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BRYANT STREET City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, PabliCHe8Ith MA01970 Present. Promote, Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHO Mayor health@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE #: GHL-17-127 DATE ISSUED: 5/3/2017 Property Located at: 183 BRYANT STREET UNIT#1 Owner/Agent: Robert McEachern Address: 19 Vista Drive City/Town: Danvers, MA Zip Code: 01923 24 Hour Phone:(978) 407-2263 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. 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. Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age. EGagakis Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN • CITY OF SALEM, MASSACHUSETTS IV BOARD OF HEALTH 120 WASHINGTON STREET,4t"FLOOR PubhCHealth Prevent.Promote.Protect. TEL. (978) 741-1800 FAX (978) 745-0343 KIMBERLEY DRISCOLL lraindin@salem.com salem.com MAYOR L�VtRY RAMD[N,RS/RE'.HS,CIAO,CP-FS xEAL,1'H 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" FEE: $50.00 PROPERTY LOCATED AT �3 S-/". UNIT#_�__ IS THIS UNIT DISIG,ATED A LEFT FRONT OR BACK,PLEASE CIRCLE ONE 12of0eri- r2cTn(,herr) OWNER/LESSER C ;4, 0- uis m(-fW,hMANAGER/AGENT n/4 NO P.O. BOX ADDRESS jq V, Sjw ADDRESS CITY, STATE, ZIP n/a n)✓ f rS YVt-� 0/b,3 CITY, STATE,ZIP / RESIDENCE PHONE 97&x' 760 zM/`MO BUSINESS PHONE (24HRS) BUSINESS PHONE1L TOTAL NUMBER OF ROOMS: /o ROOM USE: LK f 6Aa,-, 2.D i '✓i n$_ 3. becRroodn 4.li✓ �� rr.tS. {�eco✓o a y+t 6. 1' 'r rn.7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURDATE Inspectors use only Date on initial inspection: �I�I / Date of reinspection: Date of issuance of certificate: Date fee paid:�a Type of unit: Dwelling Other Check# �6 del Check date: Notes: Coe ori ent Inspector ,\ I�� 1 OOND City of Salem, Massachusetts n Board of Health 120 Washington Street, 4th Floor, Salem, th prevent.Promote. protect. MA 01970 Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, RENS, CHO Mayor health@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE#: GHL-17-128 DATE ISSUED: 5/3/2017 Property Located at: 183 BRYANT STREET UNIT#3 Owner/Agent: Robert McEachern Address: 19 Vista Drive City/Town: Danvers, MA Zip Code: 01923 24 Hour Phone:(978) 407-2263 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. 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. Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age. EGagakis Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN • CITY OF SALEM, MASSACHUSETTS lu BOARD OF HEALTH 120 WASHINGTON STREET,4".FLOOR PubliCHealth Prevent.Promote.Protert, TEL. (978) 741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL Iramdin n salem.com MAYOR LARRY RAMUIN,itS/RE[-IS,CI10,CP-FS HEAJ.T11 AG1;NT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" FEE: $50.00 PROPERTY LOCATED AT / ate- _ 3 Qjjft=aat��• UNIT#.3 ISTHIS UNITlDISIGNATED A IGH14M FRONT OR BACK,PLEASE CIRCLE ONE c?abe rt Wl(^�her-n OWNER/LESSER g ,S) MANAGER/AGENT 2 NO P.O. BOX ADDRESS—Z V D ADDRESS CITY, STATE,ZIP 7 q vl/vrr� Yn-<� 01Z. CITY, STATE,ZIP i RESIDENCE PHONE �W'7S4 `f/ 50 BUSINESS PHONE(24HRS) BUSINESS PHONE/— � 7 f- 47 6 7— (73 TOTAL NUMBER OF ROOMS: ROOMUSE: 1. ;�- 2. 'dice 3. coon 4. k; v; x 5.btd�oom 6.1 • .7. 0 8. 9. u10. THERE IS A FIFTY($50)DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE ��� ` � DATE Inspectors use only Date on initial inspection: L S'a ` 17 Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling----Other—Cheek# $3a�1 Check date: 5Ia I Notes: Code E WrceWent Inspector CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4".FLOOR PablicHea Ith TEL. (978) 741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL kamdin@salem.com LARRY RIMDIN,RS/REHS,CHO,CP-FS MAYOR AG ENT CERTIFICATE OF FITNESS CERTIFICATE#373-14 DATE ISSUED: 10/27/2014 Property Located at: 4 Bryant Street UNIT# House Owner/Agent: Chalifour Family Trust-Mary Woodcock Address: 20 Belleview Avenue City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-943-6920 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. 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 HRAMYDIN HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4°1 FLOOR 313,-1 TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR LRAMDIN@SA.EM.COM LARRY RAMDIN,RS/REAiS,CI 10,CP-FS HEALTTIAGIi.N'T l Grr Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 . "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" FE`E::$50.00 PROPERTY LOCATED AT C� zw l/p� l c�T UNIT# IS THIS UNIT�DISIG ACTED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE // L OWNER/LESSERAA—L Z��.aO MANAGER/AGENT /IIAJ?I/ /wlddr3GU/ C NO P.O. BOX ADDRESS „?O ? " 1P-,Vi440 Atry ADDRESS SYJS►tiC� . CITY, STATE,ZIP J`�79 0/q,76 CITY, STATE, ZIP RESIDENCE PHONE /n7e 9y3 - V&) BUSINESS PHONE(24HRS) Skt6crA_ _- BUSINESS PHONE TOTAL NUMBER OF ROOMS:— ROOM OOMS:ROOM USE: 1. 2. 3. 4. /�O 6. 7. 8. 9. 0. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE � DATE D 9 ��' Inspectors use only Date on initial inspection: (� �' �/� Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling—Other—Check#Check date: Notes: Code En r ent Inspector TRANSMISSION VERIFICATION REPORT TIME 11/03/2014 20:46 NAME FAX 9787450343 TEL 9787411800 SER.# 000BON341991 DATEJIME 11/03 20:46 FAX NO. /NAME 919787449614 DURATION 00: 00: 30 PAGE(S) 02 RESULT OK MODE STANDARD ECM +t1y, CITY OF SALEM9 MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR ` Ao 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#625-07 DATE ISSUED: 12/19/2007 Property Located at: 11 Bryant Street UNIT# 1 Owner/Agent: Thomas McDonald Address: P.O. Box 23 City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 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 EALTH 1"46� ACOTJOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR f CITY OF SALEM, MASSACHUSETTS + BOARD OF HEALTH • i 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 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION", PROPERTY LOCATED AT L- UNIT#—� IS THIS UNIT DESIGNATED ASR HT\LET FRONT BACK PLEASE CIRCLE ONE OWNERILESSER_ I MORA Mc-L A16 ANAGER/AGENT _ No P.O. Box p No P.O. Box ADDRESSf�L� �Z, 3 ADDRESS CITY L CITY a 1 /p 7 O RESIDENCE PHONE �____n. BUSINESS PHONE{24 HRS.} - _-_ BUSINESS PHONE 17 0 - 76 6 Zp 2 TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2.I3. Lr 4. ° 5._ 6. 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. /ffJ APPLICANTS SIGNATURE /_� <__- \� ATE t2-_7-0-7 / INSPECTORS USE ONLY DATE OF INITIAL INSPECTION/.a- - / DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE,/, -- 'O&ATE FEE PAID:_,/ ' TYPE OF UNIT: DWELLING V OTHER_ CHECK# S7`7��CHECK DATE_J,- �7 l p -7 NOTES: _ CODE ENFORCEMENT INSPECTOR 9/28198 =OND " City of Salem, Massachusetts 4 . �. lu Board of Health 3 q 120 Washington Street, 4th Floor, Salem, PubliCHealth MA 01970 Prevent. Promote. Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHo Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE#: GHL-15-121 DATE ISSUED: 6/18/2015 Property Located at: 11-13 BRYANT STREET UNIT#2 Owner/Agent: Thomas McDonald Address: P.O. Box 23 City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone:(978)766-6202 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. 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 0,--A4� Larry Ramdin, MPH, REHS, CHO HEALTH AGENT S NITARIAN CITY OF SALEM, MASSACHUSETTS • f BOARD OF HEALTH 120 WASHINGTON STREET,411 FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR LRAMDIN((�I�.SALk;M.COM LARRY RAMDIN,RS/RI?I-IS,CI IO,CP-F9 HFALTI'I 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" FEE: $50.00 PROPERTY LOCATED AT 1 j UNIT# 2 - ISS J' ITHIS UNIT DISI �,A/�TED^AASS RIGHT L�EFFF FRONT OR BACK.PLEASE CIRCLE ONE OWNER/LESSER [ —HvI aNjf} S ,L cSL� ANAGER/AGENT NO P.O. BOX y� ADDRESS P ' ©{ n ADDRESS CITY, STATE,ZIP L�gk�7�tQ.a��7/ / Mex , CITY, STATE,ZIP RESIDENCE PHONE_ 1 / 8 — !(ptp—a 'BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS:_ ROOM USE: 1. 42f-e 2. 3. 4. 5.rbc I 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE ISPAYABLEAT THE TIME OF INSPECTION APPLICANT'S SIGNATURE /(N� MCZ) DATE —201) Inspectors use only Date on initial inspection:O�/101201,5" Date of reinspection: Date of issuance of certificate:6/U/2a,5S Date fee paid: 061�20.S- Type of unit: Dwe((lliJng Othffer Check#-7r 13_(0.0 Check date:: 061012_oLS' Notes_ rh ri1 Ad /ATOXii 2 1;+A, +A Cf1LG� YlDO/ M 11V IlYl'iW • m;ddie. %-- I;✓ dygw ICY f" N RAS 0. SCYFon TOr1A AT 4e L+fo", Ohm by r jje� STOVfi neAs +0 ke- GIC.2 tot rcement h ector .• BOND , City of Salem, Massachusetts /6 U y 9 Board of Health 1 I 120 Washington Street, 4th Floor, Salem, PublicHealth MA 01970 Prevent. Promote. Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, RENS, CHO Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE #: GHL-15-21 DATE ISSUED: 4/10/2015 Property Located at: 17 BRYANT STREET UNIT#1 Owner/Agent: Jim Nieder Address: 31 Peabody Ave City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone:(978)473-9989 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. 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 Wth 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 l Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS • r BOARD OF HEALTH 120 WASHINGTON STREET,4`FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR LRAMDIN&ALEM.COM LARRY RAbID1N,ItS/REBS,CI 10,(:P-I;S HI ALTI-I 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" r FEE: $50.00 PROPERTY LOCATED AT /72yC'd / /� UNIT# l IS THIS UNIT /DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER ds m iu 0 /fA MANAGER/AGENT NO P.O.BOX 4v&� ADDRESS -8i ElixT 3ajc)S' L`dy& ADDRESS CITY, STATE,ZIP &FL�5a //lftO/ /�/J CITY, STATE, ZIP RESIDENCE PHONE %� j BUSINESS PHONE(24HRS) BUSINESSPHONE (77i, `173 — 99c?4 TOTAL NUMBER OF ROOMS:_ _ ROOM USE: 1 41V1A5V ,y2 /,J17t1ditd 1&140M 4 A rAl 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABL THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATE l Inspectors use only Date on initial inspection: �5 I 15 Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Cheek#_Check date: Notes: Code n ement Inspector (��a CITY OF SALEM, MASSACHUSETTS ® BOARD OF HEALTH s 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 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#349-06 DATE ISSUED: 8/8/2006 Property Located at: 17 Bryant Street UNIT#3 Owner/Agent: James Nieder Address: 31 Peabody Avenue City/Town: Beverly,MA Zip Code: 01915 24 Hour Phone: 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. FO T/ E OARD OF HEALTH V JOANNE SCOTT, 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 /`J 245--*"T' e� UNIT#3 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER Jim dn-AtErE_ MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS ADDRESS CITY ?aVnt2- sr) 1V14 0191/ 1� CITY RESIDENCE PHON/ECft, ga-1�025'�3 BUSINESS PHONE (24 HRS.) BUSINESS PHONE( n' T!3 —99ef TOTAL NUMBER OF ROOMS:_ ROOM USE: 1. 2. 3. 4. 5. 6. 7. 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. APPLICANTS SIGNATURE DATE In' ECTO S USE ONLY DATE OF INITIAL INSPECTION �S" DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:��6 DATE FEE PAID:_" p - 0 TYPE OF UNIT: DWELL IN OTHER_ CHECK# / I CHECK DATE S-e - 6 NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 IUMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR IMANCINI(lt)SAN-ALCOM JANF;TMANCINI ACTING HI:W xi-1.Au;N'r CERTIFICATE OF FITNESS CERTIFICATE#251-09 DATE ISSUED: 6/1/2009 Property Located at: 19 Bryant Street UNIT# 1 Owner/Agent: Two Maragrets Realty Trust Address: 16 Front Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 922-0379 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 )Q JAtNEET MANCINI ACTING HEALTH AGENT COD E ORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS i r BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TF,I.. (978) 741-1800 KIMBERLEY DRISCOLL FAX (978) 745-0343 MAYOR IMANCINI&ALEN1.COM JANET NL.•1NCINI, ACTING 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." Z //J/� FEE: $50.00 / PROPERTY LOCATED AT V o%ZLI*yr 57 UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNEWLESSER T� E b9rr� *�{ MANAGER/AGENT NO P.O. BOX ADDRESS JA F2!e!!I Sr �P�-�'�cG ADDRESS 146 Fl�-,%, Sl_ CITY, STATE,ZIP Agy � CITY, STATE,ZIP RESIDENCE PHONE ' BUSINESS PHONE(24HRS) 970 _ `r'2 2 'G 3 7 BUSINESS PHONE '7 7C— 9;l2-G 375' TOTAL NUMBER OF ROOMS:_ ROOM USE: 1. LSn PI 2. Sru 3. 4, W12j�" 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION c, APPLICANT'S SIGNATUR DATE f— Insuectors use only Date on initial inspection: ��I Date of reinspection: Date of issuance of certificate:: Date fee paid: O Type of unit: Dwelling 'V Other Check#��Check date: l P o 1 Notes: I JC(QP/lI(y� SROI 1/1 Lk I 1/1 LRAM • Mbl &W�j h04 AiQliV fig, 114E u. Pu} Un . k JQM I� /-lea.) Code Enforcement Inspec — .gyp - v � s _ CERT.# 217-01 FEE $25.00 DATE: 05/03/2001 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 19 Bryant Street UNIT #: 1 Left OWNER/AGENT: Two Maragrets Realty Trust ADDRESS: 10 Front Street I CITY/TOWN: Beverly, MA ZIP CODE: 01915 24 HOUR PHONE: 922-0379 j 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. i MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410 .000 : MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . SECTION 410.400 (B) : DWELLING UNIT (X) AND 410.400 (C) : ROOMING UNIT MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: . NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR OCCUPANTS UNDER 6 YEARS OF AGE. FOR MORE INFORMATION CALL 978-741-1800 . I I FOR THE BOARD OF HEALTH V JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR i i J u t... NE�N CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS, CHO NINE NORTH STREET HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tel:(978)741-1800 Fax: (978)740.9705 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION", PROPERTY LOCATED AT _�1 L✓ VAN-r 197- UNIT # - €S THIS UNIT DESIGNATED AS IG TEF FRON BACK PLEASE CIRCLE ONE 17- OWNER/LESSER—;k6,_/ 0IiQFi tai LMANAGER/AGENT___��N1Y___.____ No P.O. Bax No P,O. Box ADDRESS __—ADDRESS /P ° CITY CITY RESIDENCE PHONE—._—pp __BUSINESS PHONE (24 HRS.)_wL&2Mv 9 BUSINESS PHONE�'.,lo�. -QtS'Yy —_ TOTAL'NUMBERlOF ROOMS:- -I---L ROOM USE: 1, lld R _ 2.�it 1C'1" 3..r Lic A EV4,4d-It THERE IS A TWENTY-FIVE ($28.04) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SAL HEALTH EPA:Wtq MENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. ES A. SINN NSAPPLICANTS SIGNATURE fit�1 //� ' r �i DATEJ�-0 / INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 71� 3- _,0 I DATE OF REINSPECTION,_..