BRISTOL STREET CITY OF SALEM, MASSACHUSETTS
HEALTH AGENT
• w
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
KIMBERLEY DRISCOLL JSCOTT@SALEM.COM
MAYOR
JOANNE SCOTT
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#409-07
DATE ISSUED: 8/23/2007
Property Located at: 6 Bristol Street UNIT# 1
Owner/Agent: Gary Blattberg
Address: 10 Naples Road
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 744-6640
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II"
Minimum Standards of Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
ANNE MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
• CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
• 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800 /
FAX 978-745-0343
JOANNE SCOTT, MPH, RS, CHO
Kimberley Driscoll HEALTH AGENT
Mayor
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT G gAt OL S TR-Gt l UNIT#
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSERC*AY MANAGER/AGENT
No P.O. Box No P.O. Box
ADDRESS 10 AIA ?LAS ✓� c' ADDRESS
CITY 5M k'V1 I,^YL4 dly]J CITY ,r,��
RESIDENCE PHONE 9'7'6 8 b2 c�. 4 U1 BUSINESS PHONE (24 HRS.) S/ r"'C
r
BUSINESS PHONE 5' ' C
TOTAL NUMBER OF ROOMS:_ },
ROOM USE: 1.x1 �G14 2. dtea . 13K1>-III-,
5. L.I v IRA 6. & /y" 8.
THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION. =^�y�
APPLICANTS SIGNATURE-- � `—, DATE S1lZ��al
INSPECTORS US LY
DATE OF INITIAL INSPECTION ��_DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: DATE FEE PAID:__
TYPE OF UNIT: DWELLIN OTHER_ CHECK # 15S 3 CHECK DATE ��
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
Pp"g TEL. 978-741-1800
FAx 978-745-0343
Kimberley Driscoll www.SALEM.COM
Mayor JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#27-06
DATE ISSUED: 1/20/06
Property Located at: 6 Bristol Street UNIT#2
Owner/Agent: Gary Blattbera
Address: 10 Naples Road
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-882-4469
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter IF'
Minimum Standards of Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF_HEALTH
i=NETT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CrrY OF SALEM, MASSACHUSErM
BOARD OF HEALTH
120 WASHINGTON STREET,4T" FLOOR all
SALEM, MA 0 1970
TEL� 97e-741-1800
FAX 978-745-0343
STANLEY USOVICZ, JR. JOANNE SCOTT. MPH. RS, CHO
MAYOR HEALTH AGENT
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"
PROPERTY LOCATED AT-(, of_�) UNIT N
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OV
C
RES|D[NCGPH0N "7 / V66;) 7 BUSINESS PHONE (24 HRS)
�
BUSINESS PHONE
�
TOTAL NUMBER 0FRO0M&__��___�_
�
ROOM USE� 1`
5.--__--�-_8.__-_--_--7 ___-_-�-_-�8--�---_-_-�
THERE YS /\TWENTY-FIVE ($25O0) DOLLAR FEE, PAYABLE 8YCHECK 0RMONEY
ORDER T0THE CITY OFSALEM HEALTH DEPARTMENT THIS FEE |SPAYABLE ATTHE
TIME DFINSPECTION.
t,E 07NLY
APPLICANTS S|GN8TUHE ��OAJE)/ °<
INSPECTORS US
! DATE OF INITIAL INSPECTION , -
�,o - 0 e6_DATE 0FRG|N5PECT|0N_ _
DATE 0FISSUANCE OFCERTIFICATE: d~e ~�0 AATEFEC PAID /'' 20
TYPE OFVN\T DVVELL| 0TMER CMEcK � / / /'� CHECK DATE
'I/ / ' ' � ' ~
��NOTES,
g/2x/93