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HANCOCK STREET CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH a 120 WASHINGTON STREET, 4TH FLOOR p SALEM, MA O 1970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 10/26/04 Theomari & Steve Polemenakos 235 Lafayette Street Salem, MA 01970 PROPERTY LOCATED AT 4 Hancock 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 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 Health Reply to Joh e Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector I 2N-2"O,x CERT.# 520-99 9 FEE '$25.00 DATE: 09/09/99 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: 5 Hancock Street UNIT #: 1 OWNER/AGENT: James Barina ADDRESS: 5 Hancock Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-6518 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" . i 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 . 0 THE BOARD gF HEALTH JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR { ;P �0 T 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 CM111 410.000 "MINIMUM STANDARDS OF FITNESS F R HUMAN HA ITATIO ".5A my PROPERTY LOCATED AT U'fi 5 UNIT#- IS THIS UNIT DESIGNATED AS G T LEFT FRONT BACK PLEASE CIRCLE ONE OWNERILESSERJ8'&S (Y MANAGER(AGENT No P.O. BoxP.O. Box ADDRESS ADDRESS CITY �C?�17 CITY `T RESIDENCE PHONE (� 2BUSINESS 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 SALEMAiEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE lig DATE j 7 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION fC� � �� DATE OF REINSPECTION_ DATE OF ISSUANCE OF CERTIFICATE:`P ''F' �4 DATE FEE PAID: J P- TYPE OF UNIT: DWELLING OTHER` CHECK# R 1 9 CHECK DATE `/ NOTES: CODE ENFORCEMENT INSPECTOR 9(28(98 r. t CITY OF SALEM, MASSACHUSETTS a ® BOARD OF HEALTH a 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 STANLEY J. USOVICZ, JR. FAX 978-745-0343 MAYOR WWW.SALEM.COM JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE# 136-07 DATE ISSUED: 3/26/2007 Property Located at: 5 Hancock Street UNIT# 1 Front Owner/Agent: James Barina Address: 5 Hancock Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-6518 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 JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH a 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 FITN SS FOR H MAN HABITATION". PROPERTY LOCAUNIT #1_ IS THIS UNIT DESIGNATED ASIR GHT LEFT FRON BACK PLEASE CIRCLE ONE '�'ip`CT_3V/- OWNER/LESSER'�� 'B aLv"(A ZU MANAGER/AGENT No P.O. Box r No P.O.Box ADDRESS_NCO Sf .__ADDRESS_.,_ CITY_5� E � _.—_CITY_--. RESIDENCE PHONE Q7e-) l s b �16BUSINESS PHONE (24 HRS) BUSINESS PHONE----.— TOTAL HONE ` // TOTAL NUMBER OF((RO MS:—i- 2. b ROOM USE: 1._—ir 2. L-,l V 3.._ ( 41 __4.� u P 0LY6 u� v --- THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE.PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEP,AJzIITMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. j APPLICANTS SIGNATURE/ ____._DATE_3��U NSPECTORS USE ONLY DATE OF INITIAL fP7SPECTION.._3 _7__DATE OF REINSPECTION,------ _._. DATE OF ISSUANCE OF CERTIFICATE:_ _� b 7_ DATE FEE PAID:_ _ _ co 7 TYPE OF UNIT: DWELL _OTHER_ CHECK 1 .�3 CHECK DATE & NOTES . .. _.._ CODE ENFORCEMENT INSPECTOR 3+'28198 w y, CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 5! 120 WASHINGTON STREET, 4TH FLOOR o' SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT June 11, 2003 Todd Randall P.O. Box 206 Swampscott, MA 01907 PROPERTY LOCATED 6 Hancock 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. r —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. r the Board of He th Reply to Joanne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector CERT.# 856-97 3 � FEE $25.00 9 DATE: 01/22/98 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: 6 Hancock Street - UNIT #: 1 OWNER/AGENT: Hancock Trust ADDRESS: P.O. Box 206 CITY/TOWN: Swampscott, MA ZIP CODE: 01907 24 HOUR PHONE: 595-6415 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 u a 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 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT _ UNIT i — OWW.R/LESSERyGk_ �YUS4– MANAG.,R/Ac r„ENT `� ^�(,• ADDRESS Y✓� �CJ (�)� ADDRESS CITY S�4Q!�ob'W CITY T RESIDENCE PHONE 9,11 ,�;7 BUSINESS PHONE (24 HRS.) BUSINESS PHONE _ TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2._L=1 V 3._ 1 /j 4 • 5. �6. V 7.�i 8. v So THERE IS A TWENTY–FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT TI IS FEE PAYABLE AT THE TIME OF INSPECTION APPLICANTS SIGNATURE: DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION:–q-L -�/7 DATE OF REINSPECTION_ DATE OF ISSUANCE OF CERTIFICATE:—/` -� }(� DATE FEE PAID: TYPE OF UNIT: DWELLING OTHER -- � NOTES: CODE ENFORCEMENT INSPECTOR –^ CERT,# 81-02 N FEE $25.00 DATE: 02/19/2002 Rd'c� CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-' ' 120 Washington Street—4h Floor JOANNE SCOTT, MPH,RS,CHO Tel # (978)-741-1800 HEALTH AGENT Fax# (978)-745-0343 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 7 Hancock Street UNIT #: 1 Left OWNER/AGENT: Susan Picanzo ADDRESS: 7 1/2 Hancock Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 740-9319 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 ANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR i J , N CITY OF SALEM, MASSACHUSETTS ./ BOARD OF HEALTH • D 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 II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT / 0a1-Ae fisk jt lLftn UNIT#apt 1_y� IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNS LESSER ,�.Id_-!1_M ' V_6Jy �� MANAGER/AGENT N/,- BoxNo P.O. Box i ADDRESS Vi , _ ADDRESS CITY C7 ` CITY RESIDENCE PHONE ` 7_-L3 6g3GIBUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS:_ ROOM USE: 1. orn 2. 3. 4. L�� 5. 6. b 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 ��b l L2 Aa_',e tlJ DATE 2 / d INSPECTORS USE ONLY )DATE OF INITIAL INSPECTION r�j �� 7DATE OF REINSPECTION �7 DATE OF ISSUANCE OF CERTIFICATE:DATE FEE PAID: TYPE OF UNIT: DWELLING` OTHER_ CHECK#_ CHECK DATE NOTES: Gj CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS a BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1 Bob FAX 978-745-0343 STANLEY LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO - MAYOR HEALTH AGENT RELEASE In accordance with Massachusetts General Laws Chapter III ; 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, !/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. TtNAN"%LESSEP, OWNER/i,ESSOR ADDRES ADDRESS �n ADDRESS OF UNIT 0/J,B�,EI,N ECTED DAPE -- -- CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970- 02/13/2002 JOANNE SCOTT, MPH, RS,CHO 120 Washington Street—4`" Floor HEALTH AGENT Tel # (978)-741-1800 Manuel & Susan Picanzo P.O. Box 723 Fax# (978)-745-0343 Peabody, MA 01960 PROPERTY LOCATED AT 7 Hancock 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 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. R THE BOARD O HEALTH REPLY TO oanne Sco MPH,RS,CHO 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 Kimberley Driscoll WWW.SALEM.COM Mayor JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#227-06 DATE ISSUED: 5/4/06 Property Located at: 7 Hancock Street UNIT#2 Owner/Agent: Susan Picanzo Address: P.O. Box 223 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 Ir' 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 V 'Crff OF SALEM9 MASSACHUSE I BOARD OF HEALTH -._.-.._ • • 120 WASHINGTON STREETS 4TH FLOOR SALEM, MA 01970 TEL. 76-74 t 0 00 43 FAX 978-745-0'943 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR H EA LTHTWOE 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", PROPERTY LOCATED AT 1 v2 aC i IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER MANAGER/AGENT—` No P.O. Box No P.O.Box ADDRESS 1�UoC a _3 �ADDRESS CITY RESIDENCE PHONE 97 ^ 9 ��T�-G5� /BUSINESS PHONE (24 HRS.)__ BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2_ ,�tn1. 3.�5 t t�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. APPLICANTS SIGNATURE ' _ INSPECTORS_USE ONLY �^ DATE OF ItJITIAL fNSPE,_CTION 32.310 L-____,DATE OF REINSPECTION DATE: OF ISSUANCE OF CERTIFICAIE3- 1 5 "`OF DATE FEE PAID TYPE OF UNIT: DWELLING . OTHER CHECK #_ 7 24, CHECK DATE NOTES CODE ENFORCEMENT INSPECT OR �2altfti i I 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 RELEASE In accordance with Massachusetts General Laws Chapter III ; 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 ' f' g nts to inspect the residence identified below in accordance with the aforementioned statutes, regulations and ordinances. In the event it is necessary that said inspection be done in my/our absence, !/we expressly authorize the same and for my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of Health and its authorized agents from any lcss or injury sustained of whatever nature and description occasioned by my/our absence during said inspection. T?�ANT/LLSSEE O'vINE2/i FSSO . Ai)D!tESS fi Z ADDRESS ��'"� _'Sa" _101IO- 019 7d ADI)HESS OF UNIT TO iSF. iT;SPECTED D 'iE — _Z_i�T S26 _—_ y CITY OF SALEM BOARD OF HEALTH `? Establishment Name: 7 /74.� �/� S� Date: 3 3 'rJ� Page: of Rem Code C-Critical Item DESCRIPTION OF VIOLATION/ PLAN OF CORRECTION Date + No. Reference R—Red Item Verified y' PLEASE PRINT CLEARLY -;C 12 o N 7 �� l — /a o 1 . C ScA� s 5 f I I A• • I r I I Discussion With Person in Charge: Corrective Action Required: ❑ No ❑ Yes have read this report, have had the opportunity to ask questions and agree to correct all ❑ Voluntary Compliance ❑ Employee Restriction/ violations before the next inspection, to observe all conditions as described, and to Exclusion P ❑ Re-inspection Scheduled ❑ Emergency Suspension comply with all mandates of the Mass/Federal Food Code. I understand that noncompliance may result in daily fines of twenty-five dollars or suspension/revocation of ❑ Embargo ❑ Emergency Closure your food permit. 0 Voluntary Disposal ❑ Other: CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH a 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 3/6/06 Susan Picanzo P.O. Box 723 Peabody, MA 01960 PROPERTY LOCATED AT 7 Hancock Street Unit 2L 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 H Ipd th Reply to H IRS Joanne Scott MP , CHOO Pablo Valdez Health Agent Code Enforcement Inspector w ��coxwr CERT.# 62-02 _ FEE $25.00 DATE: 02/06/2002 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970 JOANNE SCOTT, MPH, RS,CHO 120 Washington Street—4`" Floor HEALTH AGENT Tel # (978)-741-1800 Fax # (978)-745-0343 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 8 Hancock Street UNIT #: 1 OWNER/AGENT: Janet Andrews ADDRESS: 28 Settlers Way CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-1196 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 OFA HEALTH /1 l� qzx-0,4f �C-psi ✓ � f JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR i a CITY OF SALEM, MASSACHUSETTS] BOARD OF HEALTH —0,2 • • 120 WASHINGTON STREET, 4TH FLOOR lam/ a 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 LOCATED AT � 17/0/7C-O� C UNIT# IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER //t)HCA&A::/ MANAGER/AGENT 'daA'r No P.O. Box No P.O. Box ADDRESS f ADDRESS CITY CITY p RESIDENCE PHONE /l 9 (o BUSINESS PHONE (24HRS.)-7yk 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. APPLICANTS SIGNAT DATE a2 D '2 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 2. 