HAYWARD STREET ,J
f
CERT.# 760-96.
FEE $25.00
3
DATE: 10/29/96
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Fax:(508)740-9705
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 5 Hayward Street UNIT #: 1
OWNER/AGENT: Jeffrey Connolly
ADDRESS: 7 Hayward Street
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-6869
AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS
BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410.000: MASSACHUSETTS STATE -
SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" .
THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE
SALEM HEALTH DEPARTMENT AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED.
MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410.000: MASSACHUSETTS STATE
SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" .
SECTION 410.400 (B) : DWELLING UNIT (X) AND 410.400 (C) : ROOMING UNIT
MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: .
NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR
OCCUPANTS UNDER 6 YEARS OF AGE.
FOR THE BOARD/s�
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
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AMICATION FOR CRETIFI WeNORTi{StnEET
IN ACCORDANCE ATE OF FITNESS To' -i wo
STANDARDS OF.FITNESS
STATE - - T -Fac(508)74"705
FITNESS FOR YUMAM P-UITDE, n,,.jcttATER TZ, 105 CMR 4!0.000 "MZNTNUM
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PROPERTY LOCATED A.T
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TQTRL.NOMRRR OF ROOtm=_
ROOM USE:
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CTIq OF SALEM gFALTH DE3•25
.00) DOLUR FEE. PAZOLE gy
i APPLICt1NTS SI ^" �' PAYAgygCUEMAT °$ MONEY•ORDER TO TUE
`N4dUEE lJ -' OF nmTCTION
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INSPEC£ORS USE' ONLY
DATE OF INITIAL INSPECTION:i_
DATE OF DATE OF REINSPEC
ISSUANCE OF CERTIFI TION
LATE: ��-�
TYPE OF UNIT: p J GATE FEE P
WELLING OTHER AID f
NOTES:
COpE ENFORCEMENT. INSPECTOR
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CERT.# 956-94
FEE $25.00
DATE: 11/08/94
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Fax:(508)740-9705
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 5 Hayward Street UNIT #: 1
OWNER/AGENT: David P. Brilliant
ADDRESS: 3124 Key Largo Court
CITY/TOWN: Antleooe, CA ZIP CODE: 95843 24 HOUR PHONE: 723-6179
AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS
BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410 .000: MASSACHUSETTS STATE
SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" .
THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE
SALEM HEALTH DEPARTMENT AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED.
MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410.000: MASSACHUSETTS STATE
SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" .
SECTION 410 .400 (B) : DWELLING UNIT (X) AND 410.400 (C) : ROOMING UNIT
MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: .
NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR
OCCUPANTS UNDER 6 YEARS OF AGE.
FOR THE BOARD OF HEALTH
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
l
�,1 a OFFICE USE ONLY
CERT. f
94M
DATE:
CITY OF SALEM HEALTH DEPARTMENT
BOARD OF HEALTH
Salem, Massachusetts 01970
9 NORTH STREET.
soeaat-teoo APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE, ,CHAPTER II, 105 CMR 410.000 "MINIMUM
STANDARDS OF FITNESS FOR HUMAN HABITATION".. 1 L
PROPERTY LOCATED AT ,rj G U (� ��1 Y-e,7 % UNIT f�
OWNS
LESSERAGUr ( �' �� I � MANAGER/AGENT
ADDRESS /n� ��a Y 1401/ .UsYnQ �t1T/ ADDRESS
CITY Hyzle'/OgS lS�y�
CITY
RESIDENCE PHONE 71-)L 3- '(D 17Q BUSINESS PHONE (24 HRS.)
BUSINESS PHONE /
TOTAL NUMBER OF ROOMS:
ROOM USE: 1 . 2. 3. 4.
5. 6. 7. 8.
THERE IS A TWENTY-FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE
CITY OF SALEM HEALTH DEPARTMENT UPON COMPLIANCE
�aAND
, ISSSUANCE OF CERTIFICATE.
APPLICANTS SIGNATURE �L.��C'IXJ� DATE
INSPECTORS USE ONLY
DATE OF. INITIAL INSPECTION: - �( `/ DATE OF. REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: /l- 8 " ( �E DATE FEE PAID:
TYPE OF UNIT: DWELLING OTHER
NOTES:
CODE ENFORCEMENT INSPECTOR
CITY OF SALEM HEALTH DEPARTMENT
BOARD OF HEALTH
Salem, Massachusetts 01970
-- 9 NORTH STREET
508-741-1800
RELEASE
In accordance with Massachusetts General Laws Chapter. 11l ; Code of Massachusetts
Regulations 410.000 et. seq. ; State Sanita ode Chapter II and Article XIII of
the City of Salem Ordinance, undersigne owne lessor and tenant/lessee of a unit
of residential property, hereby authorize the Salem Board of Health or its author-
ized agents to inspect the residence identified below in accordance with the
aforementioned statutes, regulations and ordinances.
