6 CEDARHILL ROAD CITY OF SALEM, MASSACHUSETTS
BOARD OP HEALTH
/ 120 WASHINGTON STREET,4°i FLOOR
TEL. (478)741-1800
KIN03ERLEY DRISCOI L FAX(978)745-0343
MAYOR ID1QNNF S V FM('DM
]ANI3T DIONNE
ACTING HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#466-08
DATE ISSUED: 9/23/2008
Property Located at: 6 cedar Hill Road UNIT#
Owner/Agent: Bryan &Cheryl Winter
Address: 12 Cedarcrest Road
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 il"
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 BOAR F HEALTH
J NE DIONNE
ACTING HEALTH AGENT CODEEMET INSPECTOR
CITY OF SALEM, MASSACHUSETTS I`�
BOARD OF HEALTH
120 WASHINGTON STREET,4i,.FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR [DIONNY.&ALEM.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."
� tt FEE: $50.00
PROPERTY LOCATED AT (p (I,p_d_n 1+i(� 90 A p I S-7 UNIT#
IS THIS UNIT DISIGNATED AS RIGHT LEFT RONT OR B CK,PLEASE CIRCLE ONE
Ah k
OWNERLESS jn+-e� MANAGER/AGENT SG rw
NO P.O. BOX
ADDRESS 1 a Ced&�Ccrraaa Q I ADDRESS
CITY, STATE,ZIP Soy_� p l 1 o CTI'Y, STATE,ZIP
RESIDENCE PHONE q_j $_'1 14�}_ (� 0(� BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: G
ROOM USE: 1. 2. jr,c 12«:vn3 P-e3 ..n 4. $ a-&
6.`
-&^6.` 2,_n 7. 8. 9. 10
THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS FEE ISPAYABLEAT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE C NIE rt_ �( �it/�,i1"c DATE 1 2 0
Inspectors use only
Date on initial inspection: z3 • o k Date of reinspection:
Date of issuance of certificate: q "L3• oV Date fee paid: 0l • Z3 <A
Type of unit: Dwelling_ Other - Check#32a3 2._a 3 Check date: L3- b Fr
Notes:
Code Enforcement Inspecto