The URL can be used to link to this page

JEFFERSON AVENUE 1-252 JEFFERSON AVENUE 1 -252 R E a 7 P[ 6 4 i I CITY Or SALEM, MASSACHUSETTS 10 BOARD OF HEALTH PublicHea[th 120 WASHINGTON STREET,4...FLOOR Prevent.Promu,<,Protect. TEL.(978)741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL Irarfidin@salem.com LARRY RAMI)IN,RS/REI-iS,CHO,Cl F S MAYOR FiF,AL TI.f AC ENT CERTIFICATE OF FITNESS CERTIFICATE#479-12 DATE ISSUED: 12/5/2012 Property Located at: 42 Jefferson Avenue UNIT# 1 Owner/Agent: J &G Realty Trust Address: 42 Jefferson 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 cupancy. FOR THE BOARD OF HEALTH LAR Y RAMDIN HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS r � • BOARD OF HEAI;II-I 120 WASHINGTON STREET,4...FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR LRANMNQSAJA,, .CONE LARRY RANIDIN,RS/RF.[N,cI IO,(-P-FS HIdAl,nf A(iIiNT 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 ��i�re✓SUl` �TVL° ZJNIT'# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER }G �_)%L-�j MANAGER/AGENT �y i✓9�2�� NO P.O. BOX ,,1 /� ADDRESS �� J 2��2(Spn �+V�, ADDRESS.2-- ✓ Pu5A/G�,yl 14V P. CITY, STATE,ZIl' A(`'3/�(°i'V1 A— CITY, STATE,ZIP 019 70 RESIDENCE PHONE / Sd I/ / a� BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS YABLE AT E TIME OF INSPECTION APPLICANT'S SIGNATURE DATE /ZS Inspectors use only Date on initial inspection: Date of reinspection: Date of issuance of certificate: Date fee paid:_ Type of unit: Dwelling Other Check# �� Check date: Notes: Code f ent Inspector • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTI-I 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR DGRE8NI3AUM(�SALLM.COM DAVID GRu ENBAUM ACTING HFAL,IH AGENT CERTIFICATE OF FITNESS CERTIFICATE#406-09 DATE ISSUED: 8/24/2009 Property Located at: 42 Jefferson Avenue UNIT#2 Owner/Agent: J&G Realty Trust Address: 406 Essex Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-580-1488 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 DA ID GREENBAUM ACTING HEALTH AGENT CODE ENF RCEMENT INSPECTOR ILz CITY OF SALEM, MASSACHUSETTS • BOARD OF HEALTH 120 WASHINGTON STREET,4."FLOOR / TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DCRP,LNBAUM@SA1 EM.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 1012 UNIT# d I"S THIS UNIV61SIGNATED AS RIGHT LEFT FRONT OR BACK,PLEA E CLE ONE �/ OWNER/LESSERl / �D�r (1/ MANAGER/AGEg7 ��6T/Cr.®iC� BOX ADDRESS ' U to 6;�j LAX 6,J7 ADDRESS CITY, STATE,ZIP G� l.�.t�, 1' CITY, STATE,ZIP /� RESIDENCE PHONE G 7�J�/y�� BUSINESS PHONE(24HRS) -1 7O- BUSINESS PHONE i q7 I V TOTAL NUMBER OF ROOMS:_ ROOM USE: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH-THIS FEE IS LE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE!- .telE /� DATE 0� Inspectors use only Date on initial inspection: /0� ch � Date of reinspection: Date of issuance of certificate: a r// q C Date fee paid: y G Type of unit: Dwelling1�Other Check#_ C1 p J o Check date: II d c/ Notes: ��(fPo/IS Ant (L1-�aat. for (.ufcd—ouir I bump/' oct 1n,14(Yof PM ' Pfitr Co Enfor ement Inspector HP Fax Series 900 Fax History Report for Plain Paper Fax/Copier Joanne Scott Salem BOH 978 745 0343 Sep 03 2009 12:30pm Last Fax Date Time Twe Identification Duration Paces Result Sep 3 12:29pm Sent 919787409666 0:25 1 OK Result: OK - black and white fax f 1 CITY OF SALEM, MASSACHUSETTS �! HEALTH AGENT b 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#485-07 DATE ISSUED: 9/28/2007 Property Located at: 50 Jefferson Avenue UNIT# Front Owner/Agent: Carolina Barton Address: 945 Las Palmas City/Town: Irvine, CA Zip Code: 92602 24 Hour Phone: 978-307-2845 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 ANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT IN PECTOR ' CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • i 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 "50 SE-F-FF2.50/V UNIT# �: 'A;r IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER CARoUA)A BA2.-WJ MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS ft s$- LAS �PAUYX S ADDRESS CITY _ /? 1wwF_" CITY Ce 260 0' RESIDENCE PHONE '/y 3 'I'oZ[ _BUSINESS PHONE (24 HRS) 91/9-30-7,Z$qs� BUSINESS PHONE TOTAL NUMBER OF ROOMS:__ ROOM USE: 1. 5. _6._7._& 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 q Z L07 INSPEC ORS USE ONLY / DATE OF INITIAL OF INITIAL INSPECTIONJdj 9,7 7 —DATE OF REINSPECTION____ DATE OF ISSUANCE OF CERTIFICATE: DATE FEE PAID:_y�" ^ O ' TYPE OF UNIT: DWELL _OTHER__ CNg #_.____CHECK DATE �_�'YA 7 NOTES: CODE ENFORCEMENT INSPECTOR . 9/28/98 I � +RR, CITY OF SALEM, MASSACHUSETTS �L HEALTH AGENT * 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#484-07 DATE ISSUED: 9/28/2007 Property Located at: 50R Jefferson Avenue UNIT# Rear Owner/Agent: Carolina Barton Address: 945 Las Palmas City/Town: Irvine, CA Zip Code: 92602 24 Hour Phone: 978-307-2845 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. Y P Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates,whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. F R THE BOARD Off HEALTH JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETT BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR r 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 S0R UNIT# IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER C'APAW)A 8AeToA) MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS . L+4S -PALMAS ADDRESS CITY 7-91/4JE CITY CC2 9a6� RESIDENCE PHONE '/l/ 389-d136Z BUSINESS PHONE (24 HRS.) X07 2Ry5-J BUSINESS PHONE TOTAL NUMBER OF ROOMS:_ ROOM USE: 1. 5. 6.—T-8. _ THERE IS A TWENTY-FIVE ($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE DATE Z� INSSPE ORS USE ONLY DATE OF INITIAL INSPECTION / -&7_DATE OF REINSPECTION__ DATE OF ISSUANCE OF CERTIFICATE: d-Y--o DATE FEE PAID:_j_ff,?-'k -�� TYPE OF UNIT: DWELLING/OTHER__ C)"d _CHECK DATE5��k- —'057 NOTES: /O Sri ?to V CODE ENFORCEMENT INSPECTOR 9/28/98 h CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH a e, 120 WASHINGTON STREET, 4TH FLOOR Y SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#474-04 DATE ISSUED: 10/18/2004 Property Located at: 50 Jefferson Avenue UNIT#2 Owner/Agent: Carolina Barton Address: 50 Jefferson Avenue City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-744-7819 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. �pR THE BOARD OF HEALTH JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH(03 120 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 FIT E FOR HUMAN HABITATION". PROPERTY LOCATED AT 5 t (�a��I UNIT#-Z IS THIS UNIT DESIGNATED AS RIGHT �� LEFT FRONT BACK PLEASE CIRCLE ONE (g"OWNER/LESSE (g" loen MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS_h^L,fio. *? /,t& ADDRESS CITY�f4_ .'7 CITY RESIDENCE PHONE 97 ��BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1."_2. 4. 5.--6.-7. 8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE�.� = �._� DATE a t INSPECTORS USE ONLY DATE OF INITIAL INSPECTION O IX v ✓ DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE/O-1,P-D P DATE FEE PAID: / -�� "O TYPE OF UNIT: DWELLING OTHER_ CHECK#CHECK DATE /D NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, nkSSACHUSETT'S V BOARD OF HEAIM-I 120 WASHINGTON STREET 4"'FLOOR Public Health > PrtvrnG Pmmot<.Prvte[I. TTI.. (978) 741-1800 FAX (978) 745-0343 KIDII3ERLEY DRISCOLL health&salem.com I..:1RRY R,\iYiD1N,RS/RP;HS,CHO,CP-FS MAYOR I IE:v;I ri A(;RN r Domenica Ingemi Realty Trust 7/27/16 Peteringemi 36 Margin Street Salem, MA 01970 RE: 56 Jefferson Avenue Dear Domenica Ingemi Realty Trust It has come to our attention that you are renting units at 56 Jefferson Avenue,Salem, Massachusetts 01970 and our records indicate you have not obtained a Certificate of Fitness for these units. 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 through 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$50.00 check payable to the City of Salem is required for each unit inspected at the time of inspection. A property owner is required to pay gas and electricity for residential tenants if there is not a written letting agreement stating the tenant is responsible for those utilities and if the meter(s) records electricity and gas use which is not used exclusively by that tenant. The Department of Public Utilities has billed property owners for their tenant's entire utility bills retroactive to the date of initial occupancy in cases in which cross-metering has been proven to exist. For the Board of Health: Reply to: A,— Larry Ramdin Stephanie Holinko Health Agent Sanitarian CC: File CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH ,A �(/,/1 CO LIS 3 44� 120 WASHINGTON STREET, 4TH FLOOR l `�led,$(r I, SALEM, MA 01970 TEL. 978-741-1800 �� FAX 978-745-0343 STANLEY USOVICZ, JR. ,JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT e ��/(R� �`� 1 ✓ ' 01/14/2002 Vio+S A. (VA�40-F M.0..' Domenica Ingemi Realty Trust c/o Peter Ingemi 36 Margin Street Salem, MA 01970 "'bks u✓Ir"�- PROPERTY LOCATED AT 56 Jefferson Avenu UNIT # Basement Dear Sir/Madam: It has come to our attention, that you may be considers entinga dwe ng unit at the above address. ��PY1lp�hr!j � In accordance with Chapter 11, Article XIII of the City of Salem Code of Ordinances, Section 2-334,titled "Certificate of Fitness, " each dwelling unit must be inspected and certified prior .to allowing occupancy. The inspection will be conducted in accordance with 105 CMR; State Sanitary Code, Chapter I: General Administrative Procedures and 105 CMR 410.000; State Sanitary Code, Chapter II: Minimum Standards of Fitness . for Human Habitation. Please notify us if you do not intend to rent the unit. Please contact this department within 24 hours of receipt of this notice at 978-741-1800, to :schedule, an -appointment;..for,an inspection. our office hours are Monday thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7:00 p.m. and Friday 8:00 a.m. - 4 :00 p.m. Failure to comply with this procedure, may result in a fine of Twenty (20) dollars per day for every day that the dwelling unit is occupied without a Certificate of Fitness. A $25.00 check payable to the City of Salem is required for each unit inspected at the time of inspection. A property owner is required to pay gas and electricity for residential tenants if there isnot 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. J�R THE BOARD H TH REPLY TO oanne Scott, MPH,RS,CHO PABLO VALDEZ Health,Age nt; -_.„ ,, E ENFORCEMENT INSPECTOR JAM CIT`/OF SALEM 1-11EA1.E'I^) DEPT, o CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH j 120 WASHINGTON STREET, 4TH FLOOR CERT.# S27-OI R'I SALEM, MA 01970 TEL. 978-741-1800 FEE DATE: $25.00 2001 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 56 Jefferson Avenue UNIT #: 1 OWNER/AGENT: Stephan C. Inaemi 1 ADDRESS: 36 Margin Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-4220 AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS BEEN APPROVED AND IS IN COMPLIANCE WITH 10S CMR 410.000: MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE SALEM BOARD OF HEALTH AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED. MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410.000: MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . SECTION 410.400 (B) : DWELLING UNIT (R) 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. OR THE BOARD 0 HEALTH ( JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR i t CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAx 978-745-0343 W W W.SALEM.COM Kimberley Driscoll JOANNE SCOTT, MPH, RS, CHO Mayor HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#461-06 DATE ISSUED: 9/13/2006 Property Located at: 56 Jefferson Avenue UNIT# 1 Owner/Agent: Stephen C. Ingemi Address: 7 Fairfield Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 744-4220 An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter If' Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH JOANNE SCOTT, MPH, RS, CHO �� " p HEALTH AGENT C FORCEMENT INSPECTOR Cunt OF SALEM, MAs.ACHUSE M BOARD STREET- 120 WASHINGTON STREET. 4TH FLOOR SALEM. MA 01970 TEL, 978-741-1800 FAX 978-745-0943 JOANNE SCOTT, MPH, RS, CHO Kimberley Driscoll HEALTH AGENT 'i Mayor APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410-000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION'. PROPERTY LOCATED AT S� ei .— US� UNIT #—I IS THIS UNIT DESIGNATED A RIGHT LEFT FROM BACK PLEASE CIRCLE ONE OWNERlLESSER �_.. C. N►t MANAGERIAGENT No P.O- Box n No P.O.Box ADDRESSI � GO_I��f 4 4 h S'( _ ADDRESS CITY_�,A'6In _!..—._ NC1 . �_/_-_CITY, RESIDENCE PHONE_ {t� -4!t9-i-�_-BUSINESS PHONE (24 HRS.)____ BUSINESS PHONE—1- -gaa.d TOTAL NUMBER OF ROOMS: a ROOM USE: 1A1VoiiA-._jpA&^-- -3.tI<"A 4 ------ _.-_ I, THERE IS A TWENTY-FIVE(525.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION, APPLICANTS SIGNATURE l DATE_JIIa- -D -- j3SPECTORS USE ONLY DATE OF INITIAL INSPECTLONC 13 O �' _ DATE OF REINSPECT ION, ., . ... DATE OF ISSUANCE OF CERTIFiCATE:"�/_�.1j '° 4DATE FEE PAID ' TYPE OF UNIT DWELLING, _ OTHER_ CHECK !f IT7 CHECK DATE �� y NOTES. CODE ENFORCEMENT INSPECTOR 9I2fN98 CITY OF SALEM, MASSACHUSETTS .� BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR a SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT June 11, 2003 Patricia Walker 31 Fairview Road Salem, MA 01970 PROPERTY LOCATED 195 Jefferson Avenue Unit# 1 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$25.00 check payable to the City of Salem is required for each unit inspected at the time of inspection. A property owner is required to pay gas and electricity for residential tenants if there is not a written letting agreement stating the tenant is responsible for those utilities and if the meter(s) records electricity and gas use which is not used exclusively by that tenant. The Department of Public Utilities has billed property owners for their tenants' entire utility bills retroactive to the date of initial occupancy in cases in which cross-metering has been proven to exist. For the Boardof � Reply to Joanne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector co CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH i 120 WASHINGTON STREET, 4TH FLOOR . SALEM, MA 01970 TEL. 978-74 1-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 6- January 9, 2002 Patricia Welch 195 Jefferson Avenue#2 Salem, MA. 01970 Dear Patricia: On December 13, 2001, The Salem Board of Health conducted a Certificate of Fitness inspection at your property located at 195 Jefferson Avenue#1, Salem. It was discussed at that time that you would call this office when repairs to the window sash cords and locks were repaired so that a Certificate could be issued for that unit. Please call me upon receipt of this letter so that we can schedule a reinspection time and date. Thank you. Sincerely, Jeffrey Vaughan \ Sr. Sanitarian \ CITY OF SALEM, MASSACHUSETTS 3 �0 yp '� BOARD OFHEALTH S 120 WASHINGTON STREET, 4TH FLOOR j 10 SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO - - MAYOR HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT /e$ J e US A 1/e UNIT#_Z IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER IMrIGfG .� We lei MANAGER/AGENT SaPX P No P.O. Box No P.O. Box r ADDRESS l9S .T2 YSCI✓I 4Ve_ ADDRESS S9/EGly CITY CITY RESIDENCE PHONE�'A, NS; 7i�-1 .� BUSINESS PHONE (24 HRS.) BUSINESS PHONE 91_�- SVA, 209'- TOTAL NUMBER OF ROOMS: S ROOM USE: l jK/ji 2. 1) 3. LA 4_Z�_PC 5. 6.&t T 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. f APPLICANTS SIGNATURRI'C�' DATE /� I INSPECTORS USE ONLY DATE OF INITIAL INSPECTION d-)IJ/ 114/ DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: DATE FEE PAID: /a TYPE OF UNIT: DWELLING ✓OTHER_ CHECK# t/7/J CHECK DATE /j /��i NOTES: �vi-�a• / s.,�S�s ce.w� R.�o., .P<e,.. .fI COlIE'EPTFOReEMENT INSITECTOR 9/28/98 Inspection of _ / � �� f�7j-t � Date �Q A/0f Time J. Name Name Address Owner Tel. No. n Type of Inspection CC- ,T- e7 09�T..ie.fl' Inspector // U/�L�a�f`/9-✓ y ( ' I Remarks and Violations are listed below: e`6,e A r ZC a-e'a ke,,. /61r e TL &C 2ci1a,lt�/ 14A,L. LN/NG{ULv f T)s, /t /i/r/S�ec7iaN 4,4-' / d i Report Received by:'iJ/;� ��%'�'�`�"�./".e//Yfir/'�`- ;x4'E ^t�.nww n. ` CERT.# 396-00 , 99 FEE $25.00 DATE: 06/15/2000 m CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 195 Jefferson Avenue UNIT #: 1 OWNER/AGENT: Patricia Welch ADDRESS: 195 Jefferson Avenue CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-7297 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" . j 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. FORTHE 0� V JOANNE SCOTT,. MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR 1wv _ A CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tel:(978)741-1800 Fax:(978)740-9705 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED ATJ !ZS UNIT#j IS THIS UNIT DESIGNATED AS RIGHT /LEFT FRONT BACK PLEASE CIRCLE ONE WOWNER/LESSER Tr(C(q �-U&MANAGER/AGENT No P.O. B jNo P.O. Box ADDRESS GISI�S/�YI ✓C ADDRESS CITY SS P/r>/► CITY r' RESIDENCE PHONE 7WS_-?i-0 BUSINESS PHONE (24 HRS.) ,3_ ,a--& BUSINESS PHONE TOTAL NUMBER OF ROOMS: 5f ROOM USE: 1._11/ 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 THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE ' �- ,Gi �li� L DATE /� D INSPECTORS USE ONLY DATE OF INITIAL INSPECTION DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE"/S'- DATE FEE PAID: TYPE OF UNIT: DWELLINGOTHER_ CHECK# !!�2 6 3 CHECK DATE -aa NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETI'S IV BOARD OF HEALTH 120 WASHINGTON STREET 4"FLOOR PublicHealth > Prevent.Promote.Protect. TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL Itamdin@salem.com salem.com LARRY RAMIJIN,RS/RE:HS,CFiO,(:P-FS MAYOR Hi;1ALTH A(;FNP CERTIFICATE OF FITNESS CERTIFICATE#223-13 DATE ISSUED: 7/1/2013 Property Located at: 195 Jefferson Avenue UNIT#2 Owner/Agent: Patricia Welch Address: 195 Jefferson Avenue City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 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 LAR MDIN HEALTH AGENT SANITARIAN Chi ? fi�� I q2� �r53_�ti5o CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,e FLOOR TEL. (97s 741-lsoo KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR 1AANIDINO-SAMNI.cort LARRY Rk m N,RS/REHS,CHO,CP-FS HEALTH AGENT Application for Certificate of l,Ytness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" FEE: $50.00 PROPERTY LOCATED AT 1q5- -J C4'(C(f(f 50P1 � UNIT# a IS THIS UNITnD1S1GNATED AS RICHT LEFT FRONT OR BACK,PLEA/SE CIRCLE ONE OWNER/LESSER y o�ht Ct�L �} f JeICGt MANAGER/AGENT S+- nqe NO P.O.BOX n r ADDRESS�S J e{��Or/I /�V� ADDRESS 19J J --6W506 n�ee /�71"0f CITY,STATE,ZIP 5 i?✓A, I I� 61 f Z) CITY, STATE,ZIP SR f2 ivt ff lP�� RESIDENCEPHONEBH3II�£S3$P t k� BUSINESS PHONE 97k- 771rrN�d / TOTAL NUMBER OF ROOMS: J ROOM USE: 1. K 2. b P— 3. L 4. 5. j,/ , h qt h 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE A'T'THE TIME OF INSPECTION APPLICANT'S SIGNATURE /JtuG2 — DATE Inspectors use only p Date on initial inspection: 7 II (13 Date of reinspection: / d Date of issuance of certificate: Date fee paid: Type ofu 't: Dwelling Other Check# 14 q8 Check date: Notes: C fiO 5 t CO (� I v) i�I 0 -ci (( v1,0 I c¢,$bm CsSp�c��c� Code o c mcnt Inspector 4, CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH s 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 STANLEY J. USOVICZ, JR. FAx 978-745-0343 MAYOR W WW.SALEM.COM JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#632-05 DATE ISSUED: 10/17/05 Property Located at: 196 Jefferson Avenue UNIT# House Owner/Agent: Hasan & Lindita Zepaj Address: 6 Bragg Street City/Town: Peabody, MA Zip Code: 01960 24 Hour Phone: 978-744-1817 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 �J } ?ANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH � �( J • • 120 WASHINGTON STREET, 4TH FLOOR 'v SALEM, MA 01970 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 FITNESS FOR HUMAN HABITATION". 1 PROPERTY LOCATED AT 110 OQ�1 _ EQUE UNIT#--,v 5 e IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER I� �A�1d1IND1TIk MANAGERIAGENT No P.O. Box "2�p}t7 No P.O. Box ADDRESS (0 MhUt- 3T ADDRESS CITY PC#YC: .JVVI{[ U%0 CITY q RESIDENCE PHONEVV_q 11 pa b3)-Q?991,_BUSINFzSS PHONE BUSINESS PHONE r TOTAL NUMBER OF ROOMS: ROOM USE: 1.Ltkl . hl2. VIlCettAB. _4._&aaVO1X 5.��6. 7.-8.- THERE . 8.THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE _DATE /0/1/ /OS INSPECTORS L DATE OF INITIAL INSPECTION / D -11 DATE OF REINSPECTION _ DATE OF ISSUANCE OF CERTIFICATE ill v 6 DATE FEE PAID:/-O —1 L-Vv TYPE OF UNIT: DWELLINC� OTHERCHECK #�-� CHECK DATE%O / e 6 NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4."FLOOR PubPromote Health TEL. (978) 741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL lramdin@salem.com LARRY ILI MDIN,RS/R1--1 IS,CI 10,CV-FS MAYOR III \I;I'ItrlGri'.N'I' CERTIFICATE OF FITNESS CERTIFICATE#330-14 DATE ISSUED: 9/25/2014 Property Located at: 202 Jefferson Avenue UNIT#1 Owner/Agent: Roger Martin Address: 202 Jefferson Avenue City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-239-5760 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 DIN HEALTH AGENT SANITARIAN . * CITY OF SALEM, MASSACHUSETTS Bo ARD of 11E.1LTH 120 WASHINGTON STREET,4"'FLOOR P'ablicHealth PRvmG PfomaM.Pmmpf. TEJ_ (978) 741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL IrarnALnrt salem.com MAYOR LARRY R,-AMDIN,IiS�RI:{NS,CI-f0,CY-PS Hh<SLPIdAGF.:NP 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: $50.00 PROPERTY LOCATED AT O Z_. � S°n �< UNIT# n IS THIS UNf,IIT�DISIGNATED AS RIGHT LEFT FRONT OR BACK.PLEASE CIRCLE ONE, OWNER/LESSER RNOCIIe v _/LLjt� MANAGER/AGENT NO P.O. BOXADDRESS 2oZ- �e-�S c, it ADDRESS CITY, STATE,ZIP Sc,V 6, r'-k'4 d tF 7 a CITY, STA'T'E,ZIP_ RESIDENCE PHONE r7 '7$-2 3q - S 7 6 0 BUSINESS PHONE(24HRS)_ BUSINESS PHONE n.? UA e TOTAL NUMBER OF ROOMS: ROOM USE: 1. dww 2. 3. kv) &W,, 4. Ic,{�lw. 5. R-eJeQl,, 6.w& hfjDov , 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 ta. I� APPLICANT'S SIGNATURE l 4,. 9, DATE S' (t — j Inspectors use only Date on initial inspection: g�f114/ Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check# Check date: Notes: Cod6`Vnf6Wemcnt Inspector W LJ CITY OFSALEM, MASSACHUSETTS BOARD OFHL,11:fH 120 WASHINGTON STRI.srr 4'°'F1 OOR PublicHealth 1" r.. (978) 7414800 FAX (978) 745-0343 I0MBI-1ZLLY DRISCOLL kanadin e salem.corn L nIaIY RA19DIN,Rs/Iu;.ns,ci Ip,I':h-rs 1NLIYOR HftA:I'I1 ACLTNr CERTIFICATE OF FITNESS CERTIFICATE #375-12 DATE ISSUED: 9/13/2012 Property Located at: 202 Jefferson Avenue UNIT#2 Owner/Agent: Roger Martin Address: 202 Jefferson Avenue#3 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 LARO RAMDIN HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSE'FrS BOARD OF HEALTH 120 WASHINGTON STREET,4""FLOOR PublicHealth I'rewm.i'romme.F'rolecl. TEL. (978) 741-1800 FAx (978) 745-0343 KIMBERLEY DRISCOLL ltamdin@salem.com L!ARite-•RAn1uIN,RS/KERS,CF10,CY-FS MAYOR H fS.\l;I'I�I AG Ii;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: $50.00 PROPERTY LOCATED AT 20'�,_3e-P4Jsrnn AV er tp UNIT# 2— IS IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER 'Ro 4Gr y40_,r -6� MANAGER/AGENT /U A NO P.O. BOX nn ADDRESS QOZ "Serg�Su� A-,>< ugl-- 3 ADDRESS CITY, STATE, ZIP S a\e", pdA oil-7 O CITY, STATE,ZIP RESIDENCE PHONE 5"l$' 7-3 9-S7(o O BUSINESS PHONE(24HRS) BUSINESSPHONE NA TOTAL NUMBER OF ROOMS: s ROOM USE: 1,LVS R.eOA,2. 5eA 94.1 3. Beet iZU1 4. X-*k" 5. IWrt", 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 FEEIS PAYABLE AT THE TIIM_E_OF INSPECTION APPLICANT'S SIGNATURE Yucl Imo. 'rvt?a DATE / Inspectors use only Date on initial inspection: Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling II Other I Check#-UJ-5 // J Check date: Notes: PtCLIf IOlydDli) i� b II In Y'C&0 _ CIO pul dD (L(l �IYIg 'fie{ ayt n�lrs, T Cod&Edw6emert Inspector s CITY OF SALEM, MASSACHUSET"T"S BOARD OF HEALTI'I _ 120 WASHINGTON STREET,4'"FLOOR KIMBERLEY DRISCOLL -FEL. (978) 741-1800 MAYOR FAX(978) 745-0343 lramdin@salem.com LARRY RANIDIN,RS/REI IS,CMO,CP-ISS HEAL:CI-1 A(i i?N"r - CERTIFICATE OF FITNESS CERTIFICATE #43-12 DATE ISSUED: 1/31/2012 Property.Located at: 202 Jefferson Avenue UNIT#3 Owner/Agent: David Patton Address: 27 Tower Hill Road City/Town: North Reading, MA Zip Code: 01864 24 Hour Phone: 97&664-6511 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 RLARRY RAMDIN HEALTH AGENT CgDEENFORCE INSPECTOR P R CITY OF SALEM, MASSACHUSETTS • « BOARD OF HEALTH •�" 120 NV ASHINGTON STREET,4' FLOOR TEL. (978) 741-1800 1 IQMBERLEY DRISCOLL FAN(978) 745-0343 MAYOR LRAMDINQaSALEM.COM LARRY RAMMN,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..000 PROPERTY LOCATED AT 2 Z Te� ll r 5 0 h 1V{?2 V6 UNIT# �11S THIS UNITgDISISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE,CERCLE ONE OWNER/L /� 1J ll/t V 7 /� �O r J MANAGER/AGENT ADDRESS 2 ( lalNt r H( ll V\0a r%/l ADDRESS CITY, STATE,ZIP AVd rq� 4 F(AI Ifgg CITY, STATE,ZIP 0 00 RESIDENCEPHONE ✓/� �i l�p(7J ' 5// gBUSINESS PHONE (24HRS) PHONE TOTAL NUMBER OF ROOMS r1— �/ A �/ { ROOMUSE: Lff-fChln 2. UAT � 3.�" vin t-06q. f (off 5. 1tLo' 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 fWECTION l - sl - zalZ APPLICANT'S SIGNATURE DATE Inspectors use only Date on initial inspection: I'3I /I Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check# /,7� Check date: /l! 1 � CITY OF SALEM, MASSACIIUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4" FLOOR TFL. (978) 741-1800- KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR LRAM131 C:,SALEM.COM LARRY R-M131N,RS/RENS,CHO,CP-FS - HEA1.1B AGENT Release In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 4 10.000 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. Uwe expressly authorized the same and for MY/Out 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. 6 Iller 00 V') /0/* Tenant/Lessee r/ Owner/Lessor ZGZ Tt�3C�Scn S�. Z7 %GWIr 0�'�/C r��'rll�D J e✓a�� ((n01'� , �" ' 040 Address ( r Address ZOZ .1G �"tC�soh /y>/lnuG� /"/ �, 3 / %o �/ca✓� Address on unit to be inspected / - 3 067 Q Date Updated 5/23/11 CERT.;# 79-97 FEE $25.00 DATE: 02/11/97 CITY OF SALEM BOAPD OF HEALTH Salern. Massachusetts 01970-3928 JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET HEALTH AGENT TO:(508)741-1800 Fax:(508)740-9705 CERTIPICATF OF FITNESS PROPERTY LOCATED AT: 204 Jefferson Avenue UNIT k: 1 OWNER/AGENT: William WellSZ ADDRESS: 204 Jefferson Avenue CITY/TOWN: Salem MA ZIP CODE: 01970 24 HOUR PHONE: 740-0532 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 MiAY 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 V JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR Y ' Y r 6 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tei:(565)741-1800 APPLICATION FOR CERTIFICTE OF FITNESS Fax:(508)740-9705 IN ACCORDANCE WITH STATE SANITARY:'CODE, .CNAPTER II, IDS CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATIONS 1 PROPERTY LOCATED AT (�1�� J�'\ SQ ( �• /�Ue UNIT ,4 OWNER/LESSER ® CJC� �e � / MAN,.GER/`^ENT ADDRESS 2-17 G ° ��P ADDRESS CITY `s c%- /& X-7-7 i CITY ' RESIDENCE PHONE 7 7 o S Z BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 8 I 0 Q o✓Y72. AfWroo/Y1 3.G c/,-/7 4 . �f 5._ 6. t3a/ A 7» B. — THERE IS A TWENTY-FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SAI.EK 8}r,ALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION 7 APPLICANTS SIGNATURE DXFE G' ( INSPECTORS USE ONLY DATE OF INITIAL INSPECTION -j j t7 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: 7 DATE FEE PAID: TYPE OF UNIT: DWELLING OTHER NOTES: CODE ENFORCEMENT INSPECTOR , CERT.# 159-98 FEE $25.00 DATE: 03/25/98 J J CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 204 Jefferson Avenue UNIT #: 3 OWNER/AGENT: Georae W. Weil. III ADDRESS: 204 Jefferson Avenue CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-0506 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 y�THE �, BOARD OF HEALTH JOANNE SCOTT, MPH, RS,CHO HEALTH AGENT , CODE ENFORCEMENT INSPECTOR r 7. x { �9 GITY OF SALEMBOARD.OF HEALTH Salem,.Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(508)741-1800 APPLICATION FOR CERTIFICTE OF FITNESS Fax:(508)740-9705 IN ACCORDANCE WITH STATE SANITARV CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS'OF FITHESS.FOR HUMAN HABITATION". PRoPEETY LOCATED AT� �f'I<�e �SOn. ./JI V(� UNIT # F3 OWNER/LESSER(:=&'e-)Cg! _w, W e it . MANAGER/AGENT ADDRESADDRESS CITY CITY rRESIDENCE` PHONE . 7�/q-OS-06 BUSINESS PHONE (24 NRS.) BUSINESS ,PRONE / z-67 TOTAL NUMBER OF ROOMS' rj / ROOM USE:. I- �2.� 1I 3- Fed 5. TV 6. 7. 8. THERE IS A TWENTY-FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEK BEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTIONQ APPLICANTS SIGNATORE ._DATE (] - INSPECTORS USE ONLY DATE OF INITIAL INSPECTION::-y -5 DATE OF REINSPECTION _ DATE OF ISSUANCE OF CERTIFICATE: Cr DATE FEE PAID:_ = "_S _ . TYPE OF UNIT: DWELLING OTHER NOTES: CODE ENFORCEMENT INSPECTOR r.r..yc�' � ;...-+ ��x � � ., *:3 •.?,: - CERT.# ?9 97 . ? r ` 52 FEE 5. 5 00 zl '.. DA'T'E 01`/30/97 a�i�' Tp"r4„Y"PR:4M-W• :E c 8 li.' "u'IIh'6 R ,;' a '. t' ld n t C€TY OF SALEM BOARD OF HEALTH „ a 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: 2.13 Jefferson Avenue UNIT i: ,1 OWNER/AGENT: 'William Smith ADDRESS: 213 Jefferson Avenue CITY/TOWN: Salem, MA ZIP CODE: 01970- 24 HOUR PHONE: 745-7487 AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CI4R 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, "MINIKUM 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 VJOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR i CITY OF SALEM BOARD OF HEALTH Salem,Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(508)741-1800 APPLICATION FOR CERTIFICTE OF FITNESS Fax:(508)740-9705 IN ACCORDANCE WITH STATE SANITARY CODE, .CHAPTER II, 105 CMR 4 10.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY PROPERTY LOCATED AT UNIT # / OWNER/LESSER 011Z-lAl r k171`1 MANAGER/AGENT ADDRESS_-�1�y31p l�t��E'Sd✓U AV 6' ADDRESS CITY �% / l {YI'i /// CITY - --RES-bENCE PHONE 74' � BUSINESS PHONE (24 HRS.) BUSINESS PHONE -- TOTAL NUMBER OF ROOMS: IS p�a ROOM USE: I. �2. L 1 /C 3. 4 . 5. b. THERE IS A TWENTY-FIFE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO:TIE CITY OF SALEM HEALTH DEP NT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION r f APPLICANTS SIGNATU$E �� DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTIONV-- 3(9-q 7 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:�_3 ,DATE FEE PAID: TYPE OF UNIT: DWELLING ('� OTHER NOTES: CODE ENFORCEMENT INSPECTOR A F CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT _ Tel:(508)741-1800 Date: 11/18/96 Fax:(508)740-9705 Donna & William Smith, Jr. 213 Jefferson Avenue Salem, MA 01970 PROPERTY LOCATED' AT 213 Jefferson Avenue 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 0 HEALTH REPLY TO Joanne Scott, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR �oxar CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR �*•� a, SALEM, MA 01970 CERT.# 51-03 TEL. 978-741-1800 FEE $25 .00 FAX 978-745-0343 DATE: 02/06/2003 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 213 Jefferson Avenue UNIT 4 : 1 Front OWNER/AGENT: Donna Smith ADDRESS: 213 Jefferson Avenue CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-7487 AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410 .000 : MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE SALEM BOARD OF HEALTH AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED. MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410 .000 : MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . SECTION 410 .400 (B) : DWELLING UNIT (X) AND 410 .400 (C) : ROOMING UNIT MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: . NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR OCCUPANTS UNDER 6 YEARS OF AGE. FOR MORE INFORMATION CALL 978-741-1800. FOR THE BOARD OF HEALTH 07 X�A JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR I* CITY OF SALEM, MASSACHUSETTS ��6 '� BOARD OF HEALTH 3 i 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 ,� TEL. 978-741-1800 c�'� - 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 ATA L3 \,l 6`1:76—XSel1J All, UNIT#-j IS THIS UNIT DESIGNATED AS RIGHT LEFT ROP BACK PLEASE CIRCLE.ONE OWNER/LESSER I)e /II S o221T/�MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS 2?/3 \,7fjfFES4LU &Vi6ADDRESS_ CITYL EQ') L CITY RESIDENCE PHON/J?20 2 �h4,f2 BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROCiMS: ROOM USE: 1. K 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 THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATUR DATEJ .� INSPECTORS USE ONLY DATE OF INITIAL INSPECTION /—_a 7 y7 DATE OF REINSPECTION 2 DATE OF ISSUANCE OF CERTIFICATE: ;2- 6 O3 DATE FEE PAID:_// -d��__'U3 TYPE OF UNIT: DWELLIN OTHER_ CHECK#�.9�4CHECK DATE -00 NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 X CITY OF SALEM, MASSACHUSETTS ` BOARD OF HEALTH 120 WASHINGTON STREET,4"FLOOR TEL. (978) 741-1800 ICMBERLEY DRISCOLL FAX(978)745-0343 MAYOR DGR1?IiNI3AUM@SALEM.COM DAVID Gm-,1ENBAUM ACTING HF,AL'T'H AGENT CERTIFICATE OF FITNESS CERTIFICATE#241-10 DATE ISSUED: 5/17/2010 Property Located at: 230 Jefferson Avenue UNIT#2 Owner/Agent: Antonio Fernandez Address: 230 Jefferson Avenue City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-406-1239 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. FORM IE-BOARD-OF-HEAtiH— DAVID GW AUM ACTING HEALTH AGENT CO'E E ORCEMENT INSPECTOR K CITY OF SALEM, MASSACHUSETTS + • BOARD OF HEALTH 120 WASHINGTON STREET,4"FLOOR r.J TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGREENBAUM&ALEN 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: /$550..0,0 -PROPERTY LOCATED AT�P.1'{e(l5w F JY(:� UNIT# q. IS THIS UNIT DI NATED AS RIGHT LEFT FRONT OR BACK.PLEASE CIRCLE ONE OWNER/LESSER " 111 ?) pr-Oa 'I'.IPZ MANAGER/AGENT NO P.O. BOX ADDRESS S rs Il r7 ADDRESS CITY, STATE,ZIP�hM 119& D I CITY, STATE,ZIP RESIDENCE PHONEW S�/c! d/ a � BUSINESS PHONE(24HRS) S BUSINESS PHONE ! TOTAL NUMBER OF ROOMS:_ pp ROOM USE: IAP,-J"dM � 2. rUdl,/ 3. va n 4 4vins &M �pdrYl 6./3 �irean,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" TIME OF INSPECTION APPLICANT'S SIGNATURE DATE 4S / ?' /0 Inspectors use only Date on initial inspection: 'S11-7/10 Date of reinspection: Date of issuance of certificate: S 11-7116 Date fee paid: S N 1/0 Type of unit: Dwelling ✓ Other Check# 331 Check date: !J1-7110 Notes: �Vfn ddl�A hcf wa4e/' , r2n16ez. h4h4bulhs rn er_� dfoom Q o 4v lei n mo to io Gse Code Enforcement Inspector CITY OF SALEM, MASSACHUSETTS f BOARD OF HEALTH 120 WASHINGTON STREET,4".FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGREENBAUM l&ALEM.COM DAVID GREENBAUM, 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. Tenant/Lessee Owner/Lessor �- Addres Address 9-(4- Address o unit to be inspected Date Tenant Lead Law Notification What lead paint forms must owners of rental homes give to new tenants? Before renting a home built before 1978, the property owner and the new tenant must sign two copies of this Tenant Lead Law Notification and Tenant Certification Form,and the property owner must give the tenant one of the signed copies to keep.If any of the following forms exist for the unit,tenants must also be given a copy of them: lead inspection or risk assessment report; Letter of Compliance, or Letter of Interim Control. This form is for compliance with both Massachusetts and federal lead notification requirements. What is lead poisoning and who is at risk of becoming lead poisoned? Lead poisoning is a serious environmental hazard. It is most dangerous for children under six years old. It can cause permanent harm to young children's brain,kidneys, nervous system and red blood cells. Even at low levels, lead in children's bodies can slow growth and cause learning and behavior problems. Young children are more easily and more seriously poisoned than others,but older children and adults can become lead poisoned too. Lead in the body of a pregnant woman canhurt her baby before birth and cause problems with the pregnancy. Adults who become lead poisoned can have problems having children,and can have high blood pressure,stomach problems,nerve:problems, memory problems and muscle and joint pain. How do children and adults become lead poisoned? Lead is often found in paint on the inside and outside of homes built before 1978. The lead paint in these homes causes almost all lead poisoning in young children. The main way children get lead poisoning is from swallowing lead paint dust and chips. Lead is so harmful that even a small amount can poison a child. Lead paint under layers of nonleaded paint can still poison children,especially when it is disturbed, such as through normal wear and tear and home repair work. Lead paint dust and chips in the home most often come from peeling or chipping lead painted surfaces;lead paint on moving parts of windows or on window parts that are rubbed by moving parts;lead paint on surfaces that get bumped or walked on, such as floors,porches, stairs, and woodwork; and lead paint on.surfaces that stick out which a child may be able to mouth such as window sills. Most lead poisoning is caused by children's normal behavior of putting their hands or other things in their mouths.If their hands or these objects have touched lead dust,this may add lead to their bodies.A child can also get lead from other sources,such as soil and water,but these rarely cause lead poisoning by themselves. Lead can be found in soil near old, lead-painted homes.If children play in bare, leaded soil,or eat vegetables or fruits grown in such soil, or if leaded soil is tracked into the home from outside and gets on children's bands or toys, lead may enter their bodies. Most adult lead poisoning is caused by adults breathing in or swallowing lead dust at work, or, if they live in older homes with lead paint,through home repairs. How can you find out if someone is lead poisoned? Most people who are lead poisoned do not have any special symptoms.The only way to find out if a child or adult is lead poisoned is to have his or her blood tested. Children in Massachusetts must be tested at least once a year from the time they are between nine months and one year old until they are four years old. Your doctor,other health care provider or Board of Health can do this.A lead poisoned child will need medical care. A home with lead paint must be deleaded for a lead poisoned child to get well. What kind of homes are more likely to have lead paint? In 1978, the United States government banned lead from house paint. Lead paint can be found in all types of homes built before 1978: single-family and multi-family; homes in cities, suburbs or the countryside; private housing or state or federal public housing. The older the home, the more likely it is to have lead paint. The older the paint, the higher its lead content is likely to be. Can regular home repairs cause lead poisoning? There is a danger of lead poisoning any time painted surfaces inside or outside the home are scraped for repainting, or woodwork is stripped or removed,or windows or walls are removed.This is because lead paint is found in almost all Massachusetts homes built before 1978,and so many of Massachusetts'homes are old.Special care must be taken whenever home repair.work is done.No one should use power sanders,open flame torches,or heat guns to remove lead paint, since these methods create a lot of lead dust and fumes.Ask the owner of your home if a lead inspection has been done. The inspection report will tell you which surfaces have lead paint and need extra care in setting up for repair work, doing the repairs, and cleaning up afterwards. Temporarily move your family (especially children and pregnant women)out of the home while home repair work is being done and cleaned up. If this is not possible,tape up plastic sheets to completely seal off the area where the work is going on.No one should do repair work in older homes without learning about safe ways to do the work to reduce the danger of lead dust. Hundreds of cases of childhood and adult lead poisoning happen each year from home repair work. What can you do to prevent lead poisoning? • .Talk to your child's doctor about lead. " ■ Have your child tested for lead'at least once a year until he/she is four years old. ■ Ask the owner if your home has been deleaded or call the state Childhood Lead Poisoning Prevention Program (CLPPP)at 1-800-532-9571,or your local Board of Health. • Tell the owner if you have a new baby,or if a new child under six years old lives with you. • If your home was deleaded, but has peeling paint, tell and write the owner. If he/she does not respond, call CLPPP.or your.local Board of Health.' ■ Make sure only safe methods are used to paint or make repairs to your home,and to clean up afterwards. ■ If your home has not been deleaded, you can do some things to temporarily reduce the chances of your child becoming lead poisoned.You can clean your home regularly with paper towels and any household detergent and warm water to wipe up dust and loose paint chips. Rub hard to,get rid of more lead.When you are done,put the dirty paper towels in a plastic bag and throw them out The areas to clean most often are window wells, sills,and floors. Wash your child's hands often (especially before eating or sleeping) and wash your child's toys, bottles and pacifiers often. Make sure your child eats foods with lots of calcium and iron, and avoid foods and snacks that are high in.fat. If you think your soil may have lead in it,have:it tested.Use a doormatto help prevent dirt from getting into your home. Cover bare leaded dirt by planting grass or bushes, and use mats, bark mulch or other ground covers under swings and slides. Plant gardens away from old homes, or in pots using new soil. Remember,the only way to permanently lower the risk of your child getting lead poisoned is to have your home deleaded if it contains lead paint. How do you find out where lead paint hazards may be in a home? The only way to know for sure is to have a lead inspection or risk assessment done. The lead inspector will test the surfaces of your home and give the landlord and you a written report that tells you where there is lead in amounts that are a hazard by state law. For interim control, a temporary way to have your home made safe from lead hazards, a risk assessor does a lead inspection plus a risk assessment. During a risk assessment, the home is checked for the most serious lead hazards, which must be fixed right away. The risk assessor would give the landlord and you a written report of the areas with too much lead and the serious lead hazards. Lead inspectors and risk assessors have been trained, licensed by the Department of Public Health,and have experience using,the state-approved methods for testing for lead paint. These methods are use of a sodium sulfide solution, a portable x-ray fluorescence machine or lab tests of paint samples.You can get alist of licensed lead inspectors and risk assessors from CLPPP. In Massachusetts, what must the owner of a home built before 1978 do if a child under six years old lives there? An owner of a home in Massachusetts built before 1978 must have the home inspected for lead if a child under six years old lives there. If lead hazards are found, the home must be deleaded or brought under interim control. Only a licensed deleader may do high-risk deleading work, such as removing lead paint or repairing chipping and peeling Tenant Certification Form Required Federal Lead Warning Statement Housing built before 1978 may contain lead-based paint. Lead from paint,paint chips, and dust can pose health hazards if not managed properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre- 1978 housing, lessors must disclose the presence of known lead-based paint and/or lead-based paint hazards in the dwelling. Lessees must also receive a federally approved pamphlet on Iead poisoning prevention. The Massachusetts Tenant Lead Law Notification and Certification Form is for compliance with state and federal lead notification requirements. Owner's Disclosure (a)Presence of lead-based paint and/or lead-based paint hazards(check(I)or(ii)below): (I) Known lead-based paint and/or lead-based paint hazards are present in the housing(explain). (ii)_Owner/Lessor has no knowledge of lead-based paint and/or lead-based paint hazards in the housing. (b)Records and reports available to the owner/lessor(Check(i)or(ii)below): (i) Owner/Lessor has provided the tenant with all available records and reports pertaining to lead based paint and/or lead-based paint hazards in the housing(circle documents below). Lead Inspection Report; Risk Assessment Report; Letter of Interim Control; Letter of Compliance , (i) Owner/Lessor has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing. Tenant's Acknowledgment(initial) (c) t/ Tenant has received copies of all documents circled above. (d) Tenant has received no documents listed above. (e) Tenant has received the Massachusetts Tenant Lead Law Notification. Agent's Acknowledgment(initial) -(i) Agent.has informed the owner/lessor of the owner'sriessor's obligations under federal and state law for lead- based paint disclosure and notification and is aware of his/her responsibility to ensure compliance. . Certification of Accuracy The following parties have reviewed the information above and certify,to the best of their knowledge, that the information tthey have provided is true and accurate. 9 w A � .5-/;;l - > a w r ssor - Date Owner/Lessor Date Tenant Date Tenant Date Agent Date Agent Date O er//MM//anaging Agent Information for Tenant(Please Print): 2. Name City/Town zip Telephone I(owner/managing agent)certify that I provided the Tenant Lead Law Notification/Tenant Certification Form and any existing Lead Law documents to the tenant,but the tenant refused to sign this certification. j The tenant gave the following reason: The Massachusetts Lead Law prohibits rental discrimination,including refusing to rent to families with children or evicting families with children because of lead paint. Contact the Childhood Lead Poisoning Prevention Program for information on the availability of this form in other languages. Tenant and owner must each keep a completed and signed copy of this form. C[,PPP95-17 smsrot lead paint.You can get a list of licensed deleaders from the state Department of Labor and Workforce Development. Deleaders are trained to use safe methods to prepare to work, do the deleading, and clean up. Either a deleader, the owner or someone who works for the owner who is not a licensed deleader can do certain other deleading and interim control work. Owners and workers must have special training to perform the deleading tasks they may do. After the work is done,the lead inspector or risk assessor checks the home.He or she may take dust samples to test for lead,to make sure the home has been properly cleaned up. If everything is fine, he or she gives the owner a Letter of Compliance or Letter of Interim Control.After getting one of these letter's,the owner must take care of the home and make sure there is no peeling paint. What is a Letter of Compliance? It is a legal letter under state law that says either that there are no lead paint hazards or that the home has been deleaded.The letter is signed and dated by a licensed lead inspector. What is a Letter of Interim Control? It is a legal letter under state law that says work necessary to make the home temporarily safe from serious lead hazards has been done. The letter is signed and dated by a licensed risk assessor. It is good for one year, but can be renewed for another year. The owner must fully delead the home and get a Letter of Compliance before the end of the second year. Where can I learn more about lead poisoning? Massachusetts Department of Public Health Your local lead poisoning prevention program Childhood Lead Poisoning Prevention Program(CLPPP) or your local Board of Health (For more copies of this form,as well as a full range of information on lead poisoning prevention,tenants'rights U.S.Consumer Product Safety Commission and responsibilities under the MA Lead Law,how to (Information about lead in consumer products) clean lead dust and chips,healthy foods to protect your 1-800-638-2772 children,financial help for owners,safe deleading and renovation work,and soil testing.) U.S.Environmental Protection Agency,Region 1-800-532-9571 (Information about federal laws on lead) 617-918-1524 Massachusetts Department of Labor and Workforce Development National Lead Information Center (List of licensed deleaders) (General lead poisoning information) 617-969-7177, 1-800-425-0004 1-800-424-5323 1 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4".FLOOR PublicHeaith TEL. (978)741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL Iramdin o,salem.com L,,-UiRY RA 6Il)IN,RS/RN IS,Cl 10,CP-16 MAYOR H1 AGENT CERTIFICATE OF FITNESS CERTIFICATE#399-14 DATE ISSUED: 11/4/2014 Property Located at: 235 Jefferson Avenue UNIT# 1 Owner/Agent: Jamie Santos Address: 5 Jayne Circle City/Town: Peabody, MA Zip Code: 01960 24 Hour Phone: 508-641-7032 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.. —AFC BO F HEALTH LARRY RAMDIN HEALTH AGENT SANITARIAN 4-o �S CITY OF SALEM, MASSACHUSETTS + e BOARD OF HEALTH 120 WASHINGTQN STREET,4"'FLOOR TF-L.(978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR LRAMDIN�SAU GM COM / LARRY RAMDIN,RS/REI-IS,(:HO,CF-FS HEALTFt 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--d 3 S J E Yf f SO�L Le UNIT# IIS THIS UNIT DLSIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER MANAGER/AGENT 5 NO P.O. BOX i ADDRESS S vh f' C, rc 16 ADDRESS CITY, STATE,ZIP l 6,-, CITY, STATE,ZIP M�o (� G RESIDENCE PHONE S-69 - 6 `ll - 26 3 BUSINESS PHONE(24HRS) BUSINESS PHONE .S 6 C` 6W TOTAL NUMBER OF ROOMS: ROOMUSE: 1 66 ru'�� 2. 3. k,l,�l<^ 6. 7. 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 17- "Z&� ll // Insnectors use only Date on initial inspection:Ty l (L Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check#_Check date: 14 Notes: ()yN C)X.( RaM 22 d4 5`eu pivl.c �Lt'CLa Code EnYbrc4pint Inspector e n n CERT.# 370-98 ,. FEE $25.00 3 1�ft!F DATE: 06/18/98 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS, CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978).740-9705 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 236 Jefferson Avenue UNIT # : House OWNER/AGENT: Jemay Realty Trust c/o Marie Thibault ADDRESS: 7 Louis Road CITY/TOWN: Danvers, MA ZIP CODE: 01923 24 HOUR PHONE: 774-4134 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 TI, "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 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 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 3/o �.QY (,.e 3�a P-Q ,, UNIT#IS THISAU NIT DESIGNATEDQS( LEFT FRONT BACK PLEASE CIRCLE ONE OWNE LESSE ✓Yvi 0�^ MANAGER/AGENT ADDRESS 'Zo-nAn ADDRESS CITY /Y»" d / 5a3 CITY RESIDENCE PHONE97k-7'7V -413 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 THIS FEE IS PAYABLE AT THE TIME OF INSPECTION 6 fP APPLICANTS SIGNATURE a.,-�x. �• DATE g � INSPECTORS USE ONLY DATE OF INITIAL INSPECTION L —1 `l DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE -17CPDATE FEE PAID:jC j TYPE OF UNIT: DWELLINGS OTHER NOTES: CODE ENFORCEMENT INSPECTOR 5/19/98 c CERT.# 786-97 , 3 " FEE $25.00 X11. . SIF DATE: 11/26/97 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET HEALTH AGENT - Tel:(978)741-1800 Fax:(978)740-9705 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 237 Jefferson Avenue UNIT #: 2 OWNER/AGENT: James & Therese Hudson .ADDRESS: 237- Jefferson Avenue CITY/TOWN: Salem. MA ZIP CODE: 01970 24 HOUR PHONE: 744-9025 AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410.000: MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE SALEM HEALTH DEPARTMENT AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED. MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410 .000: MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . SECTION 410.400 (B) : DWELLING UNIT (X) AND 410.400 (C) : ROOMING UNIT MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: . NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR OCCUPANTS UNDER 6 YEARS OF AGE. FOR THE BOARD OF HEALTH /J JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR c y CITY OF SALEM BOARD OF HEALTH j Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tei:(508)741-1800 APPLICATION FOR CERTIFICTE OF FITNESS Fax:(508)740-9705 IN ACCORDANCE WITH STATE SANITARY' CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT ,�2TLOj 4±".�� rst&,.t t�Y UNIT I OWNER/LESSER�fj JI-n,.e- -^ 2 //1 E i�$ f faf5y o MANAGERJAGENT —. .._... ADDRESS ADDRESS d / CITY Q/' C� `j CITY 'RESIDENCE PHONE - 9 o �j` BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: j f ROOM USE: 1. iTGLn 2. L`v+hq 3. fje,� 4. boj 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 SIGNATDREi'�K%�� •— INSPECTORS USE ONLY DATE OF INITIAL INSPECTION: ,2L DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: j ��7 _DATE FEE PAID: jfq TYPE OF UNIT: DWELLING_ OTHER NOTES : CODE ENFORCEMENT NSPECTOR 0 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 CERT.# 169-02 - FEE TEL. 978-741-1800 3/27/ 03/27/2002 2002 FAX 978-745-0343 DATE: 03/27/ STANLEY USOVICZ, JR. ,JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 237 Jefferson Avenue UNIT #: 3 OWNER/AGENT: James Hudson ADDRESS: 237 Jefferson Avenue CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-9025 AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410.000: MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE SALEM BOARD OF HEALTH AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED. MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410.000 : .MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . SECTION 410.400 (B) : DWELLING UNIT (X) AND 410.400 (C) : ROOMING. UNIT MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: . NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR OCCUPANTS UNDER 6 YEARS OF AGE. FOR MORE INFORMATION CALL 978-741-1800. FOR THE BOARD OF HEALTH JO`s ANNE S OTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR r' u CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • r 120 WASHINGTON STREET, 4TH FLOOR 1 .a SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. ,JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT 3 10 fly R000 Vif� UNIT# IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER T m e e 11(7 4 S09) MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS Za,0�esnu fav 0,ADDRESS CITY CITY RESIDENCE PHONE? 7-c76S BUSINESS PHONE (24 HRS.) ra 2 BUSINESS PHONE TOTAL NUMBER OF ROOMS:_ ROOM USE: 1./lac ✓2. 3 T), 5.1?e- 6.517. -8. THERE IS A TWENTY-FIVE"($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE- %` �� DATE J'd INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 3 ' Z o Z- DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:3 J 7-0"2- DATE FEE PAID: 3 - y7 "j2 TYPE OF UNIT: DWELLING;�OTHER_ CHECK# 161 CHECK DATE _7-� Z NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 ✓ a CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • a 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVIC7, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 03/13/2002 James & Therese Hudson 237 Jefferson Avenue Salem, MA 01970 PROPERTY LOCATED AT 237 Jefferson Avenue UNIT # 3 Dear Sir/Madam: It has come to our attention, that you may be considering renting a dwelling unit at the above address. In accordance with Chapter 11, Article XIII of the City of Salem Code of Ordinances, Section 2-334,titled "Certificate of Fitness," each dwelling unit must be inspected and certified prior to allowing occupancy. The inspection will be conducted in accordance with 105 CMR; State Sanitary Code, Chapter I: General Administrative Procedures and 105 CMR 410.000; State Sanitary Code, Chapter II: Minimum Standards of Fitness for Human Habitation. Please notify us if you do not intend to rent the unit. Please contact this department within 24 hours of receipt of this notice at 978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7:00 p.m. and Friday 8:00 a.m. - 4 :00 p.m. Failure to comply with this procedure, may result in a fine of Twenty (20) dollars per day for every day that the dwelling unit is occupied without a Certificate of Fitness. A $25.00 check payable to the City of Salem is required for each unit inspected at the time of inspection. A property owner is required to pay gas and electricity for residential tenants if there is not a written letting agreement stating the tenant is responsible for those utilities and if the meter(s) records electricity and gas use which is not used exclusively by that tenant. The Department of Public Utilities has billed property owners for their tenants' entire utility bills retroactive to the date of initial occupancy in cases in which cross-metering has been proven to exist. OR THE BOARD F HEALTH REPLY TO Joanne Sc tt, MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR X 6. CERT.# 515-98 FEE $25.00 DATE: 08/18/98 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 251 Jefferson Avenue UNIT # : 1 OWNER/AGENT: Donna Schutz ADDRESS: 91 North Street CITY/TOWN: Danvers, MA ZIP CODE: 01923 24 HOUR PHONE: 777-5505 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. qv-f "C4-Ae�lell� FOR THE BOARD OFHEALTH LA"" JOANNE SCOTT, MPH, RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR 3 gj 3-7 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 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 FORHUMAN HABITATION". / PROPERTY LOCATED AT d20 JE& F Oh Alto UNIT# IS THIS UNIT DESIGNATED AS RIGHT GHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNEWLESSER 00n4k SfG� .Z MANAGER/AGENT ADDRESS9(/ A/0{��n ��' ADDRESS CITY La)vy Pj-,� CITY 1Qf S RESIDENCE PHONE 4719`77-7 7 5549.S BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3. 4. 5. 1// 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 f� APPLICANTS SIGNATURE /� n� DATE 1 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION ,-Y P DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:'!8-f8 DATE FEE PAID:'/re -�Y TYPE OF UNIT: DWELLING OTHER__ NOTE 7 CODEENFORCEMENTINSPECTOR 5/19/98 L ! R CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(508)741-1800 Date: 10/21/97 Fax:(508)740-9705 Donna Marie Lach 91 North Street Danvers, MA 01923 PROPERTY LOCATED. AT 251 Jefferson Avenue UNIT # I .--.... ..-...-.._.-_.._._._.--- Dear SiryMadam: 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 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. SFE 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 4. CITY OF SALEM, MASSACHUSETTS ;. BOARD OFHEALTH S 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 STANLEY J. USOVICZ, JR. FAx 978-745-0343 MAYOR WW W .SALEM.COM JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT 8/11/05 Donna Marie Lach 91 North Street Danvers, MA 01923 PROPERTY LOCATED AT 251 Jefferson Avenue Unit 2 Dear Sir/Madam: It has come to our attention, that you may be considering renting a dwelling unit at the above address. In accordance with Chapter 11,Article XIII of the City of Salem Code of Ordinances, Section 2- 334, titled "Certificate of Fitness," each dwelling unit must be inspected and certified prior to allowing occupancy. The inspection will be conducted in accordance with 105 CMR 410.000; State Sanitary Code, Chapter 11: Minimum Standards of Fitness for Human Habitation. Please notify us if you do not intend to rent the unit. Please contact this department within 24 hours of receipt of this notice at 978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday thru Wednesday from 8:00 a.m. —4:00 p.m. Thursday 8:00 a.m. to 7:00 p.m. and Friday 8:00 a.m.— 12:00 p.m. Failure to comply with this procedure, may result in a fine of Twenty($20.00)dollars per day for every day that the dwelling unit is occupied without a Certificate of fitness. A$25.00 check payable to the City Of Salem is required for each unit inspected at the time of inspection. A property owner is required to pay gas and electricity for residential tenants if there is not a written letting agreement stating the tenant is responsible for those utilities and if the meter(s) records electricity and gas use which is not used exclusively by that tenant. The Department of Public Utilities has billed property owners for their tenant's entire utility bills retroactive to the date of initial occupancy in cases in which cross-metering has been proven to exist. F r the Board of Hea h Reply to '1C�K�Gi oanne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 1/12/05 Shane P. McCarthy 8 Lawrence Street Salem, MA 01970 PROPERTY LOCATED AT 252 Jefferson Avenue 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. the Board of Heal t7 Reply to {:_,oma,'. Joanne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 .� TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT May 8, 2003 Zgigniew Kicinski 8 Summit Avenue Salem, MA 01970 PROPERTY LOCATED AT 252 Jefferson Avenue Unit#2 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 ��ON�IT 3 y, CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS, CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 10/18/2000 Fax:(978)740-9705 Zgigniew Kicinski 8 Summit Avenue Salem, MA 01970 PROPERTY LOCATED AT 252 Jefferson Avenue UNIT # 2 Left Dear Sir/Madam: It has come to our attention, that you may be considering renting a dwelling unit at the above address. In accordance with Chapter 11, Article XIII of the City of Salem Code of Ordinances, Section 2-334,titled "Certificate of Fitness, " each dwelling unit must be inspected and certified prior to allowing occupancy. The inspection will be conducted in accordance with 105 CMR; State Sanitary Code, Chapter I: General Administrative Procedures and 105 CMR 410.000; State Sanitary Code, Chapter II: Minimum Standards of Fitness for Human Habitation. Please notify us if you do not intend to rent the unit. Please contact this department within 24 hours of receipt of this notice at 978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday thru Wednesday from 8 :00 a.m. - 4 :00 p.m. Thursday 8:00 a.m. - 7:00 p.m. and Friday 8:00 a.m. - 4 :00 p.m. Failure to comply with this procedure, may result in a fine of Twenty (20) dollars per day for every day that the dwelling unit is occupied without a Certificate of Fitness. A $25 .00 check payable to the City of Salem is required for each unit inspected at the time of inspection. A property owner is required to pay gas and electricity for residential tenants if there is not a written letting agreement stating the tenant is responsible for those utilities and if the meter(s) records electricity and gas use which is not used exclusively by that tenant. The Department of Public Utilities has billed property - owners for their tenants' entire utility bills retroactive to the date of initial occupancy in cases in which cross-metering has been proven to exist . OR THE BOARD 9P HEALTH REPLY TO oanne Sco t, MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR