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260 Apt 2B MRVP 2017 BOARD OF HEALTH ZYIAMP CITY OF NORTHAMPTON �%_::;s, � ,.r°�. DONNA C.SALLOOM ��hi t � SUZANNE SMITH,M.D. N JOANNE LEVIN,M.D.,Chair MASSACHUSETTS 01060 15%ili CYNTHIA SUOPIS,PhD � �� WILLIAM HARGRAVES �_ OFFICE OF THE -=� Merridith O'Leary,RS,Director BOARD OF HEALTH Daniel Wasiuk,Health Inspector Christopher Bishop,Health Inspector 212 MAIN STREET a NORTHAMPTON,MA 01060 (413)587—1214 FAX(413)587-1221 COP HOUSING INSPECTION FORM • Date: rf /3 7 Time:,,'O,41 #Occupants: ,(,/0 # Children < 6 Years es Address: Unit# a 67 City/Town: Northampton Occupant Name://W/7 -2,03,8',6440,.%)_.� Phone# Owner‘Name b 4 j f fhon # ,c3a 3 7&9 c± xA //0 /( C/� ,,exj Owner Address: ( �City/Town: Zip Code: /7/ ./d,(�e e,/Q #Dwelling/Rooming U its in Dwelling: #Stories: Floor Level of Unit: aZt)asi # Sleeping Rooms: OZ #Habitable Rooms: 4 Inspector:� ,ii/ /,) Title: /../e4/14 / 445-/eve?‘"'" KITCHEN REGULATIONS VIOLATION Heat Between 64 and 68 .900A degreessr Kitchen sink sufficient size 120 & 140.190 V' Stove (type) .100 A (2) v Space for refrigerator 1100 A (3) ,./ 2 electrical outlets or 1 and .251 A and B overhead light !,. '" Walls (type) .500 `, Floor(type) .500 ,� Ceiling .500 Natural light (if more than 70 .251.6 • sq. feet than glass no less than 8%) Ventilation(4%or mechanical) `-'' Cold water . .350 A Hot water between 110 and i .190 130 Degrees . X2t--: Zed5 /1/ e �� • �/>>�,. ��,� f -37 ex / /a- Floors (type) .500 Ceiling .500 Windows (how many) .500 , .551 , .552 amd .480 E Screens, Locks, and Useable Door .500 Is there adequate space for .400 occupant? COMMON AREA & EXIT REGULATION - VIOLATION r Sufficient Natural Lighting .250 A 2 Electrical outlets or 1 with .251 B overhead light Lighting .251 A iv Walls(type) .500 Floors (type) .500 Ceiling .500 v' Windows (how many) .500 , .551 , .552 amd .480 E Screens, Locks, and Useable v► Door .500 Stairways .042 Common Bathroom .151 v' Common area and Exit and .500 Egress 1/ Porches .500 Foundation .500 1/. Ceiling height in all habitable rooms(3/4 more than 7 feet) Stairs .500 �• Garbage and Rubbish .601 tr Private ways .600 Gutters and Downspouts .500 Roof .500 Lead Paint .502 �-" L fC,q?l7/- 4 e 441144h ed Lights .253 B �/' 1 Laundry Area .500 GENERAL REGULATION VIOLATION All services working and .690 available Hand/guard rails(1 handrail, guardrails on all open sides, balusters) Owner posted? 1/• Heating Services in good .200 v, repair Ceiling height in all habitable L� rooms (3/4 more than 7 feet) v Heat Between 64 and 68 .900 A degrees Temporary Wiring .256 sem'' Electrical Service Adequate .99S 1---"' Insects and Rodents .550 Dwelling sanitary .602 & .452 s/' Smoke Detectors and Carbon .482 `... Monoxide detectors Metering Critical Violations: (1) failure to maintain a supply of water connected to a safe water supply as required in 105 CMR 410.180; or (2) failure to provide heat and to provide or maintain heating facilities in proper condition as required by 105 CMR 410.200 or 410.201; or (3) failure to provide light as required by 105 CMR 410.254; or (4) failure to provide and maintain a sanitary drainage system as required by 105 CMR 410.300; or (5) failure to maintain in safe operating condition any facilities fixtures and systems listed in 105 CMR 410.351; or (6)termination or failure to restore promptly water,hot water,heat, electricity or gas; or (7) failure to maintain exits unobstructed as required by 105 CMR 410.451; or (8) failure to maintain every entry door of a dwelling unit as required by 105 CMR 410.480(D); or (9) failure to maintain a dwelling unit free from leaks as required by 105 CMR 410.500;or (10) failure to maintain a porch, balcony, roof or exterior stairway in a safe condition as required by 105 CMR 410.500; or (11)failure to maintain a dwelling or dwelling unit free from rodents, skunks, cockroaches and insect infestation as required by 105 CMR 410.550. Referral: 0 Electric 0 Fire 0 Plumbing 0 Building 0 Other This inspection report is signed and certified under the pains and penalti s o duty. � of Inspector Signature: .' -i,�,c- reser Occupant or Occupant's R resentative Signature: ' e,B- Reinspection Date: x Time: ...___ ,,& f ojlte. A/07rACao.t.)5 er 1/io �s vecf d //vs' recA0A/ (7/5/7) , Ceiling .500 Windows (how many) .500 , .551 , .552 amd .480 E Screens, Locks, and Useable SLEEPING ROOM # 1 REGULATION VIOLATION Heat Between 64 and 68 .900A degrees Sufficient Natural Lighting .250 A 2 Electrical outlets or 1 with .251 B overhead light v' Lighting .251 A Walls(type) .500 Floors (type) .500 Ceiling .500 Windows(how many) .500 , .551 , .552 amd .480 E Screens, Locks, and Useable Door .500 Is there adequate space for .400 occupant? (70 for one, 50 per more than one) SLEEPING ROOM#2 REGULATION VIOLATION Heat Between 64 and 68 .900A �. degrees Sufficient Natural Lighting .250 A 2 Electrical outlets or 1 with .251 B overhead light f Lighting .251 A Walls(type) .500 Floors (type) .500 Ceiling .500 Windows(how many) .500 , .551 , .552 amd .480 E Screens, Locks, and Useable Door .500 !� Is there adequate space for .400 occupant? SLEEPING ROOM #3 REGULATION VIOLATION Heat Between 64 and 68 .900A degrees y Sufficient Natural Lighting .250 A 2 Electrical outlets or 1 with .251 B overhead light !� Lighting .251 A `,« Walls(type) .500 �.. Windows .500 and .552 (screens 4/1-10/30), locks, !� usable Doors .500 s °' Plumbing connections and .350 drains BATHROOM REGULATION VIOLATION Heat Between 64 and 68 .900A degrees Hot water between .190 110 and 130 degrees s . Toilet and Seat .150 A (1) s/' Wash basin .150 A (2) t/- Shower /Shower or Tub .350 A (3) / ' Sufficient cold water .350 A Floor (type) .500 Walls (type) .500 Ceiling .500 v Door .500 t/" Light .252 A Ventilation (type)(4%or .280 A or B mechanical) v Plumbing connection, drain .350 LIVING ROOM REGULATION VIOLATION Heat Between 64 and 68 .900A degrees .1/" 2 Electrical outlets or 1 with .251 B ` " overhead light Lighting .251 A Imo' Walls(type) .500 l Floors (type) .500 Ceiling .500 Windows (how many) .500 , .551 , .552 amd .480 E Screens, Locks, and Useable DINING ROOM REGUALTION VIOLATION Heat Between 64 and 68 .900A degrees 1/- 2 Electrical outlets or 1 with .251 B overhead light ! ' Lighting .251 A s ' Walls(type) .500 Floors (type) .500 p , BOARD OF FIFALTH MEMBLRS CITY OF NORTHAMPTON A. .��=r°4, L DONNA C.SALLOOM,CHAIRl 4'4 tA,fi, JOANNE LEVIN,M.D. _A-:" SUZANNE SMITH,M.D. MASSACHUSETTS 01060 STA VAR _t ( n n i Merridith O'Leary,RS,Director OFFICE OF THE N" ' Jennifer Brown,R.N.,Public Health Nurse 212 MAIN STREET Daniel Wasiak,Health inspector HEALTH DEPARTMENT NORTHAMPTON,MA 01060 Edmund Smith,Health Inspector Heather McBride,Clerk APPLICATION FOR HOUSING INSPECTION AND CERTIFICATION OF FITNESS FOR MASSACHUSETTS RENTAL VOUCHER PROGRAM Name of Property Owner: j--e-e e-,(,5_ _VijlCJe_ 5- Date: FPI/7 Address of Property Owner: ' t- c t , �_064 _ _ Tel: c5 (1_709_ QUA --- QIP .--- Fav jai a ,�,;,J-ie� xi,eye, (1) I herewith request a Housing Code Inspection and Certification of Fitness for Human Habitation for the following ( ) apartment(s). (Give the total number of apartments to be inspected) (2) Was dwelling Constructed / _ �( r ��- Prior to 1978? Yes P7" No ❑ Signature of Owner (3) Street Address: ��‘4‘ C-\;'� n Q(DPL 1_'"{ ILA or.a3<✓ (A) Apartment#: 01Occupant's Name & Phone#: Children under six(6)years old Yes pi'''. No ❑ f J.L/ .� a/& (B) Apartment #: ____ Occupant's Mame & Phone#: Children under six(6)years old Yes 0 No ❑ (C) Apartment #: ____ Occupant's Name&Phone#: Children under six (6) years old Yes 0 No ❑ (D) Apartment #: ____ Occupant's Name & Phone#: Children under six (6)years old Yes ❑ No ❑ (E) Apartment #: Occupant's Name & Phone#: Children under six(6)years old Yes ❑ No 0 (If necessary, attach additional sheets to this application if more apartments are to be listed.) �c0 STS• ) Enclosed is a check for $ - for J inspections. ( @ $75.0° per apartment. ) 374,3 ®r (5) NOTE: If the dwelling(s) to inspected were constructed prior to 1978 and aFi� i, en t age of six (6) years reside there, you MUST have a Licensed Lea aint nspector certify, in writing, that the property is in compliance with the State Lead Paint Laws - 760 CMR 49.04 (13). A Copy of this Lead Paint Certification Report must be filed with the Board of Health prior to issuance of the MRVP Certification letter. (6) Return this application to: Northampton Board of Health 212 Main Street Northampton, MA 01060 MAKE CHECKS PAYABLE to the CITY OF NORTHAMPTON zi '7g/3 - 3‘,03 _____ g 3 7 2� (57c1e,/, /-.4 (fce/12 4/eX _ Stanley Matras 88 Rimmon Ave. Chicopee, Massachusetts 01013 (413) 592-9304 LETTER OF FULL INITIAL INSPECTION COMPLIANCE Date: Dear / /o c6-1 7-`e This letter is to certify that 1 inspected your property located at_ b apartment # and relevant common areas, in the city or town of eee �� r for dangerous levels of lead according to 105 CMR 460.730 (A) through (G): Procedur .s for lntial .1J: ection, Regulations for Lead Poisoning Prevention n Control, and determined that there were no violations. The inspection was conducted on 7 cI 6/6- Please be advised that Massachusetts law requires that only certain residential surfaces be free of lead paint. Thus, this letter does not mean that your property contains no lead paint. The premises or dwelling unit anf relevant common areas shall remain in compliance only as long as there continues to be no peeling, chipping, or flaking lead paint or other accessible materials and as long as coverings forming an effective barrier over such paint and materials remain in place. Sincerely, i Stanley Matras, 11338 Should you have any question about this letter, call the Department of Public Health's Childhood Lead Poisoning Prevention Program at (617)983-6900, ext 6932 or(800)532-9571, FILE DOPY