "' ❑ y y td 5 •L' �o N O> � Wsw�•E.o o o o a� U U y •� N ro y C c0 '2 � U U " C.2 U. C . o Q O C aCi aCi R -B❑ ai " ow 0.'bF-H yor o. w d bD •• a=i O c «+-�N �M7 F-�t 7 Q•O U 3 0.r � � y .. � O •• a V1 Ow U ti N, _A E H w re C ui 0 0 S 0 NORTH ANDOVER HEALTH DEPARTMENT 27 Charles Street • North Andover, MA 01845 Tel. 978 688-9540 • Fax: 978 688-9542 email: healthdept@townofnorthandover.com Complaint Investigation/inspection Report DATE Rev. 6104 INSPECTOR 3 Inspection Form Use for Field Training and Audit Inspections Agency Name, Address, Phone SSC 105 CMR 410.000: Chapter II, Minimum Standards of Fitness for Human Habitation Date Time # Occupants # Children < 6 Years Address Unit # City/Town Occupant Name Phone # Owner Name Phone# Owner Address City/Town Zip Code # Dwelling/ Rooming Units in Dwelling # Stories Floor Level of Unit # Sleeping Rooms # Habitable Rooms (.400) Inspector Title If violations are observed and checked, describe them fully on Page 3. Area or Element . Type of Violation Use blank boxes for ones not listed Possible Code Section(s) ",if Responsible Party Violation Observed Owner. Occupant Exterior, Yard Locks 480 & Porch Posting, ID, Exit signs/emergency lights 481, 483, 484 Handrails, steps, doors windows, roof 500, 501, 503 Rubbish—storage and collection 600,601 Maintenance of Area 602 Common Areas & Entry Light, windows 253,254,5 . 01 Egress, 450,451,452 Handrails 503 interior Halls Floors, walls ceilings 500 & Stairs Hallways, railings, stairs 503 Light, windows 253, 254, sol Bedroom 1 Location (circle): Front Rear Middle Left Middle Right Floor Level of Unit Ventilation 280 Ceiling height 401,402 Windows, screen 501,551 Bedroom 2 Location (circle): Front Rear Middle Left Middle Right Floor Level of Unit Ventilation 280 Ceiling height 401,402 Windows, screen 501,551 Bathroom Toilet, sink, shower, tub, door 150 Smooth, impervious surfaces iso Lights, outlets, ventilations 251,280 Floors/walls 504 Kitchen Sink, stove, oven; good repair, impervious and smooth, space refrig 100 Page 1 of Area or Element Type of Violation Possible Code ✓if Use blank boxes for ones not listed Section(s) Violation Observed Responsible Party , j{ Owner Occupant Lights, outlets, ventilation, Windows, screens 251, 280, 501, 551 Kitchen, cont. Ceiling height 401,402 Floor 504 Living room Lights, outlets, ventilation 250,280 and Dining Ceiling height 401,402 Room Windows/screens 501,551 Basement Maintenance 500 Watertight Soo Lighting 253 Water Source (circle): Public Private Must be potable 180 Quantity, pressure 180 Responsible for paying MGL ch 186 s 22, metering 354 Hot Water Fuel Type (circle): Natural Gas Oil Electric Other Temp.: Of Location taken: Quantity, pressure, 110 F min, 130 max 190 Venting 202 Heating Type (circle): Forced Hot Water Forced Hot Air Steam Electric No portable units 200 "Habitable room and every room with toilet, shower, tub" 201 • 68 F7 am to 11 pm, 64 F 11:01 pm to 6:59 am, except 6/15-9/15 • 78 F max in heating season/measure 5 feet wall, 5 feet floor Venting, metering 202, 354, 355 Electrical Type (circle): 110 220 Amp: Amperage, temporary wiring, metering 250, 255, 256, 354 Drainage, Type (circle): Public Private Plumbing Sanitary drainage required and maintained 300,351 Smoke & CO Required & operational 482 Detectors Pests Free of pests (rodents, skunks, cockroaches, insects) 550 Structural maintenance and elimination of harborage 5so Asbestos or Lead Paint 353,502 Curtailment 620 Access 810 Other Page 2 of _ s 1 Referral: ❑ Electric ❑ Fire ❑ Plumbing ❑ Building ❑ Other This inspection report is signed and certified under the pains and penalties of perjury. Inspector Signature Occupant or Occupant's Representative Signature Reinspection Date Time "The information presented above is only a summary of the law. Before you decide to withhold your rent or take any other legal action, it is advisable that you consult an attorney. If you cannot afford to consult an attorney, you should contact the nearest Legal Services Offices is which is (Name), (Address), and (Phone). Written description of any violation(s) checked above Include Area or Element, code citation and a description of the condition(s) that constitute the violation. You may include remedies that would be an acceptable means of achieving compliance with 105 CMR 410.000. NOTE: *indicates that this housing inspection has revealed conditions which may. endanger or materially impair the health, safety, and well-being of any person(s) occupying the premises Area/Element, Code Citation and Description of Violation I . Acceptable Remedies Page 3 of 410.990: continued THE FOLLOWLvtG ISA BRIEF SLr'WMARY OF SOINIE OF THE LEGAL REMEDIES TENANTS MAY USE LV ORDERTO GET HOUSING CODE VIOLATIONS CORRECTED. 1. Rent vVithholdiug (General Laws Chapter 239 Section SA). If Code 1 rolatiors Are, Not Being Con�ected },ou maybe entitled to hold back i -our rent p,,�lancvrf. Fou can do this r Ifhow tieing wdcted if: A. You can prove that your dwelling unit or common areas contain violations which are serious enough to endanger or materially impair your health or safety and that your landlord knew an==bout the violations before you were behind in your rent B. You did not cause the violations and they can be repaired wiuile you continue to live in the building. C. You are prepared to pay any portion ofthe rent into court if a judge orders you to pay for it (for this it is best to put the rent money aside in a. safe place.) 2. Repan and Deduct (General Laws Chapter 111 Section 127L). This law sometimes allows you to use your rent money to make the repairs yourself If your local code enforcement agrrcy cF7rffres that there are code violations which endanger ormaterially impair your health. safety or well-being and your landlord has received written notice ofthe violations, you may be able to use this remedy_ If the owner fails to begin necessary repairs (or enter into a written contract to have them made) within five days after uotice or to complete repairs within 14 days after notice you can use up to four months' rent in any year to make the repairs. 3. Retaliatory Rent Increases or Eviction Prohibited (General Laws Chapter 156, Section 18 and Chapter 239 Section 2A). The ol-mer mm= not increase tour rent or m4ct you in retaliation for mak-ing a complaint to your local code enforcement agency about code violations. If the owner raises your rent or tries to evict within six months afr eryou have made the complahnt he or she vvill have to show a good reason for the increase or eviction which is uunelated to your complaint. You may be able to site the landlord for damages if he or she tries thy_ 4. Rent. Receivership (General Laws Chapter I I I Sections 1270-H). The occupants andior the board of health may petition the District or Superior Court to allow rent to be paid into court rather than to the owner. The count may then appoint a "receiver" who may spend as much of the rent money as is needed to correct the violation. The receiver is not subject to a spending limitation of four months rent 5. Search of Wanamy of Habitability. You may be entitled to sue your landlord to have all or some of your rent returned if your dwelling rant does net meet minimum standards of habitability. 6. Unfair and Deceptive Practices (General Laws Chapter 93A) Renting an apazfinent with code violations is a violation of the consumer protection act and regulations for which you may site an owner. THE INFORMATION PRES L\= AB0I E IS 0NLY A SUMNMRY OF THE LAW, . BEFOREYOU DECIDE TO ATTHHOLD YOUR RENT OR TAKE ANY LEGAL. ACTION. IT IS AMISABL ETILATY OU CONSULT AN ATTORNEY. YOU SHOULD CONTACT THE NZEAREST LEGAL SERVICES OFFICE )WHCH IS: (NAME-) ( ELEPHONTNUMBER) (ADDRESS) Page 4 of _