CARPENTER STREET CERT.P 408-94
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a FEE: _$ 25.00 .•
•wrrne des.
DATE: 6/3/94
CITY OF SALEM HEALTH DEPARTMENT
BOARD OF HEALTH
Salem, Massachusetts 01970
9 NORTH STREET
508-741-1800 `
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT14 Carpenter Street UNIT I 1
OWNER/AGENT Robert Clayman
ADDRESS 29 Sevinor Road
CITY/TOWN Marblehead, MA ZIP CODE 01945 24 HOUR PHONE 617-631-1210
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 HEALTH
C E ENFORCEMENT INSPE OR
HEALTH AGENT
J,;.r i y.coun44e ..
e9 OFFICE USE ONLY
CERT,. #
DATE
CITY OF SALEM HEALTH DEPARTMENT
BOARD OF HEALTH
Salem, Massachusetts 01970
9 NORTH STRE.EI
508-741-1800 APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY' CODE, CHAPTER II , 105 CMR 410.000 "MINIMUM
STANDARDS OF FITNESS FOR HUMAN HABITATION'.
PROPERTY LOCATED AT 7 �CX i� }1/j/ v� UNIT # j
OWNER/LESSER (�p�lq �((,l,[/J.j//y�1,g,-�i /[ MANAGER/AGENT
ADDRESS Cj SP/I/1/Jf/2 /y/ G/�'k / ADDRESS_ y�/l
CITY "I��9 (71����/ d�� � CITY
.,RESIDENCE PHONE LBUSINESS PHONE (24 HRS.)
BUSINESS PHONE_(�VZ- -Z!%/, 7/�9- -
TOTAL NUMBER OF ROOMS: IA _ /
ROOM USE: I .zjej/)7m 2. �ifi/� 3. W ly?-i>ti 4.
J. 7. 8.
THERE IS A TWENTY—FIVE .00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE
CITY OF SALEM HEALTH D TMENT UPON IANCE AND ISSUANCE OF CERTIFICATE.
:PPLICANTS SIGNATURE DATE
INSPECTILORSS USE ONLY
DATE OF INITIAL INSPECTION: — "t / DATE .OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: j y -(—DATE FEE PAID:G
TYPE OF UNIT: DWELLING OTHER
NOTES:
CODE ENFORCEMENT INSPECTOR