HARBOR STREET 50- HARBOR STREET 50 ----
i
I'
1
City of Salem, Massachusetts
rpND
Xu"- -d
Board of Health
120 Washington Street, 4th Floor, Salem, PUb1iCH�alth
MA 01970 Prearnt.Promote. Protect.
Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS,CHO
Mayor health@salem.com Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE#: GHL-16-416
DATE ISSUED: 10/25/2016
Property Located at: 40 HARBOR STREET UNIT#2
Owner/Agent: Jason Mclsaac
Address: 17A Old Topsfield Road
City/Town: Boxford, MA Zip Code: 01921 24 Hour Phone:(781) 799-7107
Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of
rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has
been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum
Standards of Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now
be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age.
P—-,t�
re
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITARIAN
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON S'1RLET,4O'FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOI.L FAX(978) 745-0343
MAYOR LRAMDIN n.SALEM.COM
LARRY RAMD]N,RS/RBHS,CHO,CP-FS
HEALTH AGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"
� /� / r / FEE: $50.00
f
PROPERTY LOCATED AT !U Ocyz�� J l UNIT#
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
O ESSERAGENT
BOX
ADDRESS —ADDRESS
CITY, STATE,ZIP 07 b k7acZ J_ AL,�0 ?7U CTfY, STATE,ZIP
RESIDENCE PHONE L / ��� / BUSINESS PHONE(241IRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2. 3. 4.
6. 7. 8. 9. 10.
THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS FEE IS PAY EAT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE
Inspectors use only
Date on initial inspection: 104 q!/4 0±L Date of reinspection:
Date of issuance of certificate:.L01 26 Date fee paid: 101_t 5&0LC,
Type of unit: DwellingOther Check#_10Check date: M $�4_
Notes: Un er rc �ita +ort Aea covers. Sp�„� der-& m ssi
C n115rcement Irk ector
City of Salem, Massachusetts
Board of Health
120 Washington Street, 4th Floor, Salem,(9 r,� more
MA 01970
Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin,MPH, REHS,CHO
Mayor health@salem.com Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE#: GHL-16.417
DATE ISSUED: 10/25/2016
Property Located at: 40 HARBOR STREET UNIT#3
Owner/Agent: Jason Mclsaac
Address: 17A old Topsfield Road
City/Town: Boxford, MA Zip Code: 01921 24 Hour Phone:(781)799-7107
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.
Jeffrey Barosy
Larry Ramdin, MPH, REHS, CHO SANITARIAN
HEALTH AGENT
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON SIRE IiT,4"'FLOOR
TEL. (978)741-1800
KlUBERLEY DRISCOLL FAX(978) 745-0343
MAYOR LRAMD1Nt7a SALEM COM
LARRY RAMDIN,RS/RF.HS,CIiO,CP-FS
HEACCFI AGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"
FEE: $50.00
PROPERTY LOCATED AT l (7 W J ` Y !3 UNIT#
�jIS THIS U
/N
�IT DISIIGNATED/ASS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE
O ESSER L O l , I�/l�5r- ( 4 MANAGER/AGENT \Y SSB tJ M c SA��
ADDRESS rM D `tLL 51744 1C� ADDRESS
CITY, STATE, ZIP MA, 01 1 d CITY, STATE,ZIP
RESIDENCE PHONE I�1•--7r? 21,)7 BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2. (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 IS7xl
LE AT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE 4-_
Inspectors use only
Date on initial inspection: Date Date of reinspection:
Date of issuance of certificate /�9/ZCJ�� Date fee paid:�r�g12614
Type of uunit: Dwelling Other Check#/�6 Check d1ate:�y�Z�� f,
Notesi UrAn r f o�r c rcad IH lot g2 'MAPA rnm wln
C e cement Ins ctor
q
v��coua CITY OF SALEM, MASSACHUSETTS
3 �a BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
ger e �` TEL. 978-741-1800
FAX 978-745-0343
KIMBERLEY DRISCOLL JSCOTT@SALEM.COM
MAYOR
JOANNE SCOTT
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#274-08
DATE ISSUED: 6/10/2008
Property Located at: 53 Harbor Street UNIT# 1 Rear
Owner/Agent: Mark Realty Trust
Address: 51 Harbor Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-740-1700
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
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENF CeENT TOR
a?qv°
• CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,e FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR JSCOTr sALEnt 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 HUMA HABITATION."W
PROPERTY LACATED AT J 0c ( �) r #�
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACk,PLEASS CIRCLE ON
OWNER/LESSER hh-A YE MANAGER/AGENT
NO P.O. BOX �n /� ('
ADDRESScc AAI�JC a 1 g ADDRESS 0 N C �1
CITY,STATE,ZIP SAL ` ` CITY,STATE,ZIP
RESIDENCE PHONE BUSINESS PHONE(24HRS)%� -t/ —
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: 044.
ROOM USE: 1./` C 2. 3. 5.
6. 7. 8. 1 9. 10.
THERE IS A TWENTY-FIVE($25 OLLRRR FEE, A"BYOR MONEY ORDER TO THE Y OF
SALEM BOARD OF HEALT IS E qS PAY LINSPECTION /1/� q•e z
APPLICANTS SIGNATURE 1'\`� DATE
Inspectors use only
Date on initial inspection: t>- 1 o -0 1? Date of reinspection:
Date of issuance of certificate: to• 10 .09 Date fee paid: S 3� -08'
Type of unit: Dwelling✓ Other Check# 372-'1 Check date: 5-3 a-o e
Notes:
Code Enforcement Inspector
r
CITY OF SALEM, MASSACHUSETTS
' • BOARD OF HEALTH
120 WASHINGTON STREET,4' FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR 7SCOIT e SALEM COM
JOANNE SCOTT,
HEALTH 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.
Tenant/L ssee Owner/Lessor
Address (/ (J Address 0I,�6
ST ��- fir
Address on unit to be inspected
'5110'5
Date
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
/";�'d SALEM, MA 01970
` TEL. 978-741-1800
FAX 978-745-0343
KIMBERLEY DRISCOLL JSCOTT@SALEM.COM
MAYOR
JOANNE SCOTT
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#591-07
DATE ISSUED: 11/30/2007
Property Located at: 53 Harbor Street UNIT#2
Owner/Agent: Mark Realty Trust
Address: 51 Harbor Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-532-6268
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
,f/(
ay
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 T-Gtit-E�-dti S�" UNIT# -7
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ON ' / \�
OWNER/LESSER
P*TT` r MANAGER/AGENT r I� �Vb V
No P.O. Box TT / No P.O. Box d
ADDRESS /J 'a �G ADDRESS 2
CITY . 1 � (J CITY
RESIDENCE PHONE/5G2/��� BUSINESS PHONE (24 HRS.)
BUSINESS PHONE�?_t
TOTAL NUMBERR OF ROOMS: S
ROOMUSE: 1.&�'Aq Air&- ��� 4. �
THERE IS A TWENTY-FIVE($25.00) DOLLAR FE f AYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM HE H DEP R MENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION. 1(/�-
A??LICA"JTS SIGNATURE DATE lIJJC/
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION � / - 5--0 7 DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:/��0.7 DATE FEE PAID: - d - v
TYPE OF UNIT: DWELLIN/OTHER_ CHECK# S! 1,CHECK DATE�[_�_d— a7
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
S 4
CIT' OF SALEM, MASSACHUSE I`CS
1 .
BOARD OF F1F.A1X1I
120 WASFnNGTON STRFFI',4'"F1.001z
TEL. (978) 741-1800
KIMBERLF.Y DRiSC011 p jx (978) 745-0343
MAYOR
lxamdin(cr7sal ctn.corn
LARRY RANIDIN,RS/KI'.Ii S,C1 10,CP-I-S
HI:nl:rrl A(;kN 1'
CERTIFICATE OF FITNESS
CERTIFICATE#32-12
DATE ISSUED: 1/20/2012
Property Located at: 53 Harbor Street UNIT#3
Owner/Agent: Mark Realty Trust
Address: 45-55 Harbor Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-590-5401
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
LAR 04 z6d
HEALTH AGENT CODE ENVORCEIVIENT INSPECTOR
•. _ i� ���
< CITY OF SALEM, WsSACHUSEJTS All
Bo�RD Ov,HEav) 1'ti
120 W ASHING'I ON`iTREI I' 4°' FLOOR
(978) 741-1800
KINMERLEY DRTSC.OLL FAX (978) 745 0343
MAYOR �.E,viyIDIN snl.h�l.c;��va
l.,AItliti IL\idl>IN,RSH IU IS,CI ICI,CI'-I'S
1.1F,\I;PII AG{N'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 $�J 6 �-'t -� <d UNIT# 3
IS THIS UNIT DISIG]NATED AS RIGHT LEFT FRONT OR BACK PLEASE I�LE ONE /V
OWNER/LESSER Ig�` MANAGER/AGENT tu4 t1
NO P.O. BOX7 "2 r7/
ADDRESS_7 �f� `�D _ADDRESS Lt,.1 � / ! f'�
CITY, STATE,ZIP '/� / '� / � CITY, STATE, ZIP X166 IN ``'1� 66
RESIDENCE PHONE l j (l — J 3 Z.'' BUSINESS PHONE(24IIRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: !�
ROOM USE: 1!`il � 2. L �d�Il 3. r 4. 5. �
6, 7. 8. 9. 10.
THERE IS A FIFTY($50)DOLLAR ,PAYABLE CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS F AYABL T E OF INSPECTION
APPLICANT'S SIGNATURE DATE
Inspectors use only
Date on initial inspection:_ — 2A--11 Date of reinspection:
Date of issuance of certificate: )--10-1'L Date fee paid:
Type of unit: Dwelling� Other Check#_2a23 Check date:
Notes:
Code Enforcement Inspbetor
City of Salem, Massachusetts
Board of Health
` 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, REHS,CHO
Mayor Iramdin@salem.com Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE#: GHL-15-425
DATE ISSUED: 12/18/2015
Property Located at: 53 HARBOR STREET UNIT#4
Owner/Agent: Mark Realty Trust
Address: 20 Park Street
City/Town: Peabody, MA Zip Code: 01960 24 Hour Phone:(978) 532-6268
t
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
F�
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITAR N
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR
TEL. (978)741-1800
KIMBERI-EY DRISCOLL FAX(978)745-0343
MAYOR Lp ABMIN Sti .M cont
LARRY RAMDIN,WRENS,010,(T-PS -
HEALTH AGITIT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"
B $50.0J0
PROPERTY LOCATED AT 56` f I�,� UNIT#
is7WSUNIT DISIGN 77AAS 1"TFRONTORBACK PUASECnt O
OWNERJLESSERIA4(ZtC V(3 �Ctl'l a QS� MANAGER/A
GGENT U CGEr16
NO E0.BOX
ADDRESS G
Alk ADDRESS vLA
�� )
CITY, STATE,ZIP p A b 6 0PiA � CITY, STATE,Z.IP C `
RESIDENCE PHONE ! K�- ✓ rZ' 1_(��� BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
,
ROOM USE: 1.1f)`{Jiy1 2% C �3. 4. 5.
6 7 8 9. I0.
THERE IS A FIFTY($50)DOLLAR PAY Y CHECK OR ONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS FEE A AB AT TIME OF RVSP ON
_
IT-M_X
APPLICANT'S SIGNATURE a DATE
Itlsoedors use only
Date on initial inspection: Date of reinspection:
Date of issuance of certificate: Date fee paid: :Q// 1 Y/_20LC
Type of unit: Dwellin Ocher Check# ]D Check date: _2-/1-V2!)��.
i I I / i
.
No(tes:�'Sa!' 1 Wle,�v✓�7 lock M/�.S MtS O�ionr� !�r'lck Jn Y\Ook'5 6v r'hd,OWWaOf u'n' d
Shc )tart !^ur Ana lemlwt 46 b6 of. in lSS,viny 1l1 reY S
ent pector
I
o
op
b, LUAA
- ��
Al
�S �
t °
t
`oNnlT"� City of Salem, Massachusetts
lu
" Board of Health
120 Washington Street, 4th Floor, Salem, PublicHealth
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-15-291
DATE ISSUED: 9/18/2015
Property Located at: 57 HARBOR STREET UNIT#1-1
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
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANIT RIAN
R
1F
CITY OF SALEM, MASSACHUSETTS
� y"-dwsr Bl»RL)OF HEALTH
120 WASHING I'ON STREE F,4"'FLOOR
I'EL. (978) 741-1800
KINMERL.EY DRISCOLL Fax(978) 745-0343
MAYOR LRANIDIN sAt I COM
LARRY RAMi>IN,RS/RG,HS,(;HO,(: )-FS
LILALT]I AGFN1'
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 57 Harbor St., Salem, MA 01970 UNIT# 1-1
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER Salem Point II L.P. MANAGER/AGENT North Shore Property Mana ers,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: 4
ROOM USE: l.Liv. Room 2.Kitchen 3. Bedroom 4.Bedroom 5 Bedroom
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 F IS AYABL HE TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE 9/11/15
Inspectors use only
Date on initial inspection: /2AZ5" Date of reinspection:
Date of issuance of certificate: Date fee paid:0Q/1y17-015_
Type of unit: Dwelling Other Check# 1237 Check date: 69/1 y�2QZS
Notes:
Code rceyffentInspxor
City of Salem, Massachusetts
r
Board of Health
` 120 Washington Street, 4th Floor, Salem, PublicHeaith
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-15-434
DATE ISSUED: 12/24/2015
Property Located at: 57 HARBOR STREET UNIT#2-1
Owner/Agent: North Shore CDC
Address: 102 Lafayette Street
City/ own: 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 11 "Minimum
Standards of Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now
be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later,
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITARIAN
CITY OF SALEM, IVIASS.NCFIUSE"ITS
{� BoAiRi)OF 11EALTH
1201yi'ASHINGMNS M-,GFI,4"'FLOOR
-' T13L. (978) 741-1800
ItiIiv BERLEY DRISCOI-1 l,,kx(97 8) 745-0343
MAYOR Ltj41)1NA, O4
I„ti2R]'Rath t�tN,RS%RI3F1y,0110,CT-FS
I-1GAI.PttAGld;v1'
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 57 Harbor St., Salem, MA 01970 UNIT# 2-1
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE,ONE
OWNER/LESSER Salem-Point II L.P. MANAGER/AGENT North Shore Property Managers,Inc.
NO P.O.BOX
ADDRESS 106 Lafayette Street ADDRESS 102 Lafayette Street
CITY, STATE,ZIP Salem MA 01970 CffY, STATE,ZIP Salem.MA 01970 _
RESIDENCE PHONE BUSINESS PHONE(24HRS) 978-745-4961
BUSINESS PHONE 978-745-8071
TOTAL NUMBER OF ROOMS:--5—
ROOM
OOMS: 5ROOM USE: 1.Liv. Room 2.Kitchen 3,_Bcdroom 4.Bedroom 5,Bedroom
6. 7. 8. .9. ]0.
THERE IS A FIFTY ($50)DOLLAR FEE,PAYABLE.BY CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS F PAYABLE AT THE TIME OF INSPECTION 11� 1
APPLICANT'S SIGNATUR _DATE !.
I
Inspectors use only
Date on initial inspection_J )IF—_—_... Date of reinspection:
Date of issuance of certificate- L23Z 2P� Date fee paid: 1 X11 2.o.
Type of unit: Dwelling_V Cather Check# 3�s1 Check date:_i2�L J--
Notes:
i
*dn cement Spector
City of Salem, Massachusetts
Board of Health 10
a
e 120 Washington Street, 4th Floor, Salem, PuIiCHeslth
MA 01970 Prevcnt.Preroa[e. P oxect.
Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, RENS,CHO
Mayor health@salem.com Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE#: GHL-17-247
DATE ISSUED:8115/2017
Property Located at: 57 HARBOR STREET UNIT#2.2
Owner/Agent: Salem Point II L.P.
Address: 102 Lafayette Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(970)745-8071
Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of
rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has
been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum
Standards of Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the.unit may now
be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates,whichever is later.
This Certificate of Fitness Is valid only if there is a valid Certificate of Occupancy.
Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age.
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITARIAN
l -
` CITY OF SAIiEM MASSACHUSETTS
BOARD OF I IEALTH
120 W SSI IING rON S I Rt_,F*r,4"'FLOOR
TSL. (978) 741-1800
KIMBERLEY DRISCOLL F;�X(978) 7/45-0343
AlAYOR L.R NID1N@Sn LEfb1.CoNi
LARRl,R:\\IDIN,RSI/RT-,T IS,(1-10,CP-I'S
Fi,u.rrt AceN r
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"
EE: $50. 0
PROPERTY LOCATED AT 57 Harbor St., Salem, MA 01970 UNIT# 2-2
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER Salem Point II L.P. 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: 4
ROOM USE: 1.Liv. Room 2.Kitchen 3. Bedroom 4.Bedroom 5. Bedroom
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�T THE TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE 8/11/17
Inspectors use only
Date on initial inspection: Date of reinspection:
'411411 —
Date of issuance of certificate: Date fee paid:
Type of unit: Dwelling Other Check#_yoo-,�Q Check date:
Notes:
Code Enforcement Inspector
wNntz City of Salem, Massachusetts
t = r �
Board of Health
120 Washington Street, 4th Floor, Salem, vrevPUb1iCmaHB81th
MA 01970
Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343
MaMayor health@salem.com Larry Ram ea MPH, REHS, CHO
Y @ Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE #: GHL-16-322
DATE ISSUED: 8/26/2016
Property Located at: 57 HARBOR STREET UNIT#4-1
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.
Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age.
&Jeffrarosy
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITARIAN
CITY OF SALEM, MASSACHUSETTS
BOARD of I LALTH
120 WASHINGTON S'1'REE.r,4"'FLOOR
Tr_-L. (978) 741-1800
KIMBERLEY DRISCOL.L FAN (978) 745-0343
MAYOR 1RAMD1N@SAt E?I C0A
LARRY RANFDIN,RS/REAS,010,CP-FS
HEALTH AGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"
FEE: $50.00
PROPERTY LOCATED AT 57 Harbor St., Salem, MA 01970 UNIT# 4-1
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER Salem Point II L.P. MANAGER/AGENT North Shore Property Mana erg s,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: 5
ROOM USE: 1.Liv. Room 2.Kitchen 3.Bedroom 4.Bedroom 5.Bedroom
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 TIE TIME OF INSPECTION
APPLICANT'S SIGNATURE / DATE 8/23/16
Inspectors use only
Date on initial inspection: sjl�? Date of reinspection:
Date of issuance of certificate �` }� Date fee paid: DLLs LD
Type of unit: Dwelling Other Check# 15's Check date: B�r2t f�2�G
Notes:
Co orc ent Ins ctor
CITY OF SALEM, MASSACHUSETTS
• ' BOARD OF HEALTH
120 WASHINGTON STREET,4"FLOOR
TEL. 0378)741-1800
KINfBERLEY DRISCOLL FAX(978)745-0343
MAYOR N1ANCIM@dA1E\I COM
JANET NIANCINI
ACTING HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#32-09
DATE ISSUED: 1/20/2009
Property Located at: 57 Harbor Street UNIT#4-2
Owner/Agent: Salem Point L.P.
Address: 102 Lafayette Street
City/town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-4961
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter 11"
Minimum Standards of Fitness for Human Habitation".
Therefore,this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates,whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
JN-ETNG HEALTH AGENT CODE EN RCEMENT INS ECTOR
• CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4m FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR Isco snt -M.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 HUMA HABITATION."
FEE: $50.00
PROPERTY LACATED AT 0"1 UNIT#
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BAC PLEASE CIRCLE ONE
OWNER/LESSER Salem Point L.P. MANAGER/AGENT Salem Property Managers
NO P.O.BOX
ADDRESS 102Lafayette Street ADDRESS102 Lafayette Street
CITY,STATE,ZIP Salem. MA 01970 CrIY,STATEZIP Salem, MA n19un
RESIDENCEPHONE BUSINESS PHONE(24HRS) 978 745-4961
BUSINESS PHONE 928- 745-8071
TOTAL NUMBER OF ROOMS:
ROOM USE: I)PyAn-- 2. f-C41-z, 3. 4. &doe-x� 5.44*m-
6. 7. 8. 9. 10.
THERE IS A SEVENTY-FIVE($75)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF
SALEM BOARD OF HEALTH THISY IS PAYABLE AT THE TIME OF INSPECTION
APPLICANTS SIGNATURE DATE
Inspectors use only
Date on initial inspection: ` IO Date of reinspection: Q
Date of issuance of certificate: i ' 2..0 Date fee paid:
Type of unit: Dwelling ✓ Other Check# 9 3 1 Check date: 4
Notes:
ode Enforc6cntInspector
�r
.O
CITY OF SALEM, MASSACHUSETTS
• • BOARD OF HEALTH
120 WASHINGTON STREET,47 FLOOR
T'EL.(978)741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR TscoTrOsncems.COM
JOANNE SCOTT,
HEALTH AGENT
Release
In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ;
State Sanitary Code Chapter R and Article Xlll 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 /9nerlLessor
Oro
Address Address
Address on unit to be inspected
9
Date -�
�oND City of Salem, Massachusetts
f y
Board of Health
a 120 Washington Street, 4th Floor, Salem, PublicHealth
MA 01970 Prevent. Promote. Protea.
Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHO
Mayor Iramdin@salem.com Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE #: GHL-15-256
DATE ISSUED: 8/28/2015
Property Located at: 59 HARBOR STREET UNIT#1-1
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,—Akit—, -
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITARIAN
CITY OF SALEM, MASSACHUSETTS
Bo.YRD Or HL LTH
120 WASHINGTON S 1 RE h`i',4.'. FLOOR
'ISL. (97 8) 741-1800
KI1v BERLl Y DRISCOT,I. FNx (978) 745-0343
MAYOR LRnui�iNnsAl,i�;�Lcom
LARRY"Rr\MDIN,RS/RLLIS,Cl 10,CP-ES
HEALTIi A<:I NT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"
FEE: $50.00
PROPERTY LOCATED AT 59 Harbor St., Salem, MA 01970 UNIT# 1-1
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER Salem Point ll L.P. MANAGER/AGENT North Shore Property Mana erg s,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: 5
ROOM USE: 1.Liv. Room 2.Kitchen 3. Bedroom 4.Bedroom 5. Bedroom
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 PAYABLE AT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE 8/20/15
Inspectors use only
Date on initial inspection: 0_%12'7/z01s Date of reinspection:
Date of issuance of certificate:02/27/2-0.7.577 Date fee paid:MV2D1S
Type of unit: Dwelling Other Check# 1225 Check date: 0V2,01!101S
Notes:
Cod FYy rce ent Inspect
CITY OF SALEM, MASSACHUSETTS
BOARD OF H&kLTH
120 WASHINGTON STREET,4'FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR [MAN INI i,1SALEM.COM
JANET MANCINL
ACTING HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#33-09
DATE ISSUED: 1/20/2009
i
Property Located at: 59 Harbor Street UNIT# 1-2
Owner/Agent: Salem Point L.P.
Address: 102 Lafayette Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-4961
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter 11"
Minimum Standards of Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates,whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
ET MANCIN]
ACTING HEALTH AGENT CODE ENFO CEME PECTOR
CITY OF SALEM, MASSACHUSETTS
• BOARD OF HEALTH
120 WASHINGTON STREET,4'"FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR J5CQn@sALEK 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 HUMA HABITATION."
FEE: $50.00
PROPERTY LACATED AT s 9 13� UNIT# /—a'
IS THIS UNIT DISIGNATED AS RIGH1 LEFT'FRONT ORIIACY,PLEASE CIRCLE ONE
OWNER/LESSER Salem Point L.P. MANAGER/AGENT Salem Pro ert Mana ers
NO P.O.BOX
ADDRESS 102Lafavette Street ADDRESS102 Lafayette Street
CPTY,STATE,ZIP Salem, MA 01970 CITY,STATE,Z1P Ra1Am MA 0197n
RESIDENCE PHONE BUSINESS PHONE(241]RS) 978 745-4961
BUSINESS PHONE97R— 745-8071
TOTAL NUMBER OF ROOMS: //-
ROOM USE: 1&tom 2. 5.
6.&& , 7. S. 9. 10.
THERE IS A SEVENTY-FTVE($75)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
APPLICANTS SIGNATURE DATE
Insaectors use only
Date on initial inspection: '7A ®i Date of reinspection:
Date of issuance of certificate: ) Lfl-<)'i Date fee paid:
Type of unit: Dwelling )!!�Other Check# Check date:
Notes:
Code Enforcement Inspec r
CITY OF SALEM, MASSACHUSETTS ,
` BOARD OF HEALTH
120 WASHINGTON STREET,e FLOOR
TEL.(978)741-1800
KWERLEY DRISCOLL FAX(978)745-0343
MAYOR !voBLEM•COM
JOANNE SCOTT,
HEALTH.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.
&L2g"__ � .,
Tenant/Lessee er/Lessor
Address Address
Address on unit to be inspected
�13Id,
l Date -�
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
9j 120 WASHINGTON STREET, 4TH FLOOR
Eo. SALEM, MA 01970
9gAry�ryg TEL, 978-741-1800
FAX 978-745-0343
STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#458-05
DATE ISSUED: 7/22/05
Property Located at: 59 Harbor Street UNIT#2-1
Owner/Agent: Salem Point Limited Partnership
Address: 102 Lafayette Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-4961
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 Cade 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
JOAWNE SCOTT, MPH, RS, CHb
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
�1 lk%
. ' CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
i 3 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
9g 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 59 [ Y� ��l3rj l8rrn UNIT
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSERSalem Point L.P. MANAGER/AGENISalem Property Managers, 'in
No P.O. Box No P.O. Box
ADDRESS 102 TAfayette R1-reelADDRESS102 T.afAyei-te Street
�y
CITY Salem, MA 01970 CITY Salem, MA 01970
RESIDENCE PHONE BUSINESS PHONE (24 HRS.) (978) 745-4961
BUSINESS PHONE (978) 745-8071
TOTAL NUMBER OF B�ROOMS,:
ROOM USE: 1 l W lm_2.�j 19-r-
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. /
r
APPLICANTS SIGNATURE DATE
SPECTORS USE ONLY
DATE OF INITIAL INSPECTION :7 ��d'��'_�^ DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:?lP O r DATE FEE PAID:_
TYPE OF UNIT: DWELLI/'VOTHER__ CHECK# 1�� CHECK DATE 7
NOTES: �\
CODE ENFORCEMENT INSPECTOR 9/28/98
CITY OF SALEM, MASSACHUSETTS
• ih BOARD OF HEALTH
120 WASHINGTON STREET,4"FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAx(978) 745-0343
MAYOR IiMANCINT@SALF.M.COM
JANF;P MANCINI
ACTING HEAI.IlY-r AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#35-09
DATE ISSUED: 1/20/2009
Property Located at: 59 Harbor Street UNIT#2-2
Owner/Agent: Salem Point L.P.
Address: 102 Lafayette Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-4961
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
4CTI # X 4 J'^,
T MANCINNG HEALTH AGENT ODE ENFORCEMENT I P�TOR
MASSACHUSETTS CITY OF SALEM, ��,
Mal
• BOARD OF HEALTH
120 WASHINGTON STREET,4:'FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYORSCo1T@SAl K COM
JOANNE SCOTT,
HF--kLTH AGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMA HABITATION."
/� JFEE, 50,00
PROPERTY LACATED AT S91/�6 DK Q% i,�•, UNIT# a
IS THIS UNIT DISIGNATED AS RIGIft LEFT FRONT OR BAC PLEASE CIRCLE ONE
OWNER/LESSER Salem Point L.P. MANAGER/AGENTSalem Property Managers
NO P.O.BOX
ADDRESS 102Lafayette Street ADDRESS102 Lafayette Street
CITY,STATE,ZIP Salem, MA 01970 CTI'Y,STATEZIP Salem, Mn nig7n
RESIDENCE PHONE BUSINESS PHONE(24HRS) 978 745-4961
BUSINESS PHONE978- 745-8071
TOTAL NUMBER OF ROOMS:
ROOM USE: I L -&r 2. aa-k— 3. 6dA*jr 4.
6. 7. 8. 9. 10.
THERE IS A SEVEN'T'Y-FIVE($75)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF
SALEM BOARD OF HEALTHTHIS EE IS PAYABLE T THE TIME OF INSPECTION
APPLICANTS SIGNATURE DATE /
InVectors use only
Date on initial inspection: ZcD -u nl Date of reinspection:
Date of issuance of certificate: -2-4 -cz) Date fee paid: / -La d`�
Type of unit: Dwelling_j,� Other Check# 3`I Check date:
Notes:
e Enforcement lnsp for
t�
t� NDIT�
City of Salem, Massachusetts
Board of Health
m 120 Washington Street, 4th Floor, Salem Public Health
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-15-128
DATE ISSUED: 6/18/2015
Property Located at: 57-59 ARBOR STREET UNIT#3-1
Owner/Agent: Salem Point II L.P.
Address: 106 Lafayette Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 745-8071
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,
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SA ARIAN
CITY OF SALEM, MASSACHUSETTS
Bo.�RD OF HE,.AL:I'H
120 WASHING FON STREET,4:"' ftmw
11"I'. (9[8) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR LRANIDINLd)sALFAI.CONT
J_umv Rvu)jN,ws/lwl Ts,(111(:),cl,+s
Hviu,'ri f 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 59 Harbor St., Salem, MA 01970 UNIT# 3-1
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER Salem Point 11 L.P. 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:— 5
ROOM USE: I.Liv. Room 2.Kitchen 3. Bedroom 4.Bedroom 5. Bedroom
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 HEALTHTHIS F
APPLICANT'S SIGNATURE DATE 6/11/15
Inspectors use only
Date on initial inspection: S7/)-Dlf - Date of reinspection:
Date of issuance of certificate:,02015_ Date fee paid: 0 6/17/2615-
Type of unit: Dwelling_—VOther—Check# J-1-82- Check date: O"J 12 LC
Notes:
614� &e7zoz
Coe jfob(ment lnspdtor
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 W�sxtNGTON STRFIF;r 4 FI,00R PllblicHCalth
TFI,. (978) 741-1800 FAX(978) 745-0343
KIMBERLEY DRISCOL L liamdin dsalem.com
1,ARRY Rnnn»N,Rs/Riga is,ci IO,c;r-Fs
MAYOR HF.,ar;iri AGi,N r
CERTIFICATE OF FITNESS
CERTIFICATE# 154-12
DATE ISSUED: 4/27/2012
Property Located at: 59 Harbor Street UNIT#3-2
Owner/Agent: Salem Point L.P.
Address: 102 Lafayette Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-4961
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
R M IN '
HEALT GENT SANITARIA
• CITY OF SALEM, MASSACHUSETTS
• BOARD ohHEALTH
120 WX SMNGTON STREET,4`FLOOR
'11L. (978) 741-1800
KI VIBERLEY DRISCOLI. FAX()78) 745-0343
MIYYOR LRANIDINnsALEM.COM
LARRY RAMDIN,RS/RL:HS,CHO,C1'-FS
HEALTH AGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"
FEE: $50.00
PROPERTY LOCATED AT 59 HARBOR STREET UNIT# 3-2
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
NORTH SHORE
OWNERILESSER SALEM POINT L.P. MANAGER/AGENT PROPERTY MANAGERS,INC
NO P.O.BOX
ADDRESS 102 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: 5
ROOM USE: 1.LIV.RM 2.KITCHEN 3.BEDRM 4.BEDRM 5.BEDRM
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 L/
APPLICANT'S SIGNATURE 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# 1 G Check date: /
Notes: nC o� +—Root a{7G IlW I►k5Q°r �
MA
forcement Inspector
R
F CITY OF SALEM, MASSACHUSETTS 10
BOARD OF HEALTH
120 WASHINGTON STREET,4".FLOOR PublicHeaith
TEL. (978) 741-1800 FAx(978) 745-0343
KIMBERLEY DRISCOLL Iramdin c&salem.com
LARRY IiAMDIN,RS/RP,I'IS,CHO,CP-f'S
MAYOR
CERTIFICATE OF FITNESS
CERTIFICATE#337-14
DATE ISSUED: 10/15/2014
Property Located at: 59 Harbor Street UNIT#4-1
Owner/Agent: Salem Point II L.P.
Address: 106 Lafayette Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-4961
Pursuant to the requirements of City of Salem ordinance Chapter 2 Ar4icle. 1)f Dh fi.';1nn2 SeGtmen
705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your
vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with
105 CMR 410.000: Massachusetts State Sanitary Code, Chapter ll" Minimum Standards of
Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
RAMDIN
HEALTH AGENT SANITARIAN
CITY OF SALEM, MASSACHUSETTS
BoAxv<)1 IIE'AI 1'H
120 W�S7-i I N GTd IN S t REE1 4"'FLOOR
11u_ (978) 741-1800
KIMBERLEY DRISCOLL FAX (978) 745-0343
MAYOR IAANu)iN@SA EI C0NI
L,11M'%\JDIN,I6/1WI IS,CI IO,CP-FS
1-fi;;m,n i AC LsN"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 59 Harbor St., Salem, MA 01970 UNIT# 4-1
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER Salem Point II L.P. MANAGER/AGENT North Shore Propeny Managers 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
i
TOTAL NUMBER OF ROOMS: b
ROOM USE: 1.Liv. Room 2.Kitchen 3. Bedroom 4.Bedroom 5. Bedroom
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
(/ 7 ' Inspectors use only
Date on initial inspection: t or�,,X614 Date of reinspection:
Date of issuance of certificate: Date fee paid:
Type of unit: Dwelling Other Check# Check date:
Notes:
O
Code nfora entInspector
S a CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET 4°'FLOOR - PI1bI1CHe81th
p Prevent.PrOmo,a Protect.