In the event it is necessary that said inspection be done in my/our absence, I/we
expressly authorize the same and for my/our successors and assigns hereby release
and discharge the City of Salem, Salem Board of Health and its authorized agents
from any loss or injury sustained of whatever nature and description occasioned
by my/our absence during said inspection.
c
TENANT/LESSEE OWNER/LESSON R
ADDRESS ADDRESS
ADDRESS OF JJNIT TO BE INSPECTED
DATE
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Fax:(508)740-9705
Date: 10/14/94
David P. & Helen Brilliant
3124 Key Largo Court
Antleope, CA 95843
PROPERTY LOCATED AT 5 Hayward Street UNIT #
Dear Sir/Madam:
It has come to our attention, that you may be considering renting a dwelling unit
at the above address.
It is incumbent upon you as owner(s) to contact the City of Salem Health
Department to apply for a CERTIFICATE OF FITNESS before any vacant dwelling unit is
rented or occupied, or to notify us of your intent for this unit.
Each dwelling unit must be inspected and certified by the Salem Health Department
prior to allowing occupancy in accordance with Chapter" 111, Sections 127A and 127B, of
the Massachusetts General Laws, 105 CMR 400.00; State Sanitary Code, Chapter 1:
Minimum Standards of Fitness for Human Habitation, and in accordance with Chapter 11,
Article X111 of the City of Salem Code of Ordinances, Section 2-334, Certificate of
Fitness.
There is a twenty-five (25) dollar fee payable by check, or money order to the
City of Salem Health Department. This fee is payable at the time of inspection.
Inspection will not be performed without receipt of payment.
Failure to comply with this procedure, will :result in a fine of twenty (20)
dollars per day for every day that the dwelling unit is occupied without approval of
the Code Enforcement Division of the Salem Health Department.
Contact this department within 24 hours of receipt of this notice. (508)
741-1800 Monday thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7 :00
p.m. or Friday 8:00 a.m. to noon to schedule an appointment for an inspection
SEE ENCLOSED SECTION 105 CMR 410.354 METERING OF GAS & ELECTRICTY
Very truly yours,
FOR THE BOARD OF HEALTH REPLY TO
Joanne Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
Ire
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT - TBI:(508)741-1800
Fax:(508)740-9705
Date: 9/6/94
Michael Silva
40 Charlotte Street
Haverhill, MA 01830
PROPERTY LOCATED AT 6 Hayward Street UNIT # 1
Dear Sir/Madam:
It has come to our attention, that you may be considering renting a dwelling unit
at the above address.
It is incumbent upon you as owner(s) to contact the City of Salem Health
Department to apply for a CERTIFICATE OF FITNESS before any vacant dwelling unit is
rented or occupied, or to notify us of your intent for this unit.
Each dwelling unit must be inspected and certified by the Salem Health Department
prior to allowing occupancy in accordance with Chapter 111, Sections 127A and 127B, of
the Massachusetts General Laws, 105 CMR 400 .00; State Sanitary Code, Chapter 1:
General Administrative Procedures and 105 CMR 410.000; State Sanitary Code, Chapter 11:
Minimum Standards of Fitness for Human Habitation, and in accordance with Chapter 11,
Article XIII of the City of Salem Code of Ordiances, Section 2-334, Certificate of
Fitness.
There is a twenty-five (25) dollar fee payable by check, or money order to the
City of Salem Health Department. This fee is payable at the time of inspection.
Inspection will not be performed without receipt of payment.
Failure to comply with this procedure, will result in a fine of twenty (20)
dollars per day for every day that the dwelling unit is occupied without approval of
the Code Enforcement Division of the Salem Health Department..
Contact this department within 24 hours of receipt of this notice. (508) 741-1800
Monday thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7 :00 p.m. or
Friday 8:00 a.m. to noon to schedule an appointment for an inspection.
SEE ENCLOSED SECTION 105 CMR 410.354 METERING OF GAS & ELECTRICITY
Very truly yours,
FOR THE BOARD OF HEALTH REPLY TO
Joanne Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
I