LEACH STREET 41- ro
LEACH STREET
i
i
o
i
i
a
nr �
J
II
i
I�
i
+ryry, CITY OF SALEM, MASSACHUSETTS
m2L BOARD OF HEALTH
53
120 WASHINGTON STREET, 4TH FLOOR
ffi SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. - JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
1/25/05
Michaeline LaRoche
144 Federal Street
Salem, MA 01970
PROPERTY LOCATED AT 41 Leach Street Unit 1
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. C�
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
JoaJe Sc , IRS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH IV
120 WASHINGTON STREET 4r"FLOOR PublicHealth.
STREET, Prevem.Promote.Pro,ecr.
'TEL. (978) 741-1800 FAX(978) 745-0343
KIMBERLEY DRISCOLL lramdin a salem.com
I ARRY RA bIlJ1N,RS/RIi'sl-IS,CIiQ,CY-I:TS
MAYOR _ H1:AI;1'FI AGI?NT
CERTIFICATE OF FITNESS
CERTIFICATE#217-13
DATE ISSUED: 6/25/2013
Property Located at: 42 Leach Street UNIT# 1
Owner/Agent: David Eisenburg
Address: 424 Salem Street
City/Town: Medford, MA Zip Code: 02155 24 Hour Phone: 781-395-1616
Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division3, Section
705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your
vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with
105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II"Minimum Standards of
Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.,
FOR THE BOARD OF_HEALTH
LARRY RAMDIN S,4,0
HEALTH AGENT SANITARIAN
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4'"FLOOR Public Promote.Hmwm
TEL. (978) 741-1800 FAx(978)745-0343
KIMBERLEY DRISCOLL Iratndin@salein.com
MAYOR - LARRY RAmmN,ILS/RENS,CHO,CP-IS
HEAmi 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"
�/ �J FEE: $550.00
PROPERTY LOCATED AT "T 2 L� /' J / UNIT#
IS THIS UNIT DISIGNATED AS RIGHT LEFT'FRONT OR BACK PLEASSE/C'CIRCLE ONE
OWNER/LESSER ��Ul" MANAGER/AGENT /V � � /✓
NO P.O.BOX ,./ (D �('� �L
ADDRESS 7 �Z `r'r ' �'� r� ADDRESS y��/
CITY, STATE,ZIPL�F� O CITY, STATE,ZIP /�G S�
RESIDENCE PHONE 7R-771 2—blf' BUSINESS PHONE(24HRS)
BUSINESS PHONE -/72,/
TOTAL NUMBER OFFn ROOMS: (
ROOM USE: 1. 4614 2. 4/1/-& 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 `---/!G DATE z—r/7
Inspectors use only
Date on initial inspection: Date of reinspection:
Date of issuance of certificate: Date fee paid: 1
Type of unit: Dwelling Other Check#-� -Check date: 2�
Notes:
Code c t Inspector
i
t -
' CITY OF SALEM, MASSACHUSETTS
• BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR IDIONNF&AL M.COM
JANL;"r DIONNL
Acl'INc HEA]Avi AcEN,r
CERTIFICATE OF FITNESS
CERTIFICATE#472-08
DATE ISSUED: 9126/2008
Property Located at: 42 Leach Street UNIT#2
Owner/Agent: Thompson Realty
Address: 424 Salem Street
City/Town: Medford, MA Zip Code: 02155 24 Hour Phone: 781-395-1616
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
r
*Ak NN l
ACTING HEALTH AGENT CODE E NFOR CEMlNNT1 �TOR
CITY OF SALEM, M-ASSACHUSETI'S
TP.i'4)74)741 1800
KIMBERIJ-) DBUSCOLL Fxx (974')745-0343
UvVOR
I \Nj,i Dio \NUI
S1,
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION."
EEE: $50,00
�z,� / a—
PROPERTY LOCATED AT 7 g,� UNIT#
- - ()1-
IS THIS DISIGNARI)AS RIGHT LEFT FRONT OR BACK,PLEASE CI LEONE
—Z45"6 21RC
OWNER/LESSER 'A.) MANAGER/AGENT d—�4�
NO P.O.BOX
ADDRESS ADDRESS— 41,5114- 97
CITY,STATE,ZIP CITY,STATE,ZIP /&&'Or V'04 A.' /I"_
RESIDENCE PHONE BUSINESS PHONE(241IRS
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. .10" 2. -be;Kl 3. 14�r 4. /3 /Z 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 PAYABW AT THE TI W OF INSPECTION
APPLICANT'S SIGNATURE DATE.03/4:'-
IRS�eCtOYS USC Only
Date on initial inspection:-3-----2—!1 Date of reinspection:—q,-:�\ -Ot
Date of issuance of certificate:. C) -2,td rag Date fee paid:
Type of unit: Dwelling k!!7�r Other Check# 1 -7 1 Check date: 2-3
Notes: rA Gt p e,,-.
ode Enforcement Inspr
CIVY, OF SALEM, MASS "SCF USE'I'I'S
Bo\RE)OI 111� AI:i�il t?f)�1��AS1 HAG I't 1N s t t t L'C,401 Fi,00R
1,.1.. (97s) 741-1800
I;IMBF,,RL i''DRISCO L.L 1':\\(978)745-0343
IMAYUR Z�invtvr(iva�i�:ni.!'OAI
�.\\CCE DIONNE',
\\1T..\R1.U'
Release
In accordance with Massachusetts General Laws Chapter 11.1;Code of Massachusetts Regulations 414.444 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 Hoard 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.
�1
Tenant/Lessee Owner/Lessor JIF
Address Address
Address on unit to be inspected
Date
Inspection of yZ `1 �i — �'� �-- '� �. l� Date (11 Z-3 v t( Time
Name Address
Owner Tel. No.
Type of Inspection �.- ' 1 Inspector
( ' 1 Remarks and Violations are listed below:
1..) Ll + I
eL
L
l I
Report Received by:
CITY OF SALEM, MASSACHUSETTS
r BOARD OF HEALTH
120 WASHINGTON STREET,4"`FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAx(978) 745-0343
MAYOR DGlteitNtiAUM(c2SAI.r M.cOM
DAVID GRf;I-NBAUM -
Ac'I'ING HU,,AL'IH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE #440-09
DATE ISSUED: 8/19/2009
Property Located at: 44 Leach Street UNIT# 1
Owner/Agent: Thompson Realty
Address: 424 Salem Street
City/Town: Medford, MA Zip Code: 02155 24 Hour Phone: 781-774-2115
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
I
AVID GREENUM
BA
ACTING HEALTH AGENT C DE EN RCEMEN PECTOR
CITY OF SALEM, MASSACHUSE"ITS ggo'o�
+ ` BOARD OF HF_,.\LTH
- 920 WAS[-IING,rON STRFET 4"'FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAX()78}745-0343
MAYOR )GR}'iEN13 UM 'ell.GM.COM
DAVID GREENBAUINI,
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 f�y L eUNIT#
t
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER � ��E MANAGER/AGENT
NO P.O.BOX
ADDRESS _534- `.e ADDRESS
CITY, STATE,ZIP AEAAT9 CITY, STATE,ZIP All
RESIDENCE PHONE l -77 ` z!!� BUSINESS PHONE(24HRS) 5 �
BUSINESS PHONE ZEl'gV�_ 161
TOTAL NUMBER OF ROOMS: 7
OOM USE: 1.��4 2. QCU2ex'"ti 3. �1���✓4.&&a0" 5.
1 6. 7. 8. 9. 10. _
ITHERE 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 TIME OF INSPECTION J q q
APPLICANT'S SIGNATURE G4� DATE
F Inspectors use oD1v
e G
Date on initial inspection:_, i Date of reinspection:
Date of issuance of certificate: 1 Date fee paid:_
Type of unit. DwellingOther Check#-^ Check date:_.
Notes:__����1�-�.J
Code EnforcementUrlspect
¢ CITY OF SALEM, MASSACHUSE-TrS
BOARD OF HEALTH
120 WASHINGTON STREET, Pm
4"'FLOOR PI1bHCHP8Ith.
Prevent.Pr"mom. met.
TEL. (978) 741-1800 Fax(978) 745-034.3
KIMBERLEY DRISCOLL Iramdin(a�salem.com
LAR]t}'RA MDIN,RS/RI;I IS,CI 10,C:P-F5
1VL1YOR HF.N:rrl A(;'FN'I'
CERTIFICATE OF FITNESS
CERTIFICATE#218-13
DATE ISSUED:6/25/2013
Property Located at: 44 Leach Street UNIT#2
Owner/Agent: David Eisenberg
Address: 424 Salem Street
City/Town: Medford, MA Zip Code: 02155 24 Hour Phone: 781-774-2115
Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division3, Section
705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your
vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with
105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II" Minimum Standards of
Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
LARR MDIN
HEALTH AGENT SA
S • s �'� ��
CITY OF SALEM, MASSACHUSETTS 10
BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR P,ePublicHealth
TEL. (978)741-1800 FAX(978)745-0343
KIMBERLEY DRISCOLL Iramdin@saleni.com
MAYOR LARRY 1tAMI)IN,RS/RF-,HS,C1 10,CP-1--S
HEALII-i AGENT
Application for.Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
x "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"
FEE: $50.00
PROPERTY LOCATED AT /�G�2 UNIT#
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BAC PLEASE CIRCLE ONE
OWNER/LESSER �� 4Qref'✓d! 'd— MANAGER/AGENT
NO P.O.BOX
ADDRESS �/f�Z ADDRESS
CITY, STATE,ZIP 1�G elz-O CrI Y, STATE,ZIP
RESIDENCE PHONE7a( —y�' l�BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 4%A 2. /T�U //4 3. 4. 3� 5.
6. 7. 8. 9. 10.
THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM >
BOARD OF HEALTH THIS FEE IS
OF INSPECTION
APPLICANT'S SIGNATURE DATE
Inspectors use onlyuse only
Date on initial inspection: / Date of reinspection:
Date of issuance of certificate: f Date fee paid: /zJ
Type of unit: Dwelling Other Check#
100 Check date:
Notes:
Codercement Inspector
M Y
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4'FLOOR
TEL. (978) 741-1800
I01MMERLEY l-)RISCOI.,L FAX(978)745-0343
MAYOR IDION NFi SUT-,M-CO ME
JANE,'r DIONN 1';
ACTING HFAurH AGF.N`r
CERTIFICATE OF FITNESS
CERTIFICATE#-489-08
- DATE ISSUED: 9126/2008
Property Located at: 46 Leach Street UNIT#1
, K
Owner/Agent: De4lsen Realty Trust
Address: 424 Salem Street
Citytrown: Medford, MA Zip Code: 02155 24 Hour Phone: 771-2115
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II"
Minimum Standards of Fitness for Human Habitation".
Therefore,this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BPARD OF HEALTH
J T
ACTING HEALTH AGENT C DE EN C MENT INSPECTOR
2008-09-2921.46 » 9787450343 P213
i
`/ rF rr rr y I•.) 11� OI
�\.��i,`�� L.!II\\ \•y q\ .Ii'\ ,�I HI I I. 6' I'!s'Uu
i.a\Illh.lil.l'.1 Ulil?1;l)I.!. 1•\`, :);$i'71i i.a.l1 _
i vA�•I I)n IvA` .
Application for Certificate of Fitness
1N ACCORDANCE WI Ili STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNFSS FOR HUMAN HABITA MON."
FEE: S50-0U
Z6"-- h'
PROPERTY LOCATED AT
M-1-1 IINITDISI 'RATF'DASRH: TUaFRONTORRAID,PLF,ASECIRCLF.ONF.
OWNER/LESSER�Pn���� L /ru�MANAGER/AG N1'
'
ADDRESS �{Lt,/ _)/1LLSm V!/4 �iJ 141'
CITY,STATE,ZIP__ /�G-V i;044 "f?/—.0- Try.STATf_,7.1P,- 1VLV,1;VvV -2,JS
RESIDENCE PHONE V-771 //S._ BUSINESS PH71
ONF(24HRS)_ � .-3 y� le/l
BUSINESS PHONE_ //���G_
TOTAL.NUMBER OF ROOMS: '7
ROOM USE: 1. Li/r� 2.f' law ;
d2...•- - - --
THERE 1S A FIFTY($SII)DOLLAR.FEE:PA-YA4LEBY,CRECK OR-MONEY ORF4 TO-TI IE CI'1 Y OF SALEM
BOARD OF HEAL:FH THIS FEE IS PAYAI L AT THF.TIME OI'INSm'cTION
APPLICAN'1"S SIGNATURE,�__ /r)1 --- -.- -- -,..--DATE
L
Inspectors use unly
Dnta on initial inspection: n ' �o d �' Dme of rcinspeclion:_—__
Date of issuance ofcenificete: �1'- b Q Date fee paid:— •2,b
a
Typc of unit Dwelling ✓ Other, ,(Nuck tE f I-)_ ('hcck date:._g; Z
Notes:
Code Enforccmcnt Inspector
2008-09-292146 >1 9787450343 P313
-7
:"I 'Ot n; \v f 01 \1.
Release
In accordance with Massachusetts GC11CFaI Laws Chapter 111:Code of Massachusetts Regulations 410.000 et. Seq.
State Sanitary Code Chapter III 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 I lealth or its authorized agents to
inspect the residence identified below iaaccordance witKthe,aforemcntionasiatutes.regulations-andordipaoccs,
In the event it is necessary that said inspection be done in my/out absence. t/we expressly authorized the same and for
my/our successors and assignsher&y m1cas-L avd-dischar6e-thc-City LiBalem, tialemFioaalof MeaUh and its,
authorized agents from any lost Or injury sustained of whI&tcvcr nature and description occasioned by my/out absence
during said inspection-
Nnant/Lessee Owner/Lessor
5-7
Address- Address
4-7 �
ddrcss on unit to be inspected
2008-09-292L46 » 9787450343 P113
Fax Cover Sheet
THOMPSON REALTY
424 Salem St. Medford, MA 02155
(781) 395-1616 Fax (781) 395-3326
1•U: ��LC�.�
DATE: TIML•:______--
Fax Number: -----
NUMBER OF PAGES INCLUDING COVER PAGE: -3
FROM:
COMMENTS:
NOTE: IF ALL PAGES ARE NOT RECEIVED,OR IF THERE ARE ANY QUESTIONS
PLEASE GIVE US A CALL IMMEDIATF.I.Y.
THOMPSON REALTY "
(781)395-1616
ty, CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
$ 120 WASHINGTON STREET, 4TH FLOOR
o SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE# 131-05
DATE ISSUED: 2/25/05
Property Located at: 46 Leach Street UNIT#2
Owner/Agent: Dellsen Realty Trust
Address: 424 Salem Street
City/Town: Medford, MA Zip Code: 02155 24 Hour Phone: 771-2115
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
r�
JOANNE SCOTT, MPH, RS, CHO .' •���''
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
Feb 18 05 11 : 24a COTE d 'AZUR 561 844-6383 p. 3
CITY OF SALEM, MASSACHUSEI I
BOARD OF HEALTHY
Q� FAX
120 WASHINGTON STREET, ATH FLOOR
SALEM, MA 01970
TEL. 978.7E I.18001...D 978.745-0343
STANIEr JSCVIC.Z. JR. JOANV[ SCOTT, MPH, RS. CHO
MnrOR HEALTH AGENT
APPLICATION FOF. CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000
'TdINIMUNI STANDARDS OF FITNESS FOR HUMAN HABITATION',
PROPERTY LOCATED AT _ S7� --- -- -UNIT e
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESS /
ER ��ZC,S�7✓ N1ANAGER.`AGENT � 2m��a✓ y�aav&V7—
No P.O. Box No P,O. Box
ADDRESS
CITY CITY_
RESIDENCE PHONE 7.r/777/{-U//� BUSINESS PHONE (24 HRS.) 7f�_ 'U�7�'
BUSINESS PHONE�
TOTAL NUP.IBER OF ROOMS: ^Z--
ROGPJUSE: 1 U�C13J o -7-
d2.
" -
THERE IS A TWENTY-FIVE (525.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY O° SALEM: HEALTH DEPAR HENT THIS FEE IS PAYABLE AT Tr-J'
TIME CF INSPECTION.
APPLICANTS S13NAlUR 'ATE
;' F;: DPS USE N Y
DAl E O� IN_TIAL I'!SPECTIOh1. DATE OF REINSPECTION
D4TE CF ISSUANCE OF CPTIc „' Tc y-yzo� CATE =E= PAID �-
TYPE OF LINT TVd--l-LI C;71-IEi�. ::'h,=Gr:. ' '3 ( � !ai.=(1�. _�.'•.TE 2 �z-,��
MOTES
-rnF F;.1=OP Ei:^ I't' iiv'S TVH
CITY OF SALEM, MASSACHUSETTS
�4 BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
cSALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
2/10/05
Dellsen Realty LLC
64 Forest Street Unit 334
Medford, MA 02155
PROPERTY LOCATED AT 46 Leach Street Unit 213
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.
Fo Board of Health\ Reply to
(y(/y,,G�-7tiX��
Joanne Scott MPH, RS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector
f
CITY OF SA-LEMt_MASSACHUSETTS
BOARD OF HEALTH
n 120 WASHINGTON STREET 4Trr FLOOR
SALEK, MA 01970
TEL. 978-741-1800
Fn X-978-745-0343
STANLEY J. LISOVICZ, JR.- JOANNE_SCOTT,;MPH,:RS;,CHO
MAYOR HEALTH AGENT
4/21/05
Dellsen Realty LLC
64 Forest Street Unit 334
Medford, MA 02155
PROPERTY LOCATED AT 46 Leach Street Unit 2R
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," eaeh.dwelling unitmust be inspected-artdcertified prioFto-
allowing occupancy.The inspection will be conducted in accordance-with-105-CM11 410.000; State,
Sanitary Code, Chapter 11: Minimum Standards of FitnessforHuman-Habitation. ..
Please notify us if you do not intend to rent the unit.
Please contact this-departmentwithin 24hours.of receipt of this notice at 978=741-1800 tasehedule 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--1200 p.m.
Failure to complywitK this procedure, may resultan a-fine of Twenty($20.00)dollars per day for every
day that the dwelling unit is occupied.withouta.Certificate of fitness.
A$25..00 check payable to the-City of Salem is required-for each unit inspected atttre time of
inspection.
A property owner isrequired.to-pay gas-andalectricity,for residential tenants if there is nota written letting
agreement stating the tenantisresponsible-for those-utilities and if the-meter(s)-records electricity and
gas usewhich is not used exclusivetKby thattenant- The Department of Public Utilities has billed
property owners for their tenant's-entire utility bills.retroactive-to the date of initial occupancy in in
which cross-metering has been proven to exist.
For the Board of Heal Reply to
Scott MPH, RS,CHO Pablo Valdez
Health Agent. Code Enforcement Inspector
E
CITY OF SALEM, MASSACHUSETTS
.� BOARD OF HEALTH
y; 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
.yBQ TEL. 978-741-1800
-- FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE# 156-05
DATE ISSUED: 3/8/05
Property Located at: 47 Leavitt Street UNIT# 1 L
Owner/Agent: Timothy Shea
Address: 21 Buchanan Road
City/Town: Salem, MA Zip Cade: 01970 24 Hour Phone: 866-372-0200 x207 Mike Cahill
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
o
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
than ii 05 11 : 53a Joanne Scott Salem BOH 978 745 0343
p. Z
e•
0 crry OF SALEM, MASSACHUSETTS
BOARD HEALTH
S / O
120 WASHINGTON STREET, 4TH FLOOR I
SALEM, MA Of 970 / 11
TEL, 976-741.1800
Fax 976-745.0343
51ANLtY, USOVICZ,-Jet. ,JOANNE SGUI I, MPH, RS, CI 10
MAYOR HEALTH AGENT Old Saltbox Publishing
20 Locust Street, #202
Danvers, MA 01923
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF''FITNESS
t FOR HUMAN HA ITATION",
PROPERTY LOCATED AT T�4-Cj ,. t� 1 j_UNIT#1��T�-• 2'
IS THIS UNIT DESIGNATED AS RIGHT LEFTO T BACK PLEASE CIRCLE Q�( I
OWNERILESSER MANAGEFUAGENT. w`1
No P.O.Box �,,N,♦o P.O.Box
ADDRESS"vim` ' . n '� ADDRESS .. I.S' « c5r,' � 2,02
-
CITY i l� W� _4 _CITY ��_,_—�` �5.)
RESIDENCE PHONE ,,* BUSINESS PHONE(24 HRS.)&"_ 9 DZtr)
BUSINESS PHONE_f�`.- CJ Dai"
TO I AL NUMBER OF ROOMS:„__nn
ROOM USE: 1,, 2,� �p 1.IJ1N
6.—_ _6......
THERE IS A TWENTY-FIVE($23.00)DOLLAR FEE,PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF S LEM HEALTH DEPA7Ij
THIS FEE IS PAYABLE AT THE
TIME OF 1NSPfCTION,
! APPLICANTS SIGNATURE ... ... . ._DATE., G� ®S�
IN3 ECTOR�,U.,E ON'Ly
PATE OF INITIAL INSPECTION 2�Yt}` DATE OF REINSPECTION__/�
DATE OF ISSUANCE OF CERTIFICATE:_ ( d DATE FEE PAID:_Pr.J��r //_
TYPE OF UNIT: DWG .-LLINC THER„ CHECK a /d;, .,_CHRCK DATE /44•
NOTES:�ci'A•n� s{,/�^�_sg„�Uz�`° r3�'�eS�c�r4C'M' !"zucy.(._,.,.. .---,
CODE ENFORCEMENT INSPECTOR 9/28198
---
�--
�,,z� � __.- Z,�
�u,,,,��.' �.-�..
;',
ri r
l
i
' ,�
t
--
CITY OF SALEM, MASSACHUSETTS
• BOARD OF HEALTH
120 WASHINGTON STREET,4."FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAx(978) 745-0343
MAYOR ]MANCINI@SALF.M.COM
JANET'MANCINI
ACTING HEAL:IH AG ENT
CERTIFICATE OF FITNESS
CERTIFICATE#117-09
DATE ISSUED: 3/17/2009
Property Located at: 48 Leach Street UNIT# 1
Owner/Agent: Dellsen Realty Trust
Address: 424 Salem Street
City/Town: Medford, MA Zip Code: 02155 24 Hour Phone: 531-3725
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
)T�ING HEALTH AGENT DE ENFOR EME SPECTOR
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4".FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAx(978) 745-0343
MAYOR JDIONNE(@SAI,l1M.COM
JANET DIONNE,
ACTING HEALTH AGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION."
FEE: $50.00
PROPERTY LOCATED AT y '�Q S� ) 'QOjQfn ) ('y)R UNIT#
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK.PLEASE CIRCLE ONE
OWNER/LESSER D01 S Pr 2�I�y � MANAGER/AGENT
No P.O. BOX ��2m s}
ADDRESS p ADDRESS `ILA Sa12pm 3�,
CITY, STATE,ZIP Me�,,�c , CITY, STATE,ZIP
RESIDENCE PHONE -481 - 3 q S_ 1616 BUSINESS PHONE (24HRS) .S I - q,41 CL S
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. QtAwoM 2 V ^'S 3. 4 5 f3 e on 1
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
1'C/-,�'1
APPLICANT'S SIGNATURE / DATE
`T_ Inspectors use only
Date on initial inspection:_ 3 -1-1 -p9 Date of reinspection:
Date of issuance of certificate: 3- 1-1 o 4 Date fee paid: 3 -\-I o 4
Type of unit: Dwelling ✓ Other Check# 11010 8 Check date: 3 110 o I
Notes:
Code Enforcement Inspector
CITY OF SALEM, MASSACHUSETTS
• BOARD OF HFALTH
120 WASHINGTON STREET,4"i FLOOR
TET.. (978) 741-1800
ICMBERLEY DRISCOLL FAR(978)745-0343
MAYOR nclaaNsnuM(�sni.ena.coM
DAVID GREIa,NBAUM
AC'T'ING HEALTI7 A(;ENT
CERTIFICATE OF FITNESS
CERTIFICATE #441-09
DATE ISSUED: 9/2/2009
Property Located at: 48 Leach Street UNIT#2
Owner/Agent: Dellsen Realty Trust
Address: 424 Salem Street
City/Town: Medford, MA Zip Code: 02155 24 Hour Phone: 978-771-2115
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
DAVID GREENBAUM
ACTING HEALTH AGENT CVLf IENF�OktEMENT INSPECTOR
THOMPSON REALTY
424 Salem Street, Medford, Ma. 02155
781-395-1616 Fax 781-395-3326
'Tor Quafity Peace of9Hind'°
I authorize the inspection of my apartment at 48 Leach st#2, Salem for our occupancy permit by the city of
Salem.
Lucus Paratis or Alyson Silva
8/20/09 �/C
CITY OF SALEM, MASSACHUSETTS � �
M BOARD OF HEALTH
a 120 WASHINGTON STREI�rr,4"`FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR uc:aE.ian�urt(astl aa.CC?tii
DAVID GREENBAUM,
ACTING HI&\LTH 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
PROPERTY LOCATED AT
IS THIS UNIT D�ISIGNAT D AS RIGHT LEFT
TFFRONT OR SACKS PLEASE CIRCLE ONE
0WNER/LESSERZ�"� // � )e " I'nANAGER/AGENT
NO P.O. sox Z / /�"4 r ADDRESS
ADDRESS - . 7
CITY, STATE,ZIP /1/ /:5 '-/t� CITY, STATE, ZIP //l�
RESIDENCE PHONE WX 7-71- -Zll/r BUSINESS PHONE(24HRS)
BUSINESS
TOTAL NUMBER OF ROOMS: ((��
ROOM USE: 1.4j 6� 2 66P�A 3 �� 4 krlT0 W 5. &-VA9v-A,
6 7. 8. 9. 10.
THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD-OF HEALTH THIS FEE IS PAY LE AT TIME OF INSPECTION /C�
APPLICANT'S SIGNATURE � DATE �J 1 2
, Inspectors use only
Date on initial inspection: ff7 1"�'et' Q� Date of reinspection-
Date
einspectionDate of issuance of certificate: Date fee paid:
Type of unit: Dwelling—Other—Check#—H Check date: 6 17/6 f
Notes:
CodeEnforcement Ins;
IY �,
1
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR
TEL (978) 741-1800
IQMBERLEY DRISCOLL EAx (978) 745-0343
MAYOR ocREr.•.NUAUM rai SALEM.COM
DAVID GREENBAUM,
ACTING HF- LTH 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.
ee �1� _
Tenant/Lessee Owner/Lessor
111W 92/,17-
Address
2/17-
Address Address
012
Address on unit to be inspected
Date
CITY OF SALEM, MASSACHUSETTS
• _ BOARD OF HEALTH
120 WASHINGTON STREET,4"FLOOR
TEL. (978) 741-1800
ICIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR DGREINBAUM@SALCM.COM
DAVID GREF.NBAUM
ACTING HF.AI;Hi AGL;NT
CERTIFICATE OF FITNESS
CERTIFICATE#012-10
DATE ISSUED: 1/15/2010
Property Located at: 50 Leach Street UNIT# 1
Owner/Agent: John Spinale
Address: 34 Bridge 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/��D OF HEALTH
DAVID GREENBAUM
ACTING HEALTH AGENT CODE ENFON4WENT INSPECTOR
�. oxwT
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
02/14/2001
50-52 Leach Street Realty Trust
P.O. Box 3045
Salem, MA 01970
PROPERTY LOCATED AT 50 Leach Street UNIT # 1F
Dear Sir/Madam:
It has come to our attention, that you may be considering renting a dwelling unit
at the above address.
In accordance with Chapter 11, Article XIII of the City of Salem Code of
Ordinances, Section 2-334,titled "Certificate of Fitness, " each dwelling unit must be
inspected and certified prior to allowing occupancy. The inspection will be conducted
in accordance with 105 CMR; State Sanitary Code, Chapter I: General Administrative
Procedures and 105 CMR 410.000; State Sanitary Code, Chapter II: Minimum Standards of
Fitness for Human Habitation.
Please notify us if you do not intend to rent the unit.
Please contact this department within 24 hours of receipt of this notice at
978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday
thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7:00 p.m. and Friday 8:00
a.m. - 4:00 p.m.
Failure to comply with this procedure, may result in a fine of Twenty (20) dollars
per day for every day that the dwelling unit is occupied without a Certificate of
Fitness.
A $25.00 check payable to the City of Salem is required for each unit inspected at the
time of inspection.
A property owner is required to pay gas and electricity for residential tenants if there
is not a written letting agreement stating the tenant is responsible for those
utilities and if the meter(s) records electricity and gas use which is not used
exclusively by that tenant. The Department of Public Utilities has billed property
owners for their tenants' entire utility bills retroactive to the date of initial
occupancy in cases in which cross-metering has been proven to exist.
R THE BOARD O HEALTH REPLY TO
oanne Sco ,, MPO PABLO VALDEZ
Health Agent CODE ENFORCEMENT INSPECTOR
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,401 FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAY(978) 745-0343
MAYOR IMANCINI([l��SAI.P,M COM
JANI_;T MANCINI.
ACTING HrAI:PI I AGFSNT
CERTIFICATE OF FITNESS
CERTIFICATE#222-09
DATE ISSUED: 5/18/2009
Property Located at: 50 Leach Street UNIT# 1R
Owner/Agent: John S. Finale
Address: 34 Bridge 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, 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
ANET MANCINI
ACTING HEALTH AGENT COD EN RCEMENT INSPECTOR
Y .
i
CITY OF SALEM, MASSACHUSETTS o `
BOARD OF HEALTH
120 WASHING"PON STREET,4".FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR rDIONNena SALI;.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
��� c ' ®147U
0
PROPERTY LOCATED AT e-� - ✓�}�VIc�r l-a UNIT# I
IS THIS UNIT'D"I'SSIIGNAT"ED�AS RIGHT LEFT FRONT OR BACK,PLEAS CIRCLE ONE
OWNER/LESSER 7-ok&h SMANAGER/AGENT
NO P.O. BOX ;7.,
ADDRESS 171 L`IC Cl2 �T' ADDRESS
CITY, STATE,ZIP'jGL\S itt� CITY, STATE,ZIP - O l q-TO
RESIDENCE PHONE BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:__ 2 p p
ROOM USE: 1. L L� 2 6CZ7& 3. V F- eX 4 1, ly - 9(c
6. 7. 8. 9. 10.
THERE IS A FIFTY($50)DOLLAR FEE,PAYAB CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS FF,E�YABLE THE F INSPECTION
APPLICANT'S SIGNATURE 0. DATE4
Inspectors use only
Date on initial inspection: Date of reinspection:
Date of issuance of certificate: s Q 1 Date fee paid:�s if G 7 G
Type of unit: Dwelling �other Check# V's -X Check date: 1/&k 9
Notes: 11VIle, E D M no fM tN 644tvaorn W
4 Irk�(t t I A - lvi vrY down
Code Enforcement Insp tot
CITY OF SALEM9 MASSACHUSETTS
fY BOARD OF HEALTH
9i 120 WASHINGTON STREET, 4TH FLOOR
� SAo' SALEM, MA 01970
-may�p' TEL. 978-741-1800
FAx 978-745-0343
KIMBERLEY DRISCOLL JSCOTT@SALEM.COM
MAYOR
JOANNE SCOTT
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE# 138-08
DATE ISSUED: 3/20/2008
Property Located at: 50 Leach Street UNIT#2
Owner/Agent: Paul J. Luchini
Address: 23 Braod Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-1607
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter If'
Minimum Standards of Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
J NNE, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
• '� CITY OF SALEM, MASSACHUSETTS l 3�
BOARD OF HEALTH
120 WASHINGTON STREET,4"FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR Iscorr a SAia:a+.COM
JOANNE SCOTT, /1 ,
' HEALTH AGENT C
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMA HABITATION."
PROPERTY LACATED AT J D �C��-� L UNIT#
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER ��I L `J� L� �QSL MANAGER/AGENTS 3. L�K l'L0
NO P.O. BOX
ADDRESS Q ��P 5-� ADDRESS Ot� n 0, rD
CrfY,STATE,ZIP XSi49 c �� — CITY,STATE,ZIP 9ak- " \
RESIDENCE PHONE y BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: J
ROOM USE: 1. L q�, 2. 3. (6 \V—4. 5.
6. 7. 8. 9. 10.
THERE IS A TWENTY-FIVE($ DOLLAR FEE, PAY LE CHECK OR MONEY ORDER TO THE CITY OF
SALEM BOARD OF HEALTH THIS EE IS LE E IME OF INSPECTION
I (y
APPLICANTS SIGNATURE DATE D V
Inspectors use only
Date on initial inspection: 3 b (D Date of reinspection:
Date of issuance of certificate: 3 '0�0-2 Date fee paid: 3 -
Type of unit: Dwelling ther Check# heck date: Z - —
Notes:
Code Enforcement Inspector
CITY OF SALEM, MASSACHUSETTS
R BOARD OF HEALTH
y, 120 WASHINGTON STREET, 4TH FLOOR
o SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#521-04
DATE ISSUED: 11/16/04
Property Located at: 50 Leach Street UNIT#3
Owner/Agent: JDS Realty Trust, John Spinale
Address: 34 Bridge Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-1607
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
JOANNESCOTT, MPH, Rs, CHO � �
HEALTH AGENT C D ENFORCEMENT INSPEOTOR
CITY OF SALEM, MASSACHUSETTS
y BOARD OF HEALTH
- t • • 120 WASHINGTOH 1STREET,4TH FLOOR
SALEM, MAO t 970
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 L'�'C�r a7` UNIT u 3
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER Vo '�' 5 �MANAGER/AGENI
No P.O. Box No P.Q. Box
ADDRESS C ADDRESST_,
CITY,_
RESIDENCE PHONE_—_ —BUSINESS PHONE (24
BUSINESS PHONE 7o° 7�_ ! /re 0-7
TOTAL NUMBER OF ROOMS:
ROOM USE: 1 mit 2 ' ` L 3.x' _ ._4
5__6._T B.
THERE IS A TWENTY-FIVE(525.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATURE DATE
INSPEC ORS USE ONLY
DATE OF INTI IAA_ INSPECTION �l -1 b � F)AlE OI= REINSPECTION
DATI DA I L I I=E P/SIU 110
!b
TYPI- OF UNIT DWr_LI_wG�X\ll OT Ii1=I� CIil-(:K a �7 t � Fcr: PAI r
N� )IIS
t:UU1 1 NI � ri;�a Ml !l l IN:I'I (: I (�I;
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH PliblllCHP.81U1
120 WASHINGTON STREET,4t"FLOOR Prevent,Proroore.Protect.
TEL. (978)741-1800 F.Ax(978)745-0343
KIMBERLEY DRISCOLL Iramdin@salem.com salem.com
_LLARRYRAINN-IDIN,RS/RI?IIS,CFIO,CII-FS
S
MAYOR I[L?;V;1'IIA( FNT
CERTIFICATE OF FITNESS
CERTIFICATE#248-14
DATE ISSUED: 7/22/2014
Property Located at: 52 Leach Street UNIT# 1 R
Owner/Agent: John Spinale
Address: 34 Bridge Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:
Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division3, Section
705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your
vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with
105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II"Minimum Standards of
Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
LAW RAMDIN a
HEALTH AGENT SANITARIAN
P P
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET 4"`FLOOR PabHcHealth
> Prevent.Promote.Protect.
TEL. (978)741-1800 FAY(978)745-0343 .
KIMBERLEY DRISCOLL Iramdiii@satem.com
LARRY annrox>
iN,Rs/aiHs,ct ,CT-US
MAYOR
IIFiAL.TI'{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"
11 FEE: $50.00
PROPERTY LOCATED AT UNIT# ( k
IS THIS UNIT DISIGNATED AS
RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER � ��1 � MANAGER/AGENT
NO P.O. BOX �n
ADDRESS_ `� 2 A kP-0 c_ -? — ADDRESS
CITY, STATE,ZIP 9 Q Vk , CITY, STATE,ZIP V lC O Q V
RESIDENCE PHONE BUSINESS PHONE(24HRS)
BUSINESS PHONE �7 - 7 O &o 7
TOTAL NUMBER OF ROOMS: ' -
ROOM USE: 1. 2. V, 3. 'k-3 4. �5.
6. 7. 8. 9. 10.
THERE IS A FIFTY($50)DOLLAR-FEZ PAYABLEJ3Y CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH TS FEE IS PAY LE THE E 0 INSPECTION --
APPLICANT'S SIGNATURE DATE_ ff I f/(V
Inspectors use only ((
Date on initial inspection: T2- y Date of reinspection:
Date of issuance of certificate: '7-1-7' 11 Date fee paid:
Type of unit: Dwelling ll Other Check#Ci Y Check date: -Zl
Notes:
Code Enforcement Inspector
i
to - City of Salem, Massachusetts
A.
Board of Health
120 Washington Strer�et, 4th Floor, Salem, Plubliclth
}1 MA V 1970 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-17-378
c DATE ISSUED: 11/7/2017
Property Located at: 52 LEACH STREET UNIT#2
Owner/Agent: John Spinale
Address: 34 Bridge Street
City/town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 745-1607
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 tater.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age.
Larry Ramdin, MPH, RENS, CHO
HEALTH AGENT SANITAR! N
,
CM OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR
TEL(978)741-180
K]NMBERLEY DRISCOLL FAX(978)745-0343
MAYOR (// A ''ll TRAWN a&At�.t coat
LARRY RAbIDIN,ltS/RF13S,CHO,CP_O >_ q V I�qg ' ✓Z- 1-C-a /h 2t
HEALTHAGINT
Application for Certificate of Iitnew
IN ACCORDANCE WITH STATE SANITARY CODE,CHAFM 11, 105 CMR 410.000
"NIINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"
FEE: $50.00
PROPERTY LOCATED AT 7 ACU l UN Z \
IS TMS UNIT DMGNATED AS RIGHT LE"PBONr OR B�CB NZASE CIRCLE ONE
OWNER/LESSEF--Vn � �� MANAGER/AGENT
NOP.O.BOX 16 �_� ADDRESS
ADDRESS
CITY,STATE,23P .j's� 04- 1�1/L D t-- CITY,STATE,ZIP
RESIDENCE PHONE p yBUSINESS PHONE(24HRS)
sTJSINESSPHONE L Z�G 6" �O7
TOTAL NUMBER OF ROOMS:
ROOM USE: 1 `( ` 2. �
3. YkeA 4. ��`f 5.
6. 7. 8. 9. 10.
THERE IS A FIFTY($50)DO PAYABLE Tn]�NSPECTION MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH FEE IS PAY LE AT
APPLICANT'S SIGNATURE DATE
Inspectors use on]v
Date on initial iffipection: Date of reinspection
Date of issuance of certificate: Date fee paid:
Type of unit: Dwcl ingL_Other Check#_Check date.,
r
Notes: `h1A4, :6.fz �7 YUN7�_�} )tn D"IA71-n
r�91�r,rC(R f O h Jr Lri �l�t (1t 29P.�tJt
e
Code Enforcement hffector
' REMrrTANCE ADVICE
JDS REALTY TRUST 53-7055/211334 Bridde Street r
Salem,MA 01970
978-745,71607 11546
i
CHECK
AMOUNT LI
m
PAY DOLLARS
I DATE "'TO THE ORDER OF DESCRIPTION CHECK No.
I �
Sal6nTe
EIY 6\SIX Si,SLLEM,MAU19]O
111 L L546III 1: 21 L3705SIB t: 009800 L L 2611-
I
y
X �
♦.e
More swing.
a More doing."
50 TRADERS WAY (978)741-9299
NOW HIRING HOMEDEPOT.COM/CAREERS
2686 00028 68115 10/30/17 11:41 AM
CASHIER JOHN
ORDER ID: H2686-48604
RECALL AMOUNT 14.97
SUBTOTAL 14.97
SALES TAH 0.94
TOTAL $15.91
CASH 20.00
CHANGE DUE 4.09
II�II�IIIII�IIIIIII�IIIIDIIII�IIII�I�IIIII�I�IF�
2686 28 68115 10/30/2017 0165
THE ROME DEPOT RESERVES THE RIGHT TO
LIMIT 1 DENY RETURNS, PLEASE SEE THE
RETURN POLICY SIGN IN STORES FOR
DETAILS.
BUY ONLINE PICK-UP IN -)Wit
AVAILABLE NOW ON HOMEDEPOT.COM.
CONVENIENT, EASY AND MOST ORDERS
READY IN LESS THAN 2 HOURS!
W%WWW%WW%WWWW WYfWWW%WWW%'%*%WWW%%%%WWWW%W
ENTER FOR A CHANCE
HOMEODEPOTWINAGIFtOCARD1
Tell us about your store visit!
Complete our short survey and
enter for a chance to win at:
www.homedepat.com/survey
PARTICIPE EN LINA
OPORTUNIDAD DE CANAR
UNA TARJETA DE
REGALO DE THD
DE $5 . 0001
Camparta Su Opinion! Complete la breve
ancuesta sobre su visita a la thence y
tenga la oportun!dad de ganar en;
www.homedepot.com/survey
Us®r ID :
BX6T 139205 136547
Password -
17530 136519
Entries must be completed within 14 days
of purchase. Entrants must be 1S or
older to enter. See complete miles on
website. No purchase necessary.
C�a1 .
o
Y r
v
mix
Paper from
FSC responsible sources
.rraq
FSC'C101537
j
44
i
4
f ,� �
SPECIAL SERVICES CUSTOMER INVOICE Page 1 of 1 NO. H2686-48604
Store 2686 SALEM,MA Phone: (978) 741-9299VALIDATION
50 TRADERS WAY Salesperson: MAH676 2634 00023 68115 10/70/1
SALEM, MA 01970 Reviewer: SALE 72 JR0037 11:41 AM
This is only a QUOTE for the merchandise and services printed below. This becomes an ORDER ID: H2636-48604
Agreement upon payment and an endorsement by a Home Depot register validation. RECALL AMOUNT 14.97
ADDL MDSE SUBTOTAL 0.00
Name Phone SUBTOTAL 14.91
LUCHINI PAUL (978)740-1898 SALES TAX 0.94
TOTAL 315.91
Actress 23 BROAD ST Phone (978) 740-1404 CASH 20.00
Company Name
G'" SALEM Jobnescrionan nutone fan unit
State MA Zip 01970 County ESSEX QUOTE is valid for this date: 10/30/2017
• MERCHANDISE AND SERVICE SUMMARY ssoldrtocustomers right to limit the quantities of merchandise
MimiREF#W02 SKU#0000-616-664 The items listed in this section will be carried out of the store by the customer at time of sale.
STOCK MERCHANDISE CARRIED OUT:
REF# 'm SKU OTY " llM = -_ 7 DESCRIPTION -_ _rrr s-3101 O PI nTAX .PRICE EACH` 4 EXTENSION=<
R01 0000-653-432 1.00 EA 696N REPLACEMENT MOTOR WHEEL 50CFM A Y $14.97 $14.97
o e $14.97
=' END OF CARRY OUT MERCHANDISE=REF#W02W..m 'i
TOTAL CHARGES OF ALL MERCHANDISE & SERVICES
• -
Policy Id(PI): R - • $14.97
A: 90 DAYS DEFAULT POLICY; SALES TAX $0.94
TOTAL $15.91
BALANCE DUE $15.91
'The Home Depot reserves the right to limit 1 deny returns. Please see the return policy sign in stores for details.'
Ra �r� _WRIN_. i „_.._.. C_ " "':END OF,ORDER No H2686-48604_, ' .._ ._ ., . .__
t
Check your current order status online at
www.homedepot.comtorderstatus
(9801) 0100598871
Page 1 of 1 NO. H2686-48604 Customer Copy
i
i
I
�.
- _ .
` CITY Or SALEM. MASSACHUSF_ T-17S
BOARD OF HFal:rrt
'1 120 WAS[I I NGrON SI'Ru F.T,4'°' 1-1(x xR
KI'MLIIr,Itl.;hiY DRISCOIJ, 11"'j- (978) 741-1800
I-Ay{978) 745-0343
M,\YOR Iratndin salem.coin
LARRYRAAIDIN,RS/R11 IS,CI 10,01-FS
H F A r.,fH ACI;:N'I'
CERTIFICATE OF FITNESS
CERTIFICATE#012-12
DATE ISSUED: 1/10/2012
Property Located at: 52 Leach Street UNIT#2
Owner/Agent: John Spinale
Address: 34 Bridge 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 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
IIRRY RAMDIN
HEALTH AGENT C ENF R )QT INSPECTOR
CITY OF SALEM, MASSACHU-SLTI'S
BOARD of Hr-\LTH
20 WASHINGTON SIRE ET,4°' Ft.()(:K
IEeI_ (978) 741-1800
KIE 1BE.RLEN DRISCOLL lax (978) 745-0343
MAYOR LK a�,v.i: .r_ ��ei
til Rld1'It,Abll)IN,
WS/IM IS,0 10,(T-I'S
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 V ar�,>� 1(a L UNIT#_t
IS THIS UNIT DISIG ATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER'�S'I tti �[In[3�c MANAGER!AGENT 1{ ONI-Q ixE a a
NO P.O. BOX
�� o --
ADDRESS —ADDRESS ,,�A,A{
CITY, STATE,ZIP AA4 CITY, STATE,ZIP UV°
RESIDENCE PHONE BUSINESS PHONE(24HRS) 17'r–
BUSINESS
'rBUSINESS PHONE
TOTAL NUMBER OF ROOMS:_,_,__
ROOM USE: I V 2 L 3 4 6a- 5_.—_
6. 7, 8. 9. 10.
THERE IS A FIFTY ($50)-DOY.L EE,PA ABLE Y CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALT&I THIS FEE IS A L AT TIME OF INSPECTION
(0 � z---
APPLICANT'S SIGNATURE DAT —
_ �tJ}u
Inspectors use only
Date on initial inspection:11I t d i a Date of reinspection:
Date of issuance of certificate: Date fee paid: _
Type of unit: Dwelling Other Check# .�r� Check date:
Notes:7Gc )G �r�l
d&de Ln tcment inspector
" CITY OF SALEM, NtASSACHUSET IS
BOARD OF HF.A1:r1j
120 WASHINGTON STREET,4...F1,OOR
TFL. (978) 741-1800
ICTMBL RLLY DRISCOLL Fax (978) 745-0343
MAYOR Iromdin@salem.com
LARRY RANIDIN,R1,/RI311S,0110,CP-FS
H I S.\I:1'1 I AG FN I'
CERTIFICATE OF FITNESS
CERTIFICATE #242-11
DATE ISSUED: 7/20/2011
Property Located at: 52 Leach Street UNIT# 1 R
Owner/Agent: John Spinale
Address: 34 Bridge 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, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
LARRY RAMDIN \�JI
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
Wk
• CITY OF SALEM, MASSACHUSETTS
BOARD OF HSAI.I'H
120 WASHINGTON STREET,4."FLOOR
IQMBERLFY DRISCOLL
TEL. (978) 741-1800 O 1 I
FAX(978) 745-0343
MAYOR IAAM1)IN(cdsnl_cJKCOM
LARRY RAMDIN,RS/RP:I-IS,CI 10,CP-hS
FIFAIXI'I AG[:,N7'
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"
FEE`: $50.00
PROPERTY LOCATED AT UNIT#__,__1K
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLEONE
OWNER/LESSER7Y� y1.t� MANAGER/AGENT
NO P.O. BOX _
ADDRESS �7� A �(o�o �dA�—T� ADDRESS °y`
CITY, STATE,ZIP \)er-1,1,4, CITY, STATE,ZIP \2t70
RESIDENCE PHONE BUSINESS PHONE(24HRS)
BUSINESS PHONE --1q67—j&07
TOTAL NUMBER OF ROOMS:_
ROOMUSE: 1. V\�7 2. 3. 4.�� 5.
6. 7. 8. 9. 10.
THERE IS A FIFTY($50)DOLLAR FEE,PAY );E,BY CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS FEE AYAB .T THE OF INSPECTION
y
APPLICANT'S SIGNATURE Qn 4T�< DATE C 0
Inspectors use only
Date on initial inspection: �/ _ Date of reinspection: /
Date of issuance of certificate: 7 d l/[/ Date fee paid: I&-L
Type of unit: Dwelling\,� Other Check#Check date:
Notes:
Cod Enfor ement Inspector
d��a CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR Pub]icHealth
nrevrne.I'rommc.rrotcc,.
TEL.(978) 741-1800 Fad(978)745-0343 _
I IMBERLEY DRISCOLL tramditi satem.com
Z,hRRY RAMI)IN,RS/I2G1 IS,C1 K),CI tN
MAYOR I-Irm ri-I A(31i:N'r
CERTIFICATE OF FITNESS
CERTIFICATE#389-14
DATE ISSUED: 10/29/2014
Property Located at: 52 Leach Street UNIT#2R
Owner/Agent: John Spinale
Address: 34 Bridge Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:
Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division3, Section
705: Certificate of fitness of rented dwelling unit,apartment or tenement. An inspection of your
vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with
105 CMR 410.000: Massachusetts State Sanitary Code, Chapter EI" Minimum Standards of
Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000,
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
LARRY RAMDIN
HEALTH AGENT SANITARIAN
CITY OF SALEM, MASSACHUSETTS
Y I M BOARD OF HEALTH
120 WASHINGTQN STREET,41°FLOOR ��JJ
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAx(978) 745-0343
MAYOR LRAMD IM.00M
LARRY RAMDIN,RS/RGI IS,CI 10,(T-FS
H13AI:1'FI Au1ixi'
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 n k(F-dL k --t>u UNIT#
IS THIS UNIT D�ISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER�(L MANAGER/AGENT
NO P.O. BOX , � n
ADDRESS b � :y2AtaQQ2ep 73;Z— ADDRESS ��11
CITY, STATE,ZIPCITY, STATE,ZIP
RESIDENCE PHONE BUSINESS PHONE(24HRS)
BUSINESS PHONEr z�� -�CoO7
TOTAL NUMBER OF ROOMS:_ ��
ROOM USE: 1. lam- 2.�'VZ 3. C¢�,�, 4: 5.
6. 7. 8. 9. 10.
THERE IS A FIFTY LLAR FEE,PAY HECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEAL IS FEE I ABLE T THE OF INSPECTION
APPLICANT'S SIGNATURE DATE G 2 ��
IWectors use only
Date on initial inspection: Date of reinspection:
Date of issuance of certificate: �1 Date fee paid:
Type of unit: Dwelling Other Check#-q VOW Check date:
Notes:
Code Enford ent Inspector
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET
HEALTH AGENT Tel: (978)741-1800
Fax:(978)740-9705
04/03/2001
50-52 Leach Street Realty Trust
34 Bridge Street
Salem, MA 01970
PROPERTY LOCATED AT 52 Leach Street UNIT # 2RR
Dear Sir/Madam:
It has come to our attention, that you may be considering renting a dwelling unit
at the above address.
In accordance with Chapter 11, Article XIII of the City of Salem Code of
Ordinances, Section 2-334,titled "Certificate of Fitness," each dwelling unit must be
inspected and certified prior to allowing occupancy. The inspection will be conducted
in accordance with 105 CMR; State Sanitary Code, Chapter I: General Administrative ,
Procedures and 105 CMR 410.000; State Sanitary Code, Chapter II: Minimum Standards of
Fitness for Human Habitation.
Please notify us if you do not intend to rent the unit.
Please contact this department within 24 hours of receipt of this notice at
978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday
thru Wednesday. from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7:00 p.m. and Friday 8:00
a.m. - 4 :00 p.m.
Failure to comply with this procedure, may result in a fine of Twenty (20) dollars
per day for every day that the dwelling unit is occupied without a Certificate of
Fitness.
A $25.00 check payable to the City of Salem is required for each unit inspected at the
time of inspection.
A property owner is required to pay gas and electricity for residential tenants if there
is not a written letting agreement stating the tenant is responsible for those
utilities and if the meter(s) records electricity and gas use which is not used
exclusively by that tenant. The Department of Public Utilities has billed property
owners for their tenants- entire utility bills retroactive to the date of initial
occupancy in cases in which cross-metering has been proven to exist.
R THE BOARD HE L H REPLY TO
oanScot
t, MPH,RS,CHO - PABLO VALDEZ
Health Agent CODE ENFORCEMENT INSPECTOR
w
ND
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
02/14/2001
50-52 Leach Street Realty Trust
P.O. Box 3045
Salem, MA 01970
PROPERTY LOCATED AT 52 Leach Street UNIT # 2RR
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 OCertificate of Fitness n
each dwelling unit mu
st be
inspected and certified prior to allowing occupancy. The inspection will be conducted
in accordance with 105 CMR; State Sanitary Code, Chapter I: General Administrative
Procedures and 105 CMR 410.000; State Sanitary Code, Chapter II: Minimum Standards of
Fitness for Human Habitation.
Please notify us if you do not intend to rent the unit.
Please contact this department within 24 hours of receipt of this notice at
978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday
thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7:00 p.m. and Friday 8:00
a.m. - 4:00 p.m.
Failure to comply with this procedure, may result in a fine of Twenty (20) dollars
per day for every day that the dwelling unit is occupied without a Certificate of
Fitness.
A $25.00 check payable to the City of Salem is required for each unit inspected at the
time of inspection.
A property owner is required to pay gas and electricity for .residential tenants if there
is not a written letting agreement stating the tenant is responsible for those
utilities and if the meter(s) records electricity and gas use which is not used
exclusively by that tenant. The Department of Public Utilities has billed property
owners for their tenants' entire utility bills retroactive to the date of initial
occupancy in cases in which cross-metering has been proven to exist.
R THE BOARD HEALTH REPLY TO
oanne Sco MPH,RS,CHO PABLO VALDEZ
Health Agent CODE ENFORCEMENT INSPECTOR
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
R 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
11/3/04
50-52 Leach St Realty TR/John D. Spinale/Dana P Jordan TRS
34 Bridge Street
Salem, MA 01970
PROPERTY LOCATED AT 52 Leach Street Unit 3R
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
Joa S" rd'Cott NfP111, R __�7t_ Pablo Valdez
Hea Agent Code Enforcement Inspector
' CITY OF SALEM9 MASSACHUSETTS
_f r 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
CERTIFICATE OF FITNESS
CERTIFICATE# 520-04'
DATE ISSUED: 11/16/04
Property Located at: 52 Leach Street UNIT#3R
Owner/Agent: 50-52 Leach St Realty TR/John D. Spinale/Dana P Jordan TRS
Address: 34 Bridge Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-1607
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
JOANNE SCOTT, MPH, RS, CHO ��-1X�'�.t
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
e�-•_�" CM OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
_ "► • • 120 WASH/HGTOH 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 `� �''�� S UNIT v 3
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNERILESSER `1 affA.� S_f'�;-et `re-e.MANAGERIAGENT
No P.O. Box i No P.O.Box
ADDRESS_A Y /3X dmf C _JT- ADDRESS_
CITY4---er , CITY
RESIDENCE PHONE` __BUSINESS PHONE (24 HRS.),_.__._.`___
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. elr ` 24 !G' 9. 13-d_ 4
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_ Al THE
TIME OF INSPECTION.
APPLICANTS SIGNATURE (UATF
SPECT RS USE ONLY
DATE OF INITIAL_ INSPECTION f� '�� �� I_)Al E OF REINSPC-CTION
DATI= OF ISSN NCE Ol ,Ei1l"li ICA I E /1-16 DnTL EI=1- PMI) �� J
TYPE_ OF UNIT DWE-LL1N(� OTHER CHG(X 1!37; 7 vo,
t:I �Ui I IJi � )I;i :I toil YdI IbJ'.lf'I �: I �Iii ...
' OOND�A
City of Salem, Massachusetts
y 9
Board of Health
120 Washington Street, 4th Floor, Salem, PublicHealth
M O Prevent. Promote. Protect.
MA 01970
Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS,CHO
Mayor lramdin@salem.com Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE M GHL-15-35
DATE ISSUED: 4/22/2015
Property Located at: 58 LEACH STREET UNIT#1
Owner/Agent: Roger Lamontagne
Address: 58 Leach Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978)7448838
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 It "Minimum
Standards of Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now
be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
Larry Ramdin, MPH, REHS, CHO (�
HEALTH AGENT SANITARIAN
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4°1 FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAx(978) 745-0343
MAYOR I.RAMD1N SALJ M.COM
LARRY RAMDIN,RS/REI IS,CHO,CP-IS
HEAL:PH A(,ENr
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"
FEE: $50.00
PROPERTY LOCATED AT l]�/`= 4 C-�Z 0 UNIT# <
n IS THIS UNIT DISI/GNATED AS RIGHT LEFT FRONT OR BAC&PLEASE CIRCLE ONE
OWNER/LESSER I`6C���'L. i AA/ C/✓T4,�jii,MANAGER/AGENT
NO P.O. BOX _
ADDRESS �' � f vc�i ADDRESS
CITY, STATE,ZIP STATE,ZIP
q
RESIDENCE PHONE L 73 - 7�4 y 4 Sl J BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS
:
ROOM USE: 1. 16�� 2. L U C- 3. 4. 13a /,-tet 5. P
'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
4DATE� /�APPLICANT'S SIGNATURE— 3
11 � / / Inspectors use only
Date on initial inspection: `1 f( 3 I 1 5 Date of reinspecti
Date of issuance of certificate:-., Date fee paid: I I I
Type of unit: Dwelling Other Check# heck date:L4 13 1
Notes:
Code1�,
'fo• em�pector
CITY OF SALEM, MASSACHUSETTS
.l BOARD OF HEALTH
• • 120 WASHINGTON STREET. 4TH FLOOR
SALEM,
# 0)11.03
SALEM, MA 01974
TEL. 976-741-1800 FEE $25.00
Fax 978-745-0343 DATE: 12/15/03
STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
I
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 58 LEACH STREET UNIT #' 2
OWNER/AGENT: ROGER LAMONTAGNE
ADDRESS: 58 LEACH STREET
CITY/TOWN: SALEM ZIP CODE: 01970 24 HOUR PHONE: 978-744-8838
AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS
BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410.000: MASSACHUSETTS STATE
SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" .
„ THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF-THE
SALEM BOARD OF HEALTH AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED.
MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410 .000: MASSACHUSETTS STATE
SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" .
SECTION 410.400 (B) , DWELLING UNIT (X) AND 410.400 {C} : ROOMING UNIT { )
MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: .
NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR
OCCUPANTS UNDER 6 YEARS OF AGE NOR BUILDING RELATED CODES. FOR MORE
INFORMATION CALL 978-741-1800.
i
FO THF.yB�OA,RD OF HEALTH
� L ,,7
JOANNE SCOTT, MPH,RS,CHO AR -
'-
HEALTH AGENT JEVAUGHAN
CODE ENFORCEMENT INSPECTOR
I
i
CITY OF SALEM, MASSACHUSETTS
1 BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
0 FAX 978-745-0343 - I I 1 0,3
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 UNIT#2-
r
IS THIS GNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER USP 6-e fZ A&d AlYA GA1 tJfANAGER/AGENT
No P.O. Box No P.O.Box
ADDRESS S-9- ke4e° a ADDRESS
CITY �4 Le r l-o CITY AX Q.
RESIDENCE PHONE BUSINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:- �S
ROOM USE: 1frr
5.Dil ld(M6. 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 / ` 2 / Z Jd3
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION ///%/J DATE OF REINSPECTION�i�
DATE OF ISSUANCE OF CERTIFICATE: // d 03 DATE FEE PAID:
S
TYPE OF UNIT: DWELLING t,/OTHER— CHECK # 54,0�) RCHECK DATE
NOTES:
CODE & F R EMENT INS CTOR 9/28/98
�ONnIT
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET
HEALTH AGENT 09/01/99 Tel:(978)741-1800
Maryann Field Fax:(978)740-9705
30 Story Street
Essex, MA 01929
PROPERTY LOCATED AT 59 Leach 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 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7:00 p.m. and Friday 8:00
a.m. - 4:00 p.m.
Failure to comply with this procedure, may result in a fine of Twenty (20) dollars
per day for every day that the dwelling unit is occupied without a Certificate of
Fitness.
A $25.00 check payable to the City of Salem is required for each unit inspected at the
time of inspection.
A property owner is required to pay gas and electricity for residential tenants if there
is not a written letting agreement stating the tenant is responsible for those
utilities and if the meter(s) records electricity and gas use which is not used .
exclusively by that tenant. The Department of Public Utilities has billed property
owners for their tenants' entire utility bills retroactive to the date of initial
occupancy in cases in which cross-metering has been proven to exist.
OR THE BOARD jqF HEALTH REPLY TO
Joanne Scoft, MPH,RS,CHO PABLO VALDEZ
Health Agent CODE ENFORCEMENT INSPECTOR
CONDIT
t g eta
7
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET
HEALTH AGENT 09/12/2000 Tei:(978)741-1800
Fax:(978)740-9705
Arturo Caceres
62 Leach Street
Salem, MA 01970
PROPERTY LOCATED AT 62 Leach Street UNIT # 1
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.
OR THE BOARD 0 HEALTH REPLY TO
UUJoanne Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CERT.# 483-99
5q FEE $25.00
5S DATE: 08/26/99
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: 62 Leach Street UNIT #: 2
OWNER/AGENT: Arturo Caceres
ADDRESS: 62 Leach Street
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 538-5000
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
n
v � 1
��MIN6
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 11, 105 CMR 410,000
"MINIMUM STANDARDS OF FITNESS FOR��HU,,__MAN__H��AA�BITATION".
PROPERTY LOCATED AT /;Z � �_j-7'" rvT UNIT# Z_
IS THIS UNIT DESIGNATED ASIR GHT SFT FRONT BACK PLEASE CIRCLE ONE
OWNERILESSER 1A fo CGca �MANAGEWAGENT
No P.O. Box No P.O. Box
ADDRESS CO2- C e c c/-J 'i't Z ADDRESS
CITY CITY
RESIDENCE PHONE 7 yS1yo 7 BUSINESS PHONE (24 HRS.) S3 `d SOS
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: b /
ROOM USE: 1..
4.
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 r __ DATE--k-
�(�SE ONLY
DATE OF INITIAL INSPECTION 5 )-b - I f DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:S��. . "4`/ DATE FEE PAID: �C6 `q,�
TYPE OF UNIT: DWELLINGi�OTHER_ CHECK#_3_1_(, _..CHECK DATE
NOTES: —
CODE ENFORCEMENT INSPECTOR 9/28/98
'r
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT - Tel:(508)741-1800
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 II and Article XIII of
the Cit; of Salem Ordinance, undersigned owner/lessor and tenant/lessee of a unit
of residential property, hereby authorize the Salem Board of Health or its author-
ized agents to inspect the residence identified below in accordance with the .
aforementioned statutes, regulations and ordinances.
In the event it is necessary that said inspection be done in my/our absence, !/we
expressly authorize the same and for my/our successors and assigns hereby release
and discharge the City of Salem, Salem Board of Health and its authorized agents
from any loss or injury sustained of .whatever nature and description occasioned ,.._
by my/our absence d'urin.g said inspection.
TENANT/LESSEE OWNER/LESSOR
ADDRESS ADDRESS
ADDRESS OF UNIT TO BE INSPECTED
DATE
coxw� CITY OF SALEM, MASSACHUSETTS
e3� a BOARD OF HEALTH
$ 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
9epMM6 TEL. 978-741-1800
FAX 978-745-0343
KIMBERLEY DRISCOLL JSCOTT@SALEM.COM
MAYOR
JOANNE SCOTT
HEALTH AGENT
5/29/08
South Harbor Holdings
P.O. Box 677
Salem, MA 01970
PROPERTY LOCATED AT 65 Leach Street Unit 1
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
janne Scott MPH, RS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector
: r
_ P k.
. 1j�lp R
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET
HEALTH AGENT 02/17/2000 Tel:(978)741-1800
Fax:(978)740-9705
Clarke Jacobs Realty Trust c/o Donald Clarke, Trustee
P.O. Box 677
Salem, MA 01970
PROPERTY LOCATED AT 65 Leach 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 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7:00 p.m. and Friday 8:00
a.m. - 4:00 p.m.
Failure to comply with this procedure, may result in a fine of Twenty (20) dollars
per day for every day that the dwelling unit is occupied without a Certificate of
Fitness.
A $25.00 check payable to the City of Salem is required for each unit inspected at the
time of inspection.
A property owner is required to pay gas and electricity for residential tenants if there
is not a written letting agreement stating the tenant is,responsible for those
utilities and if the meter(s) records electricity and gas use which is not used
exclusively by that tenant. The Department of Public Utilities has billed property
owners for their tenants' entire utility bills retroactive to the date of initial
occupancy in cases in which cross-metering has been proven to exist.
i
R THE BOARD Of HEALTH REPLY TO
1
r oanne Sco , MPH,RS,CHO PABLOVALDEZ
Health Agent CODE ENFORCEMENT INSPECTOR
ONDIT
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
04/02/2001 Fax:(978)740-9705
John Deschamps, Jr.
66 Leach Street
Salem, MA 01970
PROPERTY LOCATED AT 66 Leach Street UNIT # 2nd Floor
Dear Sir/Madam:
It has. come to our attention, that you may be considering renting a dwelling unit
at the above address.
In accordance with Chapter 11, Article XIII of the City of Salem Code of
Ordinances, Section 2-334, titled "Certificate of Fitness, " each dwelling unit must be
inspected and certified prior to allowing occupancy. The inspection will be conducted
in accordance with 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.
I
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.
I . 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.
OR THE BOARD 0 HEALTH REPLY TO
j J6Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
I
I
��eoxor7•
99
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS,CHO
HEALTH AGENT 120 Washington Street
07/25/2001 Tel: (978) 741-1800
Fax: (978)745-0343
John Deschamps, Jr.
66 Leach Street
Salem, MA 01970
PROPERTY LOCATED AT 66 Leach 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 ifyou 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.
FOR THE BOARD LTH REPLY TO
Joanne S MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
Y•
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
1/20/05
Caroline Realty Trust/James B. Collett
P.O. Box 2098
Haverhill, MA 01831
PROPERTY LOCATED AT 74 Leach 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.
F the Board of Heal/t� Reply to
oanne Scott MPH, RS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector
� y
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#66-06
DATE ISSUED: 2/16/06
Property Located at: 76 Leach Street UNIT#2
Owner/Agent: Bradford & Kerry Martin
Address: 5 West Circle
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 740-3750
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 OFF HEALTH
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CITY OF SALEM, MASSACHUSETTS / _D
BOARD OF HEALTH
• • 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
JOANNE SCOTT, MPH, R5, 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�7jII f� J I UNIT#A
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSEP'B NI'll , (- n MANAGER/AGENT
No P.O. Box No P.O. Box
ADDRESS 5A.Ja ADDRESS
CITY CITY;g_
RESIDENCE PHONE 1`/ 8-4 USINESS PHONE (24 HRS.)
BUSINESS PHONE f n
TOTAL NUMBER
�� y_
OF ROOMS: `�'
ROOM USE: 1. VtY2.�43.
5.�qlh 6.bQA8.
THERE IS A TWENTY-FIVE ($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATURE _DATE j JU
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION -) , 16 v DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:2� 6 DATE FEE PAID: y - �6 6
TYPE OF UNIT: DWELLINC &HER_ CHECK# `7�S D CHECK DATE2_-_�
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
f
CITY OF SALEM, MASSACHUSETTS U
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
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 Cit, of. Salem Ordinance, undersigned owner/lessor and tenant/lessee of a unit
of residential property, hereby authorize the Salem Board of Health or its author-
ized agents to inspect the residence identified below in accordance with the
aforementioned statutes, regulations and ordinances.
In the event it is necessary that said inspection be done in my/our absence, !/we
expressly authorize the same and for my/our successors and assigns hereby release
and discharge the City of Salem, Salem Board of Health and its authorized agents
from any loss or injury sustained of whatever nature and description occasioned
by my/our absence during said inspection.
T.Et .'" LuSSEE OWNER/LESSOR
ADDRE j ADDRESS—
dDI?KESS OF UNIT 1'O BE INSPECTED
DA'PE
_a�j � ��_
CITY OF SALEM, MASSACHUSETTS
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
1/31/06
Bradford & Kerry Martin
76 Leach Street
Salem, MA 01970
PROPERTY LOCATED AT 76 Leach 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
d exclusive) b that tenant. The Department of Public Utilities has billed
gas use which is not use y y P
property owners for their tenant's entire utility bills retroactive to the date of Initial occupancy p y in cases in
which cross-metering has been proven to exist.
For the Board of Health Reply to
Jaenne Scott MPH, RS Pablo Valdez
Health Agent Code Enforcement Inspector
L
�,tonioir - ,
s3
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS,CHO 09/01/99 NINE NORTH STREET
HEALTH AGENT Tel:(978)741-1800
David Crosby Fax:(978)740.9705
76 Leach Street
Salem, MA 01970
PROPERTY LOCATED AT 76 Leach 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
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.
FOR THE BOARD OF HEALTH REPLY TO
oanne Scott, MPO PABLO VALDEZ
it
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
,1
CERT.# 470-97
3 FEE $25.00
1� IF' DATE: 07/22/97
AY,yRB
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: 81 Leach Street UNIT #: 1
OWNER/AGENT: Florence Cefalo
ADDRESS: 81 Leach Street
CITY/TOWN: Salem. MA ZIP CODE: 01970 24 HOUR PHONE: 744-7203
AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS
BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410.000 : MASSACHUSETTS STATE
SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" .
THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE
SALEM HEALTH DEPARTMENT AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED.
MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410.000 : MASSACHUSETTS STATE
SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" .
SECTION 410.400 (B) : DWELLING UNIT (X) AND 410.400 (C) : ROOMING UNIT
MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: .
NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR
OCCUPANTS UNDER 6 YEARS OF AGE.
FOR THE BOARD OF HEALTH
JOANNE SCOTT, MPH, RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
r
CITY OF SALEM BOARD OF HEALTH
Salem,Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH ADEM 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 sJ �// �.� b/ UNIT I f
OWNER/LESSER �1fl)/'l eicC i-. MANAGER/AGENT
ADDRESS �^) ) LC,C 4I. 'ii" ADDRESS
CITY se-le-w1 CITY r
'RESIDENCE PHONE Soy - -74t 4' - >w 3 BUSINESS PHONE (24 HRS.)
BUSINESS PHONE --
TOTAL NUMBER OF ROOMS:
ROOM USE: 1._( 2. D'✓!` 3. j,� vk
c
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 DEPARME4 THIS FEE IS PAYABLE AT THE TM OF INSPECTION
APPLICANTS SIGNATURE DATE Z
19
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION: 7 7DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:� ?DATE FEE PAID: �( 7
TYPE OF UNIT: DWELLING OTHER
NOTES:
CODE ENFORCEMENT INSPECTOR
k
3 st
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: 07/10/97 Fax:(508)740-9705
Florence Cefalo
81 Leach Street
Salem, MA 01970
PROPERTY LOCATED AT 81 Leach Street UNIT # 1
Dear Sir/Madam:
It has come to our attention, that you may be considering renting a dwelling unit
at the above address.
It is incumbent upon you as owner(s) to contact the City of Salem Health Department
to apply for a CERTIFICATE OF FITNESS before any vacant dwelling unit is rented or
occupied, or to notify us of your intent for this unit.
Each dwelling unit must be inspected and certified by the Salem Health Department
prior to allowing occupancy in accordance with Chapter 111, Sections 127A and 127B, of
the Massachusetts General Laws, 105 CMR 400.00; State Sanitary Code, Chapter 1: General
Administrative Procedures and 105 CMR 410.000; State Sanitary Code, Chapter 11: Minimum
Standards of Fitness for Human Habitation, and in accordance with Chapter 11, Article
XIII of the City of Salem Code of Ordiances, Section 2-334, Certificate of Fitness.
There is a twenty-five (25) dollar fee payable by check, or money order to the City
of Salem Health Department. This fee is payable at the time of inspection. Inspection
will not be performed without receipt of payment.
Failure to comply with this procedure, will result in a fine of twenty (20) dollars
per day for every day that the dwelling unit is occupied without approval of the Code
Enforcement Division of the Salem Health Department.
Contact this department within 24 hours of receipt of this notice. (508) 741-1800
Monday thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7 :00 p.m. or
Friday 8:00 a.m. to noon to schedule an appointment for an inspection.
SEE ENCLOSED SECTION 105 CMR 410.354 METERING OF GAS & ELECTRICITY
Very truly yours,
FOR THE BOARD OF HEALTH REPLY TO
qvLx��'-01�
.Joanne
Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4."FLOOR
TEL. (978) 741-1800
KINMERTEY DRISCOLL FAx(978) 745-0343
MAYOR ISC011112SANN COM
JOANNE S(:OTT,
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#294-08
DATE ISSUED:6/27/2008
Property Located at: 81 Leach Street UNIT#2
Owner/Agent: Linda Cefalo
Address: 74 Woodburn Drive
City/Town: Methuen, MA Zip Code: 01844 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
olt� . ,
�d "'
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFOCRtCEMENT INSPECTOR
CITY OF SALEM, MASSACHUSETTS
X
BOARD OF HEALTH
120 WASHINGTON STREET,41°FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR iSCOT1 e SALEM.COM
JOANNE SCOTT,
HEALTH AGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMA HABITATION."
FEE: $75.00
PROPERTY LACATED AT CJ� // Gjj S UNIT#
IS THIS VNIT DISIG ANTE AkIGHT FT FRONT OR BACK PLEASE CIRCLE ONE
OWNERILESSER CIi/ �i� MANAGER/AGENT
NO P.O. BOX
ADDRESS ADDRESS
CITY,STATE,ZIP Y. O CITY,STATE,ZIP
RESIDENCE PHONE� �� ���BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: Kl
ROOM USE: 1. 2. 3. 4. 5.
6. 7. 8. 9. 10.
THERE IS A SEVENTY-FIVE($75)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF
SALEM BOARD OF HEALTHTTHIS FEE IS PAYABLE AT THE TIME OF INSPECTION ^y
APPLICANTS SIGNATURE e L/I. —� DATE vim/ flp
Inspectors use only
Date on initial inspection: Ovf Date of reinspection:
Date of issuance of certificate: (,, V) Y Date fee paid: L - V1 •a$
Type of unit: Dwelling___V Other Check# 2`33 Y Check date:
Notes: 01 aoa �� Cir+ a^o2n�c �� 7cVr
Code Enforcement Insp ctor
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4".FLOOR
TEL.. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR 1SC0'IT(ll�SAI.EM.COM
JOANNE SCOTT,
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
Y + BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR INIANCINI&ALEM.COM
JAN F,T MANCIN I
AcnNG HPAJAI I AC;@:NT -
CERTIFICATE OF FITNESS
CERTIFICATE # 132-09
DATE ISSUED: 3/17/2009
Property Located at: 87 Leach Street UNIT#2
Owner/Agent: Donald Martel
Address: 7 Ordway Street
City/Town: Georgetown, MA Zip Code: 01833 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
E�B�OARD OF HEALTH d JANET MANCINI
ACTING HEALTH AGENT CODE ENFOR MENT INSPECTOR
f- S
7 '
I -oq
m.
CITY OF SALEM, MASSACHUSETTS
BOARD orIIt al,c[t
120 WASI-I[NGTA(7I'ONS1121 t)1' 4'"FwUR
,1,171.. (978) 741-1800
KIMBFRLEY DRISCOLL FAX (978) 745-0343
D/IAYOR 1n10NNFL&SA1F:v.CONN D�
iANIT DIONN]?,
SI NIOR SANITARIAN
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 8q [gam t. Un ik #2 , 1�a le m M P UNIT# 2-
IS
THIS UNIT DISIGNLA,TED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE
OWNER/LESSER 1/OI O,ld %4f. 1 MANAGER/AGENT
NO P.O.BOX
ADDRESS II ADDRESS
CITY, STATE,ZIP Mfi �I CITY, STATE,ZIP
RESIDENCE PHONE gnnp�' �I2o -n�5 BUSINESS PHONE(24HRS)
BUSINESS PHONE
TOTAL NUMBER
�O',F,ROOMS:
1.0
ROOM USE: tatlt q 2. VCrrn 3.%dtA 4. IAVlnl (M. 5. WCA(b6(Y)
6. Wflph 7. 8. j 9. U 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 SIGNATU DATE R 1
Inspectors use only
Date on initial inspection: 3-I l -o R Date of reinspection:
Date of issuance of certificate: 3 1-o�' Date fee paid:
Type of unit: Dwellingu�'—Other Check# 1) 4 Check date: �k- �1' d 4
Notes: 2T-pA,ti U^T( SToiti o ek,)t-Ntr�s
r
Code Enfoliceracru Inspe for
CITY or SALEM, NL-ksSACHUSETTS
? BOARD of HES T-f
120\X'\SI IING'ION S't'1u:r 1' 4"'PLOOR
Tl'sL. (978) 741-1800
KIiYM RL Y DR SCOLL FAX(978) 745-0343
MAYOR InIONNrni SArIAL CONT
JANEfDu>N qr,
SI:NIOR SANYL RIAN
Release
In accordance witl Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ;
State Sanitary Coe Chapter II and Article XIII of the City of Salem Ordinance, undersigned owner/lessor and
tenant/lessee of a nit of residential property, hereby authorize the Salem Board of Health or its authorized agents to
inspect the reside e identified below in accordance with the aforementioned statutes, regulations and ordinances.
In the event it is n cessary 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 om any lose or injury sustained of whatever nature and description occasioned by my/out absence
during said inspec ion.
Tenant/Lessee Owher/Lessor
Address Address
n Loan 51 . 02-
Address on unit to be inspected
Date
I
HP Fax Series 00 Fax History Report for
Plain Paper Fax Copier_ Ioanne_Scott.Salem BOH
978 745 0343
Mar232009 3,-.29Rm
Last Fax
Date- '1'i= j3pePaees_. . eS It
Mar 23 3:29prn Sent 917812074793 0:25 1 OK
Result:
OK--black- dwhiwfox
`oNn12� City of Salem, Massachusetts
1P
! +.
Board of Health
120 Washington Street, 4th Floor, Salem, PubliCHealth
MA 01970 0re.ent,Promote.
Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS,CHO
Mayor health@salem.com Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE #: GHL-16.272
DATE ISSUED: 7/29/2016
Property Located at: 94 LEACH STREET UNIT#2
Owner/Agent: Mary-Ellen &James Comeau
Address: 94 Leach Street#1
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978)7448357
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.
&Jeffyarosy
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITARIAN
o
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR I,RAMDIN@SALFM.COrf
LARRY RAMDIN,RS/REHS,CHO,CP-FS
HEALTH AGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"
t� FEE: $50.00
PROPERTY LOCATED AT / L r,+e IF ST Sk 1 '41A UNIT#
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSERAGENT
NO P.O.BOX q
ADDRESS / y Lca C k P- a� / ADDRESS �l—
CC �
CITY, STATE,ZIP 74�r"+ r /yI1) CITY, STATE,ZIP
RESIDENCE PHONEI 7L—?Y`/— 9-5 S-7 BUSINESS PHONE(24HRS)
BUSINESS PHONE C441- *5709— 5;27— O 3 5-7
TOTAL NUMBER OF ROOMS:
ROOM USE: l. �eS, % 2. 3, 4. 5.
6. 7. 8, 9. 10.
THERE ISA ($50 LLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION
7 /G
APPLICANT'S SIGNATURF�,U..--S ��O/ Com""'-- DATE
pp Lectors use on]
0712'21201 y
Date on initial inspection:_ _ b Date of reinspection:
Date of issuance of certificate: Date fee paid: 127/2g/L ,Z,6
Type Of unit: Dwellin Other z Check#Check date: //zg 7�n Z
r 1 �
Notes: w n r
Co�#°q ement InS for
CITY OF SALEM, MASSACHUSETTS
• • BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR
TEL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR LRAMD1N@SALEM.001%f
LARRY RAMDIN,RS/REHS,CHO,CP-FS
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 nspect.on.
x
Tenan sse pp Owner/Lessor , 7
Sft t u
AZz-etcl- 5�-- 5a(e-, / gY Ceti . 57+,
Address Address
�y Leap(, S+1"-c+ -OP z
Address on unit to be inspected
I
(D
Date
Updated 5/23/11
w
CITY OF SALEM, MASSACHUSETTS
g + 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#549-06
DATE ISSUED: 111612006
Property Located at: 94 Leach Street UNIT#3
Owner/Agent: James&Mary Ellen Comeau
Address: 94 Leach Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 744-8357
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
JO NMPH, RS, CHO
i✓ f
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
Cmt 00 SALEM, MASSACHUSIE I i S
.�,
BOARD OF RIE
120 WASNfNGTQN STREETT,. 4TH FLOOR
SALEM. MA 0 970
TEL. 978-741-1800
FAX 978-745-0848
JOANNE SCOTT, MPH, R5, 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 / fk�S" UNIT # 3
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
�4 Y' �/IYY fM^7S
OWNER/LESSER Shg _MANAGER/AGENT
No P.O. Box No P.O. Box
ADDRESS_ — Liu c lc s - ADDRESS_ _,_
CITY____O � "7 __CITY_______
RESIDENCE PHON17C- 7 r/yf3S7 BUSINESS PHONE (24 HRS.}
E
BUSINESS PHONE __
TOTAL NUMBEROFROOMS-3—
ROOM USE: 1._K 2. 1_,j o 3 _ � d�9.�J._._.
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 SIGNATURES"_Z_ --
INSPECTORS USE ONLY J 77
DATE OF INITIAL INSPECTION.,_ jV6 ,q _ DATF QF REINSPECTION
DATE OF ISSUANCE OI CERTIFICATE f/>!�(p ,�L� DATE PPF PAID _
_ 1
TYPE OF UNIT WELLING OTHER CHECK r+ / CHECK DATE
NOTES.
CODC- ENFORCEMFN1 IN SIICCI Oil g12t1.' 1t1
f
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
e
120 WASHINGTON STREET, 4TH FLOOR
c SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#314-05
DATE ISSUED: 5/16/05
Property Located at: 97 Leach Street UNIT#3
Owner/Agent: Martineau Realty Trust
Address: 97 Leach Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 744-5327
An inspection of your vacant Dwelling/Roaming 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.
FQ THE BOARD OF HEALTH (�
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH `1T
• 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
_ - FAX 978-745-0343
STANLEY LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT F _
a ? r UNIT,#
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER w cagy ANAGER/AGENT 1s,21,e1 12lAK7-1nJ-`#d
No P.O. Box No P.O. Box
ADDRESS 97 Lea/= Sr —ADDRESS— LS4;yu
CITY S7,4 4/- Art CITY—SA t-dFt_
RESIDENCE
ITYSA(.dt-
RESIDENCE PHONE 7fr 7'(!j�S2a-7BUSINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1f Kl'FCN�7�2, Li 2, 99-0911Cnal. RbPO A
r
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 I DATES 'IvdS
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION �^ 1 } DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATES'0 'oDATE FEE PAID: 0 j
TYPE OF UNIT: DWELLINGV OTHER_ CHECK# 5_0 7 CHECK DATES J y o
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
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
5/9/05
Martineau Realty Trust
97 Leach Street
Salem, MA 01970
PROPERTY LOCATED AT 97 Leach 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.
Fore 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, MA 01970
TEL. 978-741-1800
FAX 978-745-0343 -
STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
1/20/05
Caroline Realty Trust/James B. Collett Jr
P.O. Box 2098
Haverhill, MA 01936
PROPERTY LOCATED AT 74 Leach 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 a Board of Health Reply to
Jo ne Scott MPH, RS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector
191
« 1'�•_.
i�%_p �s'�
r i �%
L
CERT.# 629-96.
�^. FEE $25.00
DATE: 09/12/96
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: 115 Leach Street UNIT #: 2
DINER/AGENT: Constance M. Claveau
ADDRESS: 117 Leach Street
CITY/TOWN: Salem. MA ZIP CODE: 01970 24 HOUR PHONE: 745-7242
AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS
BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410.000: MASSACHUSETTS STATE,
SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" .
THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE
SALEM HEALTH DEPARTMENT AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED.
MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410.000: MASSACHUSETTS STATE
SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" .
SECTION 410.400 (B) : DWELLING UNIT (X) AND 410.400 -(C) : ROOMING UNIT
MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: .
NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE •STATE LEAD LAW FOR
OCCUPANTS UNDER 6 YEARS OF AGE.
FOR THE BOARD OF HEALTH
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
Y f
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
APPLICATION FOR CERTIFICTE OF FITNESS Fax:(508)740-9705
IN ACCORDANCE WITH STATE SANITARY: CODE, CHAPTER II, 105 CMR 4 10.000 "MINIMUM
STANDARDS OF FITNESS FOR HUMAN HABITATION". /_
PROPERTY LOCATED AT J J G//'ea a t G� UNIT
#
OWNER/LESSER C(�i1 eff ._ o p � ( a ✓ed CC MANAGER/AGENT 514)4 -
ADDRESS Lea CJ) St ADDRESS
CITY lam— CITY
RESIDENCE .PHONE `T L/ ` BUSINESS PHONE (24 HRS.)
vV e-J
BUSINESS PRONE "-
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. ( 2. L V, m 3.
5. 6. 7. 8.
THERE IS A TWENTY-FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE
CITY OF SALEM BEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION f
APPLICANTS SIGNATUREG�� � DATE
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION: 4-6jF REINSPECTION
DATE OF ISSUANCE OF CER; y�IF'CATE: i/ - ( 7o DATE FEE PAID:
G k�
TYPE OF UNIT: DWELLINOTHER ( —
NOTES:
CODE ENFORCEMENT INSPECTOR
CITY OF SALEM
� , MASSACHUSETTS
BOARD OF HEALTH
s 120 WASHINGTON STREET, 4TH FLOOR
�mne 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#455-06
DATE ISSUED: 9/7/2006
Property Located at: 97 Leach Street UNIT#3
Owner/Agent: Martineau Realty Trust
Address: 97 Leach Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 744-5327
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
r
J ANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET.
4TH FLOOR
-00 SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0949
JOANNE SCOTT, MPH, RS, CHO
Kimberley Driscoll HEALTH AGENT
Mayor
APPLICATION FOR CERTIFICATE OF FITNESS
W ACCORDANCE WITH STATE SANITARY CODE, CHAPTER It. 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT __� a UNIT t_
IS THIS UNIT DESIGNATED AS RIGHT LEFT' /F89NI SACK PLEASE CIRCLE ONE
OWNEPJ ESSER I��-2t M- A 7 ( MANAGER/AGENT_MAe'iQJf�-,A.(J 1,-q (RC T
No P.O-Box No P.O. Box
ADDRESS�Y7 I E&/Y! 5,j- —ADDRESS---
RESIDENCE
ADDRESS_ _RESIDENCE PHONE�M ' G/_5.3 BUSINESS PHONE (24 HRS.)_____._„____
BUSINESS PHONESrJ __ —
TOTAL NUMBER OF ROOMS:__
ROOM USE 1.---- - 2.— -----3 - - --- - 4 -
i
--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. ��77
APPLICANTS SIGNATURE
hNiSPECTC}RS USE ONLY
i
DATE OF INITIAL i�S�ECTI,ON � 7_ -99 �- DATE. OF REINSPECTION „- -
DATE OF ISSUANCE OF CER1IFICATE:! ?'i? DATE F'EE PAID -_<j�--7•''a G
TYPE OF UNIT: DWEi.1JN(X OTHER. CHLCK ai } C;HFGle DATF
NOTES.
CODE- ENFORCI_ME.M tN41'ECTOU 2ti^78
CITY OF SALEM, MASSACHUSETTS
• t BOARD OF HEALTH
120 WASHINGTON STREET,4"`FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR DCREENl3AUM�SALF.M.CiJM
DAVID GREENBAUM
ACTING HEAUI I-I AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#476-09
DATE ISSUED: 9/18/2009
Property Located at: 101 Leach Street UNIT#2
Owner/Agent: 101 Leach Street Realty Trust
Address: 101 Leach 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 BOA�F HEALTH
DAVID GREENBAUM
ACTING HEALTH AGENT CODE ORCEMENT INSPECTOR
CITY OF SALEM, MASSACHUSETTS
f BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR DGREENBAUM&AlEM COM
DAVID GREENBAUM,
ACTING HEALTH AGENT -
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION."
/_ FEE: $50.00 /4/
PROPERTY LOCATED AT 1'4fFL s�t=��� %S- /`��4 UNIT#
IS THIS UNIT DISIIG��NATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER/d1 �� Sr- K "--rZe95 M NAGER/AGENT VhGM , /�• I YLG1�lA�(�V'
NO P.O. BOX
ADDRESS IDA bep G(-I ST" ADDRESS
CITY, STATE,ZIP _�/� ��-1 CITY, STATE,ZIP, 0 119-7D
RESIDENCE PHONE BUSINESS PHONE(24HRS) Ti Sr- 03 5�
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: `J
ROOM USE: 1��PoclH 2. 0� 3.`I 1'J4 4�I^'I'J�7 5. Kl�` 1
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 SIGNATURICOLA`� / DATE 9 ��
Inspectors use only
/�/aDate on initial inspection: Date of reinspection:
Date of issuance of certificate: /s I Date fee paid: 9 is
Type of unit: Dwelling L-1-6ther Check#- V:7 date:
Notes: 7 U(i1N/L r t W bOO
,nni Wu
Code Enforcement ctor
c CERT.# 85-01
ig FEE $25.00
DATE: 02/22/2001
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: 101 Leach Street UNIT #: 3
OWNER/AGENT: Victor B. Theriault
ADDRESS: 101 Leach Street
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-2366
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 9778-741-1800 .
FOR THE BOARDiH -
�- k14avy
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
���'IIIY6
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 /QZUNIT#j
IS THIS UNIT DESIGNATED AS RIGHT LEFT - ONT B C PLEASE CIRCLE ONE
OWNER/LESSER&G Ok . 7T6R14U(TMANAGER/AGENT
No P.O. Box l ' No P.O. Box
ADDRESS Lid LSA � ADDRESS
CITY
RESIDENCE PHONE 445- 6236G—BUSINESS PHONE (24 HRS.)
BUSINESS PHONE —744 I I L43
TOTAL NUMBER OF ROOMS/ &fts
ROOM USE: 1. TGI+ 2. btlf 6 3. h e0f- 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 o'L is DATE o7 o`la
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION —0 " DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:2 2 DATE FEE PAID: Z —)" 2y I
TYPE OF UNIT: DWELLING� OTHER_ CHECK# a 3 CHECK DATE�_
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
Y
P
Qv6�'Ce+� CERT.# 478-99
,g FEE -$25.00
DATE: 08/24/99
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: 102 Leach Street UNIT #: 2
OWNER/AGENT: John Chaisson
ADDRESS: 1 Circle Hill Road
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 741-8763
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
* PENDING REGROUTING ALL AROUND BATH BUT.
17
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". zPROPERTY LOCATED AT �/ IA �2 I /aGh UNIT# oC
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/L -/f qd C kjSSB.>/ MANAGER/AGENT
NOP*
o P.O. Box /} No P.O. Box
ADDRESS // C/ /2CGE r� ADDRESS
CITY r/SLe_777 CITY
RESIDENCE PHONE vl'M1 4 743 /BUSINESS PHONE (24 HRS.)
✓
BUSINESS PHONE ,tlml e — �/2t o
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. ,D
APPLICANTS SIGNATUR (• DATE Z99�
i
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION n I0 `-t - Z 9 DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:1'} -fl DATE FEE PAID:
TYPE OF UNIT: DWELLING(�OTHER_ CHECK#_ I 1 CHECK DATE
CJ-
7-�k 7-C)
CODE ENFORCEMENT INSPECTOR 9/28/98
CITY OF SALEM, MASSACHUSETTS
n « • BOARD OF HEALTH
120 WASHINGTON STREET,4°1 FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAx(978) 745-0343
MAYOR DGRL,HNBAUM�SALEM.COM
DAVID GREENBAUM
ACTING Huim.,7-I AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#483-09
DATE ISSUED: 9/23/2009
Property Located at: 102 Leach Street UNIT#3
Owner/Agent: Adam Jordan
Address: 102 Leach 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
D Vla D GREENBAU�
ACTING HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CITY OF SALEM, MASSACHUSETTS tO1-6-1
-- BOARD OF HEALTH
120 WASHINGTON STREFT,4"'FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL/ FAX(978) 745-0343 .
MAYOR oGReLNBAUM( ALEM.COM
DAVID GREENBAUM,
ACTING HEALTH AGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION."
/ FEE: $50.00
PROPERTY LOCATED AT / G �— L � 5 UNIT#A
nn IS THIS UNIT DISIGNAT D AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER & jA Y MANAGER/AGENT
NO P.O. BOX t
ADDRESS _ADDRESS l
CITY, STATE,ZIP S CITY, STATE,ZIPS 1
RESIDENCE PHONE`7Ss' '� ti r S BUSINESS PHONE(24HRS) 50LII4k-
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2. 3. 4.
6. 7. 8. 9. 10.
THERE IS A FIFTY($50)DOLLAR FEE,PAYAB E BY CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS FEE I PAYABLE A THE TIME OF INSPECTION
APPLICANT'S SIGNATURE DATE Z j
J / Inspectors use only
Date on initial inspection: Date of reinspection:
Date of issuance of certificate: G/ 0 Date fee paid: d310 9
Type of unit: Dwelling Other Check# ChG/eck date: a3 G 9
Co
Notes: -e ( IC4 LA We ((0d OFF - 'W l Ar po /7 1WNr ,
4fAPM! f In ave in (LW-s i hr -f(x Pct l'�v 6�,-) -f<i r bk c
L) of I fo be de(w 6&0L
-ki aJ MOvJ 0
Code nfore entp etor
Imre
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH, RS.CHO NINE NORTH STREET
HEALTH AGENT Tel:(978)741-1800
01/13/2000 Fax:(978)740-9705
John E. Chaisson, Jr.
1 Circle Hill Road
Salem, MA 01970
PROPERTY LOCATED AT 104 Leach Street UNIT # 1
Dear Sir/Madam:
It has come to our attention, that you may be considering renting a dwelling unit
at the above address.
In accordance with Chapter 11, Article XIII of the City of Salem Code of
Ordinances, Section 2-334,titled "Certificate of Fitness," each dwelling unit must be
inspected and certified prior to allowing occupancy. The inspection will be conducted
in accordance with 105 CMR; State Sanitary Code, Chapter I: General Administrative
Procedures and 105 CMR 410.000; State Sanitary Code, Chapter II: Minimum Standards of
Fitness for Human Habitation.
Please notify us if you do not intend to rent the unit.
Please contact this department within 24 hours of receipt of this notice at
978-741-1800, to schedule an appointment for an inspection. our office hours are Monday
thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7:00 p.m. and Friday 8:00
a.m. - 4:00 p.m.
Failure to comply with this procedure, may result in a fine of Twenty (20) dollars
per day for every day that the dwelling unit is occupied without a Certificate of
Fitness.
A $25.00 check payable to the City of Salem is required for each unit inspected at the
time of inspection.
A property owner is required to pay gas and electricity for residential tenants if there
is not a written letting agreement stating the tenant is responsible for those
utilities and if the meter(s) records electricity and gas use which is not used
I exclusively by that tenant. The Department of Public Utilities has billed property
owners for their tenants, entire utility bills retroactive to the date of initial
occupancy in cases in which cross-metering has been proven to exist.
OR THE BOARD ,. HEALTH REPLY TO
Joart, MPH,RS,CHO PABLO VALDEZ
Health Agent _ CODE ENFORCEMENT INSPECTOR
�Y CERT.# 126-97
3 ' FEE $25.00
DATE: 02/28/97
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: 104 Leach Street _ UNIT #: 1
OWNER/AGENT: John E. Chaisson. Jr.
ADDRESS: 1 Circle Hill Road
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 741-8763
AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS
BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410.000: MASSACHUSETTS STATE
SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" .
THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE
SALEM HEALTH DEPARTMENT AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED.
MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410.000: MASSACHUSETTS STATE
SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" .
SECTION 410.400 (B) : DWELLING UNIT (X) AND 410.400 (C) : ROOMING UNIT
MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: .
NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR
OCCUPANTS UNDER 6 YEARS OF AGE.
FOR
THE BBI-O-+ARD OF HEALTH e
`JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT .CODE ENFORCEMENT INSPECTOR
(
' 13
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,HS,CHO NINE NORTH STREET
HEALTH AGENT Tel (508)741-1500
APPLICATION FOR CERTIFICTE OF FITNESS Fax:(508)740-9705
IN ACCORDANCE WITH STATF. SANITARY CODE, ,CfAPTER II, 105 CMR 4 10.000 "MINI_MUM-
STANDARDS OF FITNESS FOR HUMAN HABITATION". /
PROPERTY LOCATED AT -tom L6� l� r UNIT I /
OWNER/LESSER jc>,aj �47, (..A giSSo,) , g, MANAGER/AGENT
ADDRESS � t��2C��c• // '66 ADDRESS
CITY . ,SACITY ----
RESIDENCE PHONE �r/� /- r� BUSINESS PHONE (24 HRS.) _ _
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: !
ROOM USE: 1. �}: 1:N 2. 4)eA
5. ; ie0 b. 7. 8.
THERE IS A TWENTY-FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR HONEY ORDER TO THE
CITY OF SALEM*HEALTH ARTMEHT THI FEE IS PAYABLE AT THE TIRE OF INSPECTION
APPLICANTS SIGNATURE DATE :2 P1,9
- --
INSPECTORSUSEONLY
DATE OF INITIAL INSPECTION: DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: '�v ,PATE FEE PAID:
TYPE OF UNIT: DWELLING OTHER
NOTES: 5
J�� . . 'r:P, '�.':z' lir. .. •; - __,..__. __ _ `
CODE ENFORCEMENT INSPECTOR
r ,
V
• ♦ 6
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928 -
JOANNE SCOTT,MPH,RS,•CHO ; ; - NINE NORTH STREEI
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. seo : ; State Sanitary Code Chapter II and Article XIII of
the City, of Salem Ordinance, undersigned owner/Lessor and tenant/lessee of a unit
of residential property, hereby authorize the Salem Board of Health or its author-
ized agents to inspect the residence identified below in accordance with the
aforementioned statutes, regulations and ordinances.
r
I:; the event it is necessary that said inspection be done in my/our absence, I/we
expressly authorize the same and for my/our successors and assigns hereby release
and discharge the .City of Salem, Salem Board of Health and its authorized agents
from •any loss or injury sustained of whatever nature and description occasioned
by my/our absence during said inspection.
TENANT/LESSEE OWNER/LESSOR
ADDRESS ADDRESS
/D� �e,4cLi Sf
ADDRESS OF UNIT TO BE INSPECTED
f-17
DATE
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800FAx 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#304-04
DATE ISSUED: 07/12/2004
Property Located at: 110 Leach Street UNIT#2
Owner/Agent: Mack's Realty Trust
Address: 171 Jersey Street
City/Town: Marblehead, MA Zip Code: 01945 24 Hour Phone: 978-744-5450 X 157
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 r /
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CITY OF SALEM, MASSACHUSETTS (f
BOARD OF HEALTH
• • 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-74 1-1800
FAX 978-745-0343
STANLEY USOVICZ, JR. ,JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS/FOR HJ MA�N'HHABITATION".
J
PROPERTY LOCATED AT CD /.P G1 G� 6y eC__ �_ UNIT#{9.
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
/ICn
OWNER/LESSER S ea L lfU5tmANAGER/AGENTt?O�Y /e
No P.O. Box o P.O. Box C
ADDRESS / SII GY'S!!Zll S{fV ADDRESS
CITY ITY
RESIDENCE PHONE 791-431 '0099'BUSINESS PHONE (24 HRS.) 'S7"'/
S�
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:- S
ROOM USE: 1. "7IPn2. vYx j3. %✓% �w1
51� e'm 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 T FEE IS PAYABLE AT THE
TIME OF INSPECTI
APPLICANTS SIGN, �4 DATE
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION 2 0 DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:7� 2- 0 (?g�l DATE FEE PAID: ?- ( 2- °
TYPE OF UNIT: DWELLI OTHER_ CHECK# / D G CHECK DATE7_� Z a G
NOTES
CODE ENFORCEMENT INSPECTOR 9/28/98
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
s 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#303-07
DATE ISSUED: 7/10/2007
Property Located at: 110 Leach Street UNIT#3
Owner/Agent: Mack's Realty Trust
Address: 171 Jersey Street
City/Town: Marblehead, MA Zip Code: 01945 24 Hour Phone: 978-720-5937
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 HEALTHQ
zdo-�/
J NNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
t 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, 145 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT -IYO ,4-C)!� C-4 S7 UNIT#.3_
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNERtLESSER)?!ELE'/ 0 ()LtC'. MANAGERJAGENT
No P.O. BoxNo P.O. Box
ADDRESS/-// Se esp1'/ ADDRESS
CITY `w L 6A 1-/ 0 1 G � � CITY---
RESIDENCE
ITY ___,-_,.RESIDENCE PHONE—-—BUSINESS PHONE (24 HRS.) 9 2 g`7-� 0 /3 7
BUSINESS PHONE _
TOTAL NUMBER OF ROOMS:__�___
n
ROOM USE: 1. /L.- _ 2-C 3---)
THERE IS A TWENTY-FIVE ($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION
APPLICANTS SIGNATURE f�/ �G�l�u�i `` __DATE__ Jt7 (1
INSPECTORS USE ONLY
DATE OF INITIAL—INSPECTION-7--7--l-0- ',O--?---.DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:_?�0_'07 DATE FEE PAID _._ -7
i u -y
TYPE OF UNIT: DWELUNOTHERCHECK #_-Ja_ /.-_pHECK DATE ,?
NOTES:— -- --- --
CODE ENFORCEMENT INSPECTOR 9/28/98
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
Release
In accordance with Massachusetts General Laws Chapter 11 1; 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 oi'\ahatever nature and description occasioned by my/out absence durin-,
said inspection.
ruse
rant/Lessee Owner/L ssor
/,'7/ � /V say SI
LWZ
Address Address L
Address on unit to be inspected
fAN
lie
City of Salem, Massachusetts
Board of Health
120 Washington Street, 4th Floor, Salem, PPu th
revent.Promote
MA 01970 . Protect.
Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS,CHO
Mayor health@salem.com Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE#: GHL-16-393
DATE ISSUED: 10/17/2016
Property Located at: 112 LEACH STREET UNIT#1
Owner/Agent: Roger Marcorelle
Address: 171 Jersey Street
City/Town: Marblehead, MA Zip Code: 01945 24 Hour Phone:(978) 979-0840
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.
EGagakis
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITARIAN
• CITY OF SALEM, MASSACHUSETTS LJ
BOARD OF HEALTH
120 WASHINGTON STREET,4� FLOOR PublicHealth
Prevent.Promote.Protect.
TEL. (978) 741-1800 FAX(978) 745-0343
KIMBERLEY DRISCOLL Iramdin@salem.com salem.com
MAYOR LARRY IL\MDIN,RS/I2EIIS,CI 10,CP-FS
HSALrn 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"
f FEE: $50.00
PROPERTY LOCATED AT //A A 2ctS SYree UNIT#�
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNERILESSER n C IN/ a lruS F MANAGER/AGENT owea✓ 1I
'4e-
NO P.O. BOX
ADDRESS 1 71 �5t I���e ADDRESS
CITY, STATE,ZIP /'" K,.AL I ed" l CITY, STATE,ZIP M 0 l cl qs-
cg y?71r/
RESIDENCEPHONE 7?1�631'069S BUSINESS PHONE(24HRS) / I /`0 0
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:—
ROOM USE: 1. lu 2. L� 3.4II 1 Ui% 4.1\J-evti
6. 7. 8. 9. 10.
THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE By CHECK OR TqONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH T=FEEAY AT TH TIME OF IN ECTIONAPPLICANT'S SIGNATDATE l0 �tP
Inspectors use only
Date on initial inspection: lo 16 I�6 Date of reinspection:
Date of issuance of certificate: Date fee paid: told l t6
Type of unit: Dwelling Other Check# a 5j Check date: I O LK&16
Notes:
�*(6- 3CY3
Co&'Age r ement Inspector