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GLOVER STREET CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH m 120 WASHINGTON STREET, 4TH FLOOR .>�r SALEM, MA 01 970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. UISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#221-05 DATE ISSUED: 4/1/05 Property Located at: 7 Glover Street UNIT#3 Owner/Agent: Louise G. Lausier Address: 7 Glover Street Apt. 1 City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 744-2623 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 JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR �p, _....-. ... p,,,w. � • ^'w;'�. .+.: w wau:e „'O, � em .,s. �..aaA...y„w ,.,._ -,�>., ti Cn-OF SALEM, MASSACHUSETTS BOARD OF HEALTH • 120 WASH I NGTON'STREET, 4TH FLOOR i SALEM, MA 01970 I'A TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT I APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER It, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION li PROPERTY LOCATED AT o S'T° UNIT # IS THIS UNIT DESIGNATED AS RIGHT^LEFT FRONT BACK PLEASE CIRCLE ONE OWNERILESSER.�6rutia2 Ude¢ n MANAGER/AGENT-JA /I E_`_ No P.O. Box No P.O. Box ADDRESS - 7 GLdr/GR ST /e�LADDRESS_ 6 Xo i/eR ST, CITY stg hE/1{ 0 —CITY--- RESIDENCE ITY _RESIDENCE PHONE.- j3 BUSINESS PHONE {24 HRS.)___ BUSINESS PHONE _ TOTAL NUMBER OF ROOMS: ROOM USE: 1. . cc"S.�rn�o�a_4. 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. O APPLICANTS SIGNATURE _ 606 f9J�a r La,t _DATE ©3 J INSPECI ORS USE ONLY DATE OF INITIAL INSPECTION v'SDATE OF REINSPECTION__ DATE OF ISSUANCE OF CERIIFICATE._3_ ° DATE FEE PAID_ _;_ TYPE OF UNIT: DWEI_LING� OTHER.__ CHECK N-1_� I,�o _ CHECK QATE 'j - -5 NOTES_ /f(\ CODE ENFORCEMENT INSPECTOR 9/28/98 o CITY OF SALEM, MASSACHUSETTS BOARD OFHEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT May 8, 2003 Prospect Point Property 9 Glover Street Salem, MA 01970 PROPERTY LOCATED AT 9 Glover Street Unit# 1 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 1: General Administrative Procedures and 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. —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($20.00) 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 tenants' entire utility bills retroactive to the date of initial occupancy in cases in which cross-metering has been proven to exist. For the Board of Heth Reply to Joanne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector I •• �v���ONDIT �� e� 9a S Aec,MINB CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT 07/06/2000 Tel:(978)741-1800 Fax:(978)740-9705 Philip & Melanie Buckley 9 Glover Street Salem, MA 01970 PROPERTY LOCATED AT 9 Glover 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. /E1OR THE BOARD OF HEALTH REPLY TO Joanne Scott, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR :v « CERT.# 254-95 FEE $25.00 1� IP DATE: 04/27/95 CIN 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: 9 Glover Street UNIT #: 1 OWNER/AGENT: Georaiana Boucher - ✓/0�,� ADDRESS: 9 Glover 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 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 ,J JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR Y 7 !� as CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(506)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 G?4 a 11 x' `/ y��7-, UNIT f / OWNER/LESSER ��7�GF%hN/1 �o a C-I--1p MANAGER/AGENT ' ADDRESS ol1,5�T S I ADDRESS CITY CITY RESIDENCE PHONE BUSINESS PHONE (24 HRS.) - BUSINESS PHONE TOTAL NUMBER OF ROOMS:- y ROOM USE: 1. 2. 3. 4. 5. 6. 7. 8. THERE IS A. TWENTY— C LLAR FEE, PAYABLE BY CHECK OR MONEY-ORDER TO THE CITY OF SALEH HEAL THIS SSS IS PAYABLE AT THE TI2ffi OF INSPECTION `d-L �7 Q� APPLICANTS SIGNATURE �c w e� R ttia testi' DATE /� / INSPECTORS USE ONLY DATE OF INITIAL INSPECTION: Li 7 �DATE OF REINSPECTION �y DATE OF ISSUANCE OF CERTIFICATE:—v —`7-�DATE FEE PAID: TYPE OF UNIT- DWELLING OTHER NOTES: CODE ENFORCEMENT INSPECTOR MEA CODE p � ��� F, ii i 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: 09/08/97 Fax:(508)740-9705 Georgiana Boucher 9 Glover Street Salem, MA 01970 PROPERTY LOCATED AT 9 Glover 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- L ELECTRICITY. Very truly yours, FOR THE BOARD OF HEALTH REPLY TO Joanne Scott, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR k CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • ^ 120 WASHINGTON STREET, 4TH FLOOR 9 SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. .JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT May 1, 2003 Richard Thibodeau 10 Glover Street Salem, MA 01970 PROPERTY LOCATED AT 10 Glover Street Unit#2 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 1: General Administrative Procedures and 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. —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 ($20.00) 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 tenants' entire utility bills retroactive to the date of initial occupancy in cases in which cross-metering has been proven to exist. For the Board of Health Reply to Joanne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector � CONWT CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970- JOANNE SCOTT, MPH, RS,CHO 02/21/2002 120 Washington Street—0 Floor HEALTH AGENT Tel # (978)-741-1800 Fax # (978)-745-0343 Richard Thibodeau 10 Glover Street Salem, MA 01970 PROPERTY LOCATED AT 10 Glover 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 CITY OF SALEM9 MASSACHUSETTS BOARD OF HEALTH s a 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE# 183-05 DATE ISSUED: 3/14/05 Property Located at: 11 Glover Street UNIT#2 Owner/Agent: Linda Boudreau Address: 11 Glover Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 744-2686 An our inspection of p y 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 Alr JO NE SCO , MPA,-tto i G��" - ` f�h4`�`'�f�` � HE LTH AGENT CODE ENFORCEMENT INSPEC R CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 ^ TEL. 978-741-1800 _ FAx 978-745-0343 STANLEY LISOVICZ, JR. ,JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS bFOR HUMANHABITATION". PROPERTY QQ PROPERTY LOCATED AT I / /oJ = _ /dam-J ' UNIT#jR IS THIS UNIT DESIPAsIATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER ANAGER/AGENT No P.O. Box No P.O. Box ADDRESS 9� / ADDRESS CITY CITY c RESIDENCE PHONE �7g' 7� 'a6tBUSINESS PHONE (MOMS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1JA� 5. 6. 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 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 3 /o -v :f-- DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:?-/IP - =DATE FEE PAID: o -o TYPE OF UNIT: DWELLING -c(STHER CHECK# 3 0 CHECK DATE 3 / - ° 5- NOTES CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH s 9 " 120 WASHINGTON STREET, 4TH FLOOR t SALEM, MA 01970 9qQ, TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 3/1/05 Linda Boudreau 11 Glover Street# 1 Salem, MA 01970 PROPERTY LOCATED AT 11 Glover 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 410.000; State Sanitary Code, Chapter 11: Minimum Standards of Fitness for Human Habitation. Please notify us if you do not intend to rent the unit. Please contact this department within 24 hours of receipt of this notice at 978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday thru Wednesday from 8:00 a.m. —4:00 p.m. Thursday 8:00 a.m. to 7:00 p.m. and Friday 8:00 a.m.— 12:00 p.m. Failure to comply with this procedure, may result in a fine of Twenty($20.00)dollars per day for every day that the dwelling unit is occupied without a Certificate of fitness. A$25.00 check payable to the City of Salem is required for each unit inspected at the time of inspection. A property owner is required to pay gas and electricity for residential tenants if there is not a written letting agreement stating the tenant is responsible for those utilities and if the meter(s) records electricity and gas use which is not used exclusively by that tenant. The Department of Public Utilities has billed property owners for their tenant's entire utility bills retroactive to the date of initial occupancy in cases in which cross-metering has been proven to exist. ,..For the Heal h Reply to Joanne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector CITY OF SALEM9 MASSACHUSETTS 1 BOARD OF HEALTH ". 120 WASHINGTON STREET, 4TH FLOOR p SALEM, MA 01 970 .) TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE# 182-05 DATE ISSUED: 3/14/05 Property Located at: 11 Glover Street UNIT#3 Owner/Agent: Linda Boudreau Address: 11 Glover Street# 1 City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 744-2686 An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II" Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH J NNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR x:< v CITY OF SALEM, MASSACHUSETTS 1 BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR VV O SALEM, MA 01970 ` TEL. 978-741-1800 _ FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY PROPERTY LOCATED AT I �.1� 6L /+�- UNIT#,3 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER L6CA NAGER/AGENT No P.O. Box No P.O. Box ADDRESS ADDRESS CITY pCITY RESIDENCE PHONE / 7$-7 qµ -aaZBUSINESS PHONE (24 HRS.) BUSINESS PHONE 7&- TOTAL NUMBER OF ROOMS: p ROOM USE: 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 ATE /O INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 3- /0 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:3-/ ,9 -v DATE FEE PAID: 3 / 0 -'off TYPE OF UNIT: DWELLINGOTHER CHECK # -,S3 ! 0 CHECK DATE NOTES: v CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS ' '�• BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 _ - FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT RELEASE In accordance with Massachusetts General Laws Chapter 111 ; Code of Massachusetts Regulations 4. 1,0,000 et. seq. ; State Sanitary Code Cha.pte. TI and Article KIII 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. Ln the event it is necessary shat said inspection be done in my/our absence, 1/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 agents from any loss or injury sustained of whatever nature and description occasioned by my/our absence during said inspection. Tst`IANT/Loss .. OWN R/i FSSOR I ADI?Rti S 'OF UNIT IPiSPECTED wd yjpwi TO DATE I' TIME AM M w 9-211-n Pi FRO I� AREA CODE H. -//��0 v d�'12nC2�— NO. 0 OF EXT. t;N SES. M _ .. FAX# M' s G E A m 0`. SIGNED :_9& PNDNEDBACK ❑ CREIURNED E] WANiSDTO ❑ WAS IN ❑ MLL ALL URGENT El r �mr,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 Date: 09/22/97 Fax:(978)740-9705 Laurent & Claire Normand 12 Glover Street Salem, MA 01970 _ PROPERTY LOCATED AT 12 Glover 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 CERT.# 661-96. FEE $25.00 DATE: 09/24/96 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: 14 Glover Street UNIT #: 1 OWNER/AGENT: Brian Brinkers ADDRESS: 14 Glover Street #3 CITY/TOWN: Salem. MA ZIP CODE: 01970 24 HOUR PHONE: 744-9800 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 a ; PITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,AS,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 HUMAA,N, HABITATION". PROPERTY LOCATED AT CA OWNER/LESSER Ij� 2 MANAGER/AGENT ADDRESS [qq� ,p[/� �Jr" / ADDRESS CITY4 CITY RESIDENCE PHONE �� BUSINESS PHONE (24 HRS.) BUSINESS PHONE Noo -.— TOTAL NUMBER OF ROOMS: ROOM USE: 1, _2. p �� _3. _4 .�1 6. 5. i i THERE IS A TWENTY-FIVE ( ) E, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HMALTH� NT THI IS PAYABLE AT THE TIME OF INSPECTIOJN APPLICANTS SIGNATURE DATE ✓j 4 �� INSPECTORS USE ONLY DATE OF INITIAL INSPECTION: 'C1 ( JL DATE OF REINSPECTION DATE OF ISSUANCE OF CERT,fI/FICATE: ��'�' �[ 0 DATE FEE PAID: TYPE OF UNIT: DWELLING k OTHER NOTES: 7� CODE ENFORCEMENT INSPECTOR �+ �wMr.�"rr..„+r inueTM4".'^,.wri-•w� �,;5`"^ 5" e-k`+^^'••' a..«w "hV^' w ^. + Y. CERT.# 32-97_ •� �. i' ' �,,, - t i may.« 5 `} ' ,�+ q +'--, vw ,� F.EE 525 00 DATE: 01/23/97 CITY OFSALEMBOARDOkIEALTH" ,; y r . t leµ ` ` fSalem, Massachusetts 01 970-3926a JOANNE SCOTT,MPH;RS,CHO:'- - - - - NINE NORTH STREET HEALTH AGENT Tel:(508)741-1800 Fac:(508)740-9705, CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 14 Glover Street ` UNIT #: 2 OWNER/AGENT: Brian. Bri.nkers ADDRESS: 14 Glover Street #3 a ''{CITY%TOWNe�t Salem: MA ' ZIP-CODE: 01970`' 24 HOURS-PHONE: 744-9800 " AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS . :BEEN APPROVED:A4D 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 FGR 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 C'OLL ENFORCEMENT INSPECTOR M'Y i i y 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 IPI ACCORDANCE WITH STATE SANITARY CODE, .CHAPTER II , 105 Ctc 410.000 "MINIMUM STANDARD OF FITNESS FOR HUMAN HABITATION"- PROPERTY LOCATED AT ! G UNIT OWNER/LESSER y� MANAGER/AGENT ADDRESS �wlar� h(�/ ADDRESS CITY p� O(T7 CITY RESIDENCE PHONE- j/ OL"/D BUSINESS PHONE. (24 HRS.) 1 BUSINESS PHONE t V 7go TOTAL NUMBER OF ROOMS:__ ROOM USE: 1. 2.-3.-4 . 5. 6. 7. 8. I THERE IS A TWENTY-FIVE (25.0 ) DOL PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM' HEALTH DE NT IS Pt IS PAYABLE AT THE TIME OF INSPECTION APPLICANTS SIGNATURE DAA INSPECTORS USE ONLY DATE OF INITIAL INSPECTION: 1 7 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: 1—d3 DATE FEE PAID: r✓� � TYPE OF UNIT: DWELLING OTHER NOTES: AlI CODE ENFORCEMENT INSPECTOR 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: 01/13/97 Fax:(508)740-9705 Brian Brinkers 14 Glover Street Salem, MA 01970 PROPERTY LOCATED AT 14 Glover 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, cf 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. SEF ENCLOSED SECTION 105 CMR 410.354 METERING OF GAS & ELECTRICITY Very truly yours, FOR THE BOARD OF HEALTH REPLY TO I Joanne Scott, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR •'� CERT.A 604-93 FEE: ..$ 25.00 -- . _ yL �`ol.,p0+s DATE' 8/11/93 CITY OF SALEM HEALTH DEPARTMENT BOARD OF HEALTH Salem, Massachusetts 01970 ROBERT E. BLENKHORN 9 NORTH STREET HEALTH AGENT 508-741-1800 . CERTIFICATE OF FITNESS PROPERTY LOCATED AT 14 Glover Street UNIT # 2 OWNER/AGENT Emile Moreau ADDRESS 26 Dow Street CITY/TOWN Salem, MA ZIP CODE 01970 24 HOUR PHONE 744-9090 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 ROBERT E. BLENKHORN, C.H.O. ril HEALTH AGENT CODE ENFORCEMENT INSPECTO N COtU t� OFFICE USE ONLY @ CERT.-I DATE: CITY OF SALEM HEALTH DEPARTMENT BOARD OF. HEALTH Salem, Massachusetts 01970 -ROBERT-E.aL-ENKHORN - - 9 NORTH STREET HEALTH AGENT 508-741-1800 APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, ;CHAPTER II , 105 CMR 4 10.000 "MINIMUM STANDARDS OF FITNESS FaaOR HUMAN HABITATION".G PROPERTY LOCATED AT 121 UNIT / OWNER/LESSER MANAGER/AGENT ADDRESS 07, S ADDRESS CITY �7 CITY RESIDENCE PHONE � (� (/ BUSINESS PHONE (24 HRS.) BUSINESS PHONE — TOTAL NUMBER OF ROOMS: ROOM USE: I . 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 DEP UPON COMPLIANCE AND ISSUANCE OF CERTIFICATE. 0 APPLICANTS SIGNATURE. DATE DATE INSPECTORS USE ONLY DATE OF. INITIAL INSPECTION: DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: . JI DATE FEE PAID: TYPE OF UNIT: DWELLING OTHER NOTES: CODE ENFORCEMENT INSPECTOR CO.W{�l 3 f CITY OF SALEM HEALTH DEPARTMENT BOARD OF HEALTH Salem, Massachusetts 01970 ROBERT E. BLENKHORN 9 NORTH STREET HEALTH AGENT 508-741-1800 DATE: August 3, 1993 Emile & Cecile Moreau 26 Dow Street Salem MA 01970 PROPERTY LOCATED AT 14 Glover Street UNIT R 2 . DEAR SIRIMADAM: 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 127B, of. the Massachusetts General Laws, 105 CMR 400.000: State Sanitary Code, Chapter I: General Administrative Procedures and 105 CMR 410.000: State Sanitary Code, Chap- ter II: Minimum Standards of Fitness for Human Habitation, and in accordance with Chapter II, Article XIII of the City of Salem Code of Ordinances, Section 2-334, Certificate of Fitness. There is a twenty-five (25) dollar fee payable by check, or money order to the City of Salem Health Department upon issuance of Certificate. Failure to comply with this procedure , will result. in a fine of twenty (20) dollars per day for every day that the dwelling unit is occupied without approval of the Code Enforcement Division of the Salem Health Department. Contact this department 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 CMR 410.354 METERING OF GAS & ELECTRICITY Very truly yours, FOR THE BOARD OF HEALTH REPLY TO: '��'tE Robert E. Blenkhorn, C.H.O. PABLO VALDEZ Health Agent Code Enforcement Inspector CITY OF SALEM, MASSACHUSETTS .ell, BOARD OF HEALTH 9ft 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 . -" TEL. 978-741-1800 ' FAx 978-745-0343 KIMBERLEY DRISCOLL JSCOTT@SALEM.COM MAYOR JOANNE SCOTT HEALTH AGENT 3/18/08 Brian Brinkers 14 Glover Street Salem, MA 01970 PROPERTY LOCATED AT 14 Glover 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 410.000; State Sanitary Code, Chapter 11: Minimum Standards of Fitness for Human Habitation. Please notify us if you do not intend to rent the unit. Please contact this department Within 24 hours of receipt of this notice at 978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday thru Wednesday from 8:00 a.m. —4:00 p.m. Thursday 8:00 a.m. to 7:00 p.m. and Friday 8:00 a.m.—12:00 p.m. Failure to comply with this procedure, may result in a fine of Twenty($20.00)dollars per day for every day that the dwelling unit is occupied Without a Certificate of fitness. A$25.00 check payable to the City of Salem is required for each unit inspected at the time of inspection. A property owner is required to pay gas and electricity for residential tenants if there is not a written letting agreement stating the tenant is responsible for those utilities and if the meter(s) records electricity and gas use which is not used exclusively by that tenant. The Department of Public Utilities has billed property owners for their tenant's entire utility bills retroactive to the date of initial occupancy in cases in which cross-metering has been proven to exist. For the Board of H Ike th Reply to �oann MPH, RSS,CCH—O- Pablo Valdez 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 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE# 184-05 DATE ISSUED: 3/14/05 Property Located at: 16 Glover Street UNIT# 1 Owner/Agent: Mary Ginkus c/o finda Boudreau Address: 11 Glover Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-825-6225 An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II" Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH J�l SCOTT, MPH, RS, CHO d HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH / • • 120 WASHINGTON01 , 4TH FLOOR 1 � SALEM, MAA 019970 TEL. 978-741-1800 _ FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS QFOR HUMAN HABITATION". PROPERTY LOCATED AT �`+ " �/v UNIT# IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ON OWNERILESSER r` a- tura MANAGER/AGENT No P.O. Bo / No P.O. Box �(� p , ADDRESS )bL Znsu / ADDRESS // lJK l" �4 CITY Tco_�� CITY RESIDENCE PHONE 1 78"711`4 _"8�BUSINESS PHONE BUSINESS PHONE TOTAL NUMBER OF ROOMS: 5 ROOM USE: 1, t 2. 3. 4. 4-t" 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 CJS K. �^ L- DATE 0/10L - INSPECTORS USE ONLY DATE OF INITIAL INSPECTION —/o - i� DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:3,/,D DATE FEE PAID:_3 TYPE OF UNIT: DWELLING OTHER_ CHECK# 7 3 U CHECK DATE NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH ,/ • • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT RELEASE In accordance with Massachusetts General Laws Chapter III ; Code of Massachusetts Rf!gulations 410.000 et. seq. , State Sanitary Code Chapter II and Article %III 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, 1/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 a.pcat5 from any loss or injury sustained of vInatever nature and description occasioned by my/our absence duriDsaid inspection. TENANTILESSEE OWffEq11.ESSOP. ADDRESS a_ - P.D?1RESS OF IT DO iff�eSPEeTED 3l I o �OS ` CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 qqp TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#274-04 DATE ISSUED: 06/28/2004 Property Located at: 16 Glover Street UNIT#2 Owner/Agent: Mary Ginkus Address: 16 Glover Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-744-2686 An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code,Chapter If'Minimum Standards of Fitness for Human Habitation". Therefore,this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates,whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. VOBOARD O H JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT "E ENFORCEMENT I CTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • • 1 120 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 APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNE}S-S{ QFOR HUMAN HABITATION". PROPERTY LOCATED AT J _ UNIT# a IS THIS UNIT DESIGNATED ASRIGHT LEFT FRONT BACK PLEAS CIRCLE NE pp OWNER/LESSER "'`-I°" MANAGER/AGENT _ No P . Box No P.O.Box ADDRESS �GJ� _,—Lw: ADDR,ESSSJ t'L� ..— CITY CITY Yom' RESIDENCE PHONE? �'��`� BUSINESS PHONE {24 HRS.} BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1 1 taj �2.j-kk 3. -�"�"1�'" 4.-" 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. cJJL APPLICANTS SIGNATURE ' DATE L. ?a �a / INSPECTORS USE ONLY PATE OF INITIAL INSPECTION [� , DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: DATE f-DATE FEE PAID: TYPE OF UNIT: DWELLING_OTHERT CHECK#_j _CHECK DATE / NOTES: CODE ENFORCEMENT INSPECTOR 9/28198 4 ecu CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH ^3 3 120 WASHINGTON STREET, 4TH FLOOR CERT.# 296-02 SALEM, MA 01970 " TEL. 978-741-1800 FEE $25.00 FAX 978-745-0343 DATE: 05/29/2002 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 16 Glover Street UNIT #: 3 OWNER/AGENT: Mary M. Ginkus ADDRESS: 16 Glover Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-6414 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. OR THE BOARD OF HEALTH JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR o CITY OF SALEM, MASSACHUSETTS • '� BOARD OF HEALTH 3 w 120 WASHINGTON STREET, 4TH FLOOR 3 SALEM, MA 01970 qq � TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER ll, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS F R HUMAN HABITATION". PROPERTY LOCATED AT (� / /� UNIT#3 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER �'/ MANAGER/AGENT No P.O. Box q� p '- No P.O. Box ADDRESS ADDRESS CITY CITY RESIDENCE PHONE BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 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 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION S_ ' ?"�-0 2 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:S'��� �' DATE FEE PAID: 5,d. 4 _2' TYPE OF UNIT: DWELLING /OTHER_ CHECK#!f 3 o CHECK DATEy�D NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98