BURNSIDE STREET �,coxolr�,� CITY OF SALEM, MASSACHUSETTS
�"�' BOARD OF HEALTH
Q. 120 WASHINGTON STREET, 4TH FLOOR
� ' SALEM, MA 01970
sJ
TEL. 978-741-1800
FAx 978-745-0343
STANLEY USOVICZ, JR. _JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
June 10, 2002
Raymond Young
87 Federal Street
Salem, MA. 01970
Dear Mr. Young:
As property owner of 2 '/: Burnside Street/ 58 Bridge Street, Salem, it is your
responsibility to have a Certificate of Fitness for each apartment in the building.
Our records indicate there has been only one Certificate issued since 1996. Upon receipt
of this notice please contact this office at 978-741-1800 to make appointments for
inspection of these units.
Failure to respond and obtain these Certificates will result in court action being sought
against you in Housing Court.
Included with this notice are applications and tenant release forms for the Certificate of
Fitness Program.
For the oard of Health: Reply to:
Jeffrey Vaughan Pablo Valdez
Sr. Sanitarian Code Enforcement Inspector
Cc: Building Inspector
CERT.# 272-96
" FEE $25.00
DATE: 05/28/96
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: 2 1/2 Burnside Street UNIT #: 1
OWNER/AGENT: Raymond Youna
ADDRESS: 87 Federal Street
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-1572
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 HEALTH DEPARTMENT AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED.
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 THE BOARD OF }IEALTH
�Ttl-��e� r,i r� (JL4/ v✓
r/
V
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
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CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tei:(508)741-1800
APPLICATION FOR CERTIFICTE OF FITNESS Fax:(508)740-9705
IN ACCORDANCE WITH STATE SANITARY' CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM
STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT G. „� �1 UNIT / /
OWNER/LESSER MANAGER/AGENT
ADDRESS ADDRESS
CITY _�q�� CITY
RESIDENCE PHONE �!' fS ��. BUSINESS PHONE (24 HRS.) _
BUSINESS PHONE _
TOTAL NUMBER OF ROOMS: 3
ROOM USE: 1. f� -L 2. 0. 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 DEP THIS / IS PAYABLE AT THE TIM OF INSPECTION
APPLICANTS SIGNATUREH L . T DATE
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION: "7'-<-_ DATE OF REINSPECTION_
DATE OF ISSUANCE OF CERTIFICATE t>_ 6 DATE FEE PAID:
TYPE OF UNIT: DWELLING �OTHER
N '
CODE ENFORCEMENT INSPECTOR
i
May 23 , 199E �4• ,-, _,.,_ __
�0
Board of Health "Y2 D 1996
North St .
Salem, MA 01970
Attn: Pablo Valdez
Dear Mr .Valdez:
Re: 58 Bridge St . , Salem, Unit #1
A new ceiling vent has been installed in the bathroom of the above
mentioned unit by Kevin Talbot , a licensed electrician.
Could you please send my occupany permit and I thank you for you.-
help
ourhelp in this matter.
Sincer
kaond L. You g
RLY:m
May 14 , 1996 p
MAY 11 1996
('041 .
Salem Board of Health -
9 North St .
Salem, MA 01970
Attn: Mr. Valdez:
Re : 2 1/2 Burnside St. , Unit #1
Dear Mr.Valdez:
in regard to the above mentioned unit , 2 1/2 Burnside St . , Unit 1 ,
1 . Stove has been repaired by licensed plumber;
2 . Have contacted electrician to install bathroom fan in
unit; will contact you when this has been completed.
Thank you for your concern in this matter.
/aymond L. Young
RLY:m
;, SENDER:
V .Complete items)and/or 2 for additional servides. I also Wish to receive the
., •Complete items 3,4a,and 4b. following services(for an
w .Print your name and address on the reverse of this form so that we can return this extra fee:
card to you. ' 1 ai
j
-Attach this form to the front of the mailpiece,or on the back it space does not 1, ❑ Addressee's Address
permit.
y •WNWRetwn Receipt Requested'on the mailpiece below the:article number. 2. ❑ Restricted Delivery y
« •The Return Receiptwill show to whom the article was delivered and the date it
delivered. Consult postmaster for fee. .D
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PS Form 3811,beceirber 1994 Domestic Return Receipt
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I UNITED STATES POSTAL SERVICE Postage& Mail
Postage&Fees Paid 00
USPS
Permit No.G-10
• Print your name, address, and ZIP Code in this box •
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MAY 141996
ESalem Health Department' 9 North St.
Salern, Mass. 01970
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P 316 592 179
us Postel sgrvice
Receipt for Certified Mail
No Insurance Coverage Provided
Do not use for Intemational Mail See reverse
Sent to
Street&Number
Post Olfioe,Slate,&LP Code
Postage $
Certified Fee
Special De6rery Fee
Restricted Delivery Fee
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Return Receipt Showing to
Whom b Date Delivered
•� Retum Reoe4l SImirgmWhom.
Dam,6 Addressees Addms
CDTOTAL Postage 8 Fees s
M Postmark or Date
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U)
Stick postage stamps to article to cover First-Class postage,certified mall fee,and
chargee for any selected optional services(See front).
1. If you wem this receipt postmarked,stick the gummed stub to the right of the return
address leaving the receipt attached, and present the anile at a post office service m
window or hand it to your rural center(no extra Marge). m
2. If you do not wars This receipt postmarked,slide the gummed stub to the right of the m
return address of the article,date,detach,and retain the receipt,and mal the article.
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3. 8 you want a return receipt,write the certified mal number and your name and address
on a return reoeipt card,Form 3811,and attach it to the from of the article by means of the
gummed ends ff space pannhs. Otherwise,affix to back of article. Endorse from of amide '$
RETURN RECEIPT REQUESTED adacem to the number.
4. If,you'wam delivery restricted to the addressee, or to an authorized agent of the
addressee,ecdorse RESTRICTED DELIVERY on the from of the article.
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5. Enter fees for the services requested in the appropriate spaces on the from of this
receipt. N return receipt is requested,check the applicable blocks in hem 1 of Form 3811. ti
6. Save this receipt and present it 0 you make an inquiry. a
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1� SIF
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT May 8, 1996 Tel:(508)741-1800
Fax:(508)740-9705
Raymond Young
87 Federal Street
Salem, MA 01970
Dear Mr. Young:
In accordace with Chapter III, Sections 127A and 127B, of the Massachusetts General Laws, 105
CMR 400.000: State Sanitary Code, Chapter I: 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 2 112 Burnside Street Apt. 1
conducted by Pablo Valdez, Code Enforcement Inspector of the Salem Health Department,
on May 7, 1996.
An inspection of the dwelling unit at the above address has revealed that it does not comply with
the Massachusetts State Sanitary Code Chapter II: Minimum Standards of Fitness for Human
Habitation.
Therefore, a Certificate of Fitness cannot be granted from the Code Enforcement Division of the
Salem Health Department 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 repairs may require permits from the Building, Plumbing,
Electrical, Fire or other City Departments. These must be obtained before the work is
commenced.
FOR THE BOARD OF HEALTH REPLY TO
JOANNE SCOTT PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CERTIFIED MAIL P S16 592 179
Este es un docurnento legal importante. Puede que afecte sus derechos.
Enclosure
10,
CITY OF SALEM HEALTH DEPARTMENT
` 1 <' Nine North Street
Salem,Massachusetts 01970
Enclosure
Raymond Young
2 1/2 Burnside Street Apt. #1 /
Bathroom - No Winduw /y3
The owner shall provide for each habitable rgc#h cont ning a toilet bathtub or shower ventilation
to the outdoor consisting of window, skylight/t atur and mechanical ventilation.
Kitchen stove has a leak- Provide a stove an ven in good working order, either repair of
replace the stove in the apartment.
• RV, I'MR
met
•, SALEM HEALTH DEPARTMENT
9 North Street
Salem, MA 01970
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CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT May 8, 1996 Tel:(508)741-1800
Fax:(508)740-9705
Raymond Young
87 Federal Street
Salem, MA 01970
Dear Mr. Young:
In accordace with Chapter III, Sections 127A and 127B, of the Massachusetts General Laws, 105
CMR 400.000: State Sanitary Code, Chapter I: General Administrative Procedures and 105
CMR 410.000: State Sanitary Code, Chapter II: Minimum Standards of Fitness for Human
Habitation, an inspection was conducted of your property at 2 112 Burnside Street Apt. 1
conducted by Pablo Valdez, Code Enforcement Inspector of the Salem Health Department,
on May 7, 1996.
An inspection of the dwelling unit at the above address has revealed that it does not comply with
the Massachusetts Slate Sanitary Code Chapter If: Minimum Standards of Fitness for Human
Habitation.
Therefore, a Certificate of Fitness cannot be granted from the Code Enforcement Division of the
Salem Health Department 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 repairs may require permits from the Building, Plumbing,
Electrical, Fire or other City Departments. These must be obtained before the work is
commenced.
FOR THE BOARD OF HEALTH REPLY TO
JOANNE SCOTT PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CERTIFIED MAIL P 316 592179
Este es un documento legal importante. Puede que afecte sus derechos.
Enclosure
CITY OF SALEM HEALTH DEPARTMENT
1 . Nine North Street
Salem,Massachusetts 01970
Enclosure
Raymond Young
2 1/2 Burnside Street Apt. #1
Bathroom - No Window
The owner shall provide for each habitable room containing a toilet bathtub or shower ventilation
to the outdoor consisting of window, skylight, natural and mechanical ventilation.
Kitchen stove has a leak- Provide a stove and oven in good working order, either repair of
replace the stove in the apartment.
CITY OF SALEM, MASSACHUSETTS
ojr BOARD OF HEALTH
s
120 WASHINGTON STREET, 4TH FLOOR
o' SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#441-04
DATE ISSUED: 09/28/2004
Property Located at: 2 1/2 Burnside Street UNIT# 1 F
Owner/Agent: Raymond Young
Address: 87 Federal Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-1572
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 'S
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
j
�.IT�'��dP,S1lCEM1'�iIASSACIItUSE-[P'S
AL'Flft
i• - -
It 20,WASHINGTON$TtiREEF•4Tr1 FLo_ OR y +
s0197�0
TEL. 978-741-1800 / / (
=� FAx 978-745-0343 W 777
STANLEY USOVICT, JR. -JOANNE SCOTT, MPH, RS', CHO '
MAYOR HEALTH AGENT
' � Y
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER II, 105 CMR 410.000
i "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION'.
PROPERTY LOCATED AT 21 Burnside St. Salem, MA UNIT #1F
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRON BACK PLEASE CIRCLE ONE
OWNER/LESSER Raymond Young MANAGER/AGENT_ _
No P.O. Box No P_O.Box
ADDRESSi 87 Federal St. ADDRESS
CITY_ a1 m. MA-_01970 CITY i
RESIDENCE PHONE 918-745-1512._BUSINESS PHONE (24 HRS.)-978-745-1572
BUSINESS PHONE _
TOTAL NUMBER OF ROOMS:----4—
ROOM USE: 1._QT--2_. yg 3."_gg__ ._4. BRz
5. 6. 7. 8.
THERE IS A TWENTY-FIVE {825.00 DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALE H DEPARTMENT THIS FEE IS PAYARLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNAI URE _ -D TE 9/28/94 _
INSPECT ORS USE LY
DATE OF INITIAL INSPECTION_ ! _'Oc DATE OF REINSPFCTIONN__ __
DATE OF ISSUANCE OF CERTIFICATEDATE FEE PAID ! �T
TYPE OF UNIT DWELUNY OTHER D-41-CK !I CHECK DATE
NolFs.
LOkZ
CODE ENFORCEMENT INSPECTOR 9128!98
_ CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
s 120 WASHINGTON STREET, 4TH FLOOR
��. SALEM, MA 01970
q TEL. 978-741-1800
FAX 978-745-0343 _
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#76-05
DATE ISSUED: 2/1/05
Property Located at: 2 1/2 Burnside Street UNIT# 1 L
Owner/Agent: Raymond Young
Address: 87 Federal Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-1572
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
JOANNE SCOTT, MPH, CHO
, /
HEALTH AGENT CODE ENFORCEMENT INSPEC R
1
_ CITY OF SALEM, MASSACHUSETTS
'� BOARD OF HEALTH
• • 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970 / /D
TEL. 978-741-1800
FAX 978-745-0343
STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
I
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 21 Burnside St. UNIT! dist Flr. Left
IS THIS UNIT DESIGNATED AS aRl_GHTQEED FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER Raymond L. Young MANAGER/AGENT
No P.O. Box No P.O. Box
ADDRESS 87 Federal St. ADDRESS
CITY Salem, MA CITY_.. _
RESIDENCE PHONE 978-745-1572 BUSINESS PHONE (24 HRS.) Same
BUSINESS PHONE 978-745-1572
TOTAL NUMBER OF ROOMS: 3 Plus Bath
ROOM USE: 1._T.R 2. ng 3--KIT
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 SIGNATU _DATE119nin�_
INSP TOR UTONL
DATE OF INITIAL INSPECTION �- IV � DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE&,�)-, DATE FEE PAID:_,_
TYPE OF UNIT: DWELLIN OTHERCHECK riDg CHECK DATE _
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 LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO -
MAYOR HEALTH AGENT
RELEASE
In accordance with Massachusetts General Laws Chapter III ; Code of Massachusetts
P.r-gulations 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 author–
ized agents to inspect the residence identified below in accordance with tile-
aforementioned
l:eaforementioned statutes, regulations and ordinances.
In the event it is necessary Lhat said inspection be done in my/our absence , !/we
expressly authorize the same and for my/our successors and assigns hereby release
and discharge. the City of Salem, Salem Board of Health and its authorized splcnts
front any loss or injury sustained of whatever nature and description occasioned
b7 my/our absence during said inspection.
Raymond L. Young
TT_. A.NT/LESSEE — - OWNER/iFSSOR -- --------------
87 Federal St. , Salem, MA
Ai)D!:ESS --- – F.DDRESS
212 Burnside St. , Salem, MA 1st Flr. Left
P.DIMESS OF UNIT TO BE INSPECTED
1/20/05
„n u CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
• 120 WASHINGTON STREET, 4TH FLOOR
J
SALEM, MA 01970 CERT.# 406-02
TEL. 978-741-1800 FEE $25.00
FAx 978-745-0343 DATE: 08/05/2002
STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 2 1/2 Burnside Street UNIT #: Middle
OWNER/AGENT: Raymond Young
ADDRESS: 87 Federal Street
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-1572
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, 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.
F R THE BOARD OF HEALTH
(!
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
o �-
CITY OF SALEM, MASSACHUSETTS 46 6
BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY LISOVICZ, JR. ,JOANNE SCOTT, MPH, RS, CHO -
MAYOR HEALTH AGENT
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
c�
PROPERTY LOCATED AT-2� (/i2�{i�' l �'1 UNIT#1
IS THIS UNIT DESIGNATED
/ASRIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER (/" MANAGER/AGENT '
No P.O. Box No P.O. Box
ADDRESS t ADDRESS
CITY � � CITY
RESIDENCE PHONE19'4 BUSINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUTABER OF ROOMS:_ 9
ROOM USE: 1. Kd 2.
5. 6. 7. 8.
THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM HEAl TH DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATURE DATE ®2
I SP TZ USE ONLY
DATE OF INITIAL INSPECTION 9 — S z DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: - U _"' DATE FEE PAID: 3 -J —0
TYPE OF UNIT: DWELLING vOTHER_ CHECK# 3 ( 0 CHECK DAT -5 -D 7-
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
• 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 97 8-74 1-1800
FAX 978-745-0343
STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
05/23/2002
Raymond Young
87 Federal Street
Salem, MA 01970
PROPERTY LOCATED AT 2 1/2 Burnside Street UNIT # Middle
Dear Sir/Madam:
It has come to our attention, that you may be considering renting a dwelling unit
at the above address.
In accordance with Chapter 11, Article XIII of the City of Salem Code of
Ordinances, Section 2-334,titled "Certificate of Fitness, " each dwelling unit must be
inspected and certified prior to allowing occupancy. The inspection will be conducted
in accordance with 105 CMR; State Sanitary Code, Chapter I: General Administrative
Procedures and 105 CMR 410.000; State Sanitary Code, Chapter II: Minimum Standards of
Fitness for Human Habitation.
Please notify us if you do not intend to rent the unit.
Please contact this department within 24 hours of receipt of this notice at
978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday
thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7:00 p.m. and Friday 8:00
a.m. - 4 :00 p.m.
Failure to comply with this procedure, may result in a fine of Twenty (20) dollars
per day for every day that the dwelling unit is occupied without a Certificate of
Fitness.
A $25.00 check payable to the City of Salem is required for each unit inspected at the
time of inspection.
A property owner is required to pay gas and electricity for residential tenants if there
is not a written letting agreement stating the tenant is responsible for those
utilities and if the meter(s) records electricity and gas use which is not used
exclusively by that tenant . The Department of Public Utilities has billed property
owners for their tenants' entire utility bills retroactive to the date of initial
occupancy in cases in which cross-metering has been proven to exist.
R THE BOARD qg HE44TH REPLY TO
loanne Scott, MPH,RS,CHO PABLO VALDEZ
Health Agent CODE ENFORCEMENT INSPECTOR
. 0
CITY OF SALEM, MASSACHUSETTS
3� 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
05/01/2002
Raymond Young
87 Federal Street
Salem, MA 01970
PROPERTY LOCATED AT 2 1/2 Burnside Street UNIT # 2 Rear
Dear Sir/Madam:
It has come to our attention, that you may be considering renting a dwelling unit
at the above address.
In accordance with Chapter 11, Article XIII of the City of Salem Code of
Ordinances, Section 2-334,titled "Certificate of Fitness, " each dwelling unit must be
inspected and certified prior to allowing occupancy. The inspection will be conducted
in accordance with 105 CMR; State Sanitary Code, Chapter I: General Administrative
Procedures and 105 CMR 410.000; State Sanitary Code, Chapter II: Minimum Standards of
Fitness for Human Habitation.
Please notify us if you do not intend to rent the unit.
Please contact this department within 24 hours of receipt of this notice at
978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday
thru Wednesday from 8:00 a.m. - 4 :00 p.m. Thursday 8 :00 a.m. - 7 :00 p.m. and Friday 8:00
a.m. - 4 :00 p.m.
Failure to comply with this procedure, may result in a fine of Twenty (20) dollars
per day for every day that the dwelling unit is occupied without a Certificate of
Fitness.
A $25.00 check payable to the City of Salem is required for each unit inspected at the
time of inspection.
A property owner is required to pay gas and electricity for residential tenants if there
is not a written letting agreement stating the tenant is responsible for those
utilities and if the meter(s) records electricity and gas use which is not used
exclusively by that tenant. The Department of Public Utilities has billed property
owners for their tenants ' entire utility bills retroactive to the date of initial
occupancy in cases in which cross-metering has been proven to exist.
THE BOARD HEALTH REPLY TO
JR
anne Scot't, MPH,RS,CHO PABLO VALDEZ
Health Agent CODE ENFORCEMENT INSPECTOR
6o CITY OF SALEM9 MASSACHUSETTS
�- BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
�fP SALEM, MA O 1970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#43-04
DATE ISSUED: 02/11/2004
Property Located at: 8 Burnside Street UNIT#: 1
Owner/Agent: Michael F. Brown
Address: 10 Burnside Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 774-4808
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 11"
Minimum Standards of Fitness for Human Habitation'.
Therefore, this Certificate if 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 CRM 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates,whichever
is later.
This Certificate of Fitness if valid only if there is a valid Certificate of Occupancy.
F R THE BOARD/�H
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
- �CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
• i~ 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
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOUR,,HUMAN HABITATION".
PROPERTY LOCATED AT �L) t�1.S(�D� UNIT#
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNERILESSER NIc qw OW I�MANAGER/AGENT
No P.O. Box No P.O. Box
ADDRESS__jC I?QAW(PZ SL ADDRESS_
CITY S&LZ l CITY
RESIDENCE PHONE 7YCIEbl—
LC. OC - BUSINESS PHONE (24 HRS.) C �2c�0
BUSINESS PHONE NdOU_,C1-
TOTAL NUMBER OF ROOMS: `t
ROOM USE: 1. KttCIi�' 2. �l M_ RR 4.�Z
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. ��JJ
APPLICANTS SIGNATURE 711 P-4eAfL DATE �t
INSPECTORS USE ONLY 1
DATE OF INITIAL INSPECTION 1 1 a `f DATE OF REINSPECTION_.
DATE OF ISSUANCE OF CERTIFICATE:,2 -1 1 U � DATE FEE PAID: '7- — 1 1 -o `/
TYPE OF UNIT: DWELLING ..OTHER— CHECK# CHECK DATE 2-
NOTES:—.._..
CODE ENFORCEMENT INSPECTOR 9/28/98
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
$j 120 WASHINGTON STREET, 4TH FLOOR
f SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
5/9/05
Michael 8 Linda Brown
8-10 Burnside Street
Salem, MA 01970
PROPERTY LOCATED AT 8 Burnside Street Unit 2
Dear Sir/Madam:
It has come to our attention, that you may be considering renting a dwelling unit at the above address.
In accordance with Chapter 11,Article XIII of the City of Salem Code of Ordinances, Section 2-
334, titled "Certificate of Fitness," each dwelling unit must be inspected and certified prior to
allowing occupancy. The inspection will be conducted in accordance with 105 CMR 410.000; State
Sanitary Code, Chapter 11: Minimum Standards of Fitness for Human Habitation.
Please notify us if you do not intend to rent the unit.
Please contact this department within 24 hours of receipt of this notice at 978-741-1800, to schedule an
appointment for an inspection. Our office hours are Monday thru Wednesday from 8:00 a.m. —4:00 p.m.
Thursday 8:00 a.m. to 7:00 p.m. and Friday 8:00 a.m. — 12:00 p.m.
Failure to comply with this procedure, may result in a fine of Twenty($20.00) dollars per day for every
day that the dwelling unit is occupied without a Certificate of fitness.
A$25.00 check payable to the City of Salem is required for each unit inspected at the time of
inspection.
A property owner is required to pay gas and electricity for residential tenants if there is not a written letting
agreement stating the tenant is responsible for those utilities and if the meter(s) records electricity and
gas use which is not used exclusively by that tenant. The Department of Public Utilities has billed
property owners for their tenant's entire utility bills retroactive to the date of initial occupancy in cases in
which cross-metering has been proven to exist.
For the Board of Healtthh� Reply to
C??-
J Anne Scott MPH, RS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector
CITY OF SALEM, MASSACHUSETTS
a
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
March 14, 2003
Mike Brown
10 Burnside Street
Salem, MA 01970
PROPERTY LOCATED AT 8 Burnside Street Unit#2
It has come to our attention, that you may be considering renting a dwelling unit at the above
address.
In accordance with Chapter 11, Article XIII of the City of Salem Code of Ordinances,
Section 2-334, titled "Certificate of Fitness," each dwelling unit must be inspected and certified
prior to allowing occupancy. The inspection will be conducted in accordance with 105 CMR; 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.
Please notify us if you do not intend to rent the unit.
Please contact this department within 24 hours of receipt of this notice at 978-741-1800, to
schedule an appointment for an inspection. Our office hours are Monday thru Wednesday from 8:00 a.m.
—4:00 p.m. Thursday 8:00 a.m. —7:00 p.m. and Friday 8:00 a.m. —4:00 p.m.
Failure to comply with this procedure, may result in a fine of Twenty ($20.00)dollars per day for
every day that the dwelling unit is occupied without a Certificate of Fitness.
A$25.00 check payable to the City of Salem is required for each unit inspected at the time of
inspection.
A property owner is required to pay gas and electricity for residential tenants if there is not a written letting
agreement stating the tenant is responsible for those utilities and if the meter(s)records electricity and
gas use which is not used exclusively by that tenant. The Department of Public Utilities has billed
property owners for their tenants' entire utility bills retroactive to the date of initial occupancy in cases in
which cross-metering has been proven to exist.
or the Board of He Ith Reply to
(Joanne Scott MPH, RS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector
City of Salem, Massachusetts
r_ Board of Health
120 Washington Street, 4th Floor, Salem, PtablicHealth
y p o
MA 01970 Present Promote, Protect
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-17-274
DATE ISSUED: 8/30/2017
Property Located at: 9 BURNSIDE STREET UNIT#1
Owner/Agent: Tom Gagnon
Address: P.O. Box 8860
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978)7444149
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.
�S
&fre
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITARIAN
A CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALLji
120 WASHINGTON STREET,4"FLOOR
TEL. (978) 741-1800
ICMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR LRAMDIN@SALEM.COM
LARRYRANIMN,RS/REHS,CHO,CP-FS
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"
A,0 S±
$50.00
V�
PROPERTY LOCATED AT 1 (3o (y� o IX,0 S± UNIT#
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK.PLEASE CIRCLE ONE
OWNER/LESSER O YI &0q l O✓t MANAGER/ANT
NO P.O.BOX PO. - dX
ADDRESS_& QI t � R p ADDRESS
CITY, STATE,ZIP 5Q(Q M. 11b CITY, STATE,ZIP
RESIDENCE PHONE Sts USINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:_
nn
ROOM USE: 1. • 2. L R 3. 6,0& 4. 13P-4 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 I-FffiT THE TIME OF INSPECTION p
APPLICANT'S SIGNATURE/ G DATE
f
Inspectors use only
Date on initial inspection: Date Date of reinspection:
Date of issuance of certificate: Date fee paid:WZZO
Type of unit: Dwellin Other ''// Check#g21 Check date: �2�����
IZ
Notes:
gg i - ; .16v K 4c5,1(1111— nof
n ,, f e, eG or
hap�A �nr �ecCoe-
d n rcemen[ pector
' CITY OF SALEM, MASSACHUSETTS
�0 T
r �vQd BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
97
a SALEM, MA 01970 CERT.# 410-02
FEE $25 .00
sgggM'� TEL. 978-741-1800 DATE: 08/06/2002
FAX 978-745-0343
STANLEY USOVICZ, JR. JOANNE SCOTT, MPH. RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 9 Burnside Street UNIT #: 1 Left
OWNER/AGENT: Chase Realty Trust
ADDRESS: P.O. Box 8860
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 509-7292
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, 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.
qFOR T.HE BOARD OF HEALTH /
zll-
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
4
.. 4 F w�.«_..-..p. . M�r,f++.�1°«"",w ':.. i...' <. .a _ •,x,�,...s, .,i Y*5�-":"�„'�'�s'� '-+ e.,. a�p,4
' �` \..11 i Vt' JHLGIvI, IVIHSSHv..n uSG i S
�CON01
BOARD OF HEALTH
n
' 120 WASHINGTON STREET, 4TH FLOOR ' O�
SALEM, MA 01970 /�,r//Q
i
�s TEL. 978-741-1800
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 II, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT-tY 6 L)2h)
" 511p S UNIT#-
IS THIS UNIT DESIGNATED AS RIGHT LEF FRONT BACK PLEASE CIRCLE ONE
! OWNER/LESSER G L MANAGER/AGENT
No P.O. Box No P.O.Box
ADDRESS ADDRESS
CITY S L��� CITY M 7
RESIDENCE PHONE BUSINESS PHONE (24 HRS.)
BUSINESS PHONE �� `'�d 1-7
TOTAL NUMBER OF ROOMS: 2 `
ROOM USE 1 2 3 4:
J THERE IS A,TWENTY-FIVE($25.00) DOLLAR`FEE, PAYABLE BY"CHECK OR MONEY
ORDER,TO.THE CITY OF'SALEM HEALTH DEP TMEN THIS FEE IS',PAYABLE AT THE
l TIMEOFaINSPECTION.,,.- F ' `
`I APPLICANTS SIGNATOR < DATE
g INSPECTORS USE ONLY. "
DATE OF INITIAL INSPECTION 6''� t' DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATEk-G -0-1DATE FEE PAID: R-
TYPE OF UNIT: DWELLING OTHER EH€i<�IZ# /_'! o;740'6CHECK DATE-9
NOTES:
i
CODE ENFORCEMENT INSPECTOR ' 9/28/98
I �
If
a i
b.LY I( WA ..1..a1 r a Y
City of Salem, Massachusetts
tj*�,U#"
Board of Health
120 Washington Street, 4th Floor, Salem, Pul>SiCH@81th
MA 01970 Prevent. Promote. Protect.
Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CH
Mayor health@salem.com Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE#: GHL-16-483
DATE ISSUED: 12/8/2016
Property Located at: 9 BURNSIDE STREET UNIT#2
Owner/Agent: Tom Gagnon
Address: P.O. Box 8660
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 7444149
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.
P—-2r� --�-;/,j P I I ) d(�
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITARIAN
e
CITY OF SALEM, MASSACHUSETTS
• BOARD OF HEALTH
120 WASHINGTON STREET,4111 FLOOR
TFL (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR LRAMDIN a@SALPM.COM .
LARRY RAMDIN,RS/RF.HS,CHO,CP-FS
HEALTH AGFNT
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 �J
PROPERTY LOCATED AT �� aV&/I//:I P�52� UNTrlt
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT OR BAC PLEASE CIRCLE ONE
OWNER/LESSER C ,ff&C� lai�� MANAGER/AGENT
NO P.O.BOX
ADDRESSX�� ref✓1 VYI ADDRESS
CITY, STATE,ZIP CITY,STATE,ZIP
RESIDENCE PHONE BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: T
ROOM USE: 1. I1 I I 2. (, 1 �� 3. 66'b 4. .
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 SIGNATURE79 �/1�-- DATE )
�y(/ Inspectors use only
Date on initial inspection: h.- (�19l)LQ Date of reinspection: �r /
Date of issuance of certificate-pt—L I a Date fee paid:
Type of unit: Dwelling Other Check#':J�?�FZCheck date: VCG
Notes:
Codenforcem nt Inspector
e
• CITY OF SALEM, MASSACHUSETTS IV
BOARD OF ILALTH
120 WASHINGTON STRLET 4"'FI,oOR plltllicHC8lt
, Frevcm.I'ram"t".I'mircl.
TLL. (978) 741-1800 FAX(978) 745-0343
KIMBERLEY DRISCOLL Iramdinna,salem.com
LARRY RAbIDIN,RS/R} h[S,C[-LO,CV-FS
MAYOR HLAI;n i A(;FN'r'
CERTIFICATE OF FITNESS
CERTIFICATE#194-14
DATE ISSUED:6/4/2014
Property Located at: 9 Burnside Street UNIT#3
Owner/Agent: Tom Gagnon
Address: P.O. Box 8860
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 508-509-7292
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 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 OFHEALTH
LARRY RAMDIN
HEALTH AGENT SANITARIAN
® CITY OF SALEM, MASSACHUSETTS 190
BOARD OF HEALTH
120 WASHINGTON STREET 4"'FLOOR PablicHealth
> prawn,Promote.protect.