6 -_0 Z DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATEi !1! -n b DATE FEE PAID: TYPE OF UNIT: DWELLING OTHER_ CHECK#CHECK DATE �6 y NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS 3 BOARD OF HEALTH a - 120 WASHINGTON STREET, 4TH FLOOR CERT.# 232-03 o' SALEM, MA 01970 FEE $25.00 TEL. 978-741-1800 DATE: 05/22/2003 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 8 Hancock Street UNIT #: 1L OWNER/AGENT: Tony & Delores DiFillioo ADDRESS: 11 Foster Street CITY/TOWN: Lynn, MA ZIP CODE: 01902 24 HOUR PHONE: 745-6610 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 NOR BUILDING RELATED CODES. FOR MORE INFORMATION CALL 978-741-1800 . FO"]jf THE BOARD OF HEALTH JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR D CITY OF SALEM, MASSACHUSETTS4 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 APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN (�HA�B`IITATIIOjNJ PROPERTY LOCATED AT UNIT/#-f'O—, I L IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSERICTI3 I S 1 MANAGER/AGENT < o No P.O. Box l No P.O. Box ADDRESS jESS I I �OS�P� S P 4- ADDRESS So MQ CITYham/ 1"I A �y CITY LI� RESIDENCE PHONE BUSINESS PHONE (24 HRS.)a? -_](4,S-jd0�t) BUSINESS PHONE S0. _ /` TOTAL NUMBER OF ROOMS: `1 ` ODMS r _ ROOM USE: 1.bffi 2. _ K 191 �3. JI (YO�I�1 5. ___6._7_8. \J 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 0 3 INSPECTORS USE ONLY PATE OF INITIAL INSPECTION S" 2 Z -rJ DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIIFICATE:S -3).-0 S DATE FEE PAID: S �J. 2- r 3 TYPE OF UNIT: DWELLING E/ OTHER_ CHECK# ZO C CHECK DATE Z r"y 23 NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 i' CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH n 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. UISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT May 8, 2003 Janet Andrews 28 Settlers Way Salem, MA 01970 PROPERTY LOCATED AT 8 Hancock Street Unit# 1 R 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 (4e-9-xxxG -10) " Joanne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector ' CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH s 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAx 978-745-0343 Kimberley Driscoll WWW.SALEM.COM Mayor JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#353-06 DATE ISSUED: 7/21/2006 Property Located at: 8 Hancock Street UNIT#2 Owner/Agent: Anthony& Dolores Difillipo Address: 10 Hermon Road City/Town: Lynn, MA Zip Code: 01902 24 Hour Phone: 781-593-0639 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, PY must with 105 CMR 410.000. comply 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. FOTH�D OF HEALTH / JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH �f • • 120 WASHINGTON STREET. ATH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 JOANNE SCOTT, MPH, RS, 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__8 S_�� UNIT# I IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE V\ 1 `l O OWNER/LESSER �( MANIAGERIAGENT S�(N%k_ No P.O. Box No P.O. Box ADDRESSI I! Y ADDRESS CITY n� QSS—CITY—, RESIDENCE PHONE{�U63ftBUSINESS PHONE (24 HRS.),__— BUSINESS PHONE_ TOTAL NUMBER O�F,R,O�(OM�S ROOM USE: 1._ 't`x 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 . jL�l��e INSPECTORS USE ONLY DATE OF INITIAL INSPECTION Z_1* -O_:� DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE-f= '-o _DATE FEE PAID:_. _ _._-. TYPE OF UNIT. DWELLINeOl-HER.- _ CHECK #_1'7 R-S"_-.CHECK DATE 7 NOTES: CODE ENFORCEMENT INSPECTOR 9/213/98 i CITY OF SALEM, MASSACHUSETTS a 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, C:HO HEALTH AGENT i CERTIFICATE OF FITNESS CERTIFICATE#354-06 DATE ISSUED: 7121/2006 Property Located at: 8 Hancock Street UNIT#3 Owner/Agent: Anthony& Dolores Defillipo Address: 10 Hermon Road City/Town: Lynn, MA Zip Code: 01902 24 Hour Phone: An inspection of your vacant Dwelling/Rooming Unit at the above address has been approve, and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board o 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, whicr, „er is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH f QPANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT iNSPE .' pR 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 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT a� c cc- a-&� }—UNIT Jia IS THIS UNIT DESIGNATED ASIR GHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER 4 I � � MANAGER/AGENT i Q No P.O. Box I � r�((� �( No P.O. Box ADDRESS J_�C`TC.-�(1(� (� � 1_ADDRESS-- CITY ,CITY RESIDENCE PHONE--A--,q�9BUSINESS PHONE (24 HR S.)____ BUSINESS PHONE TOTAL NUMBER OF ROOMS: _ ROOM USE: f.�"2. 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. Q �� APPLICANTS SIGNATUREc= i DATE_ -7 t !t 6 D INSPECTORSUSE ONLY / r� DATE OF INITIAL INSPECTION_ l_-� � ., DATE OF REINSPECT ION DATE OF ISSUANCEOF CERTIFICATE'? �/k-�,O,(- DATE FEE TYPE OF UNIT DWELL, _OTHERCHECK H_./7 __. CHECK DATE NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 4 ' ��ON�11T 3 CERT.# 61-02 FEE $25.00 �oDATE: 02/06/2002 �MINg CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970 JOANNE SCOTT, MPH, RS,CHO 120 Washington Street—4`" Floor HEALTH AGENT Tel # (978)-741-1800 Fax # (978)-745-0343 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 8 Hancock Street UNIT #: 4 OWNER/AGENT: Janet Andrews ADDRESS: 28 Settlers Way CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-1196 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. i FOR THE BOARD OF HEALTH � r f... JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR u 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 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 NIT# IS THIS UNIT DEFqNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER MANAGER/AGENT No P.O. Bo) // \\ No P.O. Box ADDRESS Oc n�,,, �� (N�ADDRESS CITY �alje hJ(� CITY —7 RESIDENCE PHONE? !l //p/ � BUSINESS PHONE (24 HRS.) !.cP f BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2.-3.-4. 5. 6. 7. 8. THERE IS A TWENTY-FIVE 5.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITYOF/SALEM HEALTH DEP RTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE DATE Z U INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 2, i(P--0Y DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:2i6 'Vp Z DATE FEE PAID: �z ' (0 TYPE OF UNIT: DWELLINGkOTHER_ CHECK# ; 7& CHECK DATE � -�i y� NOTES: `' CODE ENFORCEMENT INSPECTOR 9/28/98 e a CITY OF SALEM, MASSACHUSETTS BOARD OF FIEAI:rI-1 Y�blicSeatth 120 WASHINGTON STREFT,4,v FLOOR TEL. (978)741-1800 FAX(978)745-0343 KLVIBERLEY DRISCOLL ]xamdin a�salem.com LARRY RAMI)I 1,RS/RFI IS,CHO,CI'-FS MAYOR Hf?AI:rr1 A(-&NT CERTIFICATE OF FITNESS CERTIFICATE#467-12 DATE ISSUED: 12/7/2012 Property Located at: 9 Hancock Street UNIT#2 Owner/Agent: John Prindiville Address: 20Stanley Road City/Town: Marblehead, MA Zip Code: 01945 24 Hour Phone: 617-943-3137 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 Cade, Chapter IP' 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 B9,ARD OF�IEALTH LARRY RAMDIN HEALTH AGENT SANITARIAN CITY OF SALF,M, M[kSSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4`..FLOOR pllbliOHealth TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERL EY DRISCOLL lramdifi@salem.com MAYOR o LARRY RAnn�IN,xS/fuslfs,(1110,CP-FS I-IFAINIf A(;'ENT 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 q r1 G A c oc k Sf UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER Job rL J1Vl11 MANAGER/AGENT NO P.O. BOX ADDRESS—7- 0 51'6(i Icv Qd ADDRESS CITY, STATE, ZIP M e c(n c&J , kA L A 019 q' CITY, STATE,ZIP RESIDENCE PHONE C l l -9q 3-313-1 BUSINESS PHONE(24HRS) 5-" BUSINESS PHONE SAr-mL TOTAL NUMBER OF ROOMS:— ROOM OOMS:ROOM USE: 1. K k 2. LR 3 4 D 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 PAY LE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE -- DATE rr z 1 12- Inspectors use only Date on initial inspection: /�2-7 ) 2 Date of reinspection: Date of issuance of certificate:_ Date fee paid: I'L --2 -)-L Type of unit: Dwelling ✓ Other NCheck# ) Ci 7 3 Check date: otes: ► PAi� >)�M� bD SftLte �a� � `r'Rae1oIC. 1� o R6a\\ aa� �4J uV�J S`��f��r1 Code Enforcement Inspector n ��CONDIT� CERT.# 533-98 FEE $25.00 DATE: 08/27/98 '�pj91IV8�� 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: 9 Hancock Street UNIT # : 2nd Floor OWNER/AGENT: Denise & Blair Budka ADDRESS: 9 Hancock Street. let Floor CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-6115 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 3 �11I1F'� CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 APPLICATION FOR CERTIFICATE OF FITNESS Fax:(978)740-9705 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". / PROPERTY LOCATED AT 9 lrvnoCK -Sf. &�s��UNIT# �Ad flood IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESScE�R�*1.1, t/ air &At MANAGER/AGENT_ Sqm -- l ADDRESS A uCoel, St. ADDRESS CITY S4 le 4 t I SfF7uo(- CITY RESIDENCE PHONE BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: (F ROOM USE: 1. DeAj 2. 3. 13ed 4. Real 5. Ee d 6. k 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 ✓zx.�-P ^, IS4-4 Cts- DATE Y Q� INSPECTORS USE ONLY DATE OF INITIAL INSPECTION S `P- f DATE OF REINSPECTION___ DATE OF ISSUANCE OF CERTIFICATE -n2 7- DATE FEE PAID: TYPE OF UNIT: DWELLING OTHER NOTES: CODE ENFORCEMENT INSPECTOR 5/19/98 CITY OF SALEM, MASSACHUSETTS a 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 03/07/2002 Frank Ouellette 25 Donovan's Way Middleton, MA 01949 PROPERTY LOCATED AT 10 Hancock 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. qanR THE BOARD 0 HEALTH REPLY TO ne Scot MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR a CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOORCERT.# 301-02 SALEM, MA 01970TEL. 978-741-1800 FEE $25.00 FAX 978-745-0343 DATE: 05/24/2002 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 10 1/2 Hancock Street UNIT #: 2 OWNER/AGENT: Frank Ouellette ADDRESS: 25 Donovans Way CITY/TOWN: Middleton, MA ZIP CODE: 01949 24 HOUR PHONE: 777-4405 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 / 4l�� JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR u CITY OF SALEM, MASSACHUSETTS o � ',� BOARD OF HEALTH 3 120 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 II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT ��/� anco�r � SBI ,�?AOI UNIT#_c� IS THIS UNBT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER 6✓2n lc 0Upl42- z MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS �1ADDRESS CITY Y I ��E ��d\ 7� 0/2VSCITY RESIDENCE PHON 9 29 77- y0� BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOT AL NUMBER OF ROGM IS:_/� /� ROOM USE: 1. {t/TU(?4 2. Q2q�aorl3. Uin/n 4. LI��K#l- 5. 6. 7. 8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALE ALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE DATE 0 � INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 5--?`( O DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE.--l- tiz DATE FEE PAID: 5- --,;1--2- O �— TYPE OF UNIT: DWELLINvTHER_ CHECK# CHECK DATES NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 3 CITY OF SALEM, MASSACHUSETTS 0 BOARD OF HEALTH n 120 WASHINGTON STREET, 4TH FLOOR i 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 lll ; Code of Massachusetts R,agulations 410.000 et. seq. ; State Sanitary Code Chapter II and Article XIII of the Cit, 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 Lhat 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 agent; from any loss or injury sustained of whatever nature and description occasioned by my/our absence during said inspection. T idA Z'/LESSEE T R/LESSOR ADDP� SS DRES ---Lo- 12-- IJ V � ADDRESS OF NIT T'0 BE INSPECT�D � j -- TATE E CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 e�MINE FAx 978-745-0343 STANLEY USOVIC7, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 05/20/2002 Frank Ouellette 25 Donovans Way Middleton, MA 01949 PROPERTY LOCATED AT 10 1/2 Hancock 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. 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. F THE BOARD OFrEALTH REPLY TO Vanne Scott,; MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR CERT.# 561-97 3 FEE $25.00 DATE: 0 08/15/8/15/ X11' . IiF� 97 MII�B 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: 11 Hancock Street UNIT #: 1R OWNER/AGENT: Pottery Realty Trust ADDRESS: 4 Pond Street CITY/TOWN: Marblehead, MA ZIP CODE: 01945 24 HOUR PHONE: 631-3027 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. qe-"G"J F THE BOARD OF HEALTH '' e)� / Q JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR 1_ , OFFICE USE ONLY 4 3 CERT. i a 2�to,MMa o� DATE: CITY OF SALEM HEALTH DEPARTMENT BOARD OF HEALTH Salem, Massachusetts 01970 ROBERT E. BLENKHORN 9 NORTH STREET HEALTH AGENT 508a41-1e00 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 IW IC-O-01G l e/lyj UNIT i � OWNER/LESSER tom / / S t MANAGER/AGENT / ADDRESS L �.�IcL �/ —I ADDRESS �/ LL't CITY RESIDENCE PHONE �-7 4r;.3/ ' 3o2 J BUSINESS PHONE (24 HRS.) �£ BUSINESS PHONE TOTAL NUMBER OF ROOMS: J ROOM USE: 1. ( 2. 3.�/ 4. �tldljC/� 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 UPON COMPLIANCE AND ISSUANCE OF CERTIFICATE. APPLICANTS SIGMATURE�/ � DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION: �jr �j J-. DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE -�s 7 DATE FEE PAID: TYPE OF UNIT: DWELLING OTHER NOTES: CODE ENFORCEMENT INSPECTOR L f A- "� � '� CERT.# 560-97 3 FEE $25.00 DATE: 08/15/97 I' /MIf� 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: 11 Hancock Street UNIT #: 2R OWNER/AGENT: Pottery Realty Trust ADDRESS: 4 Pond Street CITY/TOWN: Marblehead, MA ZIP CODE: 01945 24 HOUR PHONE: 631-3027 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 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,AS,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 CHR 4110.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION'. PROPERTY LOCATED AT GpG � UNIT # Z , OWNER/LESSER MANAGER/AGENT ADDRESS �� ADDRESS CITY >t��yf Fi12f 1 CITY RESIDENCE PHONE�f� �.31 56 � BUSINESS PHONE (24 HRS.) BUSINESS PHONE r� TOTAL NUMBER OF ROOMS: ROOM USE: 1. �2. 5, 6. 7. 8. THERE IS A TWENTY—FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR HONEY ORDER TO THE CITY OF SALEM' BEALTH DEPARTMEYT THIS FEE 'ISS''��P'A�fY`jj,A�//BLE AT THE TIME OF INSPECTION APPLICANTS SIGNATURE I9t �+w'•�—..: DATE q INSPECTORS USE ONLY DATE OF INITIAL INSPECTION: 1 S�f r� DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: DATE FEE PAID-:_��{ 7 TYPE OF UNIT: DWELLING OTHER NOTES: I 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 Kimberley Driscoll WWW.SALEM.COM Mayor JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT 2/8/08 The Winokur Family Trust, Ina Winokur, Trustee 12 Hancock Street Salem, MA 01970 PROPERTY LOCATED AT 12 Hancock 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 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 Heal h Reply to anne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector t CITY OF SALEM, MASSACHUSETTS y BOARD Of HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR IUIflNNE SA1E COM JANEIT DtONNE ACTING HE.A.IIfH AGENT i CERTIFICATE OF FITNESS CERTIFICATE#498-08 - DATE ISSUED 10!7/2008 = Property Located at: -12 Hancock Street UNIT# 1-A Owner/Agent: The W inokur Fa m Trust-Edyce Winokur Trustee Address: 30 Washington Road City/Town: Springfield, MA Zip Code: 01108 24 Hour Phone: 413-530-6560 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 fl" 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. I This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOAWF HEALTH i E ACTNG HEALTH AGENT CODE ENFO CEMEN INSPECTOR Sep -?4 OB 08i54a Joanne Scott Salem BOH 978 745 0343 p. 2 tO-0U Cn, Ov S,v,vJM5 MASSACI I USFATS RI .iunwn IW.m:111 r ►. I^II\\'.i;a w,,;n�-� d"' Ilaun: .. _• eqr+® 'Il+l..(1)7s)74 1-1800 IQ\Ilil(RLI(\'1)RI*i;Ol.l. • _ P%\(97,1)-1,45-03-13 M.11 OIZ i %Nlfl t>u ISN . OCT - 710 SI Nu nt S%Nrr.ia I uNv. ._ 7H App OF HEAL Applicationfor Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION." /VFEE: $50.00 PROPERTY LOCATE I)AT /7Lf1 �0 4k 5 r UNITN h,- r I'-A . /IISS�THIS UNIT DISIGNATED A 1 ' LF.i'r F 0 R BACK•PLEASE CIRCO,ONE OWNER)LCSSER Ed Xce IN�AtOAUR � GE A('PCNT t' NO P.O.Box ADDRFSS Dayqq#14;7d/Il ad— e AI)DRCSS CITY,STATE,Z,IP /Zf/I��1� /T CITY.S'IWI'I.,Zip 0 V RESIDENCE PHONE /#133 B �1 p PHONE(24HKS) LI-13 -630 6 5-6 0 , BUSINESS PHONE �i TOTAL NUMBER OF ROOMS: _ ROOM USE: I.All-WfA/ 2, I, 111Vi4/(y PIED 4. 5. 6. 7, R. 9. 10. THERE.IS A FIFTY(SSU)DOLLAR FEE,PAYABLL•'BY CHECK OR MONEY ORDER TO THE CITY OF SAL):M HOARD OF HEA)XH THIS FEE ISSi�PP.A,YAB`'L''EE/AT THK TIME OF INSPF:C'1'ION APPLICANT'S SIGNA'WPE —DATE—g Inspectors use only Date on initial inspection: C J Date of reinspection: Datc of issuance ofccniflcate: ) Date fee paid: ) O ) Type of unit 1)wtlling✓_Other, Chcck II S ) ) Check date: �7 • z S • d _ Notca: Ag 441 spect ' 1 I 1 CITY OF SALEM, MASSACHUSETTS t� BOARD OF HEALTH 120 WASHINGTON STRE FT,4"'FLOOR TEL. (978) 741-1800 KIMBER]:,EY DRISCC�LL FAX (978) 745-0343 MAYOR Iramdin@salcm.com LARRY RAXIDIN,16/1WI IS,0110,(j1-1;S HG,AL PI I A(;I`;NP CERTIFICATE OF FITNESS CERTIFICATE#432-11 DATE ISSUED: 10/24/2011 Property Located at: 12 Hancock Street UNIT# 1 L Owner/Agent: Jeff Cohen Address: 12 Hancock 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 LARA RAMDIN HEALTH AGENT AGENT CODE E ORCEMENT INSPECTOR i Y a gu CITY OF SALEM, MASSACHUSETTS � F BOARD OF HEALTH (�' I 120 WASHINGTON ' I STREET,4T FLOOR q"514 TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR LRAMDIN(aDSALEM COM LARRY RAmDIN,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 .L HAA/ CO ck S i UNIT# j L- IS IS THIS UNIT DISIGNATED AS RIGHT EF RONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER 9/7 FF CDN-CAI MANAGER/AGENT NO P.O.BOX ADDRESS--j 2 HAA) CC's 0C S t ADDRESS CITY, STATE, ZIPS E/YI MA 0161 '70 CITY, STATE,ZIP RESIDENCE PHONE 97 Ff - 56-7 L/(/3 BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: `-i ROOM USE: Llcifc N 2. QE)RrD M 3. -b-6 4. u✓/A,S 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 INSPEC ON APPLICANT'S SIGNATURE DATE Inspectors use only Date on initial inspection: Date of reinspection: Date of issuance of certificate: I o d Li 1 Date fee paid: I Type of unit: Dwelling_Lf�' # JOther Check _Check dater d la `G l Notes: 4ufam", hGH 6 erAkr f&r k S /I Cod Enforc meat Inspector CITY Oh SALEM, MASSACHUSETTS 13o,\RD OF HEALTH l20 W ASHINGTON STRELT,4...FLOOR KIMBE U.E,Y,DRISCOLI, TIL.. (978)741-1800 FaY (978)745-0343 MAYOR lrainchn e satcm.com LARRY RAMDIN,RS/Itli[IS,C1 10,CP-FS HFAI;ri I AGIaN,i, CERTIFICATE OF FITNESS CERTIFICATE#487-11 DATE ISSUE=D: 11/21/2011 Property Located at: 12 Hancock Street UNIT# 1 R Owner/Agent: Jeff Cohen Address: 12 Hancock 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. FORT E BOA D F HEALTH LARRY RAMDIN HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR J TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR LRAMDINnsALEA4.coM LARRY RAMDIN,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 1A yAN co C�-- 'ST UNIT# rg_ IS THIS UNIT DISIGNATED AS GH EFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER Se �P F C-OH O AJ MANAGER/AGENT NO P.O.BOX ADDRESS 1-14 IV C-0 C.4--- Sr ADDRESS CITY, STATE,ZIP SA20 0, M A O 11 -70 CITY, STATE, ZIP RESIDENCE PHONE S8 7- ( Y q 3 BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: 3 ROOM USE: 1. X�rc�+E.J 2. �r✓ (/-17 3. M k'EJ RiTnAq 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 INS CTION APPLICANT'S SIGNATURE DATE 'U a Inspectors use only Date on initial inspection: lohwhi Date of reinspection: a 11 Date of issuance of certificate: 1/ d1/11 Date fee paid: 0 11 Type of unit: Dwelling Other Check#---[ I Check date: 10 1 Notes: C n-- W N LU O c :( 1 eA- vividaz in o SUTk + Code nforce entInspector i CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASMNGTON STREET,4T"FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR LRAMDINn.SALEM.COM LARRY RAMDtN,IRS/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 H 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 I ecessary 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 inspejction. Tenant/Les Owner s or Address P.p i 1 tZ, Address Address on unit to be inspected Date Updated 5/23/11 ' CITY OF SALEM, MASSACHUSETTS BOARD OF Hr,m,I'H 120 WASHINGTON STREET,4"FI,.00R TEL. (978) 741-1800 K1M13LItL13Y uRISCOI,L FAX (978) 745-0343 MAYOR 1ramchn@sa1em.co LARRY RAMI)IN,RS/RHFIS,C[10,CP—I'S HFAI Al i AG IdN"I' CERTIFICATE OF FITNESS CERTIFICATE#431-11 DATE ISSUED: 10/24/2011 Property Located at: 12 Hancock Street UNIT#2 Owner/Agent: Jeff Cohen Address: 12 Hancock 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 11" 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. I F R THE BO D OF HEALTH /Op LARRY RAMDIN \vt HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL (978)741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR LRAMDIN@SALEM.COM LARRY RAMDIN,RS/RENS,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 l2- 1-I R A'GO LrC S-T UNIT# Z IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER--s... �-O(--C A� MANAGER/AGENT NO P.O.BOX ADDRESS 1-2- HA IV 0-,() 0G ADDRESS CITY, STATE, ZIP c„A�L6 M . M-A / //0 lq �7 0 CITY, STATE,ZIP RESIDENCE PHONE 9 7�- U l 17L T3 BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: 7 pp�� ROOMUSE: l.��b'J 2. -8Zb9.NM 3. $Eb�nn 4 I R4DAA 5 a1WA, � 6. u V i n. t., 7. Pbc i 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 iSP N APPLICANT'S SIGNATURE DATE Inspectors use only Date on initial inspection: (/ Date of reinspection: Date of issuance of certificate: /0/R SI I I Date fee paid G/// 0 1/ Type of unit: Dwelling1,.-' Other Check#_II Check date: 11 / 01q V1 Notes: �(01A BE (1 u di � �'c1T�70/n- d P S/YI f1CCf �FG� -�(U/1 f' Code nforc ent Inspector CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4" FLOOR TEL. (978) 741-1800 KINMERLEY DRISCOLL FAX(978)745-0343 MAYOR LRAMDIN@SALEM.COM LARRY RAMDIN,RS/RENS,CHO,CP-FS HEALTH AGENT Release In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 4 10.000 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. UJB VIAkJIill� � / b Te'Iant/Lessee O e s r IZ Ravlcock App Address Address rz OAJJ Cd CX s r r z Address on unit to be inspected 22- 111 Dat—e i—T Updated 5/23/11 4 City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, PubliCHea Ith MA 01970 Prevent. Promote. P Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHO Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE#: GHL-15-19 DATE ISSUED: 4/10/2015 Property Located at: 15 HANCOCK STREET UNIT#1 Owner/Agent: Anastasia Akdeniz Address: 15 Hancock Street#2 City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 745-2023 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation'. Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN • I • CITY OF SALEM, MASSACHUSETTS BOARD OF H&ALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR 1AAMDIN@SAJ,EM COM LARRY RAnH)IN,RS/REPIS,CHO,CP-FS HEAIaTI 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 S UNIT# IS THIS UNIT DISIGNATED A, GH EFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER_&zf�5-� �,C�Q�.fC�7iMANAGER/AGENT NO P.O.BOX �1, ADDRESS IS (J�{A)�.�Y�C ST jtZ ADDRESS CITY, STATE,ZIP ' f�� &/_S�U CTTY, STATE, ZIP RESIDENCE PHONE Cf 7e-� 1 -Z-02--3 BUSINESS PHONE(24HRS) call Bt7SrqM PHONE SOFT - Sa7 . S�?�'Zg� lev��Z@c�wtail.c�rPt TOTAL NUMBER OF ROOMS: o ROOM USE: 1. 13\) 01 2. V> ✓ZM 3 Ind 4 1 ( �t 5 Z U 6. W16- AM 7. r„ �i 8 I C,tarQW 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 ABLE AT THE TIME SPECTION APPLICANT'S SIGNATURE DATE Inspectors use only Date on initial inspection: ��CI'I S Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check# Check date: Il 4 ' ) Notes: Lm()fP. CO Wf;x + LAyI�A� S L'LD6 l� C,VI(7 0WQMb(-2- -fb 62cceA Qui 1/IQ(I� Code nfVement Inspector a l4 co CITY OF SALEM MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR c 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 i i CERTIFICATE#183-03 DATE ISSUED: 4/28/05 Property Located at: 15 Hancock Street UNIT#3 I Owner/Agent: Anastasia Akdeniz Address: 15 Hancock Street#2 City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-2023 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 Il" Minimum Standards of Fitness for Human Habitation". Therefore,this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates,whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH �� JOA` E SCQTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR • "": a 4 ,X,,.... +' "'✓ Y£"^" r.. �'f + ,+h�,&f.S.�7 �`; fr T{=r_'„me ,,..::. t .r.nt� it : w i� a_ i..'a+ ..,e.:� Citic aF SA�Etvc, MassACNUs>Ecrs BOARD bF 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 APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER It, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED ATle »,e <T UNIT H2 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNEWLESSERJJ iW_$ rWZ-MANAGER/AGENT .— No P.O. Box No P.O. Box ADDRESS 1S j7A/Lrl''IC. � ADDRESS _ CITY -) C I / lfl _CITY RESIDENCE PHONEQi.' BUSINESS PHONE (24 HRS.)--- BUSINESS PHONE I —. TOTAL NUMBER OF ROOMS:_ ROOM USE: 1. 2. THERE IS A TWENTY-FIVE($25.00 DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALF�M HEALTH DEPARTMFN THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. 7 APPLICANTS SIGNATURE- �� DATE '- � . INSPECTORS USE ONLY DATE OF INITIAL INSPECTION _ } °`} .DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE _ _� t' -V__`bA1 L= FEL= PAID TYPE OF UNIT DWELLING - OTHER CHECK 4, j p y CHECK DATE_ NOTES: CODE ENFOHCE.MI-NT INSPECTOR yl7ri/9ri coNL4 CERT.# 142-01 a FEE $25.00 DATE: 03/28/2001 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: 16 Hancock Street UNIT #: 2 OWNER/AGENT: Leslve Linder ADDRESS: 121 Broad Sound Avenue CITY/TOWN: Revere, MA ZIP CODE: 02151 24 HOUR PHONE: 289-7462 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 P-4 n "Olr11N61'� 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 FITNESS FOR HUMAN HABITATION". 01 PROPERTY LOCATED AT / IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNERlLESSER L 4a IT �'iu`A-t C MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS .Xf AS1•ls*JAdkA^A.—pl, t ADDRESS CITY !_��WS�ITY RESIDENCE PHONE?STI_.., 7VUNESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. THERE IS A TWENTY-FIVE($25.00)DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CCTY OF Sic H DEPARTM THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE -DATE—3 s _"' r Cy US O DATE OF INITIAL INSPECTION 3 -a 9 '0 r DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:3 DATE FEE PAID: 3 - - d TYPE OF UNIT: DWELLING4OTHER_ CHECK# /O 6 !?!-CHECK DATE r NOTES: CODE ENFORCEMENT INSPECTOR 9128/98 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 08/31/2000 Fax:(978)740-9705 Lesly Linder 121 Broad Sound Avenue Revere, MA 02151 PROPERTY LOCATED AT 16 Hancock Street UNIT # 2L 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 . 4R THE BOARD HEALTH REPLY TO t, MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR t a CITY OF SALEM, MASSACHUSETTS .T BOARD OF HEALTH R 120 WASHINGTON STREET, 4TH FLOOR a SALEM, MA 01 970 9qg TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 7/25/05 Leslye Linder 121 Broad Sound Avenue Revere, MA 02151 PROPERTY LOCATED AT 16 Hancock Street Unit 2R 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 Health Reply to 9ealth ne Scott PH, RS, CHO' Pablo Valdez Agent Code Enforcement Inspector e�.�OPIDIT �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 Fax:(978)740-9705 04/23/2001 Leslye Linder 121 Broad Sound Avenue . Revere, MA 02151 PROPERTY LOCATED AT 16 Hancock Street UNIT # 2R 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 B: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. R THE BOARD O, HEALTH REPLY TO oanne Scott, MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR i CERT.# 297-98 3 FEE $25.00 �1�'. /•Fs DATE: 05/14/98 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: 16 1/2 Hancock Street UNIT #: 2 OWNER/AGENT: Thomas Sullivan ADDRESS: 18 Lawndale Street CITY/TOWN: Belmont MA ZIP CODE: 02178 24 HOUR PHONE: 489-6612 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. FJf�O'R THE BOARD OF HEALTH JOANNE SCOTT, MPH, RS,CHO vi/ ':;d HEALTH AGENT CODE NFORCEMENT INSPECTOR NOTE: Certificate issued pending repair of two sashcords in bathroom window. 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 APPLICATION FOR CERTIFICATE OF FITNESS 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,/(, Y�- COCA 51 UNIT#fgvL_ 7- IS THIS UNIT DESIGNATED ASIR GHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER lflaaal-5 MANAGER/AGENT ADDRESS/9 Z, f lY[�/]z.{l ADDRESS �33F ^4;/ CITY �, CITY iv og,178 RESIDENCE PHON6,G/.2- BUSINESS PHONE (24 HRS.) BUSINESS PHONE 6&y e TOTAL NUMBER OF ROOMS: ROOM USE: 1. L,e 2. Ue 3. hi% 4. 13P- 5. 3R5. 13e 6. 132 7. 8. THERE IS A TWENTY-FIVE($25.00)DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THECITY OF SALEM H ALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANTS SIGNATURE DATE S �5 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION d-cg 6- 99 DATE OF REINSPECTIO�N�"�f4[� DATE OF ISSUANCE OF CERTIR ATEs/U- qg DATE FEE PAID:u /_V-gn9rlicr�-11/ TYPE OF UNIT: DWELLING ✓/ OTHER NOTES: e?nr�4/q '57Q tCd,Pa/S CODE ENFORCEMENT INSPECTOR 5/19/98 I CITY OF SALEM, MASSACHUSETTS • BOARD OF HEALTH 120 WASHINGTON STREET,4".FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR r)CRF.SNBAUM(@SAI,sNi.com DAV!D GtE13NBAUM ACTING HEALTH AG6N'P CERTIFICATE OF FITNESS CERTIFICATE#331-10 DATE ISSUED: 7/8/2010 Property Located at: 17 Hancock Street UNIT#3 Owner/Agent: Richard &Donna Morin Address: 17 Hancock 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 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 I � DA IV D GRE'4 Y4 ,ENBAUM ACTING HEALTH AGENT CODE NWORCEMENT INSPECTOR l96/1.5/2010 20:59 9787450343 PAGE 01/02 - CITY OF SALEM, MASSACHUSETTS BOARD OF HEALIT-1 7 J 120 WASHINGTON STREET,4"l FLODR TEL.(978)741-1800 1KTVBERT.EY DRISCOLL FAX(978)745-0343 MAYOR DGRPRNBAUM&AAERM,COM DAVID GREENBAUM, ACITNG 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: $50.00 'ROPERTY LOCATED AT,_I'L�A n n r csck Sty e e t uNrr# 3 M THIS UNXT DISIGNATED ASIR GAT LEVr FRONT OR$ACK.PLEASE CIRCLE ONE )WNER/LESSEFL&cjaY, 4 D �Driw MANAGER/AGENT JO P.O.SOX ADDRESS 17 ��aticocic �tre�t AnDRESS ;rrY,STATE,,ZIP S 0.11 rn NA t 1 G-7 o _ CITY, STATE,ZIP tESIDENCE PHONE q�8` 4 5 C1 a-7 9 BUSINESS PHONE(24HRS) IUSINESSPHONS_ g18' 8F34 - aaga 'OTAL NUMBER OF ROOMS: 5 ,OOM USE: .Nroo 2. i c n 3. 17evt 4.� 5, C4, • Cly. lLou cLr��Opn-j �_ 7. 8. 9 10 IiEtE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CI'T'Y OF SALEM !OARD OF HEALTH THIS FEE IS PAYABLE AT THE T1MMOlt INSPECTION NPLICANT'S SIGNA7IJR �spectors use only late on initial inspection: i7 Date of mimpoction: late of issuance of certificate: / Date fee paid: /O ype of unit: Dwel m_jz0d0d= Check#. u r Check date: /D otes: x1e cm t Inspector • " CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH IV 120 WASHINGTON STREET 4t"FLOOR PablicHealth Prevent,Promote.Protect. TEL. (978) 741-1800 FAX(978) 745-0343 KIM 3ERLEY DRISCOLL lramdinna.salem.com LARRY RAMDIN,RS/RF HS,(A 10,CP-FS MAYOR HIdALTI i AGENT F CERTIFICATE OF FITNESS CERTIFICATE # 101-14 DATE ISSUED: 3/27/2014 Property Located at: 19 Hancock Street UNIT# 1 Owner/Agent: Charles Nelson Address: 22 Northern Avenue City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 927-3672 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 IP' 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 ARD HEALTH LARRY RAMDIN HEALTH AGENT SANITARI C ,w CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET 4"`FLOOR PablicHealth STREET, Prevent.Promote.Protect. TEL. (978) 741-1800 FAX(978)745-0343 KIMBERLEY DRISCOLL lramdin@salem.com MAYOR LARRY RAMDIN,RS/RENS,CI 10,(:P-FS HI Aim i 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 W 1,�a�2,k S`T-- UNIT# IS THIS/ T DI SIG AT D AS RIGH L FC FRONT OR BACK.PLEASE CIRCLE ONE W ONERLESS CQ--E-'� MANAGER/AGENT NO P.O. BOX ADDRES ADDRESS CITY, STATE,ZIP ITY, STATE,ZIP �2 (~�� RESIDENCE PHONE - - BUSINESS PHONE(24HRS)��1 /7�� BUSINESS PH01 B— TOTAL NUMBER OF ROOMS:_Q ��// ROOM USE: 1. 2. \\ 3. T7 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 y APPLICANT'S SIGNATUR�Q / [ DATE o2 Inspectors use only Date on initial inspection: Date of reinspection: Date of issuance of certificate: / Date fee paid: Type of unit: elling Other Check# 16 LTJ Check date: Notes: -Crs�((IK r�>,b fzyl1? GC2Vl ( t (R '4f, niYl so r4ALD4 c19-4 CodeNdor&&ent Inspector ND " City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, PubliCHeB Ith MA 01970 Prevent. Promote. Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, RENS, CHo Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE#: GHL-16-31 DATE ISSUED: 1/29/2016 Property Located at: 19 HANCOCK STREET UNIT#2 Owner/Agent: Charles Nelson Address: 22 Northern Avenue City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone:(617) 285-2154 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 I— , Y/ �K Larry Ramdin, MPH, REHS, CHOSANITARIAN HEALTH AGENT OJ& CITY OF SALEM, MASSACHUSETTS BOARD OF HE,�LTH � `L 120 WASHINGTON STREET,4"'FLOOR rILJIVmu e TEL. (978) 741-1800 FAX (978) 745-0343 KIMBERLEY DRISCOLL Iramdin@salem.com MAYOR L\IiRY RA MllIN,IiS/REIiS,CHO,CP-TS HIBAI:TH 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 p� n PROPERTY LOCATED AT YL D C' �7 y �2 ��L (�Nl�# L— /IIS T/ p HIS UNIT DISIGNATEDD AS RIGHT LEFT FRONT OR BACK,PLE SE CIRCLE ONE OWNER/LESSER ( /I Qf ((° 5 1 V� MANAGER/AGENT �— NO P.O. BOX ADDRESS _O, ADDRESS CITY, STATE,ZIPS( - Ch V CITY, STATE,ZIP RESIDENCE PHONE 6 I7�2R(_')�d.(5<+ BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: y� n 1 �r ROOM USE: 1 r 2 V 3. `,a 4. 5. \ 'l (Fr� 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE ISS/PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE t ` /��dr7 —DATE-- Inspectors ATEInspectors use only Date on initial inspection: 01 a2 =016 Date of reinspection: Date of issuance of certificate: 01 126121` Date fee paid: (11.Z�16 Type of unit: Dwelling ✓ Other Check# Z3Y� Check date: 01/ZG -1 b Notes: v < r" o e f 1 1 / / 1 / {{' II rD ' p,PJ C 1� ' ^c wile oW e1 (r Y S N GD.rb,ge J1'1oSa1 L er kl'" c,6h Sihk Yw+ work["), CWWbrcem pector CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH -"" -- -- '- ----120 WASHINGTON STREET;4T"FLOOR PI$l�1CHP.8�>h Prevent.Promote,Protect. TEL. (978) 741-1800 FAx(978)745-0343 KIMBERLEY DRISCOLL Iramdin@salem.com salem.com LARRY RAMllTN,RS/REHS,CHQ,CY-FS MAYOR - - HI'',;\I;1'I-T AGENT CERTIFICATE OF FITNESS CERTIFICATE#23-15 DATE ISSUED: 1/5/2015 Property Located at: 19 Hancock Street UNIT#3 Owner/Agent: Charles Nelson Address: 22 Northern Avenue City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 617-285-2154 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 OF HEALTH LARRY DIN HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS ` BOARD OF HEALTH 220 WASHINTGToN STREET,40'FLOOR I TEL.(978)741-2800 KIMBERL.EY DRISCOLL FAx(978) 745-0343 MAYOR r,RAM IN ,sluz 1.coM LARRY RAMDIN,RS/Rl-'IiS,0140,CP-l'S HEAvii-i.AC;FN'f 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: 50DO PROPERTY LOCATED AT l�0 t1NI1`# IS THIS UNIT DISIGN D RIGHT LEFT FRONT OR BACK.PLEASE CIRCLE ONE OWNER/LESSER v- e-� r {j f1 MANAGER/AGENT NO P.O. BOX ADDRESS ADDRESS (� �y / CITY; STATE,ZIP ,� CITY, STATE,ZIP-96-0—LL— RESIDENCE IP /��f�t,j C O L L RESIDENCE PHONE 1 A /oZ 7 3Fi 72 BUSINESS PHONE(24HRS) / � r�� C7L BUSINESS TOTAL NUMBER OF ROOMS: ROOM USE: 1. /—K 2. f 3. ! . _4. .0);Ore(§�-L 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 PAAT THE TIME OF INSPECTION 1 _ APPLICANT'S SIGNATURE ti //1 DATE l f Inspectors use only Date on initial inspection: 115 �J Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check#'1 Q�6 Check date: 1 f 5' �— Notes: q23C0 rn1c(z l v1 L-A�Q)L — Co&tnf66ment Inspector 10 ow1T m CERT.# 290-01 a FEE $25 .00 ''ice q DATE: 06/07/2001 c� CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO HEALTH AGENT Tel: (978)741-1800 Fax: (978) 740-9705 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 19 Hancock Street UNIT #: 3 Front OWNER/AGENT: Charles Nelson ADDRESS: 22 Northern Avenue CITY/TOWN: Beverly, MA ZIP CODE: 01915 24 HOUR PHONE: 927-3672 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 . F R THE BOARD OF HEALTH JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR 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 Faz:(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 Ro �, C© �_�_—UNIT#-3 IS THIS UNIT DESIGNATED AS R H LEFT O BACK PLEASE CIRCLE ONE OWNER/LESSERF0 MANAGER/AGENT— No ANAGER/AGENT NADDDE Bax a t .O. S C r PRESSS CITY Gv2`r� CITY RESIDENCE PHONEqT 0�7' BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OFROOMS: t ROOM USE: 1.K I}- 2.��3. 1^-°R 4. 1' " 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 ' UC� ' DATE�f INSSPECTORS USE ONLY DATE OF INITIAL INSPECTION( , —7---0 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:X'',7-0 (DA'TE FEE PAID: 7 f TYPE OF UNIT: DWELLING k0THER_ CHECK# ,�O�CHECK DATE_� I NOTES: 6�11 YI uld.R- NQ w e. :•.y o a CODE ENFORCEMENT INSPECTOR 9/28198 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH -1cxa 120 WASHINGTON STREET,4`"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DCRH6:NBAUM(@SA7.l!M coM DAVID GRfi1P,NBAUM ACTIN(-, Hv1\j:I7-1 A<il''.NT CERTIFICATE OF FITNESS CERTIFICATE #335-10 DATE ISSUED: 7/14/2010 Property Located at: 20 Hancock Street UNIT# 1 Left Owner/Agent: Christopher Polak Address: 20 Hancock 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 DAVID B lI ACTING HEALTH AGENT CODE E O CEMENT INSPECTOR 4 „ CITY OF SALEM, MASSACHUSETTS R : BOARD OF HEALTH 120 WASHINGTON STREET,4P'FLOOR TEL.(978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR DGREENDAUM&ALE .COM DAVID GREENBAUM, 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: $150.00 tOPERTY LOCATED AT W.WI SI sq "i, X# UNIT# 1 L IS THISUNIT DISIGNNAT/ED AS RIGHT LEFT FRONT OR BACK PLEASES CIRCLE ONE WNER1LESSER_V1ZJWt/4f_ ("U/f�' K MANAGER/AGENT ,, � )DR Box �r - ADDRESS DRESS �� TY, STATE,ZIP CITY, STATE, ZIP sS1DENCE PHONE BUSINESS PHONE(24HRS) ISMESS PHONE )TAL NUMBER OF ROOMS: )OM USE: 1 LR 2 99 3. K f 4. 5. 6. 7. 8. 9. 10. ERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM )ARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME O�f�INSPECTION PLICANT"S SIGNATURE �,- C t 9� 1�f�C.— DATE -7 1 Inspectors use on e on initial inspection: y/ O Date of reinspection• e of issuance of certificate: ::7 f U Date fee paid: -7 10 �c of unit: Dwellin8_.,,�ther Check# t(v t yr Check date:. _764110 es: notun hq� I/v�r___ rCt G CIe i n wtnf� rcrc bul,(ws t) s fiu�c fi� I�uf� e Enfo em nt Inspector .co CITY OF SALEM, MASSACHUSETTS �m BOARD OF HEALTH ro .. $ 120 WASHINGTON STREET, 4TH FLOOR '• '�A o' SALEM, MA 01970 TEL. 978-741-1800 w'" Fax 978-745-0343 KIMBERLEY DRISCOLL JSCOTT@SALEM.COM MAYOR JOANNE SCOTT HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE# 145-08 DATE ISSUED: 3/24/2008 Property Located at: 20 Hancock Street UNIT# 1 Right Owner/Agent: Berube Family Trust Address: 19 Middlebury Lane City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 978-869-4373 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 oneear from date of issuance or until the current tenant vacates whichever Y , 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 I / 4 ' CITY OF SALEM, MASSACHUSETTS • • BOARD OF HEALTH 120 WASHINGTON STREET,4"FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR Iscorr n,ALHN1.COM JOANNE SCOTT, HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDSit/OF FIT/N'ESS FOR HUMA HABITATION." Q / PROPERTY WATED AT 8 A hCOC 4— �T Y P `�� UNIT# IS THIS UNIT IJISIGNATED A RIGH LEFT FRONT OR BACK,PLEASE Zyr")-?/CIRCLE O OWNER/LESSER r r MANAGER/AGENT Nn"'OGr Gy/ NO P.O. BOX ff -(r /' ADDRESS "% Ad t ieAarui V� _ ADDRESS CITY,STATE,ZIP �/C��l, C� CITY,STATE,ZIP RESIDENCE PHONE" �4 - 'l �4 BUSINESS PHONE(24HRS) -? 7 BUSINESS PHONE SC( Wl TOTAL NUMBER OF ROOMS:___ ROOM USE: L e FG4ey 2. 4. 5. 6. 7. 8. 9. 10. THERE IS A TWENTY-FIVE($25)DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH T FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANTS SIGNATURE d�� DATE 3 D Inspectors use only Date on initial inspection: -Z Date of reinspection: Date of issuance of certificate: D Date fee paid: "_3��- Type of unit: DwellingyOther Check#Check date: .-5 —1_ t4e — 64 Notes: Code Enforcement Inspector i c CITY OF SALEM9 MASSACHUSETTS 3� �w BOARD OF HEALTH 9 120 WASHINGTON STREET, 4TH FLOOR = Sipa SALEM, MA 01970 -� TEL. 978-741-1800 FAX 978-745-0343 KIMBERLEY DRISCOLL JSCOTT@SALEM.COM MAYOR JOANNE SCOTT HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE# 146-08 DATE ISSUED: 3/24/2008 Property Located at: 20 Hancock Street UNIT#2 Owner/Agent: Berube Family Trust Address: 19 Middlebury Lane City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 978-869-4373 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 ANNE SCOTT, MPH, RS, CHO V HEALTH AGENT CODE ENFORCEMENT INS CTOR • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR NICO rrO,ALEM.COM JOANNE SCOTT, HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM ST DARDS OFF/FIT ESS FOR HUMA HABITATION." r �/ PROPERTY LACATED AT � - 4 0,A,0- "-- Y Z'-e UNIT#�hal / /Ber IS THIS UN T DISICNA ED AS RIC vHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LES ER J I MANAGER/AGENT G1 k eeot / ✓> 7��f ADDRESS M GI �t P�j ADDRESS l G' r\ i CITY,STATE,ZIP 'e v ee c CITY,STATE,ZIP RESIDENCE PHONE q7(11 A) iS ��BUSINESS PHONE(24HRS) CI BUSINESS PHONE � �CI YY - TOTAL NUMBER OF ROOMS: JJ V ROOM USE: L. —4c 1 L-e v-74i7 2. V &6M 3.Q((CfI O PP✓4. J''tvyl 5. �eJ-00�1 6R,Pbi-an m 7. 8. T . 10. THERE IS A TWENTY-FIVE($25)DOLLAR FEE, PAYABLE PY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH TH EIS PAYABLI- Tr E TIME OB.IN ECTION APPLICANTS SIGNATURE DATE U n Inspectors use ons Date on initial inspection: -3 �� 4 — D 7S Date of reinspection: Date of issuance of certificate: 3 ' ) `i — 0 Date fee paid: _:3 Type of unit: Dwellin�Other Check#Check date: 3 Notes: Code Enforcement Inspector CERT.# 118-00 FEE $25.00 3IP � DATE: 02/16/2000 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO - NINE NORTH STREET HEALTH AGENT Tel:(976)741-1800 Fax:(978)740.9705 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 25 Hancock Street UNIT #: 1st floor OWNER/AGENT: Anthony Chambers ADDRESS: 43 Summit Avenue CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 825-9185 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 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 FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT �1�w179G7L' UNIT# IL IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE No P'0' Lox 411 /yam P.O. BoR/AGENT No P.O. Bax n No P.O. Box ADDRESS �t3 Si-Grnn d 4-11(2 ADDRESS CITY—5 / 17 . CITY RESIDENCE PHONE 97L'1325 -(2?-/ S- BUSINESS PHONE (24 NRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1-6 P-_2.L Le_.._3• �1 4•- v 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.2 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:��S ATE FEE PAID:2 -1G TYPE OF UNIT: DWELLING/(OTHER— CHECK#.CHECK DATE r ` NOTES — CODE ENFORCEMENT INSPECTOR 9128198 n � Itf CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 02/10/2000 Fax:(978)740-9705 Anthony Chambers 43 Summit Avenue Salem, MA 01970 PROPERTY LOCATED AT 25 Hancock 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 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 CMR1 State Sanitary Code, Chapter I: General Administrative Procedures and 105 CMR 410.0001 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) recordselectricity 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. _BOAA�� REPLY TO litne Scott, MPH,RS,CH0 PABLO VALDEZ -Health Agent CODE ENFORCEMENT INSPECTOR CERT.# 63-01 FEE $25.00 DATE: 02/13/2001 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: 25 Hancock Street UNIT #: 2nd Floor OWNER/AGENT: Anthony Chamberas ADDRESS: 43 Summit Avenue CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 825-9185 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 (K) 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 JO CO/O, TT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR I 3 M 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 FITNESS//FOR HUMAN HABITATION". PROPERTY LOCATED AT s2' S N R AICOC7C sT UNIT#.- D/L aO/Z IS THIS UNIT DESIGNATED ASIA GHT LEFT RON BACK PLEASE CIRCLE ONE OWNER/LESSEP,�giv7/YoiyYe",V)13gf1A5 MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS /1 S ate /jre ADDRESS CITY S<Ic EM CITY RESIDENCE PHONE92 S ^ 9/ S 5 BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS:_ ROOM USE: 1. 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 13 2-0 6/ INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 2 ` / 3 _b / DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: ) 3 '—Of DATE FEE PAID: Z — b 3 — 0 / TYPE OF UNIT: DWELLING OTHER_ CHECK# 3 g 5 CHECK DATE_2 NOTES: /� CODE ENFORCEMENT INSPECTOR 9/28/98 ��,e0Pll11T CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO HEALTH AGENT 120 Washington Street 401 floor 08/21/2001 Tel:(978)741-1800 Lisa Mcelrath-Popek & Albert Popek Fax:(978)745 0343 9 Brown Street Beverly, MA 01915 PROPERTY LOCATED AT 26 Hancock Street UNIT # 3R 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. OR THE BOARDqF HEALTH REPLY TO Joanne Sc t, MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR t 3y8' � fn CERT.# 145-98 3 FEE $25.00 DATE: 0 03/16/3/16/ 98 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: 26 1/2 Hancock Street UNIT #: 1L OWNER/AGENT: Lisa Sampson ADDRESS: 9 Linden Street CITY/TOWN: Maynard, MA ZIP CODE: 01754 24 HOUR PHONE: 461-0967 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 jiff, d 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 CK6 Y?— Ra,-7cock ;Jtw-�: _ UNIT I OWNER/LESSER l/5Q Sca.rrr.4Sc/,) MANAGER/AGENT- YOae- ADDRESSy// ADDRESS CITY �i/GL�ll2t3/� M71 0 ZSV CITY RESIDENCE PHONE 978 - . 6/-o9�6 -7 BUSINESS PHONE (24 HRS.) BUSINESS PHONE 617- 7z-7 TOTAL NUMBER OF ROOMS: ROOM USE: I. pedf-oom 2. {hr-,,i 3. ki�c a 4 . qI✓I/' 5. 1j'Vjjj,door 5. 7 . 8. THERE IS A,TWENTY-FIVE (25-00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPAR THIS FEE IS PAYABLE AT THE TINE OF INSPECTION APPLICANTS SIGNATURE DATE—3 114 N _ INSPECTORS USE ONLY DATE OF INITIAL INSPECTION: ``j /I[I %jg DACE OF REINSPECTION _ DATE OF ISSUANCE OF CERTIFICATE: DATE FEE PAID: TYPE OF UNIT: DWELLING OTHER_ NOTES : - — CODE ENFORCEMENT INSPECTOR � u • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET 4""FLOOR p11b,1CHC81�t. , Prevent.Promote.Protect. TEL. (978)741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL Itamdin@salem.com LARRY RAMDIN,RS/REHS,CHO,CI-FS MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#422-13 DATE ISSUED: 12/3/2013 Property Located at: 27 Hancock Street UNIT# 1 Owner/Agent: Yolanda Espinal Address: 27 Hancock Street#2 City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 781-581-8380 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 OF HEALTH ^ LARRY RAMDIN HEALTH AGENT SANITARIAN f CITY OF SALEM, MASSAiUSETTS BOARD OF HEALTH 40 T11PnblicHealth 120 WASHINGTON STREET,4FLOOR A<aonm.promote.wmem. TEL.(978)741-1800 FAX(978) 5-0343 KIMBERLEY DRISCOLL Iramdin@salem.com LARRY RAMI)IN,RS/R[?HS,CHO,(q)-FS MAYOR HEAL.CH AG EMP Application for Certifcate 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 114r1(&,e S�l UNIT# -VSA' IS THIS UNIT DISIGNATED AS RIGHT LEFT Nl'!=OR BACK PLEASE CIRCLE ONE OWNER/LESSER /AO r�. MANAGER/AGENT NO P.O. BOX ADDRESS ik e1101Y /(,i, , !ri tl t;., _ADDRESS CITY, STATE,ZIP r�.(�1v An, CIT , STATE,ZIP RESIDENCE PHONE 3:yx BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: S ROOM USE: 1. 2. 3. 4. ( 5. 6. 7. 8. 9. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK)R MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE PL/,-- Inspectors us on] Date on initial inspection: Id a411 Date of reinspection: Date of issuance of certificate: Date fee paid: f Type of unit Dwelling Other Check _Check date: Notes: ' dw— zy LUA� Code Enforcement Inspector ' CITY OF SALEM, MASSACI`3USET17S BOARD OF HE.ILTH 120 WASHINGTON STREET,41p FPublicAealth LOOR v.omm .wom TEL. (978) 741-1800 FAX(978)74 -0343 KIMBERLEY DRISCOI.L, Iramdingsalem.com MAYOR LARRY R:\MI)IN,RS/RI•:I IS,CI 10,CI F,% I-lli:\Ia'II i\GIfN'1' Release In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Secl. 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 .0 inspect the residence identified below in accordance with the aforem entioned statutes,regulations and ordinances. In the event it is necessary that said inspection be done in my/out 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 abselwe during said inspection.V11 10 FA f I k. i Tenant/Lessee er/Lessor z•�f I Address Address Address on unit to be inspected LZ Dat t Updated 523/11 CITY OF SALEM, MASSACHUSE,17S .� BoARD OF 11FALI-1 120 WASHINGTON StRI3ET,4'°FLOOR KTAvIBERLEW DRISCOLL, Tuj- (978)741-1800 7�,(� Pax(978)745-0343 LYI.Ayoft lram&n a(�7_saIgn&Qm LARRY RAMUI.N,RS/RPif-iS,o To,(:F'-Dfi I-lv'Aixii (,aINT CERTIFICATE OF FITNESS CERTIFICATE#200-11 DATE ISSUED: 6/20/2011 Property Located at: 30 Hancock Street UNIT# 1 Owner/Agent: Griffo Realty Trust c/o John Beatnie Address: 286 Humphrey Street City/Town: Swampscott, MA Zip Code: 01907 24 Hour Phone: 617-285-5595 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 11' 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 HEALTH AGENT CO NFORCEMENTINSPECTOR I • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4...FLOOR TFI- (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR 1,RAMDIN(@SAIJW.(70M LARRY RAMDIN,RS/RF'I IS,CHO,CP-FS IS, AGvN'r Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" 'I- FEE: $50.00 � f1LV PROPERTY LOCATED AT �5 UNIT# 1 / IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER 1WrALA �At MANAGER/AGENTO�ba "to NO P.O. BOX � ADDRESS & 1 1j^'f)(11 4 ADDRESS W1., ,nt,I y' CITY, STATE,ZIP S(I(aAIS4- NNOE b1(i10CITY, STATE, ZIP fx4mry-4,, Tw mR bN7 RESIDENCE PHONE BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS:_ ROOM USE: l "roc nn 2.Lw o. 3. r n 4.Wymv\ 5-D x, n 6.LW&j,e 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 ISP YABLE AT E TIME OF INSPECTION APPLICANT'S SIGNATURE DATE (, -l 1 Inspectors use only Date on initial inspection: lJ d V` /If Date of reinspection: Date of issuance of certificate: lA o Date fee paid: Type of unit: Dwelling �Other Check#!q-13.;&2 Ky4Check date: C�l �D i/� �n fFC-)-- Notes: r 1, h AkGU`P fUGM. npW bGl��?/ I !1 aJLm iddle �Y (_V_t� v Code "for ement Inspector a CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR fFa SALEM, MA 01970 s TEL. 978-741-1800 FAX 978-745-0343 KIMBERLEY DRISCOLL JSCOTT@SALEM.COM MAYOR JOANNE SCOTT HEALTH AGENT 5129108 Sergio Desouza 286 Humphrey Street Swampscott, MA 01907 PROPERTY LOCATED AT 30 Hancock Street Unit 1 Front 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 j 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 Boardof H i� Reply to Joanne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 °ro"g 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 #400-06 DATE ISSUED: 8/15/2006 Property Located at: 30 Hancock Street UNIT# 1 Front Owner/Agent: Sergio Desouza Address: 286 Humphrey Street City/Town: Swampscott, MA Zip Code: 01907 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 �e { v ANNE SCOTT, MPH, RS;CHO HEALTH AGENT ODE ENFORCEMENT INSPECTOR Aug 01 OG 03: 52p Joanne Scott Salem 80H 978 745 0343 p. 2 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 0 120 WAS FU NE'YON STREET, ATH FLOOR SALEM, MA UI`!/O TEL. 978-741-1000 FAX 979-745-0343 JOANNE SCOTT. MPH, RS, CHO Kimberley Driscoll HEALTH AGENT Mayr APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OFFITNESSFOR HUMAN HABITATION" , PROPERTY LOCATED AT . 17 (�G�Lt __ . UNIT R D� IS THIS UNIT DESIGNATED ASRIGHLEFT R N BACK PLEASE CIRCLE ONE OWNER/L[SSER... �� ,.1"46 _.. ..—MANAGER/AGENT._. ...._.. No P.O. Box No P.O.Box ADDRESS .._ .., ._—. RESIDENCE PHONFIA I� BIISINFSS PHONE (24 HRS )UT`i0l_ BUSINESS PHONE,_��v_X ..— TOTAL NUMBER OF ROOM&05., .,. ROOM USE: 1. ..._— 2..... 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 _/�__.�_DATEt� , vu. _ INSPECTORS US,E ONLY D,_T OF INITIAL,INSPECTION,.,'� „- l r ._.DATE OF REINSPECTION-_ DATE OF ISSUANCE OF CERTIFICATE—t--;-----0 ( DATE FEE PAID:_ �.1 S TYPE OF UNIT: DWELLIrTHER__. CHECK#_S,0 7 __. CHECK DATEg—. L.)' NOTES:. --- ... CODE ENFORCEMENT INSPECTOR 9/28/y8 i r CITY OF SALEM, MASSACHUSETTS ® BOARD OF HEALTH s 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAx 978-745-0343 Kimberley Driscoll WWW.SALEM.COM Mayor JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#379-06 DATE ISSUED: 8/4/2006 Property Located at: 30 Hancock Street UNIT#2 Owner/Agent: Sergio R Desouza Address: 286 Humphrey Street City/Town: Swampscott, MA Zip Code: 01907 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 If' Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH ANNE SCOTT MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR Rug :O1 ,OS 03: 52p Joanne Scott Salem BOH - 978 745 0343 p. 2 i" n osmCITY OF SALEM, MASSACHUSETTSBOARD OF HEALTH120 WASHiNGI'ON STREET. 4TH FLOOR SALEM, MA U19/U TES. 976-741-1800 FAX 976-745-0743 JOANNC SCOTT, MPH, R5, 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 .. _s��`((2Ld�- .. _. - -.—UNIT A� IS THIS UNIT DESiG?NATED AS RIGHT LEFT (9DBACK PLEASE CIRCLE ONE OWNERILESSER, [y�p_ —LLZ___`. MANAGERIAGENT_ _ C1_ -- No P.O. Box No P.O. Box ADDRESS a L *)me�A __. ADDRESS. .--- RESIDENCE DDRESS. ._RESIDENCE PHONE PHONE PHONE (24 HRS.) BUSINESS PHONE.: '- y0 - TOTAL NUMBER OF ROOMSqq^^ 06 i ROOM USE: 1.�1YA 2.,j �v3. G",4 &AwA 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 US ONLLY DAIS OF INITIALOF .INSPECTION, -_ '�...y ..._.DATE OF REINSPECTION_,_ .___.. . DATE OF ISSUANCE OF CERTIFICATE l�PDATE FEE PAID._-_ TYPE OF UNIT: DWELLIyV�__. OTHER__. CHECK#_y�.v -- CHECK DATE�_=�- 6� NOTES;. .. --... ..._-...... . .......---- '----..---- .. CODE ENFORCEMENT INSPECTOR 9/28198 RuC ,01 ,`013 03: 52p Joanne Scott Salem 90H 978 745 0343 p. 3 a,. CITY OF SALEM, MASSACHUSETTS '� BOARD OF HEALTH 3 120 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 RELEASE I:1 accordance with Massachusetts Ceneral Laws Chapter III ; Code of Massachusetts N.n Rc.11orinn< 1, 10.00(1 ,r . .qeq- ; Srni'p Sanirary Cnde Chapter 11 and Article XI11 of r.iic .it;• ef. Salem 0['divance, undersigned owner/lessor and tenant/lessee u'_' a unit Of V,asidcnLial property, hereby authorize the Salem Bozrd of Ilealch or its author- 12C6 agenl.c to inepeCt the rasidencc identified below in :crrordancp. with the aiorementi.oned statutes, regulationu C.nd ordinances. 1» Lhr cvcnt l.r iC n6CCUr,'r:'v Lhat sai.d inspection be done 10 my/nor :111.4pnYp . i/wp expressly autlwri.ae the same and for wy/our successors And assi.rns her.ldby "Id disrhar r the City of Salem, Salem lioard of liealvh ::nd its authorised ,go "t:s I.ro!n sny 'n:;:s or injury :_uta in Cd of vh�tever nntcre a,nl Gasct'iption ncr•.�cirrnNd b7 my/nur absence Jurirg saiid ins OeCL1.00 Li'sC SEi � �^ - li'.11iE4/i;iSSUk ryc. nuu!u:ss r.U012F.5. 'i)!Illh ;S (�I' tIN I'! Tcl I{ll'h:CPlil) v CERT.# 587-00 FEE $25 .00 DATE: 09/14/2000 ��/M1Ng0 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: 31 Hancock Street UNIT #: 1 OWNER/AGENT: Rhett & Pamela Rochna ADDRESS: 35 Hancock Street #2 CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-3471 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 4JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR l 5 3 � 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 FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT_ � �A C _UNIT#_t IS THIS UNIT DESIGNATED {�A,S�RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER� C7411 - rrarr 7P)L&RQ_MANAGER/AGENT No P.Q. Box,, t No P.O. Box ADDRESS_�a�tcaYlC(1C� �jT � ADDRESS _ CITY ��Q ��o _CITY RESIDENCE PHONEq 7 -7"-3� I—BUSINESS PHONE (24 HRS.) BUSINESS PHONEC172-74 U 02JI_4?=, TOTAL NUMBER OF ROOMS: ROOM USE: 4.)( �tlter l 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. �.•�'1 � C\ � APPLICANTS SIGNATURE n rn_Q pn 11A _._DATE a^� -bC� INSPECTORS USE ONLY DATE OF INITIAL INSPECTION rd O DATE OF REINSPECTION _ DATE OF ISSUANCE OF CERTIFICATEI� _ _DATE FEE PAID:.( "l �f TYPE OF UNIT: DWELLINGOTHER_ CHECK#a� CHECK DATE C( -O-0 NOTES: __ — CODE ENFORCEMENT INSPECTOR 9128198 coamr y M �f 9B�/MMB CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT 08/31/2000 Tel: (978)741-1800 Fax: (978)740-9705 Rhett Rochna & Pamela Noel 31 Hancock Street Salem, MA 01970 PROPERTY LOCATED AT 31 Hancock 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. FqR THE BOARD 0 HEALTH REPLY TO Joanne Scott, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR f coror,�� e� 4`,tol � CITY OF SALEM HEALTH DEPARTMENT BOARD OF HEALTH Salem, Massachusetts 01970 9 NORTH STREET 508-741-1800 _ DATE: March 31, 1994 Jodi L. & Jacqueline M. Hughes 32 Hancock Street 111 Salem, MA 01970 PROPERTY LOCATED AT 32 Hancock Street UNIT # 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 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: PABLO VALDEZ Code Enforcement Inspector ACTING HEALTH AGENT CITY OF SALEM, MASSACHUSETTS JL BOARD OF HEALTH 06 120 WASHINGTON STREET,4""FLOOR TEL. (978) 741-1800 KIMBERLEY DRTSCOIJ FAX(978) 745-0343 MAYOR 1mnNciN1(?a SAjEN1 coM JANISI'MANCINI - Aci IN(; Hi�Aj:n I A(;ENT CERTIFICATE OF FITNESS CERTIFICATE#241-09 DATE ISSUED: 5/27/2009 Property Located at: 39 Hancock Street UNIT# 1 Owner/Agent: Michael Stone Address: 5 Warwick Road City/Town: Belmont, MA Zip Code: 02478 24 Hour Phone: 617-839-6444 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 av lid Cert'f' cate of Occupancy. FOR THE BOARD OF HEALTH JANET MANCINI ACTING HEALTH AGENT COO, EN ORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS �yq BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 I<lN BERLEY DRISCOLL FAX(978) 745-0343 MAYOR IMANCIN19SALEN1.COM JANET MANCINI, 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." Q /�"" FETE(: $50.00 PROPERTY LOCA D AT � ` R it 1v�C�0- `` �> 94�e,JV\ UNIT#_�S � ` / IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE /' OWNER/LESSER% C V�A �� MANAGER/AGENT I tl fi �� CCs,110�E-d�S BOX ADDRESS w ,C_y, 1 ` � ADDRESS 13 1 �M Sfi CITY, STATE, ZIP �J JYIQB�l�� `" \' ` U /v'7f�' "CITY, STATE,ZIP 14\ RESIDENCE PHONE -,d!Gln BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS:p_ ROOM USE: 1. V r h1 2. �v� 1�PN 3. I� `\ 4. bpm ar ,p 7. Fuf o«I. 8. 1 ,K form 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 INSPPE,CTION APPLICANT'S SIGNATURE (0 0 DATE 2� 9 Inspectors use only Date on initial inspection: Date of reinspection: Date of issuance of certificate:/ E41-710 I Date fee paid: d Type of unit: DCwelling 'V Other Check# Q3 7 Check date: S /& 7/07 Notes: 1 (� Otr- : Ifo .cecfilon R jr OAn 4Ar 1z-e0U4� Code Enforcement Inspec or l-MPDRTAANT MESSAGE FOR 4-4{{c/ DATE Vf�� TIME A.M. PHONE AREA CODE NUMBER EXTENSION ❑ FAX U MOBILE AREA CODE NUMBER TIME TO CALL TELEPHONED PLEASE CALL ✓ i CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU RUSH RETURNED YOUR CALL " WILL FAX TO YOU G7 MESSAGE �a�' F 9-78r V,53 /1.50 Lc ' / n.c. _ O SIGNED M 4 U. S.A.1H AUE IN CITY OF SALEM MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4`"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx (978) 745-0343 MAYOR IMANCIN19SALEM.COM JANET MANCINI ACTING HEALTH AGENT Facsimile Transmittal To: OL/M ''- V;or — / OWG 5 Fax # 1 75I00 RE e Date p Page(s): including this cover# Message: 06tAA wr ng Board of Health News ----------------------------------------------For Your Information OFFICE HOURS: Monday, Tuesday, Wednesday 8:00 AM to 4:00 PM Thursday 8:00 AM to 7:00 PM Friday 8:00 AM to 12:00 NOON r HP Fax Series 900 Fax History Report for Plain Paper Fax/Copier Joanne Scott Salem BOH 978 745 0343 May 29 2009 9:01am Last Fax D= Time I= Identification Duration s Result May 29 9:OOam Sent 919784539150 0:35 2 OK Result: OK - black and white fax CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741.1800 FAx 978-745-0343 W W W.SALEM.COM Kimberley Driscoll JOANNE SCOTT, MPH, RS, CHO Mayor HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#373-06 DATE ISSUED: 7/28/2006 Property Located at: 39-41 Hancock Street UNIT#2 Owner/Agent: Michael Stone Address: 5 Warcwick Road City/Town: Belmont, MA Zip Code: 02478 24 Hour Phone: 781-599-2468 Wilfred An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter If' Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH (� qe-o,� x4jom / JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS 3" BOARD OF HEALTH I J 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 ,pB� 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 q I H ow t O(_K S+ S6 I tyn UNIT# 0)� IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER MII1 A I'1V- MANAGER/AGENT W 11 t o No P.O. Box L No P.O. Box 1 ADDRESS d//lv-C W k C K� � ADDRESS CITY_ i� tna-rY� CITY en"1 `7p� '069 p RESIDENCE PHONE A� 491 '1r 7 BUSINESS PHONE (24 HRS.) !C 1 S g g_SLY 6 6 BUSINESS PHONE TOTAL NUMBER OF ROOMS: �P S ROOM USE: 1.✓�Iltu� d-°2. 1�14 ' 4. �� THERE IS A TWENTY-FIVE($25.00) DOLLAR F' E, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. n SLAIr APPLICANTS SIGNATURE W- y"_DATE �- �a� ®� INSP CTORS USE ONLY DATE OF INITIAL INSPECTION - 2&-O\o DATE OF REINSPECTION-7—d-0-- DATE EINSPECTIONDATE OF ISSUANCE OF CERTIFICATE:7-0y DATE FEE PAID:-AE UD-0 b TYPE OF UNIT: DWELLING V_OTHER_ CHECK#,2 7 j l_CHECK DATE _ C, NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • VEY 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 RELEASE In accordance with Massachusetts General Laws Chapter III ; Code of Massachusetts B:egulations 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, 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 age:ncs from any loss or injury sustained of whatever nature and description oa_asioae6 by my/our absence ;luring said inspection. TENANT/LESSEE - - - OWNER/1. SCF. -- S-A&IADDRE s S - - --- -- -- - DDRESS A.DDKEs.S OF l7NL'I' TO BE IP:SPECTED 1 WTI CITY OF SALEMv MASSACHUSETTS BOARD OF HEALTH o s 120 WASHINGTON STREET, 4TH FLOOR o' SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 JOANNE SCOTT, MPH, RS, CHO Kimberley Driscoll HEALTH AGENT Mayor October 10, 2004 Dear Property Owner, Property Manager, or Real Estate Agents: As you may know, landlords, sellers and agents are now required to disclose known Information on lead-based paint and/or lead-based paint hazards in virtually all rent, lease, and sales transactions in dwellings built before 1978 to enable parents to protect their children. The required Tenant Notification Form is enclosed. The United States Department of Housing and Urban Development along with the State of Massachusetts Childhood Lead Poisoning Prevention Program has asked the City of Salem Board of Health to help in ensuring the disclosure process is working. The Federal Residential Lead-Base Paint Hazard Reduction Act, 42 U.S.C. 4852d, requires sellers and landlords of most residential housing built before 1978 to disclose all available records and reports concerning lead-based paint and/or lead-based paint hazards, including the test results contained in this notice to purchases and tenants at the time of sale or lease or upon lease renewal. This disclosure must occur even if hazard reduction or abatement has been completed. Failure to disclose these test results is a violation of the U.S. Department of Housing and Urban Development and the U.S. Environmental Protection Agency regulations at 24 CFR Part 35 and 40 CFR Part 745 and can result in a fine of up to $11,000 per violation. To find out more information about your obligations under federal lead-based paint requirements, call 1-800-424-LEAD. Thank you in advance for your assistance. If we can be of any assistance, please call the Salem Board of Health (978-741-1800) and ask for a Lead Paint Determinator. For the Board of Health ...lbanne Scott Health Agent Tenant Lead Law Notification What lead paint forms must owners of rental homes give to new tenants? Before renting a home built before 1978, the property owner and the new tenant must sign two copies of this Tenant Lead Law Notification and Tenant Certification Form, and the property owner must give the tenant one of the signed copies to keep. If any of the following forms exist for the unit. tenants must also be given a copy of them: lead inspection or risk assessment report. Letter of Compliance,or Letter of Interim Control. This form is for compliance with both Massachusetts and federal lead notification requirements. What is lead poisoning and who is at risk of becoming lead poisoned? Lead poisoning is a disease. It is most dangerous for children under six years old. It can cause permanent harm to young children s brain, kidneys, nervous system and red blood cells. Even at low levels, lead in children's bodies can slow growth and cause learning and behavior problems. Young children are more easily and more seriously poisoned than others, but older children and adults can become lead-poisoned too. Lead in the body of a pregnant woman can hurt her baby before birth and cause problems with the pregnancy. Adults who become lead poisoned can have problems having children, and can have high blood pressure, stomach problems, nerve problems, memory problems and muscle and joint pain. How do children and adults become lead poisoned? Lead is often found in paint on the inside and outside of homes built before 1978. The lead paint in these homes causes almost all lead poisoning in young children. The main way children get lead poisoning is from swallowing lead paint dust and chips. Lead is so harmful that even a small amount can poison a child. Lead paint under layers of nonleaded paint can still poison children, especially when it is disturbed, such as through normal wear and tear and home repair work. Lead paint dust and chips in the home most often come from peeling or chipping lead painted surfaces: lead paint on moving parts of windows or on window pans that are rubbed by moving parts: lead paint on surfaces that get bumped or walked on, such as floors, porches, stairs, and woodwork: and lead paint on surfaces that stick out which a child may be able to mouth such as window sills. Most lead poisoning is caused by children's normal behavior of putting their hands or other things in their mouths. If their hands or these objects have touched lead dust. this may add lead to their bodies. A child can also get lead from other sources, such as soil and water, but these rarely cause lead poisoning by themselves. Lead can be found in soil near old, lead-painted homes. If children play in bare, leaded soil, or eat vegetables or fruits grown in such soil, or if leaded soil is tracked into the home from outside and gets on children's hands or toys, lead may enter their bodies. Most adult lead poisoning is caused by adults breathinz in or swallowing lead dust at work, or, if they live in older homes with lead paint- through home repairs. How can you find out if someone is lead poisoned' Most people who arc lead poisoned do not have any special symptoms- The only wav to find out if a child or adult is lead poisoned is to have his or her blood tested. Children in Massachusetts must be tested at least once a year from the time they are between nine months and one year old until they are four years old- Your doctor, other health care provider or Board of Health can do this A lead poisoned child will need medical care. A home with lead paint must be deleaded for a lead poisoned child to get well. Tenant Certification Form Required Federal Lead Warning Statement Housing built before 1978 may contain lead-based paint. Lead from paint, paint chips,and dust can pose health hazards if not managed properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978 housing, lessors must disclose the presence of known lead-based paint and/or lead-based paint hazards in the dwelling. Lessees must also receive a federally approved pamphlet on lead poisoning prevention. The Massachusetts Tenant Lead Law Notification and Certification Form is for compliance with state and federal lead notification requirements. Owner's Disclosure (a) Presence of lead-based paint and/or lead-based paint hazards(check(i)or(ii) below): (i)_Known lead-based paint and/or lead-based paint hazards are present in the housing(explain). (ii)_Owner/Lessor has no knowledge of lead-based paint and/or lead-based paint hazards in the housing. (b) Records and reports available to the owner/lessor(Check(i)or(ii) below): W Owner/Lessor has provided the tenant with all available records and reports pertaining to lead-based paint and/or lead-based paint hazards in the housing(circle documents below). Lead Inspection Report; Risk Assessment Report; Letter of Interim Control; Letter of Compliance (ii) Owner/Lessor has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing. Tenant's Acknowledgment(initial) (c)_Tenant has received copies of all documents circled above. (d) Tenant has received no documents listed above. (e)_Tenant has received the Massachusetts Tenant Lead Law Notification. Agent's Acknowledgment(initial) (f)_Agent has informed the owner/lessor of the owner's/lessor's obligations under federal and state lav for lead-based paint disclosure and notification and is aware of his/her responsibility to ensure compliance. Certification of Accuracy The following parties have reviewed the information above and certify, to the best of their knowledge, that the information they have provided is true and accurate. Owner/Lessor Date Owner/Lessor Date Tenant Date Tenant Date Agent Date Agent Date Owner/Managing Agent Information for Tenant (Please Print): Name Street Apt. City/Town Zip Telephone I (owner/managing agent)certify that I provided the Tenant Lead Law Notification/"Lenart Cerification Form and am' existing Lead Law documents to the tenant, but the tenant refused to si,,;n this certification. The tenant gave the following;reason. _ The Massachusetts Lead La", pr lhibiu rental discrimination_ includim- refusing to rent to families wiih children or evicting families with children because of[cad paint. Contact the Childhood Lead Poisoning prevention program for information on the availability of this form in other languao s- Tenant and owner must cacti keep a completed and signed copy of this form_ c:Awp50Aleadl995Vforms\cip95-17.wp Rcv. 5/98 I CITY OF SALEM, MASSACHUSETTS r/. s A� BOARD OF HEALTH ff 120 WASHINGTON STREET, 4TH FLOOR c SALEM, MA 01970 ^" TEL. 978-741-1800 meq" FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#. 332-04 DATE ISSUED: 7/21/2004 Property Located at:39-41 Hancock St. UNIT# 3 Owner/Agent: Michael Stone Address: '39 Hancock Street City/Town:Salem, MA Zip Code01970 24 Hour Phone: 978-314-2468 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 /moi JOANNE SCOTT, MPH, RS. CHO HEALTH AGENT CODE FNFORCEI�4ENT INSPEC 1 OR y CITY OF SALEM, MASSACHUSETTS �2 ` ,{ +� BOARD OF HEALTH • : 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 Cy n TEL. 976-741-5800 11Ydd `kr(l t�l:/:� O �nN6 o f1 STANLEY Usoviez, JRFaX 976-745-0343 . JOANNE SCOTT, MPH, R5, CHO ,JUN 0 8 2004 MAYOR HEALTH AGENT CITY OF SALEM BOARD OF HEALTH APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF�FITNESS FOR HUMAN HABITATII�O,N{_". PROPERTY LOCATED AT .O-1 �1�`L�C.n1C� J' I UNIT#.-z 4 ' 0�f IS THIS UNIT DESIGNATED ASIR GHT LEFT FRONT BACK PLEASE CIRCLE ONE Q OWNER/LESSER�C��A1 _MANAGER/AGENT� ( t,� No P.O. Box No P.O.Box ADDRESSvaG ADQRESS CITY-:\ . CITY g _ RESIDENCE PHONEp IU4��S3 I�USINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ___ Q ROOM USE: 1. LV (?,t4,, 2. P 3. IQ t- 4.,_.4 vv\ 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. Q APPLICANTS SIGNATUR � DATES I S ECTORS USE ONLY C>ATE OF iNIT1AL INSPECTION%—2 1, p '� DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE l— _DATE FEE PAID:, � TYPE OF UNIT: DWELLIN OTHER_.^ CHECK # �O O CHECK DATE > NOTES:, CODE ENFORCEMENT INSPECTOR 9/28/98 r R CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET e4'"FLOOR PI1b�iCS@8Ith —_ - - - Prevent.Promote.Protect. TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL Ixamdin@salem.com LARRY RAMDIN,RS/RIA-1s,CHO,CRFs MAYOR HI-?AT:n-T AG EiNT CERTIFICATE OF FITNESS CERTIFICATE#15-15 DATE ISSUED: 1/26/2015 Property Located at: 41 Hancock Street UNIT#2 Owner/Agent: Mike Stone Address: 11 Stanley Road City/Town: Swampscott, MA Zip Code: 01907 24 Hour Phone: 781-599-2468 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 OF HEALTH lux ,/ i�i LAR M IN HEAL AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS `I BOARD OF HEALTH 120 VIWASIUNGTON STREET,4T"FLOOR Tr-1,. (978)741-1800 KIM 3FRLEY DRISCOLL FAx(978)745-0343 MAYOR LRANIDINgSALEM.COM LARRY RAMDIN,RS/REI-TS,CHO,U-17S 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 7/ .114AAC-oG/C.. .4w_14— 10L./L_ UNIT# Z IS THIS UNIT n IGNATED AS RIGHT LENT FRONT OR BACK.PLEASE CIRCLE ONE OWNER/LESSER /C- �X. (/�_ MANAGER/AGENT ADDRESS Af 6-b9 i� Pfi /� / C ADDRESS CITY, STATE,ZIPSSF4"1� AS c., CITY,STATE,ZIP / RESIDENCE PHONE b/7 Y8'"�SG tf BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 3. 4. 5. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR- E,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THISAYABLE AT T TIME OF INSPECTION APPLICANT'S SIGNA L DATE Z- 13— Inspectors use only Date on initial inspection: �' ��^�S Date of reinspection: Date of issuance of certificate: I' L6 I S Date fee paid: Type of unit: Dwelling L—'� Other Check# �3�_Check date: Notes: ode Enforcement Inspector CITY OF SALEM, MASSACHUSETTS s : BOARD OF HEALTH 120 WASHINGTON STREET,4"FLOOR T`EL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR IMANCINInSAi EM.COM i JANET MANCINI ACTING HEALTH AGENT i CERTIFICATE OF FITNESS i CERTIFICATE# 15-09 DATE ISSUED: 1/8/2009 Property Located at: 41 Hancock Street UNIT#3 Owner/Agent: Mike Stone Address: 5 Warwick Road City/Town: Belmont, MA Zip Code: 02478 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. i FOR THE BOARD OF HEALTH J ET MANCINI TING HEALTH AGENT CODE E ENFORC T INSPECTOR CM CITY OF SALEM, MASSACHUSETTS • BOARD OF HFALT11 120 WASHINGTON STREET,4`FLOOR TEL.(978)741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR IDIONNE e SALEM.COM JANET DIONNE, 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: $500.00 PROPERTY'LOCATED AT A W Ci 1t` St UNIT# MIS THIS UNC[` DISIGNATED AS RIGHT LFFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER } `� ' MANAGER/AGENT �_ n - NO P.O.BOX �t ADDRESS S (`c1.r Wk c 1� ADDRESS �I }C CITY, STATE,ZIP �1 ✓Y\9-Y�T AC ot47 CITY, STATE,ZIP Y-\ °I Q / q pr7 RESIDENCE PHONE k� I / S "y BUSINESS PHONE{24HRS) -7G 4 S9 z-y �' P BUSINESS PHONE � / -7 8'31 p Y Vy TOTAL NUMBER OF ROOMS:_ 6 �5 K, P p i ROOM USE: 1. 1,1 ✓ X ^� (v\ 2. )V Iv '1`'` 3. K, 4. l9- 5. 6. A� 7. tt�die 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 t C CP� '- " DATE Llf 0 9 �y Inspectors use only Date on initial inspection: ( O`C Date of reinspection: Date of issuance of certificate: Date fee paid: p Type of unit: Dwelling Other Check# i b U Check date: u I t) 1 Notes: t i - --�o GIC 4y Coder ement I Inspector v CERT.# 332-98 FEE $25.00 311 �F DATE: 06/01/98 HIPS 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: 43-45 Hancock Street UNIT #: 1 OWNER/AGENT: Roland & Mary St. Pierre ADDRESS: 23 Settlers Way CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-4997 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 3 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 APPLICATION FOR CERTIFICATE OF FITNESS Fax:(978)740-9705 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITAT] PROPERTY LOCATED AT T 9 — UNIT n IS THIS UNIT DES] ED I FT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSE ANAGER/AGENT ADDRE ADDRESS CITY CITY RESIDENCE PHONE ��7f�S<�,T BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS- ROOM USE: iJCiT�fi� ��4. 54 f 6./11,7. 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 Q APPLICANTS SIGNATUR C ATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION_ Qq DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: 61,Ab 61, DATE FEE PAID: r.1,1, 98 TYPE OF UNIT: DWELLING*t--OTHER__ NOTES: CODE ENFORCEMENT INSPECTOR 5/19/98 I CERT.# 189-96 3 FEE $25.00 5! DATE: 04/01/96 ��MfNg CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(508)741-1800 Fax:(508)740-9705 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 43 Hancock Street UNIT #: 1 OWNER/AGENT: Roland & Mary St- Pierre ADDRESS: 23 Settlers Wav CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-4997 AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410.000 : MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE SALEM HEALTH DEPARTMENT AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED. MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410 .000: MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . SECTION 410.400 (B) : DWELLING UNIT (X) AND 410.400 (C) : ROOMING UNIT MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: . NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR OCCUPANTS UNDER 6 YEARS OF AGE. FOR THE BOARD OF HEALTH � � V OANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR iL CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tei:(508)741-1800 APPLICATION FOR CERTIFICTE OF FITNESS Fax:(508)740-9705 IN ACCORDANCE KITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT , �ylp yyT UNIT OWNER/LESSER ham MANAGER/AGENT" ADDRESSg�- �$ j) �� ADDRESS CITY CITY RESIDENCE PONE .Sjj - jyt / (}r7 BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF RO��OffMS: ROOM USE: I. .��'fr�2.Gds!��E�3.d��V�i2ry 4 .� 5< N ' 6. l 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 TIM OF INSPECTION APPLICANTS SIGNATURE DATE DATET.3 ' U INSPECTORS USE ONLY DATE OF INITIAL INSPECTION:�� 'r �� DATE OF REINSPECTION _ DATE OF ISSUANCE OF CERTIFICATE:C > DATE FEE PAID: {v TYPE OF UNIT: DWELLING/1- OTHER NOTES: /— i CODE ENFORCEMENT INSPECTOR 3 --- - Wj ��MMB 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: 03/25/96 Fax:(508)740-9705 Roland & Mary St. Pierre 23 Settlers Way Salem, MA 01970 PROPERTY LOCATED AT 43 Hancock 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, FqR THE BOARD OF HEALTH REPLY TO Joanne Scott, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR I