GRAFTON STREET "NDS,4?J City of Salem, Massachusetts
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Board of Health
120 Washington Street, 4th Floor, Salem, PubliCFieaIth
MA 01970 Prevent. Promote, Protect,
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-17-192
DATE ISSUED: 6/29/2017
Property Located at: 11-U1 GRAFTON STREET UNIT#1
Owner/Agent: Weam Alsarabi &Sam Hijleh
Address: 11 Grafton Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:
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.
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
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CITY OF SALEM, MASSACHUSETTS
BOARD OP HEALTH
'0p 120 WASHINGTON STREET,4"' FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX (978) 745-0343
MAYOR LRAMDIN[ni SALF.NLCOM
LARRY RANIDIN,RS/REHS,CHO,CP-FS
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 / /�r�`U� 6141V--4�4Z UNIT#--L—
IS THIS UNIT DISIGNATEDCCAS RIGHT
LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER We" A/5al-dA iC ANAGER/AGENT A4 4
NO P.O.BOX . , ,,LC�Q CP- A&A
ADDRESS /�(97'Gt f"�l`(J�I &� (� ADDRESS P'7
7�
CITY, STATE,ZIP 6a Ac.I CITY, STATE, ZIP /nn��"rl tp (6J / q-70
RESIDENCE PHONE 929-7VS-Z-912-7 BUSINESS PHONE(24HRS) v( 7 D — 93b—W�
BUSINESS PHONE 6/7'ZJ5�r IY17�
TOTAL NUMBER OF ROOMS:/__ ,, --ee N^ /,__,
ROOM USE: l ✓ 2 16,Ik LO 3 bd t?r 4 b(�
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 /�C W45q ietf4rl �C ' DATE
{ y Inspectors use only
Date on initial inspection: V —1 Date of reinspection
Date of issuance of certificate: Date fee paid:
Type of unit: Dwellint Other Check# ` Check date:
Notes:
Code Enforcement Inspector
3
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT 01/27/2000 Tel:(978)741-1800
Fax:(978)740-9705
Rita & Howard Sweeney
12 Grafton Street
Salem, MA 01970
PROPERTY LOCATED AT 12 Grafton Street UNIT # House
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 ll, 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.
qR THE BOARD 0� REPLY TO
i
Joanne Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CERT.# 807-95
$25.0
3 FEE 10/26/' P DATE: 10/26/95
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: 12 Grafton Street UNIT #: House
OWNER/AGENT: David Robinson
ADDRESS: 11 Grafton Street
CITY/TOWN: Salem. MA ZIP CODE: 01970 24 HOUR PHONE: 744-0326
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 OFF HEALTH
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
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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 420.000 "MINIMUM
STANDARDS OF FITNESS FOR HUMAN HABITATION" .
PROPERTY LOCATED AT I JryAF ,.� �} UNIT iVJ�7L,/,S>?
OWNER/LESSER,,i)\ MANAGER/AGENT --
ADDRESS I1 CSrT1G r,,re - �3 ADDRESS $q�1
CITYCITY SR r^ F.. _
r
RESIDENCE PHONE �[ BUSINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: S
ROOM USE: 2. J< r&\Pn1 2._1y_,r n3.�}Za! 4
rte. _ � beckc-nor\�
5.( � 5. 7. 8.
THERE IS A TWENTY—FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE
CITY OF SALEM'HMTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION
APPLICANTS SIGNATURE 1� 'may"Y DATE
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION: �d �q���� DAfE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE -2-1� f/� DATE FEE PAID: (p��
TYPE OF UNIT: DWELLING OTHER
NOTE 1 -
CODE ENFORCEMENT INSPECTOR