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vQt�CONOIT CERT.# 459-99
FEE .$25.00
3 DATE: 08/17/99
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: 1 Laurel Street UNIT #: 1
OWNER/AGENT: William W. Tracy
ADDRESS: 18 Birch Street ._
CITY/TOWN: Marblehead, MA ZIP CODE: 01945 24 HOUR PHONE: 631-3011
AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS
BEEN APPROVED ANL) 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
1! JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
c m_
' 8� � �
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 i L4lGre _ Seti-� Q_ UNIT# I
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNERILESSER Wltkawn 07PRACY MANAGER/AGENT
No P.O. Box No P.O. Box
ADDRESS , � �ADDRESS
CI EITY
RESIDENCE PHONECV) ( I BUSINESS PHONE (24 HRS.)_
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. k i fc 2. Li�3, BW 4._1�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.
APPLICANTS SIGNATURE —DATE � t
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION 2 / 7 '?� _DATE OF REINSPECTION _
DATE OF ISSUANCE OF CERTIFICATET7/ 7l DATE FEE PAID:_9_�L?
TYPE OF UNIT: DWELLINGK�OTHER_ CHECK# 9 ,CHECK DATE
NOTES:__
CODE ENFORCEMENT INSPECTOR 9/28/98
„ CITY OF SALEM9 MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
� . ��o. SALEM, MA 01970
qtr,' TEL. 978-741-1800
p" D FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
November 6, 2003
Tracy William
88 Woodpond Road
West Harford, CT 06107
PROPERTY LOCATED 1 Laurel Street Unit#2
It has come to our attention, that you may be considering renting a dwelling unit at the above
address.
In accordance with Chapter 11,Article XIII of the City of Salem Code of Ordinances,
Section 2-334, titled "Certificate of Fitness,” each dwelling unit must be inspected and certified
prior to allowing occupancy. The inspection will be conducted in accordance with 105 CMR; State
Sanitary Code, Chapter 1: General Administrative Procedures and 105 CMR 410.000; State
Sanitary Code, Chapter 11: Minimum Standards of Fitness for Human Habitation.
Please notify us if you do not intend to rent the unit.
Please contact this department within 24 hours of receipt of this notice at 978-741-1800, to
schedule an appointment for an inspection. Our office hours are Monday thru Wednesday from 8:00 a.m.
—4:00 p.m.Thursday 8:00 a.m.—7:00 p.m. and Friday 8:00 a.m.—4:00 p.m.
Failure to comply with this procedure, may result in a fine of Twenty ($20.00)dollars per day for
every day that the dwelling unit is occupied without a Certificate of Fitness.
A$25.00 check payable to the City of Salem is required for each unit inspected at the time of
inspection.
A property owner is required to pay gas and electricity for residential tenants if there is not a written letting
agreement stating the tenant is responsible for those utilities and if the meter(s) records electricity and
gas use which is not used exclusively by that tenant. The Department of Public Utilities has billed
property owners for their tenants' entire utility bills retroactive to the date of initial occupancy in cases in
which cross-metering has been proven to exist.
For the Board of Health Reply to
Joanne Scott MPH, RS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector
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
08/24/2000 Fax:(978)740-9705
One Laurel Street Realty Trust c/o William Tracy, Trustee
88 Woodpond Road
West Hartford, CT 06107
PROPERTY LOCATED AT 1 Laurel Street UNIT # 2
Dear Sir/Madam:
It has come to our attention, that you may be considering renting a dwelling unit
at the above address.
In accordance with Chapter 11, Article XIII of the City of Salem Code of
Ordinances, Section 2-334,titled "Certificate of Fitness, " each dwelling unit must be
inspected and certified prior to allowing occupancy. The inspection will be conducted
in accordance with 105 CMR; 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 6:00 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.
THE BOAREPLY TO
4OR
oanne Scott, MPH,RS,CHO PABLO VALDEZ
Health Agent CODE ENFORCEMENT INSPECTOR
A
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Date: 03/13/95 Fax:(508)740-9705
One Laurel Street Realty Trust, William A. Tracy, Trustee
46 Smith Street
Marblehead, MA 01945
PROPERTY LOCATED AT 1 Laurel Street UNIT # 2
Dear Sir/Madam:
It has come to our attention, that you may be considering renting a dwelling unit
at the above address.
It is incumbent upon you as owner(s) to contact the City of Salem Health Department
to apply for a CERTIFICATE OF FITNESS before any vacant dwelling unit is rented or
occupied, or to notify us of your intent for this unit.
Each dwelling unit must be inspected and certified by the Salem Health Department
prior to allowing occupancy in accordance with Chapter 111, Sections 127A and 127B, of
the Massachusetts General Laws, 105 CMR 400.00; State Sanitary Code, Chapter 1: General
Administrative Procedures and 105 CMR 410.000; State Sanitary Code, Chapter 11 : Minimum
Standards of Fitness for Human Habitation, and in accordance with Chapter 11, Article
XIII of the City of Salem Code of .Ordiances, Section 2-334, Certificate of Fitness.
There is a twenty-five (25) dollar fee payable by check, or money order to the City
of Salem Health Department. This fee is payable at the time of inspection. Inspection
will not be performed without receipt of payment.
Failure to comply with this procedure, will result in a fine of twenty (20) dollars
per day for every day that the dwelling unit is occupied without approval of the Code
Enforcement Division of the Salem Health Department.
Contact this department within 24 hours of receipt of this notice. (508) 741-1800
Monday thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7 :00 p.m. or
Friday 8:00 a.m. to noon to schedule an appointment for an inspection.
SEE ENCLOSED SECTION 105 CMR 410 .354 METERING OF GAS & ELECTRICITY.
Very truly yours,
FOR THE BOARD OF HEALTH REPLY TO
Joanne Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
' vg��otawr,�
c! CERT.# 585-00
a FEE $25 .00
DATE: 09/11/2000
�/MINg
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: 1 Laurel Street UNIT #: 2R-Back
OWNER/AGENT: One Laurel Street Realty Trust c/o Daniel Tracy
ADDRESS: 88 Woodpond Road
CITY/TOWN: W. Hartford, CT ZIP CODE: 06107 24 HOUR PHONE: 679-9245
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
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 Tee(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 I L av cl -"t", UNIT# oZ VZ
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRON BACK LEASE CIRCLE ONE
ake- L41AV l S+. QCal� jNk4
OWNER/LESSERY� 3 MANAGER/AGENT I'Zolo{✓} G•I�Gc�
No P.O. Box C D 10c,-:a I C.'lvr. No P.O. Box
ADDRESS $8 Woody�o�d ✓2ADDRESS 6 Slo`3 Mraj0wvy?jCp4-z
CITY HCl+ �a���� Cf. OG107CITY Cdiv%c, A4 A/ G-5N
RESIDENCE PHONE $(;0 G79, 90`lS BUSINESS PHONE (24 HRS.) Rha SgrS-4i&3�
BUSINESS PHONE 6 o G - 55. R J y
TOTAL NUMBER OF ROOMS: S
ROOM USE: 1. :r:l�t�� 2. M3.` �: 4. V3ea I�ora�,
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 l C� DATE
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION q--/l o ° DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:CC- 1 1 DATE FEE PAID:- !/ .�
TYPE OF UNIT: DWELLING V OTHER_ CHECK# / C CHECK DATEU-tW'd
NOTES: /�
CODE ENFORCEMENT INSPECTOR 9/28/98
���arroll•
CERT.# 584-00
FEE $25.00
DATE: 09/11/2000
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: 1 Laurel Street UNIT #: 2F
OWNER/AGENT: One Laurel Street Realty Trust c/o Daniel Tracy
ADDRESS: 88 Woodpond Road
CITY/TOWN: West Hartford, CT ZIP CODE: 06107 24 HOUR PHONE: 679-9245
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 ,J
JOANNE SCOTT,_ ,MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
r.
L _
�3yyQ
- ��MINESA�
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 l L ZA%A-L( 5' Spee( UNIT#_1=
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER Oyu Low,( 5I 4 MANAGER/AGENT_ lvccJ
No P.O. Box C/0 OeAw -( C j No P.O. Box
ADDRESYS� rRt UA 40 J 1.100n1?� ADDRESS 510, MeaLw ✓R�S�
CITY )Aft.J 10,.,1 C-F 06ID7 CITY &Ct"N 94 V 5J�439
RESIDENCE PHONE 19O q qa ��BUSINESS PHONE (24 HRS)4'6. G%5S-� 33
BUSINESS PHONE Fi UO 7,0, a 4�
TOTAL NUMBER OF ROOMS:_
ROOM USE: 1.bl2. L6,1 3. � 4. tilti✓cin.
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 « �D
INSPECTOR ONLY
DATE OF INITIAL INSPECTION `6✓1 `1 >P' DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: < < 0 " DATE FEE PAID:
TYPE OF UNIT: DWELLING/vo OTHER_ CHECK# 1q 6 _7 CHECK DATES J
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
K '
CITY OF SALEM, MASSACHUSETTS
o BOARD OF HEALTH
z 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAx 978-745-0343
Kimberley Driscoll WWW.SALEM.COM
Mayor JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#216-06
DATE ISSUED: 4/28/06
Property Located at: 11 Laurel Street UNIT#2
Owner/Agent: Gary Katz Trustee
Address: P.O. Box 1379
City/Town: Marblehead, MA Zip Code: 01945 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 )
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
n
. _ .... r Y OF SALE'.M;' ASSACHUSE rs
BOARD OF HEALTH
120 WASHINGTON STREET,4TH FLOOR
SAUEM.MA 011979 )
TEL. 978-741-1600
FAX 376-74S-0343
STANLEY USOVICZ,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.()00
'MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION'.
_ 5 (�nc�
PROPERTY LOCATED AT UNIT 4 A
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
6 c A, /<":b f rvs 4
OWNERILESSER _ MANAGER/AGENT—
No P.O. Box urc. 7 7�-1 -r+No P.O.Box ( 37� llat5�t (�zt-c.�.
ADDRESS _ADDRESS
CITY T _CITY _
RESIDENCE PHONE BUSINESS PHONE (24 FIRS)��� �7��SCl
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: S h S
ROOM USE'. 1.All o?a m 2._Y3zG�r> 3. iivfl' ra 4.
5.
THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM; HE'.LI'l DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION. ! J
APPLICANTS SIGNATURE �i C DATE
INSPECTORS USE ONLY
DATE OF INITIAL. INSPECTION _ l _ �_ �� DATE OF REINSPECTION r�
, t]�, ` 6 1r1
DATE OF ISSUANCE OF C[RTIFICAT[4l,/id7_
J (-)All- H F PAID
TYPE OF UNIT OWL"LLINCi 01 HCR CHLCK 1i,�L t4 CHECK DATE' ''"�___e
NO]I S
CODII�IVIC)RCI-MINI IN:SI'ICI(�;i ' I+�;'ti.%`+ti
CITY OF SALEM, MASSACHUSETTS
BOARD OF HF1,L T,I{
120 WASHINGTON STREET,4"'FLOOR
TEL. (978) 741-1800
KIMBERLEY DIUSCOIJ- FAx(978) 745-0343
MAYOR nc¢rr:N�inun�na ni.r: i.cOna
DAVID GRI;[4NI �AUM
ACTING HEm,'ji i AGI;N'I'
CERTIFICATE OF FITNESS
CERTIFICATE #319-09
DATE ISSUED: 7/15/2009
Property Located at: 18 Laurel Street UNIT#2
Owner/Agent: Mary O'Leary
Address: 18 Laurel Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter ll"
Minimum Standards of Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
DAVID GR E�M _
ACTING HEALTH AGENT CODE RCEMENTINSPECTOR
CITY OF SALEM, MASSACHUSETTS
- BOARD OF HEALTH l
120 WASHINGTON STREET,4�"FLOOR
TEL. (978) 741-1800
KI ,MERLEY DRISCOLL, FAX(978) 745-0343
MAYOR DGRESNBAUMna 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 �g LCLU Y e p S+ UNIT# 2—
IS
IS UNIT DISIGN-TED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LE ER c1r ear /pqi I MANAGER/AGENT tJar�� AQ-O'L Oa -
NO P.O. BO
ADDREs l� Lc> urO Sk ADDRESS 31 Eden OPY-) AV
CITY, S ATE,ZIPl26'-' nl� a l U CITY, STATE, zIl'�nyers rn Q 19
RESIDE CE PHONE 77 BUSINESS PHONE(24HRS) NIA
BUSINESS ONE q� 7 9 3 4
TOTAL NUMBER ROOMS: JyZ
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 DATE 7//,5/07
Inspector e only
Date on initial inspection: / /J Q / c Date of reinspection:
Date of issuance of certificate:: 7IlJ� l Date fee paid: 7//,1/o
Type of unit: Dwelling—V Other Check# Check date: 7//616
Notes: 0004-Gt t(lfl1 d Diff — Call/d �* 0kUC4 (0(juf- or W tvG4�r .
Code Enforcement pe or
.r ���edddCC{
QR /� 2 097o-4658
CITY OF SALEM
HEALTH DEPT.
Li
�7
MEMBER
The Humane Society of the United States
N� c=
• �CONOIT
PXCEIVED
MAR 2 2 2001
CITY OF SALEM BOARD OF HEALTH HEALOTH DEPT
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#-Ja,
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER MANAGER/ NT
No P.O. Box NoP.O. Bo
ADDRESS ADDRES
CITY ITY
RESIDENCE PHONE - IBUSINESS PHONE (24 HRS.) `
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1.
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 USE ONLY
DATE OF 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 9/28/98
%M CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
m
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
/ 12/23/04
Rozumek Realty Trust
12 Upton Avenue
Beverly, MA 01915
PROPERTY LOCATED AT 23 Laurel Street Unit House
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
P P
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 Healltt/h/ Reply to
nne Scott MPH, RS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector
4
� CONOIT
CERT.# 484-99
` FEE $25.00
53 DATE: 08/26/99
� � le
�ciimve
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: 23 Laurel Street UNIT #: House
OWNER/AGENT: Rozumek Realty Trust
ADDRESS: 12 Red Jacket Lane
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-5678
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
ell
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
9�'��nrn1
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,OHO 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 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT____( Z L Ac) 1 5J—UNIT#
IS THIS UNIT DESIGNATED AS )IGT EF FRONT BACK PLEASE CIRCLE ONEp }
OWNER/LESSERV Z-Q/kl G\�I�f�- M)AN GER/AGENT cob�� ,\O _u Mn 6 K
ADDRESS Xnnt !�- ..RED Cjt)O T LN.ADDRESS
CITY
RESIDENCE PHONI�l f-7W;-;6 BUSINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: 6
ROOM USE: 1.
5. 6. y 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. -�pp __ .__,,.. �`}}
APPLICANTS SIGNATURE �4'ti
I�L '��'J, qA___kr�ATE
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATES'26 Atf DATE FEE PAID: "e'6 � _
TYPE OF UNIT: DWELLING-- OTHER_ CHECK# CHECK DATE
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
AUG 25 '99 08: 16 AM SALEM HEALTH +5087409705 Page 2
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
In accordance With Massachusetts General Laws Chapter III ; Code of Massachusetts
Regulations 410.000 et. seq. ; State Sanitary Code Chapter ),I and Article X111 of
r.lie City of. Salem Ordinance, undersigned owner/lessor and tenant/lessee of a unit
of residenLiol property, hercby 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.
1:1 the event it is necessary that said inspection be done. in my/our absence, I/we
expressly authorize the same and for aty/our successors and assigns hereby release
and discharge the City of Salem, Salem Board of Health and its authorized a3e.nts
from any loss or injury sustained of whatever nature and description occasioned .
by my/nur absence_ during said inspection.
I
N'l/l.'e QBE OwNBK/i n 'OK
a-3 �, ,ev. ���,. ►amt.-1�.��,1.,_
AUOCSS S- — ADDRESS
i
�3_
AUUKI:SS OF ONl'I' 70 BE: INSPECTED
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RUG 25 1999 09:30 +5067409705 PRGE.02
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
f a. 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# 177-05
DATE ISSUED: 3/11/05
Property Located at: 23 Laurel Street UNIT# 1 L (1 st& 2nd Floor Left)
Owner/Agent: Robert Rozumek
Address: 12 Red Jacket Lane
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 781-594-2587
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 T),-IE BOARD OF HEALTH
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CbdnNFORCEMENT INSPE OR
Crry OR MASSA :•
SALEM;
$OARO OF HEALTH
' 120"WASHINGTON STREET.4TH FLOOR
SALEM. MA 011970
TEL. 978-741-1800
FAX 978-745-0343 7
STANLEY USOVICZ, JR.
JOANNE SCOTT, MPH, R5, CHO
MAYOR HEALTH AGENT
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER It, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT L,y L J} UNIT p�- r/ '
4-e F t
IS THIS UNIT DESIGNATED AS RIGHTLEFT FRONT BACK PLEASE CIRCLE ONE
OWNEWLESSER � g2LKMANAGER/AGENT
No P.O. BoxJ Na P.O.Box
k
ADDRESS--a- �"ll .l u-7G/�A2�DDRESS_
CITY_. ) J'q L-E/� �CITY_,�/j•Q_�,_ _
RESIDENCE PHONE-7 5Y�2 7 r4�U4"•�USINESS PHONE (24 HRS-)_�CS�f"S
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:-6---
ROOM USE: 1Ae4l!C�2 �.i�r—_s %
THERE IS A TWENTY-FIVE (S25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION_
APPLICANTS SIGNATURE � }. "� ����� DATE J
r f
IIV,-i(?E( TOi1S L)SL OtJ1.1'
DAZE OF INIIIAI INSPI (`TIOP; � OATI[ 01" RI:INSI'TCIION
I)nu onc)I �;Llsln Ir.n� l 3—Y `�� r,n1l I If I-,�Ii)
3 r � �
IYPr C)1- 11N11 1)VJI I III (II IILI? r"'III ( :IC ,. eYl r:IIf (T 0A l
11' 1II ' ,
CITY OF SALEM, MASSACHUSETTS
» : BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL, 978.741-1800
FAX 978-745-0343
Kimberley Driscoll WWW.SALEM.COM
Mayor JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE# 133-07
DATE ISSUED: 3/26/2007
Property Located at: 23 Laurel Street UNIT#2
Owner/Agent: Robert Rozumek
Address: 12 Upton Avenue
City/Town: Beverly, MA Zip Cade: 01915 24 Hour Phone: 978-744-4354
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 HisT
JOANNE SCOTT, MPH, RS, CHO _
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
I
{
CITY OF SALEM, MASSACHUSETTS y� j�/y/j/�
BOARD OF HEALTH`"
• 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
JOANNE SCOTT, MPH, RS, CHO
Kimberley Driscoll HEALTH AGENT
Mayor
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION'.
PROPERTY LOCATED AT --4�"�� <.��UNIT#--
IS
IS THIS UNIT I DESIGNATED AS RIGHT EFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER)? Z-4�' z,-''�C L-,,4t4--4AtVAGER/Ar
No P.O. Box i No P.O.Box
ADDRESSDZ k,0 e,41
14_4,L.=_ ADDRESS_
CITY—) VL-m4-4 X CITY__IV 1T)
RESIDENCE PHONE-72 _Z�t� iNESS PHONE (24 HRS) b�yLl-4�35�
BUSINESS PHONE —� � 5�� — �Srb� `7
TOTAL NUMBER OF ROOMS:--&--
R 0 0 M
OOMS:__&J _ROOM USE: 1 `�Y(` ---
1t/_3.�114"
THERE IS A TWENTY-FIVE(S25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATURE DATE j/ZG 7
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION y_ yc -- 7 _DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE._< L_ ;-z 7DATE FEE PAID _. 3 '_ --z;, T
TYPE OF UNIT DWEL(* OTHER_ _ CHECK (3b G CHECK DATE
NOTES:_
CODE ENFORCEMENT INSPECTOR, 9/28/98 