JAPONICA AVENUE n'�' City of Salem, Massachusetts
Board of Health
120 Washington Street, 4th Floor, Salem, w.PtlbhCH�.ealth
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-15-300
DATE ISSUED: 9/18/2015
Property Located at: 1 JAPONICA AVENUE UNIT#1
Owner/Agent: John &Angie Briggs
Address: 120 Salem Street
City/Town: Lynnfield, MA Zip Code: 01940 24 Hour Phone:(781)558-0859
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
AM
Larry Ramdin, MPH, REHS, CHO $ANITAZAN
HEALTH AGENT
-J
• CITY OF SALEM, MASSACHUSETTS
BOARD OF HFALTH
120 WASHINGTON STREET,4"'FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR LRAMD j (a)SALBM.COM
LARRY RAMDIN,RS/RIiIIS,CIiO,t:P-FS
Hr:AI:rH 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 Tanon,1-a AA4 UNIT# 1
IS THIS UNI SIGNATED AS RIGNT LE FRONT OR BACK"PLEASE CIRCLE ONE
OWNERILESSER 4l,r. i Rc�7r MANAGER/AGENT
NO P.O.BOX
ADDRESS U0 Salem 9ADDRESS
CITY, STATE,ZIP la, �Cz ,/`19 !tl9Y0 CITY, STATE ZIP
RESIDENCE PHONE Z R-55-r- 0 M BUSINESS PHONE(24HRS)
BUSINESS PHONE 7FI"`C(*t" 0 r" Fell
TOTAL NUMBER OF ROOMS:___
ROOM USE: 1./li�A/-coin �- 2. k*wl o� 3.{�t21r°='m � 4. �<f�rGth 5. 0 ��'r2
6.Uk✓jd Rai 7. Qtdwa N 8. 9. 10.
THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE 'I�/,SS
IMectors use only
Date on initial inspection:C)l 1 X I2t)T$� Date of reinspection:
Date of issuance of certificate: � Date fee paid:Qt�o
Type of unit: Dwelling OCheck# Check date:0%a 4ZQ.L _—
Notes:
Coft/46rcent/col Inspector
City of Salem, Massachusetts
f 1
Board of Health
120 Washington Street, 4th Floor, Salem, Ptib�Ch
MA 01970 p+ov<nt.Promote.Prototl.
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-17-111
DATE ISSUED: 4/10/2017
Property Located at: 1 JAPONICA AVENUE UNIT#2
Owner/Agent: John &Angie Briggs
Address: 120 Salem Street
City/Town: Lynnfield, MA Zip Code: 01940 24 Hour Phone:(781) 558-0859
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.
jafij-�J, 43, T/
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITARIAN
&Aaywcon�
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,V'FLOOR
TEL (978)741-1800
KIMBF.RLF.Y DRISCOLL FAX(978)745-0343
MAYOR LRAi DIN@a SALEM.COM
LARRY RAMDIN,RS/RF.HS,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: $50.00
PROPERTY LOCATED AT 6: — UNIT#
IS THIS UNrf DI$IG`ATESA, RIGHT LEFT FRONT ORB CR PLEASE CIRCLE ONE
OWNER LESSER 3� Fk7{7p"IA CS\ MANAGER/AGENT)qd6967-
NO P.O.BOX
ADDRESS tS tel. ADDRESS / 7q tfho Sr
CITY, STATE,ZIP /C5 CrrY,STATE,ZIPyV� -1 ce �hL <U6
!r
RESIDENCE PHONE�bOply�7 ydl�1n®l�l BUsu s PHONE(24HRS) S�(J—I� , l 3
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: J= 2. 3. 4. 5.
9. 10.
THERE IS A FIFTY($50)DOLLARFEE AY BLE K OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS FEE IS AB HET PECTION
APPLICANT'S SIGNATURE DATE JC)
Inspectors use only
Date on initial inspection: Date of reinspection:
Date of issuance of certificate: Date
Date fee paid: J�
Type of unit: Dwelling ther OCheck#A A Check date: 11011
Notes:
Code E rcement Inspector
>g
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4." FLOOR
TEL. (978) 741-1800
K NIBERLEY DRISCOLL. FAX(978) 745-0343
MAYOR ec�iersNiinumn ni.i;na.con�
DAVID GRHF..NBA U M,RS
ACTING HvAixFI AGi3.N'r
CERTIFICATE OF FITNESS
CERTIFICATE#567-10
DATE ISSUED: 12/13/2010
Property Located at: 1 Japonica Avenue UNIT#2
Owner/Agent: Marie Barron
Address: 3 Peppercorn Lane
City/Town: Andover, MA Zip Code: 01810 24 Hour Phone: 978-884-0059
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
A G EENBAUM, RSy
ACTING HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CITY OF SALEM, MASSACHUSETTS
tri BOARD OF HEALTH
-�= 120 WASHINGTON STREI�T,40. FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR DGRcHNBAUMP- ALEM.COAT
DAVID GREENBAUAI,RS
ACTING HEALTH AGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION."
FEE: $50.00
PROPERTY LOCATED AT O PO/L- GC* AVS UNIT#
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER /37/4-fQ/J-� 9,49-R OIS"' MANAGER/AGENT/h/G L Gr Ctr//r✓A2�
NO P.O. BOX
ADDRESS l—,4A,15 ADDRESS 3 M~COR/y Lq4�'
CITY, STATE,ZIP 19MOfi /Y/f+, 0/gh"? CITY, STATE,ZIPf}/LaDV" MA- 0/&/O
RESIDENCE PHONE(g78J y7O-'1987 BUSINESS PHONE (24HRS) C��SJ gR
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1.A17- 2. 4111 3. B 4T/t 44/rfL� 5.91�P
6. R3", 7. /QED 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 �7. �� DATE
Inspectors use only
Date on initial inspection: 1, kkl?/U Date of reinspection:
Date of issuance of certificate: l all,31/U ( Date fee paid: /0
Type of unit: Dwelling ✓Other Check# tYj �O Check date: 3
Notes:
C de E iforcement Inspector
y I CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,41°FLOOR '
TEL. (978) 741-1800
IQMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR Ix3I f",riM4AUM@SAI,F,\I.(i0%1
DAVID GR[?I''.NBAUNf
ACTING HP;.Ai.u I AGENT
CERTIFICATE OF FITNESS
CERTIFICATE #367-10
DATE ISSUED: 7/30/2010
Property Located at: 1 Japonica Avenue UNIT#3
Owner/Agent: Marie Barron
Address: 3 Peppercorn Lane
City/Town: Andover, MA Zip Code: 01810 24 Hour Phone: 978-884-0059
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 W'
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
/A A )
DAVID GREENBAUM (/
ACTING HEALTH AGENT CO"E FORCEMENT INSPECTOR
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4m FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR DQREBN73LQU@SALP;M.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: $50.00
tOPERTY LOCATED AT C,4 4+169 #
IS THIS UNIT DISIGNATED AS RIGHT LEFC FRONT OR BACK.PLEASE CIRCLE ONE
WNER/LESSER.f' !�� Q N MANAGER!AGENT I)?i )I-
)P.O. BOX
3DRESS 3 P164PeAcOR&I L N ADDRESS P6PREJ?C.001I.-�
TY, STATE,ZIPa}NOO V� !)')A d�_CTTY, STATE,Zip f A.,'00 Lc1? M,4f O/R/0
iSIDE NCE PHONky/ I X70"`�/ 7 BUSINESS PHONE(24HRS)L?78)g$Y—005'-?
ISINESS PHONE x ZV
g29=0/ �S'�
)TAL NUMBER OF ROOMS: "t
)OM USE: 1 1L17-u4i5/ 1-1V, 1?0n 3 &eQ 4. A9-7W 5
6. 7. 8. 9. 10.
ERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM
BARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION
PLICANT'S SIGNATURE S DATE -7 O /d
IWectors use only
e on initial inspection: 3o t) Date of reinspection:_ —
e of issuance of certificate: 0 Date fee paid: !
*of unit: Dwelling L /Other Check# Check date:
es:
e En orc Tent Inspector