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HomeMy WebLinkAboutMiscellaneous - 1-3 Clarendon Street �® if CLARENDON STREET � J 210/069.0-0038-0000.0 1 �`r � �, �� �� � ° � � �� � �� ��� ,�� � � � � °°'� �� �T -�� O E CALL r M / DA T E �` TIME,9.�p ONED RETURNED -3HONE �v' YOUR CALL AREA CODE NUMB EK-TENSION �A p E CALL MESSAGE " WILL CALL AGAIN G 2ME TO L.Q N r SIGNED r (V iV2lSai FOR DATE TIME M OF L HONED RETURNEf3 PH QN E `-' � V YOUR CALL AREA CODE t MBER SION AL MESSAGE WILL CALL AGAIN CAME TO SEE YOU; WANTS TO SEE YOU: % SIGNED .I11V@ISOI 48003 FROM gm i UNITED STATES POSTAL SERVICE First-Class Mail ~ Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • Health Department 400 Osgood Street North Andover, MA 01845 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Sig ture item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse X ❑Addressee so that we can return the card to you. eceiy(Printed Name) C. D to elivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No s� 3. Ser!c MCertified Mail ❑ Express Mail ❑Registered ❑ Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. ArticleNumber (Transfer from service label) PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540 LETTER OF TRANSMITTAL North Andover Health Department N RTy •Aq,l, 400 Osgood Street North Andover, MA 01845 0 978.688.9.540 - Phone 978.688.8476 -Fax '� n��q Cot CAA It. healthdent(a-)townofnorthandover.com - E-mail www.townofnorthandover.com - Website Page / of TO: DATE: /0COMPANY: FROM:Pamela DelleChiaie Health Department Amistant RE: Phone: Fax: �Z/. We are sending you: OCopy of Letter OPlans OOther ill in below) These are transmitted as checked below: ➢ OAppmwd aas Noted ➢ OForReww and comment ➢ OMuhn& copies for ➢ O%Requested ➢ OFor Your Use dist ➢ OAsRequired ➢ OResubn* copiesfor ➢ OForAppro►aal appmw REMARKS: COPY TO: COPY TO: COPY TO: SIGNED: Town of North Andover of NORTH Office of the Health Department o Community Development and Services Division * z 400 Osgood Street " +,; *�a , " North Andover,Massachusetts 01845 ,SSACNU5�4 Michele E. Grant Public Health Inspector 978.688.9540-Phone 978.688.9542-Fax E-Mail: healthde_pt@townofnorthandover.com Website:http://www.townofnorthandover.com Letter Of Compliance DATE: June 13,2005 TO OWNER OF RECORD PROPERTY LOCATION Ralph Cerbone Jodi Polimera 1 Clarendon Street 3 Clarendon Street North Andover,MA.01845 North Andover,MA. 01845 Dear Mr.Cerbone, A Health Department ORDER LETTER dated May 10,2005 was issued to you as owner of record of the property listed above citing violations of the State Sanitary Code,105 CMR 410.000,Minimum Standards of Fitness for Human Habitation. A re-inspection of the property has found that all of the violations noted on the Order Letter have been corrected. The Health Department would like to thank you for your cooperation. Sincerely, Michele E.Grant Public Health Inspector Xc: File BOARD OF APPEALS 688-9541 BIJILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 a - - MORGAN worn AAA WPI�� WK FAM WJ M krA OR UP, �►.'�rZ!��L�� � i �.. • r �� � r_ ter%/,�:. . ,��!� Emu- All' 0 WE A RVA On Sol r • • v MM 1 . • •Sw,aiX` �'.k.1.S-0>.x..rl I s.� ! cG.' ..a`e... ,[.u.^'."S Fi`1. of r .6'J. �'.:.1'iic�.r..L.l�ce�'�'-:�1✓":7L>;.'��.�.�'•`d-i�:a: k.�:�i„ ::•1 I.� • f 1 .:I !4 ..,��R (t i r� ..i T'aY?/•�.CSr. a'�CY h��'.,tr�,� ��$ .1 I . !li':w4�,i�`L.J`wl "I 1 I i 1 f 11 111 • ! 1 / .. , . •` Z r'' '• �G+ -c .�'. 1• 1 , 1 11 ' ,./ II . ..{1 .. 1 ���'� � �� I ��'i-..I dj •}S(,r � tF'�'�: .11 . ill 11 11 .; •11 t.. 1-.. I 1 Ir:'. _ 1'•. •. . eta X1.,;1. _ t .'�Y��7�.7�'{��f"�Y�.r._ . II . _ 1 1 rf 11 . 71Ik _ _ _ ..I . I 1 . I 1 �' 1 I 1 1 ....yl •.14 . 1 1.. .1 11 rl 1 lIMF - 1 11111 :.I v'111--1 1 - 1 I II• �1 111 Irl 'Alh •.1 f.il• ij MA ij 3T 7 - 111•.. .11,1 11 _.•A t . - tl • 11 1111�.- -./ " I 1114.:' 1 1111111.. 11 •:11.• ♦.1�1 . . . fIF 1 r , 1 11 �� ""S1^'"r'vl���".i'•rr"xoY� ,1'�,,.y.ya >.t�t+✓Y�`" K�ie -- Pro.Veiemce AltgjyWcaj SeMces, Inc. Telephone: 781.835.3212 �2 Cunwrirrgs Park, 9r4mm;'bIA 91801 pacelmile: 78'-93248'r7 Email:cnemistrAproscience.net Laboratory Report Contact Oscar Begin Bafth*C 236649 client A-Painting&Lead Detection Deb recoWed: 9/7)2006 Address: 322 Jefferson Aye ni;e Date analysed- eM2005 Salam, MA 01870. Date of report 6.?2005 Project 0 N/A P.0.0 N/A Project Site: 3 Clarendon Street No.Andover,MA Lead Analysis in wipes Using SW946-7.20 Resuils in ug/f1° tJnl®ss otherwise indicated. all t'se Quality control criteria far the rrethcd above have been met NM* Dei'ectiou Lab M client 1 date Dneri !tofu Result Ludt cwnnr�os 6'4/05 Rmn 5 mvcr un'_+ .er, I3D 14.0 r 1 2 0%4105 Rant 5 1 hist:mill );DL 10.9 C 2113as 3 614/05 Room 5 Whidrw Waal SDL 15.9 C 2123!G I x'4005 Room 3 f1ccr furl BDL 10.0 C 211151 5 6'4ro5 Room a)h'irtd4w� r317L 10.9 C:11352 6/4!05 ROM 3 u istd m watt BVL 15.0 C 2!1353 7 6 4x05 Blank BILL 10.0 , X11 bbt11.-,ere reported ZZ to-alt�4ey are net ut%l to co=gf ample ulrs. EDL-Below Detection!.unit Dorina AMWOVicl,Laboratory Supervisor Martha KneiZys,Laborafty Manager Adrian Stanca,Laboratory Director The FPA 403 Final Rule Y40 CFR 745.83)requires Chet all wipe sarrples of settleddustshaii be eailectedfusing wipes t.4at mmt A5TM E1792. The analytical results,f r wipes not meeting AS7'!iy El 7r,,are;tot rec,gnited by AIHA's Acereditat;ar,Pragrarrl, Fd Wd80:L0 9002! LO 'unr 'ON Xdd : WOad Viesna Sar r New England Environmental Services Lead Paint &Asbestos Removal General Repairs and Construction Free Estimates Control No: 0 1 57 Southside Ave. Office (781) 286-6511 IMONWEALTH OF MASSACHUSETTS Lynn, MA 01905 Cell (781) 589-9375 - nts of Labor and Workforce Development -Devil®n of Occdatl6bal Safety .399.Washmgtoii Street, 5th F1oot;.Bostorn Massachusetts 02108 5 ` DELEADER CONTRACTO]i LICENSE VIESNA SAR LEADPAINT REMOVAL&,GENERAL CO NST.CO. 76 SHIRLEY AVE REVERE MA 02151 LICENSE DC000f45 EXPIRES: Tuesday,April 04,2006 IN ACCORDANCE WITH 1VIGL CH 111;:§,I97B(b)AND 454 CMR 22.03 THIS CERTIFICATE IS ISSUED BTHE DEPARTMENT OF LABOR AND WORKFORCE DEVELOPMENT,DIVISION OF OCC - ATIONALSAFETY TO THE CONTRACTOR ABOVE FOR THE PURPOSE OF EN7" GAGING IN DELEADING WORK. THIS;LICENSE IS VALID.FOR A PERIOD OF ONE YEAR. t THIS CERTIFICATE MUST BE-.MAINTAINED BY THE CONTRACTOR WHEN ENGAGED IN , OELEADING WORK IN:ACCORDANCE WITH MGL CH. 111 § 197B(b)(2)AND 454 CMR 22.03. Robert J. Prezioso,Comssioner L �+ Commonwealth of Massachusetts NFEB. .E. REGIONAL COUNCIL FEB Division of Occupational Safety MAR. F:ARPENTERS MAR Robert J.Prezioso,Commissioner APR. $ APR Deleader-Contractor �Nu MAY4u+ k MAY VIESNA SAR JUNEfi` s JUNE Eff.Date 03/30/05 JULY � JULY AUG. Joseph D.Power,Business Mgr. Exp.Date 04/04/06 Mark Erlich Business Rep. AUG. SEP. (617)547-8511 DC000145 t , Meets 4th Tues.,VFW Hall SEP. j OCT. ° 688 Huron Ave.,Cambridge OCT. Memberof C.O.N.E.S.T. 06 NOV Viesna Sar NOV BO 2005 toHOLwoRTHYsT,CAMBRIDGE MA002138 <F>,o9 2006 II�III�IIIIIIIII,I�III�II�II�IIIIIIII��II�I�N BOSTON-RENEW 10/14/23 02:32 FAX 002 LEAD PAINT REMOVAL AND GENERAL REPAIR CONSTRUCTION COMPANY 110 THORNTON STREET 4 � S REVERE,MA 02151 V , (781)286-6511 1� CONTRACT THIS AGREEMENT is made between Lead Pain em v nd General Repair Construction Company(here�'nafter referr to as "the Contractor")and � .r 2• of �' 1 Ncm s.r . 0 (hereinafter referred to as "the Owner"). The Contractor represents that he has been certified by the Commonwealth of Massachusetts to perform lead paint removal (Certificate No. DC 000145). The p irties hereto agree as follows: 1. Th Cont actor will perform deleading at the Owner's premises local ate . G . andafire to satisfactorily p rform the fo owing specific work: 2 U� s pr P C.e e.r- c 2.In consideration of the work to be performed by the Contractor, the Dwner agrees to pay to the Contractor a total of�$ aSoo —�" , to be paid as follows: (a) 'Forty(40%) percent of the total price is to be paid upon the signing of this agreement; (b) The balance is due and payable upon the completion of the work pecified above by the Contractor; (c) he Contractor has the right to charge interest in the rate of Ten (10%) percent per annum on any valance outstanding over ten days after completion of the agr d upon work. The Owner further grees to pay any costs incurred by the Contractor in collection or any outstanding amount due under his contract, including reasonable attorney's fees. 3. Th Owner agrees to remove all contents from the premises where said work is to be performed prior to the Contractor commencing said work. 4. The Owner shall save and hold the Contractor harmless from and indemnify him against any liability, claim or dem d which arises out of any damage to or loss of any contents on said premises while said work is in progress at said premises. Executed at � this of a� j C I 4r cn.�m 5-�- ll/1_�rk�4 200�. Lead Pa nt Removal and General Repair C n Company, Contractor By: G� es a Sar Owne The premises set forth above was inspected by Q I � 1 on 200 S6,52 License a License# Inspector 10/14/23 02:32 FAX IM003 Page 2 of 2 In actor dance with Massachusetts General Laws'C.111§197,454 CMR 22.00 and 105 CMRs 60.000,notice of the date and methods)of removal 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 TSF ,1(10)days prior to the beginning of deleading. NOTIFICATIONS MAY BE FAUD. 1. Department of Labor and Workforce Development,Division of Occupational Safe 399'Washington Street,5rh Floor,Boston,MA 02108 FAX(617)727- 568 2. Director,Childhood Lead Poisoning Prevention Program Department of Public Health,Donovan Health Building,5 Randolph Street,Cantor,MA 02021 3. Occupants of dwelling unit 4. All other occupants of the residential premises,if any 5. Local Board of Health/Code Enforcement Agency 6. Massachusetts Historical Commission (if premises are listed on the State R gister of Historic 220 Morrissey Blvd. .; Places,this notification most be madupon receipt of an Boston,MA 02202 " ' Order to Correct Violations or at lea t 30 days prior to FAX(617)727-5128 laidating preventive deleading) NOTIFI &TIONS SHALL BE COMPLETED IN THEIR ENTIRETY,DATED AND SIGNED. IQVCOMPLETE NOTII�ICATIONS WILL NOT BE ACCEPTED AND VALL BE RETURNED BY THE DEPARTMENT OF LABOR&WOREY ORCE DEVELOPMENT. (If owner or unlicensed owner's agent will be perforating low-risk deleading ork,complete the following): Property Owner Agent(s) Address Telephone Number—L— I umbe—(_I certify dat I 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 con ` ent. I further certify that I or my ag t will be performing the following low-risk activities (I have timed all that apply); plying liquid eneapsulantcapping baseboards n moving doors,cabinet doors,shutters a plying exterior vinyl siding covering surfaces I certify th it all the information contained in this notification is true and correct to the best of my knoi dedge and belief. Date Signed 08/04 1 1 Department of Public Health/Department of Labor&Workforce Development NOTIFICATION OF DELEADING WORK t ti� r All sections of this form must be completed in order to comply with. RECEIVED the notification requirements of M.G.L.C.111§197, 454 CMR 22.00 and 105.CMR 460.000,as most recently amend d MAY 2 3 2005 i` TOWN OF NORTH ANDOVER Contractorperfoimingproject Viesna Sar License#DC 145 Exp.Date 04 THDEPARTMENT Lead Paint Inspector John En r i qht Date of Inspection 05/14/05 License#—L3 6 5 2Exp.Date ADDRESS OF PROJECT: Street Address 1. Clarendon Street Apt.Number 1 &2 City North. Andover, Ma. Zip 01845 1?ropertyOwner Mr.. Ralph Cerbone ---_-___Address-L Clarendon 'St.N.Andover,Ma. 01845 Telephone Number--1( 9 7 8:.). 686-7225 Deleading Method: et/Dry Scraping Heat Gun Liquid Encapsulant Demolition Caustics Rep icemen �ering Other If"Other"selected,please explain Check one: Dwelling is multi-family Ye S Single-family Other Start Date 06/04/05 Completibn Date 06/25/05 When will work be done: AM 8 3 0 PM-5-3 0(Specify times on site) Weekends?Saturday &Sunday Project Supervisor Name Viesna Sar License.# DC145 Exp.Date 04/04/06 Worker's Compensation Policy Number 6 Z Z UB814 X 163804 Carrier Far & Black I3^vss bf emir;:ncv c6tact Viesna S a.r Tel, —( 7 81 ) 286-651 1 ' (Contractor's Representative) DELEADING CONTRACTOR The undersigned hereby states,under the pains and penalties of perjury,that he/she bas read and understood the Commonwealth of Massachusetts Deleading Regulations,.454 CMR 22.00,and the Lead Poisoning Preventionand.Control Regulations,105 CMR 460,00'0,and that the information contained in this notification is true o ct to the best of his/her knavvledge and belief. la ®S Date �_- Signed Company.Name Lead Paint Removal & Repair Co. Address 57 Southside Ave. Lynn, Ma. 01905 Telephone Number, ( 7 81 ) 5 9 6-8735 OVERO Page 2 of 2 In accordance with Massachusetts 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 be provided and must be received by the following agencies,at least TN(10)days prior to the beginning of deleading. NOTIFICATIONS MAY BE FAXED. 1. Department of Labor and Workforce Development,Division of Occupational Safety 399Washington Street,5`h Floor,Boston,MA 02108 FAX(617)727-7568 2. Director,Childhood Lead Poisoning Prevention Program Department of Public Health,Donovan Health Building,5 Randolph Street,Canton,MA 02021 3. Occupants of dwelling unit 4. All other occupants of the residential premises,if any 5. Local Board of Health/Code Enforcement Agency 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 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 DEPARTMENT 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—(----j- 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 owner/agent low-risk abatement and ontainment. I further certify that I or my agent will be performing the following low-risk activities (I have circled all that apply): 1 applying liquid encapsulant capping baseboards removing doors,cabinet doors,shutters applying exterior vinyl siding covering surfaces. I certify that all the information contained in this notification is true and correct to the best of my knowledge and belief. Date Signed 08/04 KTown of North Andover f -- Office of the Health Department F? Community Development and Services Division 400 Osgood Street ,q qrgo North Andover,Massachusetts 01845 "SS�CHUs`t Michele E. Grant Telephone(978)688-9540 Board of Health Inspector Fax(978)688-9542 Date: May 24,2005 To: Ralph Cerbone From: The North Andover Health Department Re: Granted Extension On May 23,2005,Mr.Cerbone and I had a phone conversation regarding an extension for work to be done on replacing inadequate screens. An extension was granted,giving Mr.Cerbone until Friday May 27,2005 to replace the screens. Thank you for your cooperation in this matter. Michele E.Grant Public Health Inspector North Andover, MA. 01.845 C l, d BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH688-9540 PLANNING 688-9535 105 CMR: DEPARTMENT OF PUBLIC HEALTH 410.500: Owner's Resyonsibility to Maintain Structural Elements Every owner shall maintain the foundation,floors,walls,doors,windows,ceilings,roof, staircases, porches, chimneys, and other structural elements of his dwelling so that the dwelling excludes wind,rain and snow,and is rodent-proof,watertight and free from chronic dampness, weathertight, in good repair and in every way fit for the use intended. Further, he shall maintain every structural element free from holes, cracks, loose plaster, or other defect where such holes,cracks,loose plaster or defect renders the area difficult to keep clean or constitutes an accident hazard or an insect or rodent harborage. - 410.501: Weathertight Elements (A) A window shall be considered weathertight only if: (1) all panes of glass are in place, unbroken and properly caulked; and (2) the window opens and closes fully without excessive effort; and (3) exterior cracks between the prime window frame and the exterior wall are caulked; and (4) one of the following conditions is met: (a) a storm window is affixed to the prime window frame, with caulking installed so as to fill exterior cracks between the storm window frame and the prime window frame; or (b) weatherstripping is applied such that the space between the window sash and the prime window frame is no larger than 1/16 inch at any point on the perimeter of the sash, in the case of double hung windows and 1/32 inch in the case of casement windows; or . (c) the window sash is sufficiently well-fitted such that, without weatherstripping, the space between the window sash and the prime window frame is no larger than 1/16 inch at any point on the perimeter of the sash in the case of double hung windows and 1/32 inch in the case of casement windows. (B) An exterior door or a door leading from a dwelling unit to a common passageway shall tf be considered to be weathertight only if: (1) all panes of glass are in place, unbroken and properly caulked; and (2) the door opens and closes fully without excessive effort; and (3) exterior cracks between the prime door frame and the exterior wall are caulked;and (4) one of the following conditions is met: (a) a storm door is affixed to the prime door frame,with caulking installed so as to fill exterior cracks between the storm door frame and the prime door frame; or (b) weatherstripping is applied such that the space between the door and the prime door frame is no larger than 1/16 inch at any point on the perimeter of the door or (c) the door is sufficiently well-fitted such that,without weather-stripping,the space between the door and the prime door frame is no larger than 1/16 inch at any point on the sides of the door or iib inch at any point on the top or bottom of the door. (C) A wall,floor,ceiling or other structural element shall be considered weathertight only if all cracks and spaces not part of heating,ventilating or air conditioning systems are caulked or filled in as to prevent infiltration of exterior air or moisture. 410.502: Use of Lead Paint Prohibited No paint that contains lead shall be used in painting any surface of any dwelling. (See 105 CMR 460.000.) 410.503: Protective Railings and Walls (A) The owner shall provide a safe handrail for every stairway that is used or intended for use by the occupants. 4/22/94 105 CMR- 1627 105 CMR: DEPARTMENT OF PUBLIC HEALTH 410.551: Screens for Windows The owner shall provide screens for all windows designed to be opened on the first four floors opening directly to the outside from any dwelling unit or room unit provided, that in an owner-occupied unit, the owner need provide screens for only those windows used for ventilation. All new or replacement screens shall be of not less than 16 mesh per square inch. Said screens: (1) shall cover that part of the window that is designed to be opened but in no case less than the area as required in 105 CMR 410.280(A); and (2) shall be tight fitting as to prevent the entrance of insects and rodents around the perimeter. (3) Expandable temporary screens shall not be deemed to satisfy the requirements of 105 CMR 410.551(1) or (2). 410.552: Screens for Doors The owner shall provide a screen door for all doorways opening directly to the outside from any dwelling unit or rooming unit where the screen door will be permitted to slide to the side or open in an outward direction,provided,that in an owner-occupied unit,the owner need provide screens only for those doorways used for ventilation. All new or replacement screens in screen doors shall be of not less that 16 mesh per square inch. Said screen door: (1) shall be equipped with a self-closing device except where the screen is designed to slide to the side; and (2) shall be tight-fitting as to prevent the entrance of insects and rodents around the perimeter; and 410.553: Installation of Screens The owner shall provide and install screens as required in 105 CMR 410.551 and 410.552 so that they shall be in place during the period between April first to October 30th, both inclusive, in each year. 410.600: Storage of Garbaee and Rubbish (A) Garbage or mixed garbage and rubbish shall be stored in watertight receptacles with tight-fitting covers. Said receptacles and covers shall be of metal or other durable, rodent-proof material. Rubbish shall be stored in receptacles of metal or other durable, rodent-proof material. Garbage and rubbish shall be put out for collection no earlier than the day of collection. (B) Plastic bags shall be used to store garbage or mixed rubbish and garbage only if used as a liner in watertight receptacles with tight-fitting covers as required in 105 CMR 410.600(A), provided that the plastic bags may be put out for collection except in those places where such practice is prohibited by local rule or ordinance or except in those cases where the Department of Public Health detemwtes that such practice constitutes a health problem. For purposes of the preceding sentence,in making its determination the Department shall consider, among other things, evidence of strewn garbage, torn garbage bags, or evidence of rodents. (C) The owner of any dwelling that contains three or more dwelling units,the owner of any rooming house, and the occupant of any other dwelling place shall provide as many receptacles for the storage of garbage and rubbish as are sufficient to contain the accumulation before final collection or ultimate disposal, and shall locate them so as to be convenient to the tenant and so that no objectionable odors enter any dwelling. 4/22/94 - 105 CMR- 1629 DALTON & FINEGOLD Fax:9784708338 May 20 2005 1056 P.02 "own of North AndoverweR*M Office of the Health Department ComnluniLy Development and Services Division �. 400 Osgood Street North Andover,ivlassachuseos 01FA5 SACHO Miihel(t E. Grant (979)683-9340-11hone Plrrlic 1kn1Fh.hispccfor (97S)655-9642-Fox NORTH ANDOVER BOARD OF HEALTH ORDER LETTER Issued under the provisions of the State Sanitary Code,Chapter II,Minimum Standards of Fitness for Human Habitation,105 CMR 410.000. Date:May 10,2005 _ To the Owner of Record property Location Ralph Cerbone Jodi Polmeno I. Clarendon Street 3 Clarendon Street Notch Andover MA.01845 North Andover,MA.01845 Dear Mr.Cerbone, An authorized inspection was made of your property at the above referenced address by North Andover Health Department personnel on May 9, 2005. This inspection revealed violations of certain regulations of the State Sanitary Code, C haptear 11,as listed on the attached Violation Foran. You are hereby ORDERED to correct these violations within the time allotted on the enclosed form. Failure to comply within the specified time period may result in further action by the North Andover Board of Health. You have the right to request a heating before the Board of Health if you feel this order should be raodifxed or withdrawn- .A,request for said hearing must be made in writing and received by the Health Department within seven (7) days from the receipt of this order. At said hewing you will be given an opportunity to be heard and to present witnesses and documentary evidence as to why this order should be modified or withdrawn. All affected parties will be informed of the date,lime and place of the hearing and of their right to-inspect and copy all records cortcerning the matter to be beard. You may be represented by an attorney. You have the right to inspect and obtain copies of all relevant records concerning the matter to be heard. i n (. Michele E.Grant Public Health Inspector U(7Alt D 07,APNFAJ.S j$SJ).541 BUII,r)!NG 6A-4-9,14$ CONNI-R Vn PION 6S.9-95,30 I Ll-AL.1 I-4/Kx-u,'49 FLA NNINQ 663-9135 zoom Xdd BC CT 5002/ZY/SO DALTON & FINEGOLD Fax:9784708338 May 20 2005 1056 P.03 ORIAX>t.MER An authorized inspection.of 3 Clarendon Street was performed by Board of Health staff on ' May 9,2005 at which violations of 105 CMR 410.000 Chapter lI of the State Sanitary Code, MWmum Standards of Fitness for Human Habitation were found. Failure to respond within the allotted time period may result in a Board of Health finding that the dwelling is unfit for hu nan habitation All violations must be corrected within seven(7) days of receipt of this Order Dexter or a plan for completioxx must be approved by this office if a professional contractor must be hired to do the work. Violation Regulatory Re- Reference I" ection Screens for Windows 410.551 Current Screens are not tight fitting and are A0�56�� not secure. Owner shall provide screens for all windows designed to be opened on the first four floors. Said Screens: SW be tight fitting as to prevent the entrance of insects and rodents around the perimeter. Owner shall provide tight fittiog and secured in place. Screens for doors- 410.552 No door outside door an front of house. Owner shall provide screen doors in all doorways .opening directly to the outside. Said Screen door: Shall be equipped with self losing device. Shall be tight fitting as to prevent the entrance of insects and rodents. Owner shall provide a outside front door with Air tight screen MaintaWng Structural Elements: 410.500 Basement window is not secure.There is a hole In the front portion of house on the right hand Side. Owner shall maintain every structural elements Free from Boles,cracks, or defect renders insect or Rodent harborage TOOxd� ae cX Sooz�z��so DALTON & FINEGOLD Fax:9784708338 May 20 2005 10:56 P.04 05/12/2005 13:38 FAX 4 003 OWAgr shall fill hOJe6 in foundation in the base --meat and secure basement window. NOTE- A,Lead Test Will be Performed ask a Latex Date. s Lead Inspection / Risk Assessment Report Page_Of 6 4 Method Used: ®Na2S Exp.Date P A N T H E ®X-Ray Fluorescence Lead Paint Inspection Model /krMO Serial# l71)7 SU Address Apt. ®❑❑❑ o❑oo❑oEEOoo❑aoao®®❑❑❑❑❑ ❑❑❑❑ City Zip Code o « oo❑❑®oaoa❑®❑❑❑❑ Owner Name: 9 �A &,k„ C t�ED ,,J Single Family _ Owner Address: `' "4'c�� '' 'Mufti Family _�1/ fes C/c,V /414 01 C,Yr #Units - Client Name if different from owner): HEALTH DEPARTMENT Condominium _ Client Address: Day Care _ Key: Inspection Other AIM Accessible/Mouthable CAP DeleadirCapped CWV Cov w/Vinyl M.Lomprehensive Inspection (/ ) CAP Capped COV Covered CWA Cov w/Aluminum COV Covered DIP Dipped Comments: INT Intact ENC Encapsulated L Loose MI Made Intal C. t i,�. _�'� S_ �.o ` r. ►� o.�, r '•', •1.:: /. M/I Moveable/Impacted PRE Prepared MET Metal REM Removed NA Not Accessible REP Replaced NC No Coating REV Reversed NEG Negative SCR Scraped POS Positive VR Vinyl Replacement VR Vinyl Replacement FI r# C Floor# 2 C I i _.....:_._. «..}......._i..w........_w ««_...................... w i w.._..Tw.w• ...... . .«...lw... •w....y'.......I.........1........�..»..wf ! ........ ........ 3 i : ..'.....}...w.«...»._:»..«...•e....«.iw.... .w....:..•.•••..1«.......;..._....}........}»w_...... w._! .».:......... .».i... .« • ._i._. .. ....... ...._.» ..,...w ..y'.......I....••...1..._...w«w.w.}.w« i .w.wi..... i t • • .« • •.t ! i _...»» ....w f D B } j i �• D : ! i is .......•.........;w......:.»...... .e.._._;.w». ...w_.„......«o........p......».}......w�. ................ ii ... .. ._y..._._. » ........ . . ..................... ......... ...»..........«!..................i..»...w_. »...... I.........i....w.......»..........!.........i.. .. -'.. .......... ! } : } i } i . : }..w .f..w ! i t A(Street Side) A(Street Side) Pb(lead) equal to or greater than 1.0 mg/cm2 with x-ray fluorescence or positive with Na2S is Dangerous. INSP. DATE Lead Hazards? 01511 4 15' R/ ((grN) Inspector (pri Signature Lic.# R.A. DATE Urgent Lead Hazards? (YorN) Risk Assessor(print) Signature Lic.# Panther Lead Paint Inspection, 969 Washington St.Braintree,MA 02184- (781) 849-7313 4 ' LEAD INSPECTION/RISK ASSESSMENT HISTORY PAGE Page 2- of Al. /9hULis Property Address Apt# City Zip INSPECTION ACTIVITY KEY EXAMPLE BOX 1.Re-Inspection 8.Full Deleading Compliance 15.Maintained Interim Control 2.Re-Occupancy Re-Inspection 9.Post Compliance Assessment Determination 16.Restored Interim Control 3.Work In Progress 10.Maintained Compliance 1 Inspection Activity Number 4.Dust Taken 11.Restored Compliance 5.Dust Received 12.Interim Control P Pass or Fail P=Pass 6.Soil Taken 13.Recertification of Interim Control F=Fail 7.Soil Received 14.Post Compliance Assessment of Interim Control Inspector Inspector Lie# Lie# Inspector Inspector T�T Lie# Lie# Inspector Inspector Lie# TT Lie# Inspector Inspector Lic# Lie# Inspector Inspector Lie# TT Lie-# Inspector Inspector TTT Lic# TT . Lic,# Inspector Inspector Lie# Lie# DATES COMMENTS ,� Panther Lead Paint Inspection,969 Washington St.Braintree,MA 02184-(781) 849-7313 EXPLANATION OF LEAD INSPECTION]RISK ASSESSMENT REPORT FORM COLUMNS This,page provides general information needed to understand the lead..in assessment report:However,you.should speak with the inspector/risk assessorbefore youstart to.do any:work on your home:. SIDE Refers to A,B,C. or D side of the building or room.See the diagram onahe cover sheet.^The"A"side of the building or ioom.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:th6"W'side move clockwise:tt the'S side on your left,ae."C side opposite you;and the':"D"side to the:nght. 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;p eces of wood(one on each'.wall),but is stilf 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 analvzer.:A number(or average number)`equal to or,greater than l 0,ing/cm2 isA dangerous level-of4dad • A``pos"or"neg"shows that the sur ce was tested with sodium sulfide "Pos"means that there is a dangerous. level of lead. • 'Wik meansahat the inspector was notable to tesi.the surface Unless the owner can get a;sample to test Ahe inspector musf assume ik surface contains lead and require it to be deleaded,if necessary • r "Metal"means that a metal surface was not:tested and only needs to be intact However,metal handrails,:metal Window'sills;and metal railing caps,:need;to be deleaded if they are equal to.or greater than 10 ing/cm2 "p0s;".. or is.N/A TYPE OF Not all lead paint must be deleaded This column-tells you IF and WHY.a surface needs deleading Th6�(eleadifig IAZARD standards below may not apply for Interim Controls:`Speak to.your risk.assessor for more,information.• • 1GI/I"circled..means.tt at the surface is a mbv6ible/impa�cted surface-and must be deieaded in its entirety. "A/M".circled,means.that the`surface is"accessible mouthable".and must be deleaded to a minimum of:EVc feet high,four inches in.from&,edge or:corner, •` L circled means that the surface is noose and must;`at minimum,-1 emade intact. •:' If more than one choice is circled,the rules for deleading may change depending upon what; of deleading you choose.:Speak_to the inspector for more information. • "N/A":means- he inspector was unable todetenmine if the surface was loose or intact Th6 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 or,marked',Wlk then itis likely.tlte surface does not need deleading Speak_to.the inspector.for more..information URG<1-W? This column is only completed during a risk assessment A risk assessment is an_evaluation of,.a,home's suitability, for Intenm.Controls Only;a l►censed rask assessor can do a risk assessment,not all:nspeclots are risk assessors. it"Y"is circled,then surface is considered an"Jrgent Lead Haiard"and some.type of deleading work is required.to`qualify`for Lntenm Control IC DATE The:date'the licensed risk assessor'determines the'.surface meets the standards fot..`Intenui.Control , 1CMETH.'_ The deleading method or structural repair done to..quahfy'the surface for Intenm Control:Refer to the deleading codes key on the cover.page DELEAD Tlie date that the lead inspector orisk assessor reinspects the surface and finds that st has been successfully deleaded DATE , for,full compiiance: DEL". The;deleading method used to bri g a surface into:�full compliance Referto deleading codes m.the Key:on the cover METH page of the inspection report.. EXCLUDED The amount of loose paint on a surface as nieasured by the lead inspector:"N/A"means that the.inspector was not . SURFACES: able:to measure the loose..paint,but has determined it is moreahan the cut=off for moderate'risk•making intact Surfaces listed here can only be made intactby a licensed deleadei•. -Note:there are'still other:.low and moderate-risk deleading.activessuch as covering,that:may be done by someone who as not a licensed deleader. SOIL TEST This information is.found on the exterior pages If your property receives certain federal funding,soil testing may be RESULTS required.There is also a space for the risk,assessor:to indicate amount of:bare soil;laboratoryresults,m ethod of : remediation;and,the date of.remediation .Check with your funding agency for more information:: Panther Lead Paint Inspection,969•Washington SC.Braintree;MA:02184-,(78i)184977313 Page_Of. 6 Inspector (printy Lic# Signature Date Risk Assessor (print) Lic# Signature Date Address of Property 3 )o 5 Apt# City EXTERIOR SIDE LOCATIO TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD A SURF7E7 HAZARD HAZ? DATE METH DATE METH A SURFACE HAZARD HAZ DATE METH DATE METH Siding 'V' L N/A Y Window Sill AIM L N/ Y Comer Bo rds ct'f( L N/A Y A Win Casing N/A Y A Lewer-Trim L WA Y Window Sash AIM L WA Y' Upper Trim. Ne L 6 Y 1 ;-.i- Window Sill AIM`L NIA , Y Win Abcwe5' L WA . Y A' Win Cas AIM L NIA Y . Porch4dove b' L WA Y endow Sash AIM L NIA Storm Door AMI L N/A Y . Cellar WMn'Sill. , N/A Y Door G U AIM L WA Y_ A Cel Win Sash. AIM L NIA Y Al Door Casing <.I AIM L WA Y Cel Win Frame AIM L WA Y Door Jamb L 1 AIM L WA Y : Cellar WjaSill AIM L NIA Y Threshold ` A/M L N/A Y A in Sash AIM L WA Y Kickplate ,C4 AIM L WA Y %Cel Win Fram A Y: Storm Door N c AIM L WA Y Cellar Win Sill AIM L WA Y Door c AIM L WA Y 'A Cel Win Sas A/M L N/A Y. A2 Door Casing "` AIM L N/A Y 9910m Fra AIM L WA. Y Door Jamb v'I AIM L N/A Y Cellar Win Sill N/– AIM .L WA Y Threshold Al AIM L N/A Y A Cel Win Sash Aj AMM L N/A Y Kickplate r-e..7 AIM L N/A Y Cel Win Frame tv y AIM L WA Y Door AIM L WA Foundation /✓G L WA Y A Door Casing A/M L. A Y A 9utkhead- A/M L WA Y Door Jamb M L N/A Y FviciS— I AIM L WA Y Threshold AIM L NIA Y Sleffs AIM L NIA Y Door AIM L N/A Y ost AN L WA Y A Door C0619, AIM L WA Y R ' ep AIM L NIA Y D Jamb AIM L N/A YHaudm#— AIM L WA Y Threshold AIM L WA Y A B rs AN L.N/A Y Window Sill o AIM L NIA Y Lower. AIM L NIA Y A Win Casing AIM L WA Y Treads !^ L AIM L WA Y Z Window Sash V7Z I A/M L WA Y Risers a a. AIM L NIA " Y Window Sill 1--A/M L N/A Y Stringer AIM L N/A Y A Win Casin AN L N/A Y Floor N AIM L NIA Y W' w Sash AIM L N/A Y Leypl m AIM L N/A Y COMMENTS/STRUCTURAL DEFECTS: Latt'ee AIM L NIA Y A . .Ceium>� AIM L WA Y 999 A/M L N/A Y Joie AIM L WA 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/1200Porn for bare soil SIDE LOCATION MEASURE:LOOSE PAINT IC IC LOCATION AREA MEASUREMENT RESULJ REMED REMED A MORE THAN 1440 SQ.IN. DATE METHPPM S uare Feet (PPM) DATE METH A Play Area A Bare soil A Comments: A Panther Lead Paint Inspection,969 Washington St.Braintree,MA 02184-(781)-849-730 r � Page_Of l Inspector (print)v Lic# Signat(ire Date . Risk Assessor (print) Lic# Signature Date / Address of Property ��fl��r uc Apt# city /V —)Over- EXTERIOR SIDE LOCATION/ LE TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD B SURFACE HAZARD HAZ? DATE METH DATE I METH B SURFACE HAZARD AZ? DATE METH DATE METH Siding L WA Y Window Sill N/A Y Comer B ards y: L N/A Y B Win Casing A/M L N/A Y B L N/A Y Window.Sash. AIM L WA Y Upper Trim Ain L Y .`nF Window Si AIM L N/A Y [Win Above 5' .1. L NIA Y B Win sing A/M L N/A Y h AboVt;5' L N/A Y mdow Sash AIM L N/A Y Storm Door AIM L WA Y Cellar Win S a N/A Y Door AIM L N/A Y B Cel Win S h 75- GI/WA Y B Door Casing AIM L WA Y Cel Win Fr g5. Cyn w Door Jamb AIM L Y Cellar Win Sill. AI WA Y Threshold N/A Y B Cel Win Sash AIM L N/A Y Kickplate AIM L N/A Y Cel Win Frame AN L WA Y Storm Door 'AIM L WA Y Cellar W' ill AIM LEA Y Door AIM L N/A Y rCe n Sash L WA Y B Door Ca ' g AIM L WA Y n Fram AIM L N/A Y DoqV,famb AIM L N/A Y Cellar Win Si AIM L WA Y reshold AIM L N/AY B Cel ash AIM L WA Y Kickplate AIM L>W Y el Win Fram A/M L WA Y Door AjeL N/A Y Foundation W 4, L N/A Y B Door Casing A/M L NIA Y B Bulkhead AIM 'L WA Y Door Jamb AIM L WA Y AIM L WA Y Threshold A/M L NIA Y Shutter§-- AIM L WA Y Door AIM L NIA Y Newel post AIM L N/A B Doo sing A/M L NIA Y Railing Cap AIM 1e<1A Y or Jamb A/M L NIA Y Handrail L NIA Y Threshold AIM L WA Y B Balusters AIM L N/A Y . Window Sill AIM L N/A Y Lower Rail AIM L NIA Y B Win Casing A/M L WA Y Treads AIM L N/A Y Window Sash AIM L WA Y Ri AIM L NIA Y Window A/M L N/A Y tringer A/M L NIA B Win asing AIM L WA Y Floor A/M A Y. indow Sash AIM L N/AY Low Trim L N/A Y COMMENTS/STRUCTURAL DEFECTS: Lattice AIM L WA Y B Column AIM L N/A . Y Ce... g AIM L N/A Y Joists 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 plaV area/1200 ppm for bare soil SIDE LOCATION MEASURE:LOOSE PAINT IC IC LOCATION AREA MEASUREMENT RESULI REMED REMED B MORE THAN 1440 SQ.IN. DATE METH (Square Feet (PPM) DATE METH B Play Area B Bare soil B Comments: B Panther Lead Paint Inspection,969 Washington St.Braintree,MA 02184-(781)849-7313 Page_Of Inspector (print) `� Lic# Signa ure bate' Risk Assessor (print) LIc# Signature Date Address of PropertyApt# City '���` ✓E! EXTERIOR SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD C SURFACE HAZARD HAZ? DATE METH DATE METH C SURFACE HAZARD HAZ? .DATE METH DATE METH Siding �f,� IL N/A Y Window Sill AIM L N/A Y Comer B8ards 2.2- IL N/A Y C Win Casing AIM Y C Lowe IL N/A Y Window Sash L WA Y Upper Trim V6 I L tgA Y in), Window Sill AIM L N/A Y Win Above 5' evA I L Y .{- C Win g AIM L WA Y Poreq-Atr6�5' I L WA Y ndow Sash AIM L WA oor AIM L N/A Y Cellar Win Sill AIM7LN TI� WA Y C Cel-Win Sash Y C f Door Casing ' 2 AIM LNIA Y Cel Win Fram AIM Y Door Jamb r.,i, AIM L WA Y Uri fr 1el ellar Win ' . AIM L NIA Y, Threshold I/(, AIM L N/A Y �`. ` el Sash AIM L NIA Y Kkjoate— AIM L WA Y Win Frame AN L NIA Storm Door v,c AIM L WA Y Cellar Win Sill A1M..I,,WA Y. Door G. AIM L WA Y C Cel Win Sash L WA Y CY Door Casing -L AIM L N/A Y Cel Win Frame AMI L NIA Y Door Jamb o AIM L WA Y Cellar Win . AMI L NIA Y Threshold C, AIM L WA Y C Celyh'rSash AIM L'WA Y Kickplate t. u AIM L N/A Y el Win Fram AIM L.NIA Y Door i AIM L N/A Y Foundation lit- I L N/A Y C Door Casing 4 u A/M L N/A Y C BaHC elf ad AIM L NIA Y Door Jamb r AIM L N/A Y . Fences'^ AIM L NIA Y Threshold L WA Y ShuHer' AIM L WA Y, . Door AIM L WA Y Newel.post 4,1 1AIM L N/A ' Y C Door Casing AIM L WA Y Railing Cap AIM L NIA Y Door b AIM L N/A Y Handrail G G AIM L WA .Y reshold AIM L VA Y . C Balusters c a AN L,WA Y Window Sill L N/A Y Lower Rail C, L AMM L WA Y C Win Casing AMI L N/A Y Treads U• L' AIM L N/A Y Window Sash AIM L N/A Y Ris AIM L WA Y Window Sill AIM L WA Y Stringer C-0. A/M L NIA Y C 'WinWing AMM L NIA Y Floor r. A/M L N/A .Y ndow Sash AIM L WA -Y Low Trim c,L A/M LNIA Y 016MMENTS/STRUCTURAL DEFECTS: Lattiee^ AIM L N/A Y C Columns % AIM L WA Y Geili+�g"�" AIM L N/A Y 77-1 Jois AIM L.NIAll 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/1200oom for bare soil SIDE LOCATION MEASURE:LOOSE PAINT IC IC LOCATION AREA MEASUREMENT RESUL1 REMED REMED C MORE THAN 1440 SQ.IN. DATE METH S uare Feet (PPM) l DATE METH C Play Area C Bare soil C Comments: C Panther Lead Paint Inspection,969 Washington St.Braintree,MA 02184-(781) 849-7313 r Jr 36�' Page Of Inspector (print)` Lic# Signature bate` Risk Assessor (print) �^ Lid Signature Date Address of Property 3 C� At p t, Apt# City EXTERIOR SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF �RG IC IC DELEAD DELEAD D SURFACE HAZARD HAZ? DATE METH DATE METH D SURFACE HAZARD H DATE METH DATE METH Siding y L NIA Y Window Sill AIM Y Comer Boa s �, L N/A Y D Win Casing M L WA Y D L N/A Y lWindow Sash AIM L N/A Y Upper Trim VA, L NQ Y Window SV AIM L N/A Y Win Above 5' N/k L 44J Y D Win sing A/M L NIA Y PQx4,Abm 5' L NIA Y indow Sash AIM L N/A Y Storm Door AIM L NIA Y Cellar Win Sill AIM PK Y Door AIM L N/A YZL D Cel Win Sash L NIA Y D Door Casing AIM L NIA lCel Win Frame AIM L N/A Y Door Jamb A/M L NjK Y Cellar Win Sil AIM L WA Y Threshold A04ZINIA Y D Cel Wi ash AIM L N/A Y Kickplate L N/A Y in Fram AIM L N/A Storm Door AIML WA Y Cellar Win Sill iv c AIMJACA Y Door AIM L N/A Y D Cel Win Sash L M L WA Y D Door Casing A/M L WA Y Cel Win Fra n. A/M L N/A Y Door Ja AMI L WA Y Cellar Win Cel A/M L N/A Y Thre old A/M L WA Y D ash el Win Fram AIM L N/A Y ckplate AIM L N/A AIM L N/A Y _ Door A/M A Y Foundation �/ L N/A Y D Door Casing L N/A Y D Bulkhead 0. L AIM L'N/A Y Door Jamb A/M L N/A Y Feaees"` A/M L WA Y Threshold AIM L WA Y Sh ers AIM L WA Y Door AIM L WA Y Newel post. G Z AIM L WA Y D Door C&94 I AIM L WA Y Railing Cap G-p AMI L WA Y Door mb AIM A Y Handrail AIM L WA Y T eshold M L WA Y D Belaews– AIM L WA Y Window Sill AIM L WA Y Lower Rail e.( AIM L WA Y D Win Casing AIM L WA Y Treads a. L AIM L WA Y Window Sas AIM L WA Y a—"--- AIM L WA Y Window dl A/M L WA Y Stringer G O AIM L WA Y D Wigeasing A/M L N/A Y Floor c ( AIM L WA Y indow Sash AIM L WA Y Low-T� AIM L WA Y COMMENTS/STRUCTURAL DEFECTS: Lattkv AIM L WA Y D Columns A(M L WA Y Ceftj— AMI L WA Y Joist&" AIM L WA 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/1200ppm for bare soil SIDE LOCATION MEASURE:LOOSE PAINT IC IC LOCATION AREA MEASUREMENT RESULT REMED REMED D (MORE THAN 1440 SO.IN.) DATE METH S ware Feet I (PPM) DATE METH D Play Area D Bare soil D Comments: D Panther Lead Paint Inspection,969 Washington St.Braintree,MA 02184-(781) 849-7313 R M 13 4/0 Y16 Page U Of k Inspector(print) Lic# Signa rel Date` Risk Assessor(print) Lic# Signature Date Address of Property 3 Apt# Cityr SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ?, DATE METH DATE METH A B Up Walls 6•L AIM L N/A Y Window Sill y M/I AIM L N/A Y XLLA B r r) LorWaalfs A/M L WA Y Win.Apron c, AIM L N/A Y A B SLL Baseboards G 1 AN L N/A Y Win Casing c ( AIM L N/A Y A B C1 waL,l4— AIM L WA Y ' Header Stop G M/I AIM L WA Y ILCU,itcy AIM L WA Y Int Stops M/I AIM L N/A Y Floor ( AIM L WA Y Win Int Sash c.r M/I AIM L WA Y Ceiling AMI L WA Y Exterior Sill c•t M/I L N/A Y Door I AIM L N/A Y ,, r.`, Part Bead E M/I L WA Y Door Casing �, A/M L N/A Y Blind Stop MII L WA Y Door Jamb c,L AIM L WA Y k'' Win Ext Sas c•t. M/I L NIA Y Threshold v AIM L N/A Y Window Sill MA AIM L N/A Y Door AIM L NIA Y Win Apron A/M L WA Y DooW.asinr AIM L N/A Y Win Casing AIM L Y Door Jamb c. AIM L N/A Y UX Header Stop M/I A/ WA Y Thre AIM L WA Y Int Stops W AIM L WA Y Door A/M L WA Y Win Int Sash M/I AIM L WA Y Door Casing AIM LW Y Exterior Sill M/I L WA Y Door Jamb L WA Y Part Be M/I L N/A Y Threshold AIM L WA Y Bli Stop M/I L WA Y Door AIM L WA Y Win Ext Sash M/I L WA Y Doo asing AIM L WA Y Closet Door AIM L WA Y oor Jamb AIM L WA Y Cl g2si� AIM L WA Y Threshold AIM L WA Y ClosaWamb-- AIM L WA Y Window Sill M/I AIM L WA Y Closet Walls c-tr AIM L WA Y Win Apronel- AIM L WA Y G Cl Baseboard AIM L WA Y Win Casing c, t A/M L WA Y Closet Pole AAM L NIA Y Header Stop Z M/I A/M L N/A Y Closet Shelf Al A/M L WA Y 6� Int Stops o�d M/I AIM L N/A Y CI Supports All, AIM L NIA Y € Win Int Sash y/Z M/I AIM L NIA ' Y Closet Floor 2 AIM L WA Y Exterior Sill t/2 M/I L WA Y Closet Ceiling- AIM L N/A Y Part Bead Vz M/I L WA Y Cabinet Frame ___AIM L WA Y Blind Stop M/1 L WA Y Cab ers AIM L N/A Y Win Ext Sash M/I L WA Y M/I AIM L N/A Y COMMENTS/STRUCTURAL DEFECTS: Mantle A/M L WA Y eplace AIM L N/A Y M/I AIM L N/A Y M/I AIM L WA Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact only b a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IC IC MORE THAN 288 SQ.IN. DATE METHOD (MORE THAN 288 SQ.IN.) DATE METHOD Panther Lead Paint Inspection,969 Washington St. Braintree,MA 02184- (781) 849-7313 R ; P • f G S Page_Of/1� Inspector(print) Lic# Signature" bate Risk Assessor(print) Lic# Signature Date AddresAofProperty 'v� Uh ��^ Apt# City SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ?j DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH A B Up Walls C- AIM L WA Y Window Sill t M/I A/M L N/A Y A B s AIM L N/A Y Win Apron c• AIM L N/A Y A B Baseboards — `j AIM L N/A Y Win Casing r L A/M L NIA Y A e mai_I_._ A/M L WA Y Header Stop c-v M/I A/M L N/A Y R AIM L N/A Y Int Stops M/I AIM L N/A Y Floor V AIM L WA Y Win Int Sash VA- M/I AIM L N/A Y Ceiling 1 AIM L WA Y Exterior Sill V/Z M/I L WA Y Door IV AIM L N/A Y Part Bead ( 0- MII L NIA Y ADoor Casing-^^c.L AIM L WA Y Blind Stop v/2 M/I L WA Y 4 DoorJamb..- c, J AIM L N/A Y ( P6 Win Ext Sash V/L M/I L N/A Y Thi AN L N/A Y Window Sill M/I PJM L N/A Y Door AIM L N/A Y Win Apron AIM L N/A L Door Casing &J AIM L N/A Y / r Win Casing AIM A Y Door Jamb c•( AIM L WA Y ` ` Header Stop M/I NML WA Y Thres"Mr AIM L N/A Y Int Stops Wr A/M L WA Y Door A/M L WA Y Win Int Sash M/I AIM L WA Y Door Casing A/M L N/ Exterior Sill WI L WA Y Door Jamb A/ N/A Y Part B M/I L"N/A Y Threshold AIM L WA Y BIirdStop M/I L WA Y Door AIM L N/A Y Win Ext Sash M/I L NIA Y Door Cap AIM L WA Y Closet Door A/�. AIM L N/A Y Do amb AIM L WA Y Cl Casing c-t AIM L N/A Y hreshold AMI L WA Y Closet Jamb U AIM L NIA Y Window Sill �. I AMI L N/A Y �` Closet Walls ( AMI L WA Y Win Apron cF p AIM L NIA Y 1� Cl Baseboard o L A/M L WA Y Win Casing G.1 AIM L N/A Y Closet Pole µ/& AIM L N/A Y Header Stop c^L M/I AIM L N/A Y Closet Shelf tv c AIM L NIA Y (? Int Stops u Mn PJM L WA Y Cl Supports N L AIM L N/A Y i� Win Int SashPL' MA AIM L N/A Y Closet Floor to L AIM L WA Y Exterior Sill V2 M/I L WA Y Closet Ceiling c s AIM L NIA Y Part Bead VA M/1 L WA Y Cabinet Fram c y) AIM L WA Y Blind Stop V/Z M/I L N/A Y Cab DrawerG' A/M L WA Y Win Ext Sash V/Z M/1 L NIA Y � c(�r1 d 2 M/I AIM L N/A Y COMMENTS/STRUCTURAL DEFECTS: Mantle AAAI L N/A Y F' ace AMI L N/A Y M/1 AIM L WA Y M/I AIM L N/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact onl by a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IC IC MORE THAN 288 SQ.IN. DATE METHOD (MORE THAN 288 SQ,IN.) DATE METHOD Panther Lead Paint Inspection, 969 Washington St. Braintree,MA 02184- (781) 849-7313 K . n r, fi /07— Inspector(print) Lic# Signature Date Risk Assessor(print) Lic# Signature Date Address of Property 3 "e`+UUh '5t-• Apt# City ` '41- v V er SIDE ,LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/: LEAD : TYPE OF URG IC IC DEL D DELEAD SURFACE . HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ? DATE MET DATE METH A BSLL Up Walls c•L AIM L N/A Y Window Sill M/I A/M L NIA Y A8 r Low Walls t.J A/M L N/A Y Win Apron AIM LWA Y A e Baseboards ( AIM L N/A Y' Win Casing AIM L V Y A B A/M L WA Y Header Stop M/I L WA Y Refttor AIM L N/A Y Int Stops AIM L WA Y Floor ` i> AIM L N/A Y Win Int Sash 7Z M/I A/M L WA Y Ceiling e L AIM'L WA Y Exterior Sill MII L NIA Y Door G t AIM L N/A Y Part Be M/1 L WA Y Door Casing c t AIM L'WA Y Bli dStop M/I L N/A Y . Door Jamb AIM L N/A Y Win Ext Sash M/I L WA Y Threshold c I . AN L N/A Y Closet Door AN L WA Y Door AIM L Y Cl Caning A/M :L N/A Door Casing L N/A Y Closet Jamb AMI L Y Door Jamb AIM L N/A Y Closet Walls Pf L WA Y Threshold AIM L N/A Y Cl Baseboard A/M L WA Y Door z A/M L NIA Y Closet Pole AIM L N/A Y D99KCasing A/M L N/A' Y Closet Sh AIM L WA Y oor Jamb A/M L N/A Y Cl sql5orts AIM L NIA. Y Threshold AIM L WA Y 9115set Floor AIM L NIA Y Door AIM L WA Y Closet Ceiling AN L WA Y Door C g . AIM L N/A Y Up Cab Frame a 0 AIM L WA Y r Jamb AIM L N/A Y Cab Door -t AIM L WA Y Threshold AIM L WA Y Up Cab Wall `-T- AIM L NIA Y Window Sill [•L Mn AIM L WA Y Up Cab Shlvs < <U AIM L N/A Y Win Apron k. AMI L N/A Y Supports f AMI L N/A Y Win Casing r I AIM L N/A Y Low Cab Fram r, AIM L.WA Y Header Stop r-j W AIM L WA Y Cab Door c j AIM L NIA Y Int Stops c-ioj MA AIM L WA Y r Low Cab Wall .o AIM L NIA Y Win Int Sash c.I W A/M L WA Y Low Cab ShIvi AIM L WAY Exterior Sill L M/I L WA Y Supports CL A/M L WA Y Part Bead ��.� MA L WA Y Drawers c.d AIM L NIA Y Blind Stop c w M/I L WA Y M/I AIM L N/A Y Win Ext Sash L Mll L N/A Y M/I AIM L N/A Y COMMENTS/STRUCTURAL DEFECTS: M/I AIM L WA Y M/I AIM L WA Y M/I AIM -L NIA Y M/1 AIM L WA Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact onlyb a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IC IC MORE THAN 288 SQ.IN.) DATE METHOD MORE THAN 288 SQ.IN: DATE METHOD 4 Panther Lead Paint Inspection,969 Washington St.Braintree,MA 02184- (781) 849-7313 5//V/0 T page ! ( Of t� Inspector(print) v Lic# Signa ure Date Risk Assessor(print) Lic# Signature Date Address of Property 3 (� �c.6JG'� Apt# City A/• ed)rav��- STAIRCASE ( TO I (5 L/v J/1 14 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 HAZ?' DATE METH DATE METH A B Up Walls 6..() AIM L WA Y Closet Door AIM L N/A Y A B Lo>;�Ialls�" AIM L N/A Y Cl Casing AIM L N/A Y A e Base AIM L WA Y Closet Jamb AIM L N/ Y A e 'r Rail G: I A/M L N/A Y M vU • Closet Walls N/A Y AIM L N/A Y Cl Baseboard ZAIM L N/A Y Floor �.,, A/M L N/A Y Closet Pole A/M L WA Y Ceiling 10AC AIM L NIA Y Closet She AMI L N/A Y Door All,41, AIM L N/A Y CI Su orts AIM L NIA Y Wing v A/M L N/A Y set Floor AIM L WA Y Door Jamb y AIM L N/A Y Closet Ceiling A(M L N/A Y TAMSMItF- AIM L N/A Y NeweF•PM AIM L N/A Y Door H, AIM L N/A Y BaiWvft AIM L NIA Y Door Casing 6 L WA Y ;'L� Handrail NL AIM L N/A Y Dow Jamb- AIM L NIA Y )< �� Beles1 s AIM L N/A Y Thres AIM L N/A Low AIM L N/A Y Door AIM L N/A Y Treads lv U AIM L N/A Y Door Casing A/M L WA Risers N L A/M L WA Y Door Jamb A Y St bgej AIM L N/A Threshold AIM L N/A Y Door NIA Y Door AIM L N/A Y Door Casing AIM L NIA Y Door Caor AIM L N/A Y Doo AIM L NIA Y Do amb AIM L WA Y hreshold A/M L WA Y hreshold N/A Y FI mg AIM L WA Y Door AIM L N/A Y osing AMI L WA Y rg Door Casing AMI L WA Y asing AIM L N/A Y �reshold or J AIM L N/A Y C�(v n,n Z M/1 AIM L N/A Y AIM L N/A Y WI; A/M L N/A Y Window Sill M/1 AIM L N/A Y M/I AIM L N/A Y Win Apron AIM L N/A Y M/I AIM L NIA Y Win Casing A/M L N/A Y M/1 A/M L WA Y Header Stop M/I A/M L N/A Y IMA A/M L N/A Y Int Stops M/I AIM L N/A Y COMMENTS/STRUCTURAL DEFECTS: Win Int Sash M/I AIM L N/A Y Exterior Sill M/I L WA Y ` Part Bead M/I L N/A Y Blind Stop M/I L N/A Y Win Ext Sash I M/1 L WA Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact only by a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IC IC MORE THAN 288 SQ.IN. DATE METHOD (MORE THAN 288 SQ.IN,) DATE METHOD Panther Lead Paint Inspection,969 Washington St.Braintree,MA 02184-(781) 849-7313 Pagl Z-Of Inspector(print) Lic# Signature bate Risk Assessor(print) Lic t# Signature Date Address of Proert 3 r,/,-�� �J�,� �. Apt# City - UL - STAIRCASE 2 SIDEJLOCATION/ LEADI TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH A e Up Walls AIM L N/A Y Closet Door AIM L N/A Y A B l,p�y yyg A/M L WA Y Cl Casing AIM L N/A Y A BBaseboards �f• I AIM L WA Y Closet Jamb AIM L N/ Y A r3 ail A/M L N/A Y Closet Walls NIA Y 2adWe'l AIM L N/A Y Cl Baseboard AIM L NIA Y Floor `✓ AIM L N/A Y Closet Pole AIM L N/A Y Ceiling 62, AIM L WA Y Closet Shelf AIM L WA Y Door G. U AIM L N/A Y CI Sup rts AIM L N/A Y Door Casing c<L AN L N/A Y set Floor AIM L WA Y /�I Door Jamb L•o AIM L WA Y Closet Ceiling AIM L N/A Y Threshold r AIM L N/A Y Newel Post AIM L WA Y Door z- AIM L N/A Y Railing Cap c, AIM L NIA Y Door Casing" to AIM L N/A Y Handrail G ( AIM L WA Y Door Jamb c L AIM L WA Y Balusters G AIM L N/A Y Threshold 1.Lr AIM L N/A Y Low AIM L N/A Y Door I AIM L N/A Y Treads C'L) AIM L N/A Y Door Casing .i AIM L WA Y Risers 2 A/M L N/A Y I Door Jamb �• AIM L N/A Y Stringer AIM LqN/A Y Threshold c AIM L N/A Y Door L Y Door AIM L N/A Y Door Casing AIM L NIA Y Door Casing •o AIM L N/A Y Door J A/M L WA Y Door Jamb i. AIM L N/A Yrashold AIM L N/A Y Threshold C-/ AIM L N/A Y Floor Casing AIM L WA Y Door AIM L N/A Y Floor sing AIM L N/A Y Door Casi AIM L N/A Y Wall Casing AIM L WA Y Do9p6mb AIM L N/A Y M/l AIM L N/Al Y hreshold AIM L NIA Y M/1 AIM L N/A. Y Window Sill M/I A/M L WA Y M/I AIM L N/A Y Win Apron AIM L N/A W AIM L N/A Y Win Casing AIM A Y M/I A/M L WA Y Header Stop M/I XM L N/A Y I IM/I AIM L N/Al Y Int Stops /I AIM L N/A Y COMMENTS/STRUCTURAL DEFECTS: Win Int Sash M/I AIM N/A Y ltJ-I15 "'C q,Ci sp At- Exterior tExterior Si M/I L N/A Y Sv �,� Y Part d M/1 L N/A Y d Stop M/I L N/A Y Win Ext Sash M/I L N/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact onl b a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IC IC (MORE THAN 288 SQ.IN.) DATE METHOD (MORE THAN 288 SQ.IN.) DATE METHOD M ` Panther Lead Paint Inspection, 969 Washington St.Braintree,MA 02184-(781) 849-7313 R Page 13 Of Inspector(print) V Lic# Sign ure ate _ 'Risk Assessor(print) // Lic If Si nature Date Address f Property (``'nom�G�t Apt# City ' X d 0)v1?r CSG Pr- SIDEJ .LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDEJ LOCATION I LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ?j DATE METH DA3E METH A B Up Walls C.p A/M L N/A Y Window Sill M/I AIM L N/A Y A B Lew.W5r1s-, A/M L N/A Y Win Apron AIM L WA Y A B Baseboards AIM L N/A Y Win Casing AIM L WA Y IK A B A/M L N/A Y Header Stop M/I A/M L Y Radiator✓ AIM L N/A Y Int Stops M/I A,/ L WA Y Floor AIM L WA Y Win Int SashAIM L WA Y Ceiling A/M L N/A Y Exterior Sill M/I L N/A Y Door c v AIM L WA Y Part Bead M/I L N/A Y Door Casing G'2 AIM L N/A Y Blind op M/I L WA Y Door Jamb AIM L N/A Y Win Ext Sash Mil L N/A Y Threshold «— AIM L N/A Y Window Sill M/I AIM L WA Y Door AIM L Y Win Apron AIM L N/A Y Door Casing N/A Y Win Casing AIM L N/ Y Door Jamb AIM L N/A Y Header StopIM/1 AIM N/A Y Threshold AIM L N/A Y Int Stops M/I L N/A Y Door AIM L WA Y Win Int Sash M/I AIM L WA Y Door sing AIM L N/A Y Exterior Sill M/1 L WA Y or Jamb AIM Y Part Be M/I L WA Y Threshold L N/A Y Bli Stop M/I L WA Y Door AIM L NIA Y Win Ext Sash M/I L WA Y Door Casi AIM L N/A Y Closet Door A/M L NIA Doo mb AIM L WA Y Cl Casing A/M L Y hreshold A/M L WA Y Closet JambL WA Y Window Sill M/I AIM L WA Y Closet Walls AIM L N/A Y Win Apron AIM L WA >11 CI Baseboard AIM L WA Y Win Casing AIM L 0 Y Closet Pole AIM L WA Y Header Stop M/I L WA Y Close elf AIM L N/A Y Int Stops AIM L N/A Y C upports AIM L N/A Y Win Int Sash W AIM L N/A Y Closet Floor AIM L N/A Y Exterior Sill M/I L N/A Y I Closet Ceiling, AIM L N/A Y Part Be MII L WA Y Cabi rame AIM L NIA Y �in i top M/I L WA Y ab Drawers AIM L N/A Y Ext Sash M/I L WA Y M/1 AIM L NIA Y C6MMENTS/STRUCTURAL DEFECTS: Ma A/M L N/A Y 5 k j 1.- 4f fireplace AIM L N/Al Y M/I AIM L N/A Y M/I AN L NIA Y 7+71 EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact onl b 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 Panther Lead Paint Inspection, 969 Washington St. Braintree, MA 02184- (781) 849-7313 R Page t Of 40_ Inspector(print) Lie# Signure Date Risk Assessor(print) Lie# Signature Date Address of Property f,i PnUr- Jf Apt# City GLM L1 SIDEJLOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH A B Up Walls �,U AIM L WA Y Window Sill M/I A/M L N/A Y A e Lnw-VdSffs�" A/M L N/A Y Win Apron AIM L WA Y A B Baseboards I AIM L N/A Y Win Casing AIM L N/A A e r - AAN L WA Y Header Stop M/I AIM_JAA Y Radiator"" AIM L N/A Y Int Stops WIXM L N/A Y Floor AIM L N/A Y Win Int Sash I A/M L WA Y Ceiling L A/M L WA Y Exterior Sill WI L NIA Y Door p/1, A/M L N/A YPart Be WI L N/A Y Door Casing c•4. AIM L N/A Y BI Stop WI L WA Y G t Door Jamb 1,o AIM L WA Y in Ext Sash M/1 L N/A Y Thmsbotd— AIM L N/A Y Window Sill M/I AIM L NIA Y Door AAN L NIA Y Win Apron AIM L WA Y L Door Casing c.9 AIM L N/A Y Win Casing A/M L N/ Y Door Jamb c•0 A/M L WA Y Header Stop MA AI NIA Y Threshold AIM L N/A Y Int Stops W AIM L N/A Y Door AIM L WA Y Win Int Sash M/I AIM L WA Y Door Casing AIM LbLW Y Exterior Sill M/I L N/A Y Door Jamb M46 N/A Y Part Bpif M/I L WA Y Threshold A/M L N/A Y B' Stop M/I L NIA Y Door AIM L N/A Y Win Ext Sash M/I L N/A Y Door Casi AIM L WA Y Closet Door /v AIM L WA Y Doopdmb AIM L WA Y Cl Casing 1- AIM L N/A Y reshold AIM L WA Y Closet Jamb �. AIM L WA Y Window Sill G,v MA A/M L WA Y Closet Walls & t AIM L WA Y Win Apron c./ A/M L NIA Y Cl Baseboard- G. A/M L WA Y Win Casing L A/M L N/A Y Closet Pole l f, A/M L NIA Y Header Stop i.,t M/I AIM L N/A Y Closet Shelf A/t, A/M L N/A Y Int Stops AAA A/M L WA Y Cl Supports me A/M L NIA Y Win Int Sash c. D M/I A/M L N/A Y Icloset Floor c nr AIM L WA Y Exterior Sill 1-3 1 WI L WA Y jClosetCeiling c AIM L N/A Y Part Bead C,,V MA L WA Y Cabinet Fw A/M L WA Y Blind Stop MA L NIA Y Lenrawers AIM L N/A Y Win Ext Sash L,f M/1 L NtAI Y M/I AIM L N/A Y COMMENTS/STRUCTURAL DEFECTS: Mantle AtM L N/A Y F' lace AIM L WA Y M/I AIM L WA Y M/I A/M L WA Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact onl b a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IC IC MORE THAN 288 SQ.IN. DATE METHOD (MORE THAN 288 SQ.IN.) DATE METHOD Panther Lead Paint Inspection,969 Washington St. Braintree,MA 02184- (781) 849-7313 K ` ` Page .4Of� Inspector(print) .v Lic# Signature bate Risk Assessor(print) Lic#. IS' nature Date Address of Property J � ''P���ih Apt# City • , err vP�'' 5� SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC 1C DELEAD DELEAD SURFACE HAZARD HAZ? DATE METHDATE METH SURFACE 1 HAZARD HAZ? DATE .M DATE METH A B Up Wells .2' AIM L N/A Y Window Sill M/1 AIM L N/A Y A B LGWAgattg""- AIM L WA Y Win Apron AIM L N/A Y 11 A B BaseboardsSLDL . G• AIM_L N/A Y Win Casing_ AIM L Y A B Qbaaail AIM L N/A Y Header Stop WI L N/A Y R421 ,,--• A/M L N/A . Y Int Stops AIM L wA Y Floor {.(,e AIM L N/A Y Win Int Sash M/I AIM `L-NIA Y Ceiling G•L AMI L WA Y Exterior Sill M/I L N/A Y Door G. ) AIM L N/A Y Part Be M/I L NIA Y Door Casing—G;Z AMI L NIA Y Bli Stop M/I L N/A Y Door Jamb 0 AIM L N/A Y in Ext Sash M/I L N/A Y . Threshold M e i A/M L N/A Y Closet Door A/M L N/A Y Door AIM L WA Y Cl Casing AIM L N/A Door Casing AIM L Y Closet Jamb A/M L Y Door Jamb L NIA Y Closet Walls L N/A Y Threshold AN L NIA Y Cl Baseboard AIM L WA Y Door AIM L N/A Y Closet Pole AIM L N/A Y Door Cao AIM L N/A Y Closet She A/M L WA Y Do amb AIM L N/A Y Cl Su rts AIM L WA Y hreshold A/M Y set Floor AIM L N/A Y Door AIM L WA Y Closet Ceiling AIM L WA Y Door Casing A/M L N/A Y Up Cab Frame a•L AIM L WA Y Door Ja A/M L NIA Y Cab Door �: o. AIM L WA Y . eshold A/M L WA Y ; Up Cab Walls iV� AIM L N/A Y Window Sill M/I AIM L N/A Y Up Cab Shlvs AN u AIM L N/A Y Win Apron A/M L NIA Y u o AMI L N/A Y Win Casing AIM L NIA Y Low Cab Fra ,I AIM L N/A Y Header Stop M/I AIM L N/A Y Cab Door v AIM L WA Y Int Stops M/I AIM L WA Y 5 (� Low Cab Wall c•( AIM L NIA Y Win Int Sash M/I AIM L N/A Y 1�c Lo AMI L N/A Y Exterior Sill M/I L WA Y Supparrs^ AIM L WA Y . Part Bead M/I L NIA Y AIM L N/A Y Blind Stop M/I L NIA Y M/I AIM L N/A Y Win Ext Sash M/I L NIA Y M/I A/M L NIA Y COMMENTS/STRUCTURAL DEFECTS: M/I A/M.L WA Y M/I AIM L WA Y M/I AIM L WA Y M/I AMI L N/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact onl b a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT 1C IC MORE THAN 288 SQ.IN. DATE 'METHOD MORE THAN 288 SQ.IN.1 DATE METHOD i Panther Lead Paint Inspection,969 Washington St.Braintree,MA 02184-(781) 849-7313 R n yr • �/ Y 3 "�'Z- 511611!r !r Page Of Inspector(print) Ll Lic# Signature Date Risk Assessor(print) Lic#/ Signature Date Address of Property J Apt# City / All, SIDEJLOCATION/ LEAD TYPE of URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE . HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH A e Up Walls AIM L NIA Y Window Sill 0. A/M L WA Y A B L s j AIM L N/A Y Win Apron q. L N/A Y A s Baseboards q r, A/M L WA Y j' F A Win Casing L WA Y A B AIM L N/A Y Header Stop AIM L WA Y HadWeF-- A/M L N/A Y Int Stops t& L N/A Y Floor A/M L NIA Y Win Int Sash M/1 AIM L WA Y Ceiling ,.L AIM L N/A Y Exterior Sill I til N/A Y Door a:t AN L N/A Y Part Bead 6,V M/I L WA Y Door Casing G y AIM L N/A Y Blind Stop CSV M/I L WA Y Door Jamb— AIM L N/A Y Win Ext Sash M/I L WA Y Thresh AIM L N/A Y Window Sill MA AIM L N/A 1 Y Door A/M L N/A Y Win Apron AIM L N/A Y Door Casing AIM L NIA Y Win Casing AIM L N/A Door Jamb c.Z AIM L N/A Y ` Header Stop M/I AIM A Y T AIM L NIA Y Int Stops M/l M L NIA Y Door AIM L WA Win Int Sash Mll AIM L WA Y Door Casing AgAWA Y Exterior Sill M/I L WA Y Door Jamb AIM L N/A Y Part Bpd M/I L N/A Y ThresholdA/M L N/A Y B54 Stop M/I L N/A Y Door AMI L N/A Y Win Ext Sash M/1 L N/A Y Door C mg AIM L N/A Y Closet Door E, AIM L N/A Y ?12±Jamb A/M L WA Y Cl Casing . C.7 AIM L WA Y Threshold AIM L WA Y Closet Jamb, c,v AIM L WA Y Window SillL WA Y I Closet Walls p.d AIM L N/Al Y Win Apron 44 N/A Y CI Baseboard a•2 AIM L WA Y Win Casing L N/A Y Closet Pole AIM L WA Y Header Stop y, 10 AIM L NIA Y CIMLShett^ AIM L N/A Y Int Stops q.h 14 MA L WA Y' CI Su AIM L N/A Y Win Int Sash M/I AIM L WA Y Closet Floor AIM L N/A Y Exterior Sill R clto t)N/A Y Closet Ceilin c.2 AIM L NIA Y Part Bead y M/I L N/A Y Cabinet Frame A/M L WA Y Blind Stop M/I L N/A Y C ers A/M L NIA Y Win Ext Sash Ic•y M/I L WA Y IMII A/M L WA Y COMMENTS/STRUCTURAL DEFECTS: Mantle AIM L WA Y t c�,�•�.r�s e "G.L G� A 1,11 c�V�, ,�� � . fireplace A/M L N/Al Y MII A/M L N/Al Y M/I AIM L N/A I Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact onl b a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IC IC (MORE THAN 288 SQ.IN.) DATE METHOD (MORE THAN 288 SQ.IN.) DATE METHOD Panther Lead Paint Inspection,969 Washington St.Braintree,MA 02184-(781) 849-7313 7 l - April 22, 2005 Ralph Cerbone 1 Clarendon Street North Andover, MA 01845 Dear Ralph and Astrid Cerbone, It is with regret that I must write this letter only for the reason that it has come to this considering the"friendly"neighbor/tenant and landlord relationship that we have had. In your own words you have praised us as tenants, saying we"were sent from heaven" because we always pay our rent, are no trouble, take care of the property and are responsible people. My husband has helped you many times per your request with upgrading your dwelling (1 Clarendon Street) and never received compensation for it even though you made promises repeatedly to do so by deducting the rent. That's why it is very emotionally hurtful to us that we believe you have taken advantage our good nature and patience that we have provided you with in the last twelve months. Since, April 2004 we have made repeated requests and complaints to you regarding no screens being in the windows and having no screen doors. You have repeatedly stated to us that you would do so. You have made excuses over and over why it has not been done and at this point, anything less than what is required by law is unacceptable to us. You also requested that we pay a rent increase of$50.00 per month so that you would have the money to make as you stated"upgrades"to the property. By upgrading you indicated to me verbally that you were using the increase to install new screens in the windows and screen doors. These are in fact, NOT"UPGRADES"as you like to call them. They are reguirements prior to anyone Owning a property to rent to any occupant(s) under not only Massachusetts Housing Laws, but