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JEFFERSON AVENUE 253-299 JEFFERSON AVENUE 253-299 w i CITY OF SALEM, MASSACHUSETTS • e BOARD OF HEALTH 120 WASHINGTON STREET,4".FLOOR TEL. (978) 741-1800 KIMBLRLEY DRISCOLL FAX(978) 745-0343 MAYOR nGRr.GNBAUM@SAr.EM.COM DAVID GRI.A NBAUM ACTING HIa.A1..CI-I A(;ENT CERTIFICATE OF FITNESS CERTIFICATE#39-10 DAT _-_ E ISSUED:002W-0 Property Located at: 255 Jefferson Avenue UNIT# 1 Owner/Agent: Jean Shea Budrow Address: 1 South Hillside Street City/Town: Stoneham, MA Zip Code: 02180 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 DAVID GREENB� ACTING HEALTH AGENT CODEF RCEMENT INSPECTOR � .h Undue a OT - C q . r 33q - 7,31V CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • 120 WASHINGTON STREET,4°1 FLOOR /1 AD 1 D TEL. (978) 741-1800 L✓�I KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGRE1,NBAU?,1@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 .� / " /7 6) UNIT#-4 ' / IS THIS UNIT //DISIGNATED AS RIGHT LEFT FRONT OR BACKPLEASE CIRCLE ONE (�pliULc� MANAGER/AGENT OWNER/LESSER. I )i/ h�Cc NO P.O. BOX pp ADDRESS 9o26 �� AA/,o4– ADDRESS CITY, STATE,ZIP )'7 A um / 1 /- CITY, STATE,ZIP RESIDENCE PHONE '7��– 5 y `69-31 BUSINESS PHONE(24HRS) j / BUSINESS PHONE l W G� 3`I 731 TOTAL NUMBER OF ROOMS:— ROOM OOMS:ROOM USE: 1. 2 ✓Z 3 Z-/Z, 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 F IS PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE f DATE Inspectors use only Date on initial inspection: oZ Ia I, 0 Date of reinspection: Date of issuance of certificate: a o Date fee paid: N D R9" U/1(n r/ q war Type of unit: Dwelling ✓Other Check# �J Check date: A) �A Notes: U. U Ufn inn-�cY�on el�c�((<cvC l,la,� �n -F ��- bedra�m lJ� Code E o cement Inspector r r ry City of Salem, Massachusetts 11": 1111W Board of Health ` 120 Washington Street, 4th Floor, Salem, i th t MA 01970 Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHo Mayor health@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE#: GHL-17-311 DATE ISSUED: 9/19/2017 Property Located at: 255 JEFFERSON AVENUE UNIT#1 Front Owner/Agent: Jean Budrow Address: 209 Rice Avenue City/Town: Revere, MA Zip Code: 02151 24 Hour Phone:(781) 454-6239 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation'. Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates,whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age. E'Z - Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CITY OF.SALEM, MASSACHUSET fS IV BOARD OF HE-\LTH 120 WASHINGTON STREET,4"' FLOOR PablicHeatth Prevent.Promote.Protect. TEL. (978) 741-1800 FAX (978) 745-0343 KIMBERLEY DRISCOLL lramdingsalem.com MAYOR L:ARRI R;AMDIN,RS/RICI-IS,CtK),(:Y-FS HP,,\Ln I.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 o2 SS A01 , RA- Dl Q3�0-UNIT#� IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR B�PLEASE CIRCLE ONE OWNER/LESSER J CAO $UdRca j MANAGER/AGENT NO P.O.BOX ADDRESS �D9 2fyl� ADDRESS CITY, STATE,ZIP RFU£PF CITY, STATE,ZIP 0o2/5/ RESIDENCE PHONE �S7� pa39 BUSINESS PHONE(24HRS) BUSINESS PHONE �A'� TOTAL NUMBER OF ROOMS: 5 ROOM USE: 1. ICi4r IPA 2. 1i vo%S ports 3. B.-ACCIr 4. W%206rn 5. I `f/ilio6n� 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE I PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATE 09j!�!7 aD/� �—� Lectors use only Date on initial inspection: Date of reinspection: Date of issuance of certificate: Date fee paid:�� Type of unit: Dwelling Other Check# 912- heck date: 0 Notes: �J=—{��11��w�nwc� 1S ((A Code Enforcement Inspector � LI CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR PbhQ1Ith Prevepe_Pmmote.Protect. TEL. (978) 741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL lram(iin@salem.com MAYOR LA.R12Y RAMUIN,RS/1213HS,(IIO,CP-F5 HI3:\CTT I 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/our 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 loss or injury sustained of whatever nature and description occasioned by my/our absence during said inspection. Tenant ess A P Owner/Lessoraim) su "-p(U aSs Jf, I�sacy4u C� fF a©9 c res AOL- Address Sim 01q-7D Address Address on unit to be inspected- -- Date Updated 523/11 OONDtT,� t� City of Salem, Massachusetts 9 Board of Health 120 Washington Street, 4th Floor, Salem, P11bliCHe..AIth MA 01970 Prevent. Promote. Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS,CHO Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE #: GHL-16-16 DATE ISSUED: 1/15/2016 Property Located at: 255 JEFFERSON AVENUE UNIT#1 Rear Owner/Agent: Jean Budrow Address: 209 Rice Avenue City/Town: Revere, MA Zip Code: 02151 24 Hour Phone:(781) 454-6239 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH O� Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN , CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4m FLOOR TEL (978)741-1800 KIMBERLEY DRISCOLL FAX(97S)745-0343 MAYOR 1 AA u IN AI_F qm LARRY RANDIN,RS/RIiIdS,010,CP-1S HrIArm AGJNT Application for Cert leate 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 �c �� L�� i�C Ur IS THIS UNIT DISIG/�NATID AS IR GHT LEFT FRONT OR RC PLEASE CIRCLE ONE OWNDW,ESSER I�Qn 1Cf/Y�CP� MANAGER/AGENT NO P.O.BOX ADDRESS�I (camI(1P ADDRESS n CrrY, STATE,ZIP Re oe CITY,STATE,ZIP RESIDENCE PHONE C) L—.V�l�� BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. L 2. /Q i-1 3 R 2 4 S 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CrrY OF SALEM BOARD OF HEALTH THIS FEE IS PAIR, LE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE PAI r/� �. �— - DATE d/ Inspectors use only Date on initial inspection:-01�1Date of reinspection: Date of issuance of certificate: l Y2,OL6 Date fee paid: 41/ 2n16 Type of/unit: Dwrelling Othea I 1Check# 12 q Clheek (date: Q Z/1.Z/2a Le 1/ 7 Notes: Ia^ kOt � kn AownfIcn reekeAe A K,14Y1Grn^ 9;y7k go+waY(:r Lgh*czclure— Q ove 1J✓0F _�'or kifc, en cAnnd lJ 4rynm si,, k, LI-900F) #9emmt pector NO. DATE I I l RECEIVED FROM A I2-,11 �rr+e i DOLLARS .51A,A J XLH Account Total $ Amoi{nt Paid Balance Due $ %9nat6rev / u 'M r .y CITY OF SALEM, MASSACHUSETTS • BOARD alt HEATTi t 120 WASHINGTON STREET,4 FLOOR TF-L. (978)741-1800 KSNiBERLEY DRISCOLL FAN(978)745-0343 MAYOR 1NAANCINI SNIF\ACONE JANET MANCINI ACTING HEAI.171 AGI7.N'I' CERTIFICATE OF FITNESS CERTIFICATE#628-08 DATE ISSUED: 12/16/2008 Property Located at: 255 Jefferson Avenue UNIT#2 Owner/Agent: Jean Shea Budrow Address: 1 South Hillside Street City/Town: Stoneham, MA Zip Code: 02180 24 Hour Phone: An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II" Minimum Standards of Fitness for Human Habitation". Therefore,this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates,whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. F RTH BO R OF HEALTH , I h� :�j JAN T MANCINI ACTING HEALTH AGENT CODE ENFORCEMENT NSPECTOR CITY OF SALEM, MASSACHUSETTS ( AJ25D ' • BOARD OF HEALTH 120 WASHINGTON STREET,4b°FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR IDIONNEna SALEM.COM JANET DIONNE, ACTING HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION." FEE: $50.00 PROPERTY LOCATED AT C)6�5- /��/ZJ �l, UNIT# OV- IS THIS UNIT DISIG,,NDDATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER ,+A) .S A5� [amu a) MANAGER/AGENT NO P.O. BOX ADDRESS ADDRESS iVF11W'V CITY, STATE,ZIP S��sL 4�1 CITY, STATE,ZIP Dales RESIDENCE PHONE T 9�.q S4-49P-0 BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS:_ ROOM USE: 1.Kl - Cc4e4 2 L /-�- 3 SA 4 Q 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 FEk IS PAYABLE AT THE/TIME OF INSPECTION APPLICANT'S SIGNATURE /e DATE? e Inspectors use only Date on initial inspection: )7-- 1 lc-e%' Date of reinspection: Date of issuance of certificate: ► 2- V -a Y Date fee paid: Type of unit: Dwelling ✓ Other Check#_Check date: I L- Sr Notes: Oq TAy Y ode Enforcement Inspector CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120WASIJINGTONSTREET•,4.".FLOOR �b.1CmHe8I�1. -- . . . TEL. (978) 741-1800 FAZ(978) 745-0343 KIMBERLEY DRISCOLL Iramdin@salem.com LARRY RAMll1N,RS/Itlil-IS,CFO,Cl [S MAYOR Hi ,\j:n-1 AG I;NT CERTIFICATE OF FITNESS CERTIFICATE#465-14 DATE ISSUED: 12/16/2014 Property Located at: 255 Jefferson Avenue UNIT#3 Owner/Agent: Jean Budrow Address: 1 South Hillside Street City/Town: Stoneham, MA Zip Code: 02180 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 incompliance 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 e. -0J4LzL LARW RAMDIN q1" zI HEALTH AGENT ANITARIAN CITY OF SALEM, MASSACHUSETTS « BOARD OF HEALTH -�- 120 WASHINGTON STREET,4°'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR I.RAmD1N=SAJXM.COM LARRY R;\MDIN,RS/RVI IS,CI 10,(:P-ISS HE,Ai xi i AG i xi, Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" a 55FEE: $50.00 PROPERTY LOCATED e 0- 29,54 � �1 UNIT# 3 IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER JEl4t) U /1/ Lb MANAGER/AGENT ADDRESS7� ou / � SIOf S-7( ADDRESS CITY, STATE,ZIP TDyEiIFfY/ll CITY, STATE, ZIP AI& 03/g 0 RESIDENCE PHONE 22 9 BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS:— ROOM OOMS:ROOM USE: 1. kip 2. 1-)K 3. kS R 4. ISR 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 PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE ac a DATE adO/y Inspectors use only Date on initial inspection: 10,1 I6 N4 Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check# Check date: Notes: Cod rc ment Inspector i o n CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET 4"FLOOR Pab11Cl3ealth, -- > r.e..m. r. n, e.r.meei TEL. (978) 741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL Iramdin@salem.com LARRY'RANt1)IN,Rti/RI3I-IS,Clio,CP-1'S MAYOR HL'.AI:I'll i1C:EN':f Release In accordance with Massachusetts General Laws Chapter 11 l; Code of Massachusetts Regulations 410.000 et. Seq. ; State Sanitary Code Chapter II and Article XIII of the City of Salem Ordinance, undersigned owner/lessor and tenant/lessee of a unit of residential property, hereby authorize the Salem Board of Health or its authorized agents to inspect the residence identified below in accordance with the aforementioned statutes, regulations and ordinances. In the event it is necessary that said inspection be done in my/out absence. I/we expressly authorized the same and for my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of Health and its authorized agents from any lose or injury sustained of whatever nature and description occasioned by my/out absence during said inspection. Tenant/Lessee Owner/Lessor Address Address Address on unit to be inspected Date Updated 5/23/11 �ONUIT c �. CERT.# 270-01 _M FEE $25 .00 _ DATE: 05/25/2001 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO HEALTH AGENT Tel: (978)741-1800 Fax: (978)740-9705 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 255 Jefferson Avenue UNIT #: 3 Front OWNER/AGENT: Joan Price ADDRESS: 4 Warren Road CITY/TOWN: Marblehead, MA ZIP CODE: 01945 24 HOUR PHONE: 631-7056 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 _ (9AL&VJOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR r vg�*.ynnt C CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tei:(978)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 ATc�FXto i✓ d' UNIT# 3 IS THIS UNIT DESIGNATED AS RIGHT E T B G PLEASE CIRCLE ONE OWNERILESSER:Jt�itn/�E7 MANAGER/AGENT No P.O. Boxf No P.Q. Box ADDRESQS/ ��.1�/3rr?�P� �✓ /t lJ ADDRESS CITYCITYr4 O r 9J RESIDENCE PHONE ,6 Z�l 7 -KBUSINESS PHONE (24 HRS.) BUSINESS PHONE-------==—"- ' TOTAL NUMBER OF ROOMS: ROOM USE: i. 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 DATE� Y;� df LRSUSE ONLY DATE OF INITIAL INSPECTION S_ r'�S�D, DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE::.') 6--U/ DATE FEE PAID: TYPE OF UNIT: DWELLINGVOTHER_ CHECK#— s g CHECK DATE> �� NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 r - - CONDIT CERT.# 416-99 . FEE "$25.00 DATE: 08/05/99 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: 255 Jefferson Avenue UNIT #: 4 OWNER/AGENT: J. Price ADDRESS: 5 Warren Road CITY/TOWN: Marblehead, MA ZIP CODE: 01945 24 HOUR PHONE: 631-7056 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 / JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR v 5 3 s CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tel:(978)741-1800 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 UNIT#W IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT ACK PLEASE CIRCLE ONE OWNER/LESSER--Ij, / ✓�/C� MANAGER/AGENT No P.O. Box�� / /,j No P.O. Box ADDRESS / �V �`5_0J ADDRESS CITY ITY 79-/ / RESIDENCE PHONE 6_-W ' 7vQ'r_-2 BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 2. �/� 3._ `� _4. 5. 6.-T 8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SAL TIME OF INSPECTION. HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE >�21APPLICANTS SIGNATURE �/f,-c AT S cf q INSPE TORS USE ONLY DATE OF INITIAL INSPECTION �4 f DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: S 'S ,4 f DATE FEE PAID: �/ ,s f TYPE OF UNIT: DWELLING OTHER_ CHECK# / 75' CHECK DATE NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 * CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH -- - - - - - " - - -- - -120 WASHINGTON STREET' 4"'FLOOR- PI1b�1CHC81t$ f Prevent.Promote.Protect. TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL lramdinksalem.com LARRY IL-\MDIN,RS/RF,1-IS,C![O,CY-IN', - MAYOR HI:;u:I'vf AGENT CERTIFICATE OF FITNESS CERTIFICATE#31-15 DATE ISSUED:2/5/2015 Property Located at: 256 Jefferson Avenue UNIT#1 Owner/Agent: Jack Ellis Address: 178 Lowell Street City/Town: Peabody, MA Zip Code: 01960 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 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 LARR AMDIN HEALTH AGENT SANITARIA o M CITY OF SALEM, MASSACHUSETTS I BOARD OF HEALTH JI 120 WASHINGTON STREET,4"`FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL Fax(978) 745-0343 MAYOR LRAMDINna s,U,RM.COM LARRY RAMDIN,RS/RF.1IS,CI 10,CP-1,S HEAI.;TTI AGENT Application for Certificate of Fitness Gr� IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" FEE: $50.00 PROPERTY LOCATED ATh�, O,,) nip—, UNIT#. IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSERZ/ Cx_G://;S MANAGER/AGENT ADDRESS—1 C�1u2LI �1'- ADDRESS CITY, STATE, ZIP 7F CITY, STATE, ZIP RESIDENCE PHONE q9t S1a — 4' — BUSINESS PHONE(24HRS) BUSINESS PHONE %n.e TOTAL NUMBER OF ROOMS:.. ROOM USE: L hiTO)%-) 2.b/,4/,4 R17n 3. � 4. � 5. 6. 'Qa. 7. J 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATE— /I Inspectrs use only Date on initial inspection: �'sl 1 J Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check#. Check date: Notes: Code n r 'ement Inspector c CITY OF SALEM, MASSACHUSETTS BOARD or HEALTH 120 WASHINGTON STREET,41..FLOOR PubliCHealth _ Pre•em.Prnmma.Pro�m�. "TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOL L ltamdin@salem.com Lr\RIiYRA M73H DIN,RS/R5,CHQ CP-FS MAYOR H}SAI;I'f i A(:ila.N"I' Release In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ; State Sanitary Code Chapter II and Article XIII of the City of Salem Ordinance, undersigned owner/lessor and tenant/lessee of a unit of residential property, hereby authorize the Salem Board of Health or its authorized agents to inspect the residence identified below in accordance with the aforementioned statutes, regulations and ordinances. In the event it is necessary that said inspection be done in my/out absence. I/we expressly authorized the same and for my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of Health and its authorized agents from any lose or injury sustained of whatever nature and description occasioned by my/out absence during said inspection. Tenant/Lessee Owner/Lessor Address Address Address on unit to be inspected Date Updated 523/11 TRANSMISSION VERIFICATION REPORT TIME 02/11/2015 22: 01 NAME FAX 9787450343 TEL 9787411800 SER. # 000BON341991 DATEJIME 02/11 22:01 FAX NO. /NAME 919789220787 PAGE(S) 0 DURATION 00:00:29 RESULT OK MODE STANDARD ECM OOND City of Salem, Massachusetts ! • i. Board of Health 9� 120 Washington Street, 4th Floor, Salem, ubUceay� MA 01970 PP Ele Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHO Mayor health@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE#: GHL-16-390 DATE ISSUED: 10/7/2016 Property Located at: 256 JEFFERSON AVENUE UNIT#2 Owner/Agent: Jack Ellis Address: 178 Lowell Street City/Town: Peabody, MA Zip Code: 01960 24 Hour Phone:(978) 532-4895 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age. —� e Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"FLOOR TEL. (978) 741-1800 KMI BERLEY DRISCOLL FAX(978)745-0343 MAYORLRnnvna(n1SALEM COM LARRY RAMDIN,RS/RENS,CHO,CP-FS ' HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" FEE: $50.00 PROPERTY LOCATED AT Q`J(v �� pl,) f�& UNIT# a IS TB7S UNIT�DIISIGNATED AS RIGIi LEFT FRONT OR BACK.PLEASE CDtCLE ONE OWNER/LESSER SftGYM MANAGER/AGENT NO P.O.BOX ADDRESS_ 19_g LOVJ�-k\ r- ADDRESS CITY, STATE,ZIP � D CITY,STATE,ZIP RESIDENCE PHONE F? ` ' QRS BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS:/ ROOM USE: 1.Be, 2. OR 3 P-A 6. 7. 8. 9 10 THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FE=JSLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATE Insn ors use only Date on initial inspection:Qqa&= Date of reinspection: Date of issuance of certificate Date fee paid: Q�/Z$/?L Type of unit: Dwelling Other Check#2$I�Check date:- ��2(9� Notes: Em o ke a- r n d a'C or-C nF�J �' /JG lfls�gllg C * n cement spector 0 rpND City of Salem, Massachusetts a Board of Health 120 Washington Street, 4th Floor, Salem, PubI�CHCaIlh MA 01970 Prevent.Promote. Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHO Mayor health@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE#: GHL-16-355 DATE ISSUED: 9/15/2016 Property Located at: 256 JEFFERSON AVENUE UNIT#3 Owner/Agent: Jack Ellis Address: 178 Lowell Street City/Town: Peabody, MA Zip Code: 01960 24 Hour Phone:(978) 532-4895 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age. I/Je r Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS l BOARD OF HEALTH 120 WASHINGTON STREET,4'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR LWID)NOSALFM.COM LARRY RAMDIN,RS/RENS,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: $50.0,0 PROPERTY LOCATED AT T7 e,-SD(J ] �I l�Z uNrr# IS TMS UMT DISIGMMD AS RIGHT LEFT FRONT OR BACK.PLEASE CIRCLE ONE OWNER/LESSER`�C\&'-y� E✓ a MANAGER/AGENT ADDRESS I /C1� �I S'Sa ADDRESS CITY,STATE,ZB'��Oti�lf)d?4 (�I 7�� CITY,STATE,ZIP RESIDENCE PHONE 1�1S 592 BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS:_ `� /l ROOM USE: 1.$IPj 2.99 3. e R 4.�\�C TI Q 5 UN lA PVr)M 6. 7. 8. 9. 10 VV THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE I PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATEO9 Inspectors use on]y Date on initial inspection:Q=—Lo Date of reinspection: Date of issuance of certificate:=f4p Date fee paid:(O yaff=C Type of unit: Dwelling-4Other Check# 3922- Check date: OIZIC12Q T(, Notes: #Cf oyement Ind ctor °NDS City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, PubIiCFIe81t11 MA01970 Prevent. Promote.Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHO Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE M GHL-15-163 DATE ISSUED: 7/10/2015 Property Located at: 258 JEFFERSON AVENUE UNIT#1 Owner/Agent: KJR Realty Trust Address: 37 Hunt Circle City/Town: Mashpee, MA Zip Code: 02649 24 Hour Phone:(508) 577-6611 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANIT IAN • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREEP,4"'FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR LRAI.MDIN&ALw'.M. OM LARRY RAMDIN,RS/RU IS,CHO,CP-IS HEALTII AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" FEE: $50.00 PROPERTY LOCATED AT o(Jr/�' �2 sic 2(' Stl Ave- V1 -�2YYl Wl>q 0)4'77UNIT# -LD S� tS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BAC P E CIRCLE ONE OWNER/LBSSER —?-,er3 A �cMANAGER/AGENT Lina` -s NO P.O.BOX \ ADDRESS 3-.1 if h 1 C\cc\2 ADDRESS d 59 I�Qa h S CITY, STATE,ZIPAS�pQQ_ (019 CITY, STATE,ZIP Gpla�x es�ec lQ, 01430 RESIDINCE PHONE_ ()a-577'7 6(o // BUSINESS PHONE(24HRS) BUSINESS PHONE ,SO2—a-72 — (,(e TOTAL NUMBER OF ROOMS:_ ROOM USE: 1.1Gi 4GhPc� 2 c�incrb (ZFb 09 QN11 4 Ro �rrrxr 5 AcrrxT 6. 7. 8. 9: 10 THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABL T THE TIME OF INSPECTION APPLICANT'S SIG Y 450ke.,, lu,-;n2� DATE Inspectors use only Date on initial inspection: O'7&z2:Q 1.5-- Date of reinspection: Date of issuance of certificate: 0 M 312-01-F Date fee paid:07/a&2LZZ Type of unit: Dwelling (/ Other Check#14Z--Check date: 0710,FI204,5— Notes: C4 rcemery pector 'L �N City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, Puth MA 01970 Prevent. Promole. Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHO Mayor health@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE#: GHL-16-406 DATE ISSUED: 10/20/2016 Property Located at: 258 JEFFERSON AVENUE UNIT#2 Owner/Agent: Jim Roman Address: 37 Hunt Circle City/Town: Mashpee, MA Zip Code: 02649 24 Hour Phone:(508) 577-6611 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates,whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age. &Je if Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN -0 L4,t. I -et'ja5 pe,14Js J <;Jes,c6m CITY OF SALEM, MASSACHUSETTS BOARD or HEALTIT 120 W\,1,HI-\G'10.\ S't RLL-'r,4'''F.I-OoR J)-,E.. O78) 741-1800 KU IMB FRLEY I)RTS(.:OJJ. I"\X ( ,978) 745-0343 MAYORI,II,\N1 D]NLa)SA 1,[W.COM Lmun RI\NMDIN,RS/RI%I IS,CI 10, H I{-\I,n-j A(; 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 !3061-) . ()19-70 UNIT# c:2, IS THIS UNIT DISIGNATED AS RIGHT LEF OR BACK,PLEASE CIRCLE ONE Utn&,I-s OWNER/LESSER MANAGER/AGENT "rA: . NO P.O. BOX ADDRESS . 3-7 (',IV ADDRESS CITY, STATE, ZIP ��sqW,, M� CITY, STATE,ZIP C-�(AX-e�, e-c, RESIDENCE PHONE5C8 -57-7— t BUSINESS PHONE (24HRS)-71 BUSINESS PHONE TOTAL NUMBER OF ROOMS:— ROOM USE: 2. 3. 6ebvcc),m 4.L�w�- 121M 5. KOV-VNer,,� -L 6.t�.r)bo� aP 7. J)ej Cc\-\ 8. -<jNom g;g-9. ek�A��l u 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 SIGNATU rY):aZ. DATE�o v Inspectors use only Date on initial inspection: -w/J-q�20jC Date of reinspection: Date of issuance of certificate-,IWMZQ�c Date fee paid: Type of unit: Dwelling�Other—Check#—'2-�2-- Check date: Notes: E , orceme , nspcctor COND , City of Salem, Massachusetts {• y Board of Health 120 Washington Street, 4th Floor, Salem, PubliCHea Ith MA 01970 Prevent, Promote, Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHo Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE#: GHL-15-268 DATE ISSUED: 9/3/2015 Property Located at: 258 JEFFERSON AVENUE UNIT#3 Owner/Agent: KJR Realty Trust Address: 37 Hunt Circle City/Town: Mashpee, MA Zip Code: 02649 24 Hour Phone:(508) 577-6611 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation'. Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH 47 Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITA RIAN . o CITY OF SALEM, MASSACHUSETTS e BOARD OF HEALTH 120 WASHINGTON STREET,4T"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR 1.RAMDIN@SALEM.COM LARRY RAMDIN,RS/REHS,CI-10,CP-FS HEADn-i 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 JrjCV �( 7j�JNIT# IS THIS//UNIT DISIGNATED AS RIGHT LEFT RONT R BACK,PL ASE CIRCLE ONE OWNER/LESSER MANAGER/AGENT L �S1�P__ X1� �6�Ies NO P.O.BOX �1 ��b, ADDRESS , 37 HUC4 0, 11 L(G (2 ADORES 1-) C- y5�12� CITY, STATE,ZIP I � 1Q �Z fn A- UaL� CITY, STATE,ZIP 6pP k-Q� L c . Mf) (-)IQ 1:5- RESIDENCE sRESIDENCE PHONE BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1 2. Ywon 3.L.'u iY YT 4.&�'xCg, 5. 6. M. 8. f> 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS P YABLE ATT TIME OF INSPE TION APPLICANT'S SIGNATI TR DATE Inspectors u e only Date on initial inspection: 0916 /)0jf Date of reinspection: Date of issuance of certificate:PUDate fee paid:0 q/01l2d7 Sr Type of unit: Dwellin Other Check#Check date:D 9116112-01J, Note . 0 Co foe ement hi;ilketor t_ CITY OF SALEM, MASSACHUSETTS 3 BOARD OF HEALTH e e gj 120 WASHINGTON STREET, 4TH FLOOR o SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE #. 342-04 DATE ISSUED: 7/23/2004 Property Located at267 Jefferson Ave. UNIT# 2 Owner/Agent: Edite Biscaia Address: ' 267 Jefferson Avenue City/Town: Salem, MA Zip Code:01970 24 Hour Phone: 978-744-2777 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 dale 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 / jlazlyr-, / V JOANNE SCOTT, fv1PI i, RS. CI-10 E 1-II.Al.I I i 11c,FNI CODE NPORCIc1�7ENT IN S1 OR r CITY OF SALEM, MASSACHUSETTS 33 BOARD OF HEALTH • • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-i 800 FAX 978-748-0343 STANLEY USOVICZ, JR. .JOANNE SCOTT, MPH, R5, 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". PROPERTY LOCATED ATo2ro7 e. i- 6Y1 RYA UNIT IS THIS UNIT DESIGNATED AS RIGHT LEFTRF ONT BACK PLEASE CIRCLE ONE OWNER/LESSER Gdi _`�%� /�9/A MANAGER/AGENT_ No P.O. Bax No P.O. Box ADDRESS c��2 Vc ADDRESS_ CITY RESIDENCE PHONE`�� -��Ill-BUSINESS PHONE (24 NRS.)_ BUSINESS PHONE TOTAL NUMBER OF ROOMS:_6 ROOM USE: 1. 5. S 6, THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE� f _DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTI0N7 _,7 D h`/ DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:2f DATE FEE PAID: 7 '3 TYPE OF UNIT: DWELLINOTHER� CHECK# 1 ! '?-)-_ ___,_CHECK DATE ` k NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 .ONO $ CERT.# 44-02 qFEE $25 .00 r DATE: 01/29/2002 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970- JOANNE SCOTT, MPH,RS,CHO 120 Washington Street — 4'h Floor HEALTH AGENT Tel # (978)-741-1800 Fax # (978)-745-0343 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 267 Jefferson Avenue UNIT #: 2 Back OWNER/AGENT: Paul Biscaia, Trustee ADDRESS: 267 Jefferson Avenue #1 CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 557-8278 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 STANDARDSOFFITNESS 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. 7 FOR THE BOARD OF HEALTH / JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR r aCITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT go Tg&iWr) _Ahe UNIT# Z IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT ASK LEASE CIRCLE ONE OWNER/LESSER T 'MANAGER/AGENT-�'L�� No P.O. Box �� No P.O. Box J ADDRESS 2077 >cXe2un—fie_ ADDRESS CITY !:Sm l g,= al-� C)197y CITY RESIDENCE PHONE 278— 71(Y-371Z. 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 HEALTHDEPART NT THIS FEE IS PAYAB EAT HE TIME OF INSPECTIO APPLICANTS SIG TURE �- DATEZ- INSPECTORS USE ONLY DATE OF INITIAL INSPECTION /- J-1`' 2' DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: -2-DATE FEE PAID: t --lF 2- TYPE TYPE OF UNIT: DWELLING/ OTHER_ CHECK#// S CHECK DATE A57� 2 NOTES: ((�� CODE ENFORCEMENT INSPECTOR 9/28/98 - CITY OF SALEll MASSACHUSETTS BOARD OF HEALTH I f y 120 WASHINGTON STREET, 4TH FLOOR o' SALEM, MA 41970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE# 140-05 DATE ISSUED: 2/28/05 Property Located at: 267 Jefferson Avenue UNIT#3 Owner/Agent: C E B Realty Trust, Paul Biscaia, Trustee Address: 267 Jefferson Avenue City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 617-557-8278 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 Ir' 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 u Ori; r HEALTH AGENT CODE ENFORCEMENT IN PECTOR ♦ CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • • 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 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 ZV7 SeC � UNIT#3- IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSERCC-b �ea' Ns MANAGER/AGENT�c.>J� No P.O. Box /r) No P.O. Box ADDRESS ZSo-I 3e-- 1 L41J�C ADDRESS CITY ScAe--w (AA 0\Rl.0 CITY RESIDENCE PHONEQ7i -7'1s_3-717-BUSIN ESS PHONE - S7 -0-z.7 9 BUSINESS PHONE f TOTAL NUMBER OF ROOMS: ROOM USE: 1. '-(LY,Yv\2, 6r0tLV^3_ I y t't�7 7GI� 5. lki�k 6. 7..-- 8' -- THERE IS A TWENTY-FIVE 25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE�C OF SALEM H EPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION �7//_ APPLICANTS SIGNATURE 1 �yl, Zr�Dric_ Zf ./ � INSPECTORS USE ONLY DATE OF INITIAL INSPECTION2_ Y ' _DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE Z=' S DATE FEE PAID TYPE OF UNIT DWELLING OTHER CHECK n �J D �--- CHECK DATE NOTES /X\ CODE ENFORCEMENT INSPECTOR 928198 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH s ig 120 WASHINGTON STREET, 4TH FLOOR oSALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 -- STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 2/15/05 C E B Realty Trust, Paul Biscaia, Trustee 267 Jefferson Avenue Salem, MA 01970 PROPERTY LOCATED AT 267 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 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. For the Board of Health Reply to nne Scott MPH, RS CHO Pablo Valdez Health Agent Cade Enforcement Inspector i City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, PubliCHeHlth MA 01970 Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHO Mayor health@salem.com Health went CERTIFICATE OF FITNESS CERTIFICATE #: GHL-17-302 DATE ISSUED: 9/14/2017 Property Located at: 271 JEFFERSON AVENUE UNIT#1A Owner/Agent: Nikolaos Karambelas Address:. 54 Paul Avenue City/Town: Peabody, MA Zip Code: 01960 24 Hour Phone: Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement.An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates,whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age. Larry Ramdin, MPH, RENS, CHO HEALTH AGENT NITARIAN J V1 VL cky`(D, ovi 6 e f CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR .PU ICITP.AIYh TEL. (978) 741-1800 FAx (978) 745-0343 KIMBERLEY DRISCOLL IramdinQsalem.com MAYOR LARRY R�AMDIN,RS/RFI P S,CIO, HE:uLPH AGENT 01ws (� a CLn)gaas Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" �p FEE: $50.00 PROPERTY LOCATED AT I r5 A V1 Q,�, tJ UNIT#� IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR B�PLEASE CIRCLE ONE OWNER/LESSER Na�:T 1aGcolq �wn_�`P/"MANAGER/AGENT NO P.O. BOX ADDRESS �OvU i,&) ADDRESS CITY, STATE, ZIP C 1,6 ®Q y w_: CITY, STATE, ZIP RESIDENCE PHON fl 9 1 — �� 8 © BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3. 4. 751 6. 7. 8. 9. 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 SIGNATUREU 4 0420, DATE Inspectors use only Date on initial inspection: Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check# Check date: Notes: Code Enforcement Inspector CITY OF SALEM, MASSACHUSETTS lu BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR PabI1CHC81th Pment.Promote.Protect. TEL. (978) 741-1800 FAx(978) 745-034.3 kIMBERLEY DRISCOLL Iramdingsalem.com MAYOR _ LARRY RANIDIN,RS/RENS,CHO,CP-FS HF„�I,I'I-I ACiIi.N'I' 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/our 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 loss or injury sustained of whatever nature and description occasioned by my/our absence during said inspection. Tenant/Lessee Owner/Lessor Address Address Address on unit to be inspected Date Updated 523/11 CITY OF SALEM, MASSACHUSETTS r BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DG1tF:ENBAUMQSALEM.COM DAVID GRLENBAUM ACTING HF.AI,IH AGENT CERTIFICATE OF FITNESS CERTIFICATE# 119-10 DATE ISSUED: 3/19/2010 Property Located at: 271 Jefferson Avenue UNIT#1B Owner/Agent: Nikolaos Karambelas Address: 54 Paul Avenue City/Town: W. Peabody, MA Zip Code: 01960 24 Hour Phone: 781-384-4890 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. FORTH A D F HEALTH J DAVID GREENBAUM ACTING HEALTH AGENT CO ENFORCEMENT INSPECTOR J . - (� n CITY OF SALEM, MASSACHUSETTS � � BOARD OF HEALTH 120 WASHINGTON STREET,4."FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGREENIBAUMC_,SALEM.COM DAVID GREENBAum, ACTING HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION." FEE: 50.00 PROPERTY LOCATED AT. Q. P jLf,%nil.P, UNIT# IS THIS UNIT DISIGNATED ASRIGHTLEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER "L d �Crl o � Ilr�/'o,,t116' Oi ,MMANAGER/AGENT NO P.O. BOX ADDRESS d�P,).VI / rch.� y1 ADDRESS CITY, STATE,Z1P P e Ac.� D O 1`/ !pr CITY, STATE, ZIP O I q RESIDENCE PHONE ILQ 7 gj �j�-� 0,3 7 BUSINESS PHONE(24HRS) BUSINESS PHONE L ^ t7 R I 329 - LI'j TOTAL NUMBER OF ROOMS:_ ROOM USE: 1. \Z . 2. _.R 3. g 4. 5. IL 1 6.61 Y+Dirt 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME /OF INSPECTION APPLICANT'S SIGNATUR44 DATE �5-- 1 .6—1 J Inspectors use only Date on initial inspection: ig/ Date of reinspection: —� Date of issuance of certificate: 3l0 Date fee paid: 10 Type of unit: Dwelling ZOther Check# 4 Check date: J//(#//O Notes: 6 (t eb)S a 5 io h� d— h.ea(coM . Co E orc ement Inspector. c . CITY OF SALEM, MASSACHUSETTS BOARD OF HE,AL'PFI 120 WASHINGTON STREET 4111 FLOOR PI1�lic�C81�1 Prorant.Promote Pm[trt. ` TEL. (978)741-1800 Fax(978)745-0343 IUMSERLEY DRISCOLL lramdin salem.cam LA1tItY RAMDIN,RS/REHS,CHO,CP-FS - MAYOR HEAL-11-i AG ENC CERTIFICATE OF FITNESS CERTIFICATE#157-13 DATE ISSUED:4/30/2013 Property Located at: 271 Jefferson Avenue UNIT#213 I Owner/Agent: Nikolaos Karambelas Address: 54 Paul Avenue City/Town: W. Peabody, MA Zip Code: 01960 24 Hour Phone: 781-384-4890 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 THEpARD ( HEALTH 440* LARRY RAMDIN HEALTH AGENT SANITARIAN e i . CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET 4"`FLOOR Pub11CHe»Ith STREET, pl..,.v.omm�.PWW. TEL. (978) 741-1800 Fax (978) 745-0343 KIMBERLEY DRISCOLL Iramdin@salem.com MAYOR LAR1iY ID RAhIN,1LS/li}i,HH (:1' S,CO, -FS 1-IE.AIXI f AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" FEE: $50.00 PROPERTY LOCATED AT ), l 1 > e F� -P—r e&n 14 V-e n u IINIT#-,�L- JB IS THI§UNIT DISIGNATED AS RIGHT LEFT'FRONT OR BACK.PLEASE CIRCLE ONE OWNER/LESSER o�-y0.Irl �FLjLxnMANAGER/AGENT NO P.O. BOX ADDRESS A iJfitff ADDRESS CITY, STATE,ZIP f".'I L U,�J'y IA 4 OL% (-) CITY, STATE,ZIP RESIDENCE PHONE q R "3 9Q-Li99 0 BUSINESS PHONE(24HRS) BUSINESS PHONE 1G�OJ TOTAL NUMBER OF ROOMS: G�k Q9,11 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 PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE v1 t I A __�14ADATE Inspectors use only Date on initial inspection:�l 3 Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check# Check date: Notes C;;Q Ord2vd ! Kao �4Xeei�l , -par CPO nlAlQ Ml' YU1Q n lN -rYrn�wnWl ib be No-A (:2GE Cocement Inspector F CITY OF SALEM, MASSACHUSETTS Cud BOARD OF HEALTH 120 WASHINGTON STREET 4."FLOOR PublicHeaIth f Prevent.Promote.Protect. TEL. (978)741-1800 FAX(978)745-0343 KIMBERLEY DRISCOLL Itamdin@salem.com LARRY RAN4DIN,RS/RGI{5,CI-IO,CP-FS MAYOR HFAI:I'l i 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. P � �� iki-L, nA9 6 Tenknt/Lessee Owner/Lessor Address Address X11 `aQ ) 1 Address o` unit to be inspected Date Updated 523/11 v� 3 � CERT.# 709-99 FEE "$25.00 DATE: 12/01/99 MRB 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: 271 Jefferson Avenue UNIT #: 2 Front OWNER/AGENT: Nikolaos Xarambelas ADDRESS: 54 Paul Avenue CITY/TOWN: W. Peabody, MA ZIP CODE: 01960 24 HOUR PHONE: 932-1331 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 JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT EDE ENFORCEMENT INSPECTOR g�gONU1T /� A 9 " G ��4111V6 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 AT -2I 7eFtHn -1_ o-'U UNIT# IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER,Vic[/ �& LH —MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS Pbj 0.V _ ADDRESS CITY mo, CITY N d RESIDENCE PHONE BUSINESS PHONE (24 HRS.) BUSINESS PHONE J JI TOTAL NUMBER OF ROOMS: ROOM USE: 1. A,,( 2. /&.A 3.e4._ `l kZk- 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 �- 1vv,w _- ,_DATE �– INSPECTORS USE ONLY DATE OF INITIAL INSPECTION //1d v/ eg DATE OF REINSPECTION�� DATE OF ISSUANCE OF CERTIFICATE% /-99 ZATE FEE PAID: TYPE OF UNIT: DWELLING /OTHER-- CHECK#, Rk CHECK DATE 9/ NOTES: e7,4-, C- O@rEN t5RC ENT INS CTOR 9/28/98 lt - ��ONDIT,{� °Fvg "' CERT.# 125-99 FEE $25.00 - ( DATE: 03/15/99 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: 271 Jefferson Avenue UNIT #: 2nd Rear OWNER/AGENT: Nikolaos Karambelas ADDRESS: 54 Paul Avenue CITY/TOWN: W. Peabody, MA ZIP CODE: 01960 24 HOUR PHONE: 535-5039 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 MORE INFORMATION CALL 978-741-1800 . FOR THE BOARD OF HEALTH JOANNE SCOTT, MPH,RS,CHO ' HEALTH AGENT COD ENFORCEME INS TOR � s �oniar 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 AT QUi7t aUNIT#' < IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT ACK PLEASE CIRCLE ONE OWNER/LESSER IYIKoI&oJ MANAGER/AGENT No P.O. Box o P.O. Box ADDRESS G L[ J>6Lc; ADDRESS CITY 'l e oQY CITY RESIDENCE PHONEII$79-SjSSd 3;1? BUSINESS PHONE (24 HRS.) BUSINESS PHONE I 7 1 X32133 1 TOTAL NUMBER OF ROOMS:® ROOM USE: 1._��2. .G 3,z/� 4. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. r APPLICANTS SIGNATURE —DATE-3 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION -3111-5- 145K �DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE L�� /Y Y DATE FEE PAID: & TYPE OF UNIT: DWELLING OTHER__ CHECK#_CHECK DATE NOTES: ..CODE ENFORCEMENT INSPECTOR 9/28/98 K 9 3 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(508)741-1800 Fax:(508)740-9705 RELEASE 1n accordance with Massachusetts General Laws Chapter III ; 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 author- ized agents to inspect the residence identified below in accordance with the aforementioned statutes, regulations and ordinances. In the event it is necessary that said inspection be done in my/our absence, i./we expressly authorize the same and for my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of Health and its authorized aliens from any loss or injury sustained of whatever nature and description occasioned by my/our absence during said inspection. r .,-IANT/LESSEE OWNER/LESS R 2L Z6& ADD IiE S S ADDRESS O1F 60 x.71 ort 2 ADDRESS TO BE INSPECTED �� { -- Dk3E < l CITY OF SALEM, MASSACHUSETTS • e BOARD OF HEALTH 120 WASHINGTON STREET,4"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAR (978) 745-0343 MAYOR DGRI'l;NBAUM&Ai EM.COM DAViD GREENBAUM ACTING HEAT;n I AGUNP CERTIFICATE OF FITNESS CERTIFICATE#87-10 DATE ISSUED: 2/24/2010 Property Located at: 271 Jefferson Avenue UNIT#2C Owner/Agent: Nikolaos Karambelas Address: 54 Paul Avenue City/Town: W. Peabody, MA Zip Code: 01960 24 Hour Phone: 781-384-4890 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 //ILUA I DAVID GREENBAUM //- ACTING HEALTH AGENT CODE E O CEMENT INSPECTOR • CITY OF SALEM, MASSACHUSETTS J BOARD OF HEALTH �+ " 120 WASHINGTON STREET,4'"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGZELNBALIMna$N.6M.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 UNIT# _ IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER IY1 O 0.1/bx'm/O ANAGER/AGENT NO P.O. BOX ADDRESS —ADDRESSCITY, STATE,ZIP ?6010 / O�D 1 0196 CITY, STATE,ZIP RESIDENCE PHONE �� BUSINESS PHONE (24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS:- 4 ROOM USE: 1. 17 2. �� 3. 4. ,Zi+M6 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 PAYABLE AT THE TIME OF IN((S`PECTIOD�N APPLICANT'S SIGNATURE V (eZio4� DATE, / 1 V Inspectors use only Date on initial inspection: a 6 Date of reinspection: Date of issuance of certificate: a 1 a Ll )U Date fee paid: a h0 Type of unit: Dwelling ✓ Other Check# Ql W I Check date: a l b Notes: d(rV ►S In fif s q60 C4 Code Enforbealent Inspector CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 0 9. 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 Qrylryg TEL. 978-741-1800 FAX 978-745-0343 -- STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 3/21/05 271 Jefferson Avenue Trust 54 Paul Avenue W. Peabody, MA 01960 PROPERTY LOCATED AT 271 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 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. FQI,- he Board of Health Reply to =H, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector � �gONDIT 6 v CERT.# 253-01 FEE $25.00 DATE: OS/21/2001 c17INY, CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO HEALTH AGENT Tel: (978)741-1800 Fax: (978)740-9705 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 271 Jefferson Avenue UNIT #: 3 OWNER/AGENT: Nikolaos Karambelas ADDRESS: 54 Paul Avenue CITY/TOWN: W. Peabody, MA ZIP CODE: 01960 24 HOUR PHONE: 932-1331 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. MAXIMUMNUMBER 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 W� 11,006 '140� ell JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR r` 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 Fait:(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 ! t r FF 'Y COn QV UNIT# IS THIS UNIT DESIGNATED AS IU TEBFON BACK PLEASE CIRCLE ONE OWNER/LESSER &, MANAGER/AGENT _ No P.O. Box No P.O.Box ADDRESS 4 Li 'PCuUI Q V ADDRESS 0 ._CITY,---- RESIDENCE ITv __RESIDENCE PHONE BUSINESS PHONE (24 HRS.)__.__._ BUSINESS PHONE TOTAL NUMBER OF ROOMS: S ROOM USE: 1.B gn THERE IS A TWENTY-FIVE($25.00)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. r {� APPLICANTS SIGNATURE MAI1P�./I�o� DATE +B INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 5-'x- 1 —O I __DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE, �( '""O1 _DATE FEE PAID: '� ' TYPE OF UNIT: DWELLING[//..OTHER_ CHECK# I Q CHECK DATE S d ) -0) NOTES:-,--.--- CODE OTES: .CODE ENFORCEMENT INSPECTOR 9/28/98 .CCU I � 6 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel: (978)741-1800 05/15/2001 Fax: (978)740-9705 Nikolaos Karambelas 54 Paul Avenue W. Peabody, MA 01960 PROPERTY LOCATED AT 271 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 thku Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7:00 p.m. and Friday 8 :00 ' i 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. i A $25.00 checkpayableto 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 HEALTH REPLY TO Joanne Sc tt, MHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR I o CITY OF SALEM9 MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR CERT.# 205-03 SALEM, MA 01970 FEE $25.00 TEL. 978-741-1800 DATE: 05/16/2003 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 1 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 272 Jefferson Avenue UNIT #: 2 OWNER/AGENT: George Jeter ADDRESS: 10 Read Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-5233 AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410.000 : MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE SALEM BOARD OF HEALTH AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED. MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410.000 : MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" SECTION 410 .400 (B) : DWELLING UNIT (X) AND 410.400 (C) : ROOMING UNIT MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: . NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR OCCUPANTS UNDER 6 YEARS OF AGE NOR BUILDING RELATED CODES. FOR MORE INFORMATION CALL 978-741-1800 . FOR THE BOARD OF HEALTH L JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS ',� BOARD OF HEALTH • • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 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". �/ PROPERTY LOCATED AT� ( 9 (1 jja m (lde UNIT#_,SJ�-0caN IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER r MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS _/(/-) ADDRESS CITY St�a4d gal al -CITY RESIDENCE PCH�OjNEC��ISm2�/5-��33 BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF /ROOMS: f� ROOM USE: 1. 2. h L(l 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 DATE INSPECTORS U ONLY DATE OF INITIAL INSPECTION S '/6 'P 3 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:-"/1, a3 DATE FEE PAID: -5 '/6 3 TYPE OF UNIT: DWELLINGgLOTHER_ CHECK#.36 6 ? CHECK DATES=/6 03 NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 i vg�CONDIT n � CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 11/27/2000 Fax:(978)740-9705 272 Jefferson Avenue Realty Trust I 10 Read Street Salem, MA 01970 PROPERTY LOCATED AT 272 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 9P HEALTH REPLY TO V llJoanne Sc t, MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR r Ncaxol CITY OF SALEM, MASSACHUSETTS 6 BOARD OF HEALTH 120 WASHINGTON STREET. 4TH FLOOR SALEM, MA 01970 TEL, 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 06/27/2002 Henry T. Gagnon Realty 16 Lockwood Lane Topsfield, MA 01983 PROPERTY LOCATED AT 275 Jefferson Avenue UNIT # 1st floor 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 HEALTH REPLY TO oanne Scott, MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR I CERT.# 454-97 FEE $25.00 DATE: 07/21/97 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(508)741-1800 Fax:(508)740-9705 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 275 Jefferson Avenue UNIT #: 1st floor OWNER/AGENT: Henry T. Gannon Realty ADDRESS: 16 Lockwood Lane CITY/TOWN: Toosfield. MA ZIP CODE: 01983 24 HOUR PHONE: 887-8406 AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410.000: MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE SALEM HEALTH DEPARTMENT AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED. MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410.000: MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . SECTION 410.400 (B) : DWELLING UNIT (X) AND 410.400 (C) : ROOMING UNIT MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: . NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR OCCUPANTS UNDER 6 YEARS OF AGE. FOR THE BOARD OF HEALTH JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR d • ova � t� jut_ 1 8 1997 CITY OF SALEM BOARD OF HEALTH /, /� '� CITY OF SALEM Salem, Massachusetts 01970-3928 /r/y% HEALTH DEPT. 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 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN/H�AB�ITATIONN� CL PROPERTY LOCATED AT / �JQt([ l Sin ' U UNIT It L7 791t— OWNER/LESSER pq Gn6✓) )(jffL-fV MANAGER/AGENT ADDRESS Ito [r)-(XUoa) tfi70c- ADDRESS CITY IPSECLO! WA 619F3, CITY _ RESIDENCE PHONE jry g" 6.6 7:kz/-a(o BUSINESS PHONE (24 HRS.) S � BUSINESS PHONE h TOTAL NUMBER OF ROOMS: / ROOM USE: 1 . 2. 3. 4 . 5. G. 7. 8. THERE IS A TWENTY-FIVE (25.00) DOL FEE, PA LE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT IS FEE IS ABLE AT THE TIME OF INS CTION APPLICANTS SIGNATURE DATE -- n INSPECTORS -U7SE ONLY / DATE OF INITIAL INSPECTION: / '�7) 2' DATE OF REINSPECTION DATE OF ISSUANCE OF CERTI°FIICATE: G. 2 7 DATE FEE PAID: �� / - . TYPE OF UNIT: DWELLING OTHER NOTES : �- - CODE ENFORCEMENT INSPECTOR isti CITY OF SALEM, MASSACHUSETTS HEALTH AGENT120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 0 TEL. 978-741.1800 NNW FAX 978.745.0343 KIMBERLEY DRISCOLL JSCOTT@SALEM.COM MAYOR .JOANNE SCOTT HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#529-07 DATE ISSUED: 10/23/2007 Property Located at: 275 Jefferson Avenue UNIT#2 Owner/Agent: Marie Gagnon Address: 16 Lockwood Lane City/Town: Topsfield, MA Zip Code: 01983 24 Hour Phone: 887-8406 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 '�44� < JdANNE SCOTT, MPH, RS, CHO HEALTH AGENT ddn ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS nJ� BOARD OF HEALTH • • 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 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 GrIT UNIT# a IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNERILESSEkt,AAl%XFi MANAGER/AGENT No P.O. Box No P.O.Box ADDRESSOo t-'ti5 ADDRESS CITY+O_k>Sr=r-Lc> CITY RESIDENCE PHONE '+--M`9K& 1-839bBUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1 c3t3> 2.a1r� 3. 4. G- 5344;y .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 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION D -} ? DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:/O ATE FEE PAID:-/-A TYPE OF UNIT: DWELLI _OTHER_ CHECK#gD O2 CHECK DATE ZZ)-- NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98' cpNDIq,,� City of Salem, Massachusetts I On Board of Health n 120 Washington Street, 4th Floor, Salem, Pah1iCHPAIth Prevent. Promote. Protect. MA 01970 Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHo Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE M GHL-16-167 DATE ISSUED: 5/20/2016 Property Located at: 275 JEFFERSON AVENUE UNIT#3 Owner/Agent: Michael McLaughlin Address: 33 Liberty Hill Avenue City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(508) 962-4800 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH 0� 4�L� Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS v . BOARD OF HEALTH Ebwm = 120 WASHINGTON STREET,4'"FLOOR n TEL. (978)741-1800 FAX(978)745-0343 KHABERLEY DRISCOLL hamdin(a)salem.com ' MAYOR LARRY RAMllIN,RS/RENS,C140,CP-FS HL:AL77I 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 )Qr Je er SO n A. Lf UNIT# -2 IS THIS UNIT DISIGNATED AS RIGHT UKFT T OR BACK PLEASE CIRCLE ONE OWNER/LESSER IClWeMANAGER/AGENT NO P.O.BOX //�//_ ADDRESS 3 -3 Zf -C r/ 40C ADDRESS CITY, STATE,ZIP SI)b4 CITY,STATE, RESIDENCE PHONE BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. Lid' 2. 3. IJ 4. 5. 6. /kf 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE A TIME FF INSPECTION APPLICANT'S SIGNATURE '// " DATE_.Ji InWggtors use only Date on initial inspection: ®571-ty-2OLj Date of reinspection: Date of issuance of certificate:()�$ u I Date fee paid: 0 S'1=040 Type of unit: Dwelling—Z—Other Check#_Check date: 0, Y_I 2_026 Notes: z C e fo ement hvqpctor �X /' OCC vQW 76 SOVA) Sgt /�Ous�06 9P. 7W 41y CITY OF SALEM, MASSACHUSETTS IV BOARD OF HEALTH 120 WASHINGTON STREET 4"t FLOOR - P1lbiliCHCAlt . STREET, Prevent Promob.Prolec,. TEL. (978) 741-1800 Fax(978) 745-0343 KIMBERLEY DRISCOLL ltamdin@salem.com salem.com LARRY RAMllIN,RS/REHS,CFIO,CP-FS MAYOR HEALTH AGEN'r CERTIFICATE OF FITNESS CERTIFICATE#200-13 DATE ISSUED:6/5/2013 Property Located at: 275 Jefferson Avenue UNIT#4 Owner/Agent: Marie Gagnon Address: 8 Cleary Lane City/Town: Topsfield, MA Zip Code: 01983 24 Hour Phone: 887-8406 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 BO D OF ALTH LARRY RAMDIN d, HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS �./ BOARD Or HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX (978) 745-0343 MAYOR DGuatNBAUM@SALEM.CONI 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 =2 2 5' S&->1 J9 Q e- UNIT#� IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER 4T C R e-qJ 1 MANAGER/AGENT 12'f 4q/i16�l NO P.O. BOX / ADDRESS �,��cz_r� /(5,yLe� ADDRESS CITY, STATE,ZIPS I P �� fY1 q. CITY, STATE,ZIP !r/ r RESIDENCE PHONE BUSINESS PHONE (24HRS) c`�7 a 7 PRcS- jo BUSINESS PHONE / 7� TOTAL NUMBER OF ROOMS: ,5 ROOM USE: 1. 2. 3: 4. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT TW TIME OF INSPECTION APPLICANT'S SIGNATURE DATE " Inspectors use only Date on initial inspection:- g- Date of reinspection: Date of issuance of certificate: to 'S' I-) Date fee paid: Type of unit: Dwelling ✓ Other Check#-,('n6 Check date: Notes: Code Enfo cement Inspector Mc ND , City of Salem, MassachusettsIV { ; Board of Health 120 Washington Street, 4th Floor, Salem, PublicHea ith MA01970 Prevent. Promote. Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS,CHO Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE #: GHL-16-133 DATE ISSUED: 4/22/2016 Property Located at: 284 JEFFERSON AVENUE UNIT#1 Owner/Agent: Mike Kantorosinski Address: 407 Essex Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978)868-8190 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH 0-�--�*4� Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIA CITY OF SALEM, MASSACHUSETTS v ' BOARD OF HEALTH th 120 WASHINGTON STREET,4"'FLOOR TEL. (978)741-1800 FAX(978)745-0343 KIMBERLEY DRISCOLL lramdin@salem.com MAYOR - LARRY RA MllIN,xS/RENS,CIiO,CM R.'ALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MMMUM STANDARDS OF FITNESS FOR HUMAN HABITATION' / FEE: $50.00 PROPERTY LOCATED AT' � l - 41-bl UNIT#� c ' IS THIS UNIT D1SIGN AS RIGHT LEFT FRONT OR BAC PLEASE CIRCLE ONE OWNER/LESSER MANAGER/AGENT NO P.O.BOX /+ , � ADDRESS a7 VYJ�G C Y ADDRESS CITY, STATE, CITY, STATE,ZIP RESIDENCE PHONE !!nn p BUSINESS PHONE(24HRS) BUSINESS PHONI(� �IOM1'O 1 g10 TOTAL NUMBER OF ROOMS: ROOM USE: 1 2 3 ti- 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 FuvIS PAYAWX AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE IT, DATE Inspectors use only Date on initial inspection: 0 YZ Date of reinspection: Date of issuance of certificate ZOl�2 f j Date fee paid&/JQ�= Type of unit: Dwelling Other Check#D D�S6n Check date:0 0L)l22pl A Notes: rcement pector City of Salem, Massachusetts > On? q Board of Health 120 Washington Street, 4th Floor, Salem, PublicHealth MA01970 Prevent. Promote. Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHO Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE#: GHL-16-48 DATE ISSUED: 2/12/2016 Property Located at: 284 JEFFERSON AVENUE UNIT#2 Owner/Agent: Mike Kantorosinski Address: 407 Essex Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 868-8190 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH 0'—1�7� I&Inolzo( Lar Ramdin Larry , MPH, REHS, CHO HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSEITS BOARD OF HEALTH 120 WASHINGTON STREET,4n'FLOOR r.., Cx.„�,t TEL. (978)741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL lramdin ,salem.com MAYOR LARRY RA MDIN,RS/REIIS,CHO,C11-17S Hl'.Arn j AGENT i Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.040 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" FEE: $50.00 PROPERTY LOCATED AT`j2Z�F PCZ-S cy UNIT#_4,_ IS THIS UNIT DISI rG//NATED AS RIGHT ILWr FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER •IZc� �uGc.J >+10 r� i MANAGER/AGENT NO P.O. BOX ADDRESS�4ib! . E5 5e 4 4L L• ADDRESS CITY, STATE,ZIP S / Y>1 t !I'1 Or CITY, STATE,ZIP RESIDENCE PHONE--L / 7:1 82?-✓S 9 S BUSINESS PHONE(241IRS} BUSINESS PHONE TOTAL NUMBER OF ROOMS:_._. / _ ROOM USE: 1. /3 eZo) 2. 6atA,rn 3 & Jru 41vacl�5 Qor l - n�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 �J2DJ APPLICANT'S SIGNATURE e / DATE C9 C• Inspectors use onlx Date on initial inspection: =L�?n1 g Date of reinspection: Date of issuance of certificate: 02 f�1 La 9 Date fee paid: 02-11-�V24V Type of unit: Dwellin8_A�-4ther Check#-Oj2 SQ - Check date: 0,2114012-04 a Notes: C c orc meat fns ctor CITY OF SALEM, MASSACHUSETTS 11 01;HEALTH 120 WASHINGTON STREET,4""FLOOR TEL. (978) 741-18(1) KIMI3 RI,EY DRISCOLI. FAX (978)745-0343 MAYOR Iramdinga salan com LARRY RAMDIN,RS/11131-[5,0110,CP-ISS 141W.,TH Aci1'1N'I CERTIFICATE OF FITNESS CERTIFICATE #219-11 DATE ISSUED: 7/7/2011 Property Located at: 284 Jefferson Avenue UNIT#3 Owner/Agent: Mike Kantorosinski Address: 407 Essex Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 744-7589 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 issuan*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 LARK RAMDIN HEALTH AGENT COI FORCE MENT INSPECTOR CITY OF SALEM, MASSACHUSETTS may/ BOARD OF HF.AL"CH 120 WASHINGTON STRFET,4...FLOOR Ti,a_ (978) 741-1800 KIMBERLEY DRISCOLL. FAX(978) 745-0343 MAYOR LR.4MDIN@SA1.e.M.COM LARRY RANIDIN,RS/REI-IS,C1 10,(:P-FS HFA],H i A(;vN,r Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" p� / t FEE: $50.00 PROPERTY LOCATED AT �O 7 I 1 A" e, UNIT# 3 IS THIS UNIT D�I)SA � AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSERJIIJI�SLF ^� k "VDJjQ.S'/Vf4C/MANAGER/AGENT NO P.O. BOX t f n J ADDRESS 707 P SC �d— ADDRESS CITY, STATE, ZIP S (A-0— CITY, STATE,ZIP 7-0 RESIDENCE PHONE 97 J' 7 V v7 K-3 USINESS PHONE (24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: / ROOM USE: 1. 2. 3. — , 4. 5. V/ 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS F IS PAYAB AT THE TIME O INSPECTION APPLICANT'S SIGNATURE DATE �2 Inspectors use only Date on initial inspection: -71-7'1 Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling_ L/ Other Check# q69,5 Check date: Notes: Code nforc ent Inspector