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FEDERAL COURT City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, MA 01970 Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH,RENS,CHo Mayor health@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE* GHL-16-237 DATE ISSUED: 71812016 Property Located at: 3112 FEDERAL COURT UNIT#1 Owner/Agent: Eric A Olson, Marie D. Olson Address: 3 Federal Ct. City/Town: Salem , MA Zip Code: 01970 24 Hour Phone:(978) 741-3025 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 S th11jvlh0, SANITARIAN HEALTH AGENT i n ih RESIDENTUL BROKERAGE MLS (978)741-4404 OFFICE Q (617)365-6316 CELL ,..,,,.. [I Janim.Ko topmlos@NEMmv ..m a 1' 1 ! NO 135-1 DATE 60I I Lo I tv RECEIVED FROM � �yi I rp VoC,in, 0( U 0s and °i0/ioo DOLLARS SOo0 Accctint Total $ _ Amount Paid $ Balance Due Signature DocuSign Envelope ID:D5613A803-978E-41 BO-BOAE-2761 BEF656FO r y t CITY OF SALEM, MASSACHUSETTS BOARD of H t.Atxi I 120 WASHINGTON$'IRE'I i' 4..n.OoR Tia.. {97$)741-1$(X) lil�[B1 R1}dl'DRlSCOLI, FAX (97$)745-0343 MAYOR z \1D1N �IaaH.eclll I.ARR}'RA4IDIN,RS/RCI IS,C:110,CP-IPS 1�1{;\1;1'11 .fit 11:N1' Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.00(1 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABrrATION" FEE: $50.00 /) PROPERTY LOCATED ATJ { �• UNrr#_ [ _ _ IS TILS UNIT DISIGNATED AS GHT FRONT O AC PLEASE CIRCLE ONE I OWNERILESSER n'r t.Sdt7 MANAGER/ GENT �41,11f. NO P.O.BOX , 9 ADDRESS Trlf J ADDRESS CITY,STATE,Zip­�� �d ri?. 1� t�/� 11 crrY, STATE,zu> ? �4 t RESIDENCEPHONE �� ` `7 �// 342 S BUSNESS PHONE(24HRS) /7- 36 C' 69 34 BUSINESS PHONE l {�,t)►� G( r�vrt(c 1 { Q r J'( Q, ()ISO P t) TOTAL NUMBER OF ROOMS: 7` co l;?t 4"f'd n ROOM USE: 1 Pf lr✓Ir 2 I A 12P/) 3.&V6470#1 4. 5. § 7 $ 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 �fki�C ..... euftn by: APPLICANT"S SIGNATURE DATE 6/13/zo16ECUOEFFBM51... Inseectors use only Date on 'initial inspection:_�I +�t ` � Date of reinspection: Date of issuance of certificate: Date fee paid: i Type of unit: Dwelling___Other Check#J J5_kCheck date: 1 t 3 t 0 Notes: ~,Q -h'na i)1i opoi3gr4cak oogi(_equ-79y23 - Pct. C e Enforcement Insp or DocuSign Envelope ID: D56BA803-97BE-41 BO-BOAE-27618EF656F0 e CITY OF SALEM, MASSACHUSETTS BOARD 01:H FSAI NI I 120\X'ASl lJNG]0N STRIiIz T,4"l 1'1.00R TT:L. (978) 741-1800 KIN111FRI-HY DRISC)1.1, FAX (978) 745-0343 KW )R lKNN11)INa)S.1I,p,D1.CUM LARRY RA\IDIN,RS/Rlil IS,Cl 10,CV-PS Ii4 AII'11:\GI V'r Release In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ; State Sanitary Code Chapter lI and Article XIII of the City of Salem Ordinance, undersigned owner/lessor and tenant/lessee of a unit of residential property, hereby authorize the Salem Board of Health or its authorized agents to inspect the residence identified below in accordance with the aforementioned statutes,regulations and ordinances. In the event it is necessary that said inspection be done in my/out absence. Uwe expressly authorized the same and for my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of Health and its authorized agents from any lose or injury sustained of whatever nature and description occasioned by my/out absence during said inspection. DocuS;9ned by: —Do Signed by: —18 111F1 B... 13 EFF l... ri % r �, ri_ C/son enant/Lessee Owner/Lessor 3Fol ra l C't� 3 l�q rad Cf• Sq1 /rel f o /t Address Address C�nl'f j Address on unit to be inspected 6/13/2016 Date Updated 5/23/11 �! t� F C..(� C� Date lQ�(Pk Time r r!r'— Inspectirvn of !, ``�� ,, t�y- Name ja FC-42 V bSiv�OLP ICES C,ieU-f "'J Address �} 22 Owner Cr I c 1.1 � O O n Tet. No. `7 7 Type of Inspection *e-3� i Zvi Cg / �.,inspector(Sko ri'..kif e ( ' l Remarks and Violations are listed below: 1�5 �X� LS! (00.0 &,rtd l e5 0 Ile toy Crn � `/�o moo . u31 ©IaS Get ?112 tY7C - a r-- �— 6�S& �-ej C��rr�.c��._.- � < 0 S cmYZ tI�D_ 5,5--t CA fob camQ y�o. �� rpt ► y60 . 5-a / - r�cJ _C^n n ill o; $' _``auT 'ti1Eej .,e;�n daor ��ia�- omens !\O/r n 160an i OCWPI'ed L!atl— �lok v`n 4e in 66) N a CQrru f rl �! t �h ra�r! �ah 7' toy �uvirz /o. �sI hip �s a�d Com' 1 i n Iia h v�can� ch ialZ o�� ats n� Pc�sP1 q srnora�� c�nd ChP& n4b��' i r 10,5" Cf»rz y i to . SgD Se " Cbrre(,�Cd -441I to 8 ) Qk+ )�ebed M&P i (Qu . (0)0Se, ve- j orhe(AeA `7lip/) 0 14bl es in t, jatl iv, cabtr en-L en-Lbelvto /G` , k 161c � 10 A/0 0 [ ( S�jm a14'!e defeCfar t st �oo� � r✓ fir )100/F 7 ReportRaceiv �f � �t � 7���/ 7rYt'G�nl r�r v v Fn3m �cr 1 W al?l(y e, CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET 4t"FLOOR PtiblicHC81t11 STREET, Prevent.Promote.Protect. TEL. (978) 741-1800 FAx(978) 745-0343 HIMBERLEY DRISCOLL h-amdin@sadem.com LARRY RAMllIN,RS/KERS,CHp,CP-FS MAYOR HEALTH A(.iEN"I' CERTIFICATE OF FITNESS CERTIFICATE#44-13 DATE ISSUED: 1/31/2013 Property Located at: 3 1/2 Federal Court UNIT#3 Owner/Agent: Marie Olson Address: 3 Federal Court City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 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. F(�{t THE BOARD F HE TH LARRY RAMDIN HEALTH AGENT SANITARIAN e CITY OF SALEM MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4'"FLOOR PublicHealth rre cm.rrammc.rromm. TFu— (978) 741-1800 FAX(978) 745-0343 `.,KIMBERLEYDRISCOLL Iramdin@salem.com LI MAYOR ViRY RADIl>IN,RS/KERS,CRO,C]'—I'S HEAT;I'If 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 50.00PROPERTY LOCATED AT �lLf°f7� Ci UNIT# 3 IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONTO ACK PLEASE CIRCLE ONE SSER���2/�. , OIti MANAGER/AGENT / ADDRESS &T ADDRESS -- CITY, STATE,ZIP S /s�r /P/J� U/970CITY, STATE,ZIP RESIDENCE PHONES7�7W30Z BUSINESS PHONE(24HRS) —_ BUSINESS PHONE TOTAL NUMBER OF ROOMS: /'//II�G ROOM USE: 1.Kl76#fk 2 b'WIV6" 3. &— M4. 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 TIMES OF INSPECTION APPLICANT'S SIGNATURE �—r Inspectors use only Date on initial inspection: 1-31, ) 3 Date of reinspection: Date of issuance of certificate: 1 31 1 Date fee paid: Type of unit: Dwelling ✓ Other Check# b Check date: Notes: ode Enforcement Inspector t q CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4`"FLOORPabliCHealth erc.mr.rmmm .r.mc �. TEL. (978) 741-1800 Fax(978) 745-0343 KIMBERLEY DRISCOLL Itaindin@salem.com MAYOR LARRY RANUNN,RS/R1;1IS,CHO,CP-FS HI;:AI:I'If AGUNT 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. ; T t/Lessee Owner/Lessor Address ilr �/fYtfs� Address �/��r.'O� i � s A40 S Address op unit to be inspected 3 Date Updated 523/11