89 Congress rooming house releases 2023 �J 9— 2 3
(1- CITY OF SALEM, MASSA.CHUSETTS
1-10ARr7 or.RRAT ru
\ 120 W SHINGTON STREET,4"'FLOOR
TFL. (978)741-1800
KINOERLEY DRISCOLL FAtX(978)745-0343
1V1AYOR DGRH1;N13AUN e sAJXa%i.COM
u.Avu.,Gict&r Muni,RS
ACTING HE3LTH AGENT
Release
In accordance with Massachusetts General Laws Chapter 111;Code of Massachusetts Regulations 410.000 et. Seq. ;
State Sanitary Code Chapter II 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.I/we 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
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Address Address
Address on unit to be inspected
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CITY OF SALEM, MASSACHUSETTS
120 WASHINGTON STREET,4n FLf)OR
TEL.(978)741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR I)QaujliidBAU MCa1S,UXP%1 COM
ACTING HE.kLTH AGENT
Release.
In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ;
State Sanitary Code Chapter II 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. I/we 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
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Address ` Address
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.Address on unit to inspected
Date
CITY OF SALEK MASSACHUSETTS`
120 WASHINGTON STREET,4T"r4U)OR
TEL.(978)741-1800
KLMBERLEY DRISCOLL FAX(978)7451-0343
MAYOR DGRI,-,NBAQM�'ka s,U'r"X1 COM.
1.:7'i�'1L li2Cr.L;iVt33UIL1,l.�J
ACTING HE.um AGENT
Release
In accordance with Massachusetts General Laws Chapter l l l;Code of Massachusetts Regulations 410.000 et. Seq. ;
State Sanitary Code Chapter II 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.I/wee expressly authorized the same and for
mylour 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
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Address Address
Address on uni#to be inspected
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CITY OF SALEM, MASSACHUSETTS
1 I Fl, RTC C)F NT+`AT'TW
120 WASHINGTON STREET,4P FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR vcRf rNsAuM(a AJX—.ts.COM
GKt�ENfisU-&4 RS
ACTING HE.-�LTH AGENT
Release
- In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ;
State Sanitary Code I Chapter.II 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. I/we 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
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Date
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CITY OF SALEM) MASSACHUSETTS
,rt_ ROARI1 nF HF,.AI_TR
120 Wr1SHINGTON STREET,e FLoOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR COM
ACTING HE.uTHAGENT..
Release
In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq.
State Sanitary Code Chapter II 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. I/we 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
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Date
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CITY OF SALEM, MASSACHUSETrS
. R(-)-kRT J op H-F--�r TP
120 ZXI,'iSHINGTON STREET,4"'Fux)R
`ILL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR DGREENBAUM ALLUM.COM
.JA ID iTxrr.N15AUTV4 AZ
ACTING HE--ki TH AGENT
Release
In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ;
State Sanitary Code Chapter II 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. I/we 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
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Address Address
Address on unit to benspected
-7,
Date
CITY OF SALEM, MASSACHUSETTS
120 WASHINGTON STREET,40'FLf)OR
TEL. (978)741-1800
KINMER.LEY DRISCOLL FAX(978)745-0343
MAYOR ncxQ cN13-AUMr&SAJ-;,Ni.COM
DA V lv 111t C t.1V15 3Ub1,i(J
ACTING HE-�L.TH AGENT
Release
In accordance with Massachusetts General.Laws Chapter 111-, Code.of Massachusetts Regulations 410.000 et. Seq. ;
State Sanitary Code Chapter II and Article XIII of the City of Salem Ordinance,undersigned owner/lessor and
tetant/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. I/we 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
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Address Address
Address on unit to be inspected`
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Date
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CITY OF SALEK MASSACHUSETTS
501
120 WASHINGTON STREET,4"FLOOR
TEL. (978)74.1-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR QQ.RI L:NRAUhi ALH,,,1 COM
I-)A V W GKk tS bA-IYN4 iW
ACTING HE:-kLTH AGENT
Release
In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ;
State Sanitary Code Chapter II 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. Uwe 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 bymy/out absence
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A dress Address /
Address on unit to a inspected
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Date
CITY OF SALEM, MASSACHUSETI'S `
r
120 WASHINGTON STREET,4"'FLOOR
TEL. (978) 741-1800
KIN BERLEY DRISCOLL FAX(978)745-0343
MAYOR 1X'MJ*F.NBAtJMnas,Uxm COM
ACTING HE.�LTH AGENT
Release
In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ;
State Sanitary Code Chapter II 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. I/we expressly authorized the same and for
MY/Our successors and assigns hereby release and discharge the City ofSalem, Salem.Board of Health and its
authorized agents from any lose or injury sustained of whatever nature and description occasioned by my/out absence
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Date
CITY OF SALEM, /IASSACHUSE'I7'S
J 1;0AT D OF 14 -AT TT-T
120 WASHINGTON STREET,4"'FLOOR
TEL. (978) 741-1800 .
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR Dc,.mCNBAUM a S,rrX 1Nt.COM
1JAVIL GKtJ--NI5A0A!,R-5
ACTING HE.-�LTH AGENT
release
In accordance with Massachusetts General Laws Chapter 11.1 Code of Massachusetts Regulations 41.0.000 et. Seq. ;
State Sanitary Code Chapter II and Article XIII of the City of Salem Ordinance,undersigned owner/lessor and
tenant/lessee of a unit ofresidential 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.I/we 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
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• CITY 4F SALEM, MASSACHUSETTS
— -. BOARD OF HF 8T.-M
120 WASiIINGTON STREET,4"FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978)745-a0343
MAYOR 1 IQIU- NBAUM AJ r-.Nt.COM
ACTING HE.-�LTH AGENT
release
In accordance with Massachusetts General Laws Chapter 11 I Code of Massachusetts Regulations 410.000 et. Seq. ;
State Sanitary Code Chapter II 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. I/we 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
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Address Address
Address on unit to be inspected
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CITY OF SALEM, MASSAC.HUSETrs
120 WASHINGTON STREET,4P'FLOOR
- TEL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR vc,R:eNRAUM&ALEM_COM
!)'Ivtll%GKt&NVt5AU-N4 AZ
ACTING HE-=H AGENT
Release
In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ;
.State Sanitary Code Chapter 1I 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. I/we 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
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Address ddress ,
Address on unit to be inspected
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CITY OF SALEM MASSACHUSETTS
11a I fI RI OF HF.ATTip A— iff
120 WASHINGTON STREET,4"'rLOOR
TEL' (978)741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR D(AU:r•.NBAUM s,uJ;1Ni.COM
L I V Lu%ffxr.J--Nts i UTv4 r%Z
ACTING HE-kLTH AGENT
Release
In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ;
State Sanitary Code Chapter II and Article XIII of the City of Salem Ordinance)undersigned owner/lessor and
tenant/lessee of 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. I/we 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
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-Date
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CITY OF SALEM, MASSACHUSETTS
B(-)ART,)op T4TZAT.734
120 WASHINGTON STREET,4"'FLOOR.
TEL. (978) 741-1800
KINBF_,RLEY DRISCOLL FAX(978)745-0343
MAYOR vcxl l.NBAU [RsAJJ',nt.COM
.UA V ll!t-ymt- 15 AUlu,Y%Z
ACTING HF-ALTH AGENT.
Release
In accordance with Massachusetts General Laws Chapter I11; Code of Massachusetts Regulations 410.000 et. Seq. ;
State Sanitary Code Chapter II 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. Uwe 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
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Address Address
Address on unit to be inspected
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CITY OF SALEM, MASSACHUSETTS
nw 110A T)OF T-TFAT:TP
120 WASHINGTON STREET,4"'FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR QGRE1.NRAUhi &,U..t.M COM
DAVluGxyN DiUA4SW
ACTING HE.3I.TH AGENT
Y2elease
In accordance with Massachusetts General Laws Chapter 1.11;Code of Massachusetts Regulations 410.000 et. Seq. ;
State Sanitary Code Chapter Il 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. I/we 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
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