DEARBORN STREET vQ�
CERT.# 610-00
FEE $25.00
�� DATE: 09/15/2000
�OMnve
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: 4 Dearborn Street UNIT #: 2
OWNER/AGENT: James Mears
ADDRESS: 4 Dearborn Street
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 741-5730
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 I/I
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
g.
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 FIT//NESSS FOR HUMA14 HABITATION".
PROPERTY LOCATED AT `1 bel-J-rkrA 9— UNIT#A rGIa0lC.
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSERJPs Inca r ,4 MANAGER/AGENT
No P.O. Box No P.O. Box
ADDRESS 4/ Oven S T ADDRESS
CITY SA-La_m ✓n4 CITY
RESIDENCE PHONE 7 yl-S 7.2 O BUSINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:�z
ROOM USE: L 1< 664e 2. ✓ _3._1�ezA"� 4.�Zg,
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��i c DATE
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION q_.. I ,���� DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: -- (� �' DATE FEE PAID: // J
TYPE OF UNIT: DWELLING
OTHER_ CHECK# b l CHECK DATE
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
CITY OF SALEM, MASSACHUSETTS
e 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
CERTIFICATE OF FITNESS
CERTIFICATE# 163-06
DATE ISSUED: 3/31/06
Property Located at: 4 Dearborn Street UNIT#3
Owner/Agent: James C. Mears
Address: 4 Dearborn Street 1st floor
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 741-5703
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
JO NNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
I
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
• i 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
I
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 / DAAA 0' ti M UNIT# 3
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER 4 A MAS M,0 r,$'MANAGER/AGENT
No P.O. Box } No P.O. Box
ADDRESS �I Dew O"Y w S I ' ADDRESS
CITY I CITY
RESIDENCE PHONE q-2p`?�')'!S7,/qU6USINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: 7
ROOM USE: 1. K - �-)y
$1�2. l of 3. 0(00
R 4.I�/t�1�U0M
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 3/294J.
J.
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION 3�) l —o 6 _DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:_ !�DATE FEE PAID:—K �_ 6
TYPE OF UNIT: DWELLING OTHER_ CHECK# ��10 _CHECK DATE
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
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
3/23/06
James C. Mears
4 Dearborn Street 1 st floor
Salem, MA 01970
PROPERTY LOCATED AT 4 Dearborn Street Unit 3rd floor
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.
F r the Board of Health - Reply to
oanne Scott MPH, RS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector
CITY OF SALEM, MASSACHUSETTS
„ e BOARD OF HEALTH
e 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#67-07
DATE ISSUED: 2/16/2007
Property Located at: 5 Dearborn Street UNIT# House
Owner/Agent: Bryon Locke
Address: 34 Upham Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-744-5213
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.
FQR THE BOARD OF HEALTH
Y rf L411
'
JOANNE SCOTT, MPH. RS. CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
• + 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343 -
JOANNE SCOTT, MPH, RS, 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
IS THIS UNIT DESIGNATED ASIR jGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSERCiO� .-2 MANAGER/AGENT
No P.O. Box No P.O. Box
ADDRESS.. ' _ADDRESS
CITY_ C S16"LQ ,q
RESIDENCE PHONE / 7a{� 7`fI—/d j,)bUSINESS PHONE (24 HRS.)_ 74,17
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1._ t' 2403.L1 t/—4.
$.
THERE IS A TWENTY-FIVE ($25.40) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
. EPARTME
ORDER TO THE CITY OF SALEM HEALTHNT THIS EEE IS PAYABLE AT THE
TIME OF INSPECTION, /
r
APPLICANTS SIGNATURE ._ _ DATE,
IN
IN PECTORS USE ONLY
DATE OF INITIAL INSPECTION,4�11 rl f _DATE OF REINSPECTION____f_______..
DATE OF ISSUANCE OF CERTIFICATE- G __DATE FEE PAID:
TYPE OF UNIT: DWELLINGAfOTHER_ CHECK #-Y 0 _CHECK DATE
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
.�e
a
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET
HEALTH AGENT Tel: (978)741-1800
05/07/2001 Fax:(978)740-9705
Carmine & Roslyn DiFruscia
6 Dearborn Street
Salem, MA 01970
PROPERTY LOCATED AT 6 Dearborn Street =IT # 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 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 -
I
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.
R THE BOARD REPLY TO
Joanne Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
i
I
C
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
CERTIFICATE OF FITNESS
CERTIFICATE #008-07
DATE ISSUED: 1/11/2007
Property Located at: 10 Dearborn Street UNIT# 1
Owner/Agent: Ana Sanchez
Address: 16 Hersey Street#2
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-210-1032
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
JOANNE SCOTT, MPH, RS, CHO d
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
/ CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
• • 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800 ���
FAX 978-745-0343
JOANNE SCOTT, MPH, RS, 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 ATM<] DER ) ST reit! UNIT#�
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER �NA 5AA16H.�_ MANAGER/AGENT
No P.O. Box / / No P.O. Box
ADDRESS IbEo fr ADDRESS
CITY 54,LEE 1A J4 CITY
RESIDENCE PHONE '7 1 I��2s BUSINESS PHONE (24 HRS.)-2"-�
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: 3
ROOM USE: 1.6eAtOA_28fd3.,,/&J we,_4. (��Ai
5-L r1 �s.Qj?Wp j7. MU8.
THERE IS A TWENTY--FIVE ($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM EALTH DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATURE ����_DATE
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION _.DATE OF REINSPECTION_
f167
DATE OF ISSUANCE OF CERRTI�FICATE! —) 1 67 DATE FEE PAID:
TYPE OF UNIT: DWELLING/_OTHER____ CHECK #
� \ ���_CHECK DATE
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
�(Aq. SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
KIMBERLEY DRISCOLL JSCOTT@SALEM.COM
MAYOR
JOANNE SCOTT
HEALTH AGENT
1/30/08
Ana Sanchez
16 Hersey Street#3
Salem, MA 01970
PROPERTY LOCATED AT 10 Dearborn 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.
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.
or the Board of He It Reply to
Joanne MPH, RS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector
c+ <
is CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4°1 FLOOR PllblicHeslt}1
1'rnrn,.Yrnmum.Pmlatl.
TEL. (978) 741-1800 F:Ak(978) 745-0343
KIMBERLEY DRISCOLL lramdinng,salem.com
LARRY 2.-A AID7N,RS/RF.t IS,CF[O,<;Y-FS
MAYOR HF At,n I A(;ENP
CERTIFICATE OF FITNESS
CERTIFICATE #266-12
DATE ISSUED: 6/28/2012
Property Located at: 11 Dearborn Street UNIT#
Owner/Agent: Lawrence Gallagher
Address: 11 Dearborn Street
City/Town: Salem, MA Zip Code: 01970 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
I
L Y RAMDIN i�,�j.1.{��/u'
HEALTH AGENT SANITARIAN
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEAL11-I
120 WAS141:NGPON SPRI3ET 4"'FLOOR PublicHealth
> Prevent.Promote.Proieet.
TEL. (978) 741-1800 Fwl(978) 745-0343
KIMBERLEY DRISCOLL lramdin@salem.com
MAYOR LA luty IznAn�IN,lis/arErs,cElo,CP-1;s
HEAI:PI-I AGE,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 DearLrC r m S �, UNIT#
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK.PLEASE CIRCLE ONE
OWNER/LESSER au,r2 nCe r MANAGER/AGENT
NO P.O. BOXnn II__
ADDRESS IJ DC'CAK k0 rvc. ADDRESS
CITY, STATE,ZII'�So t C'�bLY/tt I_ Q • y /(37r-) CITY, STATE,ZIP
RESIDENCE PHONES 1 0 " !/ Y`4-44BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2. 3. 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 AT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE 40421
1
Inspectors use only
Date on initial inspection: (o' 2 o?')`L Date of reinspection:
Date of issuance of certificate: h 12 Date fee paid: to Z&,I Z
Type of unit: Dwelling t/ Other Check �) Check date:
Notes:
ode Enforcement thspector
u • CITY OF SALEM, MASSACHUSE T I'S
BOARD OF HEALTH
120 WASHINGTON SP,REFT 4°'FLOOR Pub1lCH Ith
> Prevent.Promote.V10111.
TEL. (978) 741-1800 F'Ati(978) 745-0343
KIMBERLEY DRISCOLL lramdin@salem.com
LARRY
MAYOR RAMDIN,RS/RF,HS,CHO,CP-I'S
H F'A L:17-I AC;E?N`I.
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/Less Owner/Lessor
Address Address
Address on unit to be inspected
/g
Date
Updated 523/11 _
� � r
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT - Tel:(508)741-1800
Date: 08/27/96 - Fax:(508)740-9705
12-12 1/2 Dearborn Street Realty Trust
256 Essex Street
Salem, MA 01970
PROPERTY LOCATED AT 12 Dearborn 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.
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.
. 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
6
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Date: 08/27/96 Fax:(508)740-9705
12-12 1/2 Dearborn Street Realty
256 Essex Street
Salem, MA 01970
PROPERTY LOCATED AT 12 Dearborn 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.
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.
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
o CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
> 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 976-745-0343
STANLEY USOVICZ, JR. ,JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
05/09/2002
12-12 1/2 Dearborn Street c/o William Tracy
P.O. Box 111
Hamilton, MA 01936
PROPERTY LOCATED AT 12 1/2 Dearborn Street UNIT # 3
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.
0joanne
To
REPLY TO
, MPH,RS,CH0 PABLO VALDEZ
Health Agent CODE ENFORCEMENT INSPECTOR
3 �
'P"trml�
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Date: 09/11/97 Fax:(508)740-9705
12-12 1/2 Dearborn Street c/o Gen Tracy
One Devonshire Place, suite 2172
Boston, MA 02108
PROPERTY LOCATED AT 12 1/2 Dearborn Street UNIT # 3
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 l: 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 .
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 H�EAALTT.H.. REPLY TO
Joanne Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
X
• 3
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Date: 08/18/97 q/ Fax:1508)740-9705
12-12 1/2 Dearborn Street c/o Robert Conley
256 Essex Street
Salem, MA 01970
PROPERTY LOCATED AT 12 1/2 Dearborn Street UNIT # 3
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 l: 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.
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_T_H'E BOARD OF HEALTH REPLY TO
qjoanne
Scott, MPH,RS,CHO _ . . . PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CITY OF SALEM
HEALTH DEPARTMENT ` p,777-K-0-2
- TM
NINE NORTH STREET
SALEM, MASSACHU--r-TTS 01k70- AUG 2 103925\
+7vv
MN8 ! r a f t
�,IV. s a�� r,,,p. *�"ryJ ,Ar!4i U. POSTAG1
1"' •_ 12-122 Dearborn Street
_
1 >
Tu
., �a ??d -�sa=� �•__ III,,,..,FA,i�;i�,:1iG,,:�Ii..I ,Lal:�i,.1i,i;,ii�?i.. ,T
3
r
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Date: 02/13/95 Fax:(508)740-9705
12-12 1/2 Dearborn Street c/o Robert Conley
256 Essex Street
Salem, MA 01970
PROPERTY LOCATED AT 12 1/2 Dearborn Street UNIT # 3
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 l: 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 atwenty-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.
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
t
Joanne Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
�ONDIT 0
CERT.# 500-00
FEE $25.00
�s
`r DATE: 08/08/2000
- 9ep�M/NE
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: 14 Dearborn Street UNIT #: 2
OWNER/AGENT: Donald T. & Joanne F. Charette
ADDRESS: 14 Dearborn Street
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-4205
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 CODE ENFORCEMENT INSPECTOR
4
S
��/MINB W
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH, RS,QHO 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 FITNESS FOR HUMAN HABITATION'.
PROPERTY LOCATED AT UNIT#�
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
4)0r) >77TCaialn P F
OWNER/LESSER re 7-7-�f MANAGER/AGENT
No P.O. Box No P.O. Box
ADDRESS S O r" C ADDRESS
CITY �Sre/LP4/1 CITY !l1q_
RESIDENCE PHONE 57 R �7 -Wc`�4Bt SINESS PHONE (24 HRS.) ? 7�- 99-9
BUSINESS PHONE -7 7�� l d / oE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1._ 2._ 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. ` p
APPLICANTS SIGNATURE A DATES O
�/SPECTORS USE ONLY c /
DATE OF INITIAL INSPECTION - o DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: DATE FEE PAID: 8 '�
TYPE OF UNIT: DWELLING J�OTHER_ CHECK# � Q _9 -ODCHECK DATE -Y �
NOTES: /�
CODE ENFORCEMENT INSPECTOR 9/28/98
4 A
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT 3 Tel:( 741-1800
Date: 11/21/94 Fax:(508(508)744 0-9705
Donald T. & Joanne F. Charette
14 Dearborn Street q'd'
Salem, MA 01970
i
PROPERTY LOCATED AT 14 Dearborn Street UNIT # 3
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 l:
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 .
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
CERT.# 7-98
FEE $25.00
DATE: 01/07/98
CITY OF SALEM BOARD.OF HEALTH
Salem, Massachusetts.,01970-3928
JOANNE SCOTT, MRH,RS,CHO NINE NORTH STREET
HEALTH AGENT - Tel:(978)741-1800
!� Fax:(978)740-9705
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 15 Dearborn Street UNIT #: 1 Front
OWNER/AGENT: Elizabeth & Donald Andrade
ADDRESS: 165 Pond Street
CITY/TOWN: Sharon. MA ZIP CODE: 02067 24 HOUR PHONE: 784-6618
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
.i M1
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tei:(508)741-1800
APPLICATION FOR CERTIFICTE OF FITNESS Fax:(508)740-9705
IN ACCORDANCE WITH STATE SANITARY' CODE, CHAPTER II, 105 CMR 4110.000 "MINIMUM
STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT (j `.�� �T _ '
OWNER/LESSER qt Gf.��-at�i� i L Ie
,� MANAGERIAGENT
ADDRESS /6S- ��,. ADDRESS
CITYaciC4,_ k< eri3O 6:7 "' CITY
RESIDENCE PHONE (? ^ -7 BUSINESS PHONE (24 HRS.)
BUSINESS PHONE -
TOTAL NUMBER OF ROOMS_
ROOM USE: I. (--- 2. -, 3._` 4 .
5. 6. 7. 8.
i
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
INSPEC'T'ORS USE ONLY
DATE OF INITIAL INSPECTION r D DATE OF REINSPECTION��J
.. p DATE FEE PAID:-"/-
DATE OF ISSUANCE OF CERTIFICATE:-/ _" -
�
TYPE OF UNIT: DWELLING V OTHER
NOTES: l
i
CODE ENFORCEMENT INSPECTOR
• CITY OF SALEM, MASSACHUSETTS IV
BOARD OF HEALTH -
--120 WASHINGTON STREET 41°FLOOR PubflCHeatth
, Prevent.Promote.Pro,ect.
TEL. (978) 741-1800 FAx(978)745-0343
KIMBERLEY DRISCOLL tramdin@salem.com
LARRY RAMUIN,RS/RI.?H5,CFIO,CP-FS
S
MAYOR HE,U;ru AGF.-NT
CERTIFICATE OF FITNESS
CERTIFICATE#430-14
DATE ISSUED: 11/13/2014
Property Located at: 15 Dearborn Street UNIT#R
Owner/Agent: Elizabether H. Andrade
Address: 15 Dearborn Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-740-1804
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
/OFJHEALTH
'�� j;'
I,UA *A
LARRY RAMDIN /
HEALTH AGENT SANITARIAN
CITY OF SALEM,MASSACHUSETTS
BOARD OF HEALTH Z0_, q
120 WASHINGTQN STREET,4R'FLOOR J
TEL. (978}741-1800
KIMSERLEY DRISCOLL FAX(978}745-0343
MAYOR LRA9Q1 @ML9=N
LARRY RAMDIN,RS/KERS,cm,CP-FS
HEALTH AGENT•
Application for Certificate of Fitness a
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 /J 36"d✓"n S4 • UNIT#-k—
IS THIS UUNrFDLSIGLNA AS RIGW LEFT FRONT OR BACK.PLEASE CIRCLE ONE
OWNER/LESSERa ' " 1'Gev-/Vld" MANAGER/AGENT
NO P.OBOX
ADDRESS .5r�rrl (} ADDRESS
CrM STATE,ZIP CITY,STATE,ZIP) 'Z,. O &76
RESIDENCE PHONE27e-7q-U BUSINESS PHONE(24HRS)
BUSINESSPHONE
TOTAL NUMBER OF ROOMS:_„-_
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
L Inspectors use anly
Date on initial inspection: i�l i 3'l-t Date of minspection:
Date of issuance of certificate: Date fee paid:_ _
Type of unit: Dwelling_ Other Check#, ��Check dater
Notes: �kn ” c y � o V t�
-t t f—
r���I
Code ement Inspector
¢ CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET 4"'FLOOR Pab11CAe81th
Prcvem.Promote.Promo,.
TEL. (978) 741-1800 FAx(978) 745-0343
KIMBERLEY DRISCOLL liamdin e salem.com
LARRZ'1tAbfDlN,RS/REHS,CHO,CP f S -
MAYOR HEAL;fFiAGENP -
CERTIFICATE OF FITNESS
CERTIFICATE# 189-13
DATE ISSUED: 5/10/2013
Property Located at: 15 Dearborn Street UNIT#2
Owner/Agent: Elizabeth Andrade
Address: 15 Dearborn Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-740-1804
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 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
RY RAMDIN
HEALTH AGENT SANITARIAN
1
�J s
® CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET 4"'FLOOR PublicHealth
> Prevent.Promote.Protect.
TEL. (978) 741-1800 Fax(978)745-0343
KIMBERLEY DRISCOLL Iramdinna,salem.com
MAYOR Iramdi.n@salem.com
RAlv1DIN,RS/RF,HS,CI-IO,(:P-[-S
HRM Ti-I AGI?N'I'
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"
FLEE: p$50.00 4
PROPERTY LOCATED AT 16 �FDaYrY - ;Sc1yM �� UNIT#—Q--
IS THIS1 UNIT DISIGNATTED AS RIGHT LEFT FRONT OR BACC PLEASE CIRCLE ONE
OWNER/LESSER ;SII�a.b c�1R ISM C✓ MANAGER/AGENT
NO P.O.BOX
ADDRESSADDRESS
CITY, STATE,ZIP CITY, STATE,ZIP O19 7Q
RESIDENCE PHONE ?'3-740—/0'04 BUSINESS PHONE(24HRS) �)CIw C—
BUSINESS PHONE CCaI( Mc hlil o)
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2. 3. 5.
6. 7. 8. 10.
THERE IS A FIFTY($50)-DOLLAR PEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS FEE IS PAYABLE ATTHE IME OF INSPECTION
APPLICANT'S SIGNATURE DATE
/ / Inspectors use only
Date on initial inspection: ( I 0 3 Date of reinspection:
Date of issuance of certificate: Date fee paid:
Type of unit: Dwelling Other Check# Check date:
Notes: I Y 0 Y, .Yl
Codet4f&dement Inspector
411
g",
'
CM. OF S", EM=HEALTH OEP�IRTMEtTi
BOARD OF HEALTH
Salem,`,Massachusetts 01470
RoeERT F_8t EMCMAtt - 4 NORTH STREET
HEALTN"AGEM
508-741-18t10 ..
DATE:. / i /�
arG1-LCL jjLl" a `_m'.i ."
PROPERTY LOCATED,AT UNIT !_a,
DEAR"" 'SIRMADAHt
It"has tome 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 ali4an , occupancy in accordance with Chapter I11, Sections 127A and 127B,
of. tte:Xassachusetts General Laws, 105 CMR 400-000: State Sanitary Code, Chapter 1:
Genetal Administrative Procedures and 105 CMR 410.000: State Sanitary Code, Chap-
ter`;IL liiuimtud" Standards of Fitness for Human Habitation, and in accordance with
Chapter 1I, Article XZII of the City of Salem Code of Ordinances, Section 2-334 ,
Cextificate of Fitness.
There isa 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) 711- 1800
Monday thru Wednesday from Ea .m. - 4p.m. , Thursday 8a.m, - 7p.m. , or Friday 8a m. in
noon to schedule an appointment for an inspection.
SHE ENCLOSED SECTION 105 CHR 410.354 HETERING OF GAS h ELECTRICITY
Very ttruly."yours, .
FORTHEBOApRD, OF /HEALTH REPLY TO:
Robert E. Blenkhorn, C.H.O.
Health Agent Code Enforcement Inspector
City of Salem, Massachusetts
Board of Health
` 120 Washington Street, 4th Floor, Salem, PublicHealth
MA 01970 prevent:p omote. protect.
i 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-17-212
DATE ISSUED: 7117/2017
Property Located at: 19 DEARBORN STREET UNIT#1911
Owner/Agent: Gail M. Russell
Address: 19 Dearborn Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978}745-0484
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 It"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.
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITARIAN
C
CITY OF SALEM, MASSACHUSETTS
w.y c 1 BOARD OF HE,;ALTF1
120 WASHINGTON STREET,4' FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCO'LL FAX (978) 745-0343
1VIAYOR I..RAMDIN CI SALGn4COM
LARRY% \1DIN,RS/RE1IS,CHO,CP-FS
HF.AI:rH Ac F.NT
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 ATI wrbbr&cS� UNIT#_&2
II!SffTHI� IT DIS,,IGr NATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER VW I I�u-tt( MANAGER/AGENT
NO P.O.BOX j� ,, sr
ADDRESS )en re m� ADDRESS /, f
CITY, STATE, ZIP ^�pj,�( ��,( G, I CITY, STATE,ZIP V I Q
RESIDENCE PHONE LO ' 1`CS� `CO �f BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2. 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
Inspectors use only
Date on initial inspection: T hj r�- Date of reinspection:
Date of issuance of certificate: :11 ��I l� Date fee paid:
Type of unit: Dwelling Other Check#Check date: I ?F"
Notes:
Code Enforcement inspector
CITY OF SALEM, MASSACHUSETTS
a 2a BOARD OF HEALTH
120 WASHINGTON STREET,4"FLOOR
TEL. (978)741-1800
KIIVBERLEY DRISCOLL FAX(978) 745-0343
MAYOR LRABIDIN@SALENJ.COM
LARRS RAD4DIN,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 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 expresslyoutltorized 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.
2JI -- r
Tenam/Lessee Own/Lessor
Address Address
Address on unit to be inspected
Date
Updated 5/13/11
• CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4`FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAx(978) 745-0343
MAYOR DGRC•,rNBAUM9SALEWCOM
DAVID GRIi?ENBAum,RS
ACTING HEALTH AC ENT
CERTIFICATE OF FITNESS
CERTIFICATE#72-11
DATE ISSUED: 3/15/2011
Property Located at: 19 Dearborn Street UNIT#3
Owner/Agent: Gail Russell
Address: 19 Dearborn Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 744-3381
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 �A
DAVI GREET \M KS
ACTING HEALTH AGENT CODE ENFORCEMENT INSPECTOR
'� CITY OF SALEM, MASSACHUSETTS
�� BOAPD OF HEALTH
120 WASHINGTON STREET,4". FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOIJ- FAX(978) 745-0343
MAYOR D(7RG➢3NBAUN19-SAI,En1.COM
DAVID GREENBAUM,RS
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 .dear born Y UNIT#-3--
IS THIS
yUNIT IGNATED/AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESS , GI I l t 1c551E MANAGER/AGENT
t C74-
ADDRESS ( 1N
ADDRESS
CITY, STATE,ZIP E CITY, STATE,ZIP
RESIDENCE PHONE " / Q BUSINESS PHONE (24HRS)
BUSINESS PHONE
TOTAL NUMBER
,,OFII (ROOMS: y� / �p
ROOM USE: 1/-I VW C( 2. }fj/1/ 3 �I/ t Ala>4 �L -/A 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 F;JPAYABL E AT E TIME OF INSPECTION
APPLICANT'S SIGNATUREGEi / " DATE -1115--11
Inspectors use only
Date on initial inspection: Date of reinspection:
Date of issuance of certificate: Date fee paid: 'i j i
Type of unit: Dwelling ther Check# Sq-7 Check date: �'II�III
Notes: Imn rAn n0- IVC4-kf I�4 (W 46�\ hfn� V IBJ
Cod En orc went Inspector
.ruwf
�m CERT.# 431-00
n
s - FEE $25.00
DATE: 07/05/2000
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: 20 Dearborn Stret UNIT #: 1st floor
OWNER/AGENT: Russ & Grace Peirce
ADDRESS: 20 Dearborn Street 2nd floor
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-4017
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 CODE ENFORCEMENT INSPECTOR
�.00NUIT,{�_
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 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS
f�FOR
�HUMAN H ITATION". / J
PROPERTY LOCATED AT j-0 �`'' '^"" '7 UNIT#l5T lay-
IS THIS UA41TTS EtSIG ATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/(L�ESSER � MANAGER/AGENT
AD P.O. �� X1_6 No P.O. Box
ADP
DRESSs 3,� Yl ADDRESS al r
CITY ww CITY
RESIDENCE PHONE 1 q( q0 BUSINESS PHONE (24 HRS.)
BUSINESS PHONE /
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2.-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. I/�QQ�j`
APPLICANTS SIGNATURE 1 haw DATE
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION 7-�>'_o DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE?. - S-o DATE FEE PAID: -7- J ,p a
TYPE OF UNIT: DWELLINGeTHER,,,(' CHECK# CHECK DATE 7 3=t>
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEAL„TH
120 WASHINGTON STREET,4°1 FLOOR
K11bTBERI,EY BItISCOLI JIiL. (978) 741-1800
FAX (978)745-0343
MAYOR' . Iramdin salem.cam
LARRY RAMI?IN,RSJRi:a-IS,(a3(},C.P-I+S - - -
HiAV;17 i AG 6N7'
CERTIFICATE OF FITNESS
CERTIFICATE#42-12
DATE ISSUED: 113112012
Property Located at: 22 Dearborn Street UNIT#t
Owner/Agent: Anthony.P.Leitao:
Address: ,22 Dearborn Street
City/Town: Salem, MA.Zip Code: 0197024 Hour Phone: 5324641
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/oroccupied. '..'
Maximurrr Number of occupants, must comply with.145 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 9 there is a valid Certificate of Occupancy,
FOR THE BOARD OF HEALTH
RRY RAMDIN �e --
HEALTH AGENT COLEVENFORCEUET SPECTOR
CITY OF SALEM, NIASSACHUSEYFS
OUZD OF HEALTH
60
B
) 1'-)OW.\SFIING'ION ,)-tFj.E-F,4...Fi..om
TEL. (978) 741-1800
KINMERLEYDRISCOLL f,_\x (979) 745-0343
M, Ayolt L Ix AN as 1N
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-_"- 2k&,�Qd —UNIT#-
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE
OWNER/LESSER L/ 76W_MANAGER/AGENT___:7:�..
NO P.O.BOX
ADDRESS, --ADDRESS
CITY, STATE,ZIPS"nn CITY, STATE,
RESIDENCE PHONE_?Z* " - BUSINESS PHONE (24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1 3 2. 3. 4. 5,
6. 7. 8. 9. 10.
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 AT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE_Ae,�,_
Inspectors use only
Date on initial inspection: 0111'a Date of reinspection:—
Date of issuance of certificate: Date fee paid:
Type of unit: Dwellingi
0thcr—Qheck# Check date:
Notes:
Cien
inspector
�oment
CITY OF SALEM, MASSACHUSETTS
BOARD of HEALTH
120 WASHINGTON STREET,4...FLOOR
TEL. (978) 741-1800
KIMBERLLY DRISCOLI_ FAx(978) 745-0343
MAYOR Iramdin(@salem.com
LARRY RiANIDIN,RS/RHI-IS,C1 10,CP-FS
HRAI.XII AGIiN'I'
CERTIFICATE OF FITNESS
CERTIFICATE # 193-11
DATE ISSUED: 6/15/2011
Property Located at: 22 Dearborn Street UNIT#2
Owner/Agent: Anthony P. Leitao
Address: 18 Esquire Drive
City/Town: Peabody, MA Zip Code: 01960 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
A,
LARRY RAMDIN
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
• • CITY OF SALEM, MASSACHUSETTS IG 2 1
BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR
TEL. (978) 741-1800
KIM13ERLEY DRISCOLL FAX(978) 745-0343
MAYOR LRAMUIN@Q SAI..I:.NI.COM
LARRY RAN4DIN,RS/RIiI-IS,CFIO,(T-1'S
HEAL 1*11 AGI SN I'
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"
-h FEE: $50.00
PROPERTY LOCATED AT 7 YQA� (j e tl 5� UNIT#--,;2- _
PIIS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACKPLEASE CIRCLE ONE
OWNER/LESSER P L I *p D MANAGER/AGENT
NO P.O. BOX
ADDRESS 1,61 A' P I/ia ADDRESS
CITY, STATE, ZIP /�AR o by CITY, STATE, ZIP
RESIDENCE PHONE %7g - 53a- Y��/ BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER °O>>F ROOMS: 3
ROOM USE: 1. lel r4WA12. IPvo 3. �I✓/M
15AT& o/p5.
6. 7. 8. 9.
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 O INSPECTION
APPLICANT'S SIGNATURE p d DATE /
Inspectors use only
Date on initial inspection: b / Date of reinspection:
Date of issuance of certificate: Date fee paid:
Type of unit: Dwelling Other Check# Check date:
Notes:
Code Enforcement Inspector
.�OPmi
3 �
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(978)741-1800
02/14/2001 Fax: (978)740-9705
Louis Tarricone
25 Dearborn Street
Salem, MA 01970
PROPERTY LOCATED AT 25 Dearborn 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 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.
^ OR THE BOARD F�HEALTH REPLY TO� i
l/ Joanne Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
3
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: 02/11/98 Fax:(978)740-9705
Louis Tarricone
17 Thomas Road
Danvers, MA 01923
PROPERTY LOCATED AT 25 Dearborn 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.
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.
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
ry h
3
J'
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Date: 05/19/97 Fax:(508)740-9705
Louis, Jean, Mark, Elizabeth Tarricone
17 Thomas Road
Danvers, MA 01923
PROPERTY LOCATED AT 25 Dearborn 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.
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.
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
canne Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CERT.# 8-96
FEE $25.00
1�' I•F' _ _ DATE: 01/10/96
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: 25 Dearborn Street UNIT #: 1
OWNER/AGENT: Louis Tarricone
ADDRESS: 17 Thomas Road
CITY/TOWN: Danvers, MA ZIP CODE: 01923 24 HOUR PHONE: 774-2131 -
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, CHAP ER 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.
FO R THE BOARD OF HEALTH
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
I( Y
_4
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
APPLICATION FOR CERTIFICTE OF FITNESS Fax:(508)740-9705
IN ACCORDANCE WITH STATE SANITARY CODE, _CHAPTER II, 105 CMR 410.000 "MINIMUM
STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT '45 1 >eAdllJPti UNIT I �
OWNER/LESSER lVtliC 7;rn6vzf MANAGER/AGENT
ADDRESS 17 7 M ADDRESS
CITY PM AM CITY
RESIDENCE PHONE BUSINESS PHONE (24 HRS.)
BUSINESS PHONE 617 P? 37ip? _
TOTAL NUMBER OF ROOMS: 5 [}� �j )
ROOM USE: 1 .�jrh,�_2. D(h . ; 3. 4 . laCefil,4Vbj 7""
5. tf 4VtW , l ✓�7. 8.
THERE IS A TWENTY-FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE
CITY OF SALEM BU.ALTH DEPAR HT THIS FEE IS PAYABLE AT THE TIM OF INSPECTION
APPLICANTS SIGNATURE
^�DATE_��_
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION: '1 ( (j DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: 1 bDATE FEE PAID: ! f (� 6
TYPE OF UNIT: DWELLING OTHER
NOTES:
CODE ENFORCEMENT INSPECTOR
4 5
!P st
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT - Tei:(508)741-1800
Fax:(508)740-9705
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 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, I/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 agent;
from any loss or injury sustained of whatever nature and description occasioned
by my/our absence during said inspecti-on.
ba- lar r Yc
TENANT/LESSEE OWNER/LESSOR
ADDRESS ADDRESS
2-5 b-mv� ,,S
ADDRESS OF UNIT TO BE I 'SPECTED
a(,
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Date: 01/02/96 Fax:(508)740-9705
Louis, Jean, Mark, Elizabeth Tarricone
17 Thomas Road
Danvers, MA 01923
PROPERTY LOCATED AT 25 Dearborn 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.
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.
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
qv-o"41r�1'00�
Joanne Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
• CO
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
02/14/2001 Fax:(978)740-9705
Louis G. Tarricone
25 Dearborn Street
Salem, MA 01970
PROPERTY LOCATED AT 25 Dearborn 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.
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.
OR THE BOARD HEALTH REPLY TO
Joanne Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
A
3
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Date: 03/26/97
Fax:(508)740-9705
Louis, Jean, Mark, Elizabeth Tarricone
17 Thomas Road
Danvers, MA 01923
PROPERTY LOCATED AT 25 Dearborn 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.
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
1, HEALTH AGENT CODE ENFORCEMENT INSPECTOR
X
1
CERT.# 722-94
FEE $25.00
DATE: 08/25/94
1lP �
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970
JOANNE SCOTT,MPH,RS.CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Fax:(508)740-9705
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 25 Dearborn Street UNIT #: 2
OWNER/AGENT: Louis G. Tarricone
ADDRESS: 17 Thomas Road
CITY/TOWN: Danvers, MA ZIP CODE: 01923 24 HOUR PHONE: 774-2131
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 96 /
JOANNE SCOTT, MPH,RS,CHO ------------ -
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
v •� co.ugi 44 ..
e OFFICE USE ONLY
• 4 CERT. f ZZ-��,
DATE:
CITY OF SALEM HEALTH DEPARTMENT
BOARD OF HEALTH
Salem, Massachusetts 01970
9 NORTH STREET
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 25 Dearlao. S Meefi , 65d jW M+ojq jo UNIT # 2
OWNER/LESSER Lo UIS Cr. Tarri'r-me MANAGER/AGENT NoNE
ADDRESS 2SD-e"4�'df I7ThimoAd�IQOCW ADDRESS
CITY nwrts ,/rrl p1g2.3 CITY
RESIDENCE PHONE 2131 BUSINESS PHONE (24 HRS.)
BUSINESS PHONE 667- 956-21Rs
TOTAL NUMBER OF ROOMS: /
ROOM USE: 1 . BeAry0m 2. f-eJ rootM 3. "fVoWt 4. 'Ktiafv-v1 9, NoT uSEJ� owv�y sfnnru�e)
5. t1VlMe"M 6. b Ih1 Zvn'17• I.GG 8. 5�vWf— J
THERE IS A TWENTY—FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE
CITY OF SALEM HEALTH DEPAR=UPONMPLIANCE AND ISSUANCE OF CERTIFICATE.
APPLICANTS SIGNATURE — -�— DATE dS'
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION:,5�'-g-f Y DATE ,OF REINSPECTION p
DATE OF ISSUANCE OF CERTIFICATE: S �C DATE FEE PAID:
TYPE OF UNIT: DWELLING OTHER
NOTES:
CODE ENFORCEMENT INSPECTOR
'^J
f f�
a %
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970
JOANNE SCOTT,MPH,RS.CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Date: July 28, 1994 Fax:(508)740-9705
Louis G!/Jean M. Tarricone
Mark/Elizabeth Tarricone
25 Dearborn Street
Salem, MA 01970
PROPERTY LOCATED AT 25 Dearborn Street UNIT# 2
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 III, Sections 127A and 1276, 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,
Chapter II: Minimum Standards of Fitness for Human Habitation, and in accordance with Chapter 11, 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.
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:
- .thMPH,RS,CHO PABLO VALDEZ
V EALTH AGENT CODE ENFORCEMENT INSPECTOR
�A,coxnrr
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT 11/20/2000 Tel:(978) 741-1800
Fax:(978)740-9705
Sean & Jeanine Cunniff
28 Dearborn Street
Salem, MA 01970
PROPERTY LOCATED AT 28 Dearborn 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 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.
FOR THE BOARD
OA.F-�HEALTH 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 Tel:(978)741-1800
Date: 10/15/97 Fax:(978)740-9705
Michael Larcom
28 Dearborn Street
Salem, MA 01970
PROPERTY LOCATED AT 28 Dearborn 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.
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.
Eachdwelling 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.
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.
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
a
C(TY OF SALEM, MASSACHUSETTS
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
03/18/2002
David Currier
22A Saugus Avenue
Saugus, MA 01906
PROPERTY LOCATED AT 28 Dearborn 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.
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.
i 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
j owners for their tenants' entire utility bills retroactive to the date of initial
Il occupancy in cases in which cross-metering has been proven to exist.
4OR THE BOARDR�H REPLY TO
anne Sco MPH,RS,CHO PABLO VALDEZ
Health Agent CODE ENFORCEMENT INSPECTOR
Coo
.. i 3
a CITY OF SALEM HEALTH DEPARTMENT
BOARD OF HEALTH .
Salem, Massachusetts 01970
ROBERT E.BLENKHORN 9 NORTH STREET
HEALTH AGENT
508-741-18M -
DATE: June 3, 1992'
i
Jean L. Woods
31 Dearborn Street
Salem, MA 01970
PROPERTY'LOCATED AT 31 Dearborn S UNIT 9 1
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 allowingoccupancy in accordance with Chapter III , 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 resulE 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 CHR 410.354 METERING OF GAS & ELECTRICITY
Very rruly'yours
`,
FOR THE BOARD OF HEALTH REPLY TO:
Robert E. Blenkhorn, C.H.O. Pablo VAldez
Health Agent Code Enforcement Inspector
:.L J
'.. .,;,,,..::-,F _ .:a-Ya.� �;��n ,•a't�t",��."...y � ,� i� .+.; a+�! c:i:.7 r ,i'' `r -.
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� �.:��, 8 1 t �:i ,i� d^y3�•'"�'�y'`y3<>;'=�rr" +r����,64•`4 tt4 3�,?'y.E.•�`•Tyt er
3�y mss ly 7 .(f4 ....
".AIN •,yr r t '�.�:� v �,
OfSALEM,HEALTH DEPARTA4ENT
a c y �x � HOARQ Of HEALTH
. .. :,. Salam,, AAsssaduaetts 01970:
y_ ROBERT E $LENICNORN, - 9 NORTH STREET
• 1�fA1:n+;�c�EMr
r L %
AT 5
UM ,�
_-
4 40
3v
It c atlentua, that you,are;about tom al`lov rental of``a"dwelling unit.
R 4 A 1
'=a � dress. '� �� � �'a• - _
It 3s incumbent upon qou 7as. owaer(s) to contact the City of Salem Health Department
64 ply, of Fitness before any vacant dwelling- unit is rented or
.- .00Caplad Yk a i_iY `- .
Eac4�-dv`elliag'.unit mast be inspected and certified by the Salem Health Department
"_pric to;a5.l,,ow.ing `occupaacq.;in'` and 12accordance with Chapter 111, Sections 127A 7B, -
of, the"Massachusetta.Geaeral..Laws,_ 105 CMR 400.000: State Sanitary Code; Chapter I:
GeneralIldmiuistrative Procedures and 105 CMR 410.000: State Sanitary Code, Chap-
tes II Minimum-Standards of Fitness for Human Habitation, and in accordance with
Chdp111-ter Il ; Article kill of the City of Salem Code of Ordinances, Section 2-334,
Certifiiis a of Fitness. '
There is`a`tventq-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 EHCIASED SECTION 105 Clot 410.354 MHTB M OF GAS & ELECTRICITr
VeW 14Qilf yoliY f
FOR THS BOARD OF HEALTH ; REPLY TO:
Robert E. Blenkhorn, C.H.O.
Health Agent'.: Code Enforcement Inspector