CYPRESS STREET J
CERT.# 187-97
3 9t FEE $25.00
DATE: 03/27/97
MrB
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,-CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Fax:(508)740-9705
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 1 Cypress Street UNIT #: 2
OWNER/AGENT: John & Beverly Pasauarello
ADDRESS: 1 Cypress Street
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-5261
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
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
n
J
nnw-
CITY
OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTF,MPH,RS,CHU NINE NORTH STREET
HEALTH AGENT Tet:(508)741-1800
APPLICATION FOR CERTIFICTE OF FITNESS Fax:(508)740-9705
IN ACCORDANCE KITH STATE SANITARY'CODE, _CHAPTER II, 105 CMR 410.000 "MINIMUM
STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT UNIT I
OWNER/LESSER NAGER/AGENT
ADDRESS -__ I:� � ADDRESS —
CITY CITY
RESIDENCE PHONE 75� �� BUSINESS PHONE (24 HRS.)
BUSINESS PHONE / fQ i�-
TOTAL NUMBER OF ROOMS:_
ROOM USE: I . ���3.-����.
5. 6. 1? 7, g,
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
DAM
_
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION: q 7 DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: DATE FEE PAID: —
p,
TYPE OF UNIT: DWELLING �( OTHER
NOTES: TSV
CODE ENFORCEMENT INSPECTOR
h i
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928 '
({1u ,t."1 � y
JOANNE SCOTT,MPH,RS,CHO ,y, r y t r„: .i p, : . 1 y NINE NORTH STREET
HEALTH AGENT •' ` ` °` , ' 'r r Tel:(508j741-1800
Fax:(508)740-9705
RELEASE
In accordance with Massachusetts Ceneral Laws Chapter 111 ; Code of Massachusetts
Regulations 410.000 et. seq. ; State Sanitary Code Chapter;rII and Article XIII of
the Cifp" of-Salem Oidinance, .undersigned owner,/lessor and .tenant/lessee of a unit
or residential property, hereby authorize the Salem Board of Health or its author-
ized 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/our absence, !/we
expressly authorize the same and for my/our successors and assigns hereby release
and discharge the City of Salem, Salem Board of Health 'and,its authorized agE:ais
fror,nany loss or injury sustained of whatever nature and descr'iption occa'sirneci
by my/our. absence during said inspect -ani
mj
TE A T/LESSEE OWNER/LESSOR — -----
ADDRESS ADDRESS
ADDRESS OF UNIT TO BE INSPECTED
L� �L'��
DAT
CITY OF SALEM BOARD OF HEALTH
Sa)em, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET.
HEALTH AGENT Tel:(508)741-1800-
Date: 03/18/97 Fax:(508)740-9705
John & Beverly Pasquarello
1 Cypress Street
Salem, MA 01970
PROPERTY LOCATED AT 1 Cypress Street UNIT # 2
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
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.
of this notice. 508 741-1800
Contact this department within 24 hours of receipt ( )
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.
SFE 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
r lea-
CITY
a-
CITY OF SALEM HEALTH DEPARTMENT
BOARD OF HEALTH .
Salem, Massachusetts 01970
ROBERT E. BLENKHORN 9 NORTH STREET
HEALTH AGENT -
508-741-1800
DATE:
At WE t s
X4912 Ic 5_
0, Alew . w,4 Dlg70 T
PROPERTY'LOCATED AT�Q�L UNIT O
DEAR SIR/MADAM:
Ithascome to our attention, that you are about to allow rental of 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.
Each dwelling unit must be inspected and certified by the Salem Health Department
prior to allowing occupancy in accordance with Chapter I11 , Sections 127A and 127B,
of. the Massachusetts General Laws, 105 CMR 400.000: State Sanitary Code, Chapter I:
General Administrative Procedures and 105 CMR 410.000: State Sanitary Code, Chap-
ter II: Minimum Standards of Fitness for Human Habitation, and in accordance with
Chapter II, Article XIII of the City of Salem Code of-,Ordinances, Section 2-334,
Certificate of Fitness.
There is a twenty-five (25) dollar fee payable by check, or money order to the City
of Salem Health Department upon issuance of Certificate.
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 withiri 24 hours of receipt of' this notice. (508) 741- 1800
Monday thru Wednesday from 8a.m. - 4p.m. , Thursday 8a.m. - 7p.m. , or Friday 8a.m. to
noon to schedule an appointment for an inspection.
SEE ENCLOSED SECTION 105 CMR 410.354 METERING OF GAS ✓k ELECTRICITY
Very rimly-yours,
FOR THE BBOAQRD,, OF HEALTH REPLY TO:
pp
Robert E. Blenkhorn, C.H.O.
Health Agent Code Enforcement Insp for
CITY OF SALEM, MASSACHUSETTS
BOARD OFHEALTH
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# 399-06
DATE ISSUED: 8/15/2006
Property Located at: 4 Cypress Street UNIT# 1
Owner/Agent: Andrea Twomey
Address: 40 Barton Road
City/Town: Stow, MA Zip Code: 01775 24 Hour Phone: 978-852-0650
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 j
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
�: 'h'?. �...�;�{ � t-.r;�"e '" .- f.:.•: Jt-M.+ Pryn- ,., ; , ...,.._., ..,,- '{a� sii
CCTY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
• • 120 WASHtNGTON STREET, 4TH FLOOR
SALEM. MA 01978
TEL. 978-741-1800
FAX 978-745-0343
STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
APPLICATION FOR CERTIFICATE OF FITNESS S
IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER 11, 105 CMR 410.000
'MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT-�� � �i , - r UNIT
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE 'y7
OWNEAtLESSER _MANAGERtAGENT 1r � .
No P.O. Box - No P.O. Box ✓j
ADDRESSADDRESS C
CITY 6 t)/ . Yl�l� - L t7 CITY--'5 — �/ �s s�
RESIDENCE PHONE BUSINESS PHONE (24 HRS.) q, 67),-00p
60
PHONE--- ter""-----.--�
BUSINESS PHONE--
TOTAL NUMBER OF ROOMS: / 1 �4tUnQ�
ROOM USE: 1: ➢� 2. j r 3 14. � {G� ���� �j
U �
THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MON
ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION. /�
APPLICANTS SIGNATURE ._. ,__DATE__.J31-JJ
S CTOR U ONLY
DATE OF INITIAL INSPECTION! '-/_,I._ _ DATE OF REINSPECTION
�/
DATE OF ISSUANCE OF CERTIFICATE Z?'_!J DATE FEE PAID:__
TYPE OF UNIT: DWELLING OTHER CHECK H -3 7 -3o?_ CHECK DATE 5
NOTES:,
CODE ENFORCEMENT INSPECTOR
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#291-07
DATE ISSUED: 6/26/2007
Property Located at: 4 Cypress Street UNIT#2
Owner/Agent: Andrea Twomey
Address: 40 Barton Road
City/Town: Stow, MA Zip Code: 01775 24 Hour Phone: 978-852-0650
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 If'
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
JOA NE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
Cmr OF SALEM, MASSACHUSErrs
`• + 80AR0 OF HEALTH
120 WASHINGTON STREET,47H FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0349 '
STANLEY USOVICZ.JR. JOANNE SCOTT. MPH. RS, CHO
MAYOR 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".
PROPERTY LOCATED AT Co P`f�'5 f2- fAft+ UNIT#
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE -
OWNER/LESSER yfel (1 _MANAGER/AGENT
No P.O. Box No PClea .O.Box A
ADDRESS O f- y) ADDRESS.111. R-F{
CITY�- i-- CITY GY✓j
RESIDENCE PHONE BUSINESS PHONE (24 HRS�./) ! -0650
BUSINESS PHONE -; 1 ohn �BYV e
TOTAL NUMBER OF ROOMS.
ROOM USE: 1 2UIrW)l _3.k( _4.&° 7�f
THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM LT DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATURE ---DATE__,61 1
I E ORS U NL
DATE OF INITIAL INSPECTION .a b.. DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:,/. DATE FEE PAID:
TYPE OF UNIT: DWELLINI�I OTHER CHECK k CHECK DATE 6 - 0- 6 `U ?
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28.+98
City of Salem, Massachusetts
m Board of Health
120 Washington Street, 4th Floor, Salem, PnbliCHealM
MA 01970 Prevent Prnmote. Protect.
Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS,CHO
Mayor Iramdin@salem.com Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE#: GHL-16.54
DATE ISSUED: 2/19/2016
Property Located at: 61/2 CYPRESS STREET UNIT#2
Owner/Agent: Bakr Fakhri
Address: 6 1/2 Cypress Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(339) 224-2227
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.
FOR THE BOARD OF HEALTH
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITARIAN
CITY OF SALEM, MASSACHUSETTS U
BOARD OF HF-1LTH
120 WASHINGTON.STREET,4"FLOORv,.. m Promote.protect,
TEL. (978)741-1800 Fax(978)745-0343
KIMBERLEY DRISCOLL lramdin@salem.com
MAYOR LARRY RA MDIIN,RS/RLIiS,CHO,CP-FS
HEAi.Tii 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: $50.0
/ 0
PROPERTY LOCATED AT lV /?: (� P-Z ((J\ , UNIT#
IS THIS UNItT"DISIGNAT AS RIGHT LEFP FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSS(ER_2�(r 0.pt���r MANAGER/AGENT
ADDRESS Vf2 C w (�resbS ADDRESS
CITY,STATE,ZIP_ Sn Matic CITY, STATE,ZIP
RESIDENCE PHONE 3aj j 2 12 2.. BUSINESS PHONE(24HRS} 2 2 2
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:____ 1 p
ROOM USE: 1. Li✓i nq 2. _ r 3. K .Ct� — 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 FEEEIIS jP}�AYABLE�AT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE U,)` "'-��'�'�'"" DATE 2/1�'r I C.
Inspectors use onlX
Date on initial inspection: 024 12-016 Date of reinspection:
Date of issuance of certificate-
/CJ21ir f2nDate fee paid: OZf2�j(
Type of unit: Dwelling Al Other Check# Z03 Check date: 0?�.1`,6�ZQ?b
Notes:
#nf ement ector
City of Salem, MassachusettsIV
Board of Health
120 Washington Street, 4th Floor, Salem, P1 th
MA01970 Prevent. Promote. Protect.
Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS,CHO
Mayor Iramdin@salem.com Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE* GHL-15-165
DATE ISSUED: 7/10/2015
Property Located at: 61/2 CYPRESS STREET UNIT#3
Owner/Agent: Bakr Fakhri
Address: 6 1/2 Cypress Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(339) 224-2227
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.
FOR THE BOARD OF HEALTH
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITA IAN
CITY OF SALEM, MASSACHUSETTS
• / BOARD OF HEALTH
120 WASHINGTON STREET,41°FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR LRAMDINQ[ AJEM.COM
LARRY RANIDIN,RS/RHI IS,CHO,CP-FS
H EA L PI-I AG I.NI'
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 Vl2° J� �. '
_ UNIT# 3
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK.PLEASE CIRCLE ONE
OWNER/LESSER Tak,r MANAGER/AGENT
NO P.O. BOX
ADDRESS 4A_ �4 clWDRESS
CITY, STATE,ZIP CITY, STATE, ZIP
RESIDENCEPHONEUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:—
ROOM
OOMS:ROOM USE: 1. A,;eA 2. Li✓ . 3. 1J✓1j 4. 9,J 5. '3�
6. g4 7. 8. J 9. 10.
THERE IS A FIFTY($50)DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS FEE IS PAYABLE ATTHETIME OF INSPECTION
APPLICANT'S SIGNATURE DATEy
Inspectors use only
Date on initial inspection: ON q-4ar Date of reinspection:
Date of issuance of certificate:O7/0g_20 ,37 Date fee paid: 0710Vj�j1 T
Type of unit: Dwelling t/ Other Check# =J �' Check date:0 /0V2.D.7 S
Notes:
4F 14
Coe nfo ment Inlyfor
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4O'FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAx(978) 745-0343
MAYOR RAy11)IN(@SA1,I3M.00M
LARRY RAMDIN,RS/RGI-IS,CI 10,CP-FS
HEALTH AG ENT
Release
In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ;
State Sanitary Code Chapter II and Article XIII of the City of Salem Ordinance, undersigned owner/lessor and
tenant/lessee of a unit of residential property, hereby authorize the Salem Board of Health or its authorized agents to
inspect the residence identified below in accordance with the aforementioned statutes, regulations and ordinances.
In the event it is necessary that said inspection be done in my/out absence. I/we expressly authorized the same and for
my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of Health and its
authorized agents from any lose or injury sustained of whatever nature and description occasioned by my/out absence
during said inspection.
Tenant/Lessee Owner/Lessor
('2 �z Com,
Address Address T
6 2 CIS+, APk 3
Address on unit to be inspected
Date
Updated 523/11
• CERT-1 26-94
FEFfj: _$ 25.00 ..
wdc�s DATE: 1/12/94
CITY OF SALEM HEALTH DEPARTMENT
BOARD OF HEALTH
Salem, Massachusetts 01970
ROBERT F- BLENKHORN 9 NORTH STREET
HEALTH AGENT
508-741-1800
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT 11 Cypress Street UNIT f 1
OWNER/AGENT Leonard' Yellin
ADDRESS 228 Atlantic Avenue
CITY/TOWN Marblehead, MA ZIP CODE 01945 24 HOUR PHONE 617-631-5079
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
RO T E. BLENKHORN, C.H.O.
HEALTH AGENT ODE!' ENVORCEM9ft INSPE OR
I
OFFICE USE ONLY
CERA.
J'aorne 'A DATE:
CITY OF SALEM HEALTH DEPARTMENT
BOARD OF HEALTH
Salem, Massachusetts 01970
RooER:F-EA16ENKHORN- 9 NORTH STREES
HEALTH AGENT
508-741-1800 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 C X\//�/��SS S UNIT /
OWNER/LESSER Z �Z/L�/�hn'� 1 F�L / I tlMANAGER/AGENT
ADDRESS r t--' ADDRESS
CITY
RESIDENCE PHONE p /�� �.?j/ '/ BUSINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS-
ROOM
OOMS:ROOM USE: 1 . L/7�-)_V 2. 3. &!)$i�---4. A NIA/'
5. 6. 7. J.
—
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 /.' ./�i � ' �Eic DATE
V
INSPECTORS USE ONLY
DATE OF. INITIAL INSPECTION4— / Z ! I DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: DATE FEE PAID:_
1
TYPE OF UNIT: DWELLING OTHER
NOTES:
d
1 ,
CODE ENFORCEMENT INSPECTOR
w
1
A Y F{
v�f01MM4 001'
CITY OF SALEM HEALTH DEPARTMENT
BOARDOF HEALTH
Salem, Massachusetts 01970
ROBERT E. BLENKHORN - 9 NORTH STREET
HEALTH AGENT
508.741.1800
DATE' December 22, 1993
Eric Yellin &
T d V&114n 9
228 Atla>zfiic n
Marblehead MA 01945
PROPERTY LOCATED AT 11 Cypress Street UNIT 0 I
DEAR SIR(MADAM:
It-has come to our attention, that you are about to allow rental of 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.
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 400.000: State Sanitary Cade, Chapter I:
General Administrative Procedures and 105 CMR 410.000: State Sanitary Cade, Chap-
ter II: Minimum Standards of Fitness for Human Habitation, and in accordance with
Chapter II, Article XIII of the City of Salem Code of Ordinances, Section 2-334,
Certificate of Fitness.
There is a twenty-five (25) dollar fee payable by check, or money order to the City
of Salem Health Department upon issuance of Certificate.
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 8a.m. - 4p.m. , Thursday 8a.m. - 7p.m. , or Friday 8a.m. to
noon to schedule an appointment for an inspection.
SEE ENCLOSED SECTION 105 CMA 410.354 METERING OF GAS & ELECTRICITY
Very tviuly yours,
FOR THE BOA�RJD,, OF HEALTH REPLY TO:
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Robert E. Blenkhorn, C.H.O. PABLO VALDEZ
Health Agent Code Enforcement Inspector
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CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS,CHO
HEALTH AGENT 120 Washington Street 4"Floor
Tel: (978)741-1800
06/27/2001 Fax: 978-745-0343
134 Canal Street Realty Trust c/o Anthony Gattineri
134 Canal Street
Salem, MA 01970
PROPERTY LOCATED AT 11 Cypress Street UNIT # 2
Dear Sir/Madam:
It has come to our attention, that you may be considering renting a dwelling unit
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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 theirtenants' entire utility bills retroactive to the date of initial
occupancy in cases in which cross-metering has been proven to exist.
THEBO> I n� - REPLY TO
qoaOR
nne Scott, MPH,RS,CHO PABLO VALDEZ
Health Agent CODE ENFORCEMENT INSPECTOR