Massachusetts Department of Public Health. I would like to note that it is particularly disturbing to us that you have knowledge of these laws or at least the responsibility to know these laws, as both a landlord and licensed real estate agent in the state of Massachusetts. For example, if a tenant falls and breaks his ankle on a broken front door step the landlord will be liable if the tenant can show that: • It was the landlord's responsibility to maintain the steps (this would usually be the case, because the steps are part of the common area, which is the landlord's responsibility). • An accident of this type was foreseeable (falling on a broken step is highly likely). • A repair would have been easy or inexpensive(fixing a broken step is a minor job). • The probable result of a broken step is a serious injury(a fall certainly qualifies). • The landlord failed to take reasonable measures to maintain the steps (this will be easy to prove if the step was broken for weeks, or even days,but less so if the step broke five minutes earlier and showed no previous signs of weakening). • The broken step caused the injury(this is easy to prove if the tenant has a witness to the fall, but might be hard if there are no witnesses and the landlord claims that the tenant really injured himself somewhere else and is attempting to pin the blame on the landlord), and • He is really hurt(in the case of a broken bone,this is easy to establish). As of today, April 22, 2005, I will allow you 14 days to become in compliance with these laws, which I am sincerely hopeful that you do. However, within 14 days of this letter, if you are not compliant with these laws, I will be forced to file a complaint against you for violations under the Massachusetts Department of Public Health code, and if necessary obtain legal counsel and withhold rent until compliance is met, all of which are our rights under the Law. Sincerely, Jodi Polimeno (All laws I am referring to are listed below. In addition to this, I have also copied from this states website your liabilities as a landlord for ignoring warnings and failing to take the necessary precautions to prevent injuries on your property due to your negligence.) I must also notify you at this time that this winter we will no longer be shoveling the stairs or any entrances and exists to the premises as this is your responsibility also under the law in which you violated continuously all during this past winter. If you continue to do this during the next winter season, we are prepared to exercise our rights under the Law. We will also use our rights under the law regarding pest control, such as the ants that you have been spraying for. We were willing to allow you to make reasonable efforts to control the problem yourself. However, it obviously is not working. We are now demanding that you either find another solution n such as using a professional pest Massachusetts Housing Law for Tenants Massachusetts Department of Public Health 410.280 410.551-Screens for windows- The owner shall provide screens for all windows designed to be opened on the first four floors opening directly outside from any dwelling, unit or room provided. That in an owner occupied unit, the owner need provide screens for only those used for ventilation. A new or replacement screen shall not be less than 16 mesh per square inch. . Said Screens- 3) Expandable, temporary screens, shall not be deemed to satisfy requirements of 410.55(1) or (2j 410.552 Screens and doors The owner shall provide a screen door for all doorways opening directly from the outside to any dwelling, unit or rooming unit where the screen will be permitted to slide to the side of an outward direction, provide that in the owner occupied unit, the owner need only provide screens for those used for ventilation. A new or replacement screen doors shall not be less than 16 mesh per square inch. 410.553 Installation of screens- The owner shall vrovide and install screens as required by 105 CRM 410.552 and 410.51, so that they shall be in Mace during the Reriod of April 1, to October 30, both inclusive in each year. Q : What kind of standards do housing codes require landlords to maintain? A : Tenants should know what the local housing code requires because they have the right to demand these conditions of the landlord. Landlords should know the requirements because the municipality expects them to maintain these conditions in the property. The following conditions are typical of the broad areas covered in detail in local housing codes: • the building outside the apartment, such as garbage and refuse removal, and safe and structurally sound stairs, porches, railings and handrails, windows and doors, screens, storm windows, walls and siding, roofs, chimneys, foundations, basements, signs, awnings, and other decorative features; • the interior of the apartment, such as walls, floors, and ceilings without holes, cracks or other defects, no lead- based paint, waterproof bathroom and kitchen floors, no rodent or insect infestation; light, ventilation and space, such as minimum lighting for halls and stairways, window or mechanical ventilation, minimum adequate space for occupants;plumbing facilities and fixtures, such as running water, adequate hot water, sufficient water flow, no leaks, working fixtures; • mechanical systems, such as hot water tanks, furnaces, air conditioning, cooking equipment, fireplaces; • electrical systems, such as elevators, sufficient circuits and capacity, working fixtures, switches and receptacles; • fire safety, such as smoke detectors, fire extinguishers, automatic sprinkler systems, adequate exits, control over storage of flammable materials; • security, such as locks on the windows and doors, peepholes in the doors, shatterproof glass on windows. Under what circumstances is a landlord liable when a tenant or visitor is injured on the rental property? (I have made additional comments in italics under each point bullet) In order to hold the landlord responsible,the tenant must prove that the landlord was negligent, and that the landlord's negligence caused an injury. To do this,the tenant must show that: • the landlord had control over the problem that caused the injury (previous notification that the injury would likely occur such as an verbal or written warning prior to the injury occurring) • the accident was foreseeable(again, the landlord was informed either verbally, in writing or both, that the accident would most likely occur resulting in this injury,put did not make a reasonable effort to correct the situation in a timely manner.) • fixing the problem (or at least giving adequate warnings)would not have been unreasonably expensive or difficult (since the landlord is required to have this dwelling safe for occupancy at the time the tenant was to occupy the premises, and a year has passed with previous verbal requests by tenant, a reasonable person would conclude that more than adequate time was provided to fix the roblem. • a serious injury was the probable consequence of not fixing the problem • the landlord failed to Fake reasonable steps to avert the accident such as declining to fix the problem after several requests and warnings made by tenant • the landlord's failure-- his negligence-- caused the tenant's accident, and • the tenant was genuinely hurt. 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'7 1 1: .! 1 t 1 1 { '. /{ 1 — 1 {1.1 � � 1 .111 It ► 1 11 1 1.1 -�{ . 1 f :(: 1 J . 1 1 - 1.' :71 : 1 ♦t 1 11' 1► 1 t ►: JF of (��1 a+l17R`�'•���t�{���7"LS.atf�Mt"�t^'y,,'ff,3'�J�,li�\�'��,�`ry f A i i ♦ r � ♦ 0 • i i!� • i ' ��� • i Ali. FROM FAX tJO. Jun. 0G 20075 10:54AM P1 Oscar Begin A-Painting 6' Lead Detection Service Co, Inc, 44 Yeas Experinc'e + b 322 Jefferson Avenue • Salem, MA 01970 978.741-4063 rAX 978-741-0063 CELL 978-335-4804 10'd 88810LI78L6 dno-Ag .AagsgaM aq1 t12i3 VZS .-80 50-90-UnC DALTON & FINEGOLD Fax:9784708338 May 20 2005 1056 P.01 DALTON &FINEGOLD, tr.l.,X 1)AISON(MAt`MI) ATTORNF,YA AT LAW BARRYlk. l'111.fa)LE�(MA) Michelle Grant Town of North Andover Office of the Health Department Community Development and Services Division 404 Osgood Street North Andover,MA 01845 Re,Carbone, l Clarendon Street, rth Andover,MA Sent via Facsimile and mail-,(978)688=8.476 May Dear Ms. Grant, Please be advised that this office represents,Mr. Cerbone. We are in receipt of the letter 2005 in regards to the property located at 3(attached) sent to Mr, Carbone on May 10, � p p Y � Clarendon Street in,North Andover, MA, We have left several messages at your office and wanted to follow up with a letter to inform you that the violations have beenoi ✓�%�'`� remedied. The one outstanding item,which is the lead paint, is scheduled to be remedied A6 on June 4, 2005 by Viesna Sar, I will attach a copy of his license for your review. Please contact me with any questions or concerns. Thank you, Carlin Folkedal, Esq. S �c� �o 6-Albi ay-) 021p s�-�a2Ud S— �' 0 "5S 4-(-�-5 JV 400 CmmmanweAlLh Avenue Rmtori,MA 08815 38 Essex Street Andover,MA 01810 telephone:(978)470-8400 facsimile:(978)470-8338 www.dfllp.com DALTON 9 FINEGOLD Fax:9784708338 May 20 2005 10:56 P.05 Viesna Shr New England Environmental Services Lead Paint a Asbostos Removal General Repairs and Construction '� '� Free Estimates Conrrol No: 57 Southside-Ave. Office(781)286.6511 IMUNWEALTH Of MASSACHUSETTS Lynn, MA 01905 Coll (781) 589.9375 t(s ol'Labor and Workforce Devcinpment `- Division of OccapatAoinal Safety fi?'it5 399 WuShirl$IOA Street,5th Flonv, Boslonj Mau14husetly 021(IR DELIEAIDER CONTRACTOR LICENSE VII:SNA SAR LEADPAINT REMOVAL&GENERAL CO NST.CO. 76 SHIRLEY AVE REVERE MA 02151 LICENSE: DC000145 EXPIRES: Tuesday,April 04,2006 IN ACCORDANCE WITH MGL CH, 111,§ )97B(b)AND 454 CMR 22.03 TlIIS CERTIFICATE IS ISSUED BY'rHL DEPARTMENT OF LABOR ANO WORKFORCE DEVELOPMENT,DIVISION OF OCCUPATIONAL SAFETY TO THE CONTRACTOR ABOVE FOR THE PURPOSE OF ENTEWNO\EN(IAGING IN DELEADING WORK. •PHIS LICENSE IS VALID FOR A PEFLOD OF ONE YEAR, THIS CERTIFICATE MUST BE MAINTAINED BY THE CONTRACTOR WHEN ENGAGED IN DEL,EADINc WORK IN ACCORDANCE WITH MGI.CH. 111 § 19713(b)(2)AND 454 CMR 22.03, Roberti, Prczinso,Colttl .skincr 4"0 Commonwealth of Massachusetts td i N.L. REGIONAL COUNCIL fill Division ofOccutlarkmalsarety AZAR. n;CARPENTERSlanrt ROW Ot m o,CummMaonnpr APR APA Delaadarzontrador MAY `. MAY VIESNA sAR JUNG l�' 40 -.JUNG L11 Date 03f3 M '' is D.Power,BuclmxaMgr JUIV AUti ,' M1ark Edlch,Buslm�m EMP.[}91F L14NWU08 SCP ',. + (G17I$A7.BS1 1 AUC MeeK 4th Tuea..VFW Hul 5C!` DC�1'A5 IK T 668 Murnn Iw------ dgc IMT Wembw of C 0 N F',t M;. Noy V1130A Stir I�. NUU,. U-19p4-5273 OF � r ann5 10 No� MvwoarBr.,Ceeseplooe,MA III __• HINDU 111111111111 BOSTON RCN+Cw IQ'd 89910Lt9/-6 Aoisgam ayl VV3 d9£ : 90 50-6i-�eW N w s;3,,.3> �; IE �?...:; it.. :HSN`:' S ✓ rq Postage $ r E:3 Certified Fee ark M Return Reciept Fee / /7� P osHere (Endorsement Required) i O Restricted Delivery Fee cO (Endorsement Required) rq Total Postage&Fees M Q Sent To �/ D�� 1 or PO Box No. 7 ----------------•---------- --------- ----- -•--------------------•--- City, For u :fln �� • . .. Certified Mail Provides: ■ A mailing roceipt (—anea)aooaaunr'ooee-o:4sa s A unique identifier for your mailpiece - 1 ■ A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Maile or Priority Mail®. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Retum Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized a ent.Advise the clerk or mark the mailpiece with the endorsement"Restricted-Delivery". ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. Town of North Andover F NORTH Office of the Health Department ,1ti�p Community Development and Services Division 400 Osgood Street W,,< .,<. . •>' + North Andover Massachusetts 01845 Swc►+us 978 688-9540-Phone Michele E. Grant ( ) Public Health Inspector (978)688-9542-Fax NORTH ANDOVER BOARD OF HEALTH ORDER LETTER Issued under the provisions of the State Sanitary Code,Chapter II,Minimum Standards of Fitness for Human Habitation,105 CMR 410.000. Date:May 10,2005 To the Owner of Record Property Location Ralph Cerbone Jodi Polmeno 1 Clarendon Street 3 Clarendon Street North Andover MA.01845 North Andover,MA.01845 Dear Mr. Cerbone, An authorized inspection was made of your property at the above referenced address by North Andover Health Department personnel on May 9,2005. This inspection revealed violations of certain regulations of the State Sanitary Code, Chapter II,as listed on the attached Violation Form. You are hereby ORDERED to correct these violations within the time allotted on the enclosed form. Failure to comply within the specified time period may result in further action by the North Andover Board of Health. You have the right to request a hearing before the Board of Health if you feel this order should be modified or withdrawn. A request for said hearing must be made in writing and received by the Health Department within seven(7) days from the receipt of this order. At said hearing you will be given an opportunity to be heard and to present witnesses and documentary evidence as to why this order should be modified or withdrawn. All affected parties will be informed of the date,time and place of the hearing and of their right to inspect and copy all records concerning the matter to be heard. You may be represented by an attorney. You have the right to inspect and obtain copies of all relevant records concerning the matter to be heard. r c Michele E. Gr nt Public Health Inspector BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 IiEAL;TI-1 688-9540 PLANNING 688-9535 L ` r d L ORDER LETTER An authorized inspection of 3 Clarendon Street was performed by Board of Health staff on May 9,2005 at which violations of 105 CMR 410.000 Chapter II of the State Sanitary Code, Minimum Standards of Fitness for Human Habitation were found. Failure to respond within the allotted time period may result in a Board of Health finding that the dwelling is unfit for human habitation. All violations must be corrected within seven(7) days of receipt of this Order Letter or a plan for completion must be approved by this office if a professional contractor must be hired to do the work. Violation Regulatory Re- Reference Inspection Screens for Windows 410.551 Current Screens are not tight fitting and are not secure. _ VV Owner shall provide screens for all windows designed to be opened on the first four floors. Said Screens: Shall be tight fitting as to prevent the entrance of insects and rodents around the perimeter. Owner shall provide tight fitting and secured in place. Screens for doors: 410.552 No door outside door on front of house. Owner shall provide screen doors in all doorways opening directly to the outside. Said Screen door: Shall be equipped with self-closing device. Shall be tight fitting as to prevent the entrance of insects and rodents. Owner shall provide a outside front door with Air tight screen Maintaining Structural Elements: 410.500 Basement window is not secure.There is a hole In the front portion of house on the right hand Side. Owner shall maintain every structural elements Free from holes,cracks, or defect renders insect or Rodent harborage Owner shall fill holes in foundation in the base -ment and secure basement window. NOTE:A Lead Test Will be Performed at a Later Date. FROM FAX NO. Jun. 08 2005 02:05PM P2 Inspection and Deleadine Histoa Initial inspection done on: xr K—by� �/ r Lie # I4;1 Reoccupancy reinspection,if needed,done on: Iby ° II Lie# Final Deleading reinspection done on; �' x'11�� by �� � &e�c, i� Lic, # �� Deleading Contractor ! 9 64 �'3 License#: Deleading methods: cra ' Demolition Power sanding Caustics eat gunacemen Covering Liquid encapsulation Other Work was'done in the fel wing rooms: I13•�-'.� ��� y� , Work was done on the following types of components: 7 Start DatejO 1,�'e Id Finish Date:'4J d 7 l4j_ Cost: $ Lead-safe renovator; Lic#: Moderate risk owner/agent: Auth. #: Deleading Methods: Replacement Making intact (interior) Making intact(exterior) Covering Liquid encapsulation Work was done in the following rooms: Work was done on the following types of components: Start Date: /—/ Finish Date:_/_/= Cost; $ (Doesn't Include owners Labor) Low-risk owner/agent: Authorization#: Deleading methods: Covering Liquid encapsulation Capping baseboards Replacement(ONLY doors,cabinet doors,shutters,shelves not affixed,drawers,windows on hinges) Work was done in the following rooms: Work was done on the following types of components: Start Date:_/ /— Finish Date:—/—/— Cost: (Doesn't Include Ownor's Labor), FROM FAX NO. Jun. 08 2005 .02:04PM P1 Oscar Begin A-Painting €,a Lead Detection Service Co. inc. 44' Years Experience Fax Cover Sheet Company: r From: Company. Subject: Pages (Including Cover): The documents accompanying this facsimile transmission contain information that is confidential and/or privileged. The information is intended exclusively for the addressee named above. If you are not the intended recipient,be aware that any disclosure, copying, distribution, sale or use of the contents of the information is prohibited, If you receive this fax in error, please notify us by telephone immediately so that we can arrange for the retrieval of the original documents at no cost to you. Thank You! 322 Jefferson Avenue • Salem, MA 01970 978-741-4063 FAX 978-741-0063 • CELL 978-335-2804 I �; ekA�e o, 00 Q� rprdon - O0 1 5F- DALTON & FINEGOLD Fax:9784708338 May 19 2005 15:44 ' P.01 a r DALTON &FINEGOLD, 1..L.r WI1.1.1A.M 1, DAL ION(MA&Mlq ATTORNEYS AT LAW EiAlun12. FMkc.01.1)(MA) Michelle Grant Town of North Andover Office of the Health Department Community Development and Services Division 400 Osgood Street North Andover,MA 01845 Re: Cerboue,1 Clarendon Street,North Andover,MA Sent via Facsimile and mail: (978)688-8476 May 19,2005 Dear Ms, Grant, Please be advised that this office represents Mr. Cerbone. We are in receipt of the letter (attached) sent to Mr. Cerbone on May 10,2005 in regards to the property located at 3 Clarendon Street in North Andover,MA. We have left several messages at your office and wanted to follow up with a letter to inform you that the violations have been remedied. The one outstanding item, which is the lead paint, is scheduled to be remedied on June 4,2005 by Viesna Sar. I will attach a copy of his license for your review. Please contact me with any questions or concerns. 'thank you, Carlin Folkedal, Esq, 400 Commnnweal[h Avenue Boston.MA0291d 38 E5xx Strcct Andover,!VIA 01810 olephapm:(978)4704400 facafm{ler(978)470-8338 www.dFllp.com DALTON & FINEGOLD Fax:9784708338 May 19 2005 1544 P.02 y Town of North Andover o, I,CRTh Office of the Health Department Commulnily Development and Sexvices Division 4U0 Osgood 5ercet ► . - North Andover,MASSaKhusetts 01845 � -n,Y.. ncM%A'a M idiele E. Grant (97,$)6$8-9540-Phone Public Health a hlspector (978)6SS-9542-Fax NORTH ANDOVER BOARD OF HEALTH ORDER LETTER Issued under the provisions of the State Sanitary Code, Chapter 11;Minimum Standayds of Fitness for HL4man Habitation,105 CMR 410-000. Date:May 10,2005 _ To the Owner of Record Property Location Ralph Cerbone ,Jodi Polme>no 1 Clarendon Street 3 Clarendon Street Nedh Andover MA.01845 North Andover,MA.01945 Dear Mr.Cerbone, An authorized inspection was made of your property at the above referenced address by North Andover Health Department personnel on May 9,2005- This ,2005_This inspection revealed violations of certain regulations of the State Sanitary Code, Chapter Sl,as listed on the attached Violation Form. You are hereby ORDERED to correct these violations within the time allotted on the enclosed form. Failure to comply within the specified time period may result in fuxther action by the North Andover Board of Health. You have the aright to request a hearing before the Board of Health if you,feel this order should be modified or withdrawn. A request for said hearing must be made in writing and received by the Health Department within seven(7) days from the receipt of this order- ,At said hearing you will be given an oppoMu ity to be heard and to present witnesses and documentary evidence as to why this order should be modified or withdrawn. All affected parties will be informed of the date,time and place of the hearing and of their aright to-inspevt and copy all records coneeming the matter to be heard_ You may be represented by an attorney. You have the right to inspect and obbiin copies of all relevant records concerning the matter to be heard. Michele E-Grant Public Health Inspector 130A1U)0r ANI+F'n1.5 68S-;i.Aa! !;L!I,n1NG GAA•9;a. ii)Ntil It Vn 19Uf�65a-V,;tp I1Lnl.I!+oaK-u�dU PLnivN1NG ti88.4a39 -7nnfr7s X�':t 8E Ci 5007,/7,ji50 DALTON & FINEGOLD Fax:9784708338 May 19 2005 1544 P.03 t ORVIER LER Ari authorized in pection of 3 Clarendon Street was performed by Board of Health,staff on May 9,2005 at which violations of 105 CMR 410.000 Chapter II of the State Sanitary Code, Mirdmum Standards of Fitness for Human Habitation were found. Failure to respond within the allotted time period may result in a Board of Health finding that the dwelling is unfit fox human habitation. All violations must be corrected within seven(7) days of receipt of this Order Letter or a plaint for completioxx must be approved by this office if a professional contractor must be hired to do the work. Violation Regulatory Re- Reference Inspection Screens for Windows 410.551 Current Screens are not tight fitting and are not secure. Owner shall provide scxeens for all windows designed to be opened on the first four floors. Said Screens= Shall be tight fitting as to prevent the entrance of insets and rodents around the perimeter. Owner shall provide tight fitting and secured in place. Sinreens for doors, 410.552 No door outside door on front of house. Owner small provide screen doors in all doorways opening directly to the outside. Said Screen door: Shall be equipped with self-closing device_ Shall be tight fitting as to prevent the entrance of insects and rodents. Owner shall provide a outside front door with Air tiFLt screen Maintaining Structural Elements- 470.500 Basement window is not secure.There is a hole In the front portion of house on the right hand Side. Owner shall maintain every structural elements Free from holes,cracks,or defect render insect or Rodent harborage YQQ { XYA Wei RQOZ/ZZ/90 DALTON & FINEGOLD Fax:9784708338 May 19 2005 15:45 P.04 05/12/2005 13:38 FAX lm 003 ()wner shall fill hOles iA foundation in the base -anent and secure basement wi-ndow. NOTE:A Lead Test Will be Performed at a Later Date. DALTON 9 FINEGOLD Fax:9784708338 May 19 2005 1545 P.05 Viesna Sar New England EnArolnmenital SerrAces Lead Painl &Asbestos Removal General Repairs and Construction 19221 Fret East+mates Control N0: ide Ave, Of `781,28651 Lynn, MA07905 COtt 781 589-9375 IM0NWEAI.1'H 01 MASSACHUSETTS us of Labor and Workforce Developmenr `Y Dlvisiort of Occppatio.hal Safety 399 WashingIon Strect, 5th Flonr, 130Sturtj Massachusetus 021OR DELEADER CONTRACTOR L1CIENSF VIUSNA SAR LEADPAINT REMOVAL&GENERA I,CO NST.CO, 76 SHIRLEY AVE REVERE MA 02151 LICENSE: DC000145 EXI"IRESS! Tuesday,April 04,2006 IN ACCORDANCE WITH MGL CN, 111,§ 197B(b)AND 454 CMR 22.03 THIS CERTIFICATE IS ISSUED BY THE DEPARTMENT OF LABOR AND WORKFORCE DEVELOPMENT, DIVISION OF OCCUPATIONAL.SAFETY TO THE CONTRACTOR ABOVE FOR THE PURFORF OF ENTER[NGIENGAGING IN DELEADING WORK. THIS LICENSE IS VALID FOR A PERIOD OF ONE YEAR. T1lIS CERTIFICATE MUST HE MAINTAINED BY THE CONTRAC'T'OR WTHFN ENGAGED IN >XI,EACHNG WORK IN ACCORDANCE WITH MGL CFI, I I 1 § 197B(b)(2)AND 454 CMR 27.03, Robert]. Pw.inRo, Conn .sinner w,..IM.prYa.n REGIONAL of M!fassachuseffs sra WE. REGIONAL COUNCIL 'AN Division of Occupational So" FLU MAR. R 'ARPIENTERS AR >7dmdj Pmzwo.cumm,a<,nna ' ANA ApI7�Ileeldar�onrractol MAC MAY VIESNA SAP JUNE 40 JAC Elr Oak 03r4m July ! ";., lr,x D.Powei,SuNnr,aMgr July AUG Mark Erlich,dYSrt+rxs Rcp Aldi Exp. Date 04MMMG (G171 SWAS511 DC000145 rlf T meels du+Tuco,,VFW Hvr U-1' dBa Hwnn Arc..Cambridge nr,T hkmbvol C 0 N F h r 06 NOY Vldsda Sqr I NUv 5271 _ 711Afi 10 NOLUIfORTHY ST.,CAs98pIDGE,MA Oa1aa �CT'r� +%nllr 190510N RE rW 10-d SBOT04VB46 dno.A5 .AagsgaM pqj V82 d9E =90 SO-SL-iceW 10/14/23 02:32 FAX U001 Department of Public Health/Departm ient of Labor&Workforce Development . JI * '. NOTIRCATION OFD ING WORK I J All se.cdons of this form must be completed order to-comply Whit + {y the notification requirements of M.G.L.C.111§197, 454 CMR 22.00 and 105 L'1 R 460.000,as moat recently amended Contr ct6rperformingproject Viesna Sar Ucense#DC 145 Exp,Date 04 04 06 Lead PaintInspector John Enright Date ofInspecdon 05/14 05 Licens # I3652Eap,Date _ AUDE ENS OF FRQ Streetddress I. Clarendon Street pt Nu ber I&�2 City North. Andover, Ma. z 0 845 P ]prop Owner Mr.. Ralph Cerbone Address3 Clar.en on St.N.Andover,Ma.01845 Teleph ne Number .( 978).", 686-7225 DeleadhLghlethod Wet/Dry Scraping Heat Gun Enrspsnlant D on Caustics Replacement ove ng Other If"0th selected,please explain Check o e: Dwelling is multi-family Yes Swglc•fa dy Other Start Dat, 06/04/05 CompletlonDate 06/25/05 When wil woik be done: Am_t,= 3 0 pM 5. 3 0(sPewY times on site) Weekends?Sa turd ay &Sunda Project Supervisor Name Viesna Sar Ueense# DC145 04/04/06 Exp.Date Worker'somP `�enation Poli Number 6 Z ZUB81 4X 163804 Con'Ler Farquar & Black: In 6oibr'iaergencyc6ntaet I7iesna . Sar _Tel,# ( 781 ) 286-651 1 ' (contractor's Representative) )NTRACTOR The undersigned hereby states,under the pains and penalties of perjury,that he/she has read and understood the Commonwealth of Massachusetts Deleading Regalations,454 CMR 22.00,and the Lead Poisoning Preventionand Control Regulations,105 CMR 460-000,and that the information contained in this notification is true and to the best of his/her kn9.- ed can belief. Date Sfgned Compapy.N me Lead Paint Removal & Repair Co. Address 57 Southside Ave. Lynn, Ma, 01905 Telephone N umber (781 )596-8735 OVERO TIGER HOME INSPECTION Fax:1(781)356-4487 May 23 2005 1036 P.01 1 lrox Cover Shut 3 r ! A ttn; r ,I I. if .you have any questicnk concerrO;nq t,:, 969 Washington Stre:t '� 1i1':�il7lr{:=a NAA 02184 ' Phonf- TIGER HOME INSPECTION Fax:1(781)356-4487 May 23 2005 1036 P.02 Lead Inspection 1 Risk Assessment Report Pop of 16 ' Method Used- 0 N&S EXP,Date -/z> �` P A NT 10X-Ray Fluoreacence Lead Paint Inspection Model Ro-0 Serlsl# St,M Address ❑❑❑ baa❑�❑c����o❑®❑❑❑❑ �❑a❑® - I �P.r �'• Single Family _ GO �" Muni Famlfy ✓ i � • �•'U d o/ �►a- U���/ A Units � i li ClleM-Nm (K m Condominium .._ Day We QUInt.Addins; t Key. I AIM AoceseblelMeuthable CAPS Capped CWVCodv wMnyl Comprshansive Inspection CAP Capped COV Cmmd GWA COV w/Aluminum COV Covered DIP Dipped Comments; INT Intact ENG encapsulated L Loose MI Made lntad e' f•6 -F;�M S. a,a i` a i,r / A Mil MONeabOripadad PRE Prepared MET Metal REM Removed NA NotAccesebla REP Replaoed NC Na Coating REV Reversed NEO Negative SCR Sire* FOS Poamve VA V•myl Replacament VR Ylnyl Replacement fq kor# C C �.... -..�i►' -.j-....i.._............ ..,..F.. .. .-i- .E....,_..... .. _. ....i....L .-� -.'. ..a... .L, ,f m..;.._La -.-.L....,.i...».............'...W.. il• li�......j,...._i.. I i.,....y. A.a....•-1 I.. ..,,,...I -,, j i.....�•..._...I._. .`' I I i .�.,..�.. ..i- . i ...1-. ;,.,-.-ri.,.,-.,.ti„-m-im.-.i.-..,....,,.,.-......... (! �... .�...... .M�..,_i.......�........:.........',...,.,�...- �. ..........-..,,,........E...-_i ' ! .��............. . -- S -... .......--....-. --.-.-... ................._........ a.--- .y..y..,.... -- I Wf ' -..�,.,-. ._4 A(Sweet$ide) A($treat 8itle{ Pb(lead)equal to or greater than 1.0 mglczn2 with x-ray fluoreawrico at positive with NaaS is VangerouL I149P. *ATE Lead 0151 11910 T (gr N) -- 13654 Inspector (pri4 Signature R.A. DATE Urgent Lead Hazards? 0(y or N) Risk Assessor(print) Signature LieA Panther Lead Paint Inspection,969 Washington St.Braintme,MA 02184-(781)849-7313 TIGER HOME INSPECTION Fax:1(781)356-4487 May 23 2005 1036 P.03 LEAD INSPECTION/RISK ASSESSMENT HISTORY PAGE Page of Al. /I-do V(f yr Properly Address Apt# City Zip I INSPECTION ACTNMY KEY EXA PLE flex 1.Re-Inepectim S.Full Deleading Compliance t s.Mainiairred Interim Control 2,Re-Owupancy Re•Insp pion 9.Pam Compliance Assessment Detarmimilan 13.Restored Irtprim Control 3.Work In Progress to.Maintained Compliance t Inspeadon A"Number 4,Not Taken 11.Restored ConViAnce S.Dust Recefred 12,Interim Control P Pass or Fall P;Pass 5.Boll Taken 13.Rewrtificatfon of Interim Control F=Fed 7.BON Recomw 14.Post Compliance Asamrnent of Interim Control Inspector Inspector Lie# Lic# Inspector Inspector Lic# Lie# Inspector IT Inspector Lie# Lic# Inspector Inspector Lic# Uc# Inspector Inspector 1 11 IT Lic# L10# Ut Inspector Inspector W9# Lic�l Inspector Inspector LIG# LIC# DATES COMMENTS Panther Lead Paint inspection,969 Washington 5t.Braintree,MA 02184-(781)849-7313 TIGER HOME INSPECTION Fax:1(781)356-4487 May 23 2005 1036 P.04 r EXPLANATION OF LEAD INSPECTION/RISK ASSESSMENT REPORT FORM COLUMNS r This page provides general information needed to understand the lead inspeetient/risk assessment report.However,you should speak I with the inspector/risk assessor before yau.start to do any work on your home. SIDE Refers to A;R,C,or D side of the building or room.See the diagram on.the co w* sheet,The"A"side of the ! building or room is the sidd facing the street that.gives the property its address(usually,it is the front of the building).,Keeping your back to this.street,ftom the"A"side move clockwise to the"13"side on your left,the"C' side oppesite you,and the"D"side to the right. LOCATION/ Refers.to the building companent(s)being tested.Some surfaces maybe 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. j e 'A number shows that the surface was tested with an XRP.analyzer.A number(or average number) equal to or greater than 1.0 mg/cM2 is a dangerous level of lead. • A"pas"or`.`reg"shows that the surface was tested with sodium sulfide."Pos"means that there is a dangerous level of lead. • "NIA"means that the inspector was not able to test the surface.Unless the-owner can get a sample to test,the inspector must assume tl{e surface contains lead and require it to,be deleaded.if necessary. • "Metal".means that a meths surface was not tested and only needs to be intact.However,metal handrails,metal window sills,and metal railing caps,need to be deleaded if they are dqual to or greater than 1.0 eatg/amZ,`mss," or is"NIA." TYPE OF Not all lead paint must be deleaded,This colurtm 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 ,information. • Mtr'circled means that the surfam is a moveable/impacted surface and must be deleaded in its entirety. • "W"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 corner. * "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 a "NIA"means the inspector as was to,determine if the surface was loose or intact.The,person doing the deleading must check this surface and follow all the rules for deleading.Speak to the inspector for more information. .!o If nothing is circled or marked"N/A"then itis likely the surface does not netd deleading.Speak to the inspector for more information. URG HAW This column is only completed during a risk assessment.A risk'assessment is an evaluation of a home's suitability for Interim Controls. Only a licensed risk assessor can do a risk assessment,not eV inspectors are risk sssessors, If"Y"is circled,than this surface is considered an"Urgent Lead Hazard",and some type of deleading work is required to qualify for Irite:rim 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 or risk assessor reinspects the surface and finds that it has been successfully deleaded DATE for full compliance. DELEAD The.deleading method used:to bring a surface into fun compliance.Refer to deleading codes in the Key on the cover METH page of the inspection report. EXCLUDED The amount of loose paint on a surface as measured by the lead inspector."N/A0 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. surfaces listed here can only be made intact by a licensed deleader. Note there are still other low and moderate-risk deleading activities,such as covering,that may be done by someone who is not a licensed delesder. SOIL TEST This information is found on the exterior pages.If your property receives certain federal funding,soil testing may be WVLTS required.There is also a space for the risk assessor to indicate amount of bare soil,laboratory results,'method of remediation,and the date of remediation.Check with your funding agency for more information.. Panther Lead Paint Inspection,969 Was"gton 5t,Braintree,MA 02184-(78iT 849-7313 TIGER HOME INSPECTION Fax:1(781)356-4487 May 23 2005 1036 P.05 r , r . � ��� Psgo f of '� Inspector iPrir+t 1j0# Signa ure Date Risk Assessor (pdng Uo# signature Date Addressor f>orty 3 lGr t'� � 5F Aft# City over EXTf*A10R $IDEJ LOCATIOW LPJ TYPE OF UA4 ICLICDELEAD DELEAD SIDE LOCATIQN! LEAD TYPE OF URG IC IC DELEAD DELEAD A SURFACE HAZ? DATE DATE METH A SURFACE HAZ DATE MEtH GATE METH Siding R. L WA Y Window Sill AIM L W Comer Bpdrds L WA Y A Win casing WA Y A LWAW414M L WA Y Whrdow Sash AIM L WA Y U r Trim Nex L NA Y .b Window SWI AIM L WA Y W a# L WA Y A min Adel L WA Y pA 5 L WA Y ndow Sash AIM L W Stomt Door !w k AIM L WA Y Cellar Win Sill WA Y Door C.U AMI L WA Y A Cel Win Sash AIM L WA Y At Door Casing •( AIM L WA Y Cel Win Fre AIM L WA Y DW Jantq L 1, 1 AIM L WA Y Cellar W i l AIM L WA Y gAl,no A`L AMI L WA Y A m Sash AIM L NIA Y AIM L WA Y Cel W in F A Y N AIM L WA Y Cellar Win SWI AIM L WA Y AIM L WA Y A cel Win AIM L WA Y " AMI L WA Y F AIM L WA Y I AIM L WA Y Cellar Win Sill Ai L. AIM L WA Y Threshold N G AIM L WA Y A Cal On Sash Pf AIM L WA Y 0cpkift '' L A(M L WA Y 081 Win From A„4, AIM L WA Y Door AIM L WA Foundation L L,WA Y A Door Casing AIM A Y A 9ulkhsA�' AIM L WA Y Door Jamb L WA Y F�nceL� ` AN L WA Y Threshold AIM L WA Y S1wl9ff AN L WA Y Door AIM L WA Y AIM L WA Y A Door C g AIM L WA Y R p AIM L NIA Y Damp AN L WA Y AIM L WA Y threshold AIM L WA Y A B n3 AN L WA Y Window ail AIM L WA Y L eil AMM L WA Y A On Cdsing AIM L WA Y Trends w C AIM L WA Y 2- Window Sash V AIM L WA Y Risers v° rYM L WA r W ndow Sill L WA Y Stinger AIM L WA Y A n Cesi AIM L WA Y Floor N L AIM L WA Y Bash NM L WA Y Hm AIM L WA Y MMENTSISTRUCTURAL DEFECTS: AIM L WA Y A AIM L WA Y ow�— NM L WA Y J AIM L WA Y Excluded Surfaces:Surfaces listed in this box can be made Boil Test Results intact only by a Ilp9miad delea be less than 400corntoricilp area/1Z D Dorn for bare soil FSPILOCATION MEASURE:LOOSE PAINT 10 IC LOCATION ARRA MEASUREWMNT RESUL REMED REMED AN vµ0 IN, DATE METH (PPM) DATE METH Pla Area II A Commants: AMINEENNEWS Panther Lead Paint Inspection,969 Washington St,Braintree,MA 02184-(781)849-7313 TIGER HOME INSPECTION Fax:1(781)356-4487 May 23 2005 1036 P.06 I pap.L Of A Inspector {print) Lic# Signa re Date Risk Assessor (print) ! Lic# Slgnaturs Date Address of Property 3 C do'l,' v-, Apt# City I• " EXTERIOR SIDEoldl E TYPE OF URO IC IC DELEAD DELEAD SIDE LOCATION! LEAD TYPE OF URO IC IC DELEAD DELEAD B SURFACE HAZ7 DATE METH DATE METH B SURFACE BATE METH DATE METH L WA Y Window Sill WA Y L WA Y B Win Casing AIM L WA Y B L NIA Y Window Sash AIM L WA Y Nr? L N YWlndowS' AIM L WA Y S L WA Y B Win ng AIM L WA Y Po Abaod"6 L WA Y endow Bash AIM L WA Y Ston Darn AIM L WA Y Cellar Win Sill QMG WA Y PM AIM L WA Y B Cel Win Bach 5.9WA W WA Y . B boor Casing AIM L WA Y Cat Win Fre 9.9 Door Jamb AIM L Y Color Win SIU Y Threshold AV<NIA Y B Cel Win Bash A.M L WA Y Kickplats AIM L WA Y Cel Win Frami AIM L WA Y Storm Door AIM L WA Y Geller W' in Am L WA Y Door AIM L WA Y B 20nWh I AV.L NIA Y B Door Ca M L NIA Y Cel Win Fre AIM L WA Y ' AI Dc NM WA Y CallarWlnS AIM L WA Y mthokt AIM L WA Y NFRIallIng an AIM L WA Y KWolate AIMLO Y Frame AIM L WA Y Door WA Y n Wt- L WA Y B Door Casing AIM L WA Y AIM L WA Y DoorJamb AIM L WA Y � AIM L WA Y Threshold AIM I. NIA Y . AIM L WA Y Door AIM L WA Y st AIM L WA B Doo assn AIM L WA Y ap AIM A Y r Jamb AIM L WA Y Handrail 1 ,4 L WA Y Threshold AIM L WA Y B Balustem AIM L WA Y Window Bill AIM L WA Y Lowar Rail AIM L WA Y B Win Casing AIM L WA Y Treads AIM L WA Y Window Bash AIM L NIAI Y Ri AfM L WA Y Window AIM L WA Y tringer AIM L WA 13 VtM sing AIM L WA Y Flo AIM A Y endow Sash AIM I. WA Y Law trim e4M L NIA Y COMMENTS I STRUCTURAL DEFECTS: Lattice AIM L WA Y B Column WM L WA Y Ce'' g AIM L WA Y Diets AMI L WA Y Excluded Surfaces:Surfaces listed in this box can be made Soil Test Results intact only U a licering deleader Must be less than 400 Dom for olav area 11200oom for bare sal SIDE LOCATION MEASURE:LOOSE PAINT IC IC LOCATION AREA MEASUREMENT RESUL R5ME0 REMED BM3p9j4A&Ug=Nj DATE METH souare real I (PPM) DATE METH B Ply AMA t3are ' B Comments: S Panther Lcad Paint Inspection,969 Washington St,Braintree,MA 02184-(781)849-7313 TIGER HOME INSPECTION Fax:1(781)356-4487 May 23 2005 1036 P.07 Page L OI i Inspector (print) lee# Sign urs t lac# Si nature Date Risk Assessor (pant) '7 AddressofProcerhl 7r"'�'�'Pch ' ' „Apr# City lam' O EXTERIOR SIDE LOCATION LEA TYPE OF URO IC IC DELEAO DELEAD SIDE LOCATION/ LEAD TYPE OF UR(s IC 1t; DELEAO DELEAD C SURFACE H DATE METH DATE METH C SURFACE H HAV RATE METH DATE METH Q I L WA Y Window$III AIM L WA YL- Siding Comer Boards 2•a I L WA Y C Win Casing AIM Y C I L WA Y Window flesh M L WA Y Upper YrIM h 1 L Y inb inflow SII/ NM L WA Y Win Above 6' r, I L Y h C win C AIM L WA Y ?W*0 m I L WA Y w sash AMI L WA dor NM L WA I Y Caller Win SIIl AIM Y raw ,y WA Y C Cel Win Sash L WA Y C I Door casing z A/M L WA Y Cel Win F(ame AIM L WA Y Door Jamb NM L WA Y ur / Cellar Win AIM L WA Y Threshold N b AIM L WA Y 7` C Cel Sash AN L WA Y hcfr�glat� AMI L N/A Y el Win Frame AIM L WA Stone Door G AIM L WA Y Cellar Wm SIIl AIM JACA Y Dow o AIM L WA Y C Cel Win Sash L WA Y CY Door Casing c L AN L WA Y Cei Win Framet Z AMI L WA Y' toarJamb 0-0 AIM L N/Al Y Gollar-Winp AIM L WA Y Threshold AN L WA Y C Cel AASash A/M L WA Y . Kle0te t• u AIM L WA Y 1 Win F AIM L WA Y Door . c z AIM L WA Y Foundation c- i L WA Y CL Dabs Casing a AIM L WA Y C 6 ad AIM L WA Y Door Jamb vi* NM L NIAI._ Fem@u — AIM L WA Y Threshold r A Y Slsdterl— AIM L WA Y Door AIM L WA Y Newel post 0.1 NM L WA Y C Door Caslnoo AIM L WA Y Railing Cap ti u NM L WA Y DW016 AIM L WA Y Handrail a AMI L WA Y reshold AIM L A Y C Baiusters c, AIM L WA Y Window Sill WA Y Lower Rail AN L WA Y C Win G9aing AIM L NIA Y Treads G L NM L WA Y Window Sash AIM L WA Y Ri ArM L WA Y Xwl,dowli, AIM L WA Y Stringer `• A/M L WA Y C AIM L WA Y NM L WA Y NM L WAI Y Low Trim c L AIM L WA Y MMENTS I STRUCTURAL DEFECTS, Laurer— AIM L WA Y C Columns u L AIM L WA Y GaiBng'-�'" AN L WA Y IJ20&— AMI L WA Y Excluded Surfaces;Surfaces listed in this box can be made Soil Test Results intact only bv a licensed deleader Must be less than 400 DDM for olay area1200Dom for bare soIII FN MEASURE;LOOSE PAINT IC IC FLOCATION AREA MEASUREMENT RESUL REMED REMED RE ,IN, DATE METH UR (PPM) DATE METH Ple AreComments- C Panther Lead Paint Inspection,969 Washington St.Braintree,MA 02184-(781)849-7313 TIGER HOME INSPECTION Fax:1(781)356-4487 May 23 2005 1037 P.08 L - /�� ©'f page �-Of 0 Inspector (print) Uc# Sig atureDate, Signature Date Risk Attsessor (print) C Address of P (/' tic# SIg., �4-P J API 0 City Ab A J#ve✓ SGERIOR SIDE LOCATIONI LEAJ TYPE OF UAG IC IC DELEAD DELEAD SIDE: LOCATION/ LEAD TYPE OF URO IC IC DELEADDELEAD D SURFACE RD HAZ. DATE METH DATE METH D SURFACE RD H DATE METH DATE METH Siding L NIA Y window Bill AIM Y Comer Boards 9, L WA Y D Win Casing L WA Y D Lpp L WA Y Window Bash AIM L WA Y Upper Trim L 10 Y Window Bi AIM L WA Y Win Above 5' u& L IIIA Y D Win n8 AIM L WA Y PQM Ab"6' L WA Y indow Bash ArM L WA Storm Door AIM L WA Y Cellar win$III AIM Y Door AIM L NIA Y D Cel win Sash L WA Y D Door Casing NM L WA Cel Win Fre A!M L WA Y Doorjamb AIM L Y Cellar Win 81 AIM L WA Y Threshold WA Y D Cel sh AIM L WA Y IGokplate L WA Y in F AIM L NIA mom Storm Door AIM L WA Y Dellar Win SIP lr L AIM Y Door NM L WA Y D Cel Win Bash L L WA Y D Door C�ing AN L WA Y Cel Win Fra ro AIM L WA Y DaorJa AIM L WA Y COarWln AIM L WA Y Thr Id AIM L WA Y D Cel ash AIM L WA Y kptate AIM L WA Via Fram A/M L WA Y Door NM A Y Foundation �/ L WA Y D Door Casing L WA Y Q Bulkhead (, ; NM L WA Y Door Jamb AIM L WA Y Fsaees—^ AIM L WA Y Threshold A/M L WA Y Sh rs AIM L WA Y Door NM L WA Y Newel post d L AIM L WA Y D Door AIM L WA Y Railing Capk_Q AIM L WA Y Door NMILNWIA7� Y Handrail AIM L WA Y staid Y D 6efaeterc A/M L WA Y Window Bill AIM Lower Reil a.I AIM L WA Y D Win Casing A/M Y Treads a, L, AIM L WA Y WMdoW 52 NM L WA Y AIM L nuA Y Wlntlow AIM L WA Y Stringer (�U AIM L WA Y D Wsing AIM L WA Y Floor c r AIM L WA Y endow 8aeh AIM L NIA Y LowTlrll� AIM L WA Y COMMENTS/STRUCTURAL DEFECTS: Laltic NM L WA. Y D Columns AIM L WA Y Cele AIM L WA Y Joists-� AIM L N/Al Y Excluded Surfaces;Surfaces listed in this box can ba made Soil Test Results intact onIv bv alicenseddeleader n Dom for vlav area 11200oom for bare soil) SIDE LOCATION MEASURE.LOOSE PAINT IC IC LOCATION AREA MEASUREMENT RESULT REMED REMED D IMOR9 T14AN 1440 20,INA DATE METH I (PPM) DATE M$TH D Pia Area D are soil D Comments: D Panther Lead Paint Inspection,969 Washington St,Braintree,MA 02184-(781)849-7313 TIGER HOME INSPECTION Fax:1(781)356-4487 May 23 2005 1037 P.09 I R -• I rL < I l �i Page Of 1 Inspector(print) Lic# Signe re Date l Lip# Signature Risk Assessor(punt) �^/ Address of Properly �s [ .(;•P� f M t# Date Cites ' ~U �Pr` F LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATIOW LEAD TYPE pF URQ IC IC DELEAD DELt:AlSSURFACE HAZ? DATE METH DATE METH SURFACE ttAZ? DATE METH DATE METH Up Walls &-J, AAM L WA Y window sill l MV1 A/M L NIA 'Y Lp 1ts AIM L WA Y Win Apron b�. A/M L WA Y j A e Baseboards 1 AIM L WA Y Win Casing ell PJM L WA Y SLA A e AIM L NIA Y Header Stop &1 Mil AAM L WA Y w d allw— AIM L NIA Y Int Slops AUAL MA AN L NIA Y Floor L AIM L WA Y Win Int Sash 6.r Mil,AIM L WA Y Calling AIM L WA Y Exterior Bill c-y MA L NIA Y Door AIM L NIA Y ,G, Part Bead E MA L NSA Y DoorCasing �, A/M L WA Y Blind Stop 9rW M11 L WA Y Poor Jamb a�, AIM L WA Y win Ext Sash.- i,z M/I L WA Y Threshold v L AIM L WA Y window Sill MA AAM L NIA Y Door AIM L NIA Y Win Apron AIM L WA Y i Doarles nr AN L WA Y Wln Casing AIM L Y DoorJamb NM WA Y Lx Header Stop Mit A/ NIA Y Th AIM L WA Y Int Stops MI AAM L WA Y Door AIM L NIA Y Win Int Sash MII A/M L WA Y Door Casing AAM Y Exterior Sill MA L WA Y Door Jame L WA Y Part Be MA L WA Y Threshold AAM L WA Y BI III L WA Y Door AIM L WA Y in Ext Sash M/I L WA Y Dot.pdsing AAM L WA Y Mast Door � PJM L WA Y r Jamb AIM L N/Al Y Cl Qpslpa,_.. NM L WA Y Threshold AAM L WA Y Clo9d-** AN L WA Y Window$ip MA AAM L WA Y Closet walls w k. AIM L WA Y Win Apron PJM L WA Y G Cl Baseboard AN L WA Y Win Casing AIM L WA Y Closet Pole a AIM.L WA Y Header ki Mil AIM L WA Y Closet Shell N L AIM L WA Y A, Int Stops gjL M/I NM L WA Y Cl SUPPOM Ma AIM L WA Y 1� win Int seen y1J- Mn AIIM L WA Y Closet Floor PJM L WA Y Exterior S01 A. MII L WA Y AIM L WA Y Part Bead MA L Nle Y AI L WA Y sand Stop W L WA Y AIM L NIA Y win Ext Sash M/I L WA Y M!I L WA Y OMMENTS I STRUCTURAL DEFECTS; AAM L WA Y place AIM L NIA Y M11 AIM L N/Al Y WA AIM L NIA1 Y EXCLUDED SURFACES;SUrfaces[Me in these boxes can be made intact oniv b i a licensed deleader. SIDE LOCATION MEABUHE:LOOSE PAINT Ic IC SIDE LOCATION MEASURE:LOOSE PAINT 10 IC (MORE THAN 288 I DATE METHOD RE THAN 298 SO.INA DATE METN00 Panther Lead Paint Inspection,969 Washington St.Braintree,MA 02184- (781) 849-7313 TIGER HOME INSPECTION Fax:1(781)356-4487 May 23 2005 1037 P. 10 R y Page 1 Ot L Inspector{print) Lie# Signa re Date Risk Assessor(print) LJO $Ignature Data Addres of Property C °-°,��� Apt# city M. A-6r✓&,P, t.s.P% 'L SIDE LOCATION/ LEAD TYpE OF URO IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE Rp HAZ? DATE METH DATE METH SURFACE HAZ? DATE METH DATE METH A Up Wells U AIM L WA Y Window Sill ( MA AfM L WA Y A 0umwoffr. n AIM L WA Y Wln Apron a L) A/M L WA Y A a Beseboams C1 AIM L WA Y Win Casing 6'Zr AfM L WA Y A a Chrfla= AIM L WA Y Header Stop 6"0 Mei A/M L WA Y AIM L WA Y 10tops t' M/I A/M L WA Y Floor ff.d AIM L WA I Y Win Int Sash Vie M1I AMI L WA Y Ceiling o.1 AIM L WA Y Emerlor Bill lit MA L WA Y Door N L A/M L WA Y Part Ba3ad 9 MII L WA Y QJ Door Casing-+ C. t, AIM L NIA Y Blind Stop bt2- ANI L WA Y r` Door Jamlt.- 4, AIM L WA Y P Win Ext Sash Vii. Mel L WA Y AIM L N/Al Window Sill I MVI AIM L NIA Y Door AIM L WA Y Win Apron AIM L WA Door Casing D.J AIM L WA Y Win Casing AIM A Y DWJamb L( AIM L WA Y Header Stop MA L WA Y ThOMW AIM WA Y Intt3taps Wr AIM L WA Y Door AIM L WAI Win Int Sash M/I JIM L WA Y Door Casing AIM W ExtodorSlll W L WA Y DwJamb WA Y Pert M/I L WA Y Threshold AIM L WA Y BI' Stop IM11 L WA Y Door AIM L WA Y n Ext Sash MA L WA Y Pres AIM L WA Y Closet Door V AIM L WA Y Eamb AIM L WA Y Cl Casing c, t; AIM L NIA Y hold AIM L WA Y Closet Jamb 11.0 AIM L WA Y WlndoW 911 6. MA AIM L WA Y Closet Walls L. 1 AIM L WA Y Win AD= c JIM L WA Y CI Baseboard C L NM L NIA Y Win Casing I. AIM L WA Y Closet Pole N 1, A/M L WA Y Header Stop C'J. Mil AIM L WA Y Closet Shelf N I, AfM L WA Y D Int Stops .,o MVI AIM L WA Y CI Supports �L AfM L WA Y L7 Wen Int Sash Vk Mel AIM L WA Y Closet Floor N t A/M L WA Y Extortor Stll 1/n MVI L WA Y Closet Ceiling e t AIM L WA Y Part Bead boc M/1 L WA Y Cabinet Framer I.b) AIM L WA Y "IftpVIZ M/I L WA Y CabQr8w0re d' AIM L WA Y Ve- Mil L NIA Y �Gf LsJ Z MVI M L WA Y COMMENTS I STRUCTURAL DEFECTS: Mantle AIM L WA Y Ce AIM L NIA Y Mll AIM L WA Y MA A/M L WA Y EXCLUDED SURFACES:Surfaces listed in these box®" n made Intact onlyb a licensed deleader. SIDE LOCATION MCASURC:LODGE PAINT IC IC SIDE LOCATION MCA8LiR6;LCO89 PAINT Ic Ic MAN e$2.IN. DATE METHOD (MORE THAN P8 S .IN. DATE METHOD Panther Lead Paint Inspection,969 Washington St.Braintree,MA 02184-(791)849-7313 TIGER HOME INSPECTION Fax:1(781)356-4487 May 23 2005 1037 P. 11 K 11 --Z / Ins PelAor(print) Lic# Signature Date (p 1 Risk Asseasor(print) Litt Signature Date Addrw of P [ �.c ti�pa, E�, Apt tt City 4-d&l e 81DH LQCATION/ LEAD TYPE OF URt3 IC IC DELEAD DELEAD $ICE LOCATIpW LEAD TYPE OF UR6 IC IC DEL DELI;AD SURFACE HA2 DATE METH DATE METH SURFACE H HAZ7 DAtE MEF ATE METH A ® Up WaI� c.L NM L WA Y Window SM Wi AIM L NA Y A 6Lo LOW A rt Walla f.J AIM L WA Y Win Apron AIM L WA Y A B g ppa�s G•f AN L WA Y in Casing AIM L Y A 6 AIM L WA Y Header Stop MA WA Y Redlatis>�,� AIM L WA Y Int Stops AIM L WA Y Floor i AN L WA Y Win Int Sash MA AIM L WA Y Ceiling C L AIM L NIA Y Exterior Sid Mil L WA Y Door G L AAuI L WA Y w rG, ) Pad B MA L WA Y Door Casing c 1 AIM L WA Y @I' Slap Mn L WA Y Door Jamb s• AIM L WA Y in Ext Sash Mil L WA Y Threshold c- / AIM L WA Y Closet Door A/M L WA Y Door A/M L CI Wing AIM L WA Door Geeing L WA Y Closet Jamb AMM L Y Door Jamb AIM L WA Y Closet Walls L WA Y Thmshold NM L WA Y Cl Baseboard A/M L WA Y Door AIM L WA Y Closet Pole AM L WA Y D asing NM L WA Y Closet Sh NM L WA Y Jamb AIM L WA Y CIS ds AIM L WA Y Threshold L WA Y set Floor AIM L WA Y Door AIM L WA Y Closet Calling A/M L WA Y Door NM L WA Y Up Cab Fra m c 0 AJM L NIA Y Jamb AIM L WA Y Cab Door -r AIM L WA Y Threshold NM L NAJ Y Up cab WallAN L WA Y Window Sill e-a, M/1 NM L WAI Y Up cab 3hNa NM L WA Y Win Apron a U A/M L WA Y Supports 11 AIM L WA Y Win Casing 4o, NM L NIA Y Low Cab Frain a NM L WA Y Hefi&Stov vi MA A/M L WA Y Cab Door c NM L WA Y Int Stops r•oj MA AIM L WA Y Low Cab W9111 AAV L WA Y Wln Int Bash G 1 MA AIM L WA Y Low Cab ShN r 4 AIM L WA Y Exterior SSI 1.!• MII L NIA Y Suppoda C. c AIM L WA Y Part Bead etv WI L WA Y jDrawers e.J AAM L WA Y Bond Stop e.v I Mil L NIA YIM/1 AIM L NIA Y Win Ext Sash MA L WA Y MIi A/M L WA Y COMMENTS/STRUCTURAL DEFECTS! MA AJM L WA Y M/I NM L WA Y W AIM L WA Y MVI NM L NIA Y EXCWD DSURFACES;Surfaces listed in these boxes can ba made intact on b 1 a 11cenod deleader. BIDE LOCATION MMOURE;LWZF.PAINT IC is SIDE LOCATION MEASURE:LOOSE PAINT IC IC (MORE T DATE METHOD MOR AN 288 SOI DATE METHOD Panther Lead Paint Inspection,969 Washington St.Braintree,MA 02184-(781)844-7313 TIGER HOME INSPECTION Fax:1(781)356-4487 May 23 2005 1037 P. 12 Page�� pt1� 1 Intpector(print) Lie# signs s' Delte Date I Rlsk Assesiaor(print) UC# Signature 1 Address of PmPe.2 Pro (� G 4 Apt# City dmv ee— STAIRCASE l r�P 1 ;L,i�jggg N1 SIDS: LOOATIOW LEAD TYPE OF URO IC IC DELEAJ DELEAD SIDE LOCATIOW LEAD TYPE OF URO IC IC DELEAD DELEAD SURFACE RD ? DATE METH DATE METH SURFACE H HAZ DATE METH DATE METH A Up Wale 60 A/M L WA Y Cheat Door AAM L WA Y A B AIM L WA Y CI Casing AAM L NIA Y i A AN L WA Y Closet Jamb a L W Y A B . Rail G f AIM G NIA Y Ian v Glosel Walls WA Y AN L NIA Y Cl Baseboard AIM L WA Y Floor . NM L WA Y Closet pole AIM L WA Y I i Gelling NM L WA Y Closet She AIM L WA Y Door /� AN L WA Y CIS ds AIM L NIA Y A f Doom r. AIM L WA Y t Floor AIM L WA Y I Dos Jamb G 2, AIM L WA Y Closet Ceiling AIM L WA Y i T AIM L WA Y Natwi P AIM L WA Y ! Door 4i,r AIM L WA Y Baib9 ttp AIM L WA Y i Door Casing L WA Y L- Handrail Ar(1 AIM L NIA Y p� AIM L WA Y o (+ BaltlslB r AN L WA Y Thre A(M L WA Y ��+ G P L A!M L WA Y Door AAM L WA Y Treads N G AN L WA Y Door Casing AIM L WA Rlsars N L AN L WA Y Door Jamb A Y trlog�-. NM L WA Threshold AAuI L WA Y Door WA Y Door AIM L WA Y Door Casing AN L NIA Y DoorC AIM L WA Y Dos AN L WA Y D mb AIM L WA Y nreshold AIM L NIA Y hreshold A Y F mg AIM L WA Y Door AIM L WA Y ogln AN L WA Y Door Gasing AIM L WA Y asing AIM L WA Y poor NM WA Y Gv v„•h �. M/I AIM L WA Y =Pazrashold AN L WA Y NIA AIM L WA Y Window Sill MA AIM L NIA Y NIA AIM L WA Y Win Apron NM L WA Y MA AN L WA Y Win Caging AN L WA Y MA AIM L WA Y Header Stop W NM L WA Y MA AIM L WA Y Int s NUI AMI L WA Y COMMENTS/STRUCTURAL DEFECTS: Win Int Saatl MA NM L WA Y Fidarior Sill NUI L NIA Y Pad Bead Mil L NIA Y Blind Stop NUI L WA Y Win EM Soh Mil L WA11 Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact on1v b i a licensed deleader, $IDE LOCATION INFASUREe LOOSE PAINT IC IC SID LOCATION MEASURE:LOOSE PAINT IC IC THAN 288 S DATE METHOD 8 8 .IN. DATE MInTHOD Panther Lead Paint inspection,969 Washington St.Braintree,MA 02184-(781)849-7313 TIGER HOME INSPECTION Fax:1(781)356-4487 May 23 2005 10:37 P. 13 Tr3GSz 5 r `t of Pag/?Df1- Inspector(print) UC# Bo re bate Risk Assessor(print) Llc# Signature Date Address or Pro aClclr% k Apt# City I IV• r- STAIRCASE 1." r lac. 4, if W w SIDE LOCATION! LEAD TYPE OF URO IC IC DELEA DELEAD SIPS7LOCATION/ LEAD TYPE OF URm ICIC DELEAO DELEAD SURFACE HAZ7 DATE METH DATE METH HAZ9 DATE METH DATE METH XLLpWalls AIM L WA Y AIM L WA Y A6 �rr.WeNs'�" A/M L WA Y Cl Casing AIM L WA Y A IB Baseboard$ �r ( AIM L WA Y I OlosetJamb AIM L W Y " e cpetfr A1M1 L N/Al Y Closet wails WA Y AIM L WAI Y CI Baseboard AIM L WA Y Floor `�' AIM L WA Y Closet Pole AIM L NIA Y CeNinp c y AIM L WA Y Closet Shelf NM L NIA Y Door L. v NM L WA Y CI SU AIM L WA Y Door Caging✓ ev L NM L NIA Y Plet Floor AN L NA Y nl Door Jamb 9.0 AIM L WA Y Closet Gelling NM L N/A Y Threshold C,e AN L WA Y Newel Post IUM L WA Y Door t o AIM L WA Y walling Cap c. AIM L WA Y Door Cum— to AIM L WA Y Handrail 4f AIM L WA Y A Z Door Jamb A/M L WA Y Balusters Z AIM L WA Y Threshold l r AIM L NIA Y L VALWIL— NM L WA Y Door 6 NM L WA Y Treads Cer) NM L WA Y Door Casing r a NM L WA Y Rlsers g.t AIM L WA Y I Door Jamb (.0 AIM L WA Y d Stringer 0.1' AIM L W& Y Threshold c+f AIM L WA Y Door L WA Y Door NM L WA Y Door Caging AIM L WA Y Door Casing r r AIM L WA Y Door AIM L WA Y ell Door Jamb 6. AIM L NIA Y reshold AIM L WA Y Threshold c AIM L NIA Y Floor Casing A/M L WA Y Door NM L WA Y Floor ins AIM L WA Y Door Casi AN L WA Y all Casing AIM L WA Y DWlfmb AIM L WA Y IMA AIM L WA Y hre$hold AIM L WA Y MA AIM L WA Y Window SII/ M/I AIM L WA Y Mil AIM L WA Y Win Apron Aim L WA M/I A/M L WA Y win Casing AIM A Y MN A/M L WA Y Header Stop MII L WA Y MI1 AIM L WA Y Int s I A/M L WA Y COMMENT$/STRUCTURAL DEFECTS; Win Int Sash MI1 A/ML NIAI Y I qr."7 A L C.++r. Extarlor 8;1V' MII L WA Y 50 {(,p eke O d� AW - 1Part d MA L WA Y 366d Stop Mil L WA Y Win Ext Sash M/1 L WA Y EXCLUDE REFACES:Surfaces listed in these boxes can be made intact onlyb a licensed deleader. SrttlE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LpCATION MEASURE:L001RC PAINT IC IC MORE THA DATE METHOD (MORE THAN 288 90,IN. DATE METHOD Panther Lead Paint Inspection,969 Washington St.Braintree,MA 02194-(781)849-7313 TIGER HOME INSPECTION Fax:1(781)356-4487 May 23 2005 1038 P. 17 R r G�' Pae Of' Inspector(print) Uc# Signatowe' g Disk Assessor(print) Lia# Signature Date Addrem of ProApt# City /V, A /W P/ • ,Ililp, nPn� �• ' $10E LOCATION/ LEAD TYPE OF URO IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URQ IC IC DELEADI DELEAD SURFACE kwl— HAiAp HAZ? DATE METH DATE Mt:TH SURFACE HAZARD HAZ? DATE METH DATE METE! A e Up Wells AIM L WA Y Window Sill �, AIM L WA Y A 5 AIM L WA Y Win Apron L WA Y su A B Baseboards AIM L WA Y win Casing L WA Y A aCb,Nff— AIM L NIA Y Header Stop NM L WA Y Redd-^ AIM L N/A Y Int Stops L WA Y Floor AIM L NIA Y Win Int Sash M/I AIM L NIA Y Coling It, t NM L WA Y Exterior Sill 6WA Y Door L AMI L WA Y Part Band ,N MII L WA Y Door CaeN 6 A, AIM L WA Y Blind Stop t 1V W L WA Y Door Jamb NM L WA Y Win Ext Sash G, M11 L NIA Y Three AIM L WA Y Window Sill W AIM L WA Y Door AN L WA Y Win Apron AIM L WA Y Door Casing e.ra AIM L WA Y Win Casing NM L WA Door Jamb NM L WA Y Header Stop Mil NM A Y T AIM L WA Y Int Stops M11 L NIA Y Door AIM L W Win Int Sash NM L NIA Y Ooor CnsinpAgkNA Y Extelfor Siil Mil L NIA Y Door Jamb M L WA Y Part M11 L NIA Y Threshold AIM L WA Y Stop W L NIA Y Door OFAIM L WA Y Win Ext Sash MII L WA Y DoorqsAng NM L WA Y 010SM Door NM L WA Y DpfJ&rnb AIM L WA Y Cl Casing G 7 NM L NIA Y reshdd NM LWA Y Cloast Jamb 4 U AN L NIA Y Window Sill OWD A L NIA Y Closet wells tp.+ AIM L NIA Y Win Apron NIA Y D Cl Baseboard &,L AIM L WA Y Win Cain L WA Y Closet Pole AIM L WA Y Header Stop �, AN L NIA Y cIQWA AMI L WA Y Int Stops L WA Y CIS AIM L NIA Y Win Int Sash M/I AIM L WA Y Closet Roor AIM L NIA Y Exterior Sill WA Y Closet Ceill c. AIM L WA Y Part Bead Mlk L WA Y Cabinat From® NM L WA Y eund 22 e,-4 Mil L NIA Y NM L WA Y Win Ext Sash L&y M/I L WA Y M11 AIM L WA Y COMMENTS/STRUCTURAL DEFECTS: Mand NM L NIA Y A,P —c,y &, /104 C&V A Ah S , re lace AIM L WA Y M/I AIM L WA Y M/I AIM L NIA r EX LUDED RFACE ;Surfaods listed in ftso boxes can be mado intact oniv by a licensed deleader. SIDE LOCATION MPASURE'LOOSE PAINT IC IC SIDE LCQATION LAPARUPIM Looee ndwT le Ir_ MORE THAN 288 80,INJ DATE METHOD .JQUJaIj 200 00, N. DATE METHOD Panther Lead Paint Inspection,969 Washington St,Braintree,MA 02184- (781)849-7313 TIGER HOME INSPECTION Fax:1(781)356-4487 May 23 2005 1038 P. 14 8 ) L M'z 5_//�k' Page 13 of Lie# Si n urs ate Inspector(print) 9 Lic# SI nature Date ,/ � RiskAse®ssor(ptEnt) f /1 LdVPr Address Pro ''r°aOGr� Jtt# City Fe,,URFA LEAD TYPEOF UR IC IC DREAD DELEAD SIDe LOCATION/ LEAD TYPE OF URG IG IC DELEAD DELEAD HAZ? DATE METH DATE METH SURFACE HAZARD__ HAZ? DATE METH DA METH e•u AIM L NIA Y Window SIIl W AIM L WA Y AIM L WA Y Win Apron AMI L NIA Y .000 O( AIM L N/A Y win Casing A(M L WA YAIM L NIA Y Header Stop MII AIM L Y RaiatarAIM L WA Y IM Stops M11 WA Y Floor Eai AIM L WA Y Win Int Sash AIM L WA Y Ceiling AIM L WA Y Extartor Sill WI L NIA Y Door a v AIM L WA Y Pan Bead MII L WA Y Door Casing a : AIM L N/A Y Olin p ANI L WA Y (, Door Jamb i.a AIM L NIAJ Y1;7,Ext Sash 1141 L WA Y Threshold a•- AM L WA Y Window Sill WI AIM L N/A Y Daor AIM L Y Win Apron AIM L WA Y Door Casing AJKNIA Y win Casing AN L W Y Door Jamb AIM L WA Y Header Stop MII AIM A Y Threshold AIM L WA Y Int Stops WV<W L WA Y Door A/M L WA Y Win Int Sash AIM L WA Y Door sing NM L WA Y Exterior Sill MII L WA Y r Jamb AIM Y XEASash MH L N/A Y Threshold M L WA Y NUI L WA Y Door AM L WA Y IWI L WA Y Door Cas AIM L WA Y MW Door AN L NIA mb. AIM L WA Y CI Casing AIM L Y reshold AIM L WA Y Closet Jamb L WA Y 01 Window Bill MII AIM L WA 0 Y closatwalls AN L WA Y WIn Apron AM L WA Cl Baseboard AIM L WA Y Win Casing AIM L)91 Y Closet pole AIM L WA Y Haedor Stop Wl A6K NIAJ Y Close If AIM L NIA Y IM Stops AIM L NIAJ Y upporis AIM L WA Y Win Int trash MA AIM L WA I Y lClaset FImr. AIM L WA Y Exterior SNI Wl L WA Y lCiold Ceilin AIM L WA Y Part M/I L WA Y jCabrarna AN L WA Y Bli-roflop MA L WA Y ab Drawers AN L WA Y in Ext Sash MA L WA Y M11 AIM L N/A Y MMENTS I STRUCTURAL DEFECTS: Ma AM L WA Y k q ( -g ll,� N 4 re IaC® AIM L WA Y MA AIM L WA Y NYI AM L WAI Y EXCLUDED SURFACES3urfaces listed in these boxe made intact on1v b i a lioeneed deleader. EID£ WQAT19n MEAWFIC:LO&M PAINT ICIC S10E LWATION �rEA$UM LOOP6 PAINT IC IC RE 7 DATE METHOD RE THAN 288 DATE METHOD Panther Lead Paint Inspection,969 Washington St.Braintree,MA 02194-(781)849-7313 TIGER HOME INSPECTION Fax:1(781)356-4487 May 23 2005 10:38 P. 15 R PageIof !I 4 Inspector(print) Lic# Sign ure Date Risk A,as osor(print) *� Lic# Signature Date �t l /y_ Address of Property 9 ('--P"jam Apt# City I`� , &jGy,0,, FAI LOCATION LEAD TYPE OF URG IC IC DREAD DELEAD SIDE LCCATIONI LEAD TYPE OF UR(i IC IC DELEAD DELEAD SURFACE H HAZ? DAFE METH DATE METH SURFACE HAZ? DATE METH DATE METH Up Walls E,v AIM L WA YWindow Bili Mil NM L NIA Y t wYI fr— NM L WA Y Wln Apron NM L WA Y fl. CA e Baseboards &I AIM L WA Y Win Casing NM L NA A ® AIM L WA Y Haade►Stop Mil NM A Y B3tll9lor+"'- NM L WA Y Int stops MA L WA Y Floor a•Ir AMI L WA Y win Int Bash i NM L WA Y Ceiling L AIM L WA Y Exterior Sill Mil L WA Y Door M b AN L NIA Y Pan Be MA L WA Y Door Casing t AIM L WA Y BI' top M11 I_ WA Y G Door Jamb !r j NM L WA Y in Ext Bash MII L WA Y Thr O&kt" NM L WA Y Window Sill IMA AN L WA Y Door I AIM L WA Y Win Apron NM L WA Y Door Casing t 8 NM L WA Y Win Casing AN L W Y Door Jamba 0 NM L WA Y Haider Stop MA WA Y j Threshold AIM L WA Y Int stops hYAM L WA Y Door NM L WA Y Win IM Sash WI AJM L WA Y Door Casing AN L Y Exterior Sill MA L WA Y Door Jamb YK WA Y Pan B MII L WA Y Threshold NM L WA Y0494 Mil L WA Y Door PJM L WA Y Win Ext Sash MA L WA Y &Ircasoe AIM L WA Y Closet Door A4 AIM L WA Y D mb AN L WA Y CI Casing NM L WA Y rashold AIM L WA Y Closet Jamb F.,7 AIM L WA Y window Sill 6,j W1 AIM L WAI Y Clasetwalls a• r AIM L WA Y Win ron I NM L WA Y Cl Baeaboa b.L AIM L WA Y Win Casing 4 L NM L WA Y CWI Pole AL AIM L WA Y Header Stop .•t Mil NM L NIA Y Closet shelf W1, AIM 7A. Y IM Stops MA NM L N!A Y CI Supports Arc AIM L WA Y Win Int gash L. D MA AIM L NAI Y Closet Floor AN L WA Y Exterior Sill e. MA L WA Y Closet Coiling R.i NM L WA Y Part BoadC.V. ANI L WA Y Cab net F PJM L WA Y aund stop if W L WA Y rawer$ AN L WA Y Win Ext Sash.l e.t Mil L WA Y MII AIM L WA Y COMMENTS/STRUCTURAL DEFECTS: Imantle AN L WA Y 5wFace NM L WA Y W NM L WA Y MII NM L N/Al Y EXCLUDED SURFAC8,SurfacesSURF listed in these boxes can be made intact onl b a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IC IC —AMORETHAN 288 5 .IN. DATE IMETHOD —AMORETHAN M SO.INJ DATE wmoo Panther bead Paint Inspection,969 Washington St.Braintree,MA 02184-(78 1)849-7313 TIGER HOME INSPECTION Fax:1(781)356-4487 May 23 2005 1038 P. 16 a.�.0%r 1,36'�z z 7 Impactor(print) LiC# Signature to Filsk Assessor(print) ` LID# 5, nature Date - Address of Pre r 5 0-Pindam, Apt# CRY, /V• d a vo r` FI �WW— LEAD TYPECF UAQ 10 IC DELEAD DELEAO SIDE LOCATION! LEADTYPt:CF URG IC IC BAp DELEAD H HAZ4 DATE METH DAtt METH SURFACE HAZ? DATE DATE METH L AIM L WA Y Window 3111 W AIM L WA Y NM L WA Y Wln Apron AIM L NIA Y A Baseboards L AIM L NIA Y Win Casing AIM L Y A a aalr-w— AIM L WA Y Header Stop MA NIA Y AIM L NIA Y Int Stops NM L WA Y Floor 1•�a AIM L WA Y Wln Int Sash W PJM L WA Y Ceiling G t AIM L NIA Y Exfador Sill MII L WA Y Door d NM L WA Y Part Be MII L WA Y DocrCaslno AIM L NIA Y Blipawp M/l L WA Y Door Jamb AN L NIA Y in Ext Sash MA L WA Y T hreahaid IN (. AIM L WA Y Closet Door AIM L WA Y Door AIM L NIA Y Cl Casing AIM L WA Door Casing AIM L Y Closet Jamb AIM L Y boor Jamb L WA Y Closet Walls WA Y Thmww AIM L WA Y CI Baseboard AIM L WA Y Door AN L WA Y Closet Pole AIM L WA Y Ooaf C AIM L WA Y Closet She! AIM L WA Y D amt AIM L WA Y C1$u its AIM L NIA Y hreshold Y et Floor AIM L WA Y Door AIM L WA Y Closet Calling AVM L WA Y Door Cooing NM L WA Y Up Cab Frame m A AIM L WA Y oor D ) AIM L WA Y Cab Door c > A✓M L WA Y ;WQdd AIM L WA Y �} Up Cab Weill r, AIM L NIA Y Window Sia Mil AIM l WA Y Up Cab Shiva N U AIM L WA Y I Win Apron NM L WA Y u AIM L WA Y Win Casing I NM L WA Y Low Cob Fra w 2. AIM L NIA Y Header Ston W AIM L WA Y Cab Door NM L WA Y n Int$tops I Mf) AIM L WAI Y % 5 Low Cab Wall a-i AIM L WA Y D Win Int Sash MAI AIM L WAI Y t-,4o NM L WA Y ExteriorSill NUI L WAI Y Suppofti AIM L WA Y Part Bead W L NIA Y Q�81rerSr NM L NIA Y Blind Stop MII L WA Y Mrl NM L WA Y Win Ext Seth NUI L WA Y MAI NM L WA Y COMMENTS/STRUCTURAL DEFECTS: MII NM L NIA Y Mil NM L WA Y Mli NM L N/Al NUi AIM L WAI Yzj EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact only b 1 a licensed deleader. SIDE LOCATION MEASURE:LOOSE FAINT IC BIDE LOCATION MIENWA6,W*%C TAINTIc Id (MORE DATE METHOD q TKANgg DATE METHOD 9 Panther Lead Paint Inspection,969 Washington St,Braintree,MA 02194-(781)849-7313 TRANSMISSION VERIFICATION REPORT TIME 05/2312005 09:41 NAME HEALTH FAX 9786888476 TEL 9786888476 SER. # 000B4J120960 DATEJIME 05123 09:41 FAX NO./NAME 9788518547 DURATION 00:00:00 PAGE(S) 00 RESULT BUSY MODE STANDARD BUSY: BUSY/NO RESPONSE Health Departmartment, 5/23/05 400 Osgood St, N.Andover Ma. 01845 Please Grant me an extention until 5/27/05 on fixing the code violatio 3 Clarendon St. ?� I am in the process of replacing the screens The basement windows have been ordered by the deleader M Viesna Sar AY 2 3 2005 TOVV,j, New England Enviromental Services H . The work is to begain on 6/4/05 "I` °'RTMSrrVVTER I have made reservations at the Tage Inn for the Polimeno's For 6/4,6/5 There will be a wipe test on 6/5 but cannot be sent to the lab til Monday 6/6 So they can return on 6/6 I have repaired the cracks in the basement I have installed storm doors Thank You R Cerbone 05/22/2005 20:10 9786872454 TACE INN CORPORATION PAGE 01 _......... E '""WNEWMOI� Ge'c r"C:om ctha." --hw mst:" TACE INN ANDOVER 131 RIVER ROAD ANDOVER.MA-01810 RECEIVED Phone: 978-685-6200 MAY 2� 3 2005 Reservation Confirmation TCI§jET"DEPAR-1 ORTH TER POLOMENO, JAMES L 131 RIVER RD ANDOVER, MA 01810 Dear James Polimeno, We look forward to welcoming you to our hotel. Thank you for your patronage. We currently show the following information for your reservation, please review this for its accuracy. Guest Name: POLIMENO, JAMES Reservation Number: 4043018567 Date Made: 05/22/05 Arrival Date: 06/04/05 (Saturday) Nights: 2 Departure Date: 06/06/05 (Monday) Guests: 2/0/2 Rate: $89.95 Gtd By: DISCOVER Rate Change: Room Type: TON -2 QUEEN/NONSMOKING Deposit Received: Notes: rm &tax only cc authorization under c Viesna Sar i New England Environmental Services ; -R u� Lead Paint &Asbestos Removal R General Repairs and Construction19 22 11. Free Estimates Control No: 57 Southside Ave. Office (781)286-6511 ' RECElVE� Lynn, MA 01905 Cell (781) 589-9375 WONWEALTH OF MASSACHUSETTS nts of'Labor.and Workforce Development MAY 3 2005 division of Occla f`®hal Safety . 399.Washington Street, 5th.Floot,,Bosto%.Massachusetts 02 OF N(D TH ANDO TER (}�jW N HEALTH DEPART DEh;EADER CONTRACT ? 2 LICENSE VIESNA SAR LEADPAINT REMOVAL&GENERAL CO NST. CO. 76 SHIRLEY AVE REVERE MA 02151 A, LICENSE DC000145 EXPIRES: Tuesday,April 04,2006 TN ACCORDANCE WITH MGL CIS: I l l,4407 B(b)AND 454 CMR 22.03 THIS CERTIFICATE IS ISSUED BY THE DEPARTMENT OF,;LABOR AND WORKFORCE DEVELOPMENT,DIVISION OF OCCUPATIONAL SAFETY TO THE CONTRACTOR ABOVE FOR THE PURPOSE OF ENTERING\ENGAGING IN DELEADING WORK. THIS LICEN§E IS:VALID-FORA A PERIOD OF ONE YEAR. THIS CERTIFICATE MUST BE MAINTAINED BY THE CONTRACTOR WHEN ENGAGED IN DELEADING WORK IN ACCORDANCE WITH MGL CH. 11 I § 197B(b)(2)AND 454 CMR 22.03. e Robert J. Prezioso, Com ssioner Commonwealth of Massachusetts FEB. N.E. REGIONAL COUNCIL FEB. Division of Occupational Safety MAR. � ����SJIRPENTERS Robert J.Prezmso,Commissioner t� �° �� b MAR. Beleader-Contractor APR. , 40APR MAY MAY VIESNA SAR JUNE ' JUNE Eff.Date 03/30/05 JULY G: t )o h D.Power,Business Mgr. JULY Exp.Date OM04/06 AUG. ; Mark Edich,Business Rep. AUG. ` (617)!547-8511 DC000145 SEP. } Meets 4th Tues.,VFW Hall SEP. OCT. k 688 Huron Ave.,Cambridge OCT Member of C.O.N.E.S.T. 06 NOV Viesua Sar NOV. BO � U-19945273 DEC. b 2005 10 HtJLNVORrtiV ST,CAMBRIDGE,MA 02138 o<95>1-2006 I IIT I' 'Iii�I,I�II�III III VIII III I�I�� SON RENEW Lead Inspection / Risk Assessment Report Page 1 Of Method Used: [9 Na2S Exp.Date P A N T H E ®X-Ray Fluorescence Lead Paint Inspection Model RSD Serial# 112T' St.# Address A t. ®❑❑❑ ZJ®ao®©E]©o❑a®oo©93❑❑❑❑❑ n❑❑❑ Ci Zip Code 9aa©M❑ o©©®❑❑❑❑ ooa©© Owner Name: Single Family _ Owner Address: do Multi Family 4� �d v h r�- al sy /�. #units ?— Client Name if different from owner : Condominium _ Client Address: Day Care _ Key: Inspection Dele-adi-na Other, © Comprehensive Inspection a) AIM Accessible/Mouthable CAP Capped CWV Cov wNjnyi CAP Capped COV Covered CWA Cov w/Aluminum COV Covered DIP Dipped Comments: INT Intact ENC Encapsulated L Loose MI Made Intact Ge(.`6-�,;. .sr e o r,t �.0 1 01 •401 a M/I Moveable/Impacted PRE Prepared MET Metal REM Removed NA Not Accessible REP Replaced NC No Coating REV Reversed NEG Negative SCR Scraped POS Positive VR Vinyl Replacement VR Vinyl Replacement Floor# C Floor# tai C .......j.. j ? i .........:........ .......a........;.........:...... ? .. .».i......». ....!.... ! ......e...............I.......»i i I i.......»!.........?........:»................ E ...................�.. j i ? .......;.. i t ..rs.3.. .j. I �i .........i................? .-.. .......................?.........i.......»i.........j.........................1.........j.........1...... .. ? ..............d.......?......... .. .. I .. A .........i......... ........:.......:..»......»............... .......i........................... s..».....?........!..»....:........'....... .....i.........i.......»?.......».• ' � .. .....i... ....t». ...�...•. i j i i j 3 i } ; f »........._........�......_... ...?..... i ........ ........i.........i.......»?..... ................................................... .. .. ? i e.......f........j.. ? i : ............ ..................•..CJy1.........j.........?......»......... ........?........ .... ? ....1.... i j.....? . I ,......... .....e.»..»:........:........r. j ». ...F.. ........... r.... 1 i j .. ? .. • I ....... . ;....... ....�1�WII i........:.........:......r I..................;.........?.......... . j.............. ....,.;.......I.......»t ...... ,...... .. j...... ! i B ; ; ...;.. .!.................»'........!...................:.......»_.........i..... ..»................:................................ i .......................t ? .............F...Gr(�. .d.......i................;.........j........3.........:........?.........i».... .. ............. ....�. ; �,`.._. 1 i ! ? .......... ,.......1...........:............................... .j.........;: .........•...............».�:.........:•.........!.........j.........j�.......'...... ...... ....t. ..... ...1...... ...;3 ....... j .. j......... .................. . i »....9......i..... ! A(Street Side) A(Street Side) Pb(lead) equal to or greater than 1.0 mg/cm2 with x-ray fluorescence or positive with Na2S is Dangerous. INSP, DATE Lead Hazards? ® � l 0 5 (Or N) �d�" Eng- ' �r L Inspector (priid 7 tSignature Lic.# R.A. DATE Urgent Lead Hazards? D(YorN) Risk Assessor(print) Signature Lic.# n ,,rt,a roma nom;„�T_­.,.+4__ 040 rR A m 1 Qn 1'7Qi NQ A 0 -72 1'2 e � y LEAD INSPECTION/RISK ASSESSMENT HISTORY PAGE Page Z of Property Address Apt# City Zip INSPECTION ACTIVITY KEY EXAMPLE BOX 1.Re-Inspection 8.Full Deleading Compliance 15.Maintained Interim Control 2.Re-Occupancy Re-Inspection 9.Post Compliance Assessment Determination 16.Restored Interim Control 3.Work In Progress 10.Maintained Compliance 1 Inspection Activity Number 4.Dust Taken 11.Restored Compliance 5.Dust Received 12.Interim Control P Pass or Fail P=Pass 6.Soil Taken 13.Recertification of Interim Control F=Fail 7.Soil Received 14.Post Compliance Assessment of Interim Control Inspector Inspector Lie# Lic# Inspector Inspector II IT - Lie# Lie# Inspector Inspector II I IT - Lie# Lie# I I I IT - Inspector Inspector Lie# Lie# Inspector -IT Inspector Lie# Lie# Inspector Inspector Lie# LLie# Inspector Inspector Lie# Lie# DATES COMMENTS 7,X A AIN,OA x"01 N 0 AA • rrJJ yy J ��✓�, �� .�3�sZ �� Page 7 Of IIZ Inspector (print Lic# Sign ure bate Risk Assessor (print) / Lic# / C Signature Date Address of Property 3 cl�'r�`Oro� Or Apt# City A)* EXTERIOR SIDEJ LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD A SURFACE HAZARD HAZ7 DATE METH DATE METH A SURFACE HAZARD HAZ9 DATE METH DATE METH Siding F7 L N/A Y Window Sill AN L N/ Comer Boards 9°� L WA Y A Win Casing WA Y ° A Lower�m L N/A Y Window Sash AIM L N/A Y Upper Trim AIA- L ta Y i.�{. Window Sill AIM L WA Y Wi S: L N/A Y AtWinC ' g AIM L WAL N/A Y ow Sash A/M L WStorm Door AIM L WA Y r Win Sill WA Y Door C p A/M L WA Y AWin Sash AIM L WA Y ADoor Casing AI AIM L N/A Y ICel Win Frame AIM L N/A Y Door Jamb L A/M L WA Y Cellar W' II AIM L WA Y Threshold N` A/M L WA Y A C In Sash AIM L WA Y Kickplate A/M L N/A Y Cel Win Frame /A Y Storm Door ry c A/M L WA Y Cellar Win Sill AtM L N/A Y Door A/M L N/A Y A Cef Win S AIM L WA Y AQ oor Casing " A/M L WA Y C m Fram AIM L WA Y Door Jamb 1 AIM L WA Y Cellar Win Sill n/L AIM L WA Y Threshold N v AIM L N/A Y A Cel Win Sash 46, AIM L N/A Y Kickplate o L A/M L WA Y Cel Win Frame N L A/M L WA Y Door AIM L WA Foundation WG L N/Al Y A Door Casing NM;,,'OA' Y A AIM L WA Y Door Jamb A L N/A Y DaeeS-1 AIM L WA Y Threshold AIM L N/A Y AN L N/A Y Door 000, A/M L N/A Y s AIM L WA Y A Door C g AIM L N/A Y R" Cap' A/M L WA Y FhreshDamb A/M L WA Y H3pd> AIM L WA Y old AIM L WA Y A B AMI L WA Y Window Sill A/M L WA Y Lo ail AIM L WA Y A Win Casing AIM N/A Y Treads /ve A/M L N/A Y �—Window Sash AMI L WA Y Risers �"� A/M L WA Y Window Sill L WA Y Stringer L. A/M L N/A Y A Win Casin A/M L N/A Y Floor Af A/M L WA Y W' w Sash A/M L N/A Y rim AIM L WA Y COMMENTS/STRUCTURAL DEFECTS: A/M L WA Y A CQkffr sf ' AIM L N/Al Y A/M L N/Al Y J A/M L WA I Y Excluded Surfaces;Surfaces listed in this box can be made Soil Test Results intact only by a licensed deleader Must be less than 400 ppm for play area/1200 Dom for bare soil SIDE LOCATION MEASURE:LOOSE PAINT IC IC LOCATION AREA MEASUREMENT RESULT REMED REMED A MORE THAN 1440 SQ.IN. DATE METH Square Feet (PPM) DATE METH A Play Area A Bare soil A Comments: A D..,,+l-T -A D-+T--.,+;-- OF,O 7k4 M1 QA - !'7QI1 QA.O_'7Z11 . t Page Of /4 Inspector (print) Lic# Signa re Date Risk Assessor (print) Lic# Signature Date Address of Property 3 G0�-e</�oa S12, Apt# City 4 EXTERIOR SIDEJ LOCATIONI LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD B SURFACE HAZARD HAZ? DATE METH DATE METH B SURFACE HAZARD AZ? DATE METH DATE METH Siding , 11, L WA Y Window Sill A/ N/A Y Corner Boards q, L WA Y B Win Casing A/M L N/A Y B L L N/A Y Window Sash AIM L N/A Y Upper Trim A(6 L Nor Y rnT; Window Si AIM L N/A Y Win Above 5' VV, L WA Y B Win sing AIM L N/A Y Poreh L N/A Y endow Sash A/M L N/A Y Storm Door AIM L WA Y Cellar Win Sill (11�0 WA Y Door A/M L WA Y B Cel Win Sash 9--`! &N/A Y B Door Casing A/M L N/A ) Cel Win Frame (j>W Door Jamb AIM L NX Y Cellar Win Sill AI NIA Y Threshold A/ N/A Y B Cel Win Sash A/M L N/A Y Kickplate AIM L N/A Y Cel Win Frame A/M L N/A Y Storm Door AIM L N/A Y Cellar ill A/M L N/A Y Door 00 A/M L N/A Y B C in Sash A/kLL WA Y B Door Ca ' g A/M L NIA Y Cel Win Frame A/M L N/A Y Doo amb AIM L N/A Y Cellar Win S' AIM L NIA Y reshold A/M L N/A Y B lCeljWlash AIM L N/A Y Kickplate A/M LfiW Y el Win Frame A/M L N/A Y Door AXL N/A Y Foundation 11(o' L N/A Y B Door Casing A/M L N/A Y B BulkheadAIM L N/A Y Door Jamb A/M L N/A Y Fes' A/M L N/A Y Threshold A/M L N/A Y ShC t TT— A/M L N/A Y Door A/M L WA Y Newel post AIM L N/A olr B Doo asing A/M L N/A Y Railing Cap A/M /A Y or Jamb AIM L WA Y Handrail L N/A Y Threshold A/M L WA Y B Balusters A/M L N/A Y Window Sill A/M L N/A Y Lower Rail AIM L WA Y B Win Casing 7z A/M L N/A Y Treads . AIM L N/A Y Window Sas AIM L N/A Y Ris A/M L N/A Y WindowX AIM L N/A Y tringer A/M L WA B �Wiin asing A/M L WA Y Floor AIM A Y dowSash AIM L N/Al Y I I Low Trim M L N/A Y COMMENTS/STRUCTURAL DEFECTS: Lattice A/M L N/A Y B. Column A/M L N/A Y ..LCe'' g AIM L WA Y Joists A/M L N/A Y Excluded Surfaces:Surfaces listed in this box can be made Soil Test Results intact only b a licensed deleader Must be less than 400 p2m for Play area/1200plarn for bare soil SIDE LOCATION MEASURE:LOOSE PAINT IC IC LOCATION AREA MEASUREMENT RESULT REMED REMED B MORE THAN 1440 SQ.IN. DATE METH Square Feet (PPM) DATE METH B Play Area B Bare soil B Comments: B Panther T.earl Paint TncnP.ctinn. 969 Wnchinutnn St. Rraintree. MA 02194- (791) 949-7313 ��✓.T �' ���L d1V 6� Page Of V ef Inspector (print) Lic# Si9 na ure at Risk Assessor (print) / Lic# Si�nature Date ,gam Address of Property Apt# City /'� �o✓�/ EXTERIOR SIDE LOCATION/ LEAD TYPE OF URGIC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD C SURFACE HAZARD HAZ? DATE METH DATE METH C SURFACE HAZARD HAZ? DATE METH DATE METH Siding 1 L N/A Y Window Sill A/M L WA Y Comer Boards IL N/A Y C Win Casing A/M Y " C Lower Trim IL N/A Y Window Sash L N/A Y Upper Trim IL gk Y P-111 Window Sill A/M L N/A Y Win Above 5' 1110 IL CA Y C Win C A/M L WA Y Poral r 5' I L WA Y dow Sash A/M L WA oor AIM L N/A Y Cellar Win Sill A/MA Y Door 4A NIA Y C Cel Win Sash L N/A Y C I Door Casing P 2, AIM L N/A Y Cel Win Frame AIM L WA Y Door Jamb e.4 A/M L WA Y (I / Cellar Win AIM L N/A Y Threshold JV 1, A/M L N/A Y tr C Cel Sash AIM L N/A Y KWVaW A/M L WA Y el Win Fram AIM L WA Storm Door VG AIM L WA Y Cellar Win Sill A/M jWAA Y Door trp AIM L N/A Y C Cel Win Sash L N/A Y CY Door Casing a+. A/M L N/A Y Cel Win Frame A/M L N/A Y Door Jamb A/M L WA Y Cellar Win ' A/M L WA Y Threshold 0:. A/M L WA Y C Cel ' Sash AIM L WA Y Kickplate r;s AIM L WA Y el Win Frame AIM L N/A Y Door f/L A/M L N/A Y 0Foundation I L N/A Y C1 Door Casing u U AN L N/A Y C Bn eat' AIM L N/A Y Door Jamb At A/M L WA Y FeneeV` A/M L N/A Y Threshold , A Y Shy AIM L N/A Y Door A/M L WA Y Newel post 6S, A/M L N/A Y C Door Casin AIM L N/A Y Railing Cap o.0 AIM L N/A Y Door 406 A/M L N/A Y Handrail L A/M L WA Y reshold A/M L YAJ Y C Balusters J A/M L N/A Y Window Sill N/A Y Lower Rail G 2.1 A/M L N/A Y C Win Casing ZAIM L WA Y Treads tr'b AIM L N/A Y Window Sash A/M L WA Y Ris A/M L N/A Y Window Sil A/M L WA Y Stringer r,•o AIM L N/A Y C Winq91ng A/M L WA I Y Floor AIM L N/A Y ndow Sash AN L N/Al Y I I Low Trim e•z A/M L N/A Y MMENTS/STRUCTURAL DEFECTS: La#4e-- AIM L N/A Y C Columns r L A/M L WA Y 6 A/M L N/A Y Jois AIM L N/Al 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 pm for bare soil SIDE LOCATION MEASURE:LOOSE PAINT IC IC LOCATION AREA MEASUREMENT RESULT REMED REMED C MORE THAN 1440 SQ.IN.) DATE METH Square Feet (PPM) DATE METH C Play Area C Bare soil C Comments: C PnnthP.r Li-.ad Paint TngnPct;nn. 969 Washington St.Braintree.MA 02184- (7811849-7313 l�r/� ��' �3G�'Z 3�iy �- Page_OfG6 Inspector (print) Lic# Sig ature bate Risk Assessor (print) Lic# Signature Date Address of Property �4�°�/J� SI` Apt# City A A71*4V Vee— EXTERIOR erEXTERIOR SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDEJ LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD D SURFACE HAZARD HAZ? DATE METH DATE METH D SURFACE HAZARD H DATE METH DATE METH Siding irl L WA Y Window Sill A/M Y Comer Boards L N/A Y D Win Casing M L WA Y ° D L w L N/A Y Window Sash AIM L N/A Y Upper Trim /L L A Y Window SiAIM L N/A Y 161-1 Win Above 5' NR' L ISA Y D Win Ing A/M L WA Y Pp bone 5' L WA Y indow Sash A/M L WA Y Storm Door AIM L WA Y Cellar Win Sill AIM L Y Door AIM L WA Y D Cel Win Sash L N/A Y D Door Casing A/M L WA Cel Win Fram AIM L WA Y Door Jamb A/M L I§K Y Cellar Win Sil000, AIM L WA Y Threshold A/ WA Y D Cel Wi ash AIM L WA Y Kickplate M L WA Y in Fram A/M L WA Storm Door A/M L WA Y Cellar Win Sill ry 6 AIMM A Y Door A/M L WA Y D Cel Win Sash OVv M L WA Y wv C D Door Casing A/M L N/A Y Cel Win Frame Av A/M L WA Y Door Ja A/M L WA Y Cellar Win AIM L WA Y Thr old AIM L WA Y D Cel ' ash AIM L WA Y ckplate A/M L WA el Win Frame AIM L WA Y Door AIM XIA Y Foundation J/4 L N/A Y D Door Casing 44 L N/A Y I D Bulkhead (ri t AIM L WA Y Door Jamb A/M L WA Y Faaees^ A/M L WA Y Threshold A/M L WA Y I iShffle'rs AIM L WA Y Door or AIM L WA Y Newel post G? . AIM L WA Y D Door Cas' AIM L WA Y Railing Cap AIM L WA Y Door mb AIM A Y Handrail A/M L N/A Y T eshold XM L WA Y D Bowers— AIM L WA Y Window Sill A/M L WA Y Lower Rail �.� AIM L WA Y D Win Casing A/M L WA Y Treads •L AIM L N/A Y Window Sas A/M L WA Y • A/M L WA Y Window dl A/M L WA Y Stringer o-0 AIM L WA Y D Wi asing A/M L N/A Y Floor P ( AIM L NIA Y indow Sash AIM L WA Y Loam A/M L N/A Y COMMENTS/STRUCTURAL DEFECTS: Lag(e9— AIM L WA Y D Columns &I A/M L WA Y Ceilir A/M L WA Y Joists A/M L N/A Y Excluded Surfaces:Surfaces listed in this box can be made Soil Test Results intact only by a licensed deleader Must be less than 400 ppm for play area/1200 ppm for bare soil SIDE LOCATION MEASURE:LOOSE PAINT IC IC LOCATION AREA MEASUREMENT RESULT REMED REMED D (MORE THAN 1440 SQ.IN.) DATE METH Square Feet (PPM) DATE METH D Play Area D Bare soil D Comments: D Panther Lead Paint Inspection,969 Washington St. Braintree,MA 02184- (781) 849-7313 R y :f/I Page 4 Of Inspector(print) Lic# Signa re Date Risk Assessor(print) Lic# SSii nature Date Address of Pro err ���e�. lJ� Apt# City �vw't SIDEJLOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH A B Up Walls 0:t AIM L NIA Y Window Sill Gry M/I AIM L N/A Y A B L A/M L WA Y Win Apron o A/M L N/A Y A B Baseboards G1. AIM L WA Y Win Casing AIM L N/A Y A B A/M L N/A Y Header Stop !r?, M/I A/M L N/A Y tea -- A/M L N/A Y D Int Stops M/I A/M L N/A Y Floor GL A/M L WA Y Win Int Sash 6•l M/I A/M L N/A Y Ceiling A/M L N/A Y Exterior Sill a-Z M/I L N/A Y Door / A/M L N/A Y w..t�a Part Bead 6WM/I L N/A Y h- Door Casing aJ AIM L N/A Y Blind Stop C,' M/I L N/A Y Door Jamb. r/L A/M L WA Y ' Win Ext Sas VL M/I L WA Y Threshold V,& A/M L N/A Y Window Sill M/I A/M L N/A Y Door G p A/M L N/A Y Win Apron A(M L WA D g AIM L N/A Y Win Casing AIM L W Y el Door Jamb AIM L WA Y Header Stop M/I WA Y Ilu — AIM L WA Y Int Stops AIM L WA Y Door A/M L WA Y Win Int Sash M/I A/M L NIAJ Y Door Casing AIM Y Exterior Sill M/I L N/A Y Door Jamb L N/A Y Part B M/1 L WA Y Threshold AIM L WA Y BI' Stop M/I L WA Y Door AIM L N/A Y in Ext Sash M/I L N/A Y Do asing A/M L N/A Y Closet Door e.,0 A/M L N/A Y oor Jamb A/M L WA Y Cl casiagi A/M L WA Y Threshold AIM L WAI Y ICIO-%Wamb— A/M L N/A Y Window Sill M/1 AIM L N/A Y Closet Walls ti AIM L N/A Y Win Apron vb AIM L WA Y L Cl Baseboard A/M L N/A Y Win Casing pig AIM L N/A Y Closet Pole jj A/M L N/A Y Header Stop CO3 b M/I AIM L NIA Y Closet Shelf N(1 A/M L WA Y Ar Int Stops r O M/I A/M L WA Y Cl Supports AI& A/M L N/A Y Win Int Sash V& M/I A/M L N/A Y Closet Floor a2 A/M L WA Y Exterior Sill Vk M/I L N/Al Y ICloset Ceilin d AIM L N/A Y Part Bead V2 WI L N/A Y Cabinet Frame A/M L N/A Y Blind Stop VA M/I L WA Y Ca ers A/M L NIA Y Win Ext Sash Vit, M/I L N/A Y M/I M L N/A Y COMMENTS/STRUCTURAL DEFECTS: Mantl A/M L N/A Y replace A/M L N/Al Y M/I A/M L N/A Y M/I A/M L N/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact onl b a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDEJ LOCATION MEASURE:LOOSE PAINT IC IC (MORE THAN 288 SQ.IN.) DATE METHOD (MORE THAN 288 SQ.IN.) DATE METHOD R r pp Page I Of K Inspector(print) Lic# Signa re ate Risk Assessor(print) Lic# Signature Date Address of Property Apt# City �/• �ad ,,- ��� Z SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH A B Up Walls &I A/M L WA Y Window Sill e*( M/I AIM L WA Y a A B A/M L WA Y Win Apron p p A/M L N/A Y A B Baseboards 4}y A/M L N/A Y Win Casing 2. AIM L N/A Y A B AIM L WA Y Header Stop G-v M/I A/M L N/A Y R A/M L WA Y G Int Stops CAP M/I AIM L WA Y Floor P-J A/M L N/A Y Win Int Sash VA- M/I AIM L WA Y Ceiling r-( AIM L N/A Y Exterior Sill Vi- M/I L N/A Y Door /V L AIM L WA Y Part Bead Va M/l L N/A Y AAt Door Casing.-o,&I, AIM L N/A Y IBlind Stop v/t. M/I L WA Y Door Jamb, G.V AIM L N/A Y G $ Win Ext Sash t X M/I L WA Y Th res A/M L WA Y Window.Sill M/I A/M L WA Y Door A/M L WA Y Win Apron AIM L WA Door Casing G•d A/M L N/A Y Win Casing A/M V4AA Y Door Jamb G A/M L NIA Y Header Stop M/I 3MIL WA Y Threahuin A/M L N/A Y Int Stops K AIM L WA Y Door A/M L WA Y Win Int Sash M/I A/M L N/A Y Door Casing A/M L WA Exterior Sill M/1 L N/A Y Door Jamb AlN/A Y Part Be M/I L N/A Y Threshold . A/M L N/A Y Bli Stop M/I L WA Y Door A/M L N/A Y in Ext Sash M/I L WA Y Door Cas' A/M L WA Y Closet Door Aj A/M L N/A Y Do amb A/M L WA Y Cl Casing c.y AIM L N/A Y hreshold A/M L N/A Y Closet Jamb &.0 A/M L WA Y Window Sill G.y M/I A/M L N/A Y Closet Walls w I A/M L N/A Y Win Apron A/M L N/A Y Cl Baseboard o L A/M L N/A Y Win Casing p, A/M L N/A Y Closet Pole Fj a A/M L N/A Y Header Stop r/y M/1 A/M L WA Y Closet Shelf IVa A/M L N/A Y p Int Stops ,,,p M/I A/M L N/A Y Cl Supports Al 1, AIM L N/A Y IJ Win Int Sash Vk. W A/M L N/A Y lCloset Floor F1, AIM L N/A Y Exterior Sill 1/j M/I L N/A Y lCioset Ceiling a.i. AIM L N/A Y Part Bead VA W L WA Y Cabinet Frame &V AIM L WA Y OBlind Stop VIL M/I L N/A Y A- Cab Drawers kY AIM L N/A Y Win Ext Sash t;/A M/I L N/A Y Z MII A/M L N/A Y COMMENTS/STRUCTURAL DEFECTS: Mantle A/M L N/A Y Fi ce AIM L N/A Y M/1 AIM L N/A Y M/I AIM L N/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact onl b a licensed deleader: SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDEJ LOCATION MEASURE:LOOSE PAINT IC IC MORE THAN 288 SQ.IN. DATE METHOD (MORE THAN 288 SO.IN.) DATE METHOD n„_.t,._T __,7 K � (f• fi36SL r/1 y/0 Page LAf 1_4 Signature Date Lic# Si Inspector(print) 9 Risk Assessor(print) Lic# cL Signature Date Address of Property �C���� d� BJP: Apt# City Af 4-dc"V 1kc:f� SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDEJ LOCATION/ LEAD TYPE OF URG IC IC DEL D DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE 'HAZARD HAZ? DATE MET ATE METH A B Up Walls C.L A/M L N/A Y Window Sill M/I A/M L N/A Y A B Low Walls 1c,.j A/M L N/A Y Win Apron AIM L N/A Y A B Baseboards ( A/M L N/A Y Win Casing A/M L Y A B A/M L NIA Y Header Stop M/I WA Y Redwor - AIM L N/A Y Int Stops AIM L N/A Y Floor 7. A/M L N/A Y Win Int Sash M/I A/M L N/A Y Ceiling OrL AIM L N/A Y Exterior Sill M/I L WA Y Door G t AIM L N/A Y tm4 M/I L N/A Y Door Casing GL AIM L N/A Y BI' Stop M/I L N/A Y G Door Jamb a-.s I AIM L N/A Y in Ext Sash M/I L N/Al Y Threshold c,./ AIM L N/A Y Closet Door AIM L N/A Y Door A/M L Y Cl Caking A/M L N/A Door Casing L NIA Y Closet Jamb AIM L Y Door Jamb AIM L N/A Y Closet Walls OIL N/A Y Threshold A/M L N/A Y Cl Baseboard A/M L N/A Y Door AIM L N/A Y Closet Pole A/M L N/A Y D Casing AIM L N/A Y Closet Sh AIM L N/A Y Door Jamb A/M L N/A Y CIS orts AIM L WA. Y Threshold A/M L WA Y set Floor AIM L N/A Y Door A/M L N/A Y Closet Ceiling A/M L WA Y Door C g A/M L WA Y Up Cab Fram C.0 AIM L N/A Y r Jamb A/M L NIA Y Cab Door -f A/M L WA Y Threshold A/M L WA Y 8 Up Cab Wall -11L AIM L WA Y Window Sill C.t M/I A/M L WA Y Up Cab ShNs t W AIM L N/A Y Win Apron p.p A/M L N/A Y ISupports r A/M L N/A Y Win Casing o-( AIM L N/A Y Low Cab Fram AIM L N/A Y Header Stop c& M/I A/M L N/A Y Cab Door cl AIM L WA Y Int Stops c.,) M/I A/M L N/A Y pj Low Cab Walls AIM L N/A Y Win Int Sash c.-( M/1 AIM L N/A Y Low Cab Shly c•L AIM L N/A Y Exterior Sill c.y M/1 L N/A Y Supports C-)- A/M L N/A Y Part Bead ew M/I L WA Y Drawers C. AIM L N/A' Y Blind Stop jeov I M/I L N/AY M/I AIM L N/A Y Win Ext Sash t,y M/I L N/A Y M/I AIM L N/A Y COMMENTS/STRUCTURAL DEFECTS: I IM/I A/M L N/A Y M/I A/M L N/A Y M/I A/M L N/Al Y M/I AIM L N/A I Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact only b a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IC IC MORE THAN 288 SQ.IN. DATE METHOD MORE THAN 288 SQ.IN. DATE METHOD Donthar T­4 Doint Tncnartinn QF.Q Wnehinatnn Ct Rrnintraa MA (111 RA- (7R11 RAQ_7111 Page ' Of n Lic# Si a re Date Inspector(print) 9 Risk Assessor(print) Liicc# Signature Date Address of Property C(°i'c�YlCi� Apt# City Ai. 4,41,ov STAIRCASE l -Seine-F k/ 4vr- SIDEJLOCATION! LEAD TYPE OF URG I IC IC DELEAU DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ?j DATE METH DATE METH SURFACE HAZARD HAZ. DATE METH DATE METH A B Up Walls Gs Q A/M L N/A Y Closet Door A/M L WA Y A B A/M L N/A Y Cl Casing AIM L N/A Y A B AIM L N/A Y Closet Jamb A/M L NI Y A e • Rail Oj 1 A/M L N/A Y My n; Closet Walls A/ N/A Y R A/M L N/A Y Cl Baseboard A/M L WA Y Floor .,r. A/M L WA Y Closet Pole A/M L N/A Y Ceiling AIM L N/A Y Closet Shel A/M L N/A Y Door Alp AIM L N/A Y CI Su rts A/M L N/A Y pin v AIM L N/A Y set Floor A/M L N/A Y Door Jamb Z A/M L WA Y Closet Ceiling A/M L WA Y Tk AIM L WA Y Nawek"St` AIM L WA Y Door y,5 AIM L N/A Y 9 A/M L N/A Y Door Casing ,6 L N/A Y ,' Handrail V4(, A/M L WA Y Doom^ A/M L N/A Y o Bsldst�'� A/M L N/A Y Thres A/M L N/A Y Low AIM L N/A Y Door A/M L WA Y Treads /✓L A/M L N/A Y Door Casing A/M L WA Risers M L A/M L N/A Y Door JambA Y St w"6— A/M L N/A Threshold A/M L N/A Y Door WA Y Door AIM L WA Y Door Casing AIM L N/A Y jhffresh0ld AIM L WA Y Doo AIM L N/A Y A/M L N/A Y hreshold AIM L WA Y NIA Y Flo mg AIM L WA Y Door A/M L WA Y osin A/M L N/A Y Door Casing AIM L WA Y asing AIM L N/A Y Door AIM L N/A Y M/I A/M L N/A Y reshold A/M L WA Y M/I AIM L N/A Y Window Sill M/I A/M L WA Y M/I A/M L WA Y Win Apron A/M L WA Y M/I AIM L N/A Y Win Casing A/M L WA Y M/I A/M L WA Y Header Stop M/1 A/M L N/A Y M/I A/M L N/Al Y Int Stops M/1 A/M L N/A Y COMMENTS/STRUCTURAL DEFECTS: Win Int Sash M/I A/M L N/A Y Exterior Sill M/I L N/A Y Part Bead M/I L N/A Y Blind Stop M/I L N/A Y Win Ext Sash M/I L NIA Y EXCLUDED SURFACES;Surfaces listed in these boxes can be made intact onl b a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IC IC MORE THAN 288 SQ.IN. DATE METHOD MORE THAN 288 SQ.IN.) DATE METHOD A4A n11 OA /'701'\ OAn '7]1 • 1 6 A100 5 Y ar Pagd z--Of Inspector(print) uc# Sign re ate Risk Assessor(print) Lic# Signature Date ) 9 Address of Pro ert ���C./ �. Apt# City /V• aipr— STAIRCASE 7 SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE Q HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH A s Up Walls A/M L N/A Y Closet Door A/M L N/A Y A B A/M L N/A Y Cl Casing A/M L N/A Y A s Baseboards y A/M L WA Y Closet Jamb A/M L N/ Y A e Gharffa-==-- A/M L N/A Y Closet Walls NIA Y AIM L WA Y Cl Baseboard A/M L N/A Y Floor t*r AIM L N/A Y Closet Pole A/M L WA Y Ceiling 01, AMI L N/A Y Closet Shelf A/M L N/A Y Door G.v AIM L N/A Y Cl Sup s AIM L N/A Y Door Casin C/l. AIM L NIA Y et Floor AIM L N/A Y /)I Door Jamb 1.0 A/M L WA 'Y Closet Ceiling AMI L NIA Y Threshold CGe A/M L N/A Y Newel Post t. . A/M L N/A Y Door G A/M L N/A Y Railing Cap a' AIM L N/A Y Door Casing FC A/M L N/A Y Handrail &11 AMI L N/A Y L Door Jamb v le AIM L WA Y Balusters V L A/M L N/A Y Threshold A/M L N/A YLow AIM L N/A Y Door A/M L N/A Y Treads C•O AIM L N/A Y Door Casing A/M L NIA Y Risers t A/M L WA Y Door Jamb &0 A/M L N/A Y Stringer D.( A/M L N/ Y Threshold cw AIM L WA Y Door L N/A Y Door 4,0 AMI L WA Y Door Casing A/M L N/A Y Door Casing 0-0 A/M L N/A Y Door J AIM L N/A Y Door Jamb �i A/M L N/A Y reshold AIM L WA Y Threshold 11w/Y AIM L N/A Y Floor Casing AIM L WA Y Door AIM L N/A Y Floor sing AIM L N/A Y Door Casi A/M L WA Y all Casing AIM L N/A Y D amb A/M L N/A Y MA A/M L.N/A Y hreshold A/M L WA Y M/I A/M L N/A Y Window Sill Mill AIM L N/A Y M/I AIM L WA Y Win Apron A/M L N/A M/I AIM L WA Y Win Casing A/M /A Y M/1 AIM L N/A Y Header Stop M/I/11M L N/A Y I IMA A/M L N/A Y Int Stops 41 A/M L N/A Y COMMENTS/STRUCTURAL DEFECTS: Win Int Sash M/I AIM L N/A Y t t,5 t-¢ 9.9 ,F A.& c.�w SvF �hGl/�KJ 2k:�f Exterior Si M/I L N/A Y 5D c rQ J4 A40 Part d Mill L N/A Y B• d Stop M/I L N/A Y Win Ext Sash M/1 L N/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can.be made intact only b a licensed deleader. SIDEJ LOCATION MEASURE:LOOSE PAINT IC IC SIDEJ LOCATION MEASURE:LOOSE PAINT IC IC MORE THAN 288 SO.IN. DATE METHOD (MORE THAN 288 SO.IN.) DATE METHOD 11-11 nen 1-1 R + • �'���r �� �3GS�i Y d5- PageL30f, Inspector(print) Lie# Sign ure bate Risk Assessor(print) / Lie# Si nature Date Address of Property C Apt# City 14, rivh'' 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 DAT METH A e Up Walls 0.0 AIM L WA Y Window Sill M/I AIM L N/A Y A B LOWAWs, A/M L WA Y Win Apron A/M L WA Y A 8 Baseboards fit' AIM L N/A Y Win Casing AIM L WA Y A B Cha' A/M L N/A Y Header Stop M/I A/M L N Y Radiates' A/M L WA Y Int Stops M/I N/A Y Floor 64e AIM L WA Y Win Int Sash A/M L N/A Y Ceiling A/M L WA Y Exterior Sill M/I L N/A Y Door t"O AIM L WA . Y Part Bead M/I L N/A Y Door Casing 9.2, A/M L N/A Y Blind p M/I L WA Y Door Jamb C,-p A/M L N/A Y InExt Sash M/1 L WA Y Threshold ca„. AIM L WA Y Window Sill M/1 AIM L NIA Y 10010 000, Door A/M L N/ Win Apron A/M L N/A Y Door Casing AI WA Y Win Casing A/M L N/ Door Jamb AIM L WA Y Header Stop M/I AIM A Y Threshold AIM L N/A Y Int Stops M/I L N/A Y Door A/M L NIA Y Win Int Sash I AIM L WA Y Door sing AIM L WA Y Exterior Sill M/I L WA Y or Jamb A/M Y Part Be M/I L N/A Y Threshold nM Y Bli top Mll L WA Y Door Y in Ext Sash M/1 L N/A Y Door Casi Y Closet Door AIM L NIA Doo mb Y Cl Casing A/M L Y reshold A/M L N/A Y Closet Jamb L WA Y Window Sill M/I A/M L N/A Y Closet Walls ZAIM L N/A Y Win Apron AIM L WA Cl Baseboard rz AIM L N/A Y Win Casing' AIMLO Y Closet Pole AIM L N/A Y Header Stop M/I WA Y Close elf A/M L N/A Y Int Stops AIM L N/A Y C upports A/M L NIA Y Win Int Sash M/I A/M L WA Y Closet Floor A/M L NIA Y Exterior Sill WI L N/A Y 0 Closet Ceilinqo AIM L N/A Y Part Be M/1 L N/A Y Cabi rame A(M L N/A Y Bli top M/1 L WA Y ab Drawers A/M L N/A Y in Ext Sash MII L N/Al Y I M/1 A/M L N/A Y C MMENTS I STRUCTURAL DEFECTS: Ma A/M L N/A Y S kN ,-�l�} I� replace A/M L N/A Y M/I AIM L N/A Y M/1 AIM L N/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact only b a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IC IC MORE THAN 288 SQ.IN. DATE METHOD (MORE THAN 288 SO.IN.) DATE METHOD ri__n.- r ir. r ... nin rri__i_ .__.._._ n. n.._f._..___ �.�♦ nnne i�rnvnen nn�n R g • l� '��t� P36,S2 Page/ Of 16 Inspector(print)V Lic# Sign ure Date Risk Assessor(print) �* Li Signature Date n Address of Property `' lr`"reh c'di. q Apt# City /" e SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ? DATE METH DATE METH A B Up Walls 6.13 A/M L WA Y Window Sill M/I A/M L N/A Y e A B s AIM L N/A Y Win Apron A/M L N/A Y A B Baseboards pJ l A/M L NIA Y Win Casing AIM L WA l,);,- A B A/M L N/A Y Header Stop MII AIM A Y Rte"— AIM L N/A Y Int Stops M/I L N/A Y Floor G•r AIM L N/A I Y Win Int Sash Im A/M L N/A Y Ceiling A/M L N/A Y Exterior Sill M/I L N/A Y Door A(& A/M L NIA Y Part Be M/1 L N/A Y Door Casing 9A. AIM L WA Y 1W L WA Y G� Door Jamb IWO AIM L N/A Y in Ext Sash M/I L N/A Y 00, Thweliff— A/M L N/A Y Window Sill M/I A/M L WA Y Door 0.1 A/M L N/A Y Win Apron AIM L N/A Y ,L Door Casing `-e AIM L WA Y Win Casing AIM L N/ Y Door Jamb a0 A/M L WA Y Header Stop M/I A01,6WA Y Threshold A/M L N/A Y Int Stops M/ AIM L WA Y Door A/M L N/A YWin Int Sash M/I AIM L NIA Y Door Casing AIM L Y Exterior Sill M/I L WA Y Door JambPrL NIA Y Part B M/I L WA Y Threshold AIM L WA Y B' d Stop M/I L WA Y Door A/M L N/A Y Win Ext Sash M/1 L N/A Y Door Casi A/M L WA Y Closet Door AN L N/A Y Doo mb A/M L WA Y Cl Casing ,y AIM L WA Y reshold A/M L WA Y Closet Jamb AIM L WA Y Window Sill `,,) M/I A/M L N/A Y Closet Walls a f A/M L N/A Y Win Apron Ul A/M L N/A Y Cl Baseboard- 6.1 A/M L N/A Y Win Casing P L AIM L WA Y Closet Pole A/9- A/M L N/A Y Header Stop C..I M/I A/M L N/A Y Closet Shelf P/& AIM L N/A Y Int Stops CiLl M/I AIM L WA Y Cl Supports N'L AIM L N/A Y . Win Int Sash 6.0M/I A/M L N/A Y Closet Floor c.mr AIM L N/A Y Exterior Sill 0.3 M/I L WA Y Closet Ceiling cL AIM L N/A Y Part Bead GeV M/I L N/A Y Cabinet fpw AIM L N/A Y Blind StopCoy M/I L WAI Y I Lelffrawers AIM L N/A Y Win Ext Sas &I M/1 L N/Al Y I M/I AIM L N/A Y COMMENTS/STRUCTURAL DEFECTS: Mantle AIM L WA Y PfO'rlace AIM L N/A Y M/I A/M L WA Y M/I A/M L N/A Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact only b a licensed deleader. SIDE LOCATION MEASURE:LOOSE PAINT IC IC SIDE LOCATION MEASURE:LOOSE PAINT IC IC MORE THAN 288 SQ.IN. DATE METHOD MORE THAN 288 SQ.IN. DATE METHOD i n.,—«i.,._r --AT')-.—,r......,.,.«:,,.. n<n T).... ..«..,.,, r R n 11110 n f701, o nn '7'211 � K_ n dA Page '�Uf Lic# Signature ate Inspector(print) 9 Risk Assessor(print) Lic# Si nature Date �l Address of Property � re"► Apt# City /V, l'Tjowe— SIDE LOCATION/ LEAD TYPE OF URG IC IC IDELEAD DELEAD SIDEJ LOCATIONI LEAD TYPE OF URG IC IC D LEAD DELEAD SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAV DATE M DATE METH A e Up Walls d.L A/M L N/A Y Window Sill M/I AIM L N/A Y A B L A/M L WA Y Win Apron A/M L N/A Y A e Baseboards 0•Y A/M L N/A Y Win Casing AIM L V Y A BAR A/M L N/A Y Header Stop M/I L N/A Y Rgdi A/M L WA Y Int Stops A/M L WA Y Floor •tR A/M L N/A Y Win Int Sash Awl A/M L N/A Y Ceiling GL AIM L N/A Y Exterior Sill M/I L WA Y Door 0•V AIM L N/A Y Part Be M/I L N/A Y Door Casing (p), A/M L N/A Y Bli Stop M/1 L N/A Y I� Door Jamb rep A/M L WA Y in Ext Sash M/I L N/A Y Threshold A/M L N/A Y Closet Door AIM L WA Y Door A/M L WA Y Cl Caging A/M L WA Door Casing A/M L Y Closet Jamb AIM L Y Door Jamb L N/A Y Closet Walls WA Y Threshold AIM L N/A Y Cl Baseboard AIM L WA Y Keshold A/M L N/A Y Closet Pole A/M L N/A Y A/M L N/A Y Closet Shel AIM L N/A Y AIM L N/A Y CI Su its AIM L WA Y Y set Floor AIM 1 N/A Y AIM L N/A Y Closet Ceiling A/M L WA Y AIM L NIA Y Up Cab Frame &.4 AIM L WA Y A/M L N/A Y Cab Door &o AIM L WA Y AIM L N/A Y Up Cab Walls V c, A/M L WA Y Window Sill M/I AIM L N/A Y Up Cab Shlvs MV AIM L N/A Y Win Apron A/M L WA Y u AIM L WA Y Win Casing A/M L N/A Y Low Cab Fram a AIM L N/A Y Header Stop Mll AIM L N/A Y Cab Door G•O AIM L N/A Y Int Stops M/I A/M L N/A Y s Low Cab Wall a-1 AIM L N/A Y Win Int Sash M/I AIM L N/A Y L A/M L N/A Y Exterior Sill M/1 L N/A Y Supp ss A/M L N/A Y Part Bead M/I L N/A Y A/M L N/A Y Blind Stop M/1 L N/A Y M/I A/M L N/A Y Win Ext Sash MA L WAI Y M/I A/M L WA Y COMMENTS I STRUCTURAL DEFECTS: M/I AIM L N/A Y M/I A/M L N/A Y M/I A/M L N/A Y M/I A/M L NIA Y EXCLUDED SURFACES:Surfaces listed in these boxes can be made intact only b 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 I D--+1---T —A D—+T. „o tin. QAQ AV-1h;nntnn Qt Rrn;ntrPP MA 071 Rd_ (7R1) RAO-711 I j j R v Vt. PageL�-Of-Le Inspector(print) Lic# Signature Date Risk Assessor(print) Lic# Signature Date Address of Property 3 Apt city 4d W100- � s SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEAD SIDE LOCATION/ LEAD TYPE OF URG IC IC DELEAD DELEA SURFACE HAZARD HAZ? DATE METH DATE METH SURFACE HAZARD HAZ?,DATE, METH DATE METH A s Up Walls AMI L WA Y Window Sip G• A/M L WA Y A e l a rs A/M L WA Y Win Apron ,� l L WA Y A B X"IBaseboards �, AIM L WA Y k FWin Casing R, L WA Y A e A/M L WA Y Header Stop AIM L N/A Y Radk or— AIM L WInt S A Y tops ,`J /0 L N/A Y Floor Cw AIM L WA Y Win Int Sash �,�, M/I AMI L WA Y oiling ..z AMI L WA Y Exterior Sill ,Q WA Y Door or U AIM L WA Y Part Bead Wv MA L WA Y Door Casing Gi. AIM L WA Y Blind Stop C0/ MA L WA Y Door Jamb— g,p AIM L N/A Y Win Ext Sash 4L MA L WA Y T AMI L N/A Y Window Sill NUI AIM L WA Y Door Aft,. AIM L WA Y Win Apron AIM L WA Y Door Casing &v A/M L WA YWin Casing AIM L WA Door Jamb 4 L AMI L WA Y Header Stop MA AIM A Y T AIM L WA Y Int Stops L WA Y Door AIM L W . Win Int Sash At/I A/M L N/A Y Door Casing WA Y Exterior Sill M1AA L WA Y Door Jamb AMI L WA Y Part d MA L WA Y Threshold AIM L WA Y d Stop M/1 L N/A Y Door AMI L WA Y Win Ext Sash M/1 L WA Y Door ing AMI L WA Y Closet Door NG A/M L WA Y Jamb A/M L WA Y CI Casing 42 AIM L N/A Y Threshold AMI L WA Y Closet Jamb ad AMI L N/A Y No Window Sill L WA Y Closet Wells 4d AMI L N/A Y Win Apron 14 WA Y � CI Baseboard 02. 1 A/M L N/A Y Win Casing 7,1 Y Closet Polo NG AIM L WA Y Header Stop 11•1 AMI L WA Y ClosoFBM r AIM L WA Y Int Stops RST10 aN L WA Y CI AIM L WA Y Win Int Sash MA A/M L WA Y Closet Floor Cr/ AIM L WA Y Extenor i Sill 4.�1 �WA Y G Closet Ceiling- '2 AIM L WA Y Part Bead Gdll Mll L WA Y Cabinet Frame AMM L WA Y Blind Stop Mil L WA Y wens AIM L WA Y Win Ext Sash GY NUI L WA Y MA AIM L WA Y COMMENTS/STRUCTURAL DEFECTS: Man NM L WA Y �c ,nveS Q✓g G.L c+ A4K Gam^ors: fireplace PJM L WA Y NUI A/M L WA Y M/i PJM L WA Y EXCLUDED SURFACES:Surfaces fisted in these boxes can be made intact onlyb 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 Driving Directions from 400 Osgood St,North Andover, MA to 3 Clarendon St,North A... Page 1 of 3 Start: 400 Osgood St NO ONLINE, BOOKING North Andover, MA 01845-2909, us FEES AT ' i End: 3 Clarendon St North Andover, MA 01845-2605, us mom E good goes around Directions Distance 1: Start out going SOUTHWEST on OSGOOD ST toward 0.2 miles MILL POND. 2: Turn RIGHT onto PLEASANT ST. 0.1 miles 3: Turn RIGHT onto MA-133/CHICKERING RD/MA-125. W 0.1 miles 4: Turn SLIGHT LEFT onto E WATER ST. 0.2 miles 5: Turn LEFT onto CLARENDON ST. <0.1 miles ® 6: End at 3 Clarendon St North Andover, MA 01845-2605, US Total Est. Time: 3 minutes Total Est. Distance: 0.79 miles http://www.mapquest.com/directions/main.adp?do=prt&mo=ma&src=maps&1 gi=0&un=m... 5/6/2005 Driving Directions from 400 Osgood St,North Andover, MA to 3 Clarendon St,North A... Page 2 of 3 OY `,= 300m 0 00% 4 133 W "`i✓�� ys�9�>9 ,,. pavis SL ' \S 4�y 5� 01$ ro • , ooh,',44'id .a�. _� � tA; Park pattVL - = Parker St - Stevens Crossing G;C -� a�} i �,, .OIPond 2005 MapQuestcom,Mc. 1 �. , _-- ®2005 NAVTEQ Start: End: 400 Osgood St 3 Clarendon St North Andover, MA 01845-2909, US North Andover, MA 01845-2605, US t�APEtv�i 4• ; 1 300m :tAQ1%�ST.�-'-;-- 300m d 0�900it 3 0 9008 4c\� a 133 at, °'%° pad f � a 0 � v1 ` � Stevens Crossingo� !4l4 agr'°�- t �� N , oda `` QSy►s 133 NoB p st /4'. Px \ gt�y �pc'\ Ba Slate Rd I PondRs ►Sl i \ d 02005 MapQuestcom,Inc. 02005'N)AVTEQ 0 2005 MapQuestcom, Notes: haAYTEO All rights reserved. Use Subject to License&opyr�ht These directions are informational only. No representation is made or warranty given as to _ their content, road conditions or route usability or expeditiousness. User assumes all risk of use. MapQuest and its suppliers assume no responsibility for any loss or delay resulting from such use. http://www.mapquest.com/directions/main.adp?do=prt&mo=ma&src=maps&1 gi=0&un=m... 5/6/2005 Ralph Cerbone - ERA Home & Family Real Estate Page 1 of 1 s DOO ERA Kr.a.r,r�r+. Direct: 978-420-8732-Phone:978-470-1999 x18 Fax: 978-470-1888 qty �` ,Pro��.tyF'►rrd�s . 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Equal Housing Opportunity. » Local Business http://www.ralphcerbone.com/index.asp 5/6/2005 Xa.ssachuserts Depar�xzent�o f Public Realth State Laboratory I.ustiture Environmental Chemistry Laboratory Inorganic Laboratory 305 South Street, Rooter 310 Jamaica Plaizz, VLA 02130 (617) 933-6634 (617) 933-05635 A- (617) 983.6663 "� 8, 7 ORDER FORM FOR ENVIRONMEWAL KIT, NOTE: Checks and Money Orders Are Payable io: COMMONWEALTH OF MASSACHUSETTS Psyment and Orders for Test Kits are sent To the Above Address Daca: OFFICE USES QNf Y: Ship to/Pick up by ,bAv, b✓�4. 1Ig Date Order Received: Payment Received By, Adoress: 2-7 Ghec'< Number .Amt.: S A,Io Mtoney order Na.; Amt..a Talephbne. (27i)_ No Charge: Attention to -5 , ycs- PN:-OCLPPP _O thea apector L!cense No. 3 �- Comments: QUAN717Y TYPE UNIT" 5XTENSIDN OF KIT PRICE _-m- "Dust 560.00 S 'Paint S10.Ot) S Total Payment Received: S 4Soil 510.00 S Sodium Sulfide Lot No.: 1 'Vn/ater s�o.00 Sodium Sodium Sulfide Expiration Data: Sulfide 510.00 S Shipping and Handling: 52.00 5 T Dml Charge: Dotes Shit7C9eG: lrntl�ls: Icludes the cost of analysis •�15bVorrl xaer `arm'utS ' 411v I��n Town of North Andover F AORTH ° 4tltD °1HO Office of the Health Department Community Development and Services Division x y 400 Osgood Street North Andover,Massachusetts 01845 Et`y S�1CHU5 Michele E. Grant (978)688-9540-Phone Public Health Inspector (978)688-9542-Fax NORTH ANDOVER BOARD OF HEALTH ORDER LETTER Issued under the provisions of the State Sanitary Code, Chapter II,Minimum Standards of Fitness for Human Habitation,105 CMR 410.000. Date: May 10,2005 To the Owner of Record Property Location Ralph Cerbone Jodi Polmeno 1 Clarendon Street 3 Clarendon Street North Andover MA.01845 North Andover,MA. 01845 Dear Mr. Cerbone, An authorized inspection was made of your property at the above referenced address by North Andover Health Department personnel on May 9,2005. This inspection revealed violations of certain regulations of the State Sanitary Code, Chapter II, as listed on the attached Violation Form. You are hereby ORDERED to correct these violations within the time allotted on the enclosed form. Failure to comply within the specified time period may result in further action by the North Andover Board of Health. You have the right to request a hearing before the Board of Health if you feel this order should be modified or withdrawn. A request for said hearing must be made in writing and received by the Health Department within seven(7) days from the receipt Of this order. At said hearing you will be given an opportunity to be heard and to present witnesses and documentary evidence as to why this order should be modified or withdrawn. All affected parties will be informed of the date, time and place of the hearing and of their right to inspect and copy all records concerning the matter to be heard. You may be represented by an attorney. You have the right to inspect and obtain copies of all relevant records concerning the matter to be heard. Michele E. Grant Public Health Inspector BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 ORDER LETTER An authorized inspection of 3 Clarendon Street was performed by Board of Health staff on May 9,2005 at which violations of 105 CMR 410.000 Chapter II of the State Sanitary Code, Minimum Standards of Fitness for Human Habitation were found. Failure to respond within the allotted time period may result in a Board of Health finding that the dwelling is unfit for human habitation. All violations must be corrected within seven (7) days of receipt of this Order Letter or a plan for completion must be approved by this office if a professional contractor must be hired to do the work. Violation Regulatory Re- Reference Inspection Screens for Windows 410.551 Current Screens are not tight fitting and are not secure. Owner shall provide screens for all windows designed to be opened on the first four floors. Said Screens: Shall be tight fitting as to prevent the entrance of insects and rodents around the perimeter. Owner shall provide tight fitting and secured in place. Screens for doors: 410.552 No door outside door on front of house. Owner shall provide screen doors in all doorways opening directly to the outside. Said Screen door: Shall be equipped with self-closing device. Shall be tight fitting as to prevent the entrance of insects and rodents. Owner shall provide a outside front door with Air tight screen Maintaining Structural Elements: 410.500 Basement window is not secure.There is a hole In the front portion of house on the right hand Side. Owner shall maintain every structural elements Free from holes,cracks,or defect renders insect or Rodent harborage Owner shall fill holes in foundation in the base -ment and secure basement window. NOTE: A Lead Test Will be Performed at a Later Date. VtORTH. O`�t�ao`a'�•�p 1� 9 "ssAC U ` « HEALTH DEPARTMENT Complaint/investigation Intake Report Taken by: C- Date of Report: `� Time: Category/Type of C plaint: Address/Location of Inciden me of Person Reporting: Phone Number: (H) or (W): 6, �i/Q� Phone Number: (Cell): Name of Allege Violator: Phone Number of Alleged Violator: Complaint Details: _ ��aC Recommended corrective action to be taken: Immediate corrective action to be taken: To be Investigated by: Title: Date Scheduled for Investigation: Date Submitted for Data Entry: Date Entered: