BUTLER STREET co DI City of Salem, Massachusetts
1P
3 Board of Health u
L
120 Washington Street, 4th Floor, Salem, PP 1PablicH� Pth
eal
MA 01970
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-15-404
DATE ISSUED: 12/4/2015
Property Located at: 1 BUTLER STREET UNIT#1
Owner/Agent: Tawnya Jalbert
Address: 32 Puritan Road
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978)771-2571
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
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITARIAN
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON S7REEP,4' FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR �A�toiN[n�sa(ere.con(
LARRYRAMDIN,RS/RW S,(:HO,(T-1S
Hrmmi 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 6911"V�.QCI UNIT# 2-
IS THIS UNIT DISIGNATED 1 SAS RI AT Lr FRONS OR BACK PLEASE CERCLE ONE
OWNERLESS (t,.,i A 1A - tz- GLe�r I MANAGER/AGENT
NO P.O.BOX
ADDRESS ADDRESS
CITY, STATE,ZIP_ l,Lirti. T CITY, STATE ZB'_ /4-�l`/��
RESIDENCE PHONE �� ��� 7IBUSIIVESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: 3
ROOM USE: 1. 2. 3. 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 PAYABLE AT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE—�
0
IDspectors use only
Date on initial inspection: 1-A-10y2as- Date of reinspection:
Date of issuance of certifint
0 3 X01 Date fee paid:__12/Q /201
Type of unit: Dwellingther Check#-J=� _Cbeck date: J&L20 t�
Notes: &Aroorn W;k nWi5 AaylJ f( NoOf7�J drdCCen A110 tV- yy,' oA9 tiiJ
SC�e ens,
CV46cenicntpCpector
4 � NDIZt�
City of Salem, Massachusetts
Board of Health
120 Washington Street, 4th Floor, Salem, PublicHealth
MA 01970 Pr.event. 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-15.262
DATE ISSUED: 9/1/2015
Property Located at: 1 BUTLER STREET UNIT#2
Owner/Agent: Tawnya Jalbert
Address: 32 Puritan Road
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(976) 771-2571
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
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANIT IAN
CITY OF SALEM, MASSACHUSETTS
r BOARD OI-.HEAin'I-I
120 WASHINGTON STREET,4:`FLOOR
TEL (978) 741-1800
KIMBERLEY DRISCOLL FAX (978) 745-0343
MAYOR I.RANIDIN(a�SALENLCOM
LARRY RAMDIN,RS/REHS,CHO,CP-FS
HEALTI-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 Qt/f-/&Z St 1 len UNIT#�
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER �G nJ/l ti [b2t�r MANAGER/AGENT
NO P.O.BOX p
ADDRESS 3 2 ellyiAli V\ ADDRESS
CITY, STATE,ZIP S c km AIA- 6,110 CITY, STATE,ZIP
RESIDENCE PHONE 91 &7 , �7 BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. h 2. 3. 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 PAYABLE AT THE TIME OF INSPECTION Q
APPLICANT'S SIGNATURE DATE
Inspectors use only
Date on initial inspection: Date of reinspection:
Date of issuance of certificate: h Date fee paid: OX 3.2/2D.zT
Type of unit: Dwellin8 Other Check# 1237 Check date: 0 W131/2-0
Notes:
C e forc nentInspegt r
Taw nj r.� G-to/, co rv\
CITY OF SALEM, MASSACHUSETTS
'? BOARD OF HEALTFI
120 WASI IINGTON STREET,4"FLOOR
Tr_L. (978)741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR LR,(NID1N&WI N1 COM
LARRY RAMDIN,RS/ABRs,CHO,CP-FS
HEALTH AGENT
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 cf 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. Uwe 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
QJ p ec S�- Jn J a
1 �
Address on unit to be inspected
Date
Updated 5/23/11
v��CON01P
> CERT.# 791-00
n
y
FEE $25.00
DATE: 12/15/2000
'Pfp�
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: 1 Butler Street UNIT #: 2 Back
OWNER/AGENT: Leo Jalbert
ADDRESS: 197 197 Jefferson Avenue
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 741-2663
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
SANI"ARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" .
SECT-ON 410.400 (B) : DWELLING UNIT (X) AND 410.400 (C) : ROOMING UNIT
MINIPTUM 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
JOANNE SCOTT, MPH,RS,CHO /
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
s
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
"M NIMUM STANDARDS OF FITNESS�FOR HUMAN HABITATION".
PROPERTY LOCATED AT LC UNIT#z
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT AW PLEASE CIRCLE ONE
OWNER/LESSER ke, -3At &I'l } _MANAGER/AGENT
ADDRESS 1 l 3'-eF L60J fq V-::AD DRESS
CITY 1,:�G'-I eA— —CITY-----
RESIDENCE
ITYi_i _RESIDENCE PHONE '�L/( -2-66 3 BUSINESS PHONE(24 HRS.)
BUSINESS PHONE Sc vim.
TOTAL NUMBER OF ROOMS: _ 1C
ROOM USE: 1.__K2.^!�L__3. 4. 6 Lt ~
�j 6. Q N+�7. ._. Aj 2 1
5. 8
THERE IS A TWENTY-FIVE($25.00)DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SAL HEALTH D PARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATURE ATE / Ov
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION /af/ 0,0 DATE OF REINSPECTION_.
DATE OF ISSUANCE OF CERTIFICATE: />xZJ D..L
AT//E FEE PAID:.. L1/_AE u
TYPE OF UNIT: DWELLING _OTHER CHECK#��� _CHECK DATE��
NOTES:,
COD ENFORCE 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#44-04
DATE ISSUED: 02/11/2004
Property Located at: 16 Butler Street UNIT#: 1 Front
Owner/Agent: Karen Flaherty
Address: 16 Butler Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 617-201-5324
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
anc 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.
FOR THE BOARD OF HEALTH
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
+ CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH /
120 WASHINGTON STREET, 4TH FLOOR
9C3
'A 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 II, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT I G S� t-CeN- UNIT#
IS THIS UNIT DESIGNATED AS RICHT LFFT FRON RACK PLEASE CIRCLE ONE
OWNER/LESSER m ,e
�alCt, MANAGER/AGENT
XN
ADDRESS I lD I�tA� It_r S� ADDRESS
CITY <_:::�c ate_� CITY
RESIDENCE PHONE 911 —a01 -53a_�BUSINESS PHONE (24 HRS.) SQm-e
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1.)' VIr-N2.A` /y'0^"8. N r(2QP �4.
roo
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., XXA � �-AlO j of _ DATE — AV_0 y
11 �
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION 9.,c1' 6 "o� DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: 2-11 'f DATE FEE PAID: , f 1 4 -0
TYPE OF UNIT: DWELLING OTHER_ CHECK#_3 7 G CHECK DATE 2, -l I-*
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
o 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 J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
January 14, 2004
Karen Flaherty
16 Butler Street
Salem, Ma. 01970
PROPERTY LOCATED 16 Butler Street
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.
For the Board of Health Reply to
Joanne Scott MPH, RS, CHO Pablo Valdez
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 DGRRENIIAUMQSALGM.COM
DAvID GRESmNEAUM
ACTING HEALH-i AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#632-09
DATE ISSUED: 12/11/2009
Property Located at: 36 Butler Street UNIT# 1
Owner/Agent: Peter E. Copelas
Address: 135 Boston Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-317-4656
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 BOA PID OF HEALTH
I
DAVID GREENBAUM
ACTING HEALTH AGENT CODE ENFOR MENT INSPECTOR
• CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4"i FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR I>(3REiENBAUNI SALEM.COM
DAVID GREENBAUM,
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."
FEE: $50.00
PROPERTY LOCATED AT 3(c� S�7 UNIT#
IS THIS UNITrrDISIGNATED AS RIGHT LEFT FRONT OR BACK,PLECIRCLE ONE ( 1
OWNER/LESSER W, r�^.P� ���_�/ MANAGER/AGENT
NO P.O. BOX ( /
ADDRESS � 3, ` fy� Sf� —ADDRESS-
CITY,
DDRESSCITY, STATE, ZIP Yv\, Pr" CITY, STATE, ZIP
RESIDENCE PHONE BUSINESS PHONE(24HRS) 7 _3 ( _T S_ S'4_
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: S
ROOM USE: 1. �y�r 2. ��rl nC 3. 4
6. 7. J 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 FEEIS AT THE TIME OF IN ECTION
APPLICANT'S SIGNATURE �I \Jr I—> _ i/t. 0 DATE I1—' ? t " C
/ Inspectors use only
Date on initial inspection: / /// �� Date of re
inspection—�
Date of issuance of certificate: 6 Date fee paid: // C "/
Type of unit: Dwelling i/ 'Other Check# n C S Check date: Ilk
Notes: C(� on to l Uuc �?r'f�If'/tI h�P,� � �Jho ' (Ajnl,�llly
I0OL I ��
Code Enfor nt Inspector
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
• •
a
SALEM, MA 01970 CERT.# 138-03
FEE $25.00
TEL. 978-741-1800 DATE: 04/01/2003
FAX 978-745-0343
STANLEY USOVICZ, JR. ,JOANNE SCOTT, MPH, RS, CHO -
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 36 Butler Street UNIT #: 2
OWNER/AGENT: Peter Copelas
ADDRESS: 135 Boston Street
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 317-4656
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 NOR BUILDING RELATED CODES. FOR MORE
INFORMATION CALL 978-741-1800 .
FARD OF HEALTH
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
i
d OFFICE USE ONLY
CERT: #
Mrs DATE: L
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928 [ 3
JOANNE SCOTT,MPH,RS,CHO `✓ �/
HEALTH AGENT NINE NORTH STREET
Tel:(508)741-1800 -
APPLICATION FOR CERTIFICATE 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 Air
UNIT I " [�
OWNER/LESSER iMANAGER/AGENT ADDRESS /� ADDRESS
CITY / �� CITY —
"'RESIDENCE PHONE " Sf 7_� f/611 -'6 BUSINESS PHONE (24 HRS,)
BUSINESS PHONE_R-7t# 7h��
TOTAL NUMBER OF ROOMS: //
ROOM USE: 1 . 2. 3. 7_4 . / fyJJ
F
5. l��5. 7. 8.
THERE IS A TWENTY-FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE
CITY OF SALEM HEALTH DEP NT UP4 CO CE AND ISSUANCE OF CE1RTTIFICATE.
APPLICANTS SIGNATUREDATE " �
j INSPECTORS USE ONLY -
DATE OF INITIAL INSPECTION: '-[- - (- O/ DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTI/fJF___ICATE: � (2J DATE FEE PAID:—�cj�-
TYPE OF UNIT: DWELLING OTHER_
NOTES:
CODE ENFORCEMENT INSPECTOR
CITY OF SAI EM, MASSACHUSETTS
Y y
T3oARn or HEALTH
120 WASHINGTON STREET,4"FLOOR
'I'EL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR IANCINI SALBM.COM
JANET MANCINI
ACTING HEALn-I AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#20-09
DATE ISSUED: 1/13/2009
Property Located at: 36 Butler Street UNIT#3
Owner/Agent: Peter Copelas
Address: 135 Boston Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-317-4656
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 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 BO RD OF HEALTH
ANET MANCINI
ACTING HEALTH AGENT C ENFORC INSPECTOR
i
• CITY OF SALEM, MASSACHUSETTS p- 4
BOARD
-
BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAR(978) 745-0343
MAYOR IDIONNF. SALEM.COM
JANET DIONNE,
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."
FEE: $50.00
PROPERTY LOCATED AT 340 T` Z�- !S-� * —3 UNIT#
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE 1
OWNER/LESSER �^�r � ����� y MANAGER/AGENT_�`e.�z..'-
ADDRESS- 30562AL 51- 5d-111%14 ADDRESS
CITY, STATE,ZIP 7� ���%'► � O/J-71) CITY, STATE,ZIP
RESIDENCE PHONE BUSINESS PHONE(24HRS) 719 3 - S Y5`/
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: 4
ROOM USE: 1. k,tLL—2. II ,- 3. P5 P- 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 PAYABLE
-/AST THE TIME OF INSPECTION
APPLICANT'S SIGNATURE �-- r} \ ,� DATE I — 'I 1
Inspectors use only
Date on initial inspection: I I�3(�1 Date of reinspection:
Date of issuance of certificate: Date fee paid:
Type of unit: Dwelling Other Check# 7 61 1 19 Check date: I 69
Notes: 941ZQ i bm4trl,
es '�OC C__(3 dg I ec''cir
C nforcement Inspector
I
CITY OF SALEM, MASSACHUSETTS
M r BOARD OF HEALTH
120 WASHINGTON STREET,4`FLOOR
TEL. (978) 741-1800
KMERLEY DRISCOLL Fax(978) 745-0343
MAYOR IMANCINI SAIRMCOM
]ANHT MANCINI
ACTING HEAL.'I'I-i AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#206-09
DATE ISSUED: 4/23/2009
Property Located at: 43 Butler Street UNIT# 1
Owner/Agent: Mary C. Caridio
Address: 43 Butler Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 744-7450
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
JANET MANCINI rti
ACTING HEALTH AGENT C07 ENFORCEMENT INSPECTOR
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4T"FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
i
MAYOR NIONNE QSALLN COM
I
JANET DIONNE,
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."
FEE: $50.00
PROPERTY LOCATED AT-4-3 L3L rn , S-l-• SJ-0, �^'-" UNIT# i
is THis II Tr DISIGNNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER lir Aa-), C L{ MANAGER/AGENT
NO P.O. BOX -
ADDRESS Lf..3 �� ' � ADDRESS
CITY, STATE,ZIP CITY, STATE,ZII' c
RESIDENCE PHONE BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2. 3. 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 PAYABLE AT THE TIME OF INSPECTION
4 3
40
APPLICANT'S SIGNATURE DATE 431
Inspectors use only
Date on initial inspection: -,)L)'i '0:i Date of reinspection: / l� I Ui o mti tr
carr eked
Date of issuance of certificate: ! Date fee paid:
Cype of unit: Dwelling�Other Check#_jo{ Check date:_-y
4otes:� PDO),, cQxfti� 6-, 6i oinq�C3�_,dine)%IJ m, -. Cf� -r � c._I cry+;
- cx°�I x11l (t 5_0Pj'tnz) th fit' <s..�J4flr An Ck1fmS:Aa
✓1"toVici� f IiI� to YrieVG� Cctt .
,od
e "nforcement 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
Kimberley Driscoll WWW.SALEM.COM
Mayor JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#269-07
DATE ISSUED: 6/7/2007
Property Located at: 43 Butler Street UNIT# 1 Left
Owner/Agent: Mary C. Caridio
Address: 43 Butler Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 744-7450
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
= -�-
?0AN7NS'COTT,'1M4dPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
Ctry a»SALEM, wsS Actius;ErTS
',,,�+ BOARD OF HEALTH tU
• 120 WASNtNGTON 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 /-3 g tt- ler S r �a 1c?M� UNIT #
IS TtfIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESS.ERA✓ (�- l�� ✓ X44--MANAGER/AGENT
i No P.O. Box iNo P.O. Box
j ADDRESS /f-3 l ADDRESS
CITY --QPCLO� � C "�` CITY
RESIDENCE PHONE Y ~-7 _BUSINESS PHONE (24 HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS;_ - _
ROOM USE; 1.._i__---- _ --
I
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. f
APPLICANTS SIGNATURE -7 DATE �`/ �l
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION 4� " ( ti DATE OF REINSPECTION
DATE OF ISSUANCE OFCERTIFICATE -7,-o 7 DATE FEi= PAID:. . C,�tt /'7
9 . - ,</-
TYPE OF UNIT DWELL INS OTHER CHECK ,� of 7 f CHECI< DA11- Cv
NO FS,
CODE ENFORCEMCN-1 IN',WC =I�')I1 9/27k1i3
n City of Salem, Massachusetts `
Board of Health
120 Washington Street, 4th Floor, Salem, PuWicHealth
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-16494
DATE ISSUED: 12/1912016
Property Located at: 49 BUTLER STREET UNIT#1
Owner/Agent: Domingo Dominguez
Address: 18 Raymond Road
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 815-1089
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 Dwell I ng/Rooming Unit at the above address has
been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter li "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.
e B
Larry Ramdin, MPH, RENS, CHO SANtT AN
HEALTH AGENT
CITY OF SALEM, MASSACHUSETTS
BOARD OF HE.-U.TH
120 WASHINGTON STREET,4"t FLOOR PablicHealth
Prevent.Promote.Protect.
TEL. (978) 741-1800 FAx (978) 745-0343
KIMBERLEY DRISCOLL Iramdin e salem.com
MAYOR LARRY RAbIDIN,IiS�RF;I-[S,CFIO,CP-FS
I Ie•RI.rII 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 L/ FEE: $50.00
PROPERTY LOCATED AT /—,I q &�- UNIT#_
`�,IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE
OWNER/LESSEI�Y1�\0) — m,njP� MANAGER/AGENT
NO P.O. BOX �—
ADDRESS /� ,/� ADDRESS
CITY, STATE, ZIP }' ` ft O i c- "D CITY, STATE, ZIP I I
RESIDENCE PHONE 0 N' 2. BUSINESS PHONE (24HRS) v l l 1�
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2. 3. 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 AYABLE A E TIME OF INSPECTION
APPLICANT'S SIGNATURE !r DATE O t
Inspectors use only
Date on initial inspection:# ZO Date of reinspection: WICL
Date of issuance of certificate- 2 Date fee paid:�y�iA ,�-�
Type of unit: Dwelling f� Other Check#_Check date: 1��(S r!;
Notes:�Qa"ed)
d E orceme Spector
• CrrY OF SALEM, MASSACHUSETTS
BOARD OF HE.M,TH
120 WASHINGTON STREET,41" FLOOR ptlbl{CHP.AIth
Prevent.Promote.Protect.
Tm. (978) 741-1800 FAx(978) 745-0343
KIMBERLEY DRISCOLL lramdinc salcm.com
MAYOR LARRY RA bfIJIN,RS/RL;FLS,CFIO,CP-FS
I-IPAj..fH.AGGN'P
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/L or
Address kph- Address
yy 3 � SA-
Address on unit to be inspected
II,II DJ l 0
Date
Updated 523/11
Jrispection of +./n nnnr4 me 4 -k Date 1. 1�I I Time
Name Address (gqgr7�rlrlpP Sim+ #1 a,J #-2-
Owner
-?
Owner r vC Tel. No.
r I
Type oflnspection�r�l i;c rrtd'i� EijjcjrS- Inspector,ICgre�I'lo_nica ✓ k1k
( ' Remarks and Violations are listed below:
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Report Received b
CITY OF SALEM, MASSACHUSE'ITS
BOARD OF HEALTH
120WASHINGTONSTREET 4"'FLOOR 1�b�C�eaT>}i
--- p Prevmr.Promote.Protect,
TEL. (978)741-1800 FAX(978)745-0343
KIMBERLEY DRISCOLL lzamdin salem.cotxx
MAYOR L,A7tRi RAtviDIN,RSJREHS,CEio,(A)-FS
HFAI;I'I'[A(,T,,,N'I'
CERTIFICATE OF FITNESS
CERTIFICATE#36-15
DATE ISSUED: 1/21/2015
Property Located at: 46 Buller Street UNIT# 1 R
Owner/Agent: Gustavo A Gomez
Address: 46 Butler Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:
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 11"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
LAR IN
j HEALTH AGENT SANITARIAN
CITY OF SALEM, MASSACHUSETTS
n BOARD OF HEALTH
120 WASHINGTON STREET,4 FLOOR tel.
TEL. (978)741-1800 ✓�'
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR _ 1TAMDIN9SrM,EN1.00NI
LARRY RMADIN,RS/REI-IS,CI 10,CI>-I';S
H EAI:rl-1 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 LA 6 r �� UNIT# 12
IS\\THIS UNITDISIGNATED A RIGH LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER—Guz6u0 ry '�o Z MANAGER/AGENT
NO P.O. BOX 1,`
ADDRESS �6 Rv Ae r 5A- Lt ADDRESS
CITY, STATE, ZIP SA MA DVVICO CITY, STATE, ZIP
RESIDENCE PHONE F3 JI -'1 1 q-O B61B BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: 5
ROOM USE: I. 2. 3. 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 PAYABLE AT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE 0`0kavo " O' � 7-- DATE 1�
/ 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 Enrorc6dent Inspector
CITY OF SALEM, MASSACHUSETTS
BOARD OF I-IEALfH PublicHeaIth
120 WASHINGTON SfRFFf,4ni FLOOR P11-1.F.nmcm.v,m'..
'I'EL. (978) 741-1800 FAZ(978) 745-0343
KIMBERLEY DRISCOLL Iramdin e salem.com
LARRY R.vN[DIN,RS/RI31 IS,OLIO,(T-FS,
t
MAYOR I-II1,AL:ChI AC I iN'I'
CERTIFICATE OF FITNESS
CERTIFICATE # 198-14
DATE ISSUED: 6/16/2014
Property Located at: 46 Buller Street UNIT#L
Owner/Agent: Dana F. Richardson
Address: 6 Will Sawyer Street
City/Town: Peabody, MA Zip Code: 01960 24 Hour Phone:
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 RAMDIN
HEALTH AGENT SANITARIAN
• t �1J / �
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET 4:`"FLOOR PabhcHealth
f Prevent.Promote.Protect.
TEI,. (978) 741-1800 FAX(978)745-0343
KIMBERLEY DRISCOLL Iraindin@salem.com
MAYOR LNuty RAMDIN,RS/xFiHS,CHO,CP-ISS
HEAI,nI AGI',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 ` oIL 9y7'G6 4Z ST UNIT# L6/ /
IS THIS UNIT DISIGNATED AS RIGHT LEFT'FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER � NiY ICC//-/2h,-G✓tJ MANAGER/AGENT
NO P.O. BOX
ADDRESS WALL 519ot/Y67A �T ADDRESS
CITY, STATE,ZIP Tim G b Y //9 CITY, STATE,ZIP Cl/F 70
RESIDENCE PHONE 97�_S3 _O,20o'l BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1.136A}20Gti1 2.86bj2i 3. ko-riyeo.L 4&oM 5._yUAPop(,%/
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 TIMES OF INSPECTION
APPLICANT'S SIGNATURE �Oy�' �" (/ DATE
Inspectors use only
gidw-
Date on initial-inspections- �-- _ Date of reinspection:
Date of issuance of certificate: Date fee paid:
Type of unit: Dwelling_ Other Check# Check date:
Notes:
Code Enfor went Inspector tom'
rpND City of Salem, Massachusetts
v
Board of Health
120 Washington Street, 4th Floor, Salem, Pub1iCHBa Ith
MA 01970 Prevent. 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-16-495
DATE ISSUED: 12/19/2016
Property Located at: 49 BUTLER STREET UNIT#2
Owner/Agent: Domingo Dominguez
Address: 18 Raymond Road
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 815-1089
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.
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITA�
r
• CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4"FLOOR IN th
Prevent.Promam.Protect.
TEL. (978) 741-1800 FAX (978) 745-0343
KIMBERLEY DRISCOLL lramdin(a,salem.com
MAYOR LARRY RAMDIN,RS/REl-IS,CI-10,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"
� I // �IlFEE: $50.00
PROPERTY LOCATED ATYJ Jr�i.l�h'L Pr ST UNIT# a
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE
,�
OWNER/LESSER �M 1 n —D O ra igk-fn MANAGER/AGENT
NO P.O. BOX ,
ADDRESS -t,2,1° G4G , far, ADDRESS
CITY, STATE,ZIP-
S
� CITY, STATE, ZIP—jAA' —0 P1
RESIDENCE PHONE BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2. 3. 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 I PAYABLE AT
77E OF INSPECTION
APPLICANT'S SIGNATURE k'wv DATE (G
y / Inspectors use only
Date on initial inspection:, Date of reinspection:J2/W20Z
Date of issuance of certificate: o Date fee paid:=0�204�
Type of unit: Dwelling Other Check#Check date: �2A�
Notes: Na 14'I eA �
Coe ement Ind ctor
Claudia Forgione
49 BUTLER ST Green Thursday '151009071109001015619467 Trash 64 10/15/15
49 BUTLER ST Green Thursday '151009071007001015619466 Trash 64 10/15/15
49 BUTLER ST Green Thursday '151011204539001015320224 Recycle 96 10/15/15
49 BUTLER ST Green Thursday '151011204439001015320223 Recycle 96 10/15/15
Claudia Forgione, Principal Clerk
City of Salem—Engineering Department
120 Washington Street,4`" Floor
Salem, MA 01970
Direct# (978) 619-5675
Fax#(978) 745-0349
CONFIDENTIALITY NOTE: The information transmitted, including
attachments, is intended only for the person(s) or entity to which it is
addressed and may contain confidential and/or privileged material. Any
review, retransmission, dissemination or other use of, or taking .of any
action in reliance upon this information by persons or entities other than
the intended recipient is prohibited. If you received this in error, please
contact the sender and destroy any copies of this information:
1
,Inspection of �I q EI'5�, �-� �Aind i Date _ j�� Time zM
Name Address
Owner. or7m'4/147 1) (QL,&z Tel. No. 1§1
,
Type of Inspection_l.Q.✓'�-(r&k, oM— Fi '41q f 0w) Inspector
( ' ) Remarks and Violations are listed below:
E4 C oar'S LAJMVjM )8.-JnLV kay efr�phljaa, OLMe'r Slam_ ILI+
C n
a o
fl
`onr-(S +o `I L ln f
_
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Report Received by: '
CITY OF SALEM, MASSACHUSETTS
-ri BOARD OF HEALTH
ao 120 WASHINGT N STREET, 4TH FLOOR
e SALM, MA 01 970
TEL. 9 X741-1800
FAX 978-745-0343 -
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#341-05
DATE ISSUED: 5/27/05
Property Located at: 52 Butler Street UNIT#2
Owner/Agent: John A. Silva
Address: 48 Butler Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-804-8829
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 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
JO NE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
--g- g -ge,
CnTOFA ASSACHUSE S
13OARO OF HEALTH
20 WAs"wGT6N'STRECT,4TH FLOOR
SALEk. MA 01970
TEL. 978-741-1800 3
FAX 978-745-0343
STANLEY USOVICZ,JR-
JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION",
PROPERTY LOCATED AT
UNIT #-,,
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
QYKUQR�- ESSER_J - / / I MANAGER/AGENT,7o ^/ L
No P.O. Box No P.O.Box
ADDRESS ��_�eI7 /6L/- 577 ADDRESS--5�;V/,P>C
RESIDENCE PHONE-2�7P' -7G/// eS-BUSINESS PHONE (24 HRS.) 9 41-P^29
BUSINESS PHONE-j2,P-,-- Vl7V- P-ar---2 9
TOTAL NUMBER OF ROOMS S
ROOM USE: i-Ai ZA1A�/;�12,*�,
r2
5.-j
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 _e4p*�2 5�7-L
INSPECTORS USE ONLY
DAA [ OF INITIAL INSPETION 5^ 30�
DATE OF REINSPEC-TION
L)Al L OF IS'SUANCl- 01 Clzlil IFICATE7- DAI I- FFF I'Alt)
TYPt' OF UNIT DWFLIJNc)6 I HER CHECK f CPQ I)AI-1- 5--? 3-V s-
0t)l i N1 0Wi 101 NI INI&I C 101
f < CITY OF SALEM, MASSACHUSETTS
BOARD OF H&1LTH
120 WASHINGTON STREET 4`"FLOOR PublicHeaI'th
> r.<. m.rrnmme.r.m .
TEL. (978) 741-1800 Fax(978) 745-0343
KIM 3ERLEY DRISCOLL Iramdin ,salem.com
LARRY R;IMDIN,Rs/Rea Is,GIIo,ch-Fs
MAYOR HEAL:n-f AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#88-14
DATE ISSUED: 3/17/2014
Property Located at: 55 Butler Street UNIT# 1
Owner/Agent: Juan Espinal
Address: P.O. Box 14
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:
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
LARRY RAMDIN l t\
HEALTH AGENT SANITARIAN
L_
i
CITY OF SALEM,MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET;4" FLOOR rRPQf!} l
TEL (978)741-1800 FAX(978)745-0343 .
KIMBERLEY DRISCOLL kamdin@salem.com
MAYOR LARRY RMlDIN,RS/RENS,CHO,CP-NS
HEALTH AGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"NIINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION'
FEE:.$50.00
PROPERTY LOCATED kT S^ JTLj�,i\, S1 UNIT#
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK.PLEASE CIRCLE ONE
OWNER/LESSER V(,f)H C C flaC .Sa/C,� MANAGER/AGENT
NO P.O.BOX
ADDRESS /6F nK eli n TUC- Ld ADDRESS
CITY,:STATE,ZIP S4IfIn CITY,STATE,ZIP /j7�9; D/9;o
RESIDENCE PHONE j — yD _ _BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2. 3. 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 PAYABLE AT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE 4,fDATE I /y
Inspectors use only
Date on initial inspection: Date of reinspection
Date of issuance of certificate: Date fee paid: 3 17 Y
Type of unit: Dwelling Other Check#±y 3 Check date: 7 y
Notes:
Code Enforcement Inspector
i
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STRI-,in,4'°FLOOR
T13L. (978) 741-1800
KIMBERLEY DRISCOLL FI1X(978)745-0343
MAYORXQRI I LNj1 AUMO-SAI A0,1 rc'L
DAvin GRutu.NBAUnf,R5
AcTINca i'hr• v;ai,i Au-,.NT
CERTIFICATE OF FITNESS
CERTIFICATE#437-10
DATE ISSUED: 8/30/2010
Property Located at: 55 Butler Street UNIT#2
Owner/Agent: Juan Espinal
Address: P.O. Box 14
City/Town: Salem, MA Zip Code: 01970 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 it"
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
j is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy,
FOR THE BOARD OF HEALTH
DAVIty44 , RS _
ACTING HEALTH AGENT CODE ENFORCJEUENT INSPECTOR
1. Y
• CITY OF SALEM, MASSACHUSETTS
/I BOARD OF HL\LTH
120 WASHINGTON STRFF-r,4"'FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR DGREF',NRAUN1 S%I E,%f COINI
DAVID GREENBAUM,RS
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."
FEE: $50.00 ( 2
PROPERTY LOCATED AT �J 1�(Gr /� Z°/ S/ UNIT#
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSERJ-�(�t/! -, nkSR MANAGER/AGENT
NO P.O. BOX
ADDRESS f'O P ADDRESS
CITY, STATE,Zip S�/e9� CITY, STATE,ZIP
RESIDENCE PHONE BUSINESS PHONE (24HRS)
BUSINESS PHONE
O
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2. 3. 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 PAYABLE AT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE
Inspectors use only
Date on initial inspection:_ Vy,P /G Date of reinspection:
Date of issuance of certificate: n lOV Ag Date fee paid: TWID
Type of unit: Dwelling ✓Other Check# 3S M-T' Check date: 03,0110
10
Notes: 1)x11 up ho 46t oi nq Ssomem- .
C de Enf cement Inspector
f
CITY OF SALEM, MASSACHUSETTS
BOARD OI^'HEALTFI
120 WASHINGTON STREET,4"`FLOOR
TEL. (978) 741-1800
KINIBERLEY DRISCOLL FAx()78) 745-0343
MAYOR nc^Icrl'N11AUNIH 50ra.COAs
DAVID GREEN&IUM,RS
ACTING HEALTH AGENT
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
A 4 fax 1 Lf
Address Address
Address on unit to be inspected
Date
CITY OF SALEM, MASSACHUSETTS
_ BOARD OF HEALTH
h r 120 WASHINGTON STREET, 4TH FLOOR
r SALEM, MA 01 970
.� TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#94-05
DATE ISSUED: 2/9/05
Property Located at: 57 Butler Street UNIT# 1
Owner/Agent: Christian Dexter
Address: 57 Butler Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 617-878-4431
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
JO NE SCOTT, MPH, RS, CHO ✓f � �e �' `Y
HEALTH AGENT CODE ENFORCEMENT INSPECT R
CITY OF SALEM, MASSACHUSETTS /J
BOARD OF HEALTH L io
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
_ FAX 978-745-0343
STANLEY LISOVIC7, 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 S`] Jam//1,6 ,, UNIT#j
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER <fuaO XY MANAGER/AGENT
No P.O. Box �l No P.O. Box
ADDRESS�S7 0,Y) T/ . ADDRESS
CITY ,) . r ' CITY
RESIDENCE PHONE 7ZO' ?N.�I H BUSINESS PHONE (24 HRS.) 1r BUSINESS �� �T� y��
BUSINESS PHONE6! L,/y �
TOTAL NUMBER OF ROOMS: �7
ROOM USE: 1. 41-�?-2. 6Q7 3. OtO 4. L/ J
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. // f
APPLICANTS SIGNATURE —DATE -4
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION �/��{-___,DATE OF REINSPECTION_
DATE OF ISSUANCE OF CERTIFICATE. d ✓sem--DATE FEE PAID:--Z���
—
TYPE OF UNIT: DWELLING OTHER CHECK # 12d/ CHECK DATE
NOTES: S4 it _t-j5r"j4__.OJ• tj7&vjft �4r�_aw_jCror6A M'-
f
CODE ENFORCEMENT INSPECTOR 9/28/98
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
f c 120 WASHINGTON STREET, 4TH FLOOR
,�Mna 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 #295-06
DATE ISSUED: 6/12/2006
Property Located at: 57 Butler Street UNIT#2
Owner/Agent: Christian Dexter
Address: 202 Ipswich Road
City/Town: Topsfield, MA Zip Code: 01983 24 Hour Phone: 617-771-7825
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 r
JOA E�MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
4Y �2 r!Y!!Y•4i"�e*Ys,.q,. . . ..,' y,v 'MH.I,�.aw
:_Icny aF s^ 4 CRUSE M
BOARD OF 149ALTH
t 20 1NA8HH10TOH STREET*4TH FLOOR
SAIEN,14A 019!0
TEI.. 976441-1800
FAX 976.745-0349
STANLEY UsGVIcz.JR. JOANNE ScorT, MPH, RS, CHO
MAYOR HEALTH AGENT
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER N, 105 CMR 410.000
'MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION'
PROPERTY LOCATED AT -7 ! ) F1, Z
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSERC{+4 l am'lr MANAGER/AGENT _
No P.O. Box No P.O.Box
ADDRESS 1-b Z c 4,�--ADDRESS
CITY. Ip /'�/Q
RESIDENCE PHONE ��, �L17BUSINESS PHONE {24 HRS }__6/7 77/ 7 d1
BUSINESS PHONE
TOTAL NUht3ER OF RGGbiS: _
ROOM USE 1. Llwy/ - 2 -6-V
__3._tde✓_____. 4 _�L� _ _
THERE IS A TWENTY-FIVE (525.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FE4_ IS PAYABLE Al TI-IF-
TIME
HETIME OF INSPECTION, r /
APPLICANTSSGNAIURE �%. _ _ _ DATE= �2 ZlD6
INSPECTORS IiSE ON[ Y
f„SAT!` O[; INIl IAL INSPE CTI,C7N J � �/� � DAl1; OF f iFlN�;i'V CT ic)��
DAT I- QI- I>SUANCF 01 CI-RTN ICM I 'fal'�
TYI'FC?I UNil DVVi ! 1iNt; OIINIl (,HICK iJf1 ('I, [ )All ✓�- � 'd �o
a �i t{ k Ni �V it'.i h8V P7i 1id ;I`i i �i; . ..
CITY OF SALEM, MASSACHUSETTS
BOAR)OF HE,AL`lH
120 WaSIIING'fON b'TREI�,I` 4"'FLOOR � Ith
f I'rtven6 Vromnm.Protect.
`I'Er,(978) 741-1800 FAx(978) 745-0343
KIMBE,,RLEY DRISCOLL Iramdin(@,salem.com
LaxRYxAhnDIN,�zSlsFals,C1I0 c�>-res
MAYOx
CERTIFICATE OF FITNESS
CERTIFICATE#239-14
DATE ISSUED: 7/9/2014
Property Located at: 62 Butler Street UNIT#1
Owner/Agent: Jose Pereira
Address: 2 Longstreet Road
CitytTown: Peabody, MA Zip Code: 01960 24 Hour Phone: 977-0802
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 11" 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�B ARL7H
LARRY RAMDIN
HEALTH AGENT SANITARIAN
A CITY OF SALEM, MASSACHUSETTS
BOARD OF H&-\LTH
120 WASHINGTON STREET 4t'.FLOOR PublicHealth
> Prevent Promote.Protect.
TEL. (978) 741-1800 FAX(978)745-0343
KIMBERLEY DRISCOLL Iramdin@salem.com
MAYOR L:\RRl'R;\bIDIN,RS/REI-IS,CI 10,CP-FS
HE TATjAGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"
cFEE: $50.00
PROPERTY LOCATED AT a fi ��UNIT# i
I
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER h� P_�°,rY i r MANAGER/AGENT S(t-J�
NO P.O.BOX 1 _ n
ADDRESS Lo \CF cQtry C f I� ADDRESS
CITY, STATE,ZIP Rea b nVi M CITY, STATE, ZIP
RESIDENCE PHONE Cn 2-q-? ] -('R;�)Z BUSINESS PHONE(24HRS)
BvTa E 97�-,:;Si-7- 6Q2q
TOTAL NUMBER OF ROOMS:_
ROOMUSE: 1� l L�1 p Y\ 2 V\I�(��m13 IlDa4ib✓Vl 4 f�)acjK-b n 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-11 q
Inspectors use only
Date on initial inspection: '7,Lq 1/A Date of reinspection:
Date of issuance of certificate: q Date fee paid:
Type of unit: Dwelling Other Check# G�O ' 1 Check date:
Notes:
Code rnfolVement Inspector
L1
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET 4"FLOOR PublicHealth
Prevent.Promote.Protect.
TEL. (978)741-1800 FAx(978) 745-0343
KIMBERLEY DRISCOLL liamdin@salciii.com
LrVtRY Rr1 bID1N,Rti/RP.I-IS,CHO,CV-FS
MAYOR HF:11;rI I ACI ENT
CERTIFICATE OF FITNESS
CERTIFICATE#321-13
DATE ISSUED: 9/11/2013
Property Located at: 62 Butler Street UNIT#2
Owner/Agent: Jose,Pereira
Address: 2 Long Street Road
City/Town: Peabody, MA Zip Code: 01960 24 Hour Phone: 977-0802
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
6AARY RAMDIN
HEALTH AGENT SANITARIAN
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH-
120 WASHINGTON STREET,4"'FLOOR PablIoHealth
Prevent.Pmmom.Prelttt.
TEL. (978)741-1800 FAX(978)745-0343
KIMBERLEY DRISCOLL Itamdin@salerii.com
L/\RRl'RAh7vIN,Rti/RIi115,CI-R>,(:P-IS
MAYOR
HIALXH 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"
I ``FEE: $50.00
PROPERTY LOCATED AT UNIT#
�T^IS THI UNIT DISIGNATED AS RIGHT LEFT FRONT OR BAC PLEASE CIRCLE ONE
OWNER/LESSER �1� ��'� MANAGER/AGENT
NO P.O.BOX
ADDRESS oZ 1.���l-PY`�—�,�. ADDRESS
CITY, STATE;ZIP of fl 0 CITY, STATE,ZIP
RESIDENCE PHONEBUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:_
ROOM USE: 1142!0^ 2. 3. Iz+dry n 4. 25o4ye, 5.
6. .6;k--ft 7. L;w; aeow 8. 6410ot 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 PAYABI,.E AT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE /l DATE GI
r / Inspectors use only
Date on initial inspection: Date of reinspection:
Date of issuance of certificate: Date fee paid:
Type of unit: Dwelling Other Check#_j. a-2�-- Check date: r1 11 1
Notes:
Code-gn&p6ement Inspector
J
r
CITY OF SALEM, MASSACHUSETTS
_ r BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOL.L FAX(978) 745-0343
MAYOR IMANCINIna SAIJ NI.ConI
JANET MANCINI
ACTING HEALT[i AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#627-08
DATE ISSUED: 12/9/2008
Property Located at: 64 Butler Street UNIT# 1
Owner/Agent: Herculano Pereira
Address: 64 Butler Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 744-8932
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
IV :� .
l
A I G�%E AV NT CODE ENFORCEMENT NSPECTOR
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH r,�k � a
120WASHINGTON STREET,4°'FLOOR I jj
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR I]»ONNr;a sAI.h:m.COM
JANET'DIONNE,
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."
FEE: $50.00
PROPERTY LOCATED AT (t-1 JJ CA�k"e C
i IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BAC PLEASE CIRCLE ONE
t
OWNER/LESSER e(i et C c% MANAGER/AGENT
NO P.O.BOX
ADDRESS %U,N140 C ADDRESS
CITY, STATE,ZIP d�YT T p O l Ct � �� CITY, STATE,ZIP
RESIDENCE PHONF, q�U Lt" CJ 93 *, BUSINESS PHONE(24HRS)
C: el 1
BUSINM PHONE CI
TOTAL NUMBER OF ROOMS: 9
ROOM USE: 1 KjlZb+eY, 2. Ji At*n a 3 1"je q'enn, 4 ZeAloo r , S
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
ISS PAYABLE AT TIME40F INSPECTION
APPLICANT'S SIGNATURE t /1 1� �/y t�� DATE �a d
Inspectors use only
Date on initial inspection: 1 2-41 Date of reinspection:
Date of issuance of certificate: I �.-�f - o g Date fee paid: 12. -9 'a k
Type of unit: Dwelling -1 Other Check# 2 F 7 Check date: 1-1-4 0�
Notes:
4CodeEement Ins ector
w Q City of Salem, Massachusetts
Board of Health
120 Washington Street, 4th Floor, Salem,
0 MA 01970 Prevent.Pramu,cProtect.a
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-17-2
DATE ISSUED: 1/5/2017
Property Located at: 62 BUTLER STREET UNIT#2
Owner/Agent: Jose Pereira
Address: 62 Butler Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 317-5029
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.
e
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITARIAN
e � �
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,V'FLOOR
Ma- (978)741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR LRAMDIN&ALEM.CDM
LARRY RAMDIN,RS/RAHS,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'
/p Z FEE: $50.00
3
PROPERTY LOCATED AT C9 4 f U tZ-e I^ ,C` f UNIT#_,�
IS THIS UNIT D GNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE
OWNER(LESSER D `, MANAGER/AGENT
ADDRESS ADDRESSS,, ifl—e 3+- LA) l
CITY, STATE,ZIP � l E CITY,STATE,ZIP / / / 79 D 9 7 ca
RESIDENCE PHONE BUSINESS PHONE(24HRS)
BUSINESS PHONE - j 7 iD�
TOTAL NUMBER OF ROOMS: pp
ROOM USE: 1. L )V 22. he 3. :A 4.
6. �1 17. rP 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 r DATE � f�a /7
InsMtors use only
Date on initial inspectiowrl�() Date of reinspection:Date of issuance of certificate:f Z n C-') 2(r Date fee paid -
:, �_ lY l 15 j'(lq-
Type of unit: Dwelling Other Check#Check date:
Notes:—:H& Watl� r C�- i3�°fi mo&I- ltm r� ) Allo - 1,-2n°fi
7
orcemen pec or -
-N L �