The URL can be used to link to this page

HARBOR STREET 1-21 HARBOR STREET 1 - 21 4 ` I f �uxo1T CITY OF SALEM, MASSACHUSETTS �. BOARD OF HEALTH 3 ° 120 WASHINGTON STREET, 4TH FLOOR � CERT.# 14-02 e SALEM, MA 01970 FEE $25.00 TEL. 978-741-1800 DATE: 01/10/2002 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 1 Harbor Street UNIT #: Right Front OWNER/AGENT: Ouellette Realty ADDRESS: 1 Harbor Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-1962 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 o CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH ' 4 uiutt 120 WASHINGTON STREET, 4TH FLOOR :d 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^ -�� G'�d g UNIT# IS THIS UNIT DESIGNATED A RIGHT E T FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER MANAGER/AGENT �,,e�6( No P.O. Box JJ// No P.O.Box ADDRESS ?J #WAOX S" ADDRESS CITY S CITY RESIDENCE PHONE "7y BUSINESS PHONE (24 HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: c;z ROOM USE: 1. 5.-----6.--7--8-- THERE ._ 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 SIGNATUR _ DATE off' Ld d L INSPECTORS USE ONLY DATE OF INITIAL INSPECTION /- /C —62' DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: 1- I D" /-'- DATE FEE PAID: TYPE OF UNIT: DWELLINAOTHER_ CHECK# g q`J 3 CHECK DATE 1 NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 I- CERT.# 797-00 91 FEE $25.00 DATE: 12/19/2000 �AMI� 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: 1 Harbor Street UNIT #: 2 OWNER/AGENT: Ouellette Realty ADDRESS: 1 Harbor Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-1962 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 G CODE ENFORCEMENT INSPECTOR c e 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 jyy/ l UNIT#JOVa IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNERILESSER MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS ADDRESS CITY ., CITY 19' RESIDENCE PHONE BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 101p 2. L �" 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 SIGNATURE X DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION M/l/oo DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:_M/49 DATE FEE PAID: / /ate TYPE OF UNIT: DWELLING_OTHER `�CHECK# ' '7/� CHECK DATE L�6Z NOTES: In i�a��eQ 6J co.0 C iAi�.QQ6J co.0 C i'Ai�.QQ 0' CODE ENFORCEMENT INSPECTOR 9/28/98 w CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH a e 120 WASHINGTON STREET, 4TH FLOOR e SALEM, MA 01970 CERT.# 191-02 TEL. 978-741-1800 FEE $25.00 FAX 978-745-0343 DATE: 04/17/2002 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 1 Harbor Street UNIT #: 3 Left OWNER/AGENT: Ouellette Realty ADDRESS: 1 Harbor Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-6558 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 i ' CITY OF SALEM,sMASSAGHUSETTS BOARD OF HEALTH J • i 120 WASHINGTON STREET, 4TH FLOOR .� SALEM, MA 01970 1 TEL. 978-741-1800 .I FAX 978-745-0343 - #` i 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_L..._�`tI4 , VAA —UNIT#3 IS THIS UNIT DESIGNATED AS FLGHLEFT ROS BACK PLEASE CIRCLE ONE OWNER/LESSER fSUFCLFl%F ��G7 MANAGEWAGENT No P.O. Box // ////' - No P.O. Box ADDRESS_(_( x0/L S/ ADDRESS CITY--- RESIDENCE ITY _RESIDENCE PHONE ?f 25f I .6Z BUSINESS PHONE(24 HRS.)_ 97,F—,2w-6 S3-e dt r; BUSINESS PHONE______ 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 SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANTSJr� �� APPLICANTS SIGNATU ' �eOz IN S PECTORS USE ONLY DATE OF INITIAL INSPECTION ( ""1 7 O DATE OF REINSPECTION_. DATE OF ISSUANCE OF CERTIFICATE: 7 ! 7 ?' DATE FEE PAID: TYPE OF UNIT: DWELLING"HER— CHECK#2- 12 —CHECK DATE f-t NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 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#308-06 DATE ISSUED: 6/12/2006 Property Located at: 1 Harbor Street UNIT#3Right Back Owner/Agent: Ouellette Realty Address: 1 Harbor Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-744-1962 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 OFF HEALTHr JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR V 50 SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 JOANNE SCOTT, MPH, RS, CHO Kimberley Driscoll HEALTH AGENT Mayor APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR R HUMAN HABITATION". PROPERTY LOCATED AT ` /7 GPJ d 11 S% S,�L-4� UNIT#_S IS THIS UNIT DESIGNATED A IGHT LEFT FRON BACK LEASE CIRCLE ONE OWNER/LESSER OvGGG1,--7725 JdVZ y MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS d/Z 131- ADDRESS CITY S�VA-9�-I CITY 4 RESIDENCE PHONE '7a'-7�y_/It-ZBUSINESS PHONE (24 HRS.) c y✓/�/�� BUSINESS PHONE ' 7f-I�/�/Iy� Z TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3. 4. 5. —&-7.-8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENTTHIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATUR DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION .(0 DATE OF REINSPECTION - - DATE OF ISSUANCE OF CERTIFICATE: 1 ,3 - 0 b, DATE FEE PAID: "0/ — f -;�- TYPE OF UNIT: DWELLING OTHER_ CHECK # 3 `f-3la CHECK DATE 6—�—O .6 NOTES: /1\ CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH s 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#401-06 DATE ISSUED: 8/16/2006 Property Located at: 1 Harbor Street UNIT# 5 Owner/Agent: Ouellette Realty Address: 1 Harbor Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 744-1962 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 BOARDH JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR 4 ' CITY OF SALEM, MASSACHUSET S Q BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741.1800 FAX 978-745-0343 JOANNE SCOTT, MPH, R51 CHO - Kimberley Driscoll HEALTH AGENT Mayor APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER li, 105 CMR 410.000. "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT UNIT #. IS THIS UNIT DESIGNATED AS RIGHT EFT ,JNT BACK PLEASE CIRCLE ONE OWNER/LESSER %)Ur r:7l� All, �-tIr MANAGER/AGENT /�1zp-Y f No P.O. Box No P.O. Box ADDRESS I ffi l3�i 4,/ ADDRESS — CITY S/f�F �,� IkI114-' —CITY_ J --- RESIDENCE PHONE 7y '/ �g�BUSINESS PHONE (24 HRS.) Z,�" �W- G'S5 BUSINESS PHONE —. —.— TOTAL NUMBER OF ROOMS: 3 ROOM USE THERE IS A TWENTY-FIVE(525.00) 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 1tLl -- --DATE__71� NI SPECTOi3S USE ONLY DATE OF INITIAL INSPECTION $/,46 9 DATE OF REINSPECTION _.. DATE OF ISSUANCE OF CERTIFICATES /6 f' DATE FEE PAID._. TYPE OF UNIT: DWF LI��OTHER . CHECK 0 3 5' CHECK DATE NOTES:.._ _. CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS BOARD oj) 'HEALTH 120 WASHINGTON S1'RIiET,4'"FLOOR TEL. (978) 741-1800 ICIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR IMANCINIP-SALEM COM JANE I'MANCINI ACTING HPe\I:nI AGENT CERTIFICATE OF FITNESS CERTIFICATE#249-09 DATE ISSUED:6/3/2009 Property Located at: 1 Harbor Street UNIT#6 Owner/Agent: Ouellette Realty Address: 1 Harbor Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-744-1962 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 JA MANCINI ACTING HEALTH AGENT CODE EiF RCEMENT INSPECTOR isITY COF SALEM, MASSACHUSETTS Aq� BOARD OF HEALTH �" 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 14MBERLEY DRISCOLL FAX(978) 745-0343 MAYOR IMANCTNl([ ALEM.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." FEE: $50.00 II' PROPERTY LOCATED # IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRR�CLE ONE OWNER/LESSER D 2644 77;6 /X4947_( MANAGER/AGENT I 4 D 1)4a�:T� NO P.O.BOX ' ADDRESS I h-~Ost ADDRESS 6?m,7"''03/0/L �/" CITY, STATE, ZIP SWjop" ()Jq ?0 CITY, STATE,ZIP RESIDENCE PHONE � J Yy11�l61 BUSINESS PHONE(24HRS) BUSINESS PHONE g )S-- 7(/1/— 65-37 TOTAL NUMBER OF ROOMS:_ ROOM USE: 1A fb//C,b.W 2. 4. 5 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE ISP LE ' E T E SPECTION APPLICANT'S SIGNATURE (/ DATE 3 Inspectors use only Date on initial inspection: (p 13/Q 9 Date of reinspection: Date of issuance of certificate: (D 13/01 Date fee paid: a Type of unit::/Dwelling Other Check# I1 3 �8 I Check date: cp � o Notes: ( )06 Acl+ +(imM oN • Al Cl f6V1 in 6493 C00 Window') L7 Will bfurtud, o� forycNfis domw e6 Code Enforcement A4ect U.S. Postal Servicer,.' CERTIFIED MAIL. RECEIPT ., {oomestic Mail Only,No insurance Coverage Provided) For delivery Information visit our website at www.uspsxome r _ w r , r: Ps Form;7000,June 2002 $ee Rnverse for Instruotion5 Certified Mail Provides: (maA9e)zoozeunr'oonmcrosa ■ A mailing receipt ■ A unique identifier for your mallpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mall®or Priority Maile, • Certified Mail is notavailabie for any class of International mall. is NO INSURANCE COVERAGE IS PROVIDED with Certified Mall. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811 to the article and add applicable postage to cover the fee.Endorse mailpiece Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mall receipt is required. is For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement'Restricted Delivery. ■ If a postmark on the Certified Mail receipt Is desired,please present thg arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt andpresent it when making an li qui0j. Internet access to delivery information is not available on mail addressed to APOs and FPOs. CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR fA SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 KIMBERLEY DRISCOLL JSCOTT@SALEM.COM MAYOR JOANNE SCOTT HEALTH AGENT January 14, 2008 Ouellette Realty Corp Attn. Larry Ouellette 1 Harbor Street Salem, MA 01970 Dear Mr. Ouellette: I'm sending back your check for $75 because of a clerical error. The Certificate of Fitness is still $25 as of now. Please send a check for $25 to our office. I'm sorry about this inconvenience. Thank you, oanne Scott Health Agent Sent certified mail: 7005 3110 0000 7160 3828 s57 3554 LAURENT P. OR CORINE L. OUELLETTE 1855 ens . . 18 MST. D06861acf&r—^ SALEM,, MA MA 01970PAY ,t.��ff7Y• G ORDER THE �J U ORDER T e � 8 sf" ._�� /f/� -Lt�- DOLLARS 210 Ess eq Sale^,01970 ' MEMO 1: 21137055ID: 088614416iu• 3554 f UNITED STATES,PCIS?t#C St1(' I w f':". r:•C:: .. x" rel e P�"µ {ae ees"pip Mdkt .1844 es zz • Sender: Please print your name, address, and ZIP+4 in this box BOARD OF HEALTH SALEM, MA 01970. SENDER: DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery Is desired. ■ Print your name and address on the reverse X eZ& dressee so that we Can return the Card to you. B. Rem by(Printed Neme C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. del ryadd d rent from item 1? ❑Yes_ 1. Article Addressed to: If YES,enter delivery address below: 0 No Ouellette Realty Corp. Attn: Larry Ouellette 1 Harbor Street Salem, MA 01970 3. Service Type X:P Certified Mall ❑Express Mall 0 Registered ❑Return Receipt for Merchandise _ 0 Insured Mail ❑C.O.D. J 414. Restricted Deliver?