LAWRENCE STREET LAWRENCE STREET
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CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET
HEALTH AGENT 09/27/2000 Tel:(978)741-1800
Fax:(978)740-9705
Paul & Rosemary Carson
6 Lawrence Street
Salem, MA 01970
PROPERTY LOCATED AT 6 Lawrence 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 the 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 One Week 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.
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 eo exist .
qR THE BOARD OF HEALTHREPLY TO
anne Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
I
u CERT.# 17-00
�l �P R FEE
DATE: 001/13/1/13/-
r:/• 2000
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(978)741-7800
Fax:(978)740.9705
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 38 Lawrence Street UNIT #: 1
OWNER/AGENT: Deborah Hanley
ADDRESS: 38 Lawrence Street
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 741-9255
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.
I
FOR THE BOARD OF HEALTH
/ 96 L&Y
- JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
13
y��c (alj, cJ
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
I ;
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 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS ,FOR HUMAN HABITATION".
PROPERTY LOCATED AT ,
IS THIS UNIT DESIGNATED ASIG T LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER__N,kA✓0--k t/ 6IAtMANAGER/AGENT_
No P.O. Box No P.O.Box
ADDRESS k"Lezc _ ADDRESS
CITY_, �✓t? //a, _ CITY_
RESIDENCE PHONELIr41/-& BUSINESS PHONE (24 HRS.)
BUSINESS PHONE q?t -g' 7'G 7/J
TOTAL NUMBER OF ROOMS: 4 4 /
ROOM USE: 1. tL&A 2. L✓fi/I'k 3. ¢drv� 4, l rnt
5.._._._6.. 7. 8.
THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SAL THIS FEE IS PAYABLE AT THE TIME OF INSPECTION.
APPLICANTS SIGNATURE DATE l/3/0(3 ---
INSPECTORS USE OPJLY
DATE OF INITIAL INSPECTION JO DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE .— 3OU DATE FEE PAID: `—/ :�)d
TYPE OF UNIT: DWELLINGOTHER__ GHEGK#_)�L__CHECK OATE L �OCA
NOTES:
CODE ENFORCEMENT INSPECTOR 9128198
I
ti.
CITY OF SALEM, MASSACHUSETTS
+ BOARD OF HEALTH
120 WASHINGTON STREET,4°i FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FA%(978) 745-0343
MAYOR IDIONN6:&SALEM.COM
]ANF;I'DIONNI:'.
ACTING HEAI.X-1 AGI^.N-r
CERTIFICATE OF FITNESS
CERTIFICATE#558-08
DATE ISSUED: 9/25/2008
Property Located at: 45 Lawrence Street UNIT#3
Owner/Agent: Patricia Weinberg
Address: 45 Lawrence Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-3390
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.
Fnrfi THEA30 D F HEqJ-TH
1 W,
ANE DIONNE
ACTING HEALTH AGENT Cqy ENFORCE INSPECTOR
CITY OF SALEM, MASSACHUSETTS
e BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR lJ
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
NIAYOR 1DIONNB SAU."M.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 #
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER ANAGER/AGENT
NO P.O. BOX
ADDRESS V 1 t/2i wX (.C`a Sr ADDRESS
CITY, STATE,ZIP D) 4 7 a CITY, STATE, ZIP
RESIDENCE PHONE—_�✓l 3,5� BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: lt)111 1* 6 2. 1–/ U/ �, 3. 6 CD 4. n e V 5 K/7
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 lo �0 Cts
Inspectors use only
Date on initial inspection: / S/O Date of reinspection o 3� n
Date of issuance of certificate: Date fee paid:
Type of unit: Dwelling Other Check# Check dater
Notes:Lx::s " woldo,. i ivyyio;nelrowf V17zA,% V'.-W c C2dLh y -iu CA k 4ra fr1 I 40es
11Ct1 vi rA (I (OVo e,r) rr VL,) ' U ) t.)11�'liU ill S �Yl2Q dl C�fc1t� N��S
sC,t �,IccNG2imv �(•� Pove ittle hc13 s4,ctlr;s +
cWrpin � Ire�(iv)J rc,21n �.r^ � * �rcorrf till Wr
Enforcement Inspector �v� h2 f�le7! 3. �Oe's not X0 0
{�ryiJL br re IhSp�Cf1m , CLU giawf;Ons COf(2.c+ej+
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4`"FLOOR
TEL. (978) 741-1800
IUIMMERLEY DRISCOLL FAx (978)745-0343
MAYOR IDIONN&' SALEW COM
JANET DIONNE,
ACTING HEALTH AGENT
Release
In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ;
State Sanitary Code Chapter II and Article XIII of the City of Salem Ordinance, undersigned owner/lessor and
tenant/lessee of a unit of residential property, hereby authorize the Salem Board of Health or its authorized agents to
inspect the residence identified below in accordance with the aforementioned statutes, regulations and ordinances.
In the event it is necessary that said inspection be done in my/out absence. I/we expressly authorized the same and for
my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of Health and its
authorized agents from any lose or injury sustained of whatever nature and description occasioned by my/out absence
during said inspection.
Tenant/Lessee Owner/Lessor
Address Address
Address on unit to be inspected
Date
CITY OF SALEM, MASSACHUSETTS
4 ; BOARD OF HEALTH
s 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
W W W.SALEM.COM
Kimberley Driscoll JOANNE SCOTT, MPH, RS, CHO
Mayor HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE# 128-07
DATE ISSUED: 3/21/2007
Property Located at: 46 Lawrence Street UNIT#2
Owner/Agent: Stephen Leadvaro
Address: 46 Lawrence Street
City/Town: Salem, MA Zip Code: 01970,24 Hour Phone: 745-6628
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
JO NNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
1
/ " 1 CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
s ♦ 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL, 978-741,-1800
FAX 978-745-0343
y, JOANNE SCOTT, MPH, RS, CHO
Kimberley Driscoll HEALTH AGENT
Mayor
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 _UNIT _.
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
�E LESSERST tia, !.-ea V/ ,^_..MANAGER(AGENT_Q u1 v
0 0. Box No P.O.Box
ADDRESS _ _ADDRESS _
RESIDENCE PHONE_q7r.-2v -6 c-BUSINESS PHONE (24 HRS.)_„____
BUSINESS PHONE—
TOTAL NUMBER OF ROOMS:_ 5
ROOM USE: 1._, <J`t 2. v/ 3.
5. _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.
APPLICANTSSIGNATURE
/ -`� �_�_vDATE -_ 1`oYJ
INSPECTORS USE ONLY.
DATE dF INITIAL INSPECTION�_'_�._I_-a_7DATE OF REINSPECTION__._._____. .__._
DATE OF ISSUANCE OF CERTIFICATE 312- ) .—O -7-DATE FEE PAID:_
TYPE OF UNIT: DWELIO OTHER_ CHECK # S -7 CHECK DATE
NOTES:_
7
CODE ENFORCEMENT INSPECTOR 91'1.8/91,3
JO" ��coxw7•
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET
HEALTH AGENT Tel: (978)741-1800
02/14/2001 Fax:(978)740-9705
Stephen & Carol Leadvaro
46 Lawrence Street
Salem, MA 01970
PROPERTY LOCATED AT 46 Lawrence Street UNIT # 2 Front
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
I in accordance with the 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 One Week 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
j a.m.- 4:00 p.m.
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 eo exist.
FOTHE BOARD OF HEALTH REPLY TO
oanne Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
i
Fool
�CON�I
CERT.# 436-99
. FEE $25.00
DATE: 08/10/99
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: 46 Lawrence Street UNIT #: 2 Front
OWNER/AGENT: Stephen & Carol Leadvaro
ADDRESS: 46 Lawrence Street
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-6628
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. -�9
FOR THE BOARD /OFF HEALTH -
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
NOD I
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 it UNIT#-2,
IS THIS UNIT DESIGNATED AS RIGHT LEFT FROM BACK PLEASE CIRCLE ONE
OWNER/LESSER �- GER/AGENT
No P.O. Box No P.O. Box
ADDRESS ADDRESS
CITYi /dam /�/ �U CITY
RESIDENCE PHONE�7? '�4 oS�7n/o66 ?BUSINESS PHONE (24 HRS.)
BUSINESS PHONE_ ;'rO -///ol - �II0 X;2 oX
TOTAL NUMBER OF ROOMS:
ROOM USE:
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. \D
APPLICANTS SIGNATURE DAT �e
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION S4 I) DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:Kms/D S DATE FEE PAID, 9— 10 �I
TYPE OF UNIT: DWELLINGOTHER_ CHECK# _ Y CHECK DATE
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
o CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
ro $
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
AST TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
January 14, 2004
Alfred & Raymond Labranche
82 Commonwealth Road
Lynn, Ma. 01904
PROPERTY LOCATED 49 Lawrence Street
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
City of Salem, Massachusetts
Board of Health
120 Washington Street, 4th Floor, Salem, Pub1i�CH�lth
D i.PfD160[G,p[0(('Ct.
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-17-307
DATE ISSUED: 9115/2017
Property Located at: 49 LAWRENCE STREET UNIT#1
Owner/Agent: Kerin Cole
Address: 6 Gardner Road
City/Town: Reading, MA Zip,Code: 01867 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.
Zee
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITARIAN
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4m FLOOR
TEL(978)741-1800
KTMBEILLF.Y DRISCOLL FAX(978)745-0343
MAYOR LRAMDINtia sALEXCDM
LARRY RAMDIN,RS/REHS,CHO,CP-PS
HEALTHAGENT fi ebb tt Gj�t rG�t1 Q r �11[�CA
V--Mcuyl
Application for Certificate of Fitness
IN ACCORDANCE WrM STATE SANITARY CODE,CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"
FEE: $50.00 ?
PROPERTY LOCATED AT 99 L ate^ce 'S4 UNIT# � I a,J
THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BAC PLEASE CIRCLE ONE
OWNER/LESSSER
MANAGER/AGENT
4
NO P.O.BOX
ADDRESS i2l ADDRESS
CITY,STATE,ZIP S M � G rl7b CITY,STATE,ZIP
RESIDENCE PHONE C BUSINESS PRONE(24HRS)
Y.,
BUSINESS PHONE
TOTAL NUMBER OF ROOMS. 9
ROOM USE: 1. K 2. r3 R 3. 13R` 4. 5. �11
6. 7. R A 8. R 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 PAY LE AT THE TIME OF INSPECTION
�
APPLICANT'S SIGNATURE DATE b))7
tors use only
1
Date on initial inspection: Date of reinspection:
Date of issuance of certificate: Date fee paid:T�
Type of unit: Dwel Ing Other Check# Check dater
Notes:
Code Enforcement Inspector
i * . . Date X13 Time
Inspectio f
Name Address
Owner Tel. No.
Inspector /gyp
Type of Inspection --- 5.x"4-- 'J -�--
( ' ) Remarks and Violations are listed below:
La ca �ndc �� ccs �n —
Or
�I
Report Received by:
pDND
City of Salem, Massachusetts
n Board of Health
0 120 Washington Street, 4th Floor, Salem, PubliCHe dth
MA 01970 Prevent. Promote. Protect.
Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, RENS, CHO
Mayor health@salem.com Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE#: GHL-17-316
DATE ISSUED: 9/27/2017
Property Located at: 49 LAWRENCE STREET UNIT#2
Owner/Agent: Kerin Cole
Address: 6 Gardner Road
City/Town: Reading, MA Zip Code: 01867 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, REHS, CHO
HEALTH AGENT SANITARIAN
CITY OF SALEM, MASSACHUSETTS
BOARD OF HFALTH
120 WASHINGTON STREET,4"'FLOORhCHe
TEL. (978) 741-1800 FAZ(978)745-0343
KIMBERLEY DRISCOLL Iramdin@salem.com
MAYOR L\RRl'1L\S{DIN,RS/ItEIiS,CI{O,C1)-FS
HES j-Tld 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 �1
PROPERTY LOCATED AT U � c4 S4 S a 4,n~ MA- UNIT# 2-
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CHICLE ONE
OWNER/LESSER k enn Coe f I3r &(,_MANAGER/AGENT j o S 4, , iJ 1�
% ({k ...
NO P.O.BOX
ADDRESS r, w �.t./ ADDRESS
CITY, STATE,ZIP Ct h G /dl/ f 0j!8&TCITY, STATE, ZIP
RESIDENCE PHONE_�� — (�t�,�BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: S
ROOM USE: 1. 13 2. R R 3. 2 4. 144&14 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 P LE T T E OF INSPECTION �f
APPLICANT'S SIGNATURE DATE °? L/ 7
Inspectors use only
Date on initial inspection: Date of reinspection:
Date of issuance of certificate: Date fee paid: 3-
Type
-Type of unit: Dwelling Other Check# 17�?— Check date:
Notes:
Code Enforcement Inspector
CITY OF SALEM, MASSACHUSETTS
� - BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
2/15/05
Alfred & Raymond Labranche
82 Commonwealth road
Lynn, MA 01904
PROPERTY LOCATED AT 49 Lawrence 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 Cit of Salem Code of Ordinances, Section 2-
P Y
334,titled "Certificate of Fitness," each dwelling unit must be inspected and certified prior to
allowing occupancy. The inspection will be conducted in accordance with 105 CMR 410.000; State
Sanitary Code, Chapter 11: Minimum Standards of Fitness for Human Habitation.
Please notify us if you do not intend to rent the unit.
Please contact this department within 24 hours of receipt of this notice at 978-741-1800, to schedule an
appointment for an inspection. Our office hours are Monday thru Wednesday from 8:00 a.m. —4:00 p.m.
Thursday 8:00 a.m. to 7:00 p.m. and Friday 8:00 a.m.— 12:00 p.m.
Failure to comply with this procedure, may result in a fine of Twenty($20.00) dollars per day for every
day that the dwelling unit is occupied without a Certificate of fitness.
A$25.00 check payable to the City of Salem is required for each unit inspected at the time of
inspection.
A property owner is required to pay gas and electricity for residential tenants if there is not a written letting
agreement stating the tenant is responsible for those utilities and if the meter(s) records electricity and
gas use which is not used exclusively by that tenant. The Department of Public Utilities has billed
property owners for their tenant's entire utility bills retroactive to the date of initial occupancy in cases in
which cross-metering has been proven to exist.
F the Board of Health Reply to
,4�
oanne Scott MPH, RS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector
CITY OF SALEM, MASSACHUSETTS
' BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
a s o SALEM, MA 01970
Sys TEL. 978-741-1800
g' FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
6/21/05
Alfred LeBranche
82 Commonwealth Road
Lynn, MA 01904
PROPERTY LOCATED AT 49 Lawrence 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 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
Joanne Scott MPH, RS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector
GOND
{ ; City of Salem, Massachusetts
Board of Health
120 Washington Street, 4th Floor, Salem, PtlbliC'BeBlth
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-17-317
DATE ISSUED: 9/27/2017
Property Located at: 49 LAWRENCE STREET UNIT#3
Owner/Agent: Kerin Cole
Address: 6 Gardner Road
City/Town: Reading, MA Zip Code: 01867 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, REHS, CHO
HEALTH AGENT SANITARIAN
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR 11CH th
TEL. (978) 741-1800 FAX(978) 745-0343
KIMBERLEY DRISCOLL ItamdiL@salem.com
MAYOR L:\RRY 12:\bfDIN,RS/IiFsl-IS,Clip,(T-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"
l
FEE: $50.00 �1-
PROPERTY LOCATED AT Il L 4�erc,,,, Sri S 1� /1't°- UNIT#
is THIS UNIT DISIGppNATED AS RIGHT LEFT FRONT OR BACK,PLEASE1CIRCLE ONfE�
OWNER/LESSER C �JI� CD([ l gryAS � MANAGER/AGENT j0'ham
NO P.O.BOX
ADDRESS ADDRESS _
CITY, STATE,ZIPl7G�d .r // CITY, STATE, ZIP_K1.�,s_ 111 A- 01,14�
RESIDENCE PHONE 7 ^q L �/b BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: p
ROOM USE: 1. !� —� 2. �� 3. 4. K (,64 5 8(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 FEEYABLE AT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE °I � I
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: -1 -5-0-90
Notes:
Code Enforcement Inspector
+6, CITY OF SALEM, MASSACHUSETTS
�! BOARD OF HEALTH
• 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. .JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
3/17/05
Alfred Labranche
82 Commonwealth Road
Lynn, MA 01904
PROPERTY LOCATED AT 49 Lawrence Street 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 Heal
h Reply to
Joanne Scott MPH, RS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector
` CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
s 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
5 TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#27-04
DATE ISSUED: 01/22/2004
Property Located at: 49 Lawrence Street UNIT#: 3
Owner/Agent: Raymond LaBranche
Address: 82 Commonwealth Road
City/Town: Lynn, MA Zip Code: 01904 24 Hour Phone: 593-8618
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter 11"
Minimum Standards of Fitness for Human Habitation'.
Therefore, this Certificate if 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 CRM 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates,whichever
is later.
This Certificate of Fitness if valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
ANNE SCO ,, MP�HO r
HEALTH AGENT DE ORCEMENT INSPE
CITY OF SALEM, MASSACHUSETTS
'
a
BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970I_TEL. 978-741-1800 _0 CSI
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 "T9 �iyoro)c e ST UNIT#_3
IS THIS UNIT DESIGNATED AS RIGHT LEFT
__''FIIRaaONT BACK PLEASE CIRCLE ONE
OWNER/LESSER �K�►►'l�r��'XDI�ANAGER/AGENT
No P.O. Box No P.O. Box
ADDRESS � �ohWQG IQ t' ADDRESS
CITY��Y'�/7 U[ + /fib I GI/b p7 CITY
RESIDENCE PHONE l CYI 67,5-3&f D BUSINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:_
ROOM USE: 1. 2.-3.-4.
5. 6. 7. 8.
THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATURE DATE
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION lh3 Z/D V DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: / 01 DATE FEE PAID:
TYPE OF UNIT: DWELLING_OTHER_ CHECK CHECK DATE
NOTES:
CODE ENFORCIEIMENT INSPECTOR 9/28/98
� i
Adow
A
t
i * i i� �
i
i i I
� ii ii i
My
CERT.# 147-97
FEE $25.00
DATE: 03/06/97
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: 52 Lawrence Street UNIT #: 2
OWNER/AGENT: Louise Sullivan -
ADDRESS: 52 Lawrence Street
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-4735
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, CHi-;PTEA 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" .
I 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 LENDER 6 YEARS OF AGE.
3
i
FOR THE BOARD OF E�.ALTH
JOANNE SCOTT, MPH, RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
GITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO - NINE NORTH STREET
HEALTH AGENT - Tei:(508)741-1800
APPLICATION FOR CERTIFICTE OF FITNESS Fax:(508)740-9705
IN ACCORDANCE WITH STATE SANITARY CODE, -CHAPTER II, 105 CMR 410.000 "MINIMUM
STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT-� UNIT I
OSdNER/LESSER MANAGER/AGENT
ADDRESS 4r ADDRESS
CITY , ��,.�„ f1i/i/► CITY
RESIDENCE PHONE � .�i .. �L f. '. BUSINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:_y�_
ROOM USE: 1.* 2. _j _4, PON
�
b. 7. 8.
THERE IS A TWENTY-FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR HONEY ORDER TO THE
CITY OF SALEM-HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION
APPLICANTS SIGNATURE_ y`"_arrrf6y
INSPECTORS' USE ONLY
DATE OF INITIAL INSPECTION: 6r---17 DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATEDATE FEE PAID:
TYPE OF UNIT: DWELLING OTHER
NOTES:
CODE ENFORCEMENT INSPECTOR
K 6,
�mrm�
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET
HEALTH AGENT 11/09/99 Tel:(978)741-1800
Fax:(978)740-9705
Louise, Robert & James Sullivan
L � 52 Lawrence Street
Salem, MA 01970
PROPERTY LOCATED AT 52 Lawrence Street 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 the 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 One Week of receipt of this notice at
978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday
I thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7:00 p.m. and Friday 8:00
4:00 p.m. -
1 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 so exist.
OF
F THE BOARD REPLY TO
oanne Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
i
CITY OF SALEM, MASSACHUSETTS
BOARD Ov HEALTH
120 WASHINGTON STREET,4"'FLOOR
TEL.(978) 741-1800
KIMBERLEY DMCOLL FAx(978)745-0343
MAYOR 1x3RR1,'N0Aunrfa A!k.*nrcora
DAVID GmENBAUM
ACTING HEALTH AGENT
7/21/09
John Camire
53 Lawrence Street
Salem, MA 01970
PROPERTY LOCATED AT 53 Lawrence Street Unit
Clear 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 x111 of the City of Salem Code of Ordinances,Section 2-
334,tatted"Certificate of Fitness,"each dwelling unit must be Inspected and certified prior to
allowing occupancy. The tnspection 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$50.00 check payable to the City of Salem is required for each unit inspected at the time of
inspection.
A property owner is required to pay gas and electricity for residential tenants if there is not a written letting
agreement stating the tenant is responsible for those utilities and if the meters)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 rases In
which cross-metering has been proven to exist.
For the Tnbaum
h Reply to
David G Jennifer Keough
Acting Health Agent Code Enforcement Inspector
CITY OF SALEM, MASSACHUSETTS
BOARD OP Hi,-Ami
120 WASHINGTON STREET,4"' FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR ]MANC NI(@SA1J M.COM
]ANF""'M,\NCINI
AcVlNCi H i-,Ai a'I-I AG ENT -
CERTIFICATE OF FITNESS
CERTIFICATE#244-09
DATE ISSUED: 5/29/2009
Property Located at: 54 Lawrence Street UNIT# 1
Owner/Agent: Pedro J. Jimenez
Address: 1 Story Road
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 740-9773
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
Ctc� t{� c,tt�
Jdr�T MANCINI `
ACTING HEALTH AGENT ODE LNFORCEMENT INSPECTOR
t
f _p
MI
CITY OF SALEM, MASSACIIUSE"ITS y �
BOARD OF HEALTH
120 WAST IINGTON STRFEP,4°i FLOOR
T1314)78)741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
iiMAYOR COM
d )ANE7"DIONN'E,
AC'r]NG HEALTH AGENP
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 q
PROPERTY LOCATED ATt1�fA�n r e �Lt_ --. �H# }
y IS THIS UNIT DISIGNATED AS RIGHT LE FRONT R BACK.PLEASE CIRCLE ONE
OWNER/LESSER 4' (O �• �1 t e Z MANAGER/AGENT
NO P.O. BOX ��.,,� n q
ADDRESS N !`�QO t� S4(e-714 AR- ADDRESS_
CITY, STATE,ZIP I. q tt e w CITY, STATE,ZIP—
RESIDENCE PHONE ggtY ?4p— 1'77BUSINESSPHONE (24HRS)— _
BUSMSSPHONE (PLL I��'8�9T - 0&6?
1 TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2. 3. 4. 5.
b. T. 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
�y
APPLICANT'S SIGNATURE ._ DATE .J a- �/
Inspectors use on1Y
Date on initial inspection: J /i � _ Date of reinspection: /
Date of issuance of certificate: S j Date fee paid: � ��!t U
Type of unit: Dweliing_�Other Check# d 10 Check dater---
Notes: CiF L �G <� n(, (�Ppil /n (n/I.�l� W /n ( W �d U w��
�G t S�rvl Inr�c� �� Uu�`t �n In L,�.
�nnf oau ctor
Code Enforcement Insp etor
CITY OF SALEM, MASSACHUSETTS
• BOARD OF HEALTH
120 WASHINGTON SIREEr,4°i FLOOR
TEI.,. (978) 741-1800
ICMBERL EY DRISCOLL FAX(978) 745-0343
MAYORJDIONNJ:P-SALEM.COM
JANET DIONNE,
ACTING HEALTH AGENT
Release
In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ;
State Sanitary Code Chapter II and Article X111 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.
Ten L e Owner/Lessor
Address Address
Address on unit to be inspected
Date
Tenant Lead Law Notification
What lead paint forms must owners of rental homes give to new tenants?
Before renting a home built before 1978, the property owner and the new tenant must sign two copies of this Tenant
Lead Law Notification and Tenant Certification Form, and the property owner must give the tenant one of the
signed copies to keep.If any of the following forms exist for the unit,tenants must also be given a copy of them: lead
inspection or risk assessment report, Letter of Compliance, or Letter of Interim Control. This form is for
compliance with both Massachusetts and federal lead notification requirements.
What is lead poisoning and who is at risk of becoming lead poisoned?
Lead poisoning is a serious environmental hazard. It is most dangerous for children under six years old. It can cause
permanent harm to young children's brain,kidneys, nervous system and red blood cells. Even at low levels, lead in
children's bodies can slow growth and cause learning and behavior problems. Young children are more easily and
more seriously poisoned than others,but older children and adults can become lead poisoned too. Lead in the body of
a pregnant woman can hurt her baby before birth and cause problems with the pregnancy. Adults who become lead
poisoned can have problems having children,and can have high blood pressure, stomach problems, nerve problems,
memory problems and muscle and joint pain.
How do children and adults become lead poisoned?
Lead is often found in paint on the inside and outside of homes built before 1978. The lead paint in these homes
causes almost all lead poisoning in young children. The main way children get lead poisoning is from swallowing
lead paint dust and chips. Lead is so harmful that even a small amount can poison a child. Lead paint under layers of
nonleaded paint can still poison children, especially when it is disturbed, such as through normal wear and tear and
home repair work.
Lead paint dust and chips in the home most often come from peeling or chipping lead painted surfaces;lead paint on
moving parts of windows or on window parts that are rubbed by moving pails;lead paint on surfaces that get bumped
or walked on, such as floors,porches, stairs, and woodwork; and lead paint on surfaces that stick out which a child
may be able to mouth such as window sills.
Most lead poisoning is caused by children's normal behavior of putting their hands or other things in their mouths. If
their hands or these objects have touched lead dust,this may add lead to their bodies. A child can also get lead from
other sources, such as soil and water,but these rarely cause lead poisoning by themselves. Lead can be found in soil
near old, lead-painted homes.If children play in bare, leaded soil, or eat vegetables or fruits grown in such soil, or if
leaded soil is tracked into the home from outside and gets on children's hands or toys, lead may enter their bodies.
Most adult lead poisoning is caused by adults breathing in or swallowing lead dust at work, or, if they live in older
homes with lead paint,through home repairs.
How can you find out if someone is lead poisoned?
Most people who are lead poisoned do not have any special symptoms.The only way to find out if a child or adult is
lead poisoned is to have his or her blood tested. Children in Massachusetts must be tested at least once a year from
the time they are between nine months and one year old until they are four years old. Your doctor, other health care
provider or Board of Health can do this. A lead poisoned child will need medical care. A home with lead paint must
be deleaded for a lead poisoned child to get well.
What kind of homes are more likely to have lead paint?
In 1978, the United States government banned lead from house paint. Lead paint can be found in all types of homes
built before 1978: single-family and multi-family; homes in cities, suburbs or the countryside; private housing or
state or federal public housing. The older the home, the more likely it is to have lead paint. The older the paint,the
higher its lead content is likely to be.
z
Tenant Certification Form
Required Federal Lead Warning Statement
Housing built before 1978 may contain lead-based paint. Lead from paint,paint chips, and dust can pose health hazards if
not managed properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-
1978 housing, lessors must disclose the presence of known lead-based paint and/or lead-based paint hazards in the
dwelling. Lessees must also receive a federally approved pamphlet on lead poisoning prevention. The Massachusetts
Tenant Lead Law Notification and Certification Form is for compliance with state and federal lead notification
requirements.
Owner's Disclosure
(a)Presence of lead-based paint and/or lead-based paint hazards(check(i)or(ii)below):
(i)_Known lead-based paint and/or lead-based paint hazards are present in the housing(explain).
(ii)_Owner/Lessor has no knowledge of lead-based paint and/or lead-based paint hazards in the housing.
(b)Records and reports available to the owner/lessor(Check(i)or(ii)below):
(i) Owner/Lessor has provided the tenant with all available records and reports pertaining to lead—based paint
and/or lead-based paint hazards in the housing(circle documents below).
Lead Inspection Report; Risk Assessment Report; Letter of Interim Control; Letter of Compliance
(i) Owner/Lessor has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the
housing.
Tenant's Acknowledgment(initial)
(c) Tenant has received copies of all documents circled above.
(d) Tenant has received no documents listed above.
(e) Tenant has received the Massachusetts Tenant Lead Law Notification.
Agent's Acknowledgment(initial)
(f) Agent has informed the owner/lessor of the owner's/lessor's obligations under federal and state law for lead-
based paint disclosure and notification and is aware of his/her responsibility to ensure compliance.
Certification of Accuracy
The following parties have reviewed the information above and certify,to the best of their knowledge, that the information
they have provided is true and accurate.
Owner/Less Date Owner/Le to )
Tenant Date Tenant
Agent Date Agent Date
Owner/Managing Agent Information for Tenant(Please Print):
Name Street Apt.
City/Town zip Telephone
I (owner/managing agent) certify that I provided the Tenant Lead Law Notification/Tenant Certification Foran and
any existing Lead Law documents to the tenant,but the tenant refused to sign this certification.
The tenant gave the following reason:
The Massachusetts Lead Law prohibits rental discrimination,including refusing to rent to families with children or evicting
families with children because of lead paint.
Contact the Childhood Lead Poisoning Prevention Program for information on the availability of this form in other
languages.
Tenant and owner must each keep a completed and signed copy of this form. CLPPP95-17 Rm5104
�oorllx CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
_ 120 WASHINGTON STREET, 4TH FLOOR
1it SALEM, MA 01970
.p� TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#308-04
DATE ISSUED: 07/13/2004
Property Located at: 54 Lawrence Street UNIT#2
Owner/Agent: Peter J. Jimenez
Address: 54 Lawrence Street#1
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 740-9773
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.
7 OR THE BOARD C)F HEALTH
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
Flo
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
• t 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
_ TEL. 978-74 1-1800
FAX 978-745-0943
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 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION'.
PROPERTY LOCATED AT ,_j{{_LfiW2 �t/ �SfYL .N .—UNIT#
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNERJLESSER PETeX_ .T1a+ev4t MANAGER/AGENT_ i__
No P.O. Box No P.O. Box
ADDRESS—,�4 LmliK-EMGE 5-T- ADDRESS _
CITY a' nu (Zt Q —CITY
RESIDENCE PHON(9gf)1P`'q?I3BUSINESS PHONE (24 HRS.)
BUSINESS PHONEi
TOTAL NUMBER OF ROOMS: /
ROOM USE:
5.. —
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 SIGNATURE4
DATE !
INSPECTORS USE ONLY
DATE QF INITIAL INSPECTION) .-f3 _. �DATE OF REINSPECTION_.
DATE OF ISSUANCE OF CERTIFICATE: rT-( 5 -0 )�DATE FEE PAID. 7
TYPE OF UNIT: DWELLING, OTHER__ CHECK # 1 yi CHECK DATE
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
;r1
r
a
CITY OF SALEM, MASSACHUSETTS
�v L BOARD OF HEALTH
9, 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01 970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#309-04
DATE ISSUED: 07/13/2004
Property Located at: 54 Lawrence Street UNIT#3
Owner/Agent: Peter Jimenez
Address: 54 Lawrence Street#1
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 740-9773
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter 11"
Minimum Standards of Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
y
AN�TT, MPH, RS, CHO (/
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
i CITY OF SALEM, MASSACHUSETTS ��
BOARD OF HEALTH
• • 120 WASHINGTON STREET, 4TH FLOOR
. e 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 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT �LfW AE NC6 n Ley� UNIT#3
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSEACteIR- J1d4E/vE2- MANAGER/AGENT
No P.O. Box No P.O. Box
ADDRESS Sc( L!9 k/R.E PC& 5_T 5A-te4IADDRESS
CITY CITY
RESIDENCE PHON grl8 /7 0`777 USINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. �. �3. 4.
5. V/ 2 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 SIGNATUR01 01,4x�kpk C-)
DATE
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION 7 —/ 3 - DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:?" a `l� DATE FEE PAID: 7 —/ .3 a Y
TYPE OF UNIT: DWELLINGOTHER_ CHECK#_CHECK DATE Zen f
i
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
a 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAx 978-745-0343
W W W.SALEM.COM
Kimberley Driscoll JOANNE SCOTT, MPH, RS, CHO
Mayor HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE #65-07
DATE ISSUED: 2/21/2007
Property Located at: 55 Lawrence Street UNIT# 1
Owner/Agent: Pamela Landess
Address: 600 Cabot Street#2
City/Town: Beverly, MA Zip Code: 01915 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.
FOR THE BOARD OF HEALTH
,� 4b
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
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 � �'cz l {/I d, - UNIT#
IS THIS UNIT DES ED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER RfQW PSS MANAGER/AGENT
No P.O. Box No P.O. Box
ADDRESS_" Cft&M S%y #Z ADDRESS
CITY B2U�ny 1 M✓a 61`15 CITY
RESIDENCE PHONE 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 ALTH DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATUREATE ORJ10-69
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION �j-�- c 7DATE OF REINSPECTION______
_a.
DATE OF ISSUANCE OF CERTIFICATE:-3 I_�� _-_DATE FEE PAID:___ ' -3 --t3
TYPE OF UNIT: DWELLItVOTHER__- CHECK 4 %til v_ _ _CHECK DATE „_2. a,3 �3
NOTES: lX\
CODE ENFORCEMENT INSPECTOR 9/28/98
soxntr
nC CERT.# 313-01
FEE $25.00
..,... DATE: 07/10/2001
°MIN¢
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS,CHO
HEALTH AGENT 120 Washington Street
Tel: (978)741-1800
Fax: (978)-745-0343
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 55 Lawrence Street UNIT #: 2
OWNER/AGENT: Manuel Melia
ADDRESS: 113 Lafayette 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 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 BOARDOF TH
1F►1�J0ANNE SE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
gP sy',
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH,RS, CHO 120 Washington Street
HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tel: (978)741-1800
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 Fax: (978)-745-0343
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT S S ///� Gni? Cf,�Z 7Z UNIT#_2
IS THIS UNIT DESIGNATED AS RIGHT LEFT
FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER / Q UA/ �1/V-MANAGER/AGENT
No P.O. No
Box �u P.O. Box
�, /
ADDRESS /II, / e/ i �-ADDRESS
CITY -
RESIDENCE PHONE BUSINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF
ROOMS:
ROOM USE: 1. 2. 3. 4.
5. 6.-7.-8.
THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATURE DATE ��� 0 --6I
71'NSP�ECTO/RS
USE ONLY
ONLY
DATE OF INITIAL INSPECTION a 6� DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:?-lb—61 DATE FEE PAID:
TYPE OF UNIT`. DWELLING OTHER_ CHECK# 2k 0 7 CHECK DATE '7 - 1/b -0 f
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
R4
vQ'
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH, RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(978)741-1800
02/05/2001 Fax:(978)740-9705
Stephen Cummings
55 Lawrence Street
Salem, MA 01970
PROPERTY LOCATED AT 55 Lawrence Street 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 the 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 One Week 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.
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 eo exist.
F R THE BOARD 0 REPLY TO
oanScot
t MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CITY OF SALEM HEALTH DEPARTMENT
7P
Salem, Massachusetts 01970
CERTIFICATE OF FITNESS
CERTIFICATE#401-04
DATE ISSUED: 09/02/2004
Property Located at: 57 Lawrence Street UNIT# 1
Owner/Agent: Luisa Moore
Address: 57 Lawrence Street#2
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-927-3260
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
OANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
qq CITY OF SALEM, MASSACHUSETTS S �� v
y BOARD OF HEALTH
9 • 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
9g 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". r/
PROPERTY LOCATED AT 51 .) I Aw-f-e h c'p,-:,a UNIT#-I
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER L,W SA 906 e MANAGER/AGENT
No P.O. Box ui ,(,�Gp Z-ADDRESS 19
ADDRESS Fi 7 � 9t '01
CITY a f -c� CITY_ )LV � S�
RESIDENCE PHON ! d J '5 USINESS PHONE (24 HRS.) 0 d
9J?P_3—\'(oZ0
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:_
ROOM USE: 1.�_2_6
5. L 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. ___DATE '�'L
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION q aL -0 1 DATE OF REINSPECTION /�
DATE OF ISSUANCE OF CERTIFICATE: --a 'U r DATE FEE PAID: ? �� -r) T
TYPE OF UNIT: DWELLING OTHER_ CHECK# CHECK DATE_ Y-d7-OX
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
on
r
a
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR CERT.# 314-02
SALEM, MA 01970 FEE $25.00
TEL. 978-741-1800 DATE: 06/12/2002
FAX 978-745-0343
STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, R5, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 57 Lawrence Street UNIT #: 2
OWNER/AGENT: Nancy Hemingway
ADDRESS: 1 Fairfield Street
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-4587
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 ,TyH�E, BOARD OF �HEALTH
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
•" o CITY OF SALEM, MASSACHUSETTS
✓ '� BOARD OF HEALTHY///
3 + 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.5� /_aw cp-nu S+reQ} UNIT#-Z
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
il
OWNER/LESSER'Y C �/"MAINAGER/AGENT
No P.O. BoNo P.O. Box
ADDRESSx // O ADDRESS�
CITY �1rmA2:Fr_ CITY /W(-'l
RESIDENCE PHONE t7 / 7r/�I �USINESS PHONE (24 HRS.)
BUSINESS PHONE � ( 1 S /S c� 3
TOTAL NUMBER OF ROOMS: S'
ROOM USE: 1. i✓'2n. �(1 � Gtdyai* bed. ,yyi
5. 11113 g.' 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 / )IRIU DATE
INSPEC ORS USE ONLY
DATE OF INITIAL INSPECTION C - I J- -° ' DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE4- 1 2 X0-0 DATE FEE PAID:6 - 1 Z�" "'Z�
TYPE OF UNIT: DWELLING�OTHER_ CHECK# S 9'� CHECK DATE(, %
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
I
CCITY OF SALEMo MASSACHUSETTS
j A BOARD OF HEALTH
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#52-05
DATE ISSUED: 1/27/05
Property Located at: 61 Lawrence Street UNIT#2
Owner/Agent: Lorenzo Pequero
Address: 61 Lawrence Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-4511
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter 11"
Minimum Standards of Fitness for Human Habitation".
Therefore,this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates,whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
201
JOANNE SCOTT, MPH, RS, CHO J _
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 II, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT l/1 CL' UNIT# Z
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACi% PLEASE CIRCLE ONE
OWNER/LESSER 41) Raill ? ' MANAGER/AGENT
No P.O. Box r No P.O. Box
ADDRESS I /�� �� �G � ADDRESS
CITY 7,�%L/ /J7 CITY
RESIDENCE PHONE 97174/5-2i, / USINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:_ _
ROOM USE: 1. 2. 3. 4.
5./ 6. 7. 8.
THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION. �L ,ry
APPLICANTS SIGNATURE 1 � �—�-' IEi LDATE _ U�
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION DATE OF REINSPECTION _
DATE OF ISSUANCE OF CERTIFICATE: 0 X01 DATE FEE PAID: Jvj
TYPE OF UNIT: DWELLING OTHER CHECK# CHECK DATES
NOTES: J y�3rlla 7
CODE ENFORCEMENT INSPECTOR 9/28/98
CITY OF SALEM, MASSACHUSETTS
o
BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
'$q TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#53-05
DATE ISSUED: 1/27/05
Property Located at: 61 Lawrence Street UNIT#3
Owner/Agent: Lorenzo Pequero
Address: 61 Lawrence Street#1
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-741-4689
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
J ANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODEENFORCEMENT INSPE OR
CITY 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/HnUM�-AJ, +
HUMAN HABITATION".
LOCATED ATV I � V�/ 11�/Y UNIT#
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER4b,eeNZo �CL2 � � MANAGER/AGENT
No P.O. BoxNo P.O. Box J (�J
ADDRESS ADDRESS � /��J�GS AWP
CITY � CITY
RESIDENCE PHONES/ 7 SSS~ C/657 BUSINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1.
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
r � �
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:r �° DATE FEE PAID:
TYPE OF UNIT: DWELLINGOTHER_ CHECK 4-CHECK DATE
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
,f}
;b
s
CITY OF SALEM9 MASSACHUSETTS
HEALTH AGENT
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
KIMBERLEY DRISCOLL JSCOTT@SALEM.COM
MAYOR
JOANNE SCOTT
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#468-07
DATE ISSUED: 9/21/2007
Property Located at: 62 Lawrence Street UNIT#3
Owner/Agent: Thomas Camire
Address: 62 lawrence Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-741-4689
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter ll"
Minimum Standards of Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF
HEALTH ) J
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CITY OF. SALEM, MASSACHUSETTS
.� BOARD OF HEALTH �Alq},
• 120 WASHINGTON STREET, 4TL�ONyO, R1
SALEM, MA 01970
TEL. 978-741-1 800
FAX 978-745-0343 JJJJ `� g 3� 0
JOANNE SCOTT, MPH, RS, CH6 -�-
Kimberley Driscoll HEALTH AGENT
Mayor
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 .0
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". l;'j _
PROPERTY LOCATED AT 6G,/R1rNCJ1 UNIT# '
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER OnJ/gS �CAMl�4l� MANAGER/AGENT �bd
ADDRESS No P 0 BoxOr IAOMAJcc" L/) P.O.NADDRESS
CITY LS*Z'-M 10 Ol Q CITY
RESIDENCE PHONE9283 O l(PBUSINESS PHONE (24 HRS.)
BUSINESS PHONE_
TOTAL NUMBER OF ROOMS.
ROOM USE: 1. 49Z-T 2.J60 3.A T 4. klyd Itar
5.LwhS 6.0/_ n'/v1 7.ru N C� 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. oe
p
APPLICANTS SIGNATURE _DATE / O
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION !?�A ( -O 7 _DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: ✓Z 1 -,r7 DATE FEE PAID:
TYPE OF UNIT: DWELLI1\10<_ OTHER_ CHECK #3 D -7 3 CHECK DATE _11 —d
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
.�o CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
3
120 WASHINGTON STREET, 4TH FLOOR
a SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
8/9/05
Tracy& Rebecca Byors
63 Lawrence Street
Salem, MA 01970
PROPERTY LOCATED AT 63 Lawrence Street Unit Left side
Dear Sir/Madam:
It has come to our attention, that you may be considering renting a dwelling unit at the above address.
In accordance with Chapter 11,Article XIII of the City of Salem Code of Ordinances, Section 2-
334,titled "Certificate of Fitness," each dwelling unit must be inspected and certified prior to
allowing occupancy. The inspection will be conducted in accordance with 105 CMR 410.000; State
Sanitary Code, Chapter 11: Minimum Standards of Fitness for Human Habitation.
Please notify us if you do not intend to rent the unit.
Please contact this department within 24 hours of receipt of this notice at 978-741-1800, to schedule an
appointment for an inspection. Our office hours are Monday thru Wednesday from 8:00 a.m. —4:00 p.m.
Thursday 8:00 a.m. to 7:00 p.m. and Friday 8:00 a.m. — 12:00 p.m.
Failure to comply with this procedure, may result in a fine of Twenty($20.00) dollars per day for every
day that the dwelling unit is occupied without a Certificate of fitness.
A$25.00 check payable to the City of Salem is required for each unit inspected at the time of
inspection.
A property owner is required to pay gas and electricity for residential tenants if there is not a written letting
agreement stating the tenant is responsible for those utilities and if the meter(s) records electricity and
gas use which is not used exclusively by that tenant. The Department of Public Utilities has billed
property owners for their tenant's entire utility bills retroactive to the date of initial occupancy in cases in
which cross-metering has been proven to exist.
F F- e Board of Health. Reply to
Joanne Scott MPH, RS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector
�pNDIT
City of Salem, Massachusetts
f
3
Board of Health 1P
120 Washington Street, 4th Floor, Salem, PnblicHealth
MA 01970 Prevent. Promote. Protect.
Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, RENS, CHO
Mayor Iramdin@salem.com Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE #: GHL-15-411
DATE ISSUED: 12/11/2015
Property Located at: 74 LAWRENCE STREET UNIT#1
Owner/Agent: Michael Kiley
Address: 25 Sandra Road
City/Town: Peabody, MA Zip Code: 01960 24 Hour Phone:(978) 979-7489
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,--� ) &2VW14j,�k"
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITARIAN
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4' FLOOR
TF-L. (978)741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR LRANDINi@SiUM.COM
LARRY RAMDiN,RS/RJ9 S,CHO,CPRS
HEALTH AGENT
f .
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 7L/ lal4-erAeC S' UNIT#L_
IS TTimUNIT DisiGNATED As RIG>IT I"T FJtONT OR BACK PLEASE CIRCLE ONE
UWNER/LESSER,jjL4Z,, / //�1 MANAGER/AGENT
NO P.O.BOX Q /
ADDRESS,2< Say/c+� a h.Cl ADDRESS
CITY, STATE,ZB'Pieelk CITY, STATE,ZIP
RESIDENCE PHONE BUSINESS PHONE(24HRS)
BUSINESS PHONE 22Z-J 72—2 S�•,��l
TOTAL NUMBER OF ROOMS:_
ROOM USE: 1.1 y-1 2. R cc/ 3.
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 PAYAW AT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE
A Inspectors use only
Date on initial inspection: 12-/021 iolr Date of reinspection:
Date of issuance of certificate:12 712015- Date fee paid:J-210 7/2n25'
Type of unit: Dwelling- Otho Check#.505Check date: .12LO7 02-'>
Notes:
v
a
C ory entlns ctor
CITY OF SALEM, MASSACHUSETTS
+ f BOARD OF HEALTH
120 WASHINGTON STREET,4",FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR INIANCINI&AI.rM.coM
JANV I'MANCINI
AC'T'ING HEALTH AGEN"I'
CERTIFICATE OF FITNESS
CERTIFICATE#45-09
DATE ISSUED: 1/29/2009
Property Located at: 74 Lawrence Street UNIT#2
Owner/Agent: Michael Kiley
Address: 25 Sandra Road
City/Town: Peabody, MA Zip Code: 01960 24 Hour Phone: 978-979-7489
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^AARR,D,OF HEALTH
NET MANCINI
ACTING HEALTH AGENT CCWENFORCEIVIENT INSPECTOR
CITY OF SALEM MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOI,L FAX(978)745-0343
MAYOR mjoNNE a SALEM.COM
JANET DIONNE,
ACTING HEALTH AGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11,J05 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION."
FEE: $50.00
PROPERTY LOCATED
AT2y S T '�c ��vz^ UNIT# 2
IS THIS UNIT DISIGjNATED AS RIGHT LEFT FRONT OR BAC,K�PLEASE CIRCLE ONE
OWNER/LESSER m 1 G 4 C I K( l e Y MANAGER/AGENT
NO P.O.BOX /
ADDRESS_ �c)ovi//Cdr !' i k?,4 ADDRESS-
CITY,STATE,ZIP CITY, STATE,ZIP
RESIDENCE PHONE'�7�. S �f d k� BUSINESS PHONE(24HRS)
BUSINESS PHONE__'���nl " 7 Y _
TOTAL NUMBER OF ROOMS: /
ROOM USE: 1. 0-4 2 13,7-J 3. P-4 4. 5.
61_ijrnat 7 kiTa4e-m 8. % to.
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 m�z7/ `2C DATE_a9,C'
Inspectors use only
Date on initial inspection: to Date of reinspection:
Date of issuance of certificate: Date fee paid:
Type of it: Dwelling Other Check#_ Check date:_ Z
Notes: � r •)I �r�c icZh SPcc)d ci2��f Ie� 1n M4lvi fi� wU.tI.
Code Enforcement Inspector
p CITY OF SALEM, MASSACHUSETTS
.�! HEALTH AGENT
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
KIMBERLEY DRISCOLL JSCOTT@SALEM.COM
MAYOR
JOANNE SCOTT
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#491-07
DATE ISSUED: 10/2/2007
Property Located at: 74 Lawrence Street UNIT#3
Owner/Agent: Mike Kiley
Address: 25 Sandra Street
City/Town: Peabody, MA Zip Code: 01960 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.
FOR THE BOARD OF HEALTH
W,�
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
JOANNE SCOTT, MPH, RS, CHO
Kimberley Driscoll HEALTH AGENT
Mayor
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT / y f P4 p UNIT#
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER MANAGER/AGENT
No P.O. Box No P.O. Box
ADDRESS 5 , l} (x, ADDRESS
CITY CITY / yl
U� .
RESIDENCE PHONE 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 EALTH DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATURE DATE
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION "a "b 7 _DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:/,P _?--V 7 DATE FEE PAID: = �_ 7-
TYPE
TYPE OF UNIT: DWELLI OTHER CHECK# CHECK DATE
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
m
� 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FA-x 978-745-0343
STANLEY J. UISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
1/12/05
Jeffery&Amorette Clark
28 Mason Street#2
Beverly, MA 01915
PROPERTY LOCATED AT 99 Lawrence 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 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
Joanne Scott MPH, RS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector