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230 DERBY STREET - BUILDING JACKET 230 DERBY STREET � i i CO:vL\4ONWFALTH OF MASSACrIL �ETTs DEPARTMEN"I' OF PUBLIC HEALTH HOSPITALS AND AMBULATORY CARE FACiLITILS CLINIC QUARTERLY FIRE INSPECTIONAL REPORT r ' In accordance with the requirements of General Laws, Chapter 148, Section 4, the Marshal or the head of a fire department, to whom lie may delegate authority shall make an inspection every three months of institutions licens^d by and under the supervision of the Department. of Public Health, and shall matte a report of such inspection to the Department of Public Health on forms provided by the Department of Public Health. In accordance with the statutory mandate, the �T,y(jia Pinkham linin —1 c'0C G'linil '.,.. 14 mess iu was inspected on 6/28/84 Date s c t u bY_ A/C aro t. :Turner Namenfnspector REPORT OF NSPECTION APPROVEDX Yaintenance required on extinguishers and emergency lights. DISAPPROVED -*ate �- Fire Chief r r: igna :re and Ticid Date r 'cci Building Inspector Health- Dept. (Salem) Occupant ONE COPY SHOULD BE SENT TO CLINIC Dept. of Public Health (Mass. ) file Please Return This Report To: Carolyn Zavarine, M.D. Department of Public Health Hospitals and Ambulatory Care Facilities Room 940, 80 Boylston Street :19 Boston, Mass. 02110 Form #39 CO:�L-MONWEALTH OF MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH HOSPITALS AND AMBULATORY CARE FACILITIES :. - :. CLINIC QUARTERLY FIRE INSPECTIOA'AL REPORT In accordance with the requirements of General La1�;s, Chapter 148, Section 4, the N Marshal or the head of a fire department, to whom he may delegate authority shall :.,..: make an inspection every three months of institutions licensed by and under the supervision of the Department, of Public Health, and shall make a report of such inspection to the Department of Public Health on forms provided by the Department of Public Health. In accordance with the statutory mandate, the F Pinkham'Clinic Name ot Uliftic � a 230 Derby St Salem Mass-01970 was inspected on 1-26-84 ate. U i i hY Ra fond T Dansreau Name-of Inspector REPORT OF INSPECTION _ APPROVED Yes Conditions satisfactory_at .time .of inspection ". DISAPPROVED to Fire Chief' W igratu a and Titie cc: Building Inspector Health .Dept. (Salem) Occupant.; ONE COPY SHOULD BE SL•TiT TO CLINIC Dept, 'of Public Health (Mass. ) :'. . file Please Return This Report To: Carolyn Zavarine, M.D. Department of Aibl.ic Health Hospitals and Ambulatory Care Facilities -. Roam 940, 80 Roylstorn Street Boston, Mass. 02116 Form #39 CO.,vLMONWEALTH OF MASSACriU�,ETTS DEPARTM N C OF PURLIC HEALTH HOSPITALS AND AMBULATORY CARE FACILITIES �. CLNIC QUARTERLY FIRE INSPECTIONAL REPORT In accordance with the requirements of General Laws, Chapter 148. Section 4, the Marshal or the head of a fire department., to whom he may delegate authority shall make an inspection every three months of institutions licensnd by and under the supervision of the Department of Riblic Health, and shall make a report of such inspection to the Department of Public 1-lealth on forms provided by the Department of Public Health. In accordance with the statutory mandate, the Lydia Pinkham Clinic -- 3 c 01 ULMIC X230 Derby St Salem Mass 01970 cless-M Ullnic was inspected on 11-10-83 —VaTc-ol laspecclon. by Raymond T Dansreau Name-of nspector REPORT OF INSPECTION APPROVED G, Conditions satisfactory at time of inspection:: ,.`..: DISAPPROVED ate Fire Chief:-- ignature and I-itle r cci Building Inspector v ..:• x: :;. . Health Dept. (Salem) Occupant ONE COPY SHOULD BE SENT TO CLINIC Dept. of Public Health (Mass. ) file Please Return This Report To: Carolyn Zavarine, M.D. Department of Arbl.ic Health Hospitals and Ambulatory Care Facilities _. Room 940, 80 Boylston Street Boston, Mass. 02116 Form #39 CO:vUMONWEALTH OF MASSACr1TJ,)ET75 D.E.P R'fX'4viNf OF PUBLIC HEALTH Sir HdORTALS AND AMhULATORY CARE FACILITIES --P T. . CLINIC 0 AR �ibP1IiE NSPECTIONAL R EfaR' REC.E€`.'E0Gtl'Y REGEIYED � 5 , In accordance withOff4 Peylt�LE�1rementst1ASSo. f General Laws, Chapter 148 5eS 6 •4t ; Marshal or the head of a fire department, to whom he may delegate authority shall make an inspection every three months of institutions licenend by and under the supervision of the Department. of Riblic Health, and shall make a report of such inspection to the Departmeat of Public Health on forms provides: by the Department of Public Health. In accordance with the statutory mandate, the Lydia F Pinkham Clinic '3 c of Clinic X230 Derby St Salem Mass 01970 Acle.ress 01 UL1111c was inspected on 9-08=83 13;Cc or 13ispecElon. by Raymond T Dansreau Name-of Inspector REPORT OF NSPECTION APPROVED L Conditions satisfactory at time of inspection. DISAPPROVED to Fire Chief .. Lgature anTl ltTe to cct Building Inspector Health Dept. (Salem) -` Occupant ONE COPY SHOULD BE SENT TO CLINIC Dept. of Public Health (Mass. ) file Please Return This Report To: Carolyn Zavarine, M.D. Department of Atbl.ic Health Hospitals and Ambulatory Care Facilities Room 940, 80 Boylston Street Boston, Mass. 02116 Form #39 / CO UMONWEALTH OF MASSACrUbETTS DEPART\42I'T OF DUTILIC HEALTH ✓f HOSPITALS AND AMBULATORY CARE FACILITIES CLINIC QUARTP.T.`.' FIRE MOPECTiO\Al, REPORT ��7': a 9 S ly0FF.ce l oo In accordance with the requirements of General Laws, Chapter 118, Section�4; e _ jMiarshal or the head of a fire department., to whom he may delegate authority s wux - make an inspection every three months of institutions licensed by and under the supervision of the Department of lliblic Health, and slia.l.i make a report of such inspection to the Departme:vt of Public Health on forms provides: by the Department of Public Health. In accordance with the statutory mandate, the L'y_dia Pinkhin MCr;_Ta Me tom, m:c t w 230 Aerby St Salem Mass 01970 K. cress,o � u»c . was inspected on 03-15-b3 DaLe .or Dispecuou. hY' Raymond -T Dansrpau „ .. Name-ofInspector REPORT OF INSPECTION APPROVED � /Y f�3 DISAPPROVED Conditions. satisfactory at time of inspacton'. Date Fire Chief:-- J. tune and "Title cc : Building Inspector Health Dept. (Salem) Occupant . ONE COPY SHOULD BE SENT TO CLINIC Dept. of Public Health (Mass. ) file Please Return This Report To: Carolyn Zavarine, M.D. Department of A.ibl.ic Health Hospitals and Ambulatory Care Facilities Room 940, 80 Boylston Street Boston, Mass..02116 Form 7r39 CONLMON6Vr:1Li'1-i Or MASSACrrJ�)rTTS DEPAR'i,im "r OF PURLJC HEALTH HOSPITALS AND AMI>ULA'I.ORY CARE FACILITIES G ' CLLNIC OU:1RT1iR1. ' FIRE L`dSPECTIONAL REPOR'C In accordance with the requi.i'ements of General Laws, Chapter 148. Section 4,. the iM,arshal. or the head of a fire department, to whom he may delegate authority shall, make a.n inspection every three months of institutions liccasrA by an' d under the " supervision of the Department, of Public I-;eal.th, and slia.tl make a xeport of such Lns^_ection to the Department of Riblic Health oa For-ns provided by the Department 6.1 Public Health. In accordance with the statutory mandate, the Lydia F .Pinkham Clinic Narnc OL Uliff!Z- 230 Derby St Salem-Mass 01970 Acic.rLss r. UL1111c vias inspected on [-24-83 DarL ,br7rs cTiuu by Raymond T Dansreau 'Fs— Name-ofpector REPORT OF INSPECTION ; APPROVED x Conditions satisfactory at time' of—inspection.'.' DISAPPROVED /�Z- U,100 Fire Chief' Jg,-ntr.re aria Iitt e hz Date cc : Building Inspector Health Dept. ( Salem) Occupant ONE COPY SHOULD RE SLNT TO CLINIC . Dept. of Public Health (mass. ) file Please Return This Report To: Carolyn Zavarine, M.D. Department of Pub0c Health Hospitals and Ambulatory Care Facilities Room 940, 80 Boyls�on Street Boston, Mass. 02116 Form ;39 - COAL\10N1Vir;: Liii Oi .`.!;\:;:; �t,iii;:,l`:� 'T llia'ART\li;N'I' 011 PIiIiLJC Iii AL;'T(l HOSPITALS AND A1dRULA"CORY CARE NACTI,ITIES CLINIC Tit accotdancc whit (.he re(imienicii I tzi of Gutctal I u+•:, ( h lucr l !S SectMrt 4; tote r , \iu:nh l or the head of 1 fire: chpstrtn!eut to whum i is io ry 0, lierrui autttoV� sFf-h1 ' 5, ni tkc an inr;p i tun every three months of urstiho i nis I ii e l Pry nrid undFrMie in 6-1 ,upetvision of the Department of ;lihlic I1callh, unci ;IIAI nt iY-c t lull>et u[y h ©' 01 tr.spection tart the Department of Riblie ltualih fill foj-.'i; }nt idcd by the 1)epWl�j�e q . Of Public t-Icalth . p i In accordance with the stawtury mandate, the u Lydia F Pinkham Clinic r,230 Derby St-Salem Nias-37 01970 was inspected on 06-10-82 DaTc'o7Tt L �, tt TI — by Raymond T Dansreau Name-nf�nsl5ectnr Rr-P()R"I' OF INS PF"CTION APPROVED l/ Conditions satisfactory at time of .inspection.. DISAPPROVED Rte Fire Chief- 5tgtntr,re ane it e fste ccs Building Inspector Health Dept. ( Salem) Occupant ON[,; C(}I'Y SHOULD 13E SENT TO CLINIC Dept. of Public Health (Mass. ) file Please Return This Report "Co; Carolyn Zavarine, M.D. Department of Pnbl.ic Health Hospitals and AmGttlatory Care [',tciliLues Room 940, 80 fk)yLsron Street Boston, Mass. 02110 _ Form #39 CO�L-IONWEALTH OF MASSACrUiLTTS DEPART\4i Nr OF "UREIC EfEAL'rH HOSPITALS AND AwfRULATORY CARE FACILITIES r CLC41C QUARTERLY FIRE IINSPECTIONAL REPORT In accordance with the reyuirements'of General Laws, Chap�cr 148, Section 4, the Marshal or the head of a fire department, to whom Le may delegate authority shall make an inspection every three months of. .institutions licensed by and under the supervision of the Department, of Public Health, find sha.il make a report of such inspection to the Department of RLblic Health on forms provided by the Department of Public Health. In accordance with the statutory mandate, the Lydia F .Pinkhaam Clini.c a c o Tin Lc ' �2=�0 Perby.St_Sn_lE;.m_GI ss�)197'J=""'� y„� • u ess 01 U11111c was inspected on 12-09-81 -------TXTC-61 DispecTion. by Haymond `P ]-):insroau Namehf Spector r _ . �- R EPORT OF Lei 1SPECTION APPROVED L '' Conditions satisfnctory at time of insperct:l,ori . DISAPPROVED Fire Chief,: 4„ igrntur-e and 7 We 1101 � (Site' . cci Building Inspector Health Dept. (Salem) Occupant ONi3 COPY SHOULD BE SENT TO CLINIC Dept.: ,of ;,Public Health (Mass. ) 'R', Please Return This Report To: Carolyn Zavarine, M.D. . Department,;o f Aibl.ic Health Hospitals and Ambulatory Care Facilities Room 940, 80 Boylston Street C � Boston, Mass. 02116 •tet-' '' , a . Form #39 CO:\,LvlONWFALT1i OF MASSACrRk)I;TTS DEPARTMP,NI' OF PUBLIC HEALTH HOSPITALS AND AMI;ULATORY CA%�jjt6�4t j��i CLINIC QUARTERLY FIRE INSPECTIONAL REPORT -- -- SEPZI r9� 48❑AM '�I In accordance with the requirements of General La}��1' tl M?%S§ectlon A, the Itb Marshal or the head of a fire deparLmetit., to whom ie may c date authority shall h make an inspection every three months of institutions licensed by and under the I; supervision of the Department of Riblic Health, and shall make a report of such inspection to the Department of Public Health on forms provided by the Department of Public Health. In accordance with the statutory mandate, the Lydia E Pinkham Clinic Name ot Ulinic 1 239 Derby St Salem Mass 01970 Acic.ress Ot UIL11c 's j was inspected on September 15 1981 --ice ol laspectioa I by Raymond T Dansreau Name-of Inspector REPORT OF INSPECTION APPROVED x All Condition satisfactory at time of in.spe,ctiol DISAPPROVED Date Fire Chief i.grature�'I'itTe Date cci Building Inspector Health Dept. (Salem) Occupant ONE COPY SHOULD BE SUNT TO CLINIC Dept. of Public Health (Mass. ) file Please Return This Report To: Carolyn Zavarine, M.D. f Department of PPtbl.ic Health Hospitals and Ambulatory Care Facilities Room 940, 80 Boylston Street Boston, Mass. 02110 Form #39 COlNL\/1ONWLALTH OF MASSACrIU51: C:0.%vIMONW11'ALTl,l OF NIASSACvlU:•,l'S l•"f i DP*PAR'1'�9ir; T O1 1''Ll11LIC IiLAL'I'hl HOSPITALS AND AMBULATORY CAME FACILITILS CLGgIC QUARTERLY. FIRE INSPECTIONAL REPORT In accordance with the requirements of General Laws, Chapter 148. Section 4, the Marshal. or the Plead of a fire delxirtment, to whom lie may delegate authority shall make an inspection every three months of institutions licensctl by and under the supervi&ttu� .. the bill-l3Kh, l3akia? -a re��rFof sfek s e irspectiorrtcrthe Department of Rcblic PfcaltIfon forms provided hy'the Department' of Public Health. In accordance with the statutory mandate, the E Lvdia F,Pinkham Clinic aTrCc o inlc 239 5t Salem Mass 01970 cress 01 U11nic i :aS inspected on March 5 1981 co is iii by Raymond T Dansreau Name•of Inspector REPORT OF INSPECTION APPROVED x Conditions Satisfactory at time, of inspection..`.'„' DISAPPROVED —,Date _ Fire Chief;r ,:. sigmture and I it e ccs Building Inspector Health Dept. (Salem) Occupant ONG COPY SHOULD BE SENT TO CLINIC Dept. of Public Health (Mass. ) file Please Return This Report To: Carolyn Zavarine, M.D. Department of Public Health Hospitals and Ambulatory Care Facilities Room 940, 80 Boylston Street. Boston, Mass. 02116 Form #39 -,,...,_...-;vm�..,�TAm^p.;.�..:wW.Aw.,iSa�,.,-...gym,-....,,,m.T,•,�,n, ;'.mFn ...... .... . .. . �.c____,_�,_.�y,,,,,gay.-�•-.------"-55^1:*Te F CO.\'L\-101NwCiA1."] H OF MA5SACifUo17,T-15 Di PART,M117N; l' OI' 1'URLIC I.11.ALTH HOSPITALS AND A,1413M,A'IORY•,CARL FACILITIES CLINIC QUART10,LY hIRB .INSPECTIONA1, ItE,'POR'C: In accordance with the requirements of Gcneral Laws, Chapter 148, Section 4, the E Marshal or the head of a fire delkl.rlmenr., to whom he may dcicvate authority sball i' make an inspection every three months of institutions licnasr:d by and under the :=j supervision of the Department of tiblic 1-lealth, and slia.11 make a report of such inspection to the Department of RLblic Health on forms provided by the. Department of Public Health. ; In accordance with the statutory.mandate, the Lydia Pinkham Clinic inic f239 D erby S"tre`et; Salem, Ma. 01970 i was inspected on Dec. 39, 1980 Da-re'o by Fire Marshal David J. Goggin Name:nfTnspector REPORT OF INSPECTION APPROVED X All conditions found satisfactory at time of inspection. DISAPPROVED _ Dec. 30, -1980 Date Fire Chief igrature and 11tie Dec. 30, 1980 _Bite' ccs Building Inspector Health Dept. (Salem) Occupant ONE COPY SHOULD BE SENT TO CLINIC Dept. of Public Health (Mass. ) — file Please Return This Report To: Carolyn Zavarine, M.D. Department of Aibl.ic Health Hospitals and Ambulatory Care Facilities . Room 940, 80 Boylston Street Boston, Mass. 02110 r Form #39 CO�L�-lON�V!3;1L'i1{ oh `;inSSACIhJ�i',T-tY5 'i Di1':1RT\11i�i'l' OF P"iJRL.1C 1IFt1L"f7-1 I 1lOSPI"PALS AND Aiv1hUl A"l'ORY CARE FACI?,ITII 4JiLDING IJE 'T CIANICOUARTERLY FIRE INSPECTIONAL RC,P )RT ------.-----.. —.� - OCT 15 IV In accordance with the requirenicnts of General Laws, Chapter 1� YO Int- D��3�S. Marshal. or the head of a fire depat:LMClit. to whom he may dclgg t.. authority all make an inspection every three months of institutions licensr:d by and under the supervision of the Department of Public Heahh, and sltal.l make a report of such inspection to the Department of Rlblic Health on forms provided by the Department of Public Health. In accordance with the statutory mandate, the Lydia E; Pinkham Clinic -- NILMC oLCi nlc f2-39 Derby stiSalem Mass 01970 was inspected on 09-19-80 — —pari:of i s t u by Raymond T Dansreau Name-nf Ynspector RI:POIt"I' OF INSPECTION APPROVED Conditions satisfactory at time of inspect.icr -, DISAPPROVED ate Fire Chief,:- i n ie ane 9ZZ Date ect Building Inspector Health Dept. (Salem) Occupant ONE COPY SHOULD BE SENT TO CLINIC Dept. of Public Health (Mass. ) file Please Return This Report To: Carolyn Zavarine, M.D. Department of Nlbl.ic Health Hospitals and Ambulatory Care FacilitioS Room 940, 80 Boylston Street Boston, Mass. 02116 Form ,939 1)1 PART Mi,NN' OF PIJRLTC HF,AL'ITI HOSPITALS ANIS AMI;ULATORY CARE FACILITIES CLINICQUARTHTLY FIRE INSPECTIONAL RE['ORT ' In accordance with the requi.remcnts of General Laws, Chapter N,8. Sectlon 4, the Marshal or the head of a fire department, to whom he may delegate authority shall make an inspection every three months of Inst.itutinns licenG,:d by and under the Supervision of the Department of Iliblic Health, and slta.li make a report of such inspection to the Department of Public Health on forms provided by the Department of Public Health. In accordance with the statutory mandate, the Lydia Pinkham Clinic LMU o in:c 239 Derby St Salem Mass 01970 Auc'.ress ot U11111C i was inspected on May 22,1980 leo i s c t u by Raymond T Dansreau Numewf�nspec[nr - R1;POR'1' OF NSPFCTION APPROVED Conditions satisfactory at time of inspections ' DISAPPROVED S/a 3/f0 gate A _ __ Fire Chief I/ J tare ane I it e -fie .. cc: Building Inspector Health Dept. ( Salem) Occupant ONE COPY SHOULD BE SENT TO CLINIC Dept. of Public Health (Mass. ) file Please Return This Report To: Carolyn 7.,avarine, M.D. Department of nrblic Health Hospitals and Ambulatory Care Facilities Room 940, 80 Boylston Street Boston, Mass. 02116 Form #39 r ,