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CUSHING STREET CERT.# 506:93 • c s FEE: _$ 25.00 DATE: 7/1/93 CITY OF SALEM HEALTH DEPARTMENT BOARD OF HEALTH Salem, Massachusetts 01970 , ROBERT E. BLENKHORN 9 NORTH STREET . HEALTH AGENT 508-741-1800 CERTIFICATE OF FITNESS PROPERTY LOCATED AT 4 Cushing Street UNIT / 1st floor OWNER/AGENT Terrance J. Donovan ADDRESS 4 Cushing Street CITY/TOWN Salem, MA ZIP CODE 01970 24 HOUR PHONE 744-4941 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 THE BOARD OF HEALTH ROERT E. BLENKHORN, C.H.O. A�14 HEALTH AGENT CODE ENFORCEMENT INSPECT �M /'"•~� .� O!'N ICH USC ONLY . CERT. I . ' a^ •�` IIATP.: CITY OF SALEM HEALTH DEPARTMENT BOARD OF tiEALTH Salem. IvAassachuselts 01970 ROBERT E. BLENKHORt1 0 NORTH STREET HEALTH AGENT - taln r.I•.teoo APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE`WITH STATE SANITARY COOE; CHAPTER II, 105 CHR 410.000 "MINIMUM STANDARDS OF FITNESS FQR HUMAN HABITATION':. PROPERTY LOCATED AT (S i\P UNIT OWNER/LESSER / R/ZAtfor-77 dA/C✓YaitJ MANAGER/AGENT ADDRESS-44 r 1r / ADDRESS CITY ��Isti CITY RESIDENCE PHOML6 7 �I'K-KQ;ew BUSINESS; PHONE (24 HRS.) BUSINESS PHONE . TOTAL. NUMBER OF ROOMS: AOOH' USE: I. 2. 3. 4 . S. 6. 7. 8. THERE IS TWENTY—FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT MR—CORPLIANCE' AND ISSUANCE OF CERTIFICATE. APPLICANTS SIGNATURE I �.p DATE / INSPECTORS USE ONLY DATE OF INIXIAL INSPECTION: /ti....✓✓✓yYYYyp � UATE OF REINSPECTION DATE OF ISSUANCE OF..CERTIF(IIC�A`TEE: I' / DATE FEE PAID: / I TYPE OF UNIT: DUELLING /� OTHER _ t -- NO'T E S : 7—� / r CERT.0 422-92 t z Wv ` rl FEE• $__L5.00 DATE: 5/28/92 CITY OF SALEM HEALTH DEPARTMENT BOARD OF HEALTH Salem, Massachusetts 01970 ROBERT E. BLENKHORN - 9 NORTH STREET . HEALTH AGENT - - 508-741-1800 CERTIFICATE OF FITNESS PROPERTY LOCATED AT 4 Cushing Street UNIT # 1 OWNER/AGENT T.J. Donovan ADDRESS 4 Cushing Street CITY/TOWN Salem, MA ZIP CODE 01970 24 HOUR PHONE 744-4941 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 SA7EM :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 THE BOARD OF HEALTH RO�ERT E. BLENKHORN, C.H.O. HEALTH AGENT CO E NFORCEMEN INSPEWFOR CERT. i , k 1 DATE: CITY OF SALEM HEALTH DEPARTMENT BOARD OF HEALTH Salem, Massachusetts 01970 ROBERT E. BLENKHORN i9 ,NORTH STREET HEALTH AGENT 508-741-1800 APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II , 105 CMR .4 10.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT C4,,-J " u ccm- UNIT i OWNER/LESSER //� MANAGER/AGENT ADDRESS h.iA l! ADDRESS CITY (LA CITY RESIDENCE PHONE �JS�T � �/ BUSINESS PHONE (24 HRS. ) BUSINESS PHONE U �P l TOTAL NUMBER OF ROOMS: �3 ROOM USE: 1 . jl. /h, 2. [)AJ. IZM 3. k i/Cll e . 5. lin 6. 111 7. 8. THERE IS A TWENTY—FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT UPON COMPLIANCE AND ISSUANCE OF CERTIFICATE. APPLICANTS SIGNATURE �.�, p �^ -� DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION: 7r-V Ir .Q L DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: 15- Z-- DATE FEE PAID: TYPE OF UNIT: DWELLING Y OTHER NOTES: 7� CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS + BOARD OF HEALTH 120 WASHINGTON STREET,4r"FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR IMANCINT@SAI,PNI.COM JANET MANCINI ACTING HEAJ.TH AGENT CERTIFICATE OF FITNESS CERTIFICATE#69-09 DATE ISSUED: 2/3/2009 Property Located at: 6 Cushing Street UNIT#1 Owner/Agent: Paul Hinchion Address: 19 Winnegance Avenue City/Town: Peabody, MA Zip Code: 01960 24 Hour Phone: 532-3770 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 ) i T MANCINI l ACTING HEALTH AGENT CODE EW15RCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4""FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAx(978)745-0343 MAYOR Ib10N F G SALEM.