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99 WEBB STREET LEAD DETERMINATION RECORD INSPECTOR COPY 10-15-2024 OTC Package,Determination, 12/00 Inspector: Jeffrey Barosy License: D4227 Address of the property inspected: 99 Webb Street City/Town: Salem, MA Dopuments Sent to Property Owner: ✓✓➢ Order to Correct �➢ Cover Letter l➢ Copy of Lead Determination v➢ Lead Determination Disclaimer Residential Deleading Advisory ➢ Notice to Property Owner and Tenants: Tenant's Rights, Responsibilities, and Remedies v/➢ Notice to Tenants of Lead Paint Hazards (if common area violations) ➢ GLTO Brochure List of Deleaders List of Inspectors v➢ All About Deleading Book Do ments Sent to Tenants: ➢ Order to Correct(copy) ➢ Cover Letter(copy) ✓➢ Copy of Lead Determination Lead Determination Disclaimer v➢ Residential Deleading Advisory v➢ Notice to Property Owner and Tenants: Tenant's Rights, Responsibilities, and Remedies p Y g � Package sent by: g DatejO /d.,'�1202-y t� CITY OF SALEM, MASSACHUSETTS lu BOARD OF HEALTH 98 WASHINGTON STREET,3m FLOOR Prevent.Promote.Protect. TEL. (978) 741-1800 DOMINICK PANGALLO health&salem.com DAVID GREENBAUM,RS KkYOR HEALTH AGENT Velb S+aef R e.J4v Tr i DATE: ID fQYi2 DZq �) o c l i ors. A ©M23 Dear I did a lead determination at the residence or unit you own at �q �t bb Sfre�f This determination found lead in violation of the State Sanitary Code, 105 Code of Massachusetts Regulations (CMR) 410.750(J). This violation also constitutes a violation of the Lead Law, Massachusetts General Laws (MGL), chapter 111, section 197, and the Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000, set forth by the Massachusetts Department of Public Health. The law requires owners of homes or apartments built before 1978 to have lead violations deleaded for full compliance or brought under interim control when a child under six years old lives there. A private risk assessor must do a risk assessment and give you a lead inspection/risk assessment report before you can proceed with interim control. A private lead inspector must do a comprehensive initial lead inspection and give you a lead inspection report before you can proceed with deleading for full compliance. If you already have a Letter of Compliance for this property, please complete the last page of the Order to Correct and send it to me within 14 days. The Order to Correct that comes with this letter has important information telling you: • what you need to do • what deadlines to meet • what documents you must send to this agency • who can do the necessary deleading work • what the penalties are for not meeting the requirements in the Order to Correct • what your options are if the property has been previously deleaded Please call me as soon as possible to discuss this Order to Correct and how to meet the requirements. The following information explains the deleading process, if the property has not been deleaded previously. Revised 8/2022 1 Hiring a Lead Inspector To help you take the first step—getting a full inspection or risk assessment—a list of licensed private lead inspectors is enclosed. We recommend that you check references and make sure that the lead inspector is still licensed before hiring him or her. You can check on the license by calling the Massachusetts Department of Public Health's Childhood Lead Poisoning Prevention Program (CLPPP) at 1-800-532-9571. CLPPP can also provide you with a list of licensed priyate risk assessors for interim control and other helpful materials, including brochures explaining the difference between deleading for full compliance and interim control. Again, you can get these by calling CLPPP at 1-800-532-9571 or by checking our website at https://www.mass.aov/ork;s/childhood-lead-poisoning:prevention-pro gram. Requirements for Doing Deleading Work High-risk deleading: If you need to or choose to have high-risk deleading work done, such as having lead paint stripped or scraped, you must hire a licensed Deleading Contractor. A list of licensed Deleading Contractors is available online at https://www.mass.�,,ov/doc/find-a-licensed- deleading, Just as in the case of inspectors, we recommend that you check references and make sure the Deleading Contractor is still licensed before signing a contract. You can check license information by calling the Department of Labor Standards (DLS) at 617-626-6975. Moderate-risk deleading: Before you or your agent can do moderate-risk deleading work, such as removing windows and woodwork, you must take a course, pass a test, and get an authorization number from the Massachusetts Childhood Lead Poisoning Prevention Program (CLPPP). These courses are given by a number of groups and organizations at various places, times and prices. For a list of approved moderate-risk deleading training providers, call CLPPP at 1-800-532-9571 or visit our website at https://www.mass.Lov/orgs/childhood-lead-poisoning_prevention-proLram. Remember that you still have to meet the deadlines listed in the Order to Correct. If a course for owners and their agents to do moderate-risk deleading is not available at a convenient time or place for you to meet the deadlines of this Order to Correct, you won't be able to do moderate- risk deleading work yourself. In that case, you will then have to use other methods to delead, or hire a licensed Deleading Contractor. The licensed Deleading Contractor license number will begin with a"DC." Depending upon the kinds of hazards found and how you want to address them, you may also be able to hire a professional to do moderate-risk deleading. This person, called a Lead-Safe Renovator,must have completed the 8 hour Lead-Safe Renovator training plus an additional 4 hour training on moderate-risk deleading. His or her authorization number will begin with an"MR."To get a list of these licensed professionals, or to check their license information, call DLS at 617-626-6975. Low-risk deleading: Before you or your agent can do low-risk deleading work, such as covering surfaces, you must read the CLPPP low-risk deleading work booklet. After reading the booklet, you will take a self-corrected exam and mail it in to CLPPP. Once CLPPP receives the exam and reviews it, you will be assigned a low-risk deleading authorization number. If encapsulation is a suitable deleading method for your property,you must read CLPPP's encapsulation booklet.After reading the booklet,you will take a self-corrected exam and send it in to CLPPP. Once CLPPP receives the exam and reviews it, you will be assigned an authorization number. To get a free copy of the low-risk deleading booklet, or the encapsulation training handbook, call CLPPP at 1-800-532-9571. A copy Revised 8/2022 2 of the low-risk deleading work booklet can also be found on our website at https://www.mass.cov/orgs/childhood-lead-poisoning-prevention-program under the "Delead on My Own"quick link. Interim control work: If you or your agent will be doing other work for interim control, such as structural repairs and cleaning of lead dust, you must take safety precautions and clean up in the way described in the CLPPP booklet for interim control. To get a copy of this interim control booklet, call CLPPP at 1-800-532-9571. Please be advised that some work can only be done by a licensed Deleading Contractor, licensed moderate risk deleader(Lead-Safe Renovators who have completed the 8 hour Lead-Safe Renovator training plus an additional 4 hour training on moderate risk deleading whose license begins with an MR####), or low/moderate risk authorized owner/agent. Deleading work has to be done carefully to be safe. To protect the people who live in the home or apartment, you have to keep them out of the residence or unit, or area being worked on, in these ways: • All people and pets have to be temporarilN moved from the home or apartment for the whole time that high- or moderate-risk deleading work is taking place inside the residence or unit. You have to provide the residents with a reasonable alternative place to live for this period. People and pets who have been temporarily moved from their residence or unit can only come back after a licensed private lead inspector or licensed private risk assessor says it is safe for them to return. The inspector or risk assessor does this after reinspecting the home, including taking dust samples to assure that lead dust levels meet approved standards. This reinspection will be done at least three hours'after deleading work is all done. • People and pets have to stay out of the work area while you or your agent complete most low-risk deleading work, structural repairs, or cleaning of lead dust. They also have to stay out of the work area while any deleading work is being done in common areas outside the home or apartment. In this case, they must have another regular way (not a fire escape) to go in and out of the building and they can use the area once the work is done and the work area is cleaned up. • People and pets have to stay out of the residence or unit for the workday while you apply or your agent applies encapsulants with an airless sprayer. They also have to stay out for the day during deleading in common areas when they do not have another regular way(not a fire escape) to go in and out of the building. When people and pets are out of their home or apartment for the day, it means they can come back to the home or apartment after cleanup at the end of the workday, and don't have to be out overnight. All work for deleading and interim control has.to be neatly and properly done, in a professional way, and the residence or unit has to be returned to a condition that meets the requirements of the State Sanitary Code, 105 CMR 410.000. Deleaded surfaces cannot be primed or repainted until after they have passed reinspection by a licensed private lead inspector or risk assessor. You have to give written notice about common area lead paint violations to all other residents of the building. The"Notice to Tenants of Lead Paint Hazards" is enclosed for that purpose. Revised 8/2022 3 You also have to send a copy of the lead inspection report or lead inspection/risk assessment report and any reinspection reports to all mortgagees and lienholders of record. If your property has been previously deleaded, you may be eligible for a 30-day maintenance period. Please fill out the last page of the Order to Correct and return it to me within 14 days to take advantage of this option. If you have questions about the Department of Public Health's Lead Poisoning Prevention and Control Regulations, 105 CMR 460.000, you can ask me, or call CLPPP atl-800-532-9571. If you have questions about the DLS Deleading and Lead-Safe Renovation Regulations, 454 CMR 22.00, you can ask me, or call DLS at 617-626-6975. Remember to refer to the attached Order to Correct for more information about what you have to do. Sincerely, Jeffrey Barosy sar',n asdlei-S Board of Health Telephone: I l qg- o Revised 8/2022 4 CITY OF SALEM MASSACHUSETTS BOARD OF HEALTH 98 WASHINGTON STREET 3PD FLOOR FlublicHwlth Prevent,Promote.Protect. TEL. (978) 741-1800 DOMINICK PANGALLO health@salem.com DAVID GREENBAUM,RS MAYOR HEALTH AGENT ORDER TO CORRECT VIOLATION(S) \Alel� S�cmf R iVTV5� DATE: 1,Da m2q My 1—iVop 4 n192-3 Owner or agent of the property located at: 99 Webb Street Be advised that an agent of the Board of Health has determined certain portions of this residential property to be in violation of the State Sanitary Code, 105 Code of Massachusetts Regulations (CMR) 410.750(J). This violation also constitutes a violation of the Lead Law, Massachusetts General Laws (MGL), chapter 111, section 197, and the Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000, set forth by the Massachusetts Department of Public Health. The law requires owners.of homes or apartments built before 1978 to have lead violations deleaded for full compliance or brought under interim control when a child under six years old lives there. If you already have a Letter of Compliance for this property, please complete the last page of this Order to Correct and send it to your code enforcement lead inspector within 14 days. Conditions exist in this residence which may endanger and/or materially impair the health of the occupants of these premises. DECLARATION OF EMERGENCY The Director of the Massachusetts Childhood Lead Poisoning Prevention Program declares that the presence of this violation of the Lead Law and the Regulations for Lead Poisoning Prevention and Control constitutes an emergency pursuant to the Lead Law, MGL chapter 111, section 198 and within the meaning of the State Sanitary Code, 105 CMR 400.200(B). CORRECTION OF LEAD VIOLATION(S) The Lead Law, MGL, chapter 111, sections 189A-199B, and the Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000, require the owner of a residential premises or dwelling unit built before 1978 in which a child under the age of six lives have lead paint violations either abated or contained(referred to as "deleading") for full compliance or brought under interim control. The steps that you must follow are in the "Order" section. Revised(l/13/19 1 The Lead Law, the Regulations for Lead Poisoning Prevention and Control, and the Department of Labor Standards' (DLS) Deleading and Lead-Safe Renovation Regulations, 454 CMR 22.00, require that residential deleading work be done by authorized people. The type of authorization will determine the method of deleading that can be done. There are three levels of deleading: High Risk Deleading Only licensed Deleading Contractors or Deleading Supervisors, who will be on-site conducting and/or overseeing deleading activities,can do high risk deleading activities. These activities include scraping, stripping, demolition, and making large amounts of loose paint intact. If this type of work is done on the interior of a unit, then the occupants must be temporarily relocated until the work is complete and the unit has passed a reoccupancy reinspection. Moderate Risk Deleading Moderate risk authorized owners/agents and licensed moderate risk deleaders (Lead-Safe Renovators who have completed the 8 hour Lead-Safe Renovator training plus an additional 4 hour training on moderate risk deleading whose license begins with an MR####) can do moderate (and low risk) deleading. These activities include removal and replacement of building components such as windows, and making a small amount of loose paint intact. If this type of work is done on the interior of a unit, then the occupants must be temporarily relocated until the work is complete and the unit has passed a reoccupancy reinspection. Owners interested in becoming trained and authorized to do moderate risk deleading should contact CLPPP at 1-800- 532-9571 for more information. Low Risk Deleading Low risk authorized owners and agents can do some minor deleading activities such as covering surfaces with approved coverings and encapsulating approved surfaces. Owners interested in becoming trained and authorized to do low risk deleading should contact CLPPP at 1-800-532- 9571 for more information. These rules on who is authorized to perform what kind of deleading work apply whether the work is being done for full compliance or for interim control. An owner or owner's agent may also make structural repairs, as defined in 105 CMR 460.020, and clean lead dust, as may be required for interim control. Revisedl 1/13119 2 ORDER You are hereby ordered to remedy all violations of MGL, chapter 111, section 197 and 105 CMR 460.000, as identified by a licensed private lead inspector. If you wish to pursue interim control, you must remedy all urgent lead hazards identified by a licensed private risk assessor. Whether you pursue full compliance or interim control, you must correct the relevant violations in accordance with the following schedule: Within sixty (60) days of your receipt of this Order to Correct, you must provide proof of the following: 1. A complete analysis of the property for lead hazards. Proof consists of one of the following: • A comprehensive initial lead inspection report done by a licensed private lead inspector. The inspector must inspect the interior of the unit and the common areas of the unit, including the exterior. • A comprehensive initial lead inspection and risk assessment report done by a licensed private lead inspector who is also licensed as a risk assessor. This is only necessary if you have decided to pursue the option of interim control. For more information on the interim control program,please contact CLPPP at 1-800-532-9571. • For previously deleaded properties, a post-compliance assessment determination(PCAD) done by a code enforcement lead inspector. If you have a previously complied property and fail to return the last page of this Order to Correct within 14 days, then you may no longer be eligible for a maintenance period; however, you must still have the assessment done. Only a code enforcement lead inspector can do this assessment. 2. An established deleading plan detailing who will be deleading and when the work will be done. Proof consists of at least one of the following: • A contract with a licensed Deleading Contractor, licensed moderate risk deleader(Lead- Safe Renovators who have completed the 8 hour Lead-Safe Renovator training plus an additional 4 hour training on moderate risk deleading whose license begins with an MR####), or low/moderate risk authorized owner/agent. To check on the license for Deleading Contractors and Lead-Safe Renovators who have completed the 8 hour Lead- Safe Renovator training plus an additional 4 hour training on moderate risk deleading whose license begins with an MR####, contact the Department of Labor Standards at 617-626-6975. To check on the authorization for low risk agents, such as vinyl siders or carpet layers, contact CLPPP at 1-800-532-9571. • If you or your agent will be doing the work, a copy of the authorization letter and a completed"Documentation of Training to be an Authorized Owner/Agent And Intention to Comply with the Order to Correct" form verifying that all work will be done within required timelines (see 90 day and 120 day requirements). This form is included in this package. Revised]l/13/19 3 Contracts with licensed/authorized people as well as an authorized owner or agent's completed"Documentation of Training to be an Authorized Owner/Agent And Intention to Comply with the Order to Correct" form must also specify that the unit will meet acceptable lead dust levels under 105 CMR 460.170, as determined by the licensed lead inspector or risk assessor's dust wipe sampling. Should any of the dust samples, fail to meet acceptable standards;the last authorized person who performed high-or moderate- risk work will be required to reclean the entire unit until all dust samples meet acceptable levels. If a low or moderate risk authorized person did the deleading and dust samples fail three times, a licensed Deleading Contractor will be required to reclean the entire unit until all dust samples meet acceptable levels. Within ninety (90) days of your receipt of this Order to Correct, the following work must be completed and reinspected (including passing dust wipes if required): 1. All high and moderate risk deleading on the interior of the unit must be complete,pass the visual reinspection, and dust wipes. Please note that if high or moderate risk activities are done on the interior, then encapsulation cannot be done until after all of the high and moderate risk work has been reinspected and dust wipes have passed. 2. Removal and replacement of doors, if chosen as the method of deleading, must be complete and pass visual reinspection. 3. Loose surfaces in the interior of the unit must be made intact by the appropriately authorized person,be covered, or otherwise deleaded and reinspected. This includes loose surfaces being prepared for encapsulation(DO NOT encapsulate these surfaces until after a successful reoccupancy reinspection). Making paint intact on the interior of a unit requires dust wipes at the reinspection. There cannot be any loose paint in the unit by the ninetieth day. 4. For those owners pursuing the interim control option, rules 1- 3 still apply; however, only "urgent" lead hazards are required to be corrected. In addition, all required safeguards and structural repairs relevant to the interior of the unit must be complete and have passed reinspection and dust wipes, if required. Proof of this work consists of a copy of a reinspection report from a licensed lead inspector or risk assessor and copies of passing dust wipe results, if dust wipes were required. Copies of these documents must be provided to this agency by the 90ffi day. Within one hundred and twenty (120) days of your receipt of this Order to Correct, the following work must be completed and reinspected (including passing dust wipes if required): Revised]1/13/19 4 1. Any low risk activities on the interior of the unit that were not done by the 90th day deadline must be complete. This includes encapsulation of interior surfaces that were previously made intact. 2. All required deleading in the interior common areas and on the exterior must be complete, pass the visual reinspection, and dust wipes if they were not needed for a reoccupancy reinspection. 3. For those owners pursuing the interim control option, all of the "urgent" lead hazards must be corrected on the interior, common areas, and the exterior. Also, all required safeguards and structural repairs relevant to the interior common areas and the exterior must be complete and have passed reinspection. For interim control, a final set of dust wipes is required to be taken at the final reinspection even if dust wipes were taken previously for a reoccupancy reinspection. This means that two sets of passing dust wipes are needed for interim control when a recoccupancy reinspection is completed; one set for the reoccupancy reinspection and one set for the final reinspection. Proof of this work consists of a copy of a reinspection report from a licensed lead inspector or risk assessor, copies of passing dust wipe results, and a copy of a compliance document. Copies of these documents must be provided to this agency by the 120th day. PROSECUTION AND CIVIL PUNITIVE DAMAGES Failure to.comply with any of the deadlines set out above will require this agency to initiate criminal or civil proceedings against you within seven (7)business days. Compliance with this Order to Correct will be determined by this agency's receipt of the appropriate documents within the specified deadlines. Documents should be sent to your code enforcement lead inspector. Inspection documents required by the 60th day deadline. One of the following: ❑ Comprehensive Initial Lead Inspection-report by a licensed private lead inspector; ❑ Comprehensive Initial Lead Inspection report and Risk Assessment report by a licensed private risk assessor if pursuing interim control; ❑ Post-Compliance Assessment Determination(PCAD) done by a code enforcement lead inspector. Documents required by the 60th day deadline.At least one of the following, although there may be a combination of documents: ❑ A contract with a licensed Deleading Contractor, licensed moderate risk deleader, (Lead- Safe Renovators who have completed the 8 hour Lead-Safe Renovator training plus an Revised]l/13/19 5 additional 4 hour training on moderate risk deleading whose license begins with an MR####), or low/moderate risk authorized owner/agent; ❑ A copy of an owner/agent authorization letter from CLPPP and a completed "Documentation of Training to be an Authorized Owner/Agent And Intention to Comply with the Order to Correct" form; ❑ If you or your agent will only be doing structural repairs and lead dust cleaning for interim control, a signed written statement attesting that this work will be completed in accordance with the required timelines. Documents required by the 90th day deadline: ❑ A Letter of Lead Paint(Re)occupancy (Re)inspection Certification issued by a licensed lead inspector or risk assessor, in cases where high- or moderate-risk deleading work occurred, requiring occupants to be relocated from the unit for the duration of the work; ❑ Copies of results of all dust samples taken by the licensed lead inspector or risk assessor, and copies of all reinspection report(s) issued by a licensed lead inspector or risk assessor; ❑ Copies of any invoices documenting that all work to-date was conducted by appropriately authorized people, including a signed invoice for structural repair work and cleanup of lead dust. Documents required by the 120th day deadline: ❑ Copies of any invoices documenting that all work was conducted by appropriately authorized people, including a signed invoice for structural repair work and cleanup of lead dust; AND one of the following: ❑ A Letter of Full Deleading Compliance issued by a licensed private lead inspector; ❑ A Letter of Interim Control issued by a licensed private risk assessor; ❑ For previously deleaded properties, a Certification of Restored Compliance(an addendum to the original Letter of Compliance) issued by a code enforcement lead inspector. In all cases,the owner must ensure that a copy of the deleading notification is sent to this agency at least ten (10) days before the start of any deleading, no matter who is performing the work, and whether it is for full compliance or interim control. The law provides penalties of up to $500 for each day of noncompliance. In addition,you may become liable for civil punitive damages equal to three times any actual damages for failure to comply with this Order to Correct if a child becomes poisoned. Revised]1/13/19 6 CORRECTION OF VIOLATION BY CODE ENFORCEMENT AGENCY If within the time periods stipulated above this residential property is not brought into full compliance or interim control, this agency may contract with an authorized person or authorized persons to correct the violation(s) and obtain a Letter of Full Deleading Compliance or a Letter of Interim Control, and bill the owner, or initiate court action to reimburse itself. RIGHT TO A HEARING You may request a hearing pursuant to 105 CMR 460.900 of the Regulations for Lead Poisoning Prevention and Control, in conjunction with the procedures of 105 CMR 400.200(B), the Sanitary Code provision for hearings in emergency public health matters. As already noted, the aforementioned violation constitutes an emergency. (See "Declaration of Emergency" section.) As such, you may request a hearing only if you have complied with this Order to Correct. The hearing will be provided within ten days of your request. This agency shall issue a written decision within seven days after the hearing. FEDERAL REGULATIONS Some federal financial assistance programs require additional environmental investigation. If you are planning on or have applied for a federal loan program,please discuss these additional requirements with the program administering the loan or grant. w a n Health Agent Board of Health Telephone 9 rt"60—71il 1300 Revisedll/13/19 7 If your property already has a Letter of Compliance, you must fill out this form and return it to your code enforcement lead inspector within 14 days. Please include copies of ALL your lead- related paperwork for this address. Your code enforcement lead inspector will review the paperwork for this address and contact you to schedule a post-compliance assessment determination (PCAD). Upon this review and a site visit,you may be eligible for a 30-day maintenance period, during which you may be able to fix the hazards yourself and your Letter of Compliance remains valid. Failure to return this form to your code enforcement lead inspector within 14 days may disqualify you from this option,requiring you to follow all of the rules and timelines outlined in this Order to Correct. Only a code enforcement lead inspector can do the required inspection work for previously complied properties. The inspection and reinspection services are provided for free.Please complete and return this form immediately in order to take full advantage of this 30-day maintenance period. Please print clearly: NAME: DATE: ADDRESS: ZIP CODE: TELEPHONE NUMBER: ( � ADDRESS OF THE PROPERTY CITED: ZIP CODE: OCCUPANT(S)NAME: OCCUPANT'S TELEPHONE NUMBER: ( ) Please check off which documents you have attached to this form: ❑ Lead Inspection Report ❑ Risk Assessment Report ❑ Letter of Full Initial Inspection Compliance ❑ Letter of Abatement Compliance ❑ Letter of Full Deleading Compliance ❑ Letter of Interim Control ❑ Certificate of Maintained Compliance ❑ Certificate of Restored Compliance Other: Revisedl l/13/19 8 This is an imporEant notice. Please-have-it translated. Este a um aviso impormnte. Queira mandarlo tmduzir_ Este es un aviso importanm. Sirvase mandarlo rraducir. 10 -DAY LA MOT BAN THONG CAO QUAN TRONG XIN VUI LONG CHO RICH LAI TH6NG Qk-0 AY Ceti est important. Veuiilez faire traduire. fv IIPOEOXH, AYTO EINAI EHMANTIKO. HMAKAAO META(DPAETE Questo e un 'awiso importante. Si pregadi farlo tradurre. Revised]1/13/19 9 s C3"I"4 oF'S_uE,, . ,ssACHusETr_ BOARD OFHF_4,LTH 9 c WASfi NGTON STREET,JD.FLOOR Px2YCfl7�Ofl uft� th YS6fiC[. TEL. (97;?)741-18CW3 DCJ -ICKPA.\1GAUG healthCosalen-com A IAY Cron HEALTH AGENT LEAD DETERMINATION REPORT FORM St.# Street Name Street Type Unit S ez city L�_ ZipCode � r Date of Determination:20 /ON 1202y Sodium Sulfide expiration date: Number of Rooms in Unit X-Ray Fluorescence: Model: Serial#: Property Type: Owner: Owner Address: ❑Single Family Multi Family #of Units 2— Contact Information: — �- ' r FCondominium #of Units Home built before 1978? Yes ❑No ❑Day Care ❑Other LEAD HAZARDS? Yes ❑No Property Diagram/Unit Labels Floor# Z (level within building of unit being inspected) C B _— S �r _-_ D t ------------------------------ ------------------------ G � _4_7 A(Street Side) A(Street Side) Start Here A gray or black reaction to sodium sulfide or an X-ray fluorescence reading equal to or greater than 1.0 mg/cmz indicates a dangerous level of lead and constitutes a positive determination and violation of the Lead Law. Deleading must not be undertaken based on this report.A licensed Lead Inspector must do a full inspection identifying all lead hazards before licensed or authorized individuals do the work in order for the unit to qualify for a Compliance Letter. �y _ b422.7 10 /03l?.OL' Inspectors. ame / License# Si tare Date Page 2 of 3 /CT/ 2 . Inspector( int) Lic# na a Date Address of Property'qq W2�b S fre—t # SIDE LOCATION SOURCE Pb Hazard TN-p (circle.one) (circle one) (circle one) (circle one) (circle) A B C@ Child's bedrooi /OR Rm# indow sill POS©G INC L A B C D Child's bedroomL �t &/OR Rm# Window Int sash /Ext sash/ Exterior sill POS NEG INC MA 2 Aa C D hild's bedrooif •/OR Rm# Door edge oor jam POS Nf INC L 3 6A B C D Child's bedroom Bas OR Rm# eboar Window casing/Door casing OS NEG INC A B C D Child's bedroom&/OR Rm# Baseboard/Window casing/Door casing POS NEG INC I A B C D Kitchen/ Bath OR Room# Window sill Handrail Railing cap POS NEG INC A/M L A B C D Kitchen/Bath OR Room# Windowsill / Handrail/Railing cap POS NEG INC A/M L A B C D Kitchen/Bath OR Room# Window Int sash /Ext sash/ Exterior sill POS NEG INC M/I L A B C D Kitchen/ Bath OR Room# Window Int sash /Ext sash/ Exterior sill POS NEG INC M/I L A B C D Kitchen/Bath OR Room# Door edge /Door jamb POS NEG INC F L A B C D Kitchen/Bath OR Room# Door edge /Door jamb POS NEG INC F L A B C D Interior hallway Stair tread / Door edge Doorjamb POS NEG INC F L A B C D Interior hallway Window Int sash /Ext sash /Exterior sill POS NEG INC M/I L (common area) A B C D Interior hallway Stair tread / Door edge / Doorjamb POS NEG INC F L (common area) A B C D Interior hallway Window sill / Handrail / Railing cap POS NEG INC A/M L (common areal Interior stairway A B C D Stair tread/ Door edge /Door jamb POS NEG INC F L (common area) A B C D Porch Stair tread/ Door edge /Door jamb POS NEG INC F L A B C D Porch Railing cap/Handrail/Window sill below 5' POS NEG INC A/M L A B C D Exterior Cellar window sill POS NEG INC A/M L A B C D Exterior Window sills below 5' POS NEG INC A/M L A B C D Exterior—Main Entry Stair tread / Door edge / Doorjamb POS .NEG INC F L A B C D Exterior Main entry door casing POS NEG INC L A B C D Exterior Siding/Window casings/Door casings POS NEG INC L A B C D Garage/Outbuilding Siding/Window casings/Door casings POS NEG INC L A B C D Garage/Outbuilding Window sills below 5' POS NEG INC A/M L C f A)B C D NEG INC 5' A B(DD j r POS INC 0M it A B C D POS NEG INC ABC D POS NEG INC Key for Hazard type: A/M=Accessible/Mouthable L= Loose F=Friction M/I=Moveable/Impact Pb (lead) column: POS (positive for hazardous level of lead),NEG(negative, less than 1.0 mg/ Page 3 of 3 cmz), INC (inconclusive sodium sulfide result) Address of Properly. 9 Vej S t Yee t DISCLAIMER CONCERNING LEAD DETERMINATION REPORTS Serious lead poisoning hazards are created when materials containing lead paint are disturbed, unless proper safety guidelines are followed. If a child under six resides in this dwelling,the property owner may face criminal or civil liabilities unless all lead paint violations identified in a comprehensive lead inspection have been corrected. Therefore,the Massachusetts Lead Poisoning Prevention Law(Massachusetts General Laws,chapter 111, sections 189A through 199B) and regulations (105 CMR 460.000, Lead Poisoning Prevention and Control) require that before any deleading work can begin,the premises must first be subject to a comprehensive lead paint inspection. This inspection must be conducted by a Massachusetts fully licensed Lead Inspector. The Lead Determination report this disclaimer is attached to is NOT a comprehensive lead paint inspection report. Lead Determinations test only a small portion of those surfaces that must be tested to determine whether the premises are in full compliance with the Massachusetts Lead Poisoning Prevention Law. Once a Comprehensive Initial Inspection has been conducted, only a Licensed Deleader can do High-Risk Deleading, such as scraping or the use of caustics. Property owners,their agents, and Licensed Lead-safe Renovators may complete additional training to be licensed or authorized to do Low and Moderate-Risk Deleading. Owners and their agents should contact the Childhood Lead Poisoning Prevention Program (CLPPP)for more information. Lead-safe Renovators licensed by the Department of Labor Standards (DLS) should contact DLS regarding additional Moderate- Risk deleading training. Letters of Full Compliance will be withheld if either the inspection or authorization requirements are not met. It is illegal for rental property owners to discriminate against tenants or potential tenants with young children to avoid compliance with the lead paint law,or to retaliate against tenants for requesting a lead paint inspection. This document and all lead-related inspection, reinspection,and compliance documents must be provided to the current owner and must be transferred upon sale of the property along with the Property Transfer Notification. For rental properties,this document and all lead-related inspection, reinspection,and compliance documents must be provided to the current tenants and subsequent tenants. ALERT FOR FEDERALLY-ASSISTED PROPERTIES Please be advised that Massachusetts properties receiving federal assistance(such as HUD rehabilitation funds, Section 8 vouchers and funds, and others) must comply with both Massachusetts and Federal regulations. Lead hazard abatement or remediation activities, including paint stabilization, done based on the attached Determination report or on a HUD Inspection Report, neither of which is a comprehensive initial inspection,violates Massachusetts law. Such properties would NOT qualify for a Letter of Full Deleading Compliance. For more information, please contact the inspector who completed the attached Determination report, or the Childhood Lead Poisoning Prevention Program at 1-800-532-9571 or www.mass.gov/dph/cippp. Disclaimer Alert Revised 3/20 Page 1 of 3 CITY OF SALEM, MASSACHUSE'I'TS lu BOARD OF HEALTH 98 WASHINGTON STREET 3'FLOOR NblicHegt11 Prevent.Pronmcte.Protect. TEL. (978) 741-1800 DOMINIC PANGALLO healthCsalem.com DAVID GREENBAUM,RS MAYOR HEALTH AGENT REQUEST FOR DETERMINATION OF LEAD HAZARDS AND ENFORCEMENT OF THE LEAD LAW Date: 1 20 2-(4 request that the print name of occupant print name of local Board of Health inspect my residence or dwelling unit for lead paint.I l 1 The address of this residence or unit: qq W e_by 1 4� Street number, Street, and Apartment Number l )01 ) , Massachusetts. City or Town l Zip code TY) The telephone number to reach me there is:s ZO l ` ] (�(� Phone Number My email address: -1�! fflL1_(_6M Child or children under the age of six (6) years who reside(s) in this household: h 112017-'� — - Name Birth ate Name Birth date Name Birth date Name Birth date The following Race/Ancestry information is optional. Please circle one: (1) Black, non Hispanic ( /Hispanic (3) White, non Hispanic (4) Asian/Pacific Islander (5) American Indian/Alaskan Native (6) Other Was the residence built before 1978? Yes No 1 I understand that the lead determination requested may include all rooms of the dwelling unit or residential premises, common areas,porches and accessible exterior areas, as well as other buildings within the property lines. I further understand that if there is a child under six (6) years of age in residence, and the determination hereby requested identifies lead hazards in violation of Massachusetts General Laws, chapter 111, section 197, and Regulations for Lead Poisoning Prevention and Control, 105 Code of Massachusetts Regulations 460.110 and .750, such violations must be either deleaded for full compliance, or the unit must be brought under interim control, at the property owner's expense. The property owner must correct all violations, whether for full compliance or interim control, within 120 days of the receipt of an Order to Correct Violations. The property owner must also submit within 60 days of the receipt of such an Order, a copy of a signed contract with a licensed deleader, if one will be necessary for the required work. If the owner or his/her agent is going to perform owner/agent deleading work, the owner must also submit a special form within 60 days. If the owner fails to comply with the Order to Correct Violations, then the Board of Health shall initiate judicial proceedings against the owner to enforce the Order. The Massachusetts Department of Public Health, Childhood Lead Poisoning Prevention Program (CLPPP) conducts random audits of inspections conducted by private inspectors and risk assessments conducted by private risk assessors following lead determinations. Such monitoring is performed to assure the quality of services being provided to the public. By requesting this determination, you also agree to allow CLPPP access to your residential premises or dwelling unit during or after the initial determination, and prior to your returning once any deleading, whether for full compliance or interim control, is completed. Not all private inspections or private risk assessments will be audited, so you may not hear from CLPPP requesting access for these additional visits. Please complete both sides of this form, sign, and return it to: DPH/CLPPP 250 Washington Street, 7'h Floor Boston, MA 2108 Signat e of Occupant 2 The Commonwealth of Massachusetts Executive Office of Health and Human Services "r Department of Public Health 250 Washington Street, Boston, MA 02108-4619 MAURA T.HEALEY MARGRET R.COOKE Governor Commissioner KIMBERLEY DRISCOLL Tel: 617-624.6000 Lieutenant Governor www.mass.gov/dph RESIDENTIAL DELEADING ADVISORY The process of removing or covering lead paint hazards, commonly called deleading, can be dangerous if it is not done properly. That's why the Lead Law(Massachusetts General Laws chapter 111, sections 189A through 199B),the Regulations for Lead Poisoning Prevention and Control(105 Code of Massachusetts Regulations 460.000)and the Deleading Regulations(454 CMR 22.00)have rules for how deleading is done in homes and apartments. These rules explain who can do the work, safety steps that have to be taken while the work is done,how to clean up after the work,and how the work is finally approved. These rules are enforced by the Department of Public Health's Childhood Lead Poisoning Prevention Program(CLPPP),the Department of Labor Standards (DLS), and local boards of health. Who can do deleading work Under these laws,only a licensed deleading contractor can do high-risk work,such as scraping or stripping lead paint, repairing large areas of chipping or peeling lead paint so it can be repainted, and demolishing lead-painted building parts.Besides deleaders,property owners and their agents who take a one-day course can do moderate-risk deleading work, such as removing windows,woodwork,and just about any other surface of a house, as well as repairing small.amounts of chipping and peeling lead paint so it can be repainted.Lead-Safe Renovators with an additional 4 hour training and license issued by the Department of Labor Standards(DLS)beginning with the prefix MR,may also be hired to do moderate- risk deleading work. Finally, low-risk deleading work can be done by all the people who can do high-or moderate-risk deleading work,as well as owners and their agents, including contractors,who complete the CLPPP low-risk authorization booklet(and/or encapsulant booklet). Low-risk deleading includes covering surfaces, applying encapsulants, removing doors, cabinet doors and shutters, and applying exterior siding.Property owners and their agents may also do structural repairs and lead-dust cleaning for interim control. Staying out of the home or parts of the home during deleading To protect the people who live in the home or apartment being deleaded,the law also has rules about making sure they stay out of the home or apartment, or the area being worked on: • All people and pets must be temporarily moved from the home or apartment for the whole time that high-or moderate-risk deleading work is taking place inside the home or apartment.The owner must provide tenants with a reasonable alternative place to live during this time.Property owners and tenants should refer to the CLPPP document,"Notice to Property Owners and Tenants: Tenants' Rights,Responsibilities"for more information on alternative housing during deleading. • People and pets must stay out of the work area while most low-risk deleading work, Residential Deleading Advisory 2022 Page 1 structural repairs, or cleaning of lead dust is taking place. They also must stay out of the work area when deleading work of any kind is taking place in common areas outside of the home or apartment, as long as they have another regular way(not a fire escape)to go in and out of the building.In these cases,people and pets can use the area once cleanup is completed after all the work in the area is done. • People and pets must stay out of the home or apartment for the day during deleading of common areas when they do not have another regular way to go in and out of the building.When people and pets are out of their home or apartment for the day, it means they can come back to the home or apartment after cleanup at the end of the workday,and don't have to be out overnight. It is very important that people whose home or apartment is being deleaded think carefully about what they will need during the time they are away from home,and take it with them.No one can return to a home or apartment while deleading that requires them to be out is still taking place,and has not been properly cleaned up. Property owners and tenants must take deleading safety rules seriously and cooperate fully to make sure everyone is protected.No one should interfere with the work being done safely. Getting ready for deleading to begin People who live in a home or apartment in which any kind of deleading work is going to be taking place must receive written notice at least 10 days before the start of this work.This also applies to other tenants of a building,if any deleading work will take place in common areas.Before deleading work begins,all household possessions of every type should be removed or stored in plastic bags in non- work areas.Closets and cabinets to be deleaded must be emptied. As a last resort,large furniture and belongings not removed from the work area should be put in plastic bags and left in the center of the room,where they will be covered with heavy plastic and sealed with duct tape by the person doing the deleading. The reason for this is to protect everything in the home or apartment from lead dust contamination.Belongings must also be protected before an owner or agent performs low-risk deleading work, or other work that may be required for interim control,but the precautions are not as extensive for this type of work.In general,it is recommended that furniture and belongings be moved outside the work area, or covered with thick plastic and sealed with duct tape,before low-risk deleading begins. Cleanup after deleading and returning home A final cleanup will be done at least two hours after all the interior high- or moderate-risk deleading work is done. This delay is to make sure that fine lead dust will settle out of the air and be removed in the final cleanup. People and pets who were temporarily moved to alternative housing can return only after a licensed lead inspector or risk assessor says that the home is safe.The licensed lead inspector decides this after doing a reoccupancy reinspection, which includes an analysis of lead dust levels within the home. Tenants should leave a phone number where they can be reached so that the licensed lead inspector or risk assessor can call them and let them know when it is safe to return home.If the property owner or agent is going to be doing low-risk deleading work or other work for interim control after the tenants return home,they will be taking some safety steps for this, as described in the CLPPP low-risk authorization booklet. They will also be doing a cleanup when they are done with the low-risk work.A licensed lead inspector or risk assessor will return at the completion of all the work and do a reinspection to check the owner's or agent's work. Residential Deleading Advisory 2022 Page 2 Temporary ways to protect children from lead poisoning . Children exposed to lead paint hazards are at risk of becoming lead poisoned. This disease can affect every part of a young child's developing body,and in particular, can seriously and permanently hurt the brain,kidneys,and nervous system.Even at lower levels of exposure,lead can cause children to have learning and behavioral problems. The best and only permanent way to protect children from lead poisoning is deleading.But even before that process begins,there are some important steps that can be taken to protect young children from lead poisoning.Your licensed lead inspector's or risk assessor's advice should be carefully followed because he or she knows your child's home. As part of their normal behavior,young children place things in their mouths,especially toys and their own fingers. If there are lead paint chips and dust in your home,they may be picked up by your child's fingers, as well as by toys, foods, and pacifiers that fall on the floor, and end up in your child's mouth. It is especially important to wash your child's toys and to keep your child's hands clean, particularly before meals and at bedtime. Areas of peeling or chipping lead paint and dust should be cleaned.Wet wiping with paper towels and a general household detergent is best. Do not use your household vacuum cleaner to clean up paint chips,because this will only send fine lead dust into the air. In particular,windows,window sills,and the floors under windows are often areas where children can be exposed to lead.Window sills should be cleaned regularly if paint dust or flakes collect there. If windows are in poor condition,the best thing to do may be to keep the lower sash closed and open only the upper sash for ventilation. This also protects your child from accidentally falling from the window. Contact paper may be applied to areas of peeling paint or,window sills, ;galls, or other surfaces as a temporary measure. Sometimes furniture can be moved to block children from deteriorating paint or plaster. If deteriorating paint or plaster is in the child's bedroom,use another room as the child's room, if possible. Think of those parts of the home where your child spends most of his or her time,and try to keep them as clean as you can before your home is deleaded. Lead paint can also get into soil.If the outside of your home has chipping or peeling paint,do not let your child play in the soil closest to the house. Be careful to wipe your shoes off on a mat before walking into your house, so you don't track in soil from these areas.Follow the advice of your licensed lead inspector or risk assessor about soil on the property. For more information about how the deleading process works,and how to protect your children from lead poisoning, call the toil-free CLPPP information line, at 1-800-532-9571. Residential Deleading Advisory 2022 Page 3 The Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Public Health 250 Washington Street, Boston, MA 02108-4619 MAURA T.HEALEY MARGRET R.COOKE Commissioner Governor 617-624-6000 KIMBERLEY DRISCOLL Tel:www.mass.gov/dph Governor NOTICE TO PROPERTY OWNERS AND TENANTS: www'mass.gov/dph TENANT'S RIGHTS AND RESPONSIBILITIES Hazards Lead paint hazards under the Lead Law and the state Sanitary Code have been found in the home or apartment listed in the attached documents. These hazards may be a danger to the health of the people living in the home or apartment. Children younger than six years old are at the most risk of being lead poisoned. Lead can damage a child's growing brain and other parts of the body. Even small amounts of lead can harm a child. The owner of this home or apartment is responsible for removing or covering the lead hazards (deleading) if a child under six lives in the home. Legal Rights and Responsibilities For these lead hazards to be deleaded as quickly and safely as possible,it helps if both the owner and the tenant cooperate with each other. It is important that tenants and owners know their rights under state law. Because the laws are not simple, tenants may need to get legal help and/or legal advice before trying to use the rights found below (1) Temporary Housing. (Massachusetts General Laws chapter 111, section 197) Tenants and their pets must be temporarily moved out of the home or apartment for the whole time that high-risk or moderate-risk deleading work is taking place inside the home or apartment. They cannot return until that work is done,the unit is cleaned up and a licensed lead inspector finds that the home or apartment is safe. The owner and tenants have to agree on a plan for temporary housing. If the tenants choose to move in with family or friends they do not have to pay rent to their landlord while they are out of their home. If the tenants do not stay with family or friends, the owner must find the temporary housing and offers it to the tenant.The Law requires that owners pay any charges for the temporary housing the owner offers, and that tenants continue to pay their full normal rent during the time they live in the temporary housing. The temporary housing must be one that"does not cause undue economic or personal Tenant Rights 2022 Page 1 hardship to the tenant." If the temporary housing chosen by the owner would not cause a hardship, and the tenant still refuses to accept it, then the tenant has to find and arrange for his or her own temporary housing during deleading. In this case,the tenant doesn't have to pay rent for the days he or she is not at home,but has to pay the cost of the temporary housing he or she has chosen. In this case,the owner has to pay the tenant any amount by which the cost of the temporary housing first chosen by the owner is more than the rent for that period. No matter where the tenant stays, the owner must pay reasonable moving costs. Tenants are advised to get legal help if they cannot agree with the owner on a plan. (2) Protection from Retaliatory Rent Increase or Eviction. A property owner may not evict a tenant,or increase the rent or refuse to renew the lease of a tenant in retaliation (getting even) for the tenant reporting a suspected lead paint violation to a code enforcement agency such as the local board of health. If the rent is raised, or tenants get an eviction notice or their lease is not renewed within six months after the tenants called the board of health or got their home deleaded, a court can automatically find that the owner took this action in retaliation unless the owner can show clear evidence that he or she had other reasons, unrelated to the violations. An eviction based on not paying the rent is not retaliatory. Property owners who are found to.have threatened or taken actions against tenants for exercising rights under the Lead Law are liable for damages under M.G.L. c. 186, s. 18 and M.G.L. c. 93A. A tenant who believes that the owner has retaliated against him or her because of lead violations may also file a complaint with the Massachusetts Commission Against Discrimination (MCAD). (3) Rent Withholding. (Massachusetts General Laws chapter 239, section 8A) Tenants have a basic obligation to pay rent for their home or apartment to the owner. But,if lead violations are not being deleaded,tenants may have a right to hold back their rent payments. Tenants may take this step only if they were up to date in their rent at the time the owner was notified of the lead paint violations, and they did not begin withholding until this point. Owners have the right to go to court to evict tenants for not paying rent.To fully protect themselves against attempted evictions,tenants withholding rent for Lead Law violations may need to place withheld rent money in an escrow (separate savings) account, or may be ordered to do so by the court. If these conditions are met, tenants may not be evicted for not paying rent or for any other violation that is not the tenants' fault. Owners have the right to enter the tenants' home or apartment, if possible by appointment,but in any case in emergencies,to inspect for lead violations and to have them repaired. Tenants have a responsibility to cooperate with owners and allow all necessary access to their home or apartment for repairs. Tenants who do not cooperate with this right of entry may be subject to eviction. If rent was withheld, the court may Tenant Rights 2022 Page 2 order that all or part of the withheld rent be paid to the owner after the violations are deleaded. (4) Abatement of Rent or Damages. Even when the rent withholding statute does not apply, tenants may be able to have their rent reduced or get back rent they have already paid,if their home or apartment has Lead Law violations. The landlord always has a duty to provide housing that meets basic housing standards.A tenant can bring a court action for breach of this "implied warranty". (5) "Rent Receivership". (Massachusetts General Laws, chapter 111, sections 127C - 127J) This law allows tenants, the state Childhood Lead Poisoning Prevention Program or the local board of health to ask the court to find that Lead Law violations exist, and to allow rent to be paid into court rather than to the owner, to pay for necessary repairs. (6) Owner Liability_Compensatory and Punitive Damages. (Massachusetts General Laws chapter 111, section 199) The owner of a home or apartment built before 1978 is liable for damages to a child under age six who becomes lead poisoned as a result of the owner's failure to comply with the Lead Law and regulations. The owner of such home or apartment who is notified- through an Order to Correct Violations or Order to Restore Interim Control Measures of lead violations, and who willfully fails to correct the violations, in accordance with the Lead Lave and Regulations, is also subject to punitive damages, which are triple the actual damages found. NOTE: All the information presented above is only a summary of the law.Before you decide to withhold your rent or take any other legal action, it is advisable that you consult an attorney.If you cannot afford to consult an attorney,you should contact the nearest Legal Services office. Repainting Violations of the Lead Law are also violations of the state Sanitary Code. Surfaces from which lead paint or other coatings have been removed have to be repainted under 105 CMR 410.020 of the state Sanitary Code. Deleaded surfaces have to be sealed and made easy to clean. Deleaded surfaces can only be repainted after the surfaces have been reinspected while bare and approved by a licensed lead inspector. Tenants may want to contact the owner if the required repainting is not done. If the owner does not respond, tenants should call the local board of health. Tenant Rights 2022 Page 3