(Extra Fee) ❑Yes 2. Article Number 70053110 0000 7160 3828 (Fransfer from service Iabso r PS Farm 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 i CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH a 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 CERT.# 135-03 FEE 03/27/ TEL. 978-741-1800 FAX 978-745-0343 DATE: 03/27/2003 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 1 Harbor Street UNIT #: 7 OWNER/AGENT: Ouellette Realty Corp. ADDRESS: 1 Harbor Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-1962 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 . FOR THE BOARD OF HEALTH i� JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR a CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR 3 SALEM, MA 01970 l * TEL. 978-741-1800 FAX 978-745-0343 STANLEY LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". �J PROPERTY LOCATED AT VJ P� �� UNIT# / IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSEROUF4L/r,y7G,� 96! ( YMANAGER/AGENT l QC' No P.O. Box o P.O. Box ADDRESS ADDRESS GIZ S 0.� S � CITY CITY RESIDENCE PHONE p ` / BUSINESS PHONE (24 HRS.)BUSINESSPHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2.-3.-4. 5__6. 7. 8. THERE IS A TWENTY-FIE($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 SIGNATURDATE IN PECTORS USE ONLY DATE OF INITIAL INSPECTION— �)- DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: -d-7 3 DATE FEE PAID:_;' 7 TYPE OF UNIT: DWELLIN KOTHER_ CHECK# j,;2 751 CHECK DATE 3 > NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHING'T'ON STREET,4"'FLOOR TEL. (978) 741-1800 IQMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGR6:1?N13AUMl7SiV.13M.00M D;\vID GRI:'FNBAUM,RS AC;I']NG Hv,M.:CI-I.AGuNT CERTIFICATE OF FITNESS CERTIFICATE#483-10 DATE ISSUED: 10/7/2010 Property Located at: 1 Harbor Street UNIT#9 Owner/Agent: Ouellette Realty Corp. Address: 1 Harbor Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 744-1962 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 BOARDPF HEALTH IUUIAJ I d Z��, DAVID GREENBAUM, RS ACTING HEALTH AGENT CODE EN CEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4`..FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR uc;iu;r:Ni;nuMnns, i rti.COM DAVID GREENBAUM,RS ACTING HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION." FEE: $50.00 PROPERTY LOCATED AT �/��Oit -r,—) UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER 6uELLC77-e 44-IyV 00140 MANAGER/AGENT/ DO.OUE 7TE ADDRESS Y #911D/Z s/ ADDRESS CITY, STATE,ZIP 0/9�d CITY, STATE,ZIP S.S 74;" / /Apl 0/r/�O RESIDENCE PHONEUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: Lb /;V(— 2. /3�� 3. A�'TE//AP4 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 I P L T TH IME O INSPECTION APPLICANT'S SIGNATURE , c/�� DATE /0 0/0 Inspectors use only Date on initial inspection: - /� Date of reinspection: Date of issuance of certificate: /0 I l U Date fee paid: Type of unit: Dwelling -7Other Check k j_F0Check date: /0 /-7//D Notes: Code Enfort4nent Inspector CITY OF SALEM, MASSACHUSETTS _ BOARD OF HEALTH 120 WASFIINGTON STREET,4...FLOOR TEL. (978) 741-1800 1QMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGRi�TNBALTNI a ALEM.CONI DA\'ID G'REENBAUM,RS ACTING HF.ALTH AGENT Release In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ; State Sanitary Code Chapter II and Article XIII of the City of Salem Ordinance, undersigned owner/lessor and tenant/lessee of a unit of residential property, hereby authorize the Salem Board of Health or its authorized agents to inspect the residence identified below in accordance with the aforementioned statutes, regulations and ordinances. In the event it is necessary that said inspection be done in my/out absence. I/we 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. uYD2 Carte r f7kACLW Tenant essee Owner/Lessor Address Address l Aim, '02 197, ZV I / / Address on unit to be inspected Date CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STRrET,4:"'FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR ]DIONNE, )SALFNLCOM JAN F-i'DJONNFI ACTING Hi.:Aj:ii i A(,i,;N'i' CERTIFICATE OF FITNESS CERTIFICATE#562-08 DATE ISSUED: 10/30/2008 Property Located at: I Harbor Street UNIT#9 Left Front Owner/Agent: Ouellette Realty Corp. Address: 1 Harbor Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 744-1962 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. NNTHE BOA F HEALTH L E D ON NE ACTING HEALTH AGENT COR�,ENFORCEMBNT INSPECTOR CITY OF SALEM, MASSACHUSETTS » BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR 7DI0NNP,&AL1.;,M.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: $50.00 PROPERTY LOCATED AT�� IS THIS NIT DISIGNATED AS RIGHT EEDZ.VONTjbRBACK PLEASE CIRCLE/O�NE OWNER(LESSER( 4' &,�Te�7y—�MANAGER/AGENT L/U� ADDRESS I p�Q� I ADDRESS CITY, STATE,zw 5h'�Xkoi 0/1/7 0 CITY, STATE,ZIP_i/�s.�- ° of 910 RESIDENCE PHONE z / g 751-!yl� �- BUSINESS PHONE(24HRS) 1 72'"?Vy 65-6-9, BUSINESS PHONE TOTAL NUMBER OF ROOMS: 3 ROOM USE: 1. d 1! fVl/6-4:13. A te. 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 TRIS FE IsLTTHjL1ET OF'INSPECTION APPLICANT'S SIGNATUREDATE 1013410F t Inspectors use only Date on initial inspection: 1 C) 3o LD8 Date of reinspection: Date of issuance of certificate: �n Date fee paid: ) Type of unit: Dwelling Other Check# Check date: 4, )A / Notes: Co&Efiforcernent Inspector CITY OF SALEM, MASSACHUSETTS • e BOARD OF HEALTH 120 WASHINGTON STREET,47 FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 NL1YOR MIONNE&SALF14.COTNI JANET DIONNE, SENIOR SANITARIAN- Release In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ; State Sanitary Code Chapter II and Article XIII of the City of Salem Ordinance,undersigned owner/lessor and tenant/lessee of a unit of residential property, hereby authorize the Salem Board of Health or its authorized agents to inspect the residence identified below in accordance with the aforementioned statutes,regulations and ordinances. In the event it is necessary that said inspection be done in my/out absence.I/we expressly authorized the same and for my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of Health and its authorized agents from any lose or injury sustained of whatever nature and description occasioned by my/out absence during said inspection. Tenant/Lessee Owner/Lessor. AAut G,«� Address Address Address on unit to be inspected �d'OS-BB Date CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH s y, 120 WASHINGTON STREET, 4TH FLOOR o SALEM, MA O 1970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE# 171-04 DATE ISSUED: 04/29/2004 Property Located at: 1 Harbor Street UNIT#9 Right Front Owner/Agent: Ouellette Realty Corp. Address: 1 Harbor Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-744-6558 An inspection of your vacant Dwelling/Roaming 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. F R THE BOARD OF, HEALTH JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH ' w w 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�1Q12 � L UNIT#� ISTMS UNIT DESIGNATED ARI IGH LEFT G T ACK PLEASE CIRCLE ONE OWNEWLESSER L Uk6-/--e77,F-,4 - ?1 C�A.lMANAGER/AGENT No P.O. Box = No P.O.Box ADDRESS // .zB d2 sT _ADDRESS CITY Zf �-^ CITY RESIDENCE PHONE 7VLd6 BUSINESS PHONE(24 HRS.) f7f-)W (05 BUSINESS PHONE TOTAL NUMBER OF ROOMS: 3 ROOM USE: 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. �� jj APPLICANTS SIGNATURE/4�` INSc�PECTORS USE ONLY IAL INS DATE OF INITPECTION t `_k _qDATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: q DATE FEE PAID: 3'�( TYPE OF UNIT: DWELLING OTHER__ CHECK# ( G CHECK DATE ✓_� NOTES: —. CODE ENFORCEMENT INSPECTOR 9/28/98 f .co CITY OF SALEM, MASSACHUSETTS vQ' BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 976-74 1-1 800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#235-04 DATE ISSUED: 05/28/2004 Property Located at: 1 Harbor Street UNIT# 10 Owner/Agent: Ouellette Realty Address: 1 Harbor Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 744-1962 An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II" Minimum Standards of Fitness for Human Habitation'. Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE rzNFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSET -S D BOARD OF HEALTH r 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 FITNEE�SS ,�S FOR HUMAN HABITATION". PROPERTY LOCATED AT l X44%6 57714 % UNIT#10 Q IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER MANAGERtAGENT NO P.O. Box -- ' No P.O. Box ADDRESS I �d12 S/ ADDRESS CITY_ 5'A,65�t CITY RESIDENCE PHONE 1/'GLBUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS:__3 ROOM USE: 1�/�/ � . /(14r _ 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. � L APPLICANTS SIGNATURE_T _DATEa LNSP CTORS USE ONLY DATE OF INITIAL INSPECTION 5f'Lb° 6,e DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:_{4 ¢ DATE FEE PAID:.5r_ Jf _ TYPE OF UNIT: DWELLING v�THER_ _ CHECK#., ? 9 .CHECK DATE VMS NOTES: 3'� P� 61Wui/ rs✓ ARuy ru�cOteiNs 81+r v_�Nt� CODE ENFORCEMENT INSPECTOR 9/28/98 All CITY OF SALEM, MASSACHUSETTS -7 BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR CERT.# 522-03 SALEM, MA 01970 FEE $25.00 TEL. 978-74 1-1800 DATE: FAX 978-745-0343 10/8/03 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, R5, CHO MAYOR HEALTH AGENT 1 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 1 HARBOR STREET UNIT #• 11 OWNER/AGENT: OUELLETTE REALTY ADDRESS: 1 HARBOR STREET CITY/TOWN: SALEM, MA ZIP CODE: 01970 24 HOUR PHONE: 978-744-1962 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 HUMPH 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 T�D O`FHEALTH � JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR N CITY OF SALEM, MASSACHUSETTS 2 ,y BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR d(, SALEM, MA 01970 TEL, 978-74 1-1800 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 HABiTTATTION"_ PROPERTY LOCATED AT UNIT# �� IS THIS UNIT DESIGNATED AS IG LEFT FRON AC PLEASE//CIRCLE ONE OWNER/LESSEF) 4*zMANAGER/AGENT No P.O,Box No F.O.Box ADDRESS /_ 'ge)e S% ADDRESS CITY /4 7 _—CITY 1;7'14 r RESIDENCE PHONE ZW ZA.W BUSINESS PHONE (24 HRS.) BUSINESS PHONE 'I 2f7y 4/1 �S TOTAL NUMBER OF ROOMS:_ ROOM USE: 1. 2._----_-3.-4. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEfikTi DEPART THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. ! APPLICANTS SIGNATU ` DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION—Z 5 — a "a3 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: L6 —G 05_DATE FEE PAID: !l/ " -a TYPE OF UNIT: DWELLING OTHER_ CHECK 3-' CHECK DATE Id CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS c a BOARD OF HEALTH . — 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 STANLEY J. USOVICZ, JR. FAX 978-745-0343 MAYOR W W W.SALEM.COM JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#599-05 DATE ISSUED: 9/27/05 Property Located at: 1 Harbor Street UNIT"# 11 Right Back Owner/Agent: Ouellette Realty Address: 1 Harbor Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-744-6558 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 JOQ29-1 NE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 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 IIFO__ '3 R HUMAN HABITATION". // // PROPERTY LOCATED AT / 1''//746,44 � '� UNIT qj/ IS THIS UNIT DESIGNATED A IGHT EFT FRONT ACK LEASE CIRCLE ONE OWNER/LESSER OOA /W67`1/ MANAGER/AGENT No P.O. Box �- No P.O.Box ADDRESS // 01L ADDRESS CITY CITY ., S S RESIDENCE PHONE &-7Y9"-Iy'bZ- BUSINESS PHONE (24 HRS.) �/ ?�' ?W— 6Z? BUSINESS PHONE TOTAL NUMBER OF ROOMS: ��.,, , ' ROOM USE: 1. L (07* 2. i�� 3 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 SIGNATUR _DATE_ lt_ OS INSPECTORS USE ONLY DATE OF INITIAL INSPECTION _Y-_ /_ f< - _ DATE OF REINSPECTION..__________, DATE OF ISSUANCE OF CERTIFICATE: _B-3 _DATE FEE PAID:__ TYPE OF UNIT: DWELLINd /OTHER CHECK w_ j 3_D._CHECK DATE (=' � NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 w co CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE# 170-04 DATE ISSUED: 04/29/2004 Property Located at: 1 Harbor Street UNIT# 12 Owner/Agent: Ouellette Realty Corp. Address: 1 Harbor Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-744-6558 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 )� JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARO OF HEALTH � . 120 WASHINGTON STREET, 4TH FLOOR '� v SALEM, MA 01970 TEL. 978-74 1-1800 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 AT,��k 5 I _ UNIT#, , IS TH'sS UNIT DESIGNATED AS RIGH L T FR T A PLEASE CIRCLE ONE OWNER/LESSERUuLiC,6 �F?fL7C ANAGER/AGENT No P.O. Box No P.O.Box ADDRESS--( ADDRESS CITY irk CITY RESIDENCE PHONE BUSINESS PHONE (24 HRS.) C? 70c-,;>��653T BUSINESS PHONE5�2,&" 1;W__655`7 - TOTAL NUMBER OF ROOMS: 3 ROOM USE: 1. 2. 3. 4. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPWMWT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE r. _ DATE_ u INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 'S 4 z' — _DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: - k-v_r' DATE FEE PAID: TYPE OF UNIT: DWELLING OTHER_ CHECK#_j CHECK DATE NOTES: -- CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS • + BOARD OF HEALTH 120 WASHINGTON STREET,4...FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAZ(978) 745-0343 MAYOR 1MANC1N1@SA1N,M.(-0M JAW YNItMINI A("1'INC; Hf?Al:n i AC;I..N'C CERTIFICATE OF FITNESS CERTIFICATE#145-09 DATE ISSUED: 3/31/2009 Property Located at: 11 Harbor Street UNIT# 1 Front Owner/Agent: Biet Nguyen Address: 203 Cabot Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 978-524-8850 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�O�FF HEALTH 4CNETTING HEALTH AGENT CO,!�,ENFORCEULsW INSPECTOR CITY OF SALEM, MASSACHUSETTS 1 1 J-6 BOARD OF HEALTH 120 WASHINGTON STREET,4"i FLOOR. TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR 1DIoNNe(a),SAt BM.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: $50.00 S'± PROPERTY LOCATED AT t66� S'f UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER_ � I' ,(/ a. rl MANAGER/AGENT NO P.O. BOX ADDRESS r03 G 4670- �/ ADDRESS CITY, STATE,ZIP UC-Je7K( y A,(ot CITY, STATE,ZIP c� RESIDENCE PHONE .��T 00 72 ` 7BUSINESS PHONE(24HRS Q503 } BUSINESS PHONE q1 r _OSS(1 TOTAL NUMBER OF ROOMS:__.,,.,_` ROOM USE: 1. 2. ' e"' 3. "� 4. ✓ 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PA L-AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE t,/� DATE '3! O / / Inspectors use only Date on initial inspection: 13/ � Date of reinspection: Date of issuance of certificate: Date fee paid: / Type off unit: Dwelling-Other-Check#-- Check date: 1 �_ dates: +uCyi 4 ocn-n +,0 616,ode " rcement Inspector CITY OF SALEM, MASSACHUSETTS • BOARD OF FIEALTH 120 WASHINGTON STREET,4'FLOOR TEL. (978)741-1800 KINSERLEY DRISCOLL FAx{978)745-0343 MAYOR IINONNF 'A1.FM COM JANET DIONNE ACFING HEsAI,II-1 AGENT CERTIFICATE OF FITNESS CERTIFICATE#475-08 DATE ISSUED: 9/30/2008 Property Located at: 11 Harbor Street UNIT#2 front Owner/Agent: Biet Nguyen Address: 203 Cabot Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 617872-7503 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 i jf AN T DIONNE ACTING HEALTH AGENT CODE ENF CEMENT INS ECTOR CITY OF SALEM, MASSACHUSETTS ' BOARD OF HEALTH 120 WASHINGTON STREET,4"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR IDIONNEna SALFM.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: $50.00 PROPERTY LOCATED AT W M A4� o f A'7d UNIT# 2 IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR�BACICPLEASE CIRCLE ONE 2 OWNER/LESSER 1✓G G - 04�'u y ,cJ MANAGER/AGENT NO P.O. BOX ADDRESS 2 a Cef Qty I S'7' ADDRESS CITY, STATE,ZIP_ QCII r_W�,y 46I- Qr q 1,C- CITY, STATE,ZIP /� 1 dn RESIDENCE PHONE BUSINESS PHONE(24HRS1 C 17 M BUSINESS PHONE TOTAL NUMBER OF ROOMS: r__ s� ROOM USE: 1./ rJl do., 2. CJ�JN Qcaa.3. Ua /Led t4 / e�/?d 5 I�L1Q, 6. 7. j 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 DATEI� Inspectors use only Date on initial inspection: 9-?Cj Date of reinspection: Date of issuance of certificate: 1• 3o -a �t Date fee paid: R- 3J -O g Type of unit: Dwelling/ Other -- Check#-3-6 j Check date: o Q Notes: f �J Code Enforcement Inspector L 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#331-07 DATE ISSUED: 7/23/2007 Property Located at: 11 Harbor Street UNIT#2R Owner/Agent: Biet Nguyen Address: 203 Cabot Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 978-524-8850 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. FO THE BOARD OF FJEALTH JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR ~ CITY OF SALEM, MASSACHUS S sr-6-M BOARD OF HEALTH • i 120 WASHINGTON STREET, 4TH O f_{-f"� tN SALEM, MA 01974 1 t j _ TEL- 978-741-1800 FAX 978-745-0343 �� JOANNE SCOTT, MPH, RS, CHO Kimberley Driscoll HEALTH AGENT ov A, Mayor I APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 41, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION", PROPERTY LOCATED AT IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRC OWNER/LESSER >✓t & U fL&) MANAGER/AGENT No P.O. Box No P.O. Box i �� ADDRESS �3 (n ADDRESS - CITY�A�Ut�c v A-11+ 01cf16- CITY _ RESIDENCE PHONE_ _ .__BUSINESS PHONE (24 HRS.) ___ BUSINESS PHONE_-qZ&--_5 =t - 05 TOTAL NUMBER OF ROOMS:m__ ROOMUSE: ,-f- --3 _ --- 4.- —. - 5.—.__6 7._8.-- THERE . 8.-_THERE IS A TWENTY-FIVE(525.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT TETE TIME OF INSPECTION. APPLICANTS SIGNATURE ) __.___`__DATE INSPECTORS USE ONLY DATE OF INITIA�,iNSPECTION _" 3 � __DATE OF REINSPECTION DATE OF ISSUANCE OF CERIIFICATE-?,.,) }'� DATEFEE PAID TYPE OF UNIT: DW ELLINNOINERCHECK #_ ._)_ ,,_.CHECK DATE 7 " .7 NOTES:.—__---------_.._ CODE ENFORCEMENT INSPECTOR 9/28/98 �fia s CITY OF SALEM, MASSACHU S BOARD OF HEALTH 120 WASHINGTON STREET, 4TH O SALEM, MA 01970 TEL. 978-741-1800 • • FAX 978-745.0343 JOANNE SCOTT, MPH, RS, CHO Kimberley Driscoll HEALTH AGENT �,� f 2 � o Mayor �a !Y� , 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 AT1—T+_ _. _ / , £<C UNIT# I IS THIS UNIT DESIGNATED AS�RIGH �T LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER GNV ?t ( �u _MANAGER/AGENT, NoP.O. No P.O. Box ADDRESS Box e2� 3i ��l i SJ ADDRESS_ CITY VtQ CITY RESIDENCE PHONE_ ,BUSINESS PHONE (24 HRS) BUSINESS PHONE 97(f - 5�2 4.- X_ 6 TOTAL NUMBER OF ROOMS:_ ROOM USE: 1.__.—. 2, -- 3. -- -4. THERE IS A TWENTY-FIVE(325:00) DOLLAR FEE., PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE. ".__ —DATE__ _ INSPECTORS USE ONLY QATE OF INfiIAL INSPECTION,- � _? _.DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE,9 5""-� DATE FEE PAID: ' . _ ? TYPE OF UNIT: DWELLINh Z) <� // OTHERCHECK �_,_GHECK DATE 7� a NOTES___ CODE ENFORCEMENT INSPECTOR 9/28198 C DI�i City of Salem, Massachusetts1P Board of Health e 120 Washington Street, 4th Floor, Salem, PublicHealth 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-16-209 DATE ISSUED: 6/13/2016 Property Located at: 11 HARBOR STREET UNIT#3 Owner/Agent: DKKM, LLC Address: P.O. Box 3005 City/Town: Andover, MA Zip Code: 01810 24 Hour Phone:(781) 572-6235 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 Wrlwwl��/ Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN V a I CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,REEr,4'"FLOOR TEL. (978) 741-1800 KTMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR LR51%1llIN@SA1 EM.COM LARRY RAMDIN,RS/RF.HS,( HO,CP-FS IILALTH 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 f f- /3 /�/�wk.(Wt jr • UNIT# 3 IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER ?)1ekA4 MANAGER/AGENT MIetiAll I NO P.O.BOX ADDRESS R9 Ra ¢ 3Das Rr Dey-Av h/1 ADDRESS �+� CITY, STATE,ZIP +Nr)PVW%,- MA 618/6 CITY, STATE,ZIP J✓ �_ RESIDENCE PHONE 7,91 -n BUSINESS PHONE(24HRS) "-�- BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOMUSE: I.L,v 2 2. Mc4AAJ+ 3. <-d^1 4. A01, 5. / 6. /3k4H 7. f 444k 8. kl,lC� 9. #d1l 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//S�AT HE TIME OF INSPECTION APPLICANT'S SIGNATURE--J 22//— DATE Inspectors use only Date on initial inspection: Date of reinspection: Date of issuance of certificate: !2a/0qaD1L Date fee paid: Type of unit: Dwellin Other Check#_Check date: VL&%ZDJ� Notes: Coe or hent Insp for a 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 01/14/2002 Deborah Dalessandro 35 Pleasant Street Salem, MA 01970 PROPERTY LOCATED AT 11 Harbor Street UNIT # 4 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 BOARD AF HEA. TH REPLY TO Joanne Sco t, MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH a 120 WASHINGTON STREET, 4TH FLOOR p SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#40-04 DATE ISSUED: 02/09/2004 Property Located at: 11-13 Harbor Street UNIT#: 2 Owner/Agent: Robert Chilton Address: 1 Sevinor Road City/Town: Marblehead, MA Zip Code: 01945 24 Hour Phone: 978-578-0253 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 if 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 CRM 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates,whichever is later. This Certificate of Fitness if valid only if there is a valid Certificate of Occupancy. OR THE BOARD,qF HEALTH /; � JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS ' '� BOARD OF HEALTH • i 120 WASHINGTON MA 01970TH FLOOR p TEL. 978-741-1800 FAX 978-745-0343 FEB 9— 2004 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT DUTY OF SALEM BOARD OF HEALTH d TL � APPLICATION FOR CERTIFICATE OF FITNESS / IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION'. 1 PROPERTY LOCATED AT Li(3 11 t)4 0, St. 2- UNIT# IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER ( 01,E Ckl( 61 MANAGER/AGENT No P.O. Boxpp No P.O. Box ADDRESS St'yi n or ai ADDRESS kl1l/4y 61e k eAj CITY CITY d I 1� N RESIDENCE PHONE 7(f(-?9o- 3003 BUSINESS PHONE (24 HRS) 'q 7 S`:,) BUSINESS PHONE r -7 P S_ -7 If �Z 3 TOTAL NUMBER OF ROOMS: Lo- ROOM USE: 1. t3ld 2.__I ,lb, DIS 5, L(V;K 6. V4e-tt') 7._ 8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. p APPLICANTS SIGNATURE DATE 4 F INSPECTORaU1SEONLY 1 DATE -E INITIAL INSPECTION . -4 -0 7 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE ,g -0 _DATE FEE PAID: ;?- TYPE TYPE OF UNIT: OWELLINGY OTHER_ CHECK# 7 7 5 CHECK DATE NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 ' CqN gw CERT.# 150-99 FEE $25.00 DATE: 03/29/99 ��2°�iMmigW CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel: (978)741-1800 Fav(978)740-9705 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 11-13 Harbor Street UNIT #: 2 Front OWNER/AGENT: Dick D'Alessandro ADDRESS: 35 Pleasant Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 596-7855 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 MORE INFORMATION CALL 978-741-1800. FOR THE BOARD OF HEALTH JOANNE SCOTT, MPH,-Rs CHO - �' - � - HEALTH AGENT' - CODE ENFORCEMENTINSPECTOR W R 3 1999 9 OFSALEM HEAi_TH DEPT. CITY OF SALEM BOARD OF HEALTH (� Salem, Massachusetts 01970-3928d ' 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 FITNESSFORHUMAN HABITATION'. PROPERTY LOCATED AT S:1Sr'`� �"'^ UNIT#Z F IS THIS UNIT DESIGNAT D ASRIGHT EF F T BACK PLEASE CIRCLE ONE �ic OWNER/LESSER_.`� esSCLvL) Y'Q MANAGER/AGENT P.O. 0. BOX AD S ADXk�.V` �S dl . S*NO ADDRESS_ DRESS t _. .— CITY ^" VY'l 0L�t ��`CITY_. RESIDENCE PHONE—)1- `L 1 BUSINESS PHONE (24 HRS.) Y BUSINESS PHONE mgt a3 366Z TOTAL NUMBER OF BROOMS: ROOM USE: 1. �+ _2. � 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 SIGNATURE /'1A7E—"2'2 m INSPECTORS USE ONLY DATE OF INITIAL INSPECTION _�t c1 DATE OF REINSPECTION _. DATE OF ISSUANCE OF CERTIFICATE:--- ' =-DATE,,/FEE PAID: _ `± `i t TYPE OF UNIT: DWELLING/ OTHERCHECK# 0 2 Y•' 3 CHECK DATE NOTES: — CODE ENFORCEMENT INSPECTOR 9/28/98 City of Salem, Massachusetts q Board of Health ��. 120 Washington Street, 4th Floor, Salem, Prevent. Promote.MA 01970 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-16-56 DATE ISSUED: 2/26/2016 Property Located at: 13 HARBOR STREET UNIT#11- Owner/Agent: 1LOwner/Agent: Michael O'Brien Address: 56 Hampshire Street City/Town: Methuen, MA Zip Code: 01844 24 Hour Phone:(781) 572-6623 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 IVA,F-� Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4°'FLOOR mo, .Health TEL. (978)741-1800 FAX(978)745-0343 KIMBERLEY DRISCOLL Iramdin@salem.com MAYOR L\RRYRAMDIN,RS/RIIiS,CffO,CP-f�'S HFALrII 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 !3 UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER M0&Iek) MANAGEFJ AGENT 54"'f NO P.O. BOX / ADDRESS 56 /Aftp-1 144 .5f ADDRESS ,I (� CITY, STATE,ZIP sLhm y I/� // CITY, STATE,ZIP M 019 y 7 RESIDENCE PHONE -)El —971 ^b� 3S BUSINESS PHONE(24HRS) BUSINESS PHONE S/+-A4 `C, L/J TOTAL NUMBER OF ROOMS: / ROOM USE: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE ISPA THE TIME OF INSPECTION / APPLICANT'S SIGNATURE DATE Inspectors use only Date on initial inspection:0 V1' Date of reinspection:©wZS�/�DL( Date of issuance of certificate: 2S 2,01.6 Date fee paid:Dz jz5,42©.Z6 Type of unit: Dwelling--Z—Other—Check# 29 Sj- Check date: Co 2/�S/2dr 6 Notes: r,U- t (1j) hjjvin 16-4imns (orre.Aed C qelynXrcement Spector r. Inspecticn of U cya Amt m 4 Date C))-1 /20.1.6 Time 1.2,30 c, Name ^^^^ Address L3 14C.,�6� S{'r<z4 4--,L& o M l Owner I Cklu I (91 prife n �/^^ t- Tel. No. _ / -S-72-f (n Z3S T Type of Inspection_Cer+1 F� Ctr.�'a c C F i4 NeSS Inspector J6wi Ucu^O ( ' ) Remarks and Violations are listed below: #L �tXme, Ljr4 m Ar, f Wlnj9)u' I/A mJ� je- J� a S /X,ojaQ e, 0. Cjtj� 4 LOJJ� M OY h SII LIVllvin rook„ ,)fir WI'MLw M 1- r r% 4 wilA 4&,,, fGreeh _ r 1 I f r t , � , II � , L—IVlnn v^nm,ar `'V hole, In cerl/no 1,1'A ey Sj C/ irM.r�m -� II I t �Kirr4c w ®wp Js r(q il-.S -0 drp zrt CIAO r I'l' l e-4r WI4dn1,, 10"-r6l��r if L-S a Loqu, �7Q/1 n4 SRSh 4r tn./+�j 614a wkn�tn/ h0.S roc ck rcreen (/1 S'0./it, 14n i,✓ L9 J �` adje, ur6,o m S � �n ceIlllnrw wlJ-'- �'c mCtd. Cl rtr.,rrl"�r I /n � 0rr0M COY lroh4 e-n+ran r_e %�tJJw1VIl/�owpn flit' 1,1 4� Gre Pn ir-,, iSas MOP" W l hMwr k-AX1e, -�OY'Y% St.V;2nf T I r ` s , V I r 7 rTY _ r ` / 1 r , I 0 � l Io IS +0 roato6lt 4L 511e11 RDaej ©t' NPn14A �—ej W9 OL, M��0.r1 �611 ow- L14 r y R Report Received by: rAN City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, PuWicHcalth MA 01970 Prevent.Promote. Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, RENS, CHO Mayor health@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE M GHL-16-354 DATE ISSUED: 9/15/2016 Property Located at: 13 HARBOR STREET UNIT#1R Owner/Agent: DKKM, LLC Address: P.O. Box 3005 Cityrrown: Andover, MA Zip Code: 01810 24 Hour Phone:(781) 572-6235 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 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. Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age. &JeyEosy Larry Ramdin, MPH, RENS, CHO HEALTH AGENT SANITARIAN m CITY OF SALEM, MASSACHUSETTS � BOARD OF HEALTH 120 WASHINGTON STREET,4z FLOOR TEL. (978) 741-1800 KIM BERLEY DRISCOLL FAX(978)745-0343 MAYOR ,AnA>DmGnls .can€ LARRY RAMDIN,RS/RENS,CHO,CP-FS ` HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER 11, 145 CMR 410.000 'MINIMUM STANDARDS OF FffNESS FOR HUMAN HABITATION" FEE: $% PROPERTY LOCATED AT I/ - 13 A tL(xd Std t M A UNIT# s Is TRIS UNrT DISIGNATED AS RIGHTS FRONT OR BACK.PLEASE CIRCLE ONE OWNER/LESSER_Ll Ic kM MANAGER/AGENT(,1.�-- NO P.O.BOX n ADDRESS 'k4 Rb CROk 3605 ADDRESSAr 1Day8�t lYfi�C) CITY, STATE,ZIP la bA SJ Y-Ir-lo ay-y -' CITY,STATE,ZIP S✓�^ �^ RESIDENCE PHONEf –S? Dl (�3.f BUSRMSS PHONE(24HRS) Sv4 Ant- BUSINESS PHONk t✓ TOTAL NUMBER OF ROOMS: ROOMUSE: I. , 2. Liv 3. 13-CJ 4 rJ 4. 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 PAYABLEATTHE TIME OF INSPECTION APPLICANT'S SIGNATUREIIcwt. DATE /-C Inspectors use only Date on initial inspection: Date of reinspection: Date of issuance of certificate: Date fee paid: Oq/.Z�f2t)11` Type of unit: Dwelling—Z—Other Cheneck#—II Check date:0 64 f2.DDZ(' Notes:��n -Q �r T L 11 L cd L rVIf. �a �e Ante E orcemen spector °° u' City of Salem, Massachusetts VQ { ►. Board of Health 120 Washington Street, 4th Floor, Salem, PubliCHea2th Prevent Promote. Protect. MA 01970 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-16-57 DATE ISSUED: 2/26/2016 Property Located at: 13 HARBOR STREET UNIT#2L Owner/Agent: Michael O'Brien Address: 56 Hampshire Street City/Town: Methuen, MA Zip Code: 01844 24 Hour Phone:(781) 572-6623 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 BOARDS OF HEALTH Larry Ramdin, MPH, RENS, CHO SANITARIAN HEALTH AGENT i — • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"l FLOOR n..emm TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL iramdin(c1�,salem.com LARRY RAKIDIN,RS/REBS,Clio,(,T-FS MAYOR HEAL-M 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 � /�92i1U? Ct— UNIT# a e� IS T��H��I""S UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER-)A4)LCIsI 4 I C) 154-1&A MANAGER/AGENT SAM C NO P.O. BOX / ADDRESS Sb IAM��IQ� S� ADDRESS CITY, STATE,ZIP .�riIlJr��✓iJ CITY, STATE,ZIP M4 D � RESIDENCE PHONE � W - � G 1-6a 9S' BUSINESS PHONE(24HRS) BUSINESS PHONE 94 /kg TOTAL NUMBER OF ROOMS:— ROOM OOMS:ROOM USE: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OFF INSPECTION APPLICANT'S SIGNATUREY�1`'V DATE 2- �7 Inspectors use only Date on initial inspection: 02/1-7/2-01L Date of reinspection: Date of issuance of certificate- 02/ZS-1202C Date fee paid: ©2/2S�/201" 6' Type of unit: Dwelling OtAhelr V/10 / Check#� _Check date: 02/25/201 Notes:�Se, �- ) H1/ Vi`o(a.�lm �f1N✓ec'�cd C e f cement 96fector L Inspection of—aA(r p.�ivig.;14 Date C)2L1Q1)1J16 Time 11-.j0'M / Name `y 1 Address Ll iltC'6r/ne� S/E'r o4 1#1-and 1 IeY1 Tel. No. _! (Z' leZ3� � Owner M ;C a� � © �//✓' //^^ 11-- /r�r/s y� Type of Inspection Le.,-+;Ec.4e, o h F i4 h e.SS Inspector Jdit - D p ( � ) Remarks and Violations are listed below: Av"Ih e ll A "rDnlxl IL.aYa 1'rort� eYt-�_r�.r a.S tv�n�o w �a,^�1, t I� 4Q lell %.J l �� a '�o^e n S /,� nQ- 0.T L'416Kr o>` fi"p Ca r II // ///'^ I I V 1 n o L rm n, ;. Wj'h d y w 1 h A✓ r 10 L4 ! 'E'n c-,p �cr"A - UI8oi Coo 14 e. 1Yl Cei In.o W;4k Px o rYr J / I r CAE4 WGJ^ LJC hW S' rf � A�^ ' II a_ Ur Le-.-, 164 —Xija� tVjoda4l lok,,6'rt /► ' eIr w,1A'6� wrMjow, has S4r cls scaf-n 1 0r1 Sct� !`n e) W 1✓h{Clot+ � Ypo n S 1 �r !n rbrl 11'4 N LJ� �'rhmSed Cl rccc, I � VeAroOrn hear l rp Yt} Cri 1 ran� hn,c�w 1 nDl�W o r��r�r' �a.C'�' t• r'f� f�r6 nn �rnal'�'�C� _ I 1 FI /(�y.lTnoroph7 � nr ��C �'mYn Sr ✓';2nS IVI ✓ I` I I e e44 I I iir 1, lip _ 11I11 r t�l19 Wtoyis av_gTr� 6r- corro PrJel pDlnfy G.1/v;o&41ot A5',,r rYC�e 1^^LVAer 1 I ` i Report Received by: v4.. Y 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 01/03/2000 Fax:(978)740-9705 Robert Copodilipo 26 Park Drive Burlington, MA 01803 PROPERTY LOCATED AT 15 Harbor 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. THE BOARD 0 HEALTH REPLY TO lR ' .. {� A ` anne Scot MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR CITY OF SALEM9 MASSACHUSETTS o ; 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#223-07 DATE ISSUED: 5/14/2007 Property Located at: 15-17 Harbor Street UNIT# 11 Owner/Agent: Harbor 1 LLC Address: 629 Broadway City/Town: Everett, MA Zip Code: 02149 24 Hour Phone: 617-429-6030 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 J ANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 JOANNE SCOTT, MPH, RS, CHO Kimberley Driscoll HEALTH AGENT Mayor APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION", PROPERTY LOCATED AT�J _ C�yf7o( ---UNIT kJ/ IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER IkAd- 6,2C L Lb- —MANAGER/AGENT CiVAC C,�Oca- No P.O. Box No P.O. Box ADDRESS G ri�cljag�( _ ADDRESS /S 'I Mc (boc S_k' CITY 4y'e-2'' MC-t. D 21��_CITY S GI kfy\ks.— RESIDENCE PHONE BUSINESS PHONE (24 HRS.)_4 1_7:�W-66,30 BUSINESS PHONE6/7' 3,/-/i� /O TOTAL NUMBER OF ROOMS. ROOM USE 1, _V_ 2 - _3 4. THERE IS A TWENTY-FIVE ($25.00) DOLLAR FEE. PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH RTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. n APPLICANTS SIGNATUR -_ / ie __,_DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION u�/li//-7 DATE OF REINSPFCIION, DATE OF'ISSUANCE OF CERTIFICATEr- 1 V '07 DAT E FEE PA 10 TYPE OF UNIT` DVdEI-LING�OTHER CHE ,: �� ( l CI IECI< I', =.TE 6�" �O 7 NOTES. CODE ENI ORCFIJiEN 1 INSPECTOR CITY OF SALEM, MASSACHUSETTS s BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGRBCNBAOM@SALI:,M COM DAVID GRGENBAum ACTING HFALt'-I AGI3N'f CERTIFICATE OF FITNESS CERTIFICATE#238-10 DATE ISSUED: 5/25/2010 Property Located at: 15-17 Harbor Street UNIT#12 Owner/Agent: Andrew Philbin Address: 629 Broadway City/Town: Everett, MA Zip Code: 02149 24 Hour Phone: 617-529-1931 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 -- DA IDV GREENBAU ACTING HEALTH AGENT CODE NF RCEMENT INSPECTOR 05/17/2020 MON 16: 02 FAX PHILBIN INS-EVERETT 0002/(p0 May. 11. 2010 3: 53PM VINFEN No. 0245 P. 2/3 C= OF SALE,lvl, MASSACHUS= � BOARD OF HEALTH 120 WASHINGTON STREET,e FLOOR TtL.(978)741-1800 KhVIBERLEY DRISCOI7 FAX(978)745-0343 IVIA'YOIZll(ILLNBAN11nS.1�1.RAI.COM 3 j DAVID GREENBAUM, ACTINGHEALTHAGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION." FEE: $50.00 PROPERTY LOCATED AT I S — FIARBOX s r, SA►-FM vNrr# 6 Z IS THIS UNIT DISIGNATSD AS RIGHT L, EFT,FRONT OR BACK,PLEASE CHICLE ONE OWNER/LESSER ANOhL-'W PNj:L8rj4 MANAGERIAGENT,GNAA -TE Pf+/22 No P.O.BOX ADDRESS 10-4 &ROAPWA y ADDRESS /s'-1 } IaAIL&A Sl tf J CITY, STATE,ZIP L'V2IsTr.,MA, 07-1 q q CITY,STATE,ZIP SALEM ANA RESIDENCE PHONE 6/9 S 7-1 1131 BUSINESS PHONE(2414RS) BUSINESS PHONE T 52111131 TOTAL NUMBER OF ROOMS: ROOMUSE: 1.86VR06M 2. ktr(N4J 3. LLVXNG 4.60MPOM S. 6. 7. 8 9. 10. j THERE IS A FIFTY(S50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM i BOARD OF HEALTH THIS FEE IS P =TRAE OF INSPECTION APPLICANT'S SIGNATURE DATE 1� d Inspectors use only Date on initial inspection: d J �/O Date of reinspection: Date of issuance of certificate; S /d S /D Date fee paid: Typeofunit: Dwelling ✓Other Check# 0lO5 Check date: a /� Notes: L l� &b oy (l0ye, M/ t SV1 5 SIytyt. In (A)Indow in lc laches, Code 1 of ementlnspector May 24, 2010 To Whom It May Concern: My name is Jeff Chasse. I work in the Housing Dept at Vinfen Corporation, a non-profit Human Services agency that assists people in finding and maintaining housing. Enclosed please find an Application for a Certificate of Fitness for 15-17 Harbor Street, Salem. A check for$50 to pay the inspection fee is also enclosed. The inspection is scheduled for Tuesday May 25`h, 2010. Please send me a copy of the Certificate once it is generated. Salem Housing Authority will require this to administer the subsidy the tenant will be using. It can be sent to 950 Cambridge St, Cambridge, MA, 02141 atm: Jeff Chasse Thank you, Chasse Rental Subsidy Coordinator Vinfen Corporation Phone: 617 441 1884 Fax: 617 441 1858 chassei@vinfen.org V1nfenCorporatron ' 950(am bridReStreet Cambridge,MA02141-1001 617,441.7800 W VAS_Vir)f'€+9.orrr7 C " CITY OF SALEM, MASSACHUSETTS o h 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#224-07 DATE ISSUED: 5/14/2007 Property Located at: 15-17 Harbor Street UNIT# 13 Owner/Agent: Harbor 1 LLC Address: 629 Broadway City/Town: Everett, MA Zip Code: 02149 24 Hour Phone: 617-429-6030 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. 9 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 r: CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 JOANNE SCOTT, MPH, RS, CHO - Kimberley Driscoll HEALTH AGENT Mayor APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". 2 PROPERTY LOCATED AT /S'/ �_�l yP�_5 ---UNIT H_1✓ IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER 1-14llboC LGL MANAGER/AGENT CV10,CW> No P.O. Box //�� No P.O. Box ADDRESS 4,4i `1 progaW-j ADDRESS/S---/;Z P-qf -ivy fit, CITY ✓ems M�. 6e_ly�_CITY 5gleM RESIDENCE PHONE _BUSINESS PHONE (24 HRS) /o/7_y/ c9_4030 BUSINESS PHONE //7 3fr -_&A9 TOTAL NUMBER OF ROOMS. I-- ROOM USE 1 2. 3 4 S. 6. 7 8 THERE IS A TWENTY-FIVE (S25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH MENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATUR NS, ECT USE ONLY DATE OF INITIAL INSPECTION s��y�o� DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:-f--N '07 DATE FEE PAID 07 TYPE OF UN11DVNELLIN� OTHER CHECK ,a /f TG q CHECK NOTES d� CODE ENFORCEIdiENI INSPECTOR { CITY OF SALEM, MASSACHUSETTS Bo FLD OF HEALTH 120 WASHINGTON STREET,4."FLOOR TEL. (978)741-1800 KINE3ERLEY DRISCOLL F,vx(978) 745-0343 MAYOR nGREENBAUNInsAIUM DAVID GREENBAUM ACTING I-1EALT1-i AGENT CERTIFICATE OF FITNESS CERTIFICATE#612-09 DATE ISSUED: 12/2/2009 Property Located at: 15-17 Harbor Street UNIT#14 1 Owner/Agent: Harbor 1 LLC Address: 629 Broadway City/Town: Everett, MA Zip Code: 02149 24 Hour Phone: 617-429030 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=rF HEALTH DAVID GREENBAUM ACTING HEALTH AGENT CODE ENF R EMENT INSPECTOR . • CITY OF SALEM, MASSACHUSETTS �a�o BOARD OF HEALTH 120 WASHINGTON STREET,4"`FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGREENBAUMnSALEM.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." n FEE: $50.00 PROPERTY LOCATED AT S' I �qC �d(1 S� UNIT# IS THIS UNIT DISIGNATED AS RIGHT LE,FF FFROON—T OR BACK,PLEASE CIRCLE ONE OWNER/LESSER IAoAoL -. LLC— < ANjA EG ENTI.�aI Parr NO P.O. BOX ADDRESS WS troa0kW4\- ADDRESS CITY, STATE,ZIP (fid C fC�n} 1 U�l�_ d� l q CITY, STATE,ZIP f� c> RESIDENCE PHONE —I !�I l' BUSINESS PHONE(24HRS) (/O ' ` " b I C) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATE I2 Q 0 G Inspectors use only Date on initial inspection: A/Q I Date of reinspection: Date of issuance of certificate: & Date fee paid: o Type of unit: Dwelling /Other Check# Check date: /L Notes: C64e En rcement Inspector t r e + 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 CERTIFICATE OF FITNESS CERTIFICATE#225-07 DATE ISSUED: 5/14/2007 Property Located at: 15-17 Harbor Street UNIT# 15 Owner/Agent: Harbor 1 LLC Address: 629 Broadway City/Town: Everett, MA Zip Code: 02149 24 Hour Phone: 617-429-6030 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 INE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH o� • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 JOANNE SCOTT, MPH, RS, CHO - Kimberley Driscoll HEALTH AGENT Mayor APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT7_9Q,020� S� _ _UNIT IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER 414,060<-1 L44- • MANAGER/AGENT ,J r/ems/ a� No P.O. Box No P.O. Box ADDRESS (, ;; q aroa�.wav ADDRESS CITY 4"`�C'e- fy)ct• O 2—I4'7CITY 59 P1 RESIDENCE PHONE_ _BUSINESS PHONE (24 HRS )_Gl7 y��X030 BUSINESS PHONE 4417 3, LV-/A-110 TOTAL NUMBER OF ROOMS:__1_____ ROOM USE t 2. 3. 4. 5 6_7 8 THERE IS A TWENTY-FIVE (S25.00) 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 -1`�11o7 INSpECTOBS USE ONL ' DATE OF INITIAL INSPECTION //y/0 -7 DAT'E OF REINSPCC1ION DATE OF ISSUANCE OF CERTIFICATE J" 7 DATE FEE PAID: 5 / ttc TYPE OF UNIT D1hIEl_l_IN� OTHER CHECK: J� f' /q CHECK Di-.T"c 7 NOTES CODE ENFORCEMI-NI INSPECTOR 1 F CITY OF SALEM, MASSACHUSETTS a ® 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#226-07 DATE ISSUED: 5/14/2007 Property Located at: 15-17 Harbor Street UNIT#21 Owner/Agent: Harbor 1 LLC Address: 629 Broadway City/Town: Everett, MA Zip Code: 02149 24 Hour Phone: 617-429-6030 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 / JO)4 NE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR f r: k CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 JOANNE SCOTT, MPH, RS, CHO - Kimberley Driscoll HEALTH AGENT Mayor APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT /5--/,7 /4atr _ _ _ _ UNIT #__2I IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSERA4&,1'bpi— 2 L-1-4 MANAGER/AGENT_C-Mf/C5 4' No P.O. Box No P.O. Box ADDRESS 42� /9roqdJw7 _ ADDRESS /57 CITY ��`� )IV, A. O Z I bl / CITY !;4 le M __ G RESIDENCE PHONE_ _BUSINESS PHONE (24 HRS)_ BUSINESS PHONE-6 17-3,U-4-10 TOTAL NUMBER OF ROO�JS:- ______ ROOM USE. 1. r// 2 3. 4 5. 6 7 8. THERE IS A TWENTY-FIVE (525.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPA5114.ENT THIS FEE IS PAYABLE AT THE TiNME OF INSPECTION. " - APPLICANTS SIGNATUR _.DATE S/ly1 NSPECTORS USE ONL ' DATE OF INITIAL INSPECTION ��/ 107 DATE OF REINSPECI IUh: ? DATE OF ISSUANCE OF CERTIFICATE x'/11,7 DATE FEE PAID TYPE OF UNIT DWE� OTHER CHECK f 9 NOTES. CODE ENFORCEMENT INSPECTOR Z CITY OF SALEM, MASSACHUSETTS o 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#227-07 DATE ISSUED: 5/14/2007 Property Located at: 15-17 Harbor Street UNIT#23 Owner/Agent: Harbor 1 LLC Address: 629 Broadway City/Town: Everett, MA Zip Code: 02149 24 Hour Phone: 617-429-6030 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 JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 JOANNE SCOTT, MPH, RS, CHO Kimberley Driscoll HEALTH AGENT Mayor APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT /5-- 11- 1dAd�C S-t. UNIT 42-3 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER f/-4lW< 2 L-GL MANAGER/AGENTC 6(e5 Yaac No P.O. Box No P.O. Box ADDRESS L7./r gCjG,kAw j _ ADDRESS /� 6k40 Sfi. CITY �f��e Met- DZ/y% CITY[-e RESIDENCE PHONE_ _BUSINESS PHONE (24 HRS.jfp1�- BUSINESS PHONE 4017- � l TOTAL NUMBER OF ROOMS:_____ ROOMUSE: 1. t'1�2 3 4 THERE IS A TWENTY-FIVE (525.00) 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 IGNATURE _ INSPECTORS USE ONLY DATE OF INITIAL INSPECTION s/)y/,0�7 DATE OF REINSPECT ON DATE OF ISSUANCE OF CERTIFICAI ES - /f O -" DATE FEE PAID TYPE OF UNITDWELLIly1' OTHER CHECK ' NOTES CODE ENPORCF..AFNT INSPECTOR CITY OF SALEM, MASSACHUSETTS oo 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#228-07 DATE ISSUED: 5/14/2007 Property Located at: 15-17 Harbor Street UNIT#25 Owner/Agent: Harbor 1 LLC Address: 629 Broadway City/Town: Everett, MA Zip Code: 02149 24 Hour Phone: 617-429-6030 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 OFrEALTH J ANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR r' CITY OF SALEM, MASSACHUSETTS o217rd� BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01 970 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 /iF,/-��/�1 �_ 57t. __UNIT 42_� IS THIS UNIT DESIGNATED ASRIGHTLEFT FRONT BACK PLEASE CIRCLE ONE / OWNER/LESSER k! l Z MANAGER/AGENT�P Cc6 No P.O. Box No P.O. Box ,__• ADDRESS 6-A ! LQ/'oac�_ ADDRESS_ Z5-- 1 ,7- CITY lS-1 ,?-CITY CVele-f7 /�y• 62�/y� CITY 5gI&M RESIDENCE PHONE_ /_BUSINESS PHONE (24 HRS.)_ /�' yo�� 03f7 BUSINESS PHONE �/7- =31� //- 4110 TOTAL NUMBER OF ROOMS.--- ROOM USE. 1 2 3 4. THERE IS A TWENTY-FIVE ($25.00) DOLLAR FEE. PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SA"HEALTHDEPNT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE _ ._ --DATE A7- INSPECT INSPECTORS USE ON Y DATE OF INITIAL INSPECTION -/ DATE DATE OF REINSPECTION 7 DATE OF ISSUANCE OF CERTIFICATE:_'�. DATE FEE PAID flf/�7-- TYPE OFUNIT DWELLIf OTHER CHECK CHECX1,,",M NOTES CODE ENFOFRCEPAENT INSPECTOR + CITY OF SALEM, MASSACHUSET fS 10 BOARD OF HEALTH 120 WASHINGTON STREET 4t"FLOOR Plilll�iCH881t$ > Prevent.Promote.Protect. TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL Iramdinna,salem.com LARRY ItAMI)IN,RS/RFI-IS,CFIO,CP-1S MAYOR HEM:ITI A(:ENT CERTIFICATE OF FITNESS CERTIFICATE#400-13 DATE ISSUED: 11/18/2013 Property Located at: 15-17 Harbor Street UNIT#26 Owner/Agent: Harbor 1 LLC Address: 629 Broadway CitylTown: Everett, MA Zip Code: 02149 24 Hour Phone: 978-601-8342 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. JOR THE BOARD OF HEALTH LARRY RAMDIN HEALTH AGENT SANT N I 1 m CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH V 120 WASHINGTON STREET 4"�FLOOR PnblicHealth STREET, Prevent.Promote.Nr tem. TEL. (978) 741-1800 FAX(978)745-0343 KIMBERLEY DRISCOLL Iramdin@salem.com MAYOR LARRY R\�IUIN,RS/R@.FIS,CHO,CT-FS H EA],rii AG EN"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" �7 FEE: $50.010 I PROPERTY LOCATED AT , ( I �A GL f � o t S 7 UNIT# ISTHIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER IAO,(S u n '� LLC— MANAGER/AGENT GIY `�' S Pot r r NO P.O. BOX ++ n ADDRESS l�� !7 F J r�� R �I ADDRESS C CITY, STATE,ZIP L V e C 1A 'M A' C)a t`1 1 CITY, STATE,ZIP RESIDENCE PHONE BUSINESS PHONE(24HRS) BUSINESSPHONE TOTAL NUMBER OF ROOMS: J ROOM USE: 1. kLLvd 2. %-J( 3. 4. 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION {JJ APPLICANT'S SIGNATURE \P^�d�h,/ `�'v- . DATE Inspectors use only Date on initial inspection: Date of reinspection: Date of issuance of certificate: Date fee paid: ) Type of unit: Dwelling Other Check#T— 1 Check date: ! / /) v Notes: )CodeIrclemniInspector CITY OF SALEM, MASSACHUSETTS gt BOARD OF HEALTH x€ 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#229-07 DATE ISSUED: 5/14/2007 Property Located at: 15-17 Harbor Street UNIT#31 Owner/Agent: Harbor 1 LLC Address: 629 Broadway City/Town: Everett, MA Zip Code: 02149 24 Hour Phone: 617-429-6030 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 Xd ANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MAsSAcHusErrs BOARD OF HEALTH • 120 WASHINGTON STREET. 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 JOANNE SCOTT, MPH, RS, CHO Kimberley Driscoll HEALTH AGENT Mayor APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR /HUMAN HABITATION'. f PROPERTY LOCATED AT )'Y- � _�t�ll!�� --_UNIT#-3 IS THIS UNIT DESIGNATED AS RIGHT LFFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER A(IV,r GGCf MANAGER/AGENT__k61*re_ No P.O. Box No P.O. Box ADDRESS 6a�I A-00141_ ADDRESS /S/ CITY ( RESIDENCE PHONE7 BUSINESS PHONE (24 HRS.)j BUSINESS PHONE �� ✓ �//�/� TOTAL NUMBER OF ROOS ROOM USE: 1,--//- 2 - ----3 -' - - 4 -- - THERE IS A TWENTY-FIVE ($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH D RTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATUR _. _;_DATE__y�//-y INSPECTORS US E_ak1y / DATE OF INITIAL INSPECTION �fy� - DA1`E OF REINSPECTION DATE OF ISSUANCE OF CF.RTIFICATE,"/ 1't -0 DATE FEE PAID.__ TYPE f,)F UNiL DWELLIL� OTHER CHL.CK =+ �� CHECK C)A i t 5 '' � 7 NOTES: �� GODF ( NFORCEWJv1I Ii�SI'G CTUII N2ti{tl�tf 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#230-07 DATE ISSUED: 5/14/2007 Property Located at: 15-17 Harbor Street UNIT#33 Owner/Agent: Harbor 1 LLC Address: 629 Broadway City/Town: Everett, MA Zip Code: 02149 24 Hour Phone: 617-429-6030 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 JO NE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAx 978-745-0343 - JOANNE SCOTT, MPH, RS, CHO Kimberley Driscoll HEALTH AGENT Mayor APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION'. PROPERTY LOCATED AT 1�� r ___—UNIT N IS THIS UNIT DESIGNATED ASRIGHT LEFT FRONT RACK PLEASE CIRCLE ONE // OWNEWLESSER. _MANAGER/AGENT 6kr-(f/eS No P.O. Box No F.O. Box ADDRESS 4,21 .g Vcl /_wkf —_ADDRESS_!S7'-/7_.I- c,/b°� CITY Fye f�n-- e2 141 CITY_59/l � --- RESIDENCE PHONE —`BUSINESS PHONE (24 HRS) e-r77 BUSINESS PHONE_ 7- TOTAL NUMBER OF ROOMS:__- ____ ROOM USE: 1._�_ 2 _-- ----3 ---- -- ._4 _.-- ----- THERE IS A TWENTY-FIVE ($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPA ENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE ----- ___--_ _.__ :___.. -- _.--------DATE_ uT1y INSPECT QRS USE ONLY / DATE O INITIAL 1 SPECT_IO�� , l�f�y�� -, DATF OF REINSPECTION DATE OF ISSUANCE OF CERTIFICAT} S t`f "'p 7 DATE FEE PAID ., TYPE OF UNIT. DWE_+ e OTHER CHECK t J g CHECK DAT!_ � NOTFS oc CODE I'._NFOHCEMENI INS.;Pt CTUi t t?r)11 gt3 1tlu City of Salem, Massachusetts W Board of Health A 120 Washington Street, 4th Floor, Salem, PablicHea ith MA01970 Prevent. Promote. Protect. 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-16-130 DATE ISSUED: 4/20/2016 Property Located at: 1517 HARBOR STREET UNIT#35 Owner/Agent: North Shore CDC Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 8254018 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 0,—7A4� Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS Bo .m)oiHE_ LFF1 120 WASHING 1'(.)N STREET,4"'F1,o()R 'D-,j,. (978) 741-1800 KTM13ERLEYDRISCO[J.. F_-.x(978) 745-0343 MAYOR LRAM DIN ra_SA 1.1'AI.CON1 LARRY RAMDIN,RS/RF1 fS,CFIO,(T-VS ft�uxi i A(;i_,,,\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" FEE: $50.00 PROPERTY LOCATED AT 15-17 Harbor St., Salcm,.MA 01970 UNIT# 35 IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER 15-17 Harbor LLC. —MANAGER/AGENT North Shore Property Managers,lnc. NO P.O. BOX ADDRESS 106 Lafayette Street ADDRESS . 102 Lafayette Street CITY, STATE, ZIP Salem, MA 01970 —CITY, STATE,ZIP Salem, MA 01970 RESIDENCE PHONE BUSINESS PHONE(24HRS) 978-745-4961 BUSINESS PHONE 978-745-8071 TOTAL NUMBER OF ROOMS:— 2 ROOM USE: I.Kitchen 2.Bedroom 3. 4. 5. 6. 7. 8. 9. 10. THERE IS A FIFTY ($50)DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IQ PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE TWVf DATE 4/15/16 Inspectors use only Date on initial inspection: 0�/j 91101L Date of reinspection: - Date of issuance of certificate:,n V11(2k1_-4 Date fee paid:0' /jq/ZojC Type of unit: Dwelling_,�Other Check# heck date: Notes: cement/f cOf - rtt I, pector r d CITE' OF SALEM, MASSACHUSETTS t v s zo BOARD OF HEALfI-I 120 WASHINGTON SfREEI,4"" FLOOR TEL. (978) 741-1800 KMMERLEY DRISCOL.I, FAX(978) 745-0343 MAYOR IAAMINN SALEM.CON LV21IY RA-N'IDIN,RS/IWIIS,(110,CP-FS HtsAl'xi l,'10Eh'I' Release In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ; State Sanitary Code Chapter II and Article XIII of the City of Salem Ordinance, undersigned owner/lessor and tenant/lessee of a unit of residential property, hereby authorize the Salem Board of Health or its authorized agents to inspect the residence identified below in accordance with the aforementioned statutes, regulations and ordinances. In the event it is necessary that said inspection be done in my/out absence. I/we expressly authorized the same and for my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of Health and its authorized agents from any lose or injury sustained of whatever nature and description occasioned by my/out absence during said inspection. 15-17 Harbor LLC X Tenant/Lessee Owner/Lessor 102 Lafayette Street, Salem, MA 01970 15-17 Harbor St. #35Salem, MA Address Address 15-17 Harbor St. #35 ,Salem, MA Address on unit to be inspected 4/15/16 Date Updated 5/23/11 OON➢Ip� City of Salem, Massachusetts 1P t NO , Board of Health m 120 Washington Street, 4th Floor, Salem, PlubliCHeA Ith I • � MA 01970 Prevent. Promote. Protect. 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-16-176 DATE ISSUED: 5/20/2016 Property Located at: 15-17 HARBOR STREET UNIT#36 Owner/Agent: North Shore CDC Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 825-4018 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 0,— � &ey Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN y' a CITY OF SALEM, MASSACHUSETTS • ^ BOARD OF HEALTH 120 WASHINGTON STREET,4:`FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR 1,RAMDIN@SALI3M.COM LARRY RAMDIN,RS/RENS,CHO,CP-FS I-O'At;FI-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 15-17 Harbor St., Salem,MA 01970 UNIT# 36 IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER 15-17 Harbor LLC. MANAGER/AGENT North Shore Property Manaeers,Inc. NO P.O.BOX ADDRESS 106 Lafayette Street ADDRESS 102 Lafayette Street CITY, STATE,ZIP Salem,MA 01970 CITY, STATE,ZIP Salem,MA 01970 RESIDENCE PHONE BUSINESS PHONE(24HRS) 978-745-4961 BUSINESS PHONE 978-745-8071 TOTAL NUMBER OF ROOMS: SRO ROOM USE: 1. 2. 3. 4. 5 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE A THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATE 5/16/16 Inspectors use only Date on initial inspection: Dal .261 Date of reinspection: Date of issuance of certificate:, ®SS�2��19Z6 Date fee paid: OS�9�2�? Type of unit: Dwelling Other Check# Check date: ©5 41 2 1 Notes: C of •cement Spector CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR I.RAM1)1N(7SAL1,a4.CON1 LARRY RAMDIN,RS/RF:HS,CHO,CP-FS HFIAL:1HAGI NNT Release In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ; State Sanitary Code Chapter II and Article XIII of the City of Salem Ordinance,undersigned owner/lessor and tenant/lessee of a unit of residential property,hereby authorize the Salem Board of Health or its authorized agents to inspect the residence identified below in accordance with the aforementioned statutes,regulations and ordinances. In the event it is necessary that said inspection be done in my/out absence. I/we expressly authorized the same and for my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of Health and its authorized agents from any lose or injury sustained of whatever nature and description occasioned by my/out absence during said inspection. 15-17 Harbor LLC. xL� yy, /r) M e� l�n Tenant/Lessee Owner/Lessor 102 Lafayette Street, Salem, MA 01970 15-17 Harbor LLC., Salem, MA Address Address 15-17 Harbor LLC. ,Salem, MA Address on unit to be inspected 5/16/16 Date Updated 5/23/11 - i CITY OF SALEM, MASSACHUSETTS + e, BOARD or, HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KJINIBERLBY DRISCOLL FAX(978)745-0343 MAYOR ISCO E A� i E'L[.COM JOANNE SCOTT, HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#334-08 DATE ISSUED: 7/30/2006 Property Located at: 19 Harbor Street UNIT# 1 Owner/Agent: Fred Jabre Address: 65 Arlington Road City/Town: Woburn, MA Zip Code: 0180124 Hour Phone: 761-937-3071 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 IANNEtSCOTT, MPH, RS, CHO la — HEALTH AGENT CqK ENFORCEMENT INSPECTOR I � 33� CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4`FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR IscOIT&ALEiM.COM JOANNE SCOTT, 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 /g / l a r 1pQr St Sa I e M is 0 /C 70 UNIT# / IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BAICIPLEASE CIRCLE ONE I OWNER/LESSER .5Y'e/JI ( a re MANAGER/AGENT He /e h �,ci bYP NO P.O. BOX h ADDRESS � /`1 r ( I r �ys rADDRESS am p CITY, STATE,ZIP D uY V1 A O l 8 0 I CITY, STATE, ZIP RESIDENCE PHONE 19'/ - 9 3 7 3 0 7 / BUSINESS PHONE(24HRS) 7 / - 9 3 7-,3 0'7 / 1- 781 3Sy-3`376 c e // BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3. 4. 5 6. 7. 8. 9. 10 THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE 12 49t, DATE-01 IL 3 0. 0 {y Ins pecto use only Date on initial inspection: / 130/()E? Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other n S' Check.SC,i'`e#Check date: 7 � Notes: o��W'ot)Y)9 (A)'1n <)L.._) VLP_ dA °�few o t, d r�r CO ��Clzyr 1 f��'r� rr d>z �,c.ro,2�� Ch)CA4 1b(k,1'1r✓1 Lr)f alp 0 Ut 071 WCV I e E forcement Inspector r , CITY OF SALEM, MASSACHUSETTS ,N o BOARD OF HEALTH ° g. 120 WASHINGTON STREET, 4TH FLOOR S3 >° SALEM, MA 01970 CERT.# 13-03 FEE 01/07/ TEL. 978-741-1800 DATE: 01/07/2003 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 19 Harbor Street UNIT #: 1 Front OWNER/AGENT: Harbor Street Realty Trust C/o Frank ADDRESS: 27 Water Street CITY/TOWN: Wakefield, MA ZIP CODE: 01880 24 HOUR PHONE: 245-0888 AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS BEEN APPROVED AND IS IN COMPLIANCE WITH 10S 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 10S 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 kZOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR _A CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 3 + 120 WASHINGTON STREET, 4TH FLOOR { SALEM, MA 01970 I',� TEL. 978-741-1800 IIV''SI11Y1 I1�"".°1 FAX 978-745-0343 {� y STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, R5, CHO i8- JUL 1 2002 MAYOR HEALTH AGENT Li i r UL 'si lLEM BOARD OF HEALTH APPLICATION FOR CERTIFICATE OF FITNESS 03 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT 5 UNIT#� IS THIS UNIT DESIGNATED AS RIGHT LEF FRON CK PLEASE CIRCLE ONE OWNER/LESSER } 1 MANAGER/AGENT Fm rl< No P.O. Box -2 -7 No P.O. Box ADDRESS ADDRESS CITY CITY RESIDENCE PHONE BUSINESS PHONE (24 HRS.) 8i 3�iJ• OW )3 BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1.k ;,nn pp,2.�k�. 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 SALEVH.EALTH DE ENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATUR DATE INSPECTORS USE ONLY DINE OF INITIAL INSPECTION /, � -O� DATE OF REINSPECTION )- 7-03 DATE OF ISSUANCE OF CERTIFICATE: 03 DATE FEE PAID: 0 Z TYPE OF UNIT: DWELL11/0THER_ CHECK#CHECK DATE 19 -8 '0 Z NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 p CRA IIIAA A SSACHUSLC.Ti S .CO T viT i� V� JAi..�. AA vg BOARD OF HEALTH �{ m 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 V TEL. 978-741-180b CV � 114 .� FAX 978-745-0343 J� - STANLEOVICZ, JR. MAYOR JOANNE SCOTT, MPH, RS, CHO JUL 1 B 2002 MAYHEALTH AGENT CITY OF SALEM BOARD OF HEALTH RELEASE In accordance with Massachusetts General Laws Chapter 111 ; Code of Massachusetts Regulations 410.000 et. seq. ; State Sanitary Code Chapter iI and Article XIII of Che 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. 1;1 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 agents from any loss or injury sustained of whatever nature and description occasioned by my/our absence during said inspection. TENANT/LESSEE OWNER/LESSOR ADD�iESS ADDRESS s ` ADDRESS OF UNIT TO BE INSPECTED i DATE -- R ' t� e0N01T fi n � �m 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 August 27, 1998 Frank Pascuito Harbor Street Realty 27 Water Street, Suite 101 Wakefield, MA 01880 Dear Mr. Pascuito: Please contact this office at your earliest convenience so that we can arrange for a Certificate of Fitness inspection of your property at 19 Harbor Street#1 &#3 in Salem,MA. Enclosed please find(2)two release forms to be signed by the tenants in both apartments. Thank you. FOR THE BOARD OF HEALTH REPLY TO / i . oarine Scott Pablo Valdez Health Agent Code Enforcement Inspector 1S/mfp p k 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 August 12, 1998 Harbor Street Realty e27i Salem;ro1R O"ftr1 �6 � � L Dear Mr. Frank C. Pascuito: Kindly contact this office at your earliest convenience so that we can arrange for a Certificate of Fitness inspection of your property located at 19 Harbor Street 1 & 3 in Salem, MA. . Enclosed please find (2)two release forms to be signed by the tenants in both apartments. Thank you. For the Board of Health Reply to Joan Pablo Valdez Health Agent Code Enforcement Inspector JS/mfp CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR - SALEM, MA 01970 _ TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 1/24/05 6 Cousins Street Realty Trust 5 Walsh Street Peabody, MA 01960 PROPERTY LOCATED AT 19 Harbor Street Unit 2 Dear Sir/Madam: It has come to our attention, that you may be considering renting a dwelling unit at the above address. In accordance with Chapter 11, Article XIII of the City of Salem Code of Ordinances, Section 2- 334, titled "Certificate of Fitness," each dwelling unit must be inspected and certified prior to allowing occupancy. The inspection will be conducted in accordance with 105 CMR 410.000; State Sanitary Code, Chapter 11: Minimum Standards of Fitness for Human Habitation. Please notify us if you do not intend to rent the unit. Please contact this department within 24 hours of receipt of this notice at 978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday thru Wednesday from 8:00 a.m. —4:00 p.m. Thursday 8:00 a.m. to 7:00 p.m. and Friday 8:00 a.m.— 12:00 p.m. Failure to comply with this procedure, may result in a fine of Twenty($20.00)dollars per day for every day that the dwelling unit is occupied without a Certificate of fitness. A$25.00 check payable to the City of Salem is required for each unit inspected at the time of inspection. A property owner is required to pay gas and electricity for residential tenants if there is not a written letting agreement stating the tenant is responsible for those utilities and if the meter(s) records electricity and gas use which is not used exclusively by that tenant. The Department of Public Utilities has billed property owners for their tenant's entire utility bills retroactive to the date of initial occupancy in cases in which cross-metering has been proven to exist. Fo the Board of Health Reply to A�Canne Scott MPH, RS Pablo Valdez Health Agent Code Enforcement Inspector CERT.# 103-01 FEE $25.00 DATE: 02/27/2001 �np�M 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: 19 Harbor Street UNIT #: 2R OWNER/AGENT: Frank Pasciuto ADDRESS: 27 Water Street, Suite 101 CITY/TOWN: Wakefield, MA ZIP CODE: 01880 24 HOUR PHONE: 245-0888 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 F✓ JOANNE XSCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR t D s n, FEB 2 7 20Oi CITY OF SALEM HEALTH pEPT, CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 b �� JOANNE SCOTT,MPH, RS,CHO - NINE NORTH STREET HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tet(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", p PROPERTY LOCATED AT H I A,,� UNIT#Jt P,, IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE i OWNER/LESSER?RLS-s-s. MANAGER/AGENT_ No P.O.Box No P.O.Box ADDRESS L�.hper� ADDRESS CITY a ,wf � --CITY--- RESIDENCE ITY _RESIDENCE PHONE 4&— IM QWUSINESS PHONE(24 HRS.)-- BUSINESS RS.) _BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3.., aek ._Lt 5. 6. 7. 8. THERE IS A TWENTY-FIVE($25.00)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THECITYNOF ALEM HEALTH RTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTIO . xx � APPLICANTS SIGNATURE DATE,,k' SP R ONLY DATE OF INITIAL INSPECTION - " 7.0 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:.2 -, - 11DATE FEE PAID: TYPE OF UNIT: DWELLIN OTHER_ CHECK# CHECK DATE NOTES:_ CODE ENFORCEMENT INSPECTOR 9/28/98 w _ 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 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 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 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 agents �. from any loss or injury sustained of whatever nature and description occasioned by my/our absence during said inspection. TENANT/LESSEE E /1,.M.S01k ------- -- ADDRESS — --- ADDRESS— -- -- ADDRESS OF UNIT TO BE INSPECTED DAVE ti � �ONUIT CERT.# 130-99 5i FEE $25.00 ' DATE: 03/16/99 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: 19 Harbor Street UNIT #: 3 Front OWNER/AGENT: Frank Pasciuto ADDRESS: 27 Water Street, Suite #101 CITY/TOWN: Wakefield, MA ZIP CODE: 01880 24 HOUR PHONE: 245-0888 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. MAXI E MUM 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 Lgev qo-fl--X-� SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM BOARD OF HEALTH . Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,IRS,CHO NINE NORTH STREET HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tel:(978)741-1800 Fax:(978)740-9705 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410,000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT # IS THIS UNIT DESIGNATED ASRIG!jT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER/�i� 4; t�_ ,g-,�,.-MANAGER/AGENT—_ No P.O. Box 1 No P.O. Box ADDRESS,q2_kL-_L _&L-ADDRESS- CITY ujA--k--tg- 6tc � RESIDENCE PHONE —BUSINESS PHONE (24 HRS_)__ BUSINESS PHONE.-- TOTAL NUMBER OF ROOMS: ROOM USE: I.—2.--3._4.- THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE DATE INSPECTORS USE ONLY DATE OF INITIAL DATE OF REINSPECTION___ DATE OF ISSUANCE OF CERTIFICATE:->-4111F=� Y __DATE FEE PAID TYPE OF UNIT: DWELLING OTHER CHECK tf__j_(o �_CHECK DATE NOTES CODE ENFORCEMENT INSPECTOR 9/28/98 ¢oxwr c 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 Fax:(978)740-9705 August 27, 1998 Frank Pascuito Harbor Street Realty 27 Water Street,Suite 101 Wakefield, MA 01880 Dear Mr. Pascuito: Please contact this office at your earliest convenience so,that we can arrange for a Certificate of Fitness inspection of your property at 19 Harbor Street#1 &j#3 in Salem,MA. Enclosed please find(2)two release forms to be signed by the tenants in both apartments. Thank you. FOR THE BOARD OF HEALTH REPLY TO %Joanne Scott Pablo Valdez Health Agent Code Enforcement Inspector JS/mrp CITY OF SALEM, MASSACHUSETTS • BOARD OF HEALTH 120 WASHINGTON STREET,4""FLOOR TEL. (978) 741-1800 ICNIBERLEY DRISCOLL FAx(978) 745-0343 MAYOR Ix;Rr:r=.N nuM(a�snLr•.M.aml DAvID GRJ.,',F.NBAUM,RS ACTING HEAI.IFf AGENT CERTIFICATE OF FITNESS CERTIFICATE#459-10 DATE ISSUED: 9/17/2010 Property Located at: 19 Harbor Street UNIT#4 Owner/Agent: Helen Jabre Address: 65 Arlington Road City/Town: Woburn, MA Zip Code: 01801 24 Hour Phone: 781-324-6440 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 GREENBAUM, RS � ACTING HEALTH AGENT C ENFO NT INSPECTOR CITY OF SALEM, MASSACHUSETTS • 'I e BOARD OF HEALTH 120 WASHINGTON STRFF"I',4."FLOOR rFL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR I)G F1ENRAL1M@SA1A M.CONI DAVID GREENBAUM,RS ACTING HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION." FEE: $50.00 PROPERTY LOCATED AT. '9 QY L D t a 13 a//e vl++ UNIT#- IS THIS UNIT DI IGNATED AS RIIGHT LEFT FRONT OR BACK.PLEASECIRC OWNER/LESSER H?-164 (nd 6n JAr� a I ,,-,N MANAG AGENT G-/' ee-6w11Q 537C0 NO P.O. BOX iY 61 ADDRESS 3�l artrls S A� h mq. ADDRE c . _ 6 1v� CITY, STATE, ZIP CITY, STATE,ZII' RESIDENCE PHONE 7 g 1 .3 2 G 9 y D BUSINESS PHONE (24HRS) r7g / �3,2q C V 440 BUSINESS PHONE ar`11 33 a 7 9 D.S TOTAL NUMBER OF ROOMS:_ ROOM USE: illvi n q 2. bedrooms 3. 4. 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS P Y LE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATES i D Ins ors use onlyT Date on initial inspection::i (i U Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check##Check date: II Notes: V1 i*( Qd C-D d-2- 'eu*pc (14A C forcement Inspector • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX (978) 745-0343 MAYOR IMANCINI(R SALEM COM JANIi;I'NLINCINI Ac,FNG, Hf±AI:I'I-I AC,rSNP CERTIFICATE OF FITNESS CERTIFICATE#225-09 DATE ISSUED: 5/18/2009 Property Located at: 21 Harbor Street UNIT# 1 Owner/Agent: Aaron Kovallsik Address: 52 Athol Street City/Town: Allston, MA Zip Code: 02134 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 JA T MANCINI ACTING HEALTH AGENT CODE E O CEMENT INSPECTOR i I LEE C. SMITH �, . Inrpecrrn SALEM HOUSING A U T H 0 R i T Y 27 CHARTER STREET SALEM MA 01970-3699 978.744A431 EXT,110 FAX 978.744.9614 . EMAIL SHAOSSP..I o Cy,,�- ,u�-��s ,fid J G 0 Ute' -rU S p,,('✓v� e.4-(jv� f/' `I' ct s� ill i CITY OF SALEM, MASSACHUSETTS _ BOARD OF HEALTH 120 WASHINGTON STREET,4°i FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR MANCEN19—SA1,eM.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." FEE: $50.00 PROPERTY LOCATED AT 6H w bor 6-1 • UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER O N ICJ -q ICS/A— MANAGER/AGENT NO P.O. BOX A ADDRESS �/��ps'At ho) L ADDRESS � � CITY, STATE, ZIP o N CITY, STATE,ZIP /I nV I &J a 13 L/ RESIDENCE PHONE 6/0 BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS:_ yt ROOM USE: 1. �j� 2. k��Chtl�-3. 6CA'L 4. 5. )Jk & LIZ 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 P"LE THE TIME OF INSPECTION APPLICANT'SSIGNATURE Inspectors use only Date on initial inspection: l l 6(�J G Date of reinspection: Date of issuance of certificaDate fee paid: S 118 IO 1 Type of unit: Dwelling Other Check#— q Check date: S119MC1 Notes: tffi G Code Enforcement ecto " • CITY OF SALEM, MASSACHUSETTS BOARD OF HFALTF[ 120 WASHINGTON STREET,4`"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLJ- FAX(978) 745-0343 MAYOR 1MANCINI(@SA1.i`,u Cott ],ANI:';C MANCINI AC'T'ING HvAI.a'1-1 AGI'.N'I' CERTIFICATE OF FITNESS CERTIFICATE#180-09 DATE ISSUED: 4/9/2009 Property Located at: 21 Harbor Street UNIT#2 Owner/Agent: Aaron Address: 146 Lafayette 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 JAt T MANCINI ACTING HEALTH AGENT CODE ENFORCEM T INSPECTOR CITY OF SALEM, MASSACHUSETTS /�b BOARD OF HEALTH ' 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR [DIONNNEQSALF_M.COM .JANET DIONNE, SENIOR SANITARIAN 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 2� r1°��"r S r Sft(e A, &xA 0 70 UNIT#--()I_ IS THIS UNIT DISIGNATED ASIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER AA(&&) V=Qtf AL(S l�� MANAGER/AGENT NO P.O.BOX - ADDRESS ADDRESS CITY, STATE,ZIP S«(e wIt M A O NI d CITY, STATE,ZIP RESIDENCE PHONE 6 (6- S40—r 7 vZ BUSINESS PHONE (24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: Ll ff'' ROOM USE: 1. 6Cj 2. �C� 3 ):Vih4 4 I"'I+Je, 5 6. 7. 8. 9. 10. THERE IS A FIFTY ($50)DOLLAR FEE,PAYAB ECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABL T OF INSPECTION APPLICANT'S SIGNATURE DATE �{ D Inspectors use only Date on initial inspection: y. 9 O fit' Date of reinspection: Date of issuance of certificate: 9. 9'-o g Date fee paid: SI, Q.d9 Type of unit: Dwelling__j,-- Other Check# 32.9 Check date: N • 9 -cog Notes: *odeEnfo'ce4men't Insp ctor CITY OF SALEM, MASSACHUSETTS o BOARD OF HP_ALTH 120 WASHINGTON STREET,4"FLOOR TEL. (978)741-1800 KIMBERLLY DRISCOLL FAX(978)745-0343 MAYOR JDIONNF0_( SALEM.COM JANET DIONNL, SENIOR SANITARIAN Release In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ; State Sanitary Code Chapter 11 and Article X111 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 na e and description occasioned by my/out absence during said inspection. Tenant/Lessee Ow r Address r1 L Address Address on unit to bi inspected L /0 Date • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4°'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGREENBAUM&AL.EM.COM DAVID GmENBAUM ACTING HE.AI,Lt 1.AGI%,N'r CERTIFICATE OF FITNESS CERTIFICATE#375-10 DATE ISSUED: 8/5/2010 Property Located at: 21 Harbor Street UNIT#3 Owner/Agent: Rick Thomas Address: 25 Harbor Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-654-1766 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 130A RD OF HEALTH Au DAVID GREENBAUM ACTING HEALTH AGENT COPY ENFORCEMEtNT INSPECTOR **The front door must be repaired and emergency light in the front hall must be replaced" TRANSMISSION VERIFICATION REPORT TIME : 08/11/2010 21:57 NAME : FAX : 9787450343 TEL : 9787411800 SER. # : 000BON341991 DATEJIME 08111 21:57 FAX NO./NAME 919785311012 DURATION 00:00: 00 PAGE(S) 00 RESULT BUSY MODE STANDARD BUSY: BUSY/NO RESPONSE CITY OF SALEM, MASSACHUSETTS • • BOARD OF HEALTH 120 WASHINGTON STREET,4" FLOOR TEL. (978) 741-1800 ICIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR QCREENI3AUM(9SALF.M.CQM DAVID GREENRAUM ACTING HEAL IH AGLNT Facsimile Transmittal To: �Q✓r ( 17,n f�'c�n Y j d k) Fax # RE: Date Page(s): including this cover# Message: Phi 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 TRANSMISSION VERIFICATION REPORT TIME 08/11/2010 22: 59 NAME FAX 9787450343 TEL 9787411800 SER.# 000BON341991 DATEJIME 08/11 22:58 FAX N0./NAME 919785311012 DURATION 00: 00: 29 PAGE(S) 02 RESULT OK MODE STANDARD ECM -,��J'� � R � �� - �C� � a �� . /-q7g a� y " �� CITY OF SALEM MASSACHUSETTS BOARD OF H&%LTH 120 WAiHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIIvIBERLEY DRISCOLL FAx(978) 745-0343 MAYOR DGRFUNBAunf o SALEM.COM DAVID GREENBAUI%I, ACTING I-IFALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "A.!T?iTA.TT is! 0T A T TTZ A n T Q .n..'' 'pTT1 n; C Cl1P 1IT iT R ANT H DITiA TTl1Tl ''r'l tt FEE. $_50.00 PROPERTY LOCATED AT A.(600 �11 UNIT#� nd t 1 IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER IyAflYi� kofl�(� 1hIA MANAGER/AGENT'I , _%C nn 1 6C✓) ADDRESS ADDRESS CITY, STATE, Q ZIP—Allskc ©�1�{ CITY, STATE,ZIP RESIDENCE PHONE `1qq l0 - Q 10- 5p 7 BUSINESS PHONE(24HRS) 11? _ Lo 5 q - l 16n 2 BUSINESS PHONE TOTAL NUMBER OF ROOMS:— ` ROOMUSE: L kifehAm 2 IiUiAX/2�/hM 3 �'lNM 4 h0.t6a s 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 ISP LE AT THE TIME OF INSPECTIOT APPLICANT'S SIGNATURE � DATE Inspectors use only / Date on initial inspection: 1.5 6 O Date of reinspection: V l l/ '0 Date of issuance of certificate: Date fee paid: ''ll Type of unit: D{welling 1 Other Check#_ Check date: V Notes: aut dl�.f �l \ aR em_q l zj I � Lin ; �svr�- aG( bu-n.�cs o� 5�-cNe wore �rov� e�ceceafe fir kc1c.P�en I�1�#cowet } Co ear Iforcement his $jtl rPIY15Pec �vY1 �i all Y\-Vir bedvo-ah 4,tD ,a,� uv r v��IQtI�7a3 VIOi� GO(1N85 bc� coYypcd. �C61t door must ee Y �pan�� e vn ¢n�eh[� {51 n �rowi haat I�epl a cu d. �� P � ,S � y ��9 s� L✓ / � � / P �� s� x ��o � � � � . � Q .Q � QQ � S � � �� n � f ._ � ;+ �� '', i f r ��oeorr CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970- 02/11/2002 JOANNE SCOTT, MPH, RS,CHO 120 Washington.Street-;4`" Floor HEALTH AGENT Tel # (978)-741-1800 Harbor Street Realty Trust c/o Frank Pasciuto, Trustee 11 Sl as Mariam Way Fax # (978)-745-0343 Middleton, MA 01949 PROPERTY LOCATED AT 21 Harbor Street UNIT # 3 Left 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 BOARD HEA TH REPLY TO Joanne Sco t, MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR v6�gONDIT 9B��MIIYE CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970 02/11/2002 .JOANNE SCOTT, MPH, RS;CHO 120 Washington Street—41h Floor HEALTH AGENT Tel # (978)-741-1800 Harbor Street Realty Trust c/o Frank Pasciuto, Trustee Fax # (978)-745-0343 11 Silas Meriam Way Middleton, MA 01949 PROPERTY LOCATED AT 21 Harbor Street UNIT # 3 Right 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, Section2-334,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 BOA�RID� HEALTH REPLY TO Joanne Scof.t, MPH O - PABLO VALDEZ Health Agent - CODE ENFORCEMENT INSPECTOR I PERIM �., CERT.# 558-99 �. FEE $25.00 DATE: 09/17/99 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: 21 Harbor Street UNIT #: 4 OWNER/AGENT: 21 Harbor Street Realty Trust ADDRESS: 21 Harbor Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-7043 AN INSPECTION OF YOUR VACANTDWELLING/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/ ��JO'* ANNE SCOTT, MPH,RS,CHO - HEALTH AGENT CODE ENFORCEMENT INSPECTOR - i I 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 II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT Z f 1�I�nrsGfi�r�£ / UNIT# I IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNERlLESSER7 /fR &6Ifj 'ML 'ENTT_9QLDf �i1lu J4��6G� No P.O. Box No P.O. Box ADDRESS 2-t 4"90,e= 1' ADDRESS CITY Sha- CITY RESIDENCE PHONE BUSINESS PHONE (24 HRS.) _5-' '74q3 BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1, !` 2. 3. 4: _ 5 6. 7.--8,- THERE ._ 8.THERE IS A TWENTY-FIVE($25,00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION !/- / 7 —DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:`C '� 7 J/�D��ATEE FEE PAID:# TYPE OF UNIT: DWELLINGVOTHER_ CHECK _CHECK DATE �� f f NOTES: .CODE ENFORCEMENT INSPECTOR 9/28/98 O -,N t �y !n CERT.# 24-98 3 FEE $25.00 3 R �1Yi� DATE: 01/23/98 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: 21 Harbor Street UNIT #: 4 OWNER/AGENT: 21 Harbor Street Realty Trust ADDRESS: 27 Harbor Street CITY/TOWN: Salem MA ZIP CODE: 01970 24 HOUR PHONE: 745-7043 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 /� •may �' i JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR t s y f) 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 AT21_ K— CjatKE [ UNIT If OWNER/LESSER Zt k L f[[�( �,j�(,("�Z"T MANAGER/AGENT rny6- } U)" fibU ADDRESS a� ll glRl�DI2� yiT�� ADDRESS CITY } tn^ CITY RESIDENCE PHONE JiK (j j BUSINESS PHONE (24 HRS.) BUSINESS PHONE till 3 t tk ,- TOTAL NUMBER OF ROOMS: ROOM USE: 1. (j�2. (� _3. 4 . 5. 6. 7. B. THERE IS A TWENTY-FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO TEE CITY OF SALEM HEALTH DEPARTMENT `THI(S� FEE IS PAYABLE AT THE TENS OF INSPECTION APPLICANTS SIGNATURE_��1 fit �I ii n i { DATE ! 3- _ INSPECTORS USE ONLY DATE OF INITIAL INSPECTION_ f ..�� ✓�� DATE OF REINSPECTION--.--- L-'�-1- �(� _ 1—p� �IS DATE OF ISSUANCE OF CERTIFICATE: �' BATE FEE PAID: 3 TYPE OF UNIT: DWELLING a/ OTHER_ NOTES: T CODE ENFORCEMENT INSPECTOR