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." FEE: $50.00 1 PROPERTY LOCATED AT S� . UNIT# / IS THIS U7'NITT DISIGNATEED AS RIG LEFFT/FRONT OR BACK.PLEASE CIRCLE ONE OWNER/LESSER t� f��!/Z � /t /1��/ 'IGIANAGER/AGENTrG2Az7i/� f NO Y.O. BOX ADDRESS J //P li' �P. c%f, ADDRESS /} CITY, STATE,ZIP C� & CITY, STATE,ZIP , G RESIDENCE PHONE 1✓f f&y70� BUSINESS PHONE(24HRS)—. C BUSINESS PHONE C �� �S� `' / / 'S TOTAL NUMBER ���OrrFjjROOMS: / ROOM USE: 1.7)'116`( ?h" 2 A1111S`o 6. 7. V 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE.BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THISFEE I AYABLE AT E.TIME OF INSPECTION APPLICANT'S SIGNATUR - DATES C/ Inspectors use only Date on initial inspection: 2 3 -C-' Date of reinspection: Date of issuance of certificate: 2. 3" �' Date fee paid: 2. 3 - a9 Type of unit: Dwelling_j; Other Check# 1 S' l Check date: 2-- *3 --5 Notes: 4Coenforcement Inspector r CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH s 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAx 978-745-0343 Kimberley Driscoll www.SALEM.COM Mayor JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#79-06 DATE ISSUED: 3/1/06 Property Located at: 7 Cushing Street UNIT# 1 Owner/Agent: Raymond Beaupre Address: 16 Vista Avenue City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-5582 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 ll" 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. FO THE BOARD OF HEALTH JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS l BOARD OF HEALTH 7 • • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 JOANNE SCOTT, MPH, R5, CHO Kimberley Driscoll HEALTH AGENT Mayor 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 7 UNIT# I IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER aa-1 / MANAGER/AGENT No P.O. Box �v I No P.O. Box ADDRESS '' AAy�L � ADDRESS CITY /d�e-,pn 2 Ca44 CITY RESIDENCE PHONE USINESS PHONE (24 HRS.) 4--e� BUSINESS PHONE * �— TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. _3. � 5.,"'wo 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 SIGNATUREgay —DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION -1 -1 3 'o (, DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: 5 -& C DATE FEE PAID: 3 —0 _6 TYPE OF UNIT: DWELLI11�_OTHER_ CHECK # 3 q CHECK DATE NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL, 978-741-1800 FAx 978-745-0343 Kimberley Driscoll www.SALEM.COM Mayor JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT 2(6!06 Raymond Beaupre 16 Vista Avenue Salem, MA 01970 PROPERTY LOCATED AT 7 Cushing Street Unit 1 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. For the Board of Health Reply to panne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector aC CERT.# 189-01 FEE $25 .00 DATE: 04/23/2001 M�Na 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: 10 Cushing Street UNIT #: 1 OWNER/AGENT: Brendan Rennedv ADDRESS: 12 Cushing Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-4680 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 BOARD OF HEALTH JOANNE SCOTT, MPH,RS,CH0 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 Tei:(978)741-1800 Fax:(978)740-9705 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION PROPERTY LOCATED AT tO 1p UNIT# IS THIS UNIT DESIGNATED AS RIGHT EF FRONT BACK PLEASE CIRCLE ONE OVdNER/LESSER���ANAGER/AGENT No P.O. Bax P.O.Bax ADDRESS—1 ( /� S /J/1,-I'J ADDRESS CITY S� �2k_z F Tw, G / zl 2 CITY RESIDENCE PHONETZF�7q<g66nUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1._f L 2. 4- 3. � 4. 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 SIGNATUREDATE � � INSPECTORS USE ONLY DATE OF [Nil IAL INSPECTION DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: 3 -v/ DATE FEE PAID: 'a 3 -D-I TYPE OF UNIT: DWELLINGrHER_ CHECK# ? CHECK DATE v/ NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH s 120 WASHINGTON STREET, 4TH FLOOR Fso SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 KIMBERLEY DRISCOLL JSCOTT@SALEM.COM MAYOR JOANNE SCOTT HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE# 134-08 DATE ISSUED: 3/19/2008 Property Located at: 10 Cushing Street UNIT#2 Owner/Agent: Susan Rich Address: 19 Cunningham Drive City/Town: S. Hamilton, MA Zip Code: 01982 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 ll" 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 C✓�i7'3�N�x-G� V JO/ANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR Of • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH l 120 WASHINGTON STREET,4"FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR Ixc�'rrn ,ua•a+.COM JOANNE SCOTT, HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR /HUMA HABITATION." PROPERTY LACATED AT A C � /V**; /�{ � UNIT# IS THIS UNIT DISIGNATEDA ICHT LFVT FRONT OR B,<CK PLEASECIRCLEONE OWNER/LESSER /'1 � MA1'AGER/AGENT NOP*0' OP.O. BOX ADDRESS //J(�// I RGQYY! ice' ADDRESS I G CITY,STATE,ZIPS4 ll�l�/�/i/GTJ�J y CITY,STATE,ZIP "/ 0 7 Z RESIDENCE PHONE / 2?-7l0 �4/ � BUSINESS PHONE(24HRS) _�%P 4V e BUSINESS PHONE TOTAL NUMBER OF ROOMS: 6 ROOM USE: 1 2. r-W 3.1dI^m 4. j)4 /11 5. �1 jig rooms 6. tdron 7. 8. 9. 10. THERE IS A TWENTY-FIVE($25)DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABL THE TIME OF INSPECTION APPLICANTS SIGNATUR DATE Inspectors use only Date on initial inspection: l —D C Date of reinspection: Date of issuance of certificate: 73 1 6i --D Date fee paid: Type of unit: Dwelling Other Check # �' 3��Check dater _ a$ Notes: Code Enforcement Inspector `4�� 176�Nar� 7�g 33� - aYy� CITY OF SALEM, MASSACHUSETTS • BOARD OF HEALTH 120 WASHINGTON STREET,4°i FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx 978 745-0343 MAYOR DGRe:r,NSAUM&ALEM.COM DAVID GREENBAUM ACTING HuAj,:PII.AGENT CERTIFICATE OF FITNESS CERTIFICATE#643-09 DATE ISSUED: 12/21/2009 Property Located at: 12 Cushing Street UNIT# 1 Owner/Agent: Susan W Rich Address: 19 Canning Drive City/Town: S. Hamilton, MA Zip Code: 01982 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 ll" 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 RCF DAVID GREENBAUM ACTING HEALTH AGENT CODE EN CEMENT INSPECTOR • CITY OF SALEM, MASSACHUSETTS ` BOARD OF HEALTH 120 WASHINGTON STREET,4".FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGREENBAUM&ALEM.COM DAVID GREENBAUM, 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." FEE: $50.00 PROPERTY LOCATED AT _ I C U�s h I I n � S-+ - UNIT# ''IS THIS UNIT DI�SIGNATED ASR T LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSEIZ ��a-!5,/I W ( �" {/MANAGER/AGENT NO P.O.BOX /C r ADDRESS �y ( -U {' 14) n OI VA 114 ADDRESS p CITY, STATE,ZIP �J/ /7G{f(��/��7 . CITY, STATE,ZIP c, 0 RESIDENCE PHONE 9W�W—�2�/7 2 BUSINESS PHONE (24HRS) BUSINESS PHONE TOTAL NUMBER OF JROOMS: ®® // ` ROOM USE: 1 zeo{ awf 2.�drWl• 3. //U%�Iq 4. e57'/r///I9 5. 9f/�� w 6a6b4vM 7. 8. v 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 AT THE E OF INSPECTION APPLICANT'S SIGNATUX 1 DATE Inspectors use only Date on initial inspection: 10 /a ! I G y Date of reinspection: Date of issuance of certificate: Date fee paid: a=0 r Type of unit: Dwelling_�Other Check#Check date: �a d I 0 1 Notes: ��( ( (cv bon � o J�9 s , up5hWS I j Used 4,5- 6/Z . (�/lk S/1-)&)Lt -f�or b4 C/z Le, /Loon-I . A11 wl daus >v 16 CK. �-- Code Enfor t Inspector tlNUip CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR 3S SALEM, MA 01970 CERT.# 633-02 TEL. 978-741-1800 FEE $25.00 Fax 978-745-0343 DATE: 12/18/2002 STANLEv USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 15 Cushing Street UNIT #: 1st floor OWNER/AGENT: Brandt Gillespie ADDRESS: 15 Cushing Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 799-7399 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 BOARD OF HEALTH JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT WnE `ENFORCEMENT INSPECTOR ,� ;~• .co CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH /7 Q 3 3s 120 WASHINGTON STREET, 4TH FLOOR { SALEM, MA 01970 qB ^^•� TEL. 978-741-1800 A' FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 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 G!S'��/�/� �T UNIT# I_ IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE //A. N OWNER/LESSER Pr,,�11, A MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS J S / ADDRESS CITY _S,, 14� AIZI CITY 7 y RESIDENCE PHONE Y-7� , SINESS PHONE (24 HRS.) 7�/ BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. Gpp'/��Gyyh�"" 2.� �e 3. i lT�f�4. � � lgf 5.A�%. 7. 8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEAyLTH DEPARTauIENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE /� /� i DATE r� l ' INSPECTORS-USE ONLY DATE OF INITIAL INSPECTION ,a;, DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE. i8 DATE FEE PAID: TYPE OF UNIT: DWELLING r/OFI�THER_ CHECK# f/® CHECK DATE,2 NOTES: COD5,2 FO ENT INSPEC 9/28/98 ' CITY OF SALEM MASSACHUSETTS v��coxm BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR E SALEM, MA 01970 CERT.# 348-02 TEL. 978-741-1800 FEE $25 .00 FAX 978-745-0343 DATE: 07/08/2002 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 19 Cushing Street UNIT #: 1 OWNER/AGENT: Tom Rossi ADDRESS: P.O. Box 24 CITY/TOWN: Waterville Valley, NH ZIP CODE: 03215 24 HOUR PHONE: 726-4774 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 BOARD OF HEALTH 1� qJOANNE SCOTT�, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR o CITY OF SALEM, MASSACHUSETTS vQ' a BOARD OF HEALTH m� m 120 WASHINGTON STREET, 4TH FLOOR )F-Q SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO ' MAYOR HEALTH AGENT 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 I ���5�1�� 57-� UNIT#1 IS THIS UNIT D_ESSIIGGNATEDAS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER IOM ( S5/ MANAGER/AGENT No P.O. B t� No P.O. Box ADDRESS ( be¢� ADDRESS Cl Zf-44W — CITY -- RESIDENCE PHON56 7�6'4`7Z�USINESS PHONE (24 HRS.) BUSINESS PHONE--=- TOTAL HONEiTOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3.�4. S jK 5. l/ 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. _ �Th� APPLICANTS SIGNATURDATE 7 O Z INSPECTORS USE ONLY DATE OF INITIAL INSPECTION /-5-0 a DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: 7 F-c DATE FEE PAID: -57- /6 -- 2� TYPE OF UNIT: DWELLING_OTHER_ CHECK# 3 4✓ CHECK DATE .�--/6 -6 z NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 I coxa CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH ° 120 WASHINGTON STREET, 4TH FLOOR a SALEM, MA 01970 CERT.# 347-02 FEE $25.00 TEL. 978-741-1800 DATE: 07/08/2002 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 19 Cushing Street UNIT #: 2 OWNER/AGENT: Tom Rossi ADDRESS: P.O. Box 24 CITY/TOWN: Waterville Valley, NH ZIP CODE: 03215 24 HOUR PHONE: 726-4774 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 BOARD OF HEALTH Ql4djl� JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR . n r J un wa na .r�v a.�o+.2�,ym♦. .. .4Fv.:� ��nW.nfi:.. CITY OF SALEM, Mk5!§ACH.�UpSETTS r -1 - .CU . . r ►6 t t"._Z 1- +,f*`.`4 T•7pv BOARD OF HEALTH } - r/i�.-D� + i 120 WASHINGTON STREET, 4TH FLOOR T SALEM MA 01970 . . , TEL. 978-74 1-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO - MAYOR HEALTH AGENT 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 I I �l I/Ij � UNIT# Z IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNERILESSER awl a5-5-C MANAGER/AGENT No P.O. BoxrjQ�C No P.O. Box ADDRE�S�S Z �r77 ADDRESS Cl // CITY RESIDENCE PHONFy!.a3 7Zb Y7 74USINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. r�, 2_e�23. 4. 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 / li-= / \ DATE 6 2 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 7, 9 - 0 't- DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: DATE FEE PAID: v TYPE OF UNIT: DWELLING OTHER— CHECK# - CHECK DATE 5- Z' NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 5 FROM :WU SHIRT CO FAX N0. :16032364660 Jul. 23 2002 07:50PM P1 t: CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • 120 WASWINGTON STREET, 4TH FLOOR CERTA 347-02 SALEM, MA 01970 TEL, 978-741-1800 FEE 07/08/ DATE: 07/08/2002 Fax 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, R5, CHO MAYOR HEALTH AGENT � li 11 VV JUL 2 4 2002 CI IY OF SALEM BOARD OF HEALTH CERTIFICATE OF FITNESS I PR PERTY LOCATED AT: 19 Cushing Street UNITDa 0 ER/AGENT: Tom ROeai ADDRESS: P.O. Box 24 CIPY/TOWN: Waterville Valley, NH ZIP CODE: 03215 24 HOUR PHONE: 726-4774 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 SA]1EM BOARD OF HEALTH AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED. SEIIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410.000: MASSACHUSETTS STATE S ITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". SE TION 410.400 (B) : DWELLING UNIT (X) AND 410.400 (C) : ROOMING UNIT MINIMUM SQUARE FOOTAGE FOR SLEEPING P NO#: ROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD FOR OCCUPANTS UNDER 6 YEARS OF AGE. FOR MORE INFORMATION CALL 978-7 1-1800. FO THE BOARD OF HEALTH 4 60-w-r-cl t/ U zav JOANNE SCOTT, MPH,RS,CHO EALTH AGENT CODE ENFORCEMENT INSPECTOR a � Ud c �