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CHURCH STREET CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 1 $j 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 11/3/04 Robert Nuzzo 11 church street 111 Salem, MA 01970 PROPERTY LOCATED AT 11 Church Street Unit 111 Dear Sir/Madam: 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 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. to 7:00 p.m. and Friday 8:00 a.m. — 12:00 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 tenant's entire utility bills retroactive to the date of initial occupancy in cases in which cross-metering has been proven to exist. J"oa_rd.of Healt Reply to Joanne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector i euro CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 9 120 WASHINGTON STREET, 4TH FLOOR � - CERT.# 255-02 ` jP s' SALEM, VIA 01970 FEE $25.00 �� TEL. 978-741-1800 '�py,� DATE: 05/10/2002 FAx 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 11 Church Street UNIT #: 125 OWNER/AGENT: Lois Russell ADDRESS: 11 Westwood Road CITY/TOWN: Somerville, MA ZIP CODE: 02143 24 HOUR PHONE: 627-9961 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. FOR MORE INFORMATION CALL 978-741-1800. FOR THE BOARDO�H V kdne--e JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR �� ..,x-> b'i"K°�"..�.'y u.•". '" vh &-::5'�- Jb ..^.,.v i a 5 `stF 2:'k.x?'>.: dax +e i eiw¢' #3.:: +.a:. a' �iu�..T,n rSt • $s� �i t 3'_s k i yrrm r e inje^..SCy.K ?d � IAA g CITY OF SALEM, MASSACHUSETTS i 'D o� r .� _. BOARD OF HEALTH. • • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO ^'MAYOR J.' HEALTH AGENT' - aI , 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 �� C 9'f UNIT# SCO IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK..PLEASE CIRCLE ONE OWNER/LESSER Rt. :MANAGER/AGENT No P 0 Box No.P.O.Box. ' ADDRESS C( Lo 6aacf ADDRESS C. ` f4 CITY *RESIDENCE PHONE (ol7-&2:?-95 ( BUSINESS'PHONE (24 HRS.) � ,, BUSINESS PHONE x s 5s i Iii v. F +�r�� u . TOTAL NUMBER OF,ROOMS: .3 ` ' is a a � r 1 ^AFIOOM USE 1 1 1 _ 2.�t�3. 4 ' W { 7. i. A THERE IS ATWENTY-FIVE($25.00)DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO.THE CITY OF SALEM HEALTH DEPARTMENT THIS F_EE'IS PAYABLE AT THE aTIME-OF INSPECTION. APPLICANTS SIGNATURE DATE SCO O -- ' INSPECTORS USE ONLY S '=DATE OF INITIAiA!NS EOTION �0 L DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE-��10 _6 Z DATE FEE PAID: S '!D C � TYP..E"OF UNIT-'DWELL IN OTHER_ CHECK#SCHECK DATES ;NOTES: 1 ' i'EcODE ENP6RCEMENT IN80ECTOR 9/28/98. �. i�,-�.'� if st Y a'}•;£,.,}a � �y 4'-4 i i.+yn.��o-Y i .. '�Frct �i {s . 'g}�'{f ,�,P£'#Mlx ####ccc TTT 1 S A W ry 3 k . 1 4 ♦�Z C 'IF.("�y �� L Y��r".i �'� �e 3 1."y �"1 �i`Z� .F�x��£'Tl It E.i9 v 4 � n � 2Y;<.. � r .4.� a C.�.b dC f kM1.'� ♦,5 N t a s a.{ JF ".4 g �axo CITY OF SALEM, MASSACHUSETTS 9w BOARD OF HEALTH �'. 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 '� TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 03/21/2002 Lois Russell _ it Westwood Road Somerville, MA 02143 PROPERTY LOCATED AT 11 Church Street UNIT # 125 Dear Sir/Madam:. It has come to our attention, that you may be consideringrenting 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 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) 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. OR THE BOARD H A TH REPLY TO oanne Scott, MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS ' , BOARD OF HEALTH 51 120 WASHINGTON STREET, 4TH FLOOR CERT.# 269-03 o' SALEM, MA 01970 FEE $25.00 TEL. 978-741-1800 DATE: 06/04/2003 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 11 Church Street UNIT #: 126 OWNER/AGENT: Harbor Rental & Realty Property Manager c/o Valery Timofeyer ADDRESS: 111 Derby Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 741-0389 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. FOR THE BOARD OF HEALTH JOANNE S OTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR Jon 03 03 10: S98 Joanne Soott Salem HCH 978 745 0343 P. 2 CITY OF SALEM, MASSACHUSE'T'TS BOARD OF HEALTH a- 120 WASHINGTON STREET, 4TI4 FLOOR 9ALCM, MA 01970 TEL. 97S-741.1806 FAX 976.745-0349 STANLRY USOVTC:i, JR, JOAN)14E SCOTT, MPH, RS, CHO MAYOR HE,"TH Ar,�'NT APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER it, 105 CMR 410,000 "MINIMUM STANDARDS DF FITNESS FOR HTAN H'ASITTATION'. PROPERTY LOCATED AT 1 !� . .0. 1 ' UNIT Ik-06 IS THIS UWr DES �I/GNATED AS RIGHT LEFT FRONT BACK PLEASE CIRC ONE OWNER/LESSER V i � i YYI� t eV MANAGERtArENTJ� r��i(�� 4d1�}{� 7t� 1 �N No 1 .0. 84 J NO P.O.B4X j�n,� J l ADDRESS ._. _ _At?0RI:sx-u t.,�ll�`� _ '1 RESIDENCE PHONE—..._^BUSINESS PHONE. (24 HRS.) `[ BUSINESS 1PHOPLE_ TOTAL NUMBER OF ROOMS: ROOM USE: THERE I5 A TWENTY-FIVE{$25.00)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALE HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE. i TIME OF INSPECTION. _ APPLICANTS SIaaNATURE �TLO—Y .DATE OF INITIAL DATE OF RE)NSPFCT1(7N,_._. DANE OF ISSUANCE OF CERTIFICATE.,/,,--,!U,Z1.._DATE FEE PAID: ,�s�:3tZ�__tt TYPE OF UNIT. UWLLUTAG 9THEFty CHECK 1r�.7_.�CliEGK DATE L. CODE ENfORCDA ENTI.I�iSPECTOR 9/28!98 — JVn 03 03 11: 008 Joanne Soott Salem BOH 978 745 0343 P• 3 ,J• .Y CITY OF SALEM, MASSACHUSETTS UOARO OR HFALTH a • 12.0 WASHINGTON STRF_El", 4TH FLOOR 6ALCht, MA 01970 'rE L. 978.741.1800 FAX 878-745-0343 STANLCY USOVIC:'L. JR. JOANNC SCOTT, MPH, RS, CHO MAYOR HEAi_rH AGENT" RELEASE In 8cc.0rda11ce with M89a3ChUSCttS Ceneral l,evs Chapter II i ; Code of Massachusetts Ro,gulations 410.000 et. seg. ; State Sanitary Code Chapter TT IAu4 Art.0^2c XZZI of Die CIL; of Salem Urdinance, under6igned owner/lessor and tenant I1CSsW1t, OF a, unit of resi6ential property, hereby authorize the Salem Board of Health or its author— i,red agea(T s Ca inspect the res%deltce identified below in accordance with tile: einremeatianed srav,atcs, zegulations and ordinances . lv� t4o event it i.s neCessary that sai.d inspection hr dobe i.n my/oUt 4b3encc, 1/we expressly authorize the some and for my/our successors and assigr:s hereby r,�,it^aao and discPlargc the City of Salem, Salem board or Health and its authorit�ad a�4.rtc ::vta any `.oss or injury sustained of v.-har.ever nar,:ra and description oacasiunt:d 1>y .myloux abscace krrina said faspection. 7 •�"D tl� 1M6t11a�1T,,/n/f— �. nzari 1>9SEE watt hUch cn?r - i b X1 ' 6A 0u..SS .,DDIRUSS ADDRESS QF UN!'I' 1'C) BE TNSPECTFL) DATR CITY OF SALEM, MASSACHUSETTS a BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01 970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, 3R. .JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 04/03/2002 Charles Tremble 11 Church Street #217 Salem, MA 01970 PROPERTY LOCATED AT 11 Church Street UNIT # 217 Dear Sir/Madam: 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 the 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 One Week 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. 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 eo exist. O�Z�OARD F 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 DGRceNIIAUMnsAr.eM.COM DAVID GRITNBAUM ACTING HEALII'I AGENT CERTIFICATE OF FITNESS CERTIFICATE# 16-10 DATE ISSUED: 1/8/2010 Property Located at: 11 Church Street UNIT#218 Owner/Agent: Alexander Khoury Address: 1338 29th Street NW City/Town: Washington DC Zip Code: 20007 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 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 AVID GREENBAUM ACTING HEALTH AGENT CODE ENNOORCEMENT INSPECTOR 01/07/2010 11 .28 FAX 2023702227 fax2227 Opt/002 • CYtY OF SALEM, MASSACHUSETTS r 130AIw ol1 1"ILRI:I'F, 120 WAS)IINGTON S3'Iitdtil'.4"FLOOR Tt:a..(978)741-1800 KIN23E'ALF;Y 1)dISCON, I�AX(979)745-0343 Im Y01, CX3hi D}kvm GRrrr TiAUitf; AC1"1,NG Hi.. IurII AGIN'T Application for Certificate of Fitness, IN ACCORDANCE WITH STATE SANITARY COBE,CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OFFITNESS FOR'HMANHABITATION. FEE: $50.00 I PROPERTY LOCA"PED AT If S_L&gr. , ek — UNIT#`1 V_ IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT O BACK, LEASE CIRCLE ONE OWNER/LF.SSER_ /�yS„d a/ k EiVsr•�.,MANAGER7 AGENT' NO P.Q. BOX ADDRESS 133k—IS t—" S4- _;_ L-V ADDRESS CITY,STATE,ZIP, i'`��I,{ ; j L11:49&—CITY, STATE,ZIP RESIDENCEPHONE Lryf "1`cS�b' *lkyCF _BUUSINESSPHONE{24HRS) BUSINESS PHONI .10; & -'506 to 3 TOTAL NUMBER OF ROOMS: V. ROOM USE: �;.sce 2 ostk. 3.. it 4 Rte.. 5_ 7. THERE IS A FIFTY (S50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE . THE TIME OF INSPECTION- APPLICANT'S SIGNATURE DATE t/ o. Instxctomuse only, Date on initial inspef cion: 'a b U _ Ditto of reinspection: Date of issuance of certificate: //&//,0 0//,0 Date fee paid: Type of unit: Dwelling ✓ )))Other Check# --CheckOle: Notes:_ in b4f j6m 'F II�t �1 in Code Enf went Ir s etor Pe 01/07/2010 11 28 FAX 20"V00227 f.�x2227 lj�002/002 CITY OF SALEM, MASSACHUSETTS B0M0iJ W* IV:Q.'1b,, 120 WA9l IINGN I'OS CRU:V.41"F0 1, 01( C#t if,))tl '11,i_(978) 741-1800 KIMERLEY 1)USCO]1, VAX (978)745-0343 11;1'�Yo t I_)AvmGRnr,iH:\vm, ACTING HRAUl'i Ac;ENT se In accordance with Massachusetts General-Laws,Chapter I11 Cock of Massachusetts Regulations 410.000 et:Seq.i State Sanitary Code Chapter 11 and Article X111 of the City of Salem Ordinance,undersigned owner/lessor and tenant/lessee of a imit of residential property, hereby authorize the Salem ffbard of Health or its authorized agents to inspect the resides cc identified below in accordance with the aforementioned statutes,regulations and ordinances,, In the event it is n,.-cessary that said inspection be done in my/out absence. 1/we expressly authorized the same and for mylour successons and assigns hereby release and dischargetheCity of Salem, Salem 861rd'of lieWth and its authorized agents from any lose or injury sustained of whatever nature and description occasioned by mytout absence during said inspecier. Tenant/Lessee Owner/Le6#r MV Sf Address Address Address on unit to be inspected Date 0 toND City of Salem, Massachusetts n Board of Health 120 Washington Street, 4th Floor, Salem, PIub1�CHealth 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-16.421 DATE ISSUED: 10/28/2016 Property Located at: 11 CHURCH STREET UNIT#220 Owner/Agent: Cheryl Tuttle Address: 9 Mariners Lane City/Town: Marblehead, MA Zip Code: 01945 24 Hour Phone:(646) 300-1090 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. Lbjre Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS BoARD OF HEALTH 120 \ 3stuvG',rc,vtiutl:F'i,4" FLOOR TEI.. (978) 741=1800 KIMBERLEY DRISCOLL FAX (978)745-0341 MAYOR LRANIDI\ ilSAHu Mi CONI L.ARRF R:A�,Nm A,RS%RUNS,CNO,CP-PS - Hr:,v.TH ACI.Nr 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 �L/`Y lJT UNIT#aW IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE o OWNER/LESSER� MANAGER/AGENT NO P.O.BOX ADDRESS 9hsin0lb �. ADDRESS / CITY, STATE,ZIP ��aj� Ani/ - CITY, STATE,ZIP 0�9 2� RESIDENCE PHONE / /6/ BUSINESS PHONE(24HRS) BUSINESS PHONE /f TOTAL NUMBER VvOFLLROOMS: ROOMUSE: I kihrl//m2Upl7r/p/n 3 944-�j!--4 �eQ�B��•-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 �ATTIZTHE OF INSPECTIONAPPLICANT'S SIGNATURE / i%// � DATE q , Inspectors use only Date on initial inspection:i012AIZoLi� Date of reinspection: Date of issuance of certificate: Date fee paidgJ,0/1,y/201 f Type of unit: Dwelling Other Check# Check date: Notes: od nfq cement Ind ector CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH,RS,CHO - NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 02/07/2000 Fax:(978)7409705 Stephanie Ann Bourns 35 Mystic #3 Charlestown, MA 02129 PROPERTY LOCATED AT it Church Street UNIT # 320 Dear Sir/Madam: 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 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 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) 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 j 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. R THE BOARD Oy HEALTH REPLY TO oanne Sco M O PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR 3 :R M. CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741.1800 12/16/99 Fax:(978)740-9705 Nathaniel & Susan Bowditch USIS/ACCRA Dept.of State Wash 20521 PROPERTY LOCATED AT 11 Church Street UNIT # 418 Dear Sir/Madam: It has come to our attention, that you may be considering renting a dwelling unit at the above address. In accordance with Chapter Article XIII of the Cit of Salem Code of P Y .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 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 B: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. I I R THE BOARD OYIHEALTH REPLY TO anne Scot MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR 3i� fp CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 11/12/99 Fax:(978)740.9705 _ ' Nathaniel & Susan Bowditch USIS/ACCRA Dept.of State Wash DC PROPERTY LOCATED AT 11 Church Street UNIT # 418 Dear Sir/Madam: 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 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 this notice at j 978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday i thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7:00 p.m. and Friday 8:00 j 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. OR THE BOARD F ,. TH REPLY TO - Joanne Scott, MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR v CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT 11/08/99 Tel:(978)741-1800 Fax:(978)740-9705 Joanne Libert 11 Church Street #419 Salem, MA 01970 PROPERTY LOCATED AT it Church Street UNIT # 419 Dear Sir/Madam: 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 the 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 One Week of receipt of this notice at 978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday thru Plednesday 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. 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 eo exist. FR THE BOARD OF HEALTH REPLY TO I oatlne Scott, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR n CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET HEALTH AGENT 06/16/99 Tel:(978)741-1800 Nicholas Hammond Fax:(978)740-9705 20 Crownshield Road Marblehead, MA 01945 PROPERTY LOCATED AT 11 Church Street UNIT # 420 Dear Sir/Madam: 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 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 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) 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. q THE BOARD REPLY TO nne Scot , MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR .gON01T V� CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT 11/28/2000 Tel:(978)741-1800 Fax:(978)740-9705 Charles Bockoff 11 Church Street #514 Salem, MA 01970 PROPERTY LOCATED AT 11 Church Street UNIT # 514 Dear Sir/Madam: 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 the 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 One Week 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. 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 eo exist. F R THE BOARD OF HEALTH REPLY TO oanne Scott, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR n CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Date: 06/05/98 Fax:(978)740-9705 Mary Cronkhite . 600 Brackett Place Marblehead, MA 01945 PROPERTY LOCATED AT 11 Church Street UNIT # 615 Dear Sir/Madam: It has come to our attention, that you may be considering renting 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, or to notify us of your intent for this unit. Each dwelling unit must be inspected and certified by the Salem Health Department prior to allowing occupancy in accordance with Chapter 111, Sections 127A and 127B, of the Massachusetts General Laws, 105 CMR 400.00; 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, and in accordance with Chapter 11, Article XIII of the City of Salem Code of Ordiances, Section 2-334, Certificate of Fitness. There is a twenty-five (25) dollar fee payable by check, or money order to the City 3 of Salem Health Department. This fee is payable at the time of inspection. Inspection will not be performed without receipt of payment. 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 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7 :00 p.m. or - Friday 8:00 a.m. to noon to schedule an appointment for an inspection. SEE ENCLOSED SECTION 105 CMR 410.354 METERING OF GAS & ELECTRICITY. Very truly yours, FOR THE BOARD OF HEALTH REPLY TO Joanne Scott, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS �L BOARD OF HEALTH 3� 120 WASHINGTON STREET, 4TH FLOOR . c SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745.0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT May 7, 2003 Sally Milo 11 Church Street Salem, MA 01970 PROPERTY LOCATED AT 11 Church Street Unit#619 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 h �UND1T� CERT.# 323-99 FEE $25.00 c DATE: 06/25/99 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: 11 Church Street UNIT #: 619 OWNER/AGENT: Barbara Morin ADDRESS: 3 Lucia Road CITY/TOWN: Marblehead, MA ZIP CODE: 01945 24 HOUR PHONE: 631-4978 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. FOR MORE INFORMATION CALL 976-741-1800. FOR THE BOARD OF HEALTH '/JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR 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 II, 105 CMR 410.000 '!MINIMUM STANDARDS OF FITNE S FOR HUMAN ABITATION". PROPERTY LOCATED AT // MA �� UNIT#_,Q9 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER 1'6,zea, RaI'le MANAGER/AGENT No P.O. Box �7 No P.O. Box ADDRE/Sy�S � ��p r_i a /K ADDRESS CITY_ I�GG.P dZE _Gt'cr�k, CITY r RESIDENCE PHONEBUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1.8ago) 5. 6. 7. 8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE DATE DATE '1991 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION - _DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:A'7 5 - ffDATE FEE PAID:ao - ,�)-"-5_ "T TYPE OF UNIT: DWELLINGj�OTHER__ CHECK#2�CHECK DATE �:-2- Lf NOTES: J\ CODE ENFORCEMENT INSPECTOR 9/28/98 s , CI14Y OF SALEM, 1v.wASSACHUSEn s BOA RD OF Z-Is\L Tt-I th 120 WASHINGTON S'CRI 1'I',4"'FI:OOR TsL. (978) 741-18001 FAX (978) 745-0343 KSMBE.RL'EY DRIB LOLL Iramdinna salem.i ona L,A$II}'R,i NII7IN,RS/RI?.IIS,CJ 10,CP-FS MAYOR Ht?;uxi l Ac GN'r CERTIFICATE OF FITNESS CERTIFICATE#009-15 DATE ISSUED: 1/15/2015 Proporty Located at: 11 Church Street UNIT#704 Owner/Agent: Andrea Dodge Ad&r ss: 7 1/2 Church Street City[Fown: Salem, MA Zip Code: 01970 24 Hour Phone: 7819534396 Purs Iant 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 2MR 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 Heal th and the unit may now be rented and/or occupied. Max,mum 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 lacer. Thi; Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOf t THE BOARD OF HEALTH ' 1 � HE,ILTH AGENT SANITARIAN `r �.� CITY OF SALEM, MASSACHUSETTS f Io BOARD OF HEALTHY\ 120 WASHINGTON STREET,4`FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 ?vLSYOR I RAMDIN&ALEM.COM LARRY RAMDT,N,RS/RF]N,CHO,CP-FS H[iAJ fH A(3ENT 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: $50.1010 PROPERTY LOCATED AT l U rytp U /\ 151 -701 UNIT#--)Dl IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER (ISII.A MANAGER/AGENT NO P.O.BOX ADDRESS (P00 (�L� (�1k ADDRESS Y2Ct40 1' S "- S/,, CITY, STATE, ZIP �2 CITY, STATE, ZIP RESIDENCE PHONE (�03 562— D^I 1 D BUSINESS PHONE(24HRS) BUSINESS PHONE a1'lj.(tC1 e 6o e C TOTAL NUMBER OF ROOMS:— ROOM OOMS:ROOM USE: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATE 15' Inspectors use only Date on initial inspection: i Its Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check# I ,��J� Check date: Notes: QE rre Ir wa(( und'm StLq-f' JT.tilhyCom5ihk arc( r�tLiQ't1 NIf� v Coen& ement Inspector s CITY OF SALEM,MASSACHUSETTS 10 BOARD OF HEALTH 120 WASHINGTON STREET 4t"FLOOR PubliciieaIth STREET, Prevent.Promote.Protect. TEL. (978) 741-1800 Fax(978) 745-0343 KIMBERLEY DRISCOLL Iramdin@salem.com salem.com LARRY lU\MIDIN,R$/ltl?I-TS,040,CP-FS MAYOR HL;LTHAc.ENC CERTIFICATE OF FITNESS CERTIFICATE#356-13 DATE ISSUED: 9/9/2013 Property Located at: 11 Church Street UNIT#707 Owner/Agent: Diana Sims Address: 898 Arlington Street City/Town: Oakland, CA Zip Code: 94608 24 Hour Phone: 978-532-4800 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 LARAMRAMDIN HEALTH AGENT SANITARIAN SARA MAURNO Y RFALTOR*,sales Ass«iate (978) 741-4404 BUSINESS (978)743-5706 FAX 1 (978)471-9937 CEL[. Sara.Maurao(a)NEMoves.wm samrdaywcksxom BLOG RESIDENIBA BROOME 7 12 Church Stet 1 Salem MA 01970 oAned And Operated By NRT LLC ww.NepEngiandMoves.com 0 CITY OF SALEM, MASSACHUSETTS �1 BO:\RU OF HF'..'1L'rI-I 120 WASHINGTON STREE'r,4®' F1..0OR TEL. (978) 741-1800 IUMBERLEY DRISCOLL Fet(978) 745-0343 MAYOR LR-AMDIN@SALrnt.COM LARRYRAib1D1N,RS/REHS,C110,CP-FS - HEALTH AG ENT (kms 0 0 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 I V/1 Lf 6 l 3t- %( 1&, M 01970 UNIT#]� IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONTORBACK,PLEASE CIRCLE ONE OW EW ER �1(SmTDc CL UI m's MANAGER/AGENTl1flLP✓, S� Ifs N (l��UroW- NOP.O.B /' � I I 1 ADDRESS I� (�l inG �� " p ADDRESS A �. Wkn i I bki CITY, STATE,ZIP k 6,,A,, � 9 4 (GOU CITY, STATE,ZIP�P�66 b 1 c)(P �� PHONE0&fflM — 199(b BUSINESS PHONE(24HRS) 970 732- 6M BUSINESS PHONE Q /A TOTAL NUMBER OF ROOMS:- ROOM OOMS:ROOM USE: L LV 2. M 2 R 3. � K 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 I^/� A" _ 52loRz( APPLICANT'S SIGNATURE MAUA,wtD ��i�I (�Q ir� DATE i_Psser (annCIL a Inspectors use only Date on initial inspection: Date of reinspection: Date of issuance of certificate: Date fee paid: ! Type of( t: Dwelling Other (Other��Check#� �I Check date: 191, 11, Notes: �l� l �J CI PTtcfi �f unil -t0 be- im-4�� 48-3L.10 . .440,S Coe nf6ro mentInspector c-A 94(epcl 0 CITY OF SALEM, N1ASSACHUSETTS c BOARD OF HEALTH 120 WASHINGTON S"rREET,4°1 FLOOR TEL. (978) 741-1800 KIAMERLEY DRISCOLL FAX(978) 745-0343 MAYOR LRAMDINgSALEM.COM LARRY RAMDIN,RS/REHS,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 H 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. Itwe 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 O� ll n �ftt� Tj� Address on unit to be inspected Date Updated 5/23/11