The Commonwealth of Massachusetts
Department of Public Safety
Architectural Access Board
One Ashburton Place, Room 1310
Boston Massachusetts 02108-1618
Phone: 617-727-0660
Fax: 617-727-0665
www.mass.gov/dps





Docket Number


____________
(Office Use Only)


CURB CUT COMPLAINT FORM
Section 21, 521 CMR


PLEASE BE ADVISED THAT THIS FORM IS A MATTER OF PUBLIC RECORD AND WILL BE DISCLOSED UPON REQUEST.

1.	List the name of the street/intersection believed to be in violation of the Rules and Regulations. Please give EXACT street locations. (Use separate forms for each street/intersection)
	Address: ______________________________________________________________
	City/Town: _____________________________________________________________

2.	In order for the Board to take action on the complaint, the following work must be completed or in the process of being performed. Please check where appropriate:

____	Curb cuts are currently under construction, repair, or reconstruction.
____	Curb cuts have been repaired, reconstructed or constructed on:
		____ between June 10, 1975 - August 31, 1996. Approximate date: ______________
		____ after September 1, 1996.

3. Please check the following items which you believe are in violation and please identify the location of the violation by the closest street address or telephone pole number:
	
	____	Curb cuts are not provided where an accessible route crosses a curb. (Section 21.2)
		____________________________________________________________________
	
	____	Curb cut is not provided at each corner of intersection, located within the crosswalk and/or the pedestrian path of travel. (Section  21.2.1)
		____________________________________________________________________

	____	Curb cut is not perpendicular to the curb at the street crossings and/or does not have a level landing at the top. (Section 21.2.1)
		____________________________________________________________________

	____	At marked crossings, the bottom of the ramp run, exclusive of flared sides, is not contained within the marked crossing. (Section 21.2.1)
		____________________________________________________________________

	____	Curb cuts are being constructed or reconstructed on one side of the street and curb cuts are not provided on the opposite side of the street. (Section 21.2.2)
		____________________________________________________________________

	____	Curb cuts are not provided at driveways intersecting sidewalks when the driveway has side curbs. (Section 21.2.3)
		____________________________________________________________________

	____	Raised island in crossing is not cut through level with the street and/or does not have curb cuts at both sides and a level area at least 48 inches long between the curb cuts in the part of the island intersected by the crossings. (Section 21.2.4)
		____________________________________________________________________

	____	Curb cuts are obstructed by parked vehicles. (Section 21.2.5)
		____________________________________________________________________

	____	Maximum slope exceeds1:12 (8.3%). (Section 21.3)
		____________________________________________________________________
	
	____	Cross-slope of curb cut center slope exceeds 1:50 (2%). (Section 21.3)
	_________________________________________________________________

	____	Transition from curb cut to walk, gutter, or street is greater than a ½ inch high.  (Section 21.4)
		____________________________________________________________________

	____	Grading and drainage are not designed to minimize water pooling, ice accumulation, or water flowing at the bottom of the curb cut. (Section 21.5)
		____________________________________________________________________

	____	Curb cut center slope is less than 36 inches, exclusive of flared sides. (Section 21.6)
		____________________________________________________________________

	____	A landing at the top of the curb cut is not 48 inches in length. (Section 21.6.1)
		____________________________________________________________________

	____	The slope of the landing exceeds 1:50 (2%) in any direction. (Section 21.6.1)
		____________________________________________________________________  
	
	____	The sides of the curb cut are less than 24 inches at the curb. (Section 21.7)
		____________________________________________________________________
	
	____	Maximum flare slope exceeds 1:10 (10%). (Section 21.7)
		____________________________________________________________________


	____	Curb cuts with returned sides are provided and are not protected by handrails, street furniture, or landscaping. (Section 21.8)
		____________________________________________________________________


	____	Built-up curb cut is provided and projects into vehicular traffic lanes. (Section 21.9)
		____________________________________________________________________

	____	Pedestrian street crossing controls (if provided):
		____  Controls are not raised from or flush with their housings and/or are not a 	minimum of two (2) inches in the smallest dimension. (Section 21.10.1)
		____  Force required to activate controls exceeds 5 lbs.
		____  Controls are not located as close as practicable to the curb cut serving the 	controlled crossing and/or do not permit operation from a clear ground space. 	(Section 21.10.2)
		____  Pedestrian-actuated controls are not at a maximum of 42 inches above the 	sidewalk. (Section 21.10.3)
		____  A stable and firm area, complying with Forward Reach (Section 6.5) and Side 	Reach (Section 6.6), is not provided at the controls. (Section 21.10.4)
		____  Where parallel approach is provided, controls are not within ten (10) inches
			horizontally and/or are not centered on the clear ground space. (Section 	21.10.4)
		____  Where a forward approach is provided, controls do not abut and/or are not 	centered on the clear ground space. (Section 21.10.4)
		____	Other (please specify):____________________________________________


4. What was the most recent date you observed the violation? _________________________


5.	Name and address of person/organization filing this complaint (if organization is filing, please provide the Board with the name of a contact person) (required):________________________________________________________________
	_________________________________________________________________________
	E-mail:___________________________________________________________________
	Telephone: _______________________________________________________________
	
6.	Individual Signature (required):________________________________________________
	Date: ____________________
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