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LEAVITT STREET LEAVITT STREET y it J i { I,� City of Salem, Massachusetts / • i. n Board of Health 120 Washington Street, 4th Floor, Salem, q«. Promote. Protect. MA 01970 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-16-363 DATE ISSUED: 9/30/2016 Property Located at: 14 LEAVITT STREET UNIT#2 Owner/Agent: David P. Black Address: 14 Leavitt Street#1 City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 766-1281 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. &effrsy Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4T"FLOOR TSI.. (978) 741-1800 ls'L'vIBERLEY DRISCOLL FAX(978)745-0343 MAYOR LRm'wRV(als' LF .COM 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" FEE: $50.00 PROPERTY LOCATED AT 1 LI Lea _j� �� Sa(��, Ag t9l 4 74 UNYP# 2 IS THIS UNIT DISIGNATED AS LEFT FRONT OR BACK.PLEASE CIRCLE ONE OWNER/LESSER__PtL,'L P- 0 tzo e MANAGER/AGENT NO P.O.BOX ADDRESS Ly L e" Y �f ADDRESS CITY,STATE,ZIP S ale tf lr Q7 t1 70 CITY,STATE,ZIP RESIDENCE PHONE 879, " ?4C L2 B I BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: 6 ROOMUSE: 1. �,'N;M 2. 3. 9K�k 4. SfW 5. 6,d 6 63 7 15t,( 8. fie 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 jA�T THEE TIME OF INSPECTION APPLICANT'S SIGNATURE 0 gc' SCJ Z� DATE eSZ`/ /6 Inspectors use only Date on initial inspection: C&T7�f)Q IX Date of reinspection:014W f24019 Date of issuance of certificate• DI� Date fee paid:u 8/� ZP Z F Type of it: Dwellin Other Check#I-0 ,y Check date: 0 Notes of D !1n f C /)Y ro C C o er ent Ins ,ctor Inspection of, ft W/Qrr'FM Date 0�.1�f4L_OW y Ti,eei Name n I,, Address rnTtLza-nn f 51 AhL� , Owner.Dayi Plug t� Tel. No. =l fld— [44—= Type of Inspection�}I Cirji�n� F;4-hrz Inspector / gams/ ( � 1 Remarks and Violations are listed below: kl+cl4 � ( e f m MregA 0. 4 f r p� n I —QQLpea.,r�: t AeO � Is r Irn ci I r U2dt room Tx&Qc �t�A I,p "hn tq n r ,v]n ,/ t.,,W1— 4 AI, (f1 Cc_f^re tro®�^ �anracf flrr+� i^oan7 SS 4!- ! � 11rys�� Ili�c1Tr tiu�t0�t14/s hate SG,^�r r _ LI t/tIA n rn f 1,[ nw ne-6 r.C+ � raj. j o f Gf �r G hrl wo rQ 1tI Y �tl M �Q.�W'P4 ��rtG�1 �1� p0.7'{1 YDOM�f DYIC tW I/r��pW:-1 -1 'pt r�or�l s'cre�2I1 • �rDp,v, n�Qt'�' lnnna /Y�owt `1aS wl �'FDw t Ic�'� wIT •�alllcto Q!� f L t M f Sc I ria n&ze r r 2G f � r C � 1 Report Received by: Q, ( �/ City of Salem, Massachusetts Board of Health 9 120 Washington Street, 4th Floor, Salem, �yU Prevent.Promote. Protect. MA 01970 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-16-362 DATE ISSUED: 9/30/2016 Property Located at: 14 LEAVITT STREET UNIT#1 Owner/Agent: David P. Black Address: 14 Leavitt Street#1 Cityl-rown: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 766.1281 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates,whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age. Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS BOARD or-HEALTH 120 WASHINGTON Si'RErrr,4TN FLOOR TEL.(978)741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR M01 NCa)SA ENI.00M LARRY RAMDIN,RS/RENS,CHT),CP-FS HEALTFI 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: $50.00 PROPERTY LOCATED AT Lec St Sk f ems 12 a< 01270 UNIT# IS THIS UNIT DISIGNATED AS R1GRT Lm FRONT OR BACK.PLEASE CIRCLE ONE OWNER/LESSER MANAGER/AGENT NO P.O.BOX ADDRESS I q Leao. ADDRESS CITY, STATE,ZIP--, a le n 4 ai c/g 7?5 Crl'Y, STATE,ZIP RESIDENCE PHONE � 7 r$ 6-!2&�) BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOMUSE: 1. Uvi' � 2. 3. (het/am 4. fizdra. 5. 6 K,*'4ttant ? r«-f 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 THEE TIME OF INSPECTION APPLICANT'S SIGNATURE 4� DATE Inspectors use only Date on initial inspection: V2-oj ol' Date of reinspection: Date of issuance of certificate:ng(U121)9X Date fee paid: 0 969/2-� Type of 't: D�rwelling_Z-70ther� Check# 3s Check dale: 9=12,04,9 Notes- rnrj g Ca Y/ec F[�rX (�ivn r Z 0 Leu�" Cod c ent Inspec r Inspection of LM UAr+M&h4 . • P / (1 (^ Date01241� Time Name Address:�7lgayil Owner /XryTel. No. _ rd—744—J2V— � Z Typeoflnspection l�I'�17-iGy'�'o.n� h��'f�cSS Inspectorj0�r"e. ar»iy _y( ' ) Remarks and Violations are listed below: G9 � t {AmaCt C r s fI G r�r t a co - �j✓A l or k� :Aa are- ra , I Lg6� �9fZ CrT�1 i�r�o,rt a �1aTlthdMn� �nS wt t w z G✓r� wi enr r t n " am L✓ S WYS tiet' nws' L9 LIt/14TnAm I4,Jok/ nr_n ✓6orT- oyf Ly --to f� idvl d 4ors✓e (v, Gree r r c hr( wofack dor cf©se prDDu�v. p�0� baf'htDOm n�S Oh2 wt/r`�uir�'f'►P1 Wrop � �nnnoroot� has wl[n w40wajf jc4� wrf a1/rc,o SQ! n It t p Jf G P i Report Received by: y r? CITY OF SALEM, MASSACHUSET"I'S BOARD or HEArrPI 120 WASHINGTON STREsHT,4°'FLOOR Ith Fmeen,.promme.{4olae TEL. (978) 741-1800 FAx(978) 745-0343 KTMBERLEY DRISCOLL tiamdin&.ateni.com 1 a2RY 12r1 MINN,RS/RVI t5,0-10,(J P, '-RS MAYOR HIGAI:J H AG Ii:N'I' CERTIFICATE OF FITNESS CERTIFICATE # 102-12 DATE ISSUED: 3115/2012 Property Located at: 2 Leavitt Street UNIT#3 Owner/Agent: Victor Therlault&Janice Miano Address: 2 Leavitt Street CitylTown: 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 LADIN HEALTH AGENT C� NFORC T NSPECTOR • CITY OF SALEM, MASSACHUSETTS 1 � BOARD OF HeALI"H 120 WASHINGTON STREET,4... FLOOR Tr-,'L. (978) 741-1800 KIMI3ERLEY DRISCOLL FAX (978) 745-0343 MAYOR AAMDIN SAJE%1.COM LARRY RAMUIN,I0;/R1'.I IS,CI Iq,CP-I�S Hr,Aj x1 I A(I I;NT 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 ATUNIT#,- IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE !✓`i div /szt"�iad� (t LESSER r, mir AX41nd" MANAGER/AGENT o. sox ADDRESS eLz,Ci1t/if/_ Ste- ADDRESS CITY, STATE,ZIP�4�4 CITY, STATE,ZIP RESIDENCE PHONE USINESS PHONE(24HRS) B PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2`. 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 PAYABLE ATTJ THE TIME OF INSPECTION APPLICANT_S SIGNATURE J"#k" DATE ,3 Inspectors use only Date on initial inspection: 31��/�a Date of reinspection: _ . 37/62) Date of issuance of certificate: Date fee paid: r� Type of unit: Dwelling Other Check#)Check date: J `f Notes: u; e CL Dft FA3 1 , 04 x4ce 4G Code`19f&dement Inspector CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4°1 FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx (978) 745-034.3 MAYOR RAN1DIN&A1EN1.00ib1 LARRY RANIDIN, �.11S,Ch10,C11-1'S HISAL 111 AG I?N'I' Release In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq.; State Sanitary Code Chapter II and Article XIII of the City of Salem Ordinance, undersigned owner/lessor and tenant/lessee of a unit of residential property, hereby authorize the Salem Board of Health or its authorized agents to inspect the residence identified below in accordance with the aforementioned statutes, regulations and ordinances. In the event it is necessary that said inspection be done in my/out absence. I/we expressly authorized the same and for my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of Health and its authorized agents from any lose or injury sustained of whatever nature and description occasioned by my/out absence . during said inspection. } , Tenant/Lessee Owner/Lessor Addr&r Address `7� - Address on unit to be inspected h Date Updated 523/11 � 9 CITY OF SALEM, MASSACHUSETTS TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGRBeN14AUM@SAI.BM.COM DAVID GREENBAUM ACTING HEALTH AGP.N'r CERTIFICATE OF FITNESS CERTIFICATE#22-10 DATE ISSUED: 1/27/2010 Property Located at: 14 Leavitt Street UNIT#1 Owner/Agent: Yaleena Shrestha Address: 11 Goodhope Lane City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-766-2049 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 CODE EN CEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS r� + BOARD OF HEALTH 120 WASHINGTON STREET,4...FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGKr1:.NBAUMnaesA1.EM.COM DAVID GREENBAUM, _ ACTING HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION." / FEE: $50.00 PROPERTY LOCATED AT J -1 r E'GW -# S �;ef�)efn M✓a Cif 9`}D UNIT#_L IS THIS UNIT DISIGGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE oc1 kYeSI MANAGER/AGENT OWNER/LESSER \jq�e NO P.O. BOX 1 ADDRESS f/ 4 o g o )%--O b ADDRESS CITY, STATE, ZIP S CITY, STATE, ZIP fY1 d 1 a RESIDENCE PHONE T)1 T`q 'IS�4 C1 BUSINESS PHONE(24HRS) Ct-tt q ?9 T6 SI. - q� 9 BUSINESS PHONE -7E,6 20u TOTAL NUMBER OF ROOMS: ,- ROOM USE: 1. 2. 3. 4. l SZ 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FF/E,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAY ' LE AT THE,,TME OF INSPECTION APPLICANT'S SIGNATURE �(' DATE Inspectors use only Date on initial inspection: -7 k U Date of reinspection: Date of issuance of certificate: /h-7//O Date fee paid: r y 10 Type of unit: Dwelling Other -7Check#_� Check date: IcZ (.0 d Notes: ��f�0/l ( ' i bd la e'( tr, P,& Ur rP'214 ri) Code Enfore4nt Inspector CITY OF SALEM,MASSACHUSETTS BOARD OF H&9LTH 120 WASHINGTON STREET 4tn FLOOR PublicHea Ith Prevent.Promote.Protect. - TEL. (978)741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL liamdin@satem.com LARRY RA MUI.N,RS/R1-'A-1S,CF[O,CP-FS MAYOR Hl:?AI:,"1'I 1 AG 13N'I' CERTIFICATE OF FITNESS CERTIFICATE#445-12 DATE ISSUED: 11/17/2012 Property Located at: 14 Leavitt Street UNIT#2 Owner/Agent: Yaleena Shrestha Address: 11 Good Hope Lane City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-766-2049 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 7NITARIAN CITY OF SALEM, MASSAC tJSETP-s Bomzn oiF ffi:zu ll 120 VVASIIIN(;TON STREET,4"' FJ,00x T'Ih3.. (978) 741-1800 KIM1313RLL Y llRISCOLi. F� (978)745-0343 MAYOR lraindin @saleiiixoin L.A RItI'RAMAN, RS/RHI IS,010,(:P-FS FI F.A1:I'l I AG FIN I Facsimile Transmittal To: ��V1 C�.A n Fax # 1 .5� N 3 RE: Date Page(s): including this cover# Message: Board of Health News ------------------------------- ---------For Your Information OFFICE HOURS: Monday, Tuesday, Wednesday 8:00 AM to 4:00 PM Thursday 8:00 AM to 7:00 PM Friday 8:00 AM to 12:00 NOON ` TRANSMISSION VERIFICATION REPORT TIME 11/27/2012 03:43 NAME FAX 9787450343 TEL 9787411800 SER.# 000BON341991 DATEJIME 11127 03: 43 FAX NO. /NAME 919784539150 DURATION 00:00:25 PAGE{S} 02 RESULT OK MODE STANDARD ECM �\ s �. CITY OF SALEM, MASSACHUSETTS ta BOARD OF HEALTH R4 120 WASHINGTON STREET,4...FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR LUMUfNQQ VEM.00M LARRY RAbIDIN,RS/RFf IS,C[10,CP-PSS HIi;V;fI I AGI,m, 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: $50.00 PROPERTY LOCATED AT 1 v/ l�(,7i1//7T c�� CCQPiyy> fY//� q/QUIVIT# _ IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR B�PLEASE C Cl LE ONE OWNER/LESSER "\ICI lFeeklq S E?( a MANAGER/AGENT NO P.O. BOX / � ADDRESS // O�l�(y ADDRESS CITY, STATE,ZIP Sc?� CITY, STATE,ZIP OW,9 0/97-3e RESIDENCE PHONE --7W V 73 VV BUSINESS PHONE (24HRS) `7� BUSINESS PHONE TOTAL NUMBER OF ROOMS:_$_ ROOM USE: 1. 2. 3 4. 1 '• 6. 7. 8. 9. Y.� THERE IS A FIFTY($50)DOLLARkEPAYABLE BY C CK ORMONEYORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE ISAT OF INSPECTION APPLICANT'S SIGNATURE DATE J 2 Inspectors use only Date on initial inspection:_ I Date of reinspection: Date of issuance of certificate: Date fee paid: Jill I Type of unit: Dwelling Other Check# Check date: Notes: w IF �^ C e rcement Inspector CITY OF SALEM, MASSACHUSETTS lu BOARD OF I LAo'x PublicHeaIth 120 WASHINGTON STREET,4`FLOOR me r.rrnmme.retie=. 'f EL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLI. Iramdin@salem.com LARRY R;\NIDIN,RS/REBS,C1 R),CP-FS MAYOR III?;\1;11 I AGI:iN'I' CERTIFICATE OF FITNESS CERTIFICATE #233-14 DATE ISSUED: 7/10/2014 Property Located at: 15 Leavitt Street UNIT# 1 Owner/Agent: Michael Kantorosinski Address: 407 Essex Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-968-8190 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter If' Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARP OF HEALTH LARRY RAMDIN HEALTH AGENT SANITARIAN aPublicHeafth CITY OF SALEM, MASSACHUSETTSBOARDOF I IEaLTH 120 WASHINGTON STREET„4t°'FLOOR nev c.aromum.r.ama. TEL.(978)741-1800 FAX(978)745-0343 KIMBERLEY DRISCOLL Itamdin@salem.com L.$It1ZY R,IAIDiN,RS/IU-1-IS,C;t[O,(:I'-[5 MAYOR HEm:rti 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 ATtf ° c11-- 5a)&, b-0 gC ,O UNIT# I pp IS THIS UNIT DISIGNATED AS RIGHT LEFC FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSERRI kLIAJ k N 1,V 1'/��MANAGER/AGENT ADDRESS n_ ADDRESS CITY, STATE,ZIP S4 f Oe4g )Ci CITY, STATE, ZIP RESIDENCE PHON�� BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: , ROOM USE: 1 2. 3. 4. 5. 6 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS F IS P T THE T E OF INSPECTION APPLICANT'S SIGNA"I LIRE DATE �� l j Inspectors use only Date on initial inspection:___►/ Date of reinspection: Date of issuance of certificate: _ Date fee paid: Type of unit: Dwelling Other Check Check date:— Notes: Codent Inspector �t"ce 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 04/10/2001 15-17 Leavitt Street Realty Trust 27 Harbor Street Salem, MA 01970 PROPERTY LOCATED AT 15 Leavitt 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 2: 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 riot 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. THE BOARD 0 HEALTH REPLY TO JR anne Scott, MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR CITY OFMASSACHU S S ALEM SETTS a BOARD OF HEALTH Publicxealth 120 WASHINGTON STREET,4."FLOOR rrc.e",.rrnmmc..r."eem. TEL. (978) 741-1800 FAx(978)745-0343 KIMBERLEY DRISCOLL Iramdin@salcin.com LARRY RAMDIN,R5/RI:HS,CHQ CP—FS MAYOR - - HI:',AJ,n'r ACENP CERTIFICATE OF FITNESS CERTIFICATE# 154-14 DATE ISSUED: 5/5/2014 Property Located at: 15 Leavitt Street UNIT#3 Owner/Agent: Michael Kantorosinski Address: 407 Essex Street City/Town: Zip Code: 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 A*A- LARRTAAMDIN HEALTH AGENT SANITARIAN PW CITY OF SALEM, MASSACHUSETTS � 6 BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR P61iCHealth Prevent.Promote.Protect. TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL Iramdin@salem.com MAYOR Lr11iRY 1LVMllIN,RS/IiF{FIS,0-10,CP-FS HEA]:.CH A("ENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" 1 FETE: $50.00p PROPERTY LOCATED AT )S I.+c 5 t 5atQ , kk44-3 0/e/ 70 UNIT#_3— IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNERILESSER MANAGER/AGENT I G 0& ADDRESS 15- S d J� ADDRESS CITY, STATE,ZIP CITY, STATE,ZIP P7G�l Ty RESIDENCE PHONEr� //�� BUSINESS PHONE(24HRS) BUSINESS PHONE Qj 0 n � FJ y((0 TOTAL NUMBER`,O,F ROOMS: ROOM USE: 1. t � 2. 3. 4. 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS F E IS PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATE I Inspectors use only Date on initial inspection:-6 Date of reinspection: Date of issuance of certificate: Date fee paid: _ Type of unit: Dwelling Other Check# Check date: Notes: tII lx in �0i,h ]n Whit" fd be Cod nfdcement Inspector 4 { v' r1� CITY OF SALEM, MASSACHUSETTS ry ,; BOARD OF HEALTH s 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 STANLEY J. USOVICZ, JR. FAX 978-745-0343 MAYOR W W W.SALEM.COM JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#597-05 DATE ISSUED: 9/27/05 Property Located at: 15 Leavitt Street UNIT " Owner/Agent: David T. Ramsey Address: 58 Gregory Is Road City/Town: Hamilton, MA Zip Code: 01936 24 Hour Phone: 978-468-4953 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 JOAE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECT R CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION/". PROPERTY LOCATED AT / A �� ls <�� / E'er UNIT# IS THIS UNIT DESIGNATED AS RIGHT LEF FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER/ ' " ? �a. se1� MANAGER/AGENT No P.O. Box, No P.O. Box ADDRESS �U��or 7�s ��T ADDRESS CITY Aeg�2 Z/7 0 98 Z CITY RESIDENCE PHONE" g�� S3 BUSINESS PHONE (24 HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. (t 2. Q1 3. � 4._ 5. 6. 7. 8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE —DATE ` " Z2 _>k INSPECTORS USE ONLY DATE OF INITIAL INSPECTION � � 2- 0 J� .DATE OF REINSPECTION_ DATE OF ISSUANCE OF CERTIFICATE: '1- z a'�`_ DATE FEE PAID:_ Y TYPE OF UNIT: DWELLING OTHERCHECK #—(o I S CHECK DATE NOTES: v� CODE ENFORCEMENT INSPECTOR 9/28/98 Al 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. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE# 51-05 DATE ISSUED: 1/20/05 Property Located at: 15 Leavitt Street UNIT#5 Owner/Agent: David T. Ramsey Address: 58 Gregory Is Road City/Town: Hamilton, MA Zip Code: 01936 24 Hour Phone: 978-468-4953 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 JOAN SPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR i L �'B CITY OF SALEM, MASSACHUSETTS B<.tARt7 of HEALTH WASHINGTON WASHINGTON STREEP,401 FLOOR TEL.(978)741-1800 KII&ERLEY DRISCOLL Fax(978) 745-0343 MAYOR I c:c>ri s a:nt.COM i JOANNE SCOTT, HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#392-08 DATE ISSUED:8/20/2008 Property Located at: 15 Leavitt Street UNIT#Unit 5(31-eft) Owner/Agent: David T. Ramsey Address: 58 Gregory Is Road Citylfown: South Hamilton,MA Zip Code: 01982 24 Hour Phone: 978.488.4953 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 O , ;�� 'e . ANNE SCOTT, MPH, RS,CHO HEALTH AGENT C NFORCEM514T INSPECTOR I qe,N rurz- {7 U • 0 . CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4" FLOGR TEL. (978)741-1800 KIM BE J-EY DRISCOLL FAX(978)745-0343 MAYOR 11;COTf& LRM.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 FITNESSTOR HUMAN HABITATION." / �FfEE: $50..0,/0 /icy ,�� PROPERTY LOCATED AT ! PQ U t� ''+ " 5 4`�'� UNIT#, Lft d IS THIS UNIT DLSIGNATED ASIIL GHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE -+f� OWNEIULESSER DAO fd(7FQ� f'� MANAGER/AGENT Rge4l f W / l� NO P.O.BOX / ADDRESS � �'+ ADDRESS --�-� t-� aq ga CITY,STATE,ZIP CITY, STATE,ZIP RESIDENCE PHONE 7ZF�4 yG,S "lI fS BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: -Jk t-f4 ROOM USE: 1 jer4 CA++ 2 Pf-W—I1V, C?w J--w-N. 5. G. 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 AjJM TIME OF INSPECTION APPLICANT'S SIGNATURE �� _ DATE !S Lectors use only Date on initial inspection: O/a01 Date of reinspection: Date of issuance of certificate: Date fee paid:_ Type of unit: �n ke4ch�anDw".YellmgOther ' Check#` ,�i_ Check date: ' Notes: Y-- mt hhr ":8 S+09" u)fzr +) :EA0 � c` ufr— � 1!&& � Lb "o�P i�WEnfbrcemcnt Inspector CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH e $ 120 WASHINGTON STREET, 4TH FLOOR a SALEM, MA 07970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT i CERTIFICATE OF FITNESS CERTIFICATE#397-05 DATE ISSUED: 6/22/05 Property Located at: 15-17 Leavitt Street UNIT# 1 Left Owner/Agent: David Ramsey Address: 58 Gregory Island Road City/Town: Hamilton, MA Zip Code: 01936 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 isss Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR 1 CITY OF SALEM, MASSACHUSETTS .y, BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978.74 1-1800 ,✓J FAX 978.745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO - MAYOR HEALTH AGENT i APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATI/O�N�". PROPERTY LOCATED AT S 1 WeUNIT# JJ LP�k/J IS THIS UNIT DESIGNATED AS RIGHTLEFT FRONY/BA-CZ PLEASE CIRCLE ONE .i: OWNER/LESSER MANAGERIAGENT _' � No P.O. Box /! ��+ No P.O.Box ADDRESS lY. Qf� _---`ADDRESS_ l" � CITY _CITY k"_� l __ RESIDENCE PHONL01Z.br114f' `F�3� -BUSINESS PHONE (24 HRS) BUSINESS PHONE 6ff TOTAL NUMBER OF ROOMS: , ROOM USE: 1' #� —2" & J g_Re � 4 THERE 1S A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. ^� APPLICANTS SIGNATURE / — DA SIGNATURE u_o`Or NSPECI'OR5 USF ONS DATE OF INITIAL INSPECTION _ .- p .-_DATE OF REINSPECTION - lr DATE OF ISSUANCE OF CERTIFICATE(;-;-$�'�_ __-DATE FEE PAID TYPE OF UNIT: DWI-[ LiTHER CHECK 1! 7/6 CHECK DATE6 2 a' NOTES CODE ENFORCEMENT INSPECTOR 9128/9£3 CITY OF SALEM, MASSACHUSETTS �." BOARD OF HEALTH u .h 120 WASHINGTON STREET, 4TH FLOOR 5! SALEM, MA 01970 CERT.# 628-02 TEL. 978-741-1800 FEE $25.00 FAX 978-745-0343 DATE: 12/26/2002 STANLEY USOVICZ, JR. JOANNE SCOTT. MPH. RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 15-17 Leavitt Street UNIT #: 1st floor right OWNER/AGENT: 15-17 Leavitt Street Realty Trust ADDRESS: 10 Linden Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 639-1883 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 i i JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CQDE -EN ORCEMENT INSPECTOR CITY OF SALEM MASSACHUSETTS !� 0 o a� BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR n 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 lS-/7 L.e0q4/TT St UNIT# IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE /f--/7 " QVne OWNER/LESSER Rsa4.rt ?tZusl� MANAGER/AGENT Adill AkAOL,f) No P.O. Box No P.O. Box ADDRESS /O G/44/9aet S/• ADDRESS CITY t�A�� CITY RESIDENCE PHONE In 375� YDl. BUSINESS PHONE (24 HRS.)2ff! BUSINESS PHONE_ TOTAL NUMBER OF ROOMS: ROOM USE: 1. bT 2. LV 3. V___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 DEP RTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE DATE J`L`Z6 - D3 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION DATE OF REINSPECTION ri/9 DATE OF ISSUANCE OF CERTIFICATE: DATE FEE PAID: /d/(f TYPE OF UNIT: DWELLING 't,�OTHER_ CHECK# ,//4/ CHECK DATE A? rj NOTES: C NOR ENT INSPECTOR 9/28/98 r CITY OF SALEM, MASSACHUSETTS y� BOARD OF Hr—),LTH �! 120 WASHINGTON STREET,4"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR DGREHNBAUM@SALEM.COM DA\riD GRE.ENBAUM ACHNG HI3AI.TH AGENT CERTIFICATE OF FITNESS CERTIFICATE #005-10 DATE ISSUED: 1/13/2010 Property Located at: 15-17 Leavitt Street UNIT#2nd floor Owner/Agent: David Ramsey Address: 58 Gregory Island Road City/Town: Hamilton, MA Zip Code: 01982 24 Hour Phone: An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II" Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. F =7 OF HEALTH DAVID GREENBAUM ACTING HEALTH AGENT CODE ENFORCEMENT INSPECTOR A)S CA • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4:"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGREENBAUM(/SAIAN CONI DAVID GREENBAUM, ACTING HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION." / FEE: $50.00 PROPERTY LOCATED ATlS��h a��// -70Z"w-i UNIT# IS THIS U�NNI-T DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER ��'I / MANAGER/AGENT NO P.O.BOX / ADDRESSyse // e%3 ��c� ADDRESS CITY, STATE,ZIP/ CITY, STATE, ZIP RESIDENCE PHONE BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. %— 2. Uri 3. �7� 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 P Y L THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATE/ Inspectors use only 2 � Date on initial inspection: ✓ �G _ Date of reinspection: Date of issuance of certificate: 1' 11311c' Date fee paid: 13 /U Type of unit: Dwelling Other Check# N Check date: 1 1-� 1U Notes: 1 !` °ti- � t d ok) ✓ ��4 5� �� '.I � � (1 l Jy)` S l-I.zk l'1 Cur I• G-201)� i^(�.(%V✓ a ) bor(uy I t �j.I \ �=yw Code Enforcement Inspector K7b - ,31_ 00, CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL Fax(978) 745-0343 MAYOR DORBr?NI3AUM(C�I�SAI,EM.coM DAVID GRI'.UNBAUM ACTING HF'ALI71 AGENT Facsimile Transmittal To: Fax# C/ �' � l RE: / "1 C gw U3`�7y6 c-rA 02 `O Y(1/I-er Date : /zl�o Page(s): including this cover# Message: , / Board of Health News ---------------------------------------------------------------For Your Information OFFICE HOURS: Monday, Tuesday, Wednesday 8:00 AM to 4:00 PM Thursday 8:00 AM to 7:00 PM Friday 8:00 AM to 12:00 NOON HP Fax Series 900 Fax History Report for Plain Paper Fax/Copier Joanne Scott Salem BOH 978 745 0343 Jan 22 2010 1:23pm Last Fax .. Date _ Time. _..Type. Identification Durai.n. .Paees _RgLu11 Jan 22 1:22pm Sent 919785311012 0:35 2 OK Result: OK - black and white fax CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTf-I 120 WASHINGTON STREET,4'FLOOR TP-L. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR i2LRREN BAUM(@,SA)13.M.CoM DAVID GRUNBAUM,RS ACTING H1IALT4 AGENT CERTIFICATE OF FITNESS CERTIFICATE #14-11 DATE ISSUED: 1/312011 Property Located at: 15-17 Leavitt Street UNIT#2- 1st floor right back Owner/Agent: David Ramsey Address: 58 Gregory Island Road City/Town: Hamilton, MA Zip Code: 01982 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 K there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH DAbU D GREENBAUMI,, RS _ ACTING HEALTH AGENT CODE ENFO CEMENT INSPECTOR TRANSMISSION VERIFICATION REPORT TIME 01/18/2011 03: 43 NAME FAX 9787450343 TEL 9787411800 SER.# 000BON341991 DATEJIME 01/18 03:43 FAX N0. /NAME 919784684953 DURATION 00:00:19 PAGE(S) 01 RESULT OK MODE STANDARD ECM �- no Coln �s�1 i�c 01/03/2011 00:13 9787450343 PAGE 01 CITY OF SALEM, MASSACHUSETTS BOARD OF HvALTH 120 WASHINGTON STREET,4"'FLOOR Ti31..(978)741-1800 K MBF.RM,EY DRISCOLL FAX(978) 745.0343 MAYOR ?GIl!l u Com Demo GREENSAUM,RS .A.CTING HFsALTI.I AGENT Application for Certificate of Fitness 1N ACCORDANCE WITH STATE SANITARY CODE,CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATI. FEE: $5Q.00 Aac PROPERTY LOCATEDAT I5'f 7� P ayt,+f s� ��'/ � {„ , � `f UWT# IS THIS U�NNIIT�DpISIGNATLtn A S! 1„�T FRO &ACK PLEASE CIRCLE ONE ' OWNER/LESSER, ��r / ' + �'°"Se MANAGER/AGENT NO P.O. Box /,10-/ ADDRESSJV 2-!m° ./C!ig !!( ADDRESS ! CITY,STATE,ZIP r CITY,STATE,ZIP RESIDENCE PHONE d'" '`{fie `f�. S BUSINESS PHONE(24HRs) BUSINESSPHONEY�-<- TOTAL NUMBER OF ROOMS: ROOM USE. 1. Kr'" 2. 3. j3c4 4. 5. 7. 8. 9. 10. TIM IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYAB T THE TIME OF INSPECTION APPLICANT'S SIGNATURE — DATE JpMp tors use,anlY Date on initial inspection: Date of reinspection: Date of issuance of certificate: Datc fee paid: Type of unit: Dweiliug._Other_Check# 171:� ) ,-Cheek date: Notes: 4 Code En cem tInspector. PAGE 91 fCITY OF SALEM,MASSACHUSETTS BOARD OF HMLTH 120 WASHINGTON S=W,4n'FLOOR TLG(978)741-1800 KRv1 BUZY DRLSCOLL FAX(978)745-0343 MAYOR AAvw GRaENDAum Aawc,HEAL' i AGENT CERTIFICATE OF FITNESS CERTIFICATE 0005-10 DATE ISSUED:1/1812010 Property Looeted st 15.17 t savillStmt UNIT*Z ;. Owner/Agent, David Ramsey Address: SB GnaM island Road Clty/Tovm: Hamilton,MA Zip Code: 01 24 Hour Phone: An inspection of your vacant Owall(4Roomin8 Unit at the above address ties been approved _ and Is In compliance with 105 CMR 410.000: Massachusetts State Sanitary Code,Chapter lip Mitdmum Standards of Fitness for Human HabifeUoW. Therefore,this CartiNceto Is issued by the Code Erdoroement Division of the Selern Board of Health and the unit-may now be rented and/or occupied, Maximum Number of occupants,must comply with 10 CMR 410.000. Certificate validons y� fforn date of issuance or until the current tenant vaostee,whichever 19 later. This Certificate of Fitness Itivelld only if there is a valid CeMeateof occupancy. F;=7 OF HEALTH DAVID GREENBAUM ACTING HEALTH AGENT CODE ENFORCEMENT INSPECTOR �i� Q ti�SS J'-i�Y+r— y eGJ/ CITY OF SALEM, MASSACHUSETTS jBOARD Or HI�,v-TI I 120 WASHINGTON STREET,4." FLOOR Tr-,L. (978) 741-1800 1UNIBERLEY DRISCOLL FAx(978) 745-0343 MAYOR uGIWEMMUNln AI&AI.COM DAVIDGi .;13NBAUIN,RS Ac'nNG1 TI_,A1;I'I-I.AG I:•;N'I' November 17, 2010 David Ramsey 58 Gregory Island Road Hamilton, MA 01982 Dear Sir/Madam: In accordance with Chapter II of the State Sanitary Code, 105 CMR 410.000, Minimum Standards of Fitness for Human Habitation, a recent re-inspection was conducted of your property located at 15-17 Leavitt Street Unit 1L,conducted by Jennifer Keough, Code Enforcement Officer of the Salem Board of Health on November 16, 2010. A Certificate of Fitness will be issued for this unit upon receipt of an application and checklmoney order for$50 made out to the City of Salem. All violations noted in the inspection report of September 2, 2010 have been corrected. Thank you for your cooperation in this matter. For a BP ealth, Reply to: e avid Greenb u Jen ife KKe�eoouugghh-- Acting Health Agent Code nforcement Officer - ��/ ' \ Gl�?T <Q G G X55 `�e S I�c�y S p; o'.N ✓ri'y. !/ ,Pd r / / Jose. J, ISsks� �7�3r�o CITY OF SALEM, MASSACHUSETTS ` • BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR DGREFNBAUM(@SAL13M.COM DAVID GREENBAUM ACTING HEALTH AGL'Nt CERTIFICATE OF FITNESS CERTIFICATE#517-09 DATE ISSUED: 10/15/2009 Property Located at: 15-17 Leavitt Street UNIT#3 Owner/Agent: David Ramsey Address: 58 Gregory Island Road City/Town: Hamilton, MA Zip Code: 01936 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 9F HEALTH DAVID GREENBAUM .— ACTING HEALTH AGENT C ENFOR T INSPECTOR • CITY OF SALEM, MASSACHUSETTS �1 �.0`�n BOARD OF HEALTH I 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR DGRGENBAUM&ALLM.COM DAVID GRE ENBAUM, 76 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 �/J PROPERTY LOCATED AT f b , ` L u/-064-7� -�>CC-/Lffot UNIT#, 3 yy�� IS THIS UNIT DISIGN ,TTE,DD,As RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE W ONER/LESSER Pt evI ""`�/ MANAGER/AGENT NO P.O:BOX ADDRESS 5�� ADDRESS CITY, STATE,ZIP ''" `'/ CITY, STATE,ZIP �� RESIDENCE PHONE !T` �� " Y rl�� BUSINESS PHONE(24HRS) 1 BUSINESS PHONE TOTAL NUMBER OF ROOMS: �O ROOM USE: 1. 2. y 3. 4. ('6 fi– 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 FEEAY AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATEA ®� Inspectors use only Date on initial inspection: 'T'cy� Date of reinspection: Date of issuance of certificate: Date fee paid: _ Type of unit: Dwelling Other Check#--6 —6check date: Notes: PMU�JSL� �jJ_ l J2� (�2, in Co orcement Inspector C 4 , 4 L CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH a 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#42-07 DATE ISSUED: 1/31/2007 Property Located at: 15-17 Leavitt Street UNIT#3 Front Owner/Agent: David Ramsey Address: 58 Gregory Island Road City/Town: South Hamilton, MA Zip Code: 01982 24 Hour Phone: 978-468-4953 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 HEALTH AGENT CODE ENFORCEMENT INSPECTOR • r 1 • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 3 i 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 efi�1 TEL. 978-741-1800 RECEIVED FAX 978-745-0343 JOANNE SCOTT, MPH, R5, CHO FEB - 5 2001 KimberleyHEALTH AGENT Driscoll CITY OF ui':LEM Mayor BOARD OF HEALTH APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". S PROPERTY LOCATED AT � 'i7�P�rtfS SSP UNIT#3 IS THIS UNIT DESIGNATED AS RIGHT LEFTFRON BACK PLEASE CIRCLE ONE OWNER/LESSER , d Q/�YlSP ANAGER/AGENT� No P.O. Box / No P.O. Box G ADDRESS c�a 2l�2��7�i��S�J�� ADDRESS CITY��'/f� yv/ /� CITY RESIDENCE PHONE'?P-fy67-q? � BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: (� Q ROOM USE: 1. i-7� 2.-I,-e— 3. 601� 4. 5.C--et 6. 90.1( 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 SIGNATUREV�� _DATE 3 r b INSPECTORS USE ONLY DATE OF INITIAL INSPECTION ✓ //10k> _DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: / j d_DATE FEE PAID:- 'z �'02 TYPE OF UNIT: DWELLING&,-16THER CHECK# Bye CHECK DATE A�l ie� NOTES: CODE ENFORCEM INSPECTOR 9/28/98 Tenant Certification Form Ufa, Required Federal Lead Warning Statement Housing built before 1978 may contain lead-based paint. Lead from paint, paint chips,and dust can pose health hazards if not managed properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978 housing, lessors must disclose the presence of known lead-based paint and/or lead-based paint hazards in the dwelling. Lessees must also receive a federally approved pamphlet on lead poisoning prevention. The Massachusetts Tenant Lead Law Notification and Certification Form is for compliance with state and federal lead notification requirements. Owner's Disclosure (a) Presence of lead-based paint and/or lead-based paint hazards(check (i)or(ii) below): (i) Known lead-based paint and/or lead-based paint hazards are present in the housing(explain). (ii)_Owner/Lessor has no knowledge of lead-based paint and/or lead-based paint hazards in the housing. (b) Reand reports available to the owner/lessor(Check(i)or(ii) below): (i)cord Owner/Lessor has provided the tenant with all available records and reports pertaining to lead-based paint and/or lead-based paint hazards in the housing(circle documents below). Lead Inspection Report; Risk Assessment Report; Letter of Interim Control; leZer :fC ompliance (ii) Owner/Lessor has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing. Tenant's Acknowledgment(initial) (c)_Tenant has received copies of all documents circled above. (d) Tenant has received no documents listed above. (e)_Tenant has received the Massachusetts Tenant Lead Law Notification. Agent's Acknowledgment(initial) (f) Agent has informed the owner/lessor of the owners/lessors obligations under federal and state law for lead-based paint disclosure and notification and is aware of his/her responsibility to ensure compliance. Certification of Accuracy The following paries have reviewed the information above and certify, to the best of their knowledge, that the information they hav rovided is true accurate. wner/Lessor Date Owner/Lessor Date Tenant Date Tenant Date Agent Date Agent Date Owner/Managing Agent Information for Tenant (Please Print): Name Street Apt. City/town Zip Telephone I (owner/managing agent) certify that I provided the Icnant Lead Law Notification/Tenant Certification Form and any existing Lead Law documents to the tenant, but the tenant refused to sian this certification. The tenant gave the following reason: The Massachusetts Lead Law prohibits rental dl�(rllnln 11011. including rrCusing to rent to families with children or evicting families with children because of lead paint. Contact the Childhood Lead Poisoning Prevention Program for information on the availability of this firm in other langua;es. Tenant and owner must each keep a completed and signed copy of this form. cAwp50\]cadl995Vforns\clp95-17.xvp Rcv. 5/98 I I RECEIVED FEB - 5 2007 CITY OF SPoLEM BOARD OF HEALTH I a CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1600 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 06/18/2002 15-17 Leavitt Street Realty Trust 10 Linden Street Salem, MA 01970 PROPERTY LOCATED AT 15-17 Leavitt Street UNIT # 3 Left Dear Sir/Madam: - It has come to our attention, that you may be considering renting a dwelling unit at the above address . In accordance with Chapter 11, Article XIII of the City of Salem Code of Ordinances, Section 2-334,titled "Certificate of Fitness, " each dwelling unit must be inspected and certified prior to allowing occupancy. The inspection will be conducted in ac ordance with 105 CMR; State Sanitary Code, Chapter I: General Administrative Pro ce ures 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. THE BOARD HEA TH REPLY TO JR anne 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 W W W.SALEM.COM Kimberley Driscoll JOANNE SCOTT, MPH, RS, CHO Mayor HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#35-06 DATE ISSUED: 2/14/06 Property Located at: 15 Leavitt Street UNIT#3 2nd floor Owner/Agent: David T. Ramsey Address: 58 Gregory Is Road City/Town: So. Hamilton, MA Zip Code: 01936 24 Hour Phone: 978-468-4953 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 � � "14�� /;9?0 JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR � `�. is r...^�"'�'�+"�•.:. . . p. CITY OF SALEM, MASSACHUSETTS J BOARD OF HEALTH • : 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 976-741-1800 FAX 978-745-0343 STANLEY LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT APPLICATION FOi;CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT 3 f 44)& i G f q4 UNIT q, IS THIS UNIT DESIGNATED fA`S�RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER _MANAGER/AGENT ^ �� No P.O. Bax r- No P.O. Box ADDRESS------..- DDRESS – } , - 4��__ ADDRESS_, i CITY 'ol�� ,� 1 ,, �� — CITY_ RESIDENCE PHONE91V--'I6', S/9 S3BUSiNESS PHONE (24 HRS) = BUSINESS PHONE TOTAL NUMBER OF ROOM& ROOM USE: 1. 5. A 6. 7._ 8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE L� =v ---- DATE INSPECT t p � INSPECTORS USE ONLY DATE OF INITIAL INSPECTION_} .` IF , __DATE OF REINSPECTION a_-_�_ DATE OF ISSUANCE OF CERTIFICATF _ _ DATE FEE PAID �.� _66 TYPE OF UNIT: DWELL.INC OTHER CHECK 4 CIALCK DATE NOTF6: 77–� GODF ENFOHC I-MENI INSPEC I OR 4!�18t9tt i ��y77 CITY OF SALEM HEALTH DEPARTMENT w ' ° Salem, Massachusetts 01970 Page 1 Ot f Date: /- / / - 0 Name: Address: F A VITLG� Co �fD o Specified Time Reg.#410- ViOiati0O(5) r' t r I Y ; � aoE' ,9A4 ! r Cn L) C r N t2 1 bq t7. G r n/ r ry i r L o n j ' A tv F1-ftp cL i�-1 L f Page of Date: Name: Address: Specified Time Reg.#410.. Violation(s) x_. HP Fax Series 900 Fax History Report for Plain Paper Fax/Copier Joanne Scott Salem BOH 978 745 0343 Feb 13 2006 10:39am Last Fax Date Time T)dje Identification D r n P Feb 13 10:38am Sent 919784684953 0:27 1 OK Result: OK - black and white fax v CITY OF SALEM, MASSACHUSET"T"S BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAY(978) 745-0343 MAYOR IMANCINI l@SALEM COM JANFI'M[ANCINI ACTING HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#27-09 DATE ISSUED: 1/26/2009 Property Located at: 15-17 Leavitt Street UNIT#4 Owner/Agent: David Ramsey Address: 58 Gregory Island Road Cityfrown: Hamilton, MA Zip Code: 01982 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 NET MANCINI ACTING HEALTH AGENT C0NFORCEMENT INSPECTOR -� V� -�h� -Fay �' O - � Ccvtn O V'� W� (tS Yp¢�C�, ��w�� U • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4°t FLOOR TEL.(978)741-1800 KIMBERLEY DRISCOI.L FAX(978) 745-0343 MAYOR IDIONNE e„N,EM.COM JANET DIONNE, AC'T'ING 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: $%00 ( , PROPERTY LOCATED AT 1 :5 "1�7 x QG2 Z,7��fi J t,4' UNIT#-�V IS THIS UNyIT D II GNATED AS RIGHT LEFT'FRONT OR SAC LEASE CIRCLE ONE OWNER/LESSER Qrir01 f 42-Arr,% le�7 MANAGER/AGENT ADDRESS ADDRESS �+ CITY, STATE,ZIPA" t"�IlAfp p CITY, STATE,ZIP- RESIDENCE PHONE, � '��0 'y! Sri BUSINESS PHONE(24IIRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2-Ai; 4� 3 64(6 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 ISA E AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE ��/f DATE/ p Inspectors use only �� Date of reinspection:Wa Date on initial inspection: ��I�!v Date of issuance of certificate: Date fee paid: Type of it: Dwelling Other Check# ) (�1 _Check date: Notes: t Q=LvIct a c t ° I a U 1" 1SS17 r Gt Orr o �../ I'►}qQ�- r\Q,-Inst tb31 -CI (l ViG71cet1�/1s C nforcement Inspector IMPORTAPGT MESSAGE 7OF E -10- LY A4" PHONE AREA CODE NUMBER EXTENSION U FAX U MOBILE AREA CODE NUMBER TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU RUSH RETURNED YOUR CALL WILL FAX TO YOU MESSAGE 4-27� i SIGNED FORM 49 . MADE IN .S.A. L 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 Fax: (978)740-9705 04/04/2001 P & L Realty Trust c/o Peter C. LaCascia 66 Ware Street Dedham, MA 02026 PROPERTY LOCATED AT 16 Leavitt 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 exclusively by that tenant. The DepartmentofPublic Utilitieshasbilled 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 AV HEALTH REPLY TO Joanne Sc t, MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR r i yyt ? CEP.T.# 128-97 3 FEE $25.00 DATE: 02/27/97 CITE' 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: 16 Leavitt Street UNIT #: 1 OWNER/AGENT: Peter C. LaCascia ADDRESS: 66 Ware Street CITY/TOWN: Dedham, MA ZIP CODE: 02026 24 HOUR PHONE: 329-9913 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 I5 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 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3-028 !nnvnc -COT!,MPH,PS,CHO NA'F NORTH STPFrT HEALTH AGENT - Tei:(508)741-1800 APPLICATION FOR CERTIFICTE OF FITNESS Fax:(508)740.9705 IN ACCORDANCE WITH STATE SANITARY'CODE, CHAPTER II, 105 CMR 4 10.000 "MINIMUM j STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT 16 /eke /Ay tjt f- a O" UNIT OW.T E_°.-iT,Eccry �et er ( !• l o s C{c, MANAGEVAGENT' ADDRESS J &re„ - cCJfi ADDRESS CITY_ tt Gum , ,AfCt . Q 10 a CITY RESIDENCE PHONE (L, ' - a,C/. �- � t 3 BUSINESS PHONE (24 HRS.) BUSINESS PHONE - 1400 TOTAL NUMBER OF ROOMS: ROOM USE: 1. nvZ=�3' 5, b/P.A 6. 7. 8. THERE IS A TWENTY-FIVE (25. ) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEP NT S'F/�IS�PAYABLE AT THE TIME OFF INSPECTION SIGNATURE Com/ z/! �.. s- DATE o`Ids / �- INSPECTORS USE ONLY DATE OF INITIAL INSPECTION: Z 2 : DATE OF REINSPECTION v DATE OF ISSUANCE OF CERTIFICATE: 7 ATE FEE PAID: -f 7 TYPE OF UNIT: DWELLING �( OTHER �'--�- NOTES: T� CODE ENFORCEMENT INSPECTOR o` CERT.# 440-96 3 � FEE $25.00 DATE: 07/15/96 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: 16 Leavitt Street UNIT #: 2 OWNER/AGENT: Joseph L. Wilkinson ADDRESS: 13 Lowe Street CITY/TOWN: Peabody. MA ZIP CODE: 01960 24 HOUR PHONE: 532-1132 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 ® Jj JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(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 Ito l�llit!!�`� # ,�ax3 lJl� 7� DNIT 1 OWNERJLESSER �k) 1 B. LZ . nSu» GS4 1ik�hGOY1 MANAGER/AGENT arIis ` ` ADDRESS j'3 14w2 cSt . ADDRESS lave CITY >a�f, �InA 01460 RESIDENCE PHONE BUSINESS PHONE (24 HRS.�u3Z BUSINESS PHONE ) 0,4 q4—vc TOTAL NUMBER OF ROOMS:' ROOM USE: 1. n1� aKyo,y� 2. Bt�.rr 3, 4, a 61dvp 5.�� J 6. jG�a-t� 7. l�a�.we�++ 8• THERE IS A TWENTY-FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEH HEALTH D�EPELGCIiENr-TH-IS FEE ISLE AT TID3 TIl� OF INSPECTION APPLICANTS SIGNATURE l�2 � y DATE 7 . 115 '�J�j�^ INSPECTORS ^ USE ONLY DATE OF INITIAL INSPECTION: / -� - �co DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: � _ j_DATE FEE PAID: TYPE OF UNIT: DWELLING OTHER NOTES: CODE ENFORCEMENT INSPECTOR �� 0� ��n/� ��c��AQ CITY . SALEM, MASSACHUSETTS BOARD 0PHEALTH "~ -- 120 WASHINGTON STREET,4...FLOOR PublicHealth TEL. (978) 74l 1800F.6}L/978) 745'0343 KDMBEDLBYD0SC0C[ LARRY R/\&{D[0,RS/RN IS,CR(),[Y'KS 81AY0X 82JJ2B6CBNl � CERTIFICATE OF FITNESS CERTIFICATE#173-14 DATE ISSUED: 5/1G/2014 Property Located at: l7Leavitt Street UNIT#1 [)wner/Aoent: Michael Knntorooinoki Address: 4O7Essex Street City/Town: Salem, MA Zip Code: O107U24Hour Phone: 978-068`8190 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. /\ninspection ofyour � vacant Dwelling/Rooming Unitntdhe$bOveaddreayhaobeenappnovedandioinunmclionoowiih 105CMR410.000: Massachusetts State Sanitary Code, Chapter 11" Minimum Standards of Fitness for Human Hobitation' Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now berented and/or occupied. Maximum Number ofoccupants, must comply with 105CMR 410.O00. 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. FORTHEB TH LARRYRAMD|N HEALTH AGENT SANITARIAN | CITY OF SALEM, MASSACHUSETTS BOARD OF HFALTH 120 WASHINGTON STREET' 4'"FLOOR %bliCHealth Prevent.Promote.protect. TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL Iramdin@salem.com MAYOR Lr\RRY IZAIiI[SHSh 6��IN,RS� ,CIO,(;1'-FS HFLA) r]