__ DATE OF ISSUANCE OF CERTIFICATE:'"/ J-4? DATE FEE PAID:51-_,� o TYPE OFUNIT. DWELLING, _koTHER__ CHECK#�Io CHECK DATES - �` NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 m Lf CITY OF SALEM, MASSACHUSETTS > BOARD OF HEALTH _ 120 WASHINGTON STREET,4".FLOOR p11bi1CHE:81t$ Prevent.Vromam.Profw[. TEL. (978) 741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL ltaindin@salem.com LARRY IL\MD7N,Rti/REI-IS,CEIO,CP-FS MAYOR HI3N:1'I-f AGHN'I' CERTIFICATE OF FITNESS CERTIFICATE#437-12 DATE ISSUED: 9/28/2012 Property Located at: 19 Bryant Street UNIT#2 Owner/Agent: Two Margarets Realty Trust Address: 16 Front Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 922-0379 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 Y RAMDIN k � HEALTH AGENT SANITARIAN 1 a CITY OF SALEM, MASSACHUSETTS a BOARD OF HEALTH 120 WASHINGTON STREET,4111 FLOOR PubliCHealth I'icvfnl,PrOmnie.Pla1C[I. TEL. (978) 741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL Iramdin@salem.com MAYOR LiVLRYRAMl>IN,RS/121?HS,CHO,CP-FS HG.AJ,of I AGL+.N'f Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" /� � FEE: $50.00 PROPERTY LOCATED AT /.gyp 6� �2Y/�b''% - UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER ZLG1i / Cts � MANAGER AGENTS "'� ¢ ��� NO P.O. BOX _ ADDRESS /Z /�rG,� Si ADDRESS `&6 14� -'t CITY, STATE, ZIP '` CITY, STATE,ZIPG ` RESIDENCE PHONE 9?t. '572 7--c 5r7`J' BUSINESS PHONE (24 BUSINESS PHONE FZ�- f,;71'- e)f'c 3 Z G TOTAL NUMBER OF ROOMS: L ROOMUSE: 1. (- IA-44 2. �A-SA" 3. xcr 4. d3C-P 5 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNAT � DATE_ Z Inspectors use only Date on initial inspection: c(/g.ji a Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check# Check date: Notes: Co or ment Inspector * CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH a 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 WWW.SALEM.COM Kimberley Driscoll Mayor JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#203-07 DATE ISSUED: 4/25/2007 Property Located at: 19 Bryant Street UNIT#2L (unit 3) Owner/Agent: Two Margarets Realty Trust Address: 10 Front Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 922-0379 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. R THE BOARDH JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH CJ% � • • 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 HAB,,ITTATTION". PROPERTY LOCATED AT��Iy� 71 � F( UNIT# 3 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASECIRCLEONE OWNER/LESSER`G�l�D Aii� W4 , MANAGER/AGENT ` I��NN f SCUM-9 No P.O. Box / W4 No P.O. Box 6 ADDRESS ri(ovi 4 ___ADDRESS Ib I/� DN� s7 CITY valy 04k' _CITY ,BILI p 0/9/5 RESIDENCE PHONE�760 • � OCTITBUSINESS PHONE (24 HRS.)jI` Q :_�' '6,3q� BUSINESS PHONE G/,[S TOTAL NUMBER OF ROOMS:_/� ROOM USE: 1.L//2/n 2. J E _3.%.1« CM4. RAA Ph'1 5._ 6. 7. 8. THERE IS A TWENTY-FIVE ($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEP RTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. jJ APPLICANTS SIGNATURE 1_ _DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION_�-�S _� DATE OF REINSPECTION_-- __-_o 7 DATE OF ISSUANCE OF CERTIFICATE: 72DATE FEE PAID:_._?� _� __ 7 TYPE OF UNIT: DWELLI __OTHER___. CHECK #5; U CHECK DATE Ll NOTES:_L v — ---- - CODE ENFORCEMENT INSPECTOR 9/P8/98 o CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR �Pa SALEM, MA 01970 TEL. 978-741-1800 a FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#: 440-03 DATE ISSUED: 8/25/2003 Property Located at:: 19 Bryant Street UNIT#: 2 Right Owner/Agent: Two Margarets Realty Trust Address: 10 Front Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 978-922-0379 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. This approval does not certify compliance with the State Lead Law for occupants under 6 years of age. For more information call 978-741-1800. 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 oanne Scott, MPH, RS, CHO Health Agent CODE ENFORCEMENT INSPECTOR s CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS, CHO NINE NORTH STREET HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tel: (978)741-1800 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 Fax: (978)740-9705 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT-ft-,6p,I YAlyv7T-- ST UNIT# IS THIS UNIT DESIGNATED AS IGHT )LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER"f6UDMAR&AREIS AQIiVR NAGER/AGENT��"J4rS No P.O. Box No P.O. Box ADDRESS Cb oie6aT s7• ADDRESS IP 7ff_0.,j1-r 57— CITY 7CITY ��(/l�d�yCYgI' CITY_ wvfi 7U11i� �l7IJ �J RESIDENCE PHONE Q p BUSINESS PHONE (24 HRS.) BUSINESS PHONE Z�d ,/ TOTAL NUMBER OF ROOMS: "- ROOM USE: 1. 5. 6.-7.