CARROLLTON STREET CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
A 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
.�, TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. UISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
May 8, 2003
Patricia Blair
1 Carrollton Street
Salem, MA 01970
PROPERTY LOCATED AT 1 Carrollton 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.
Forthe Boardofof He� Reply to
Joanne Scott MPH, RS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector
�aW11�,
S�` d,
' 5r �, CERT.# 168-99
FEE $25.00
3
DATE: 04/08/99
���/MINETA
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 Carrollton Street UNIT #: House
OWNER/AGENT: Catherine J. Conners
ADDRESS: 13 Charles Street
CITY/TOWN: Danvers, MA ZIP CODE: 01923 24 HOUR PHONE: 777-9229
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 MORE INFORMATION CALL 978-741-1800 .
iSFOR THE BOARD OF HEALTH /
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
� w+.lkRo
i
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tel: (978)741-1800
Fax:(978)740-9705
IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT i CAKKOU4'1 S+ UNIT# 03
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER
041cr ng,Cannaf-3 MANAGER/AGENT ,
No P.O. Box No P.O. Box
ADDRESS 13 2,6efts Sd ADDRESS
CITY_.. fin Harz s CITY tYl A
47g
RESIDENCE PHONE ajl ) 777 -4 a-1 1^ BUSINESS PHONE (24 HRS.) q 0�Q
BUSINESS PHONE —
TOTAL NUMBER OF ROOMS:__
ROOM USE:
5. 3�8. 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.
APPLICANTS SIGNATURE J( _DATE—At,�M_
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION LF --7-� _I DATE OF REINSPECTION`.. ���
DATE OF ISSUANCE OF CERTIFICATE:-1 � � DATE FEE PAID:'�/ f
TYPE OF UNIT: DWELLINGVOTHERf CHECK# CHECK DATE
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
c a,
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
RELEASE
In accordance with Massachusetts General Laws Chapter III ; Code of Massachusetts
Regulations 410.000 et. seq. ; State Sanitary Code Chapter II and Article XIII of
t:tie 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 the
aforementioned statutes, regulations and ordinances.
L•i the event it is necessary that 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 agents
from any loss or injury sustained of whatever nature and description occasioned .
by my/our absence during said inspection.
RoP "ro - 1 c5tya� x C
TENANT/LESSEE OWNER/LESSOR
13 ChARlbs S- lonusu
ADDRESS-- --- ADDRESS -----
1 CQ&2a Man S�
ADDRESS OF UNIT TO BE INSPECTED
DATE- -- -
gONU1T
c e
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT 03/24/99 Tel:(978)741-1800
Catherine J. Conners Fax:(978)740-9705
13 Charles Street
Danvers, MA 01923
PROPERTY LOCATED AT 1 Carrollton Street UNIT # House
Dear Sir/Madam:
It has come to our attention, that you may be consiriering 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 Lhis 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.
RR THE BOARD O HEALTH _ REPLY TO
Joanne Scott, MPH,RS;CHO PABLO VALDEZ
Health Agent CODE ENFORCEMENT INSPECTOR
CERT.# 645-96.
' 3 FEE $25.00
DATE: 09/18/96
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,AS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Fax:(508)740-9705
1
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 1 Carrollton Street UNIT #: House -
OWNER/AGENT: Catherine J. Conners
ADDRESS: 13 Charles Street
CITY/TOWN: Danvers. MA ZIP CODE: 01923 24 HOUR PHONE: 774-5607
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_xTHE BOARD O
F HEALTH
1dv1Gxx_1 -e�
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
r
t , : t�yryl
• i 6
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT NINE
(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 C .d�+K 2 o// !d/T SY UNIT / () us e
OWNER/LESSERFpIrs_ �_ onnc cS MANAGER/AGENT
ADDRESS 13 C'AaaelFs . �� ADDRESS
CITY 07A CITY
RESIDENCE PHONE _ ?714 >-flac, " BUSINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: i
ROOM USE: 1. �rj� cit S 3.
5. it- 6. .g K 7. 8.
THERE IS A TWENTY FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE
CITY OF SALEH HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION
APPLICANTS SIGHATURB � � � DATE 4,p
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION:_q, DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: j ' to DATE FEE PAID: 4 6
TYPE OF UNIT: DWELLING_J(/ OTHER
NOTES:
�C
CODE. ENFORCEMENT INSPECTOR
CITY OF SALEM HEALTH DEPARTMENT
BOARD OF HEALTH .
Salem, Massachusetts 01970
ROBERT I- BLENKHORN r 9 NORTH STREET
HEALTH AGENT
So8J41-1800
DATE: August. 12, 1993 J
Kevin J. Martin. op
Gloria A. Martin 1(11///f"
1 Carlton Street
Salem, Mass. 01970
PROPERTY LOCATED AT 1 Carlton St. UNIT 9 1
DEAR SIRJMADAM:
It has 'come to our attention, that you are about to allow rental of a dwelling unit
at the above. address.
It is incumbent upon you as owner(s) to contact the City of Salem Health Department
to apply for a•Certificate of Fitness before any vacant dwelling. unit is rented or
occupied.
Eachdwelling unit must be inspected and certified by the Salem Health Department
prior to allowing occupancy in accordance 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, Chap-
ter II: Minimum Standards of Fitness for Human Habitation, and in accordance with
Chapter II, Article XIII of the City of Salem Code of Ordinances, Section 2-334,
Certificate of Fitness.
There is a twenty-five (25) dollar fee payable by check, or money order to the City
of Salem Health Department upon issuance of Certificate.
Failure to comply with this procedure, will result in a fine of twenty (20) dollars
per day for every day that the dwelling unit is occupied without approval of the
Code Enforcement Division of the Salem Health Department.
Contact this department within 24 hours of receipt of' this notice. (508) 741-1800
Monday thru Wednesday from 8a.m. - 4p.m. , Thursday 8a.m. - 7p.m. , or Friday 8a.m. to
noon to schedule an appointment for an inspection.
SEE ENCLOSED SECTION 105 CHR 410.354 METERING OF GAS 6 ELECTRICITY
veYy.. t.Euly.,you.rs';-
FOR THE BOARD OF HEALTH REPLY TO:
10 ,9 �� '
Robert E. Blenkhorn, C.H.O. PABLO VALDEZ
Health Agent Code Enforcement Inspector