31 Salem Street - Street File (51) CITY OF SALEM, MASSACHUSETTS
_.Stt BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
srp� SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
April 19, 2005
Timothy Klotz
9 Warden Place
Lynn, MA 01902
Dear Sir/Madam:
In accordance with Chapter III, Sections 127A and 127B of the Massachusetts General Laws, 105
CMR 400.00; State Sanitary Code, Chapter 1: General Administrative Procedures and 105 CMR
410.00: State Sanitary Code, Chapter 11: Minimum Standards of Fitness for Human Habitation,
an inspection was conducted of the property at 31 Salem Street Apt. #4 occupied by Santiago
Santos conducted by Janet Dionne, Senior Sanitarian on Friday April 15,2005 @ 10:45 a.m.
Notice: if this rental unit is occupied by a child or children under the age of 6 years, it is the
property owner's responsibility to notify tenants of lead related reports and tests, and to ensure
that this unit complies fully with 105 CMR 460:000: Regulations for Lead Poisoning Prevention
and Control. For further information or to request an inspection, contact the Salem Board of
Health at 978-741-1800.
You are hereby ORDERED to make a good-faith effort to correct the violations listed on the
enclosed inspection report.
Failure on your part to comply within the time specified on the enclosed inspection report will
result in a complaint being sought against you in Salem District Court. Time for compliance
begins with receipt of this Order.
Should you be aggrieved by this Order, you have the right to request a hearing before the Board
of Health. A request for said hearing must be received in writing in the office of the Board of
Health within 7 days of receipt of this Order. At said hearing, you will be given an opportunity to
be heard and to present witness and documentary evidence as to why this Order should be
modified or withdrawn. An attorney may represent you. Please also be informed that you have
the right to inspect and obtain copies of all relevant inspection in investigation reports, orders and
other docunyIentary information in the possession of this Board, and "that any adverse party has
the right to be present at the hearing.
Please be advised that the conditions noted may enable the occupant(s)to use one or more of
the statutory remedies available to them as outlined in the enclosed inspection report form.
go
Reply to:
nne Scott Janet Dionne
Health Agent Senior Sanitarian
cc:tenant
HL
Sent certified mail-7003 3110 0005 1992 1233
Ica „ CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
(+ 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
w
TEL. 978-74 1-1 800
FAX 978-745-0343
STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
LEAD DETERMINATION REPORT FORM
Date of Determination:
Inspector: ?nef �a 1
License#: a,
Method Used: A-- Sodium Sulfide Expiration date: 5 11
X-Ray Fluorescence Model:
Serial#:
Property Address: 1 yyl Apt.#
Description of Property:
Single family
'L Multi-family #units
Garage
Fence
Other structures
Age of Property: Pre-1978
Post-1978
Occupant: n 7 ,3 r4ps
Occupants u er six ye� ,of age:
�,J,► aC �� _ DOB:
DOB:
DOB:
Occupant's Telephone: -
Property Owner(s):
Owner's Address:
L
Owner's Telephone: 91- 593 — 0091E 7S/— 953 - 5-3 9g
Lead Hazards found? Yes No
An X-ray fluorescence reading equal to or greater than 1.0 mg/cm2 or a gray or black reaction to
sodium sulfide indicates a dangerous level of lead and constitutes a positive determination.
Deleading should not be undertaken based on this report. A licensed lead inspector must do a full
inspection in order for you to qualify for a Compliance Letter.Deleading of lead painted surfaces
must be performed by an appropriately authorized person, including a licensed"deleading
contractor,a licensed lead-safe renovator,and an owner/agent who is trained to perform specific
work as required under the Lead Law.Contact the Childhood Lead Poisoning Prevention
Program for additional information regarding deleading and training.
Determination Report form without letterhead.doc rev 8/02
LOCATION SOURCE Pb
� 4
l. Child's bedroom Window parting bead/exterior sill area
2. -Child's bedroom Window sill
Ale
3. Living room Window parting bead/exterior sill area
4. Kitchen Window parting bead/exterior sill area
5. Interior Flaking paint a-t3earz7zrnS
6. Exterior Flakingpaint
P / Porth •R Ja,rn
7. Exterior }
Cellar window units
8. Exterior Window sills below 5'
9. Exterior Main entry door casing
10. Interior Outside corner of baseboard
11. Kitchen or Bathroom �e
Chair rail t W/, n6c..)
12. Bathroom
Window sill
.13. Exterior Threshold
14. Interior ha]lway(common area Stair tread or stringer
15. Interior hallway(common area) Balusters
Ale
16. Interior hallway(common area) Door casing
17. Porch
Stair tread or riser
18. Porch Railing cap
19. Porch Balusters p
20. Porch T S
Support columns(<6"diameter or square)
21. Porch Staircase stringer
22. Exterior Bulkhead
23. Garage/Outbuilding Door casing or jamb
24. Interior Closet door or baseboard(uncapped)
25. Interior Cabinet door,shelf,or wall
S
Determination Report form without letterhead rev 1/00