-8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DENFITMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. JA S A. FIN ONS APPLICANTS SIGNATURE +2- DATE 06s INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 32 A,;� — ED.3 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: DATE FEE PAID: 4; -- - --TYPE O& N IT 9WELL'ING OTHER CH_ECK4 - y> CHECK DATE =_03 — _= -- � NOTES:- __ -. - F:... ....tea. . .....r.... CODE ENFORCEMENT INSPECTOR 9/28/98 vg:c CITY OF SALEM, MASSACHUSETTS ^T g BOARD OF HEALTH a , IIA 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 �a�MIN6 TEL. 978-741-1800 FAX 978-745-0343 KIMBERLEY DRISCOLL JSCOTT@SALEM.COM MAYOR JOANNE SCOTT HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE # 178-08 DATE ISSUED: 4/15/2008 Property Located at: 19 Bryant Street UNIT#3 Owner/Agent: Two Margarets Realty Trust Address: 10 Front Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 922-0379 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. PFF THE BOARD OF EALTH 1� V JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR - - TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR ISco rr(aSAJT'.M.COM JOANNE SCOTT, HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMA HABITATION." PROPERTY LACATED AT / 7 n- Y�y/��/T UNIT# 3 IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER 7 MANAGER/AGENT NO P.O. BOX _ ADDRESS �'/l i//.�iZnT f ADDRESS CITY,STATE,ZIP G' � Gt! `�- CITY,STATE,ZIP RESIDENCE PHONE BUSINESS PHONE(24HRS) 7 Z z >S BUSINESS PHONE / TOTAL NUMBER OF ROOMS: Y ROOM USE: 1. L 7 h ` 2. u 61— 3. 4. -6--a 5. 6. 7. 8. 9. 10. THERE IS A TWENTY-FIVE($25)DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANTS SIGN " ATE Inspectors use only Date on initial inspection: -D Date of reinspection: Date of issuance of certificate:( - I J ­0 V Date fee paid:. 4 ' �( � 7�— Type of unit: DwellinOther Check#_3 s"7 Check date: Notes: Code Enforcement Inspector '� ¢o CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR a fSp SALEM, MA 01970 9ggA TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#: 382-03 DATE ISSUED: 7/28/2003 Property Located at:: 19 Bryant Street UNIT#: 3 2nd floor left Owner/Agent: Two Margarets Realty Trust Address: 10 Front Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 922-0379 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. This approval does not certify compliance with the State Lead Law for occupants under 6 years of age. For more information call 978-741-1800. 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 Joanne MPH, RS, CHO Health Agent CODE ENFORCEMENT INSPECTOR , o.oni' OFFICE USE •' ° "� RESIDENCE ` CODE CITY OF SALEM HEALTH DEPARTMENT BOARD OF HEALTH Salem, Massachusetts 01970 ROBERT E. BLENKHORN 9 NORTH STREET HEALTH AGENT (617) 741.1800 APPLICATION FOR CERTIFICATE OF FITNESS In Accordance with State Sanitary Code , Chapter II, 105 CMR 410.000. "MinimumUQ Standards of Fitness For Human Habitation". PROPERTY LOCATED AT ! 9 �pAV A /J� �6 /,� UNIT (/7 OWNER/LESSER-6/0 MAR(sQ/e4E f� �JQ��+�M.ANAGER/AGENT'') ��,✓�t¢JG�75 ADDRESS �/) /Pbns`r ?% ADDRESS CITY f/ yf A ©7��� CITY RESIDENCE PHONE BUSINESS PHONE (//2114"' HRS. ) 10, 72' BUSINESS PHONE � ' -p3L � �i7✓)�D3 TOTAL NUMBER OF ROOMS: Raz JJ ROOM USE: 1 . t IV R M 2. L/J /skin, 3. 4 . T �✓ 5. 6. 7. 8. FEE: $25.00 PAYABLE TO — CITY OF SALEM HEALTH DEPARTMENT OFFICE USE TOTAL SQUARE FOOTAGE: SQ. FT. TOTAL SQUARE FOOTAGE FOR SLEEPING PURPOSES: SQ. FT. DATE OF INITIAL INSPECTION: 3 DATE OF REINSPECTION; DATE OF ISSUANCE OF CERTIFICATE: 12 ,) -o j DATE FEE PAID: 7 TYPE OF UNIT: DWELLING /-' ROOMING_ —6T}FER � fL �2 g�f� NOTES: CODE ENFORCEMENT INSPECTOR APPLICANTS SIGNATURE DATE o CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH gj 120 WASHINGTON STREET, 4TH FLOOR rsa SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#359-04 DATE ISSUED: 07/29/2004 Property Located at: 19 Bryant Street UNIT#3 Left Owner/Agent: Two Margarets Realty Trust Address: 10 Front Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 978-922-0379 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. F R THE BOARD OF HEALTH JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR ev��00NDIT��Q' n 22 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tel: (978)741-1800 Fax: (978)740-9705 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT 1 Q 888 n IV UNIT#_- IS THIS UNIT DESIGNATED AS RIGHTEFT FRONT BACK PLEASE CIRCLE ONE OWNER LESSER_WDfj/PRifE/ES MANAGER/AGENTj1✓/dr No P.O. Box ',vm/ry mver No P.O. Box ADDRESS /D tRr vA ')) S!' ADDRESS !D �0N77! CITY �Ey�,✓E�L,V CITY veA RESIDENCE PHONE 97IP?.2-2.0 317 BUSINESS PHONE (24 HRS.)_2_vr_a__�= BUSINESS PHONE TOTAL INUMBER OF ROOMS: ROOM USE: 1. 2. /]ysY/1A3. 4407"f ' 5. 6.-7.-8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE; PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEP RTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. Ile APPLICANTS SIGNATUR DATE �7 eA INSPECTCRS USE ONLY DATE OF INITIAL INSPECTION 7 a`1 ' yy_DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: 7 - a y a `>'DATE FEE PAID: -2� Yf y W^ ''CHECK--# �,`j CHECK DATE -TYRE QF U I Q�WE�L'ING -OTHER ' _. ' NOTES CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM9 MASSACHUSETTS BOARD OF HEALTH _ 120 WASHINGTON STREET, 4TH FLOOR Sia 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#187-08 DATE ISSUED: 4/22/2008 Property Located at: 19 Bryant Street UNIT#4 Owner/Agent: Two Margarets Realty Trust Address: 10 Front Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 922-0379 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 ll° 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 JOANNE SCOTT, MRH, RS, CHO —4he .. HEALTH AGENT CODE ENFORCEMENT INSPECTOR . . r CITY OF SALEM, MASSACHUSETTQS I -0 c�U ' • BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR ISCarr e SALEM.COM JOANNE SCOTT, HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMA HABITATION." PROPERTY LACATED AT _ Z 2J/ ! UNIT#— � IS THIS U�DISIG'NATEEy-AS RIGHT LEFT FRONT OR BACK,PLEASECIRCLEONE OWNER/LESSER T2-" w, / - ! • MANAGER/AGENT NO P.O. BOX i^ ADDRESS S!' ADDRESS_ CITY,STATE,ZIP � CITY,STATE,ZIP L'� �✓ — /�l/tl RESIDENCE PHONE BUSINESS PHONE(24HRS) '5�72� 1;?Z BUSINESS PHONE '5�77 Z -E TOTAL NUMBER OF ROOMS:_ ROOM USE: 1. ILZA" 2. LCc'T 3. 4. 5. 6. 1 7. 8. 9. 10. THERE IS A TWENTY-FIVE($25)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE-AT-THE TIME CTION APPLICANTS SIGNATURE _ DATE �2 Inspectors use only Date on initial inspection: �� 2 -u, L3 Date of reinspection: Date of issuance of certificate: , '1 Z U S-- Date fee paid:_ y'Z L Type of unit: DwellingV_Other Check#3 `t 6-5- Check date: , 4 - "" -0 Y Notes: Code Enforcement Inspector CITY OF SALEM, MASSACHUSETTS m. a BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAx 978-745-0343 W W W.SALEM.COM Kimberley Driscoll JOANNE SCOTT, MPH, RS, CHO Mayor HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#441-06 DATE ISSUED: 8/29/2006 Property Located at: 19 Bryant Street UNIT#4 Right Front Owner/Agent: Two Margarets Realty Trust Address: 10 Front Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 922-0379 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 l JqAVNNE T, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH ♦ • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-74 1-1 800 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 IHUMAN HABITATION°. pp PROPERTY LOCATED AT Iq—� T --. _UNIT #4 IS THIS UNIT DESIGNATE,JD,tAS IGHT LIEF RON BACK' PLEASE , CCIIRCLE ONE OWNERILESSER 141/0 1l M686 cf /�'� MANAGER/AGENQT� {J✓N J� Na RE Boz No P.O. SS 1, V Aa L�� 4 ox ADDRESS lL� l/`Cb/✓AT,�,� ST~ ADDRESS ��/(j CITY /���'P4 WA CITY RESIDENCE PHONE D �Z� _BUSINESS PHONE (24 NRS.)—"7 37 BUSINESSPHONE TOTAL NUMBER OF ROOMS: (F ROOM USE: 5._..__6. _7. 8. — THERE IS.A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPAPAMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. S A. F N ONS APPLICANTS SIGNATURE n _DATE_ 6 INSPECTORS USE ONLY SATE OF gMAL INSPECTION_ �D -�?_.DATE OF REINSPECTION_________ DATE OF ISSUANCE OF CERTIFICATE: :X10 6EDATE FEE PAID:a-�` 5�'' TYPE OF UNIT: DWELLIN�OTHERCHECK #34-O' -_,CHECK DATE R.-0` NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#38-05 DATE ISSUED: 1/19/05 Property Located at: 19 Bryant Street UNIT#4-2nd Floor Right Owner/Agent: Two Margarets Realty Trust Address: 10 Front Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 922-0379 An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR410.000: Massachusetts State Sanitary Code,Chapter IP'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 r� 1 JOANQE SCOTT, MPH, RS, CHO HEALTH AGENT O FORCEMENT INSPECTOR y ��ONUIT�� 16 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS, CHO NINE NORTH STREET HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tel: (978)741-1800 Fax: (978) 740-9705 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". a PROPERTY LOCATED AT l_9 /J R�f�1Y %T UNIT #- 1 IS THIS UNIT DES�IGNATE�DnA IGH T LEFT FRONT BACK PLEASE CIRCLE ONE + OWNER/LESSER 22f,1,0 'fuael�g AGERLAGENT�>N i jf- No P.O. Box / No P.O. Box ��Qpy � ADDRESS lD �(1rn� ADDRESS 77 v7 �i %���1 / CITY 15E1,15R,4V CITY 0( `5 RESIDENCE PHONE ` _BUSINESS PHONE (24 HRS.)_ $ r� a� 7 ? BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3. 4. 5. 6. 7. 8. THERE IS A TWENTY-FIVE ($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPAR ENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE h DATE / INSPECTORS USE ONLY DATE OF INITIAL INSPECTION /-1 S _b�! DATE OF REINSPECTION_____ DATE OF ISSUANCE OF CERTIFICATE: DATE FEE PAID:--/ TYPE OF UNIT DINELLING�­OT-HERCHECK# ` /'a" :CHECK DATE NOTES,- -. CODE ENFORCEMENT INSPECTOR 9/28/98 aCITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS. CHO MAYOR HEALTH AGENT May 23, 2002 Two Margarets Realty Trust c/o James Finn & Sons 10 Front Street Beverly, MA 01915 Dear Sir/Madam: In accordance with Chapter 111, Sections 127A and 1278, of the Massachusetts General Laws, 105 CMR 400.000: State Sanitary Code, Chapter 1: General Administrative Procedures and 105 CMR 410.000: State Sanitary Code, Chapter 11: Minimum Standards of Fitness for Human Habitation, an inspection was conducted of your property at 19 Bryant Street#5 conducted by Pablo Valdez, Code Enforcement Inspection of the Salem Board of Health, on May 22, 2002. An inspection of the dwelling unit at the above address has revealed that it does not comply with the Massachusetts State Sanitary Code Chapter 11: Minimum Standards of Fitness for Human Habitation. Therefore, a Certificate of Fitness cannot be granted from the Code Enforcement Division of the Salem Board of Health and the unit may not be rented or occupied until the noted violations have been corrected and a reinspection has been made. VIOLATIONS: SEE ENCLOSURE: ONE OR MORE OF THE NOTED VIOLATIONS MAY ENDANGER OR MATERIALLY IMPAIR THE HEALTH, SAFETY AND WELL-BEING OF THE OCCUPANTS. Please note that some of the necessary repair may require permits for the Building, Plumbing, Electrical, Fire or other City Departments. These must be obtained before the work is commenced. FOR THE BOARD OF 4HEALTH REPLY TO Joanne Scott/ Pablo Valdez Health Agent Code Enforcement Inspector Este es un documento legal importante. Puede que afecte sus derechos. Enclosure CERTIFIED MAIL 7001 1140 0000 6731 2551 JS/mfp CITY OF SALEM HEALTH DEPARTMENT rP -� Salem, Massachusetts 01970 Enclosure May 23, 2002 Two Margarets Realty Trust c/o James Finn & Sons 19 Bryant Street#5 Repair wallpaper in Front Room. Replace missing outlet cover in Back Room. .,.�v. .. CERT.# 844-96 FEE $25.00 DATE: 12/03/96 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT;MPH,RS,CHO NINE NORTH STREET HEALTH AGENT _ Tel:(508)741.1800 Fax:(508)740-9705 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 19 Bryant Street UNIT #: 5 OWNER/AGENT: Two Margaret's Realty Trust ADDRESS: 10 Front Street CITY/TOWN: Beverly, MA ZIP CODE: 01915 . .24 HOUR PHONE: 922-0379 AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS BEEN APPROVED AND IS IN COMPLIANCE WITH 105CMR410.000: 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 HEALTH DEPARTMENT AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED. - MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 Cp2R 410.000: MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . SECTION 410.400 (B): DWELLING UNIT (X) AND 410.400 (C) : ROOMING UNIT MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: . NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR { OCCUPANTS UNDER 6 YEARS OF AGE. 1 FOR THE BOARD OF HEALTH JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR si �y.corur,� e e OFFIGE USE ONLY GG •- A CERT. / N V DATE: CITY OF SALEM HEALTH DEPARTMENT BOARD OF HEALTH Salem, Massachusetts 01970 9 NORTH STREET 508-741-1800 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 �JTGn gl - ,// UNIT_ 3 5 ,/ ,{�/�9rgplAe �� �� MANAGER/AGENT 4765 1. ., OWNER/LESSERNY�'/p/6 T 7 ,NN I'J21ar1 ADDRESS /Jj �DC A T S% / ADDRESSJp f b.y /�s--/ CITY ✓.,Z4 Fj CITY %yl'IQ [l/g7Sslf RESIDENCE PHONE BUSINESS PHONE (24 HRS. 08) 'a�7) BUSINESS PHONE — TOTAL NUMBER OF ROOMS ROOM USE: 1 . 2. 3. 4. 5. 6. 7. 8. THERE IS A TWENTY-FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT UPON COMPI 10E AND ISSIIANCE OF CERTIFICATE. APPLICANTS SIGNAI"'URE NP 4S DATE /01-b11 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION: '3 y DATE .OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: Z.� 3 b DATE FEE PAID: 3 6 TYPE OF UNIT: DWELLING OTHER NOTES:J�L/ f Gy 11 /) 5 t^ 1 yS t2iZ LJiLtclu W -1'"ay..,-:�" f�rn lce..r1✓'F.' ��t .rilifl/f K... CODE ENFORCEMENT INSPECTOR it c CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH `� gt 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#39-05 DATE ISSUED: 1/19/05 Property Located at: 19 Bryant Street UNIT#5 Left Owner/Agent: Two Margaret's Realty Trust Address: 10 Front Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 922-0379 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 t fi JO NE SCOTT, RS, CH HEALTH AGENT CODE ENFORCEMENT INSPECTOR t 5 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS, CHO ,NINE NORTH STREET HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tel: (978) 741.1800 Fax: (978) 740-9705 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT�9�4 �N � UNIT f_ Sad L IS THIS UNIT DESIGNATED AS RIGHT EFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSEFFIjU ANAGEPJAGENT �JN T���5 No P.O. Box No P.O. Box ADDRESS ADDRESSZL �//lYi7` CITY CITY RESIDENCE PHONE �yBUSINESS PHONE (24 HRS )*�S -Z�?7y BUSINESS PHONE_'"Gd lol� ` U � / TOTAL(NUMBER OF ROOMS:__ ROOM USE: 1. 2.--3.-4.- 5.— . 3. 4.5. 6. 7. 8. THERE IS A TWENTY-FIVE ($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPART NT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. '79 APPLICANTS SIGNATURE ..< K DATE G-/�7 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION I— ) g" � DATE OF REINSPECTION DATE OF ISSUANCE OF CER IFICATEI g-6S DATE FEE PAID:_ -TYPE OF UNIT aOWELUN OTH_ ER CHECK.:-:;0$- _CHECK°DATE r' \ : NOTES.--- -- CODE ENFORCEMENT INSPECTOR 9/28/98 A R CITY OF SALEM, MASSACHUSETTS lu BOARD OF H&j LTH 120 WASHINGTON STREET,4""FLOOR PublicHCeltli Pmvev.Promom_Pralec,. TEL. (978)741-1800 FAx (978) 745-0343 KIMBERL EY DRISCOId, Iratndin@salem.com I,;\RRl'R;\MDIN,RS/RIi,I IS,C:1 K),CP-F+ti MAYOR I-II SALI'1 f AGIiN'1' CERTIFICATE OF FITNESS CERTIFICATE#237-14 DATE ISSUED: 7/9/2014 Property Located at: 19 Bryant Street UNIT#6 Owner/Agent: Two Margarets Realty Trust Address: 16 Front Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 978-922-0379 x 201 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. 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 "', � LA MDIN HEALTH AGENT SANITARIAN I CITY OF SALEM, MASSACHUSETTS lu �3)4 BOARD OF H&-LTH 120 WASHINGTON STREET,4°i FLOOR PublicHealth Prevent. Promote.Protect. TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL Iramdinna,salem.com MAYOR L,vItRY 1LVMDIN,IL4/121%F[S,CIiO,CP-ISS . HEAF;ITf A(;FNT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" QFEE: $50.00 PROPERTY LOCATED AT ( 40—�A, T UNIT#� IS THIS UNIT DISIGNATED AS MIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER �C���zt�t�,� /Z- MANAGER/AGENT /'//t-N 4 _� S NO P.O. BOX _ ADDRESS / FITA vT -15 ADDRESS l CITY, STATE,ZIP �' ^ CITY, STATE,ZIP RESIDENCEPHONE ems?� le.�/-Grle3 BUSINESS PHONE(24HRS)�!- 7, 922 BUSINESSPHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. (ac dL`t 2. 3. 4. 6?� 5. ��- 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE T _ APPLICANT'S SIGNATUR Inspectors use only Date on initial inspection: I c, Date of reinspection: Date of issuance of certificate: n_ Date fee paid: Type of unit: Dwelling Other Check# C _Check date: 7 fl Notes: Code&1v96wncnt Inspector 6 CITY OF SALEM, MASSACHUSETTS BOARD oFHEdLTH' 120 WASHINGTON STREET 4"'FLOOR I't1�I�CIICRI�I1 TEL. (978) 741-1800 FAX(978) 745-0343 KIMBF_RLEY DRISCOLL Iramdin ,salem.com MAYOR IAli12Y"7tAMllIN,ILSf la�.t 1s,c:rlo,cr-res I IEAi:n I AGI:?N'r CERTIFICATE OF FITNESS POLICY 1. A Certificate of Fitness inspection is required for all rental units older than 5 years, per City of Salem ordinance; 2. A Certificate of Fitness is good for 1 year or the life of the tenant, whichever is longer; 3. A Certificate of Fitness inspection may be obtained by calling or coming into the Health Department and requesting an appointment; 4. Appointments must be requested at least 24 hours in advance pending an open appointment; 5. No "same day' appointments will be granted; 6. All appointments are subject to the schedule of the inspector, 7. A rental unit will be considered occupied when either the previous tenant or the current tenant has belongings in the unit. In the case of an occupied unit, either the tenant whose belongings are in the unit must be present at the time of inspection, OR have signed a release statement allowing the Board of Health to inspect the unit. 8. Please allow at least one week turnaround time for the Certificate to be issued, especially at the end of the month; 9. A Certificate ofFitness will be granted when: a. An inspection has been conducted by a Health Department employee b. An application has been filled out and a check or,money order has been received 10. If you have any questions, please contact the Health Department i � P o CIS' OF SAIaFNI, MASSACHUSETTS BOARD OFIIEALTH PubliaHealth 120 WASHINGTON S'7'REET,4r.i FLOOR TFi- (978)741-1800 FAX(978)745-0343 KIMBERLEY DRISCOLL Iramdin@salem.com L MAYOR ViRI'RAbil)IN,1L8/RliHS,CI 10,(T-I'SHF+,ti�l'I I A(;IiN'I' Release In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ; State Sanitary Code Chapter II and Article XIII of the City of Salem Ordinance, undersigned owner/lessor and tenant/lessee of a unit of residential property, hereby authorize the Salem Board of Health or its authorized agents to inspect the residence identified below in accordance with the aforementioned statutes,regulations and ordinances. In the event it is necessary that said inspection be done in my/out absence. I/we expressly authorized the same and for my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of Health and its authorized agents from any lose or injury sustained of whatever nature and description occasioned by my/out absence during said inspection. Tenant/Lessee Owner/Lessor Address Address Address on unit to be inspected Date Updated 503/11