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HARRISON AVENUE CITY OF SALEM, MASSACHUSETTS '� BOARD OF HEALTH e 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY LISOVICZ, JR. ,JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT May 1, 2003 Thomas Murphy PO Box 1044 Salem, MA 01970 PROPERTY LOCATED AT 1 Harrison Ave It has come to our attention, that you may be considering renting a dwelling unit at the above address. In accordance with Chapter 11, Article XIII of the City of Salem Code of Ordinances, Section 2-334, titled "Certificate of Fitness, each dwelling unit must be inspected and certified prior to allowing occupancy. The inspection will be conducted in accordance with 105 CMR; State Sanitary Code, Chapter 1: General Administrative Procedures and 105 CMR 410.000; State Sanitary Code, Chapter 11: Minimum Standards of Fitness for Human Habitation. Please notify us if you do not intend to rent the unit. Please contact this department within 24 hours of receipt of this notice at 978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday thru Wednesday from 8:00 a.m. —4:00 p.m. Thursday 8:00 a.m. —7:00 p.m. and Friday 8:00 a.m.—4:00 p.m. Failure to comply with this procedure, may result in a fine of Twenty ($20.00) dollars per day for every day that the dwelling unit is occupied without a Certificate of Fitness. A$25.00 check payable to the City of Salem is required for each unit inspected at the time of inspection. A property owner is required to pay gas and electricity for residential tenants if there is not a written letting agreement stating the tenant is responsible for those utilities and if the meter(s) records electricity and gas use which is not used exclusively by that tenant. The Department of Public Utilities has billed property owners for their tenants' entire utility bills retroactive to the date of initial occupancy in cases in which cross-metering has been proven to exist. For the Board of Health Reply to Joanne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector r ` CITY OF SALEM, MASSACHUSETTS Y + BOARD OF HEALTH 120 WASHINGTON STREET,4°i FLOOR TEL. (978)741-1800 KINMERLEY DRISCOL.L FAX(978) 745-0343 MAYOR iSCOI nn Snr,ear.COM JOANNE SCOTT, HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#367-08 DATE ISSUED: 8/13/2008 Property Located at: 3 Harrison Avenue UNIT# R Owner/Agent: Lola Eanes Address: 28R Putnam Street City/Town: Beverly, MA Zip Code: 01915 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 MPH RS CHO HEALTH AGENT CO ENFORCEM NSPECTOR CITY OF SALEM, MASSACHUSETTS 3(p�,q BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR Isco,rrnSALEM COM JOANNE SCOTT, HEALTH AGENT Application for Certificate of Fitness . IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION." JJ FEE: $50.00 PROPERTY LOCATED AT q( r r IAC O r) (Tin UN1T# IS THIS UNIT DISIGNATED AS RICHT LEFT FRONT OR BAC PLEASE CIRCLE ONE OWNER/LESSER LCUL-A-�ti _( MANAGER/AGENT NO P.O.BOX ADDRESS ZA` DU����I St- ADDRESS / , CITY, STATE,ZIP —,CL CITY, STATE,ZIP /��-`f RESIDENCE PHONE �I 7_�L7— �� BUSINESS PHONE(24HRS) BUSINESS PHONE 9,�y`� TOTAL NUMBER OF ROOMS: ROOM USE: 1. 1`7 /(- 2. ��. 3. (J� 4. X- 6. j4!�-7. l/� 77 8. 9. 