TEL. (978)741-1800 FAx(978) 745-0343
KIMBERLEY DRISCOLL Iramdin@salem.com
MAYOR LARRY RANIDIN,RS/R@HS,C1 10,(:P-1'•S
HL'AI;I'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"
Q FE/E:: $50.00
PROPERTY LOCATED AT ( �l �/C S I UNIT#
IS THIS UNIT DIISSIIGNATED AS RIGHT LENT FRONT OR BAM PLEASE CIRCLE ONE )
OWNER/LE �H0) N S ►C C��G—/V(6K MANAGER/AGENT O'M �rI�IG—/Voll
NO P.O.BOX �y X
ADDRESS L 766 SA(-cm , M l4 dMOADDRESS
CITY, STATE,ZIP J , CITY, STATE,ZIP
RESIDENCE PHONE BUSINESS PHONE(24HRS)
BUSINESS PHONE��
TOTAL NUMBER OF ROOMS: 3
ROOM USE: 1. ��( l 2. ( 1/ 3. 13(% 4. 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 PAY LE AT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE ��ii �/ DATE 0/
Inspectors use only
Date on initial inspection:_(�r�4— Date of reinspection:
Date of issuance of certificate: Date fee paid:
Type of unit: Dwell=
��� Other Check#Check date:
Notes: )l. �2 Y�I1�.l 11,Ls � lQMgAA S�aI(T
Code nfo •ement Inspector
vg
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
02/21/2001
.Scott Galber
9 Belleair Drive
Swampscott, MA 01907
PROPERTY LOCATED AT 10 Burnside Street UNIT # 1
Dear Sir/Madam:
It has come to our attention, that you may be considering renting a dwelling unit
at the above address.
In accordance with Chapter 11, Article XIII of the City of Salem Code of
Ordinances, Section 2-334,titled "Certificate of Fitness, " each dwelling unit must be
inspected and certified prior to allowing occupancy. The inspection will be conducted
in accordance with 105 CMR; State Sanitary Code, Chapter I: General Administrative
Procedures and 105 CMR 410.000; State Sanitary Code, Chapter II: Minimum Standards of
Fitness for Human Habitation.
Please notify us if you do not intend to rent the unit.
Please contact this department within 24 hours of receipt of this notice at
978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday
thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7:00 p.m. and Friday 8:00
a.m. - 4:00 p.m.
Failure to comply with this procedure, may result in a fine of Twenty (20) dollars
per day for every day that the dwelling unit is occupied without a Certificate of
Fitness.
A $25.00 check payable to the City of Salem is required for each unit inspected at the
time of inspection.
i
A property owner is required to pay gas and electricity for residential tenants if there
is not a written letting agreement stating the tenant is responsible for those
utilities and if the meter(s) records electricity and gas use which isnot used
exclusively by that tenant. The Department of Public Utilities has billed property
owners for their tenants' entire utility bills retroactive to the date of initial
occupancy in cases in which cross-metering has been proven to exist.
_ OR THE BOARD .. HEALTH REPLY TO
Joanne Sc t, MPH,RS,CH0 PABLO VALDEZ
Health Agent CODE .ENFORCEMENT INSPECTOR
r
CERT.# 650-99
FEE $25.00
DATE: 10/28/99
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: 10 Burnside Street UNIT #: 1
OWNER/AGENT: Scott Galber
ADDRESS: 9 Belleair Drive
CITY/TOWN: Swampscott, MA ZIP CODE: 01907 24 HOUR PHONE: 592-4462
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, 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
i 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.
FOR THE BOARD OF HEALTH ,J
VJOANNE SCOTT, MPH,RS,CHO vv
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
i
w
� 3 ra
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 Tee(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 /D l Uh/�5�}9 f Sl UNIT#1
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER d '� MANAGER/AGENT
No P.O. Box S[,Df No P.O. Box
ADDRESS ,D ki/f ADDRESS )c
CITY �5� �r // CITYZ� /
RESIDENCE PHONE N k 6% BUSINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2. D 3. 410 4. 40
5. 6. 7. 8.
THERE IS A TWENTY-FIVE($2 .00) DOLL R F E, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF AL M HEALT DE ARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
Z�
APPLICANTS SIGNATOR DATE/�_ �
INSPE ORS USE ONLY
DATE OF INITIAL INSPECTION/o - XX '4 S DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:/"0 -),F-f 5 DATE FEE PAID:/�gv Y
TYPE OF UNIT: DWELLING
1�_OTHER_ CHECK#4�o Q _CHECK DATEQ
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
A
v6��ONDIT �
CERT.# 255-01
1 FEE $25.00
s9@. .�..,. DATE: 05/18/2001
�/MMg
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT Tel: (978)741-1800
Fax: (978)740-9705
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 10 Burnside Street UNIT #: 2
OWNER/AGENT: Scott Galber
ADDRESS: 9 Belleair Drive
CITY/TOWN: Swampscott, MA ZIP CODE: 01907 24 HOUR PHONE: 592-4462
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, 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.
FOR THE BOARD OF HEALTH
V
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
G �w'
01
�C7�Ng
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 Tet (978)747-1800
Fax: (978)740-9705
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
U12rfS71�� 5 t_..
PROPERTY LOCATED AT�Q /.� --UNIT# 2,
IS THIS UNIT DESIGNATED A/S'+RIGH Tp} LE FRO BACK PLEASE CIRCLE ONE
OWNER/LESSER�5C _17GL —MANAGER/AGENT
No P.O. Box No P.O. Box
ADDRESS_j- �( L K._DfiLVE ADDRESS
CITY 61 'SCO �f �0 CITY,
RESIDENCE PHONIf' �E s L(4b ZZ—BUSINESS PHONE (24 HRS.}
BUSINESS PHONE P/
TOTAL NUMBER OF ROOMS:A
ROOM USE: 1. t � _2. 3. 4. kIv'—
5. 6. 7. 8.
THERE IS A TWENTY-FIVE($25.0 } OLLAR FE PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM ALTH DEP M T THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION. 7�y
APPLICANTS SIGNATURE __DATE_
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTIONS 'r �' , (—) /—DATE OF REINSPECTION ._
DATE OF ISSUANCE OF CERTIFICATE-5�-/ Y - a 1 DATE FEE PAID:,:1 ' d l
TYPE OF UNIT: DWELLING (/OTHER_ CHECK#_ Q_i�_ ,�-CHECK DATE � 1
NOTES:._-. _—..
CODE ENFORCEMENT INSPECTOR 9/28/98
�XOW
� � a
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
03/16/2001
Scott Galber
9 Belleair Drive
Swampscott, MA 01907
PROPERTY LOCATED AT 10 Burnside Street UNIT # 2
Dear Sir/Madam:
It has come to our attention, that you may be considering renting a dwelling unit
at the above address.
In accordance with Chapter 11, Article XIII of the City of Salem Code of
ordinances, Section 2-334,titled "Certificate of Fitness, " each dwelling unit must be
inspected and certified prior to allowing occupancy. The inspection will be conducted
in accordance with 105 CMR; State Sanitary Code, Chapter I: General Administrative.
Procedures and 105 CMR 410.000; State Sanitary Code, Chapter II: Minimum Standards of
Fitness for Human Habitation.
Please notify us if you do not intend to rent the unit.
Please contact this department within 24 hours of receipt of this notice at
978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday
thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7:00 p.m. and Friday 8:00
a.m. - 4:00 p.m.
Failure to comply with this procedure, may result in a fine of Twenty (20) dollars
per day for every day that the dwelling unit is occupied without a Certificate of
Fitness.
A $25.00 check payable to the City of Salem is required for each unit inspected at the
time of inspection.
A property owner is required to pay gas and electricity for residential tenants if there
is not a written letting agreement stating the tenant is responsible for those
utilities and if the meter(s) records electricity and gas use which is not used
exclusively by that tenant. The Department of Public Utilities has billed property
owners for their tenants' entire utility bills retroactive to the date of initial
occupancy in cases in which cross-metering has been proven to exist.
OR THE BOARD HEALTH REPLY TO
Joanne Sco t, 6MPH,RS,CHO PABLO VALDEZ
Health Agent CODE ENFORCEMENT INSPECTOR
" CITY OF SALEM, MASSACHUSETTS
- BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR
KIMBERLEY DRISCOLL TEL. (978) 741-1800
FAX (978) 745-0343
MAYOR Iramdin o salem.com
LARRY RAMDIN,RS/IWI-IS,CI 10,(:RFS
HF.ALTIi A(i ENT
CERTIFICATE OF FITNESS
CERTIFICATE#157-11
DATE ISSUED: 5/13/2011
Property Located at: 15 Burnside Street UNIT#3
Owner/Agent: Carol Augulewcz
Address: 27 Nelson 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 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 BOARDOFHEALTH
LARRY RKIVIDIW
HEALTH AGENT CODE AFORCEMENTINSPECTOR
CITY OF S LEN't, MASSACHUSETTS
lz BO ARDoi III \u iI ` jj�)
(978)x7741-1800 " La.�xiit
K1%413l�RI.l_,Y DRISC01.L F y-x ()78) 745-0,43
MAYOR Ct)_m
� 1�,1['IDC�RLI:;ti13,1U1i,R5
ACTING Hc:v.:Ix AGH\1
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 STz2 r-r7` UNIT# 3
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNERJLESSER C7"VL MANAGER/AGENT
NO P.O. BOX �7 NE(-So�/ ff ✓�
ADDRESS ADDRESS
CITY, STATE,ZIP B re y CI`1"Y, STATE, ZIP M14
RESIDENCE PHONE f3� BUSINESS PHONE(24FIRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: LY4kh#N 2.)6tJ1a#rt 3. OFMcf 4.4 f✓/✓c 4#ry 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 SIGNATURE DATE
Inspectors use only
Date on initial inspection:__ l Date of reinspection:��
Date of issuance of certificate: 13 11 _ Date fee paid:_
Type of unit: Dwelling I Other Check #j __Check date:___�D P1
_
Notes:__
Co Enfo cement Inspector