TEL. (978) 741-1800 FAR(978) 745-0343
KIMBERLEY DRISCOLL lramdin e salem.com
LARRY RAbIDIN,RS/R} HS,CFO,CP-1711;
MAYOR H1,',A1;n i AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#338-14
DATE ISSUED: 10/15/2014
Property Located at: 59 Harbor Street UNIT#4-2
Owner/Agent: Salem Point II L.P.
Address: 106 Lafayette Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-4961
Pursuant to the requirements n�o_o o y of S Iernordinanre Chapter Article IV ni i 4 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
LA RAMDIN
HEALTH AGENT SANITARIAN
Npj,�5 ��
CITY OF SALEM, MASSACHUSETTS
! B0:1RU OF HEALTH
$1q
1201 'ASxTNcTT>N SIttEE1,41"FLOOR
1Ei_ (978) 741-1800
KIMI3ERLEY DRISCOLL Eix ()78) 745-0343
MAYOR rRANfDIN([ SAI.H'J.COAT
LAmn,RAS'IDIN,RS/RVI IS,C1 10,CP-PS
HE;ALTI I_1CBN1'
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 59 Harbor St., Salem, MA 01970 UNIT# 4-2
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER Salem Point II L.P. MANAGER/AGENT North Shore Property Managers,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: )
ROOM USE: I.Liv. Room 2.Kitchen 3. Bedroom 4.Bedroom 5. Bedroom
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 FEF4S PAYABLE AT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE
Inspectors use only
Date on initial inspection:_'jis'b7 L Date of reinspection:
Date of issuance of certificate: Date fee paid:
Type of unit: Dwelling Other Check# Check date:
Notes:
tP
Code EMordeinent Inspector
TRANSMISSION VERIFICATION REPORT
TIME 10/22/2014 20: 40
NAME
FAX 9787450343
TEL 9787411800
SER.# 000BON341991
DATEJIME 10/22 20:39
FAX NO. /NAME 919787445616
DURATION 00:01: 01
PAGE(S) 05
RESULT OK
MODE STANDARD
ECM
1
"
` CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTI-I
120 WASHINGTON STREET,4... FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL" FAX (978) 745-0343
MAYOR BamdinQsalemxom
LARRY RAiMDIN,RS/RGhIS,CFIO,(y-1;S
HEALPI I AGFiN'I
CERTIFICATE OF FITNESS
CERTIFICATE#435-11
DATE ISSUED: 10/27/2011
Property Located at: 64 Harbor Street UNIT# 1-1
Owner/Agent: Salem Point L. P.
Address: 102 Lafayette Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-4961
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 onlyif there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
LARRY RAMDIN
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
,l
to ` ��
CITY OF SALEM, MASSACHUSETTS
• BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR DGREENBAUM!@J SALEM.COM
DAVID GREENBAUM,
ACTING HEALTH AGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION."
FEE: $50.00
PROPERTY LOCATED AT 64 HArbor Street, Salem, MA 01970 UNIT# 1-1
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BAC PLEASE CIRCLE ONE
OWNER/LESSERSalem Point Limited PartAE MANAGER/AGENT Salem Property Managers, INC
NO P.O.BOX
ADDRESS 102 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: 5
ROOMUSE: I.Liv.Rm 2,Bedrm 3.Bedrm 4.Bedrm 5 Kitchen
6. 1 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
Inspectors use only
Date on initial inspection:__ �a /1 Date of reinspection:
Date of issuance of certificate: / 0 rz // Date fee paid: a �Z
Type of unit: DweIling_f_.=:�9ther Check# Lol(r Check date: /d C7
Notes:
Code E orceme t Inspector
TRANSMISSION VERIFICATION REPORT
TIME 02/28/2012 23: 21
NAME
FAX 9787450343
TEL 9787411800
SER.# 000BON341991
DATEJIME 02/28 23:21
FAX N0. /NAME 919787454345
PAGE(S)
DURATION 00: 00: 20
RESULT OK
MODE STANDARD
ECM
CITY OF SALEM, MASSACHUSETTS
Jr� BOARD OF HEALTH
120 WASHINGTON STREET,4""FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR DGa=,e:NBAUM@S.Afa>.u.cOkf
DAVID GRF.[;NBAUM
ACl'IN(:, HA.AI.;I'1-I AGENT'
CERTIFICATE OF FITNESS
CERTIFICATE# 120-10
DATE ISSUED: 3/22/2010
Property Located at: 64 Harbor Street UNIT#2-1
Owner/Agent: Salem Point L. P.
Address: 102 Lafayette Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-4961
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 BOA)rF HEALTH
DAVID GREENBAUM
ACTING HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CITY OF SALEM, MASSACHUSETTS i -�-
BOARD OF HEALTH
120 WASHINGTON STREET,41"FLOOR
TEL.(978)741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343'
MAYOR jsccrnYn}5,7 COM,;
JOANNE SCOTT, j
HEALTH AGHNT
Application for Certificate of Fitness ~
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMA HABITATION."
PROPERTY LACATID AT === =C Qtr s UNIT1111
IS THIS UNIT DISIGNATED AS RIG LEFT FRONT OR BACK PLEASE CIRCLE ONE
j
OWNERILESSER Salem P....,int L.P. MANAGM AGENT Salem Property Managers
NO P.O.BOX i
ADDRESS_ _ °102Lafayette Street ADDRESS102 Lafayette Street
CITY,STATE,ZIP_Ialgm• MA 01970 CTTY,STATE,ZIP Sa mF MA 01 Q70
3
RESIDENCEPHQNE BUSINESS PHONE(24HRS) 978 745-4961
BUSINESS PHONEg7B— 745—At}ZI
TOTAL NUMBER OF ROOMS:I "
i
ROOM USE: , p �` 1'7� 2 3. 4 �aii^c S +v
fi. 7. 8 9 IO
THERE IS A SEVENTY FIVE($75)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF
SALEM BOARD OF HEALTHi S FEE IS PAYABLE AT THE TIME OF INSPECTION
APPLICANTS SIGNATURE
DATE 'l
Inspectors use only
Date on initisl'inspeetiom 1, 10 Date of reinspection: �—
Date of issuance of certificate: a f U
- 3 Date fee paid: ,7 as 11 o
Type llmg—_—..__"Uth Check# 14115
T of unit: Dwe ' �.�Check date: 3 LJL IIO
Notes _ $- SYMS ' (A 11V1114 room P14 r11?CGIAf� , �j riy{�tJG✓G�1
Code EnforceinentInspector
1
CITY OF SALEM, mmsACH sus
BOARD OF HEALTH
120 WASHINGTON STREET,4m FLOOR
TEL.(978)741-1800
KWF,FL.EY DRISCOLL FAX(978)745-0343
MAYOR Isc COM
JOANNE SCOTT,
HEALTHAGENT
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 aS3zementioned 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
Address Address
Address on unit`•to be inspected
Date
A
t
City of Salem, Massachusetts
Board of Health
120 Washington Street, 4th Floor, Salem, Pr� ma«
MA 01970
. Proteot.
Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin,MPH, REHS,CHO
Mayor health@salem.com Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE#: GHL-16-415
DATE ISSUED: 10/25/2016
Property Located at: 64 HARBOR STREET UNIT#2-1
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.
Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age.
Jeff y
Larry Ramdin, MPH, REHS, CHO SANITARIAN
HEALTH AGENT
�I
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WAS]I INGTON S i RE F.r 4i° FLUOR
'ILL. (978) 741-1.800
k1b1BERI:,[iY DRISCOLL I'A\ (978) 745-0343
IWAYOR t.R9bIDIN@SAEEaI.00n(
LARRYRANIDIN,RS/REHS,CHO,CP-PS
HEAETH A6EN'C
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 64 Harbor St., Salem MA 01970 UNIT# 2-1
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER Salem Point II L.P. MANAGER/AGENT North Shore Property Mana erg s,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: 5
ROOM USE: l.Liv. Room 2.Kitchen 3. Bedroom 4.Bedroom 5.Bedroom
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 FE PAYABLE AT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE 10/12/16
Inspectors use only
Date on initial inspection: 1(J�Iq�7�� Date of reinspection:
Date of issuance of certificate: 9 C Date fee paid: t6
Type of unit: Dwellin Other Check# 1.51- 7----Check date: 10%11/2614
Notes:
Cod El or9 ment Insp for
City of Salem, Massachusetts
Board of Health
120 Washington Street, 4th Floor, Salem, PubliCHelth
MA 01970 Prevent. Proroam. Protect.
Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 tarry Ramdin,MPH,RENS,CHO
Mayor lramdin@salem.com Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE#: GHL-15-433
DATE ISSUED: 12/24/2015
Property Located at: 64 HARBOR STREET UNIT#3-1
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 It"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, IAI�12v�
Larry Ramdin, MPH, RENS, CHO
HEALTH AGENT SANITARIAN
CITY OF SALEM, MASSACHusE-as
Bo. iu)OF HEALTH
120 WASI IINGTON S 4" I_'L(,)()R
"TEL. (978) 741-1800
KINMERLEY DRISCOLL FAX(978) 745-0343
MAYOR PI.Conr
LARRY RANIDIN,1111RU1 IS,1:111),0'41
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 64 Harbor St., Salem, MA 01970 UNIT# 3-1
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE
OWNERILESSER Salem Point 11 L.P. -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(24FIRS) 978-745-4961
BUSINESS PHONE 978-745-8071
TOTAL NUMBER OF ROOMS:- 5
ROOM USE: I.Liv. Room 2.Kitchen 3. Bedroom 4.Bedroom 5.Bedroom
6. 7. 8. 9. to.
THERE IS A FIFTY($50) DOLLAR FEE, PAYABLE BY CHECK OR MONEY OR-DER TO THE CITY OF SALEM
BOARD OF HEALTH THIS FEE YABLE T E TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE
Inspectors use only
Date on initial inspection: Date of reinspection:_
Date of issuance of certificate: 23 Date fee paid: 121ZZr2ZIr
Type of unit: Dwelling _Other Check# 13 YJ- heck date:1_2_Liflr
Notes:
4dz 4 LAP�
Cffnf/ceolent/spector
• CITY OF SALEM, MASSACHUSETTS lu
BOARD OF IIE.ALTH PablicHeaIth
120 WASHINGTON STREET,4"FLOOR Ymmme.Rmcc,.
TEL. (978)741-1800 FAX(978)745-0343
KIMBERLEY DRISCOLL 1tamdin@salem.com
LARRY RAb1DIN,RS/RFAB,CHO,CP-FS
S
MAYOR HI:AIIt'H t�GENP
CERTIFICATE OF FITNESS
CERTIFICATE#447-14
DATE ISSUED: 12/9/2014
i
Property Located at: 641/2 Harbor Street UNIT#1-1
Owner/Agent: Salem Point L. P..
Address: 106 Lafayette Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-4961
Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division3, Section
705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your
vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with
105 CMR 410.000: Massachusetts State Sanitary Code,Chapter II"Minimum Standards of
Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates,whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
LARR RAMDIN
HEALTH AGENT SANITARIAN
CITY OF SALEM, MASSACHUSETTS
Bo. RD OF LILA'm
120 W SSI INGTON S iRFF',1,,41 FLOOR
(978) 741-1800
KINMERLEY DRISCOLL F-1% (9718) 745-0343
MAYOR LRANIDINCO AIJMCON
L\ RA%IDIN,RS/RFI IS,(1110,CP-FS
HFAIxi i A(;FN f
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"
FEE: $50.00
PROPERTY LOCATED AT 64.5 Harbor St., Salem, MA 01970 UNIT# 1-1
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE
OWNER/LESSER Salem Point It L.P. —MANAGER/AGENT North Shore Property Managers,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:- 5
ROOM USE: I.Liv. Room 2.Kitchen 3. Bedroom 4.Bedroom 5. Bedroom
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 F"PAYABLE AT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE 12/9/14
Inspectors use only
Date on initial inspection: la�C, 11a Date of reinspection:
Date of issuance of certificate: T Date fee paid:
Type of unit: Dwelling Other Check# Check date:
Notes:
Code tdore ent Inspector
9% D'T City of Salem, Massachusetts
( N
Board of Health
120 Washington Street, 4th Floor, Salem,
MA 01970
Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS,CHO
Mayor health@salem.com Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE #: GHL-16-218
DATE ISSUED: 6/30/2016
Property Located at: 64.5 HARBOR STREET UNIT#2-1
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
Jeffrey Barosy
Larry Ramdin, MPH, RENS, CHO SANITARIAN
HEALTH AGENT
CITY OF SALEM, MASSACHUSETTS
Bwiu)OFFILALTH
120 WvS]f ING 1'(.)N STREET,41 FI_,00R
Tim. (978) 741-1800
KINMERLEY DR]SC01.1, FAX(978) 745-0:34)
MAYOR 11UMI>INQa SALEM.COM
R,\MDIN, 16'/Rlil IS,Coro,
14vI \j:ii I A(i];N 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 64.5 Harbor St., Salem,MA 01970 UNIT# 2-1
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER Salem Point 11 L.P. -NIANAGER/ AGENT North Shore Property Manavers,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:— 5
ROOM USE: I.Liv. Room 2.Kitchen 3. Bedroom 4.Bedroom 5.Bedroom
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 FE S PAYABLE AT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE 6/20/16
Inspectors use only
Date on initial inspection:0 6111q120t6 Date of reinspection:
Date of issuance of certificate:PCa=q J)DI-C Date fee paid:ng
Type of unit: Dwelling Other Check# 1501- Check date: 10"%(2=02Z
Notes:
4 zg 44?d4
L716�rce7nt pector
DIS" City of Salem, Massachusetts
�O
q Board of Health
120 Washington Street, 4th Floor, Salem, PtibliGHealth
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-15-438
DATE ISSUED: 12/23/2015
Property Located at: 641/2 HARBOR STREET UNIT#3-1
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 li"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,
U
Larry Ramdin, MPH, REHS, CHO SANIT iAN
HEALTH AGENT
CITY OF SALETNI, MASSACHUSETTS
Bo.�RD OF f 1EAUM
120 WASH INGTON S 4FLOOR
Ti-u_ (978) 741-1800
KINMERLEY DRISCOIJ., FI�x(9!9) 745-0343
MAYOR LR AM 1)IN @SA LlrNLCO N1
LAR10'R\mmt\' lts/mH[is,CI to,cil-us
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 64 1/2 Harbor St., Salem, MA 01970 U[NIT# 3-1
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE
OWNER/LESSER Salem Point 11 L.P. -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:— 5
ROOM USE: I.Liv. Room 2.Kitchen 3. Bedroom 4.Bedroom S.Bedroom
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
Inspectors use only
Date on initial inspectiow-D./zy2bly Date of reinspection:
Date of issuance of certificate: Date fee paid:
Type of unit: Dwelling- _Other—Check# 1-311 Check date: 12-11 V2aS�-
Notes:
Coffn/oreemerspector
CITY OF SALEM, MASSACHUSETTS
BOARD OF FIE UXI I
120 WAST-HNGTON SFREET,4"'1 L01 nz
KIN113ERLEY=SCOId. TG:L. (978) 741-1800
FAN (978) 745-0343
MAYOR Iramchn@salem.com
L,-ARRY 10-NIDIN,RS/RI?I LS,CI-10,CP-FS
CERTIFICATE OF FITNESS
CERTIFICATE#487-11
DATE ISSUED: 11/23/2011
Property Located at: 69-71 Harbor Street UNIT# 1
Owner/Agent: 69-71 Harbor Street Trust
Address: P.O. Box 149
City/Town: Prides Crossing, Beverly, MA Zip Code: 01965 24 Hour Phone: 781-858-8967
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
LARRY RAMDIN
HEALTH AGENT CODE FORCEMENTINSPECTOR
Cl TTS //nn
I
KIMI3EE7_P.Y DRISCOLL
MAYOR
Lmun' !S,r:I IO,CP-!;c
Application
IN ACCORDANCE WITH STATE c I R 410.000
"MINIMUM STANDARDS OF FITNESS FOR tlumtuv
// FEE: $50.00
PROPERTY LOCATED AT 6 9-1 X�— 1-E UNIT# )
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE
OWNER/LESSER-6rI )�L/yy �eS7 �P�a-,7 Jr MANAGER/AGENT_C Iwo j�j
NO P.O. BOX
ADDRESS �D . ADDRESS
CITY, STATE, ZIP 0/56J, CITY, STATE,ZIP—
RESIDENCE RESIDENCE PHONE J7�' �SZ—��19� BUSINESS PHONE(24HRS) 7o/4✓F �G
BUSINESS PHONE '92�- " `�Z)- 2 Z4P
TOTAL NUMBER OF ROOMS:_._
ROOM USE: 2. A6&-7,> / 3 &D Z 4 LIVIAI - 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 PAYABL T THE TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE // 3
Inspectors use only
Date on initial inspection: / Date of reinspection:
Date of issuance of certificate: / Gl // Date fee paid: !1 f
Type of unit: Dwelling---j-,,t0tlier Check#_ I t- ` _Check date: 182///
Notes: t(J Nf�4 � /� • F �IZ P I-7S-SS)-07S7
Coded nforc ent Inspector
� is � �
I
• CI'T'Y OF SALEM, MASSACHUSETTS
BOARD OF HEALM
120 WASHINGTON S7RF.E-1 4°1 FLOOR
TFL. (978) 741-1800
I<'1N4B RLEY DRTSCOL L FAX(978) 745-0343
MAYOR LRAN1DINQQJJk:NI.( ONI
LlvRRY R4NIDIN,161/1W]IS,C!I(!,(:I'-I�S
FII:AI:I'II A(;I':N'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 9�7� ; <!% L�Ft; UNIT#
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE
OWNER/LESSER�f-)7yl4�WA'-�7".>?.E aG ;11—, rMANAGER/AGENT
NO P.O.BOX
ADDRESS D -9W /V-P ADDRESS P/
CITY, STATE, ZIP /Gt -qj- AG f - O/cl�f� CITY, STATE,ZIP
RESIDENCE PHONE_ 6/14 BUSINESS PHONE(24HRS) 7��4✓° ��G/
BUSINESS PHONE 9 ]� `3Z/" 2 Zoe
TOTAL NUMBER OF ROOMS:—
ROOM
OOMS:ROOM USE: I f/Jfi/_ _�✓ 2. &-'7-> ( 3. ftj) Z 4. 6/V/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 PABL T THE TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE
Inspectors use only
Date on initial inspection: Ll 1 /i Date of reinspection*.' //
Date of issuance of certificate: d // Date fee paid: /o /
Type of unit: Dwellmg�@Mer Check# Check date: r� d3 //
Notes: I Z ub?l T 'SSI-075 7
Code nforc meat Inspector
.J�
• CITY OF SALEM, MASSACHUSETTS
BOARD or HF \Eni
120 WASHINGTON STRF,E1',4". FLOOR
TEL. (978) 741-1800
IQMI3ERL1--,.Y DRISCOLL FAx (978) 745-0343
MAYOR ]ZAMIANCa SALENI. 771m1
L.nttRY RANIDIN,RS/10:1IS,(:110,CP-r:S
HFALiII A(;I IN
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
Address Address
Address on unit to be inspected
Date
Updated 5/23/11
TRANSMISSION VERIFICATION REPORT
TIME 11/28/2011 01: 26
NAME
FAX 9787450343
TEL 9787411800
SER.# 000BON341991
DATEJIME 11/28 01: 25
FAX NO./NAME 919789212288
DURATION 00:00:18
PAGE{S} 01
RESULT OK
MODE STANDARD
ECM
CITY OF SALEM, MASSAC.HUSLrrs
• BoARD OF M U:rl1
120 WASI-IINGTON STRUT-r,4"'Fl,Om
1`HL. (978) 741-1800
1<IMlil�]tLEY llRISCOI-I. Fix (978)745-0343
MAYOR IlalndlnnQ salem.coin
LA 1MYR.AMIAN, RS/1W IS,0I(1,(T-FS
Fir:;�1:rn Ac F.N r
Facsimile
- ,/ Transmittal
To: � I �Y d1 X06& A141 V 0
Fax # cn'l 01 D 0 C l
RE: Gq- 7 �G6CX�4 D.M�7b
Date : l 1����J�
Page(s): including this cover#
Message:
Board of Health News -- ----------------------------------For Your Information
OFFICE HOUR'S:
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
' CITY OF SALEM, MASSACHUSETTS
vQ
BOARD OF HEALTH
1 Yi 120 WASHINGTON STREET, 4TH FLOOR
.3iAo' SALEM, MA 01970
- TEL. 978-741-1800
FAX 978-745-0343
KIMBERLEY DRISCOLL JSCOTT@SALEM.COM
MAYOR
JOANNE SCOTT
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE# 157-08
DATE ISSUED: 4/7/2008
Property Located at: 69-71 Harbor Street UNIT# 1 Rear
Owner/Agent: 69-71 Harbor Street Trust
Address: 19Rezza Road
City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 978-852-4967 Brian
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 H ALTH //
V�
JO NNE MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
I',
CITY OF SALEM, MASSACHUSETTS pi
BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR sco'rrCn�sni. M.COM
JOANNE SCOTT,
HEALTH AGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUUM STANDARDS OF FITNESS FOR HUMA HABITATION."
PROPERTY LACATED AT 6 ` � '/ �Q l`G 1 5+ UNIT# I
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE l_
OWNER/LESSER O "�I Fia')F�0(' O *rVV S+ MANAGER/AGENT &i Ct l j G
NO P.O. BOX /�
ADDRESS M RP,-?-ZA 11K CQ ADDRESS
CITY,STATE,ZIP CITY,STATE,ZIP 1 qI Y'i�y 0
RESIDENCE PHONE9� \ZI— /1 I BUSINESS PHONE(24HRS)
BUSINESS PHONE Illi
TOTAL NUMBEROFROOMS:
� 1 D,�
ROOM USE: 1. �1�ktl 2. L (� 3. YW� 4. P.ArVA 5.
6. 7. 8. 9. 10.
THERE IS A TWENTY-FIVE($25)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF
SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION J Q
APPLICANTS SIGNATURE Q��[V DATE
Inspectors use only
Date on initial inspection: — -7 -v Date of reinspection:
Date of issuance of certificate: y -7 —b Date fee paid: —7
Type of unit: DwellingOther Check# Check date: — 'D
Notes:
Code Enforcement Inspector
� .r►
t .
�,
�,
� ... 4 ,. '�., � { .
�. � �
� `�}�
.. R a
{ � �ti 3 � µ r ~}'
. 6 t � 1 iin � ..
4 11 _ R '.
�. Y i
,Y `✓
�Y
sit ar
`4
S� i F,\ �.
r `
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CITY OF SALEM, MASSACHUSETTS
- -- - --- BEARD OP HEALTH -- ---- - -----
120 WASHINGTON STREET,4" FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR UGRGI3NBAUM([ef7,SALPTICOM
DAviD GRFENBAUM
ACTING HGAI:im AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#231-10
DATE ISSUED: 5/13/2010
Property Located at: 69-71 Harbor Street UNIT#2
Owner/Agent: 69-71 Harbor Street Realty Trust
Address: 19 Rezza Road
City/Town: Beverly Zip Code: 01915 24 Hour Phone: 781-858-8967
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
DAVD�I
BAU
ACTING HEALTH AGENT CODE O EMENT INSPECTOR
CITY'OF SALEM, MASSACHUSETTS
+ • BOARD OF HEALTH
120 WASHINGTON STREET,4"`FLOOR
TEL. (978) 741-1800 I
IQMBERLEY DRISCOLL FAX(978) 745-0343 2 I
MAYOR DGREENBAUM&ALEM.COM J
DAVID GREENBAUM,
ACTING HEALTH AGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION."
FEE: $50.00
PROPERTY LOCATED AT JT UNIT#_
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER 11/"2I/ f� CJ'7 7 (�j j /JT MANAGER/AGENT f/1//l J ,/i✓e?i7ee-
NO P.O.BOX
ADDRESS /Ky Bd.- /�/j ADDRESS
CITY, STATE,ZIP CITY, STATE,ZIP /�L G�r�10yV 61/1/1—
RESIDENCE PHONE SLI b,y'e!/0 BUSINESS PHONE(24HRS)
BUSINESS PHONE %AZO ' IZ�—ZZ�d
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. I1 T 2. Gl(/ 3. /��J1/, 4. 9&-- 5. 4�7P
6. &2 7. 8. 9. 10.
'THERE IS A FIFTY($50)DOLLAR FEE,PAYAB E BY CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS FEE IS PAYAB/S� THE TIME OF INSPECTION
APPLICANT'S SIGNATURE / DATE
Inspectors use only .
Date on initial inspection: /U Date of reinspection:
Date of issuance of certificate: Date fee paid: IO
Type of uni Other �� Check date:_
Notes: If\ WAclw d Q lG a W6 sk to
I
iX, U &UF G/1
eloe4rte C"
Code Enforcen4t Inspector
Co+1� CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
1 9. 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
smxe ' FAX 978-745-0343
KIMBERLEY DRISCOLL JSCOTT@SALEM.COM
MAYOR
JOANNE SCOTT
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#284-08
DATE ISSUED: 6/2412008
Property Located at: 69-71 Harbor Street UNIT#3
Owner/Agent: 69-71 Harbor Street Trust
Address: 19 Rezza Road
Cityrrown: Beverly, MA Zip Code: 01915 24 Hour Phone: 978-852-4967
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Cade, Chapter 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 Fitnessis valid only if there is a valid Certificate of Occupancy.
F R THE BOARD OE
,
rJ;
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE EN ORCE ENT I ECTOR
• + CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR lsco'rr@SALeM.COM
JOANNE SCOTT,
HEALTH AGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMLU�M STANDARDS OF FITNESS FOR HUMA HABITATION."
PROPERTY LACATED AT 1 —�I I�� "^ �� UNIT#
` 1, IS THIS UNIIT DISIGNLATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE�O2N,�E I_
OWNER/LESSER 6 1— �I �Qr kjo( ST p T� MANAGER/AGENT �r ►c �l r, cke5
NO P.O. BOX
ADDRESS �('ZZ I�\ ADDRESS
CITY,STATE,ZIP hrkv,01\ 0 1 CITY,STATE,ZIP NO o1R1s
RESIDENCEPHONE _1N I' �' Io�G�/ BUSINESS PHONE(24HRS) �7� 8Sz y56
BUSINESSPHONE q� D � 5Z � 10-
TOTAL NUMBER OF ROOMS: 1 / L
ROOM USE: 1.Od Y m2. 6d rM 3. QZ 4. X lt(t'I ,.
�'15.
6. 7. 8. 9. 10.
THERE IS A TWENTY-FIVE($25)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF
SALEM BOARD OF HEALTH THIS FEE IS PAYABLE
�ATTHE TIME OF INSPECTION
APPLICANTS SIGNATURE T&U'ny--17 DATEA 21,10?
Inspectors use only
Date on initial inspection: Date of reinspection:
Date of issuance of certificate: b-Ly -Q V Date fee paid:
Type of unit: Dwelling ✓ Other Check# I dy3 Check date: L
Notes:
- W.t
C e Enforcement Inspec or
i
CITY OF SALEM, MASSACHUSETTS
• • BOARD OF HEALTH
120 WASHINGTON STREET,4""FLOOR
TEL. (978) 741-1800
IC MBERLEY DRISCOLL FAX(978) 745-0343
MAYOR IDIONNE SN.ISM CONI
JANF:1'DIONNF,
A("PING HI AI:a'11 Au:N'r
CERTIFICATE OF FITNESS
CERTIFICATE #500-08
DATE ISSUED: 10/16/2008
Property Located at: 69-71 Harbor Street UNIT#5
Owner/Agent: 69-71 Harbor Street Trust
Address: P.O. Box 149
City/Town: Prides Crossing, MA Zip Code: 01965 24 Hour Phone: 781-858-8967
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
4I
ACING HEALTH AGENT COOVENFORCEMENT INSPECTOR
CITY OF SALEM, MASSACHUSETTS
e BOARD OF HEALTH
120 WASHINGTON STREET,4T FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR IDIONNE SALEM.COM
JANET DIONNE,
.ACTING HEALTH AGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION."
FEE: $50.00
PROPERTY LOCATED AT 611-71 11.4.4&le S7- S,4Ct-Al M4 0/970 UNIT#
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASSECIRCLE OHNE+
OWNER/LESSER �09-`�/ l�aP&tCsT ! T�fiJ/ MANAGER/AGENT Oh�IS
NO P.O. BOX n p 0065'
ADDRESS POBBJC �Y`IP�IDEJC:P / lf/�l� ADDRESS
CITY, STATE,ZIP CITY, STATE,ZIP
RESIDENCE PHONE 97ff' 47921— 1' BUSINESS PHONE(24HRS)
GG
BUSINESS PHONE 97�' dn- y9G7
TOTAL NUMBER OF ROOMS: 4
ROOM USE: 1. ZJWN(1- 2. Kl7C//E1 3. &V 4. i'tD 5.
6. 7. 8. 9. 10.
THERE IS.A FIFTY($50)DOLLAR FEE,PAY L BY CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS FEE IS PAYAB TIME OF INSPECTION
APPLICANT'S SIGNATURE t DATE 6 0
Inspectors use only
Date on initial inspection: �'I cke Date of reinspection:
Date of issuance of certificate: Date fee paid:
Type of unit: Dwelling -- -jOther Check#Check date: //��)A J 16100 ( f
Notes: OVZA Ll� Yt1tk�1� N.-w bU(b Ctvl reYkak CA1T)Yn) ::@c- 1IC61'F 4 (_n broom,
Code-t4forcement Inspector
°0Nniz"HQ City of Salem, Massachusetts
Board of Health
°9 120 Washington Street, 4th Floor, Salem, PublicHea ith
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-16-197
DATE ISSUED: 6/3/2016
Property Located at: 69-71 HARBOR STREET UNIT#6
Owner/Agent: 69-71 Harbor Street Realty Trust
Address: P.O. Box 149
City/Town: Pridescrossing, MA Zip Code: 01945 24 Hour Phone:(978) 852-4967
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
&Je lr4�71
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITARIAN
CITY OF SALEM, MASSACHUSEM --V
BOARD OF HEALTH
i 120 WASHINGTON STREET,4a'FLOOR
TEL. (978)741-1800 FAX(978)745-0343
KIMBERLEY DRISCOLL kamdinom
MAYOR LARRY RAMI)IN,RS/REII..%CHO,CP-I
fliumn 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"
r f I� FEE: $50.
to 00/
PROPERTY LOCATED AT - 1 f 4"r -1)/ �Zf2/,1 3v-6 wT#__L
IS TRIS UNIT DISIGNATED AS RUM I Imo, OR BACK PLEASE CIRCLE ONIL
OWNEWLESSER69'2/ AW-Ve✓P 411/ /�7"t MANAGER/AGENT
NO P.Q BOX
ADDRESS PO 011e A/d� ADDRESS
C1TY, STATE,ZIP Pj&r, l ;17 CITY,STATE,ZIP
RESIDENCE PHONE p BUSINESS PHONE(24HRS) J
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 21� F�, . c /��/ 3. 14 4 gell 5
6. 7. S. 9 10
THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE#Y CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS FEE IS P=TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE—"Z
moors use onty
Date on initial inspection:pb&2,/2p16 Date ofremspection:
Date of issuance of certificate 2..tI Date fee paid: IO zf p3
Type of unit: Dwel inOther Cheek# 1 7 l —Check date: a1621,7F1 i
Notes:Pe Lot- dej tIf od.Ll4t4 L t� L tttyfnno C06kh� A
j Ul remij
C ent specior
�� a 1r CITY OF SALEM, MASSACHUSETTS
�. BOARD OF HEALTH
*� 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970 CERT.# 90-03
FEE $25 .00
4'" TATE:
978-741-1800 DATE: 03/03/2 003
Fax 978-745-0343
STANLEY USOVIC2, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 71 Harbor Street UNIT #: 1
OWNER/AGENT: Scott Galber
ADDRESS: 9 Belleair Drive
CITY/TOWN: Swampscott, MA ZIP CODE: 01907 24 HOUR PHONE: 592-4462
AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS
BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410 .000: MASSACHUSETTS STATE
SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" .
THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE
SALEM BOARD OF HEALTH AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED.
MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410 .000 : MASSACHUSETTS STATE
SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" .
SECTION 410 .400 (B) : DWELLING UNIT (X) AND 410 .400 (C) : ROOMING UNIT
MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: .
NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR
OCCUPANTS UNDER 6 YEARS OF AGE NOR BUILDING RELATED CODES. FOR MORE
INFORMATION CALL 978-741-1800 .
FOR THE BOARD OF HEALTH
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
�
�
�
0
L�nNill A'/
CITY OFSALEM BOARD OF HEALTH
Salem, Massachusetts D1470'3g7X
JCwmNESC0TT� ��PM� �RS CMO NINE NORTH STREET
|
HEALTH AGENT APPLICATION FOR CERTIFICATE OFFITNESS Tel: (970)7^1 /000
Fax:(970)7^0'9r05
|NACCORDANCE WITH STATE SANITARY CODE, CHAPTER ||. 1O5CMR 41O.V08
"MINIMUM STANDARDS DFFITNESS FOR HUMAN HA8|TAT|ON"
PROPERTY LOCATED AT14NUD& � UN|T #�_
ISTHIS UNIT DESIGNATED AS RIGH LEFT FRON BACK PLEASE CIRCLE ONE
OWNER/LESSER&>CQ —MANAGER/AGENT
CITY
CITY 5Lj^AiescZ,7
/ \\
AES|[)ENCEP�f SSPHONE 84HRS] �
BUS|NESSPH0N
TOTAL NUMBER 0FROUMS:
THERE IS A TWENTY-FIVE($ 5.0 D LLAR FEE, BILE BY CHECK OR MONEY
PW
ORDER TO THE CITY OF SA EM E L;H DEPA RTJ T THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
QZ;L t3
APPLICANTS SIGNATURE DATE
INSPECTORS USE QALY
DATE OF INITIAL INSPECTIOU ____DATEOFRE/NSPECT|0N________ __
�
�
DATE OFISSUANCE 0FCERT|F|CATE: DATE FEE P8|Di___�_�_��'��~�
�
TYPE[>FUNIT: DVVELL|0 OTHER— CHECK # -CHECK DATE
~\`
NOTES:____
'
CODE ENFORCEMENT INSPECTOR 9/28/98
�
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
gl 120 WASHINGTON STREET, 4TH FLOOR
r o SALEM, MA 01 970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
1/12/05
Seventy-one Harbor Realty Trust
9 Belleair Drive
Swampscott, MA 01907
PROPERTY LOCATED AT 71 Harbor Street Unit 1 L
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.
Fthe Board of Healtp Reply to
JI anne Scott MPH, RS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
a 120 WASHINGTON STREET, 4TH FLOOR
ate 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# 131-06
DATE ISSUED: 3/10/06
Property Located at: 71 Harbor Street UNIT#2
Owner/Agent: Scott Galber
Address: 203 Washington Street#254
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-269-4173
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II"
Minimum Standards of Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
• X31-o(a
CITY OF SALEM BOARD OF HEALTH
Salem,Massachusetts 01970-3928
•►
JOANNE SCOTTNINE NORTH STREET, MPH, AS,CHO _ Tel:(978)741-1800
HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Fax:(978)740.9705
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR'410.000
"MINIMUM STANDARDS OFF /FITNESS FOyR� HUMAN HABITATION".
PROPERTY LOCATED AT 1- �/yf�'7 °h UNIT#
IS THIS UNIT DESIGNATED AS RIGHT IM FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSERSCd7/ Lt&Yb� MANAGER/AGENT�—
ADDRESS 203 WAS411+9Tcn) 51' )#25� ADDRESS V J
CITY �ALfm MA 1D1970 CITY
RESIDENCE PHONE?�8 2-4 4173 BUSINESS PHONE (24H
BUSINESSPHONE 978 74.1' /66 %
TOTAL NUMBER OF ROOMS: `S
ROOM USE: 1. �-Iy• 2. /I/ 1. 3.RDISM 4.h�2
5.4/a_6. 7 8.
THERE IS A TWENTY-FIVE($25. ) OLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM LTH D PARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION
APPLICANTS SIGNATURE DATE � �Yb
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION 3-i U - O DATE OF REINSPECTION _
DATE OF ISSUANCE OF CERTIFICATE: ,/ -OAflATE FEE PAID: 3 —
TYPE OF UNIT: DWELLING OTHER Cle �� 3
NOTES:
CODE ENFORCEMENT INSPECTOR
5/19/98
P
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
n
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#: 376-03
DATE ISSUED: 7/24/2003
Property Located at:: 71 Harbor Street UNIT#: 2 Rear
Owner/Agent: Scott Galber
Address: 9 Belleair Drive
City/Town: Swampscott, MA Zip Code: 01907 24 Hour Phone: 592-4462
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.
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.
Certificate valid for oneY ear 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.
Joanne Scott, MPH, RS, CHO
Health Agent CODE ENFORCEMENT INSPECTOR
60,
s ` .COtJT1tT ��
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH, RS, CHO _- N6NE NORTH STREET
HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Ter. (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 —__--_-_-�-UNIT #_ t h
IS THIS UNIT DESIGNATED AS RIGHT LEFTRF ONT BACK PLEASE CIRCLE ONE
OWNER/LESSERSOgtt MANAGERIAGENT ___v
No P.O. Box No P.O. Box
ADDRESS-5 /3kLLF,9/Y1_ fQnI K� ADDRESS__
CITY JOILT—Al _CITY—___
RESIDENCE PHONIZ) $ zZ BUSINESS PHONE (24 HRS)
BUSINESS PHONE P/ 1 �C
TOTAL NUMBER OF ROOMS:____
ROOM USE 1._f(II _ 2. iV 3._
THERE IS A TWENTY-FIVE($2 . 0) D AR FEE, PAYAB BY CHECK OR MONEY
ORDER TO THE CITY OF SAL HE LT DEPARTMENT HIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
�1
APPLICANTS SIGNATURE -.----------.-DATE_
.----------.-DATE_
INSPECTORS USE ONLY
r
DATE OF INITIAL INSPECTION 7��_�t_3_.—_DATE OF REINSPECTION.____.____
DATE OF ISSUANCE OF CERTIFICATE:_ �J _DATE FEE PAID,7'd"4-1 �3
TYPE OF UNIT: DWELLfNGY OTHER_ CHECK # 1 S -,,.CHECK DATE _�=,Lf
CODE ENFORCEMENT INSPECTOR 9/28)98
it
c• CITY OF SALEM, MASSACHUSETTS
�2! BOARD OF HEALTH
n '
� 120 WASHINGTON STREET, 4TH FLOOR
a o SALEM, MA O 1970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#246-05
DATE ISSUED: 4/19/05
Property Located at: 71 Harbor Street UNIT#3
Owner/Agent: Scott Galber
Address: 203 Washington Street#254
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-269-4173
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 ?67,X-6
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET
Tel:((978 740-7600
HEALTH AGENT
APPLICATION FOR CERTIFICATE OF FITNESS Pax: s�a)740-9705
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT ZZ NA402 S) UNIT#
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSERSC97t CrAL,61�k -MANAGER/AGENT
ADDRESS 203 WA541�iTrW A' *'15� ADDRESSqq
CITY_SALCA MA 17/ 970 CITY
RESIDENCE PHONEY -z�� �t�73 BUSINESS PHONE (24H )
BUSINESS PHONE 97 8. 2�J-16 b
TOTAL NUMBER OF ROOMS: Y
ROOMUSE: I. LIV• 2. /ri 3.g�4. 13041"
5. 6_7_8.
THERE IS A TWENTY-FIVE($25.00)DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF AL HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION
z
J
APPLICANTS SIGNATURE DATE �� J
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION DATE OF REINSPECTION _
DATE OF ISSUANCE OF CERTIFICATE: /a Lr DATE FEE PAID: _l v
TYPE OF UNIT: DWELLING OTHER C/L -9 3 o Z
NOTES:
CODE ENFORCEMENT INSPECTOR
5/19/98
~ CITY OF SALEM, MASSACHUSETTS J
BOARD OF HEALTH
'® 120 WASHINGTON STREET, 4TH FLOOR
5i
SALEM, MA 01970 CERT:# 247-02
TEL. 978-741-1800 FEE , $25.00
FAX 978-745-0343 DATE: 05/07/2002
STANLEY USOVICZ, JR. ,JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 71 Harbor Street UNIT #: 3 (2nd fl. rear)
OWNER/AGENT: Scott Galber
ADDRESS: 9 Belleair Drive
CITY/TOWN: Swampscott, MA ZIP CODE: 01907 24 HOUR PHONE: 592-4462
AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS
BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410 .000: MASSACHUSETTS STATE
SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" .
THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE
SALEM BOARD OF HEALTH AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED.
MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410 .000 : MASSACHUSETTS STATE
SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" .
SECTION 410 .400 (B) : DWELLING UNIT (X) AND 410 .400 (C) : ROOMING UNIT
MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: .
NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR
OCCUPANTS UNDER 6 YEARS OF AGE. FOR MORE INFORMATION CALL 978-741-1800 .
i
i FOR THEBOARD OF HEALTH
JOANNE SCOTT, MPH,RS,CHO -
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
i
J
i
i
)47,0,
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREE I
HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tel, (978) 741-180C
Fax (978)740-9705
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT �Z tlA—
IS THIS UNIT DESIGNATED AS RIGH LEFT FRONT BACK PLEASE CIRCLE ONE (0
OWNER/LESSER,�`CQt� C&&14�_MANAGER/AGENT
No P.O. Box No P.O. Box
ADDRESS� LBj& kzi VE ADDRESS
CITY CITY---
RESIDENCE PHON(J$i BUSINESS PHONE (24 HRS.)
BUSINESS PHONEc�7 /
TOTAL NUMBER OF ROOMSi_1_i7
ROOM USE: 1. LIJ 2- W11 3, 4, 41-21V
THERE IS A TWENTY-FIVE ($25. LLAR FE , PA ABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALE A H DEP PIT NT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATURE
INSPECTO S USE ONLY
DATE Or"�INITI INSPECTION i57-?----O-,,'-DATEOE: REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE,S-_7 0 2-- DATE FEE PAID: <Z- - -7
TYPE OF UNIT: DWELLING XOTHER_ CHECK kCHECK DATE
NOTES:—
CODE ENFORCEMENT INSPECTOR 9/28/98
t
CITY OF SALEM, MASSACHUSETTS
a e 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# 130-06
DATE ISSUED: 3/10/06
Property Located at: 71 Harbor Street UNIT#6 (3 Front)
Owner/Agent: Scott Galber
Address: 203 Washington Street#254
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-269-4173
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter IP'
Minimum Standards of Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates,whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH 1�
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
1
CITY OF SALEM BOARD OF HEALTH
Salem;Massachusetts 01970-3928
•
JOANNE SCOTT,MPH,RNINE NORTH STREETS,CHO _ Tel:(978)741-1800
HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Fax:(978)740.9705
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION°. /
PROPERTY LOCATED AT / / IYA UNIT# b
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSERSr-olt C LM, MANAGER/AGENT�—
ADDRESS 203 WASbf'J jTo,1 51" #29 ADDRESS U J
CITY� MA 0197° CITY
RESIDENCE PHONE 1; '24 - L 173 BUSINESS PHONE (24 H
BUSINESS PHONE 77$170_ /66q
TOTAL NUMBER OF ROOM�S:0
ROOM USE: 1. tI V• 2JUT i, 3.lJ�4.�nd^
5*dyh fi. ✓�Ir/` 7. 8.
THERE IS A TWENTY-FIVE($25. DOLLAR FE A -BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM EALTH DE RTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION
APPLICANTS SIGNATURE Av DATE 3 J
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION,5 — 1 0-- d DATE OF REINSPECTION _
DATE OF ISSUANCE OF CERTIFICATE: —/ a-04DATE FEE PAID: 3 — —d
TYPE OF UNIT: DWELLING/b," OTHER CSG ! 0 3
NOTES:
CODE ENFORCEMENT INSPECTOR
5/19/98
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
s _ g 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 41970
TEL. 978-741.1800
FAX 978-745-0343
KIMBERLEY DRISCOLL JSCOTT@SALEM.COM
MAYOR
JOANNE SCOTT
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#581-07
DATE ISSUED: 11130/2007
Property Located at: 73 Harbor Street UNIT#201
Owner/Agent: EAZ Reaity Trust
Address: P.O.Box 4542
CitylTown: Salem, Ma Zip Code: 01970 24 Hour Phone: 978-745-5892
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter 11"
Minimum Standards of Fitness for Human Habitation".
Therefore,this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply With 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARDOF� j I
t::
COTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
f v
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH -
+ • 120 WASHINGTON STREET, 4TH FLOOR _
SALEM, MA 01970
TEL. 978-741-1800 Vh /
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 1,3 q G r'b f� V 1 UNIT# I
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNERILESSER MANAGER/AGENT
No P.O. Box —1 No P.O.Box
ADDRESS P. O , (_(SUP- ADDRESS O• JJniC �ISN�
CITY Sa\P CITY QSh)i-QN--
RESIDENCE PHONE BUSINESS PHONE (24 HRS.) R)LNS -_5SX'2
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2.-3.-4.-
5.
. 3. 4.5. 6. 7. 8.
xy.
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. n n
APPLICANTS SIGNATURE �Jl Lt �C�L �XIi DATE
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION J�__�b DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:.//--3 D 077 DATE FEE PAID:--& l / �_6 7
TYPE OF UNIT: DWELLI _OTHER` CHECK# B CHECK DATE ! / `�J '2
NOTES: _
CODE ENFORCEMENT INSPECTOR 9/28/98
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAx 978-745-0343
Kimberley Driscoll www.sALEM.COM
Mayor .JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE# 188-06
DATE ISSUED: 4/11/06
Property Located at: 73 Harbor Street UNIT#202
Owner/Agent: EAZ Realty Trust
Address: P.O. Box 4542
CitytTown: Salem, Ma Zip Code: 01970 24 Hour Phone: 978-745-5892
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter il"
Minimum Standards of Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tec(978)741-1800
Fax:(978)740-9705
IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER It, 105 CMR 410.004
"MINIMUM STANDARDS OF FITNESSFORHUMAN HABITATION".
`A
PROPERTY LOCATED AT �3 P r
IS THIS UNIT DESIGNATED AS RIGHT 'LEFT FRONT BACK PLEASE CIRCLE ONE
OWNERILESSER 14 Z1j. tL V MANAGER/AGENT�f�✓r`t: �/3�f`�
No P.O.Boz R No P.O.Box
ADDRESS � KLiqL- ADDRESS lAX V-Svifl-
CITY � `► CITYJ� $ ui 7 "
RESIDENCE PHONE BUSINESS PHONE(24 7`/
BUSINESS PHONE ?t- 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 DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
7 — - oCp
APPLICANTS SIGNATURE e" DATE '14 1A
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE l I - C ,� DATE FEE PAID:Y---//=.-061
TYPE OF UNIT: DWELLINGI�OTHER_-._ CHECK# �✓ z^CHECK DATE Y -11
05 `fd- v74yL- lOb
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
04/10/2006 14 ;04 FAX 6179841025 ALLIANCE EXPRESS j002/002
84/10,'2006 81: 1,5 J9787455569 NORTH EAST REALTY PAGE 82
CF"(WSAUM90AW0FHEAM
was+,MassaClatilBaft,01 S7R}�928
JOANW SCOTT,MPH,Pz9,CW0 NINE NORTH 44M#'?
HCA"A6E 0 Aar:ISM 741-1806
Fen:(We)740.9705
RELCASR
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/leaser and tenantlleaaee of a unit
of residential property, hereby authorize the Salem board of Health or its author-
iced agents to inspect the residence identifiod below in accordance with the
afnrsmaotioncd statutes, regulation& and ordinances.
In the event it is necessaty that said inspection be Jona in my/cur absence, I/we
expressly Authorize the saw anal for my/our successors and assigca hereby releeso
and discharge the City of Salem, Salem Board of Health and its Authorited agents
from any loss or inj+zry systained of whatever nature and description occasioned
by my/our absence during said inapeetion.
2£NAXIILSs 0aEGSB oe9DR X42
7 3 14 ckr 7, ; m c . 13 a,A y v
p rv-, -1� u 5 A")6 A�ERA�&el Ie(y) �/^�+'" dvT-2
11R.ES OF _10NtT To BE 5 CT£U—
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DATE
I
4
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
n 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAx 978-745-0343
STANLEY J. t„1SOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE M 385-03
DATE ISSUED: 7/2912003
Property Located at:: 73 Harbor Street UNIT M 301
Owner/Agent: Eaz Realty Trust
Address: P.O. Box 4542
CitylTown: Salem, MA Zip Code: 01970 24 Hour Phone: 745-5892
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.
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.
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
0 V
Joanne Scott, MPH, RS, CHO
Health Agent ODE ENFORCEMENT INSPECTOR
4
CITY OF SALEM, MASSACHUSETTS
*0
� BOARD OF HEALTH
• • 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".IT
PROPERTY LOCATED AT / 3 19�g 4"ie Sd— UNIT# 3a
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER Z &-d3/_C$--MANAGER/AGENT s--MANAGER/AGENT Z'-/p3Z L,As/Q"-�
No P.O. Box �,y ' No P.O. Box
ADDRESS G. a �X /� S�Z ADDRESS
CITY
RESIDENCE PHONE BUSINESS PHONE (24 HRS. `92001""-Y8yn
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: /
ROOM USE: 1.- ( 2. 3. 4.
5. 6.
THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION. 4s
APPLICANTS SIGNATURE LSE -7
INSPECTORS USE ONLY
PATE OF INITIAL INSPECTION`?-�-1 'mob DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE )ffDATE FEE PAID: jL f-D 3
TYPE OF UNIT: DWELLING�THER CHECK# 7 b CHECK DATE NOTES-
CODE
�--
CODE ENFORCEMENT INSPECTOR 9/28/98
P
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
a 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
STANLEY J. USOVICZ, JR. FAX 978-745-0343
MAYOR W W W.SALEM.COM
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#657-05
DATE ISSUED: 10/31/05
Property Located at: 73 Harbor Street UNIT#303
Owner/Agent: EAZ Realty Trust
Address: P.O. Box 4542
City/Town: Salem, Ma Zip Code: 01970 24 Hour Phone: 978-745-5892
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
JOAA NE�MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
S
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
Far.(978)740.9705
IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER 11, 105CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION'.
PROPERTY LOCATED AT I7Afz hO2 4
� o UNIT q-zG 3
IS THIS UNIT DESIGNATED AS RM LM FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER Z Z A41t-r 7R-j°'—MANAGER/AGENT Si1�1.2.
No P.O.Box p ao y��Z No P.O.Box
ADDRESS l� ADDRESS
CITY
RESIDENCE PHONE `I-/2ys' -( -0S? BUSINESS PHONE(24 HRS.)
BUSINESS PHONE CPfE)
TOTAL NUMBER/SOF ROOMS:
ROOM USE: 1. 2--3.-4
5.-6.-7.—S.—
THERE
. 6. 7. 8.THERE IS A TWENTY-FIVE($26.00)DOLLAR FEE,PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM HEALTH E ENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATU —Z —DATE—/-" "
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION_ y��b � a-��a� DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:/L2--2Z-o DATE FEE PAID: /-6 I<
TYPE OF UNIT: DWELLIN OTHER_,. CHECK#aL3/ CHECK DATE j
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
o CITY OF SALEM, MASSACHUSETTS
,j BOARD OF HEALTH
0 120 WASHINGTON STREET, 4TH FLOOR
f q SALEM, MA O 1970
�Q TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#259-05
DATE ISSUED: 4/25/05
Property Located at: 73 Harbor Street UNIT#304
Owner/Agent: EAZ Realty Trust
Address: P.O. Box 4542
City/Town: Salem, Ma Zip Code: 01970 24 Hour Phone:
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II"
Minimum Standards of Fitness for Human Habitation'.
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
s
4
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 Tei:(978)749-1800
r 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 z4iv
-` �? 3� 2 `moi— UNIT# 6 Y
IS THIS UNIT DESIGNATED AS BIGHT LM<,—
FR NT BACK PLEASE CIRCLE ONE
OWNER/LESSER G<°t'Z �odll {.z,, MANAGERtAGENT AZ, k'-
No P.O. Box No P.O. Box
ADDRESS-- ADDRESS
y� ADDRESS
CITY
RESIDENCE PHONE BUSINESS PHONE (24 HRS.)
BUSINESS PHON ?;?--) "25" ����;;���cY`t Z
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2.
5.
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�^ 5 �� --------DATE
INSPECTORS U5 ONLY
DATE OF INITIAL INSPECTION DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: r} I'v:r DATE FEE PAID:
TYPE OF UNIT: DWELLING( OTHER_ CHECK# � 0
S: �� S 7 CHECK DATE`,:
NOTE
CODE ENFORCEMENT INSPECTOR 9/28t99
4 CITY OF SALEM, MASSACHUSETTS
BOARD OF FIEALTH
120 WASHINGTON STREET,4°1 FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR DGRPrNBAu\I(01sA)AiRCCOnt
DAVID GRI31r.NBAUM
Al.,IING Hi.;Auri I.AGI,NT -
CERTIFICATE OF FITNESS.
CERTIFICATE#376-09
DATE ISSUED: 8/7/2009
Property Located at: 73 Harbor Street UNIT#308
Owner/Agent: EAZ Realty Trust
Address: P.O. Box 4542
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-5892
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter IP'
Minimum Standards of Fitness for Human Habitation'.
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE B RD OF HEALTH
DAVID GREENBA M
ACTING HEALTH AGENT C"
DE 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 �GiircNnnu rCn sw.rna.coti
DAv1D GREI NBAUb(
AC:'1'INC:i HFAI;1'1-I.A(;LNS'
Facsimile
rj Transmittal
To:
Fax # - c1 $
Date
Page(s): including this cover#
Message:
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
HP FA Series 900 Fax History Report for
Plain Paper Fax/Copier Joanne Scott Salem BOH
978 745 0343
Aug 13 2009 10:58am
Last Fax
Date Time Twe Identification Duration Asa ult
Aug 13 10:58am Sent 919787411159 0:34 2 OK
Result:
OK - black and white fax
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CITY OF SALEM, MASSACHUSETTS
` J • BOARD OF HEALTH
120 WASHINGTON STREET,4"�FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAx(978)745-0343
MAYOR - Ib70NN'�a Sql FM.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
FROPERTY LOCATED AT 7-3 h��&,P -5 d UNIT# 3e�
IS THIS UNIT DDISSIGNATED—ASRIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE
OWNER/LESSER Z kl" "144 MANAGER/AGENT
NO P.O. BOX ,` /
ADDRESS . f '�. ! y G Z ADDRESS
CITY, STATE,ZIP �` 1--74 614P4 CITY, STATE,ZIP
RESIDENCE PHONE BUSINESS PHONE(24I-IRS)
BUSINESS PHONE4 V
TOTAL NUMBER OF ROOMS: 3
ROOM USE: l_ (S 2 &3• 4• 5•_
6. 7. 8. 9. 10.
THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR 44ONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS FEE IS PAYABLE T'IE IM 0 PECTION
APPLICANT'S SIGNATURE - DATE �ZF � a
11-711d)
f Inspectors use on1Y
Date on initial inspection:_ / -701
11` v Date of reinspection:
Date of issuance of certificate:_\ / i 0 1 Date fee paid: /70/-
Type of unit: DweIling�Other Check#�D � L Check date:
Notes: V64v 4mU/1tcl/ j ll)4 r/,)
to OW iR d ' 1 SLC ,
Code Enforcement pecto
CITY OF SALEM, MASSACHUSETTS
• BOARD OF HEALTH
120 WASHINGTON STREET,47 FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR )DIONNF, SALEM.COM
JANET DIONNE,
ACTING HEALTH 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.
Z:A
Tenant/Lessee Owner/Lessor
Address Address
Address on unit to be inspected
Date