10 THERE IS A FIFTY($50)DOLLAR FEE,-PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS P/ THE TIME OF INSPECTION APPLICANT'S SIGNATURE - //2 - DATE Inspectors use only Date on initial inspection: I I3 los Date of reinspection: Date of issuance of certificate: Date fee paid: Type of DwellinS Other + C�h�eck# �, b / 7 Check date: Notes: -yE u1h oto tV - -ek 60C V-oor ��e-, �YS I5 c n AroVll Q 4 U, ��- tL-albs on ,`���Q + '�n � C b� /..1 n hrWJ��IY � I`'t� 'lf(]YlY DI LA /.t�J Code nforcement Inspector CITY OF SALEM, MASSACHUSETTS o BOARD OF HEALTH s 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAx 978-745-0343 Kimberley Driscoll WWW.SALEM.COM Mayor JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#241-07 DATE ISSUED: 5/18/2007 Property Located at: 3 Harrison Avenue UNIT# 1 Owner/Agent: Lola Eanes Address: 28R Putnam Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter ll" Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH �7 JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR COPY OF SALEM, MASSACIiuSE I A BOARD OF HEALTH .•+ • 124 WASHINGTON STREET. 4TH FLOOR CTS 1111 777XYYY SALEM, MA 01970 _ TEL. 978-741-1800 FAX 978-745-0343 JOANNE SCOTT, MPH, RS, CHO Kimberley Driscoll HEALTH AGENT Mayor APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMA 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT_ � �L )O� / __—UNIT li-- IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER–Z,e4�f _MANAGER/AGENT _ ____- NO P:O. B6 �N No P.O. Box ADDRESS_ } , ✓ �----.ADDRESS---- _ CITY—_AL� r"'Y._---_ �, J RESIDENCE PHONE-T?t� -7�-ZZs BUSINESS PHONE (24 HRS.)__ .__-- BUSINESS PHONE------------ TOTAL NUMBER OF ROOMS:---- ROOM USE i.._` ._ 2, 4 __3 _(/ 4 THERE IS A TWENTY-FIVE ($25.00) DO FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEKLI' DEP A TMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE _..DATE-----.__._,.__-_._ _ I INSPECl_QRS USE ONLY, GATE OF INIT_IAL INSPECTIOI I, Ju 7 DATE OF REINSPECTION i DATE OF ISSUANCE OF CERTIFICATE,5-­J..y - 6 7 DATE FEE PAIL) 'TYPE OF UNIT DW[ITING�OTHIR C-HECK ,, / 0919 CHECK DATE 5 NOTES. COOL FN(t)HCEMLN? IfVs;}'I-CTU!{ !3'2t1'9t1 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"FLOOR PublicHealth Prevent.Promote.Protect. TEL. (978) 741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL Iramdin@a,salem.com LARRY ILr1MD1N,RS/RT.',FIS,CI-10,CP-PS MAYOR HEAL rII AG FN'r CERTIFICATE OF FITNESS CERTIFICATE#130-13 DATE ISSUED: 4/9/2013 Property Located at: 3 Harrison Avenue UNIT#2 Owner/Agent: Lola Eanes Address: 28R Putnam Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: 978-697-3254 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 Ile 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 AR HEALTH LARRY RAMDIN HEALTH AGENT SANITARIAN CITY OF SALEM,MASSACHUSETTS BOARD OF HEALTHPublicHealth 120 WASHINGTON STREET,4'"FLOOR PMwet Promote.P aleeL TEL.(978)741-1800 FAX(978)745-0343 KIMBERLEY DRISCOLL kgmdhLnj&alem.com MAYOR LARRY RAMDIN,RS/REHS,CHO,CP-B 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 V� 1't�6✓YYIAd"Lt �°F rZ UNIT# IS THIS UNIT DLSIGNATED AS RIGHT LEFT FRONT OR RACY.PLEASE CIRCLE ONE OWNER/LESSER A I -En P f MANAGER/AGENT j NO P.O.BOX //�� ADDRESS__& !moi )tf ,I" S fi q' ADDRESS CITY,STATE,ZIP i /v CITY, STATE,ZIP_ r RESIDENCE PHONE �� � �-3 Ste/ BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: 7 n ROOM USE: 1. 2. L 2 3. 2 4. 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLARFEE,P LE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PA L AT T TIME OF INSPECTION APPLICANT'S SIGNATURE / DATE Inspectors use only Date on initial inspection: "JA / Date of reinspection Date of issuance of certificate: Date fee paid: 2 Type of unit: Dwelling__Other Check 2. #/ Check date: 3 _ Notes: U (PtL (TV c�uVl �� e7 Ih �( k `7. ecLh'm O "'Sgsh Q. Code osceent Inspector ND NQ City of Salem, Massachusetts Board of Health a � m 120 Washington Street, 4th Floor, Salem, P �PubliCPrOmoHeAlth MA 01970 Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ranndin, MPH, REHS,CHO Mayor health@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE#: GHL-17-252 DATE ISSUED: 8/21/2017 Property Located at: 4 HARRISON AVENUE UNIT#3 Owner/Agent: Lola Eanes Address: 28R Putnam Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone:(978) 697-3254 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwellingunit apartment or tenement. An inspection of our vacant Dwellin /Roomin Unit at the above address has P P Y 9 9 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. sy Larry Ramdin, MPH, REHS, CHO HEALTH AGENT rSAN IAN • CITY OF SALEM, M.ASSACHUSEI"TS BOARD OF HEALTH 120 WASHINGTON STREF,L",4"FLOOR TEL.(978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR LRAMDIN&SALF..M.COM LARR'v RAMDIN,RS/REHS,CHO,CI?-FS HEAUM 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 `1 1' ': ` N-t l 6 4/40- " UNIT#-_ IS THIS�F[INT"�DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER LUtc` y" "�I�✓NPS MANAGER/AGENT NO P.O.BOX ADDRESS 2� �pp�f�{Ji9/Yl S� ADDRESS / CITY, STATE,ZIP /�P o)Cir LiA CITY, STATE,ZIP G"I 4- RESIDENCE PHONE BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. /� 2. LA- 3. (,f/- 4. 5. 6. 7. 8. 9. 10. THERE IS A FIFTY ($50)DOLLAR FEE, ABL BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS P ABLE THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATE Inspectors use only Date on initial inspection: f o /2J7 Date of reinspection: Date of issuance of certificate: Date fee paid: 2A312-01�7 Type of unit: Dwellin Other Check# 3 12-0 p Check date: 0 Z Notes: ELL- R,.8-N / iOx/ Lo If n WOI�k/pnp Code Enforcement Inspector CITY OF SALEM, MASSACIIUSL'1 TS BOARID OF HEAL -i 120 WASPIINGTON STREET,4"FLOOR TEL. (978) 741-1800 KIMBERLEY"DRISCOLL FtLx(978) 745-0343 MAYOR LRAMDIN@[ SALEM.COM LARRY RAMDIN,RS/REHS,CHO,CP-FS HEALTH AGENT Release In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ; State Sanitary Code Chapter 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 d�2/sow due S�IP� P(JffA, Address Address Address on unit to be inspected 7' 7 Date Updated 5/23/11 City of Salem Massachusetts Board of Health Nor 120 Washington Street, 4th Floor, Salem, P'ub&Health MA 01970 Prevent. Prmmote. Prnteci. 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-16-294 DATE ISSUED: 811212016 Property Located at: 5 HARRISON AVENUE UNIT#1st Floor Owner/Agent: Lola Eanes Address: 28R Putnam Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: (978) 697-3254 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. yeffrey7arosy Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN • - CIT'1' OF SALEM MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4' FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLT. FAx(978) 745-0343 MAYOR Lj Anlnmm@sALeaI.COM LARRY RANIDIN,RS/REHS,CHO,CP-FS HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" FEE: $50.00 PROPERTY LOCATED AT UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER l�l� �rt i/�f MANAGER/AGENT NO P.O.BOX ADDRESS 2,o4' 9 /f fno /'1 5;7` ADDRESS CITY, STATE,ZIP 0 erg CITY, STATE,ZIP /"qA' o=-f— RESIDENCE (/�� RESIDENCE PHONE 617 3 / BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: v /� ROOM USE: 1. �4 2. 3. J 4. 6. E 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FE ,PAY LE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS YAB TIME OF INSPECTION APPLICANT'S SIGNATURE DATE W Inspectors use only Date on initial inspection: 0 8/L 112D1 Date of reinspection: Date of issuance of certificate: Date fee paid:(2111/2n2�- Type of unit: Dwelling Other Check# 31 - Check date: OW L12.014 Notes: fin/°' Se er ✓1re�I.�CPd �.,nr mrdPY Ye T �o dourrS d fit M,e AI- rn Sol Tr10n / C e f ement L}a ector SND City of Salem, MassachusettsWOR "�-� Board of Health u 120 Washington Street, 4th Floor, Salem, PabliCHealth MA 01970 Prevent.Promote. Protect, Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, RENS,CHO Mayor health@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE#: GHL-17-162 DATE ISSUED: 6/7/2017 Property Located at: 5 HARRISON AVENUE UNIT#2 Owner/Agent: Lola Eanes Address: 28R Putnam Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone:(978) 697-3254 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. e JJeff r ros Larry Ramdin, MPH, RENS, CHO HEALTH AGENT Ifl SANIT N : CITY OF SALEM, MASSACFIUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,47"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR LRAMDIN@SALEM.COM LARRYRAMDIN,RS/RFHS,CHO,CP-FS HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" FEE: $50.00 PROPERTY LOCATED AT ��` ' � � UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE ` OWNER/LESSER V', �—t MANAGER/AGENT NO P.O.BOX ,ry /� _ ADDRESS �P/C, 1" t%' Gill/ 7/ ADDRESS CITY, STATE,ZIP �7 U 7 �/ l'��I CITY, STATE,ZIP RESIDENCEPHONE 7 .J� Z�5-`� BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: �� ROOM USE: 1. J�_ 2. 3r i� 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 PPA BLEAT THE TIME OF INSPECTION APPLICANT'S SIGNATURE ' � �f �� DATE Inspectors use only Date on initial inspection: 21 Date of reinspection: Date of issuance of certificate:. Date fee paid:04/0 Z�2 0q1yy'//� Type of unit: Dwellin Other Check#3 300 Check date:��i��) � L Notes: e o I orcemen spector o a CITY OF SALEM, MASSACHUSETTS 10 BOARD OF HEALTH 120 WASHINGTON STREET,4""FLOOR )P11b�1CI�P.Alth Prevent.Prn,nn e.Protect, TEL. (978) 741-1800 K\x(978) 745-0343 KIMBERLEY DRISCOLL tramdinnsalem.coin L;\]iRl'R;\nfUIN,RS/RI311S,Cl f0,(:134S AtikYOR Hlr:,\7:ni AG vN'r CERTIFICATE OF FITNESS CERTIFICATE#350-12 DATE ISSUED: 9/5/2012 Property Located at: 11 Harrison Avenue UNIT# 1 Owner/Agent: Benigho Bonilla Address: 11 Harrison Avenue City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 781-858-5012 An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II" Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FO TH OA F HEALTH LARRY RAMDIN IP�� HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS BoARD OF RF T 120 W�ISHINGTNGTON S'STRSLT,4"FLC7C:7R TEL. (978)741-1800 J KII M RLEY DRISCOLL FAX(979)745-0343 MAYC)R az tiii»N sniath.i'c mt x.nitxi lt,vnti)t J,Ott/tt 1t1 is,U 10,C1-r8 Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER.11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" FEB: 50.00 PROPERTY LOCATED AT It RQ M SOLA kV • UNIT# IS THIS UNIT DISIGNATED AS RIGHT'LEFT FRO ORB, ACu.PLEASE CIRCLE ONE OWNER/LESSER (5E"i r*$i0 gOta�_ —MANAGERI AGENT NO P.O.BOX ADDRESS V • Shy ADDRESS CITY, STATE,ZIP_ 71.z.0 aYl doh CITY, STATE,ZIP Q iG ► 0 RESIDENCE PHONE Vt 1 BUSINESS PHONE(241IRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: 3 ROOM USE: 1. ii elkrz-01z.L uta 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 13 APPLICANT'S SIGNATURE W_d- O t Rjp s `(, DATE S Inspectors useOnl Date on initial inspection: i Date of reinspection: Date of issuance of certificate: CI Lt' 1 Date fee paid:--! 6_ 11 _ Type of unit: Dwelling-L.,- Other_ Check# �� ..,,Check date: Notes: C e Enforcement Inspector co City of Salem, MassachusettsIV � . 610K Board of Health 120 Washington Street, 4th Floor, Salem, PubliCHeslth MA01970 Prevent, Promote. Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHO Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE#: GHL-16.159 DATE ISSUED: 5/13/2016 Property Located at: 11 HARRISON AVENUE UNIT#2 Owner/Agent: Benigno Bonilla Address: 11 Harrison Avenue City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(781) 858-5012 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". ion". b 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,—*LJL &Jeffrey Barosy Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS Lf BOARD OF HEALTH 120 WASHINGTON STREET,4" FLOOR TEL (978) 741-1800 FAX(978)745-0343 K.IMBERLEY DRISCOLL hwndin@saIem.com ' MAYOR LARRY RAMDIN,RS/RE115,CHO,CNH HEAmij 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" pp FEE: $50.00 PROPERTY LOCATED IS THIS UNIT DISIGNATED ASR Lam+' Fah OR PLEASE CIRCLE ONE OWNERtLESSER R,jEWr IA.6 kn tkL l { . —MANAGER/AGENT O VJ NO P.O.BOX ADDRESS_ a 6,itsti QA W ADDRESS CITY, STATE,ZIP ;!�� � =1_70 CITY, STATE,ZIP RESIDENCE PHONE I Qi S.00 GO) BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 4. 5. 6. 8. 4 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 r APPLICANT'S SIGNATURE_ bLJ , DATE In___ps ectors use only Date on initial inspection: DyDy ar Date of reinspection: Date of issuance of certificate ( , Date fee paid: S/0 Type of of unit: Dwelling_ Othcr Check# _Check date: �SIDq�2D Notes: C o ement ector NDtz"� City of Salem, Massachusetts .r' y Board of Health ` m 120 Washington Street, 4th Floor, Salem, PublicHealtl>t ➢. Prevent. Promote. Protert. MA 01970 Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHO Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE #: GHL-15-195 DATE ISSUED: 7/30/2015 Property.Located at: 12 HARRISON AVENUE UNIT#1 Owner/Agent: Lola Eanes Address: 28R Putnam Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone:(978) 697-3254 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 01 Larry Ramdin, MPH, REHS, CHO7717 HEALTH AGENT SANIT RIAN • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4n'FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR IAAMDIN SALEM.COM LARRY RAMDIN,RS/REliS,Clio,CP-IS HRAL*n l AGr-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 12- 0.6 ✓ A,/ UNIT# � IS THIS UNIT DISIGMATED ASRIGHT 111FTF fO OR BACK PRASE CIRCLE ONE OWNERLESSE thq 1(� �_S MANAGER/AGENT ADDRESS O�� f2 PQ-64 CGS WL S�• ADDRESS CITY, STATE,ZIP CITY, STATE,ZIP RESIDENCE PHONE q7k/61 1 -3 ZSq BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: C5- ROOM 5ROOM USE: 1. 4A 2. K 3. D 4. 6 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE PgIBLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAY TIME OF INSPECTION APPLICANT'S SIGNATURE DATE !Wectors use only Date on initial inspection: 07/j 112n25— Date of reinspection: Date of issuance of certificate:D 2 20 Date fee paid: 07/2 912 S— Type of unit: Dwelling Other Check#-2:1Check date: D Z/ZY/2D1 - Notes: C orc entInspec - �"15-I �5 �C0 Dlq,,� y City of Salem, Massachusettslu f An Board of Health s 120 Washington Street 4th Floor, Salem, PublicHealth M Prevent. Promote. Pmtert. 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-15-209 DATE ISSUED: 7/31/2015 Property Located at: 12 HARRISON AVENUE UNIT#2 Owner/Agent: Lola Eanes Address: 28R Putnam Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone:(978) 697-3254 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 S/}P ITARIAN I CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978)741-1800 KIMEERLEY DRISCOLLFAX(978)745-0343 MAYOR FO-X', I +f K �IRAMQIN O( S=M.COM 0 LARRY RA� IN,RS/REBS,CHO,CP-IIS 1. l HLALTII AGENT � LQ,Y1e.s t/+W K el 1 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: $5,0�.J00 PROPERTY LOCATED AT l'� >�Z UNIT# !/ IS THIS UNIT DISIGNATED AS RIGHT LOT MW OR BAC PLEASE CIRCLE ONE OWNER/LESSER l t—dc- MANAGER/AGENT NO P.O.BOX ADDRESS 2-,P'g Alhd-M 5d-411,�r1 � DRESS CITY,STATE,ZIP �. R'f- 61913 CITY, STATE,ZIP i RESIDENCE PHONE BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS:_ ROOM USE: 1. L/C 2. lC 3. 4. rS /r 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR ABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS Y AT THE TH-AE OF INSPECTION APPLICANT'S SIGNATURE Cc DATE Inspectors use only Date on initial inspection: 0'&2-9 12 I i- Date of reinspection: Date of issuance of certificate: Date fee paid: ©%/7 12-0 S- Type of unit: Dwelling- Other Check# 2 -6 Check date: n V2,?Z O Notes:�see ��cti Code Enforcement Inspector his - ami P — n/� 1 qa Inspection of (IJA JQ Ep eAj± Cate ava/2�1 Time /A�1 1 t^1 Address J Ho-rr I'so h JTV'evlve. 7-no�Fla, Name J� ��� r- Owner L 01A F n ne,5i Tel. No. � Pr Type of Inspection C" Ji r�" "�� e�- 'ri "' n�r Inspector F- .,$ Sa; V ( ' ) Remarks and Violations are listed below: '^ ¢ ,^rp_-�Zrnoe.�a."�vrE�^-t'or/�KPTC�n Ue�1' d'a.o nJ, �._ ;tG�-T ���y1-��GtS avty t.vt��tr.-sir-t-1 r1 a. tOoC�?�t.vTiiv�tuYw' .._.�$�.P.e_,_J�r.5t{9a1.-.-k�-JJt�- t r'1 4.s..wrC, �2,e�t?.w_._K}g..C-ta...-�L�-�-`N-'—�..�4.4,n�nw S'rK�'�-r^•i-- Itp, ' � .��p � p r,,, ,/1,,• -[v_!.v'JiS�C..(�' [�"1 J) f �,,�� (r, �/}^/ r �i—v! Ca�- .���(� wuF �t m_D-�} toa ^ ie yt N/ et1 �r+ i✓ � p TT,I;t nes ,.—.Cr.rrvvn r ?r,�, S4,ox Ce [r-a�UMI--�+n S we d�n�v SC.rotn.,._e.,. ('J—.rd.d„6.ft,S..'Jdd.Y•1fi--.�C.3rGF.��-1r7 Gtt�...f��P �aoi r____�n_�SG/G�e!l.o Report Received by: k CITY OF SALEM9 MASSACHUSETTS HEALTH AGENT 82 120 WASHINGTON STREET, 4TH FLOOR @@ SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 KIMBERLEY DRISCOLL JSCOTT@SALEM.COM MAYOR JOANNE SCOTT HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#543-07 DATE ISSUED: 11/1/2007 Property Located at: 14 Harrison Avenue UNIT# 1 Owner/Agent: Ondina Ortiz Address: 14 Harrison Avenue 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 4J0AN=ESCOTT, MPH, RS, CHO HEALTH AGENT cbft 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, R5, CHO Kimberley Driscoll HEALTH AGENT Mayor APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT Gv2. — UNIT # IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER ONM�_ MANAGER/AGENT No P.O. Box 06 No P.O. Box ADDRESS / L/ ADDRESS CITY o t C Z ° CITY RESIDENCE PHONP , '-(y -3,> I IpUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: Y ROOM USE: 1.I_2. L3. _4._ 9� 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 ' ------� DATE D INSPECTORS USE ONLY+� DATE OF INITIAL INSPECTION f J !—_ +DATE OF REINSPECTION_ ) DATE OF ISSUANCE OF CERTIFICATE//— T DATE FEE PAID:--4L— �— 4 1 TYPE OF UNIT: DWELLINTHER__ CHECK 4___ CHECK DATE)_—�� 6� NOTES: �'� CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS l - BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR 578-03 SALEM, MA 01970 CERT.# � FEE $25.00 TEL. 978-741-1800 DATE: FAX 978-745-0343 11/24/03 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT r CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 14 HARRISON AVENUE UNIT #: 2 OWNER/AGENT: MELVIS AND MIOZOTY VITTINI ADDRESS: 3 MASON STREET, #2 CITY/TOWN: SALEM ZIP CODE: 01970 24 HOUR PHONE: 978-741-9071 AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410.000: MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE SALEM BOARD OF HEALTH AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED. MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410 .000: MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . SECTION 410.400 (B) : DWELLING UNIT (X) AND 410.400 (C) : ROOMING UNIT ( ) MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: . NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR OCCUPANTS UNDER 6 YEARS OF AGE NOR BUILDING RELATED CODES. FOR MORE INFORMATION CALL 978-741-1800. FO THE BOARD OF HEALTH JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT F RY W.�AUGHAN SR. SANITARIAN CITY OF SALEM MASSACHUSETTS BOARD OF HEALTH (- D 3 120 WASHINGTON STREET, 4TH FLOOR ` y `F SALEM, MA 01970 3 V TEL. 978-741-1 800 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 FITyN/ESS' FOR HUMAN HABITATION". PROPERTY LOCATED AT UNIT# IS THIS UNIT DESIGNATED AS RIGHT LEFT LEASE CIRCLE ONE /nel�;s v;TN; OWNERILESSER ^'oz Ti. vim' MANAGER/AGENT 3 e✓S� d No P.O. Box No P.O. Box /!ZADDRESS � Hc^-/ri S� CY+ "� ADDRESS CITY t'o CITY RESIDENCE PHONE l7/BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: S ROOM USE: 1. 2. 3. 4. 5. 6. 7. 8. THERE JS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE ��- DATE 2 - D3 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION DATE OF REINSPECTION /i1,WXJ DATE OF ISSUANCE OF CERTIFICATE: DATE FEE PAID: ///i>/'-7 TYPE OF UNIT: DWELLING 11 OTHER_ CHECK# 75S CHECK DATE NOTES: Air COD CEMENT IN CTOR 9/28/98 .r CITY OF SALEM, MASSACHUSETTS o BOARD OF HEALTH s 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAx 978-745-0343 Kimberley Driscoll WWW.SALEM.COM Mayor JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE #352-06 DATE ISSUED: 7/21/2006 Property Located at: 14 Harrison Avenue UNIT#3 Owner/Agent: Ondina Ortiz Address: 13 Harrison Avenue City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-744-3219 An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter If' Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH f` r J ANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH �w • 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 I� a/ ✓ 50 A ` UNIT#,3 IS THIS UNIT DESIGNATED/ AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER ©4414-6 0,e//* _MANAGER/AGENT No P.O. Box No P.O. Box ADDRESSSS� 1�`� 2✓Y7Se�l/ 4V� ADDRESS / f 1 CITY 6' e U n 14A CITY 45 A!t M P l 14, _ RESIDENCE PHONEggq - 74V-80r BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 5. —6.-7.-8.— THERE . 7. 8.THERE IS A TWENTY-FIVE ($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. _ APPLICANTS SIGNATURE Z'� �1 _4--!�-DATE 6' INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 7- / 9-o(-' DATE OF REINSPECTION D� DATE OF ISSUANCE OF CERTIFICATE1v4-9�__ DATE FEE PAID:_- TYPE OF UNIT: DWELLI OTHER_ CHECK #0 19 I CHECK DATE S� NOTES: - -- - - CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM9 MASSACHUSETTS f� BOARD OF HEALTH n ' � 120 WASHINGTON STREET, 4TH FLOOR o SALEM, MA 01 970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#211-05 DATE ISSUED: 3/28/05 Property Located at: 15 Harrison Avenue UNIT# 1 Owner/Agent: Rosario Beltre Address: 15 Harrison Avenue City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter ll" Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH JO NE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS `i BOARO OF HEALTH ti • i 120 WASHINGTON STREET, 4TH FLOOR ..+111 SALEM, MA 01970 c5/4= ( TEL. 978-741-1800 FAX 978-745-0343 STANLEY LISOVICZ, JR, JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410-000 "MINIMUM STANDARDS OF FITNESSFORHUMAN HABITATION"- PROPERTY LOCATED AT I_Yp_('J A��Z �� /? � " UNIT 01- IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNEWLESSER /C t7 SA 21 o I �L7`2 MANAGER/AGENT_ . No P.O. Box No P.O. Box ADDRESS: � J A p�am�_ ��ADDRESS CITY �7_f-�.L � I �I s 1��9'7 6 CITY RESIDENCE PHONEI"11-' BUSINESS PHONE (24 HRS.)__._ BUSINESS PHONE----- TOTAL HONE _ _TOTAL NUMBER OF ROOMS:_ ROOM USE: 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 �"L�,�-�'-L�'-,�'�`_' _...DATE INSPECT'O`RS USE ON DATE OF INIT{AL INSPECTION .� lr� i a DATE OF REINSPECTION __ DATE OF ISSUANCE OF CEHTIFICATE:� —`( O' DATE FEE PAID:_ TYPE OF UNIT: DWELLING !f OTHER ^ CHECK#_! TE ✓� CHECK DA NOTES: e5�,���. CODE ENFORCEMENT INSPECTOR 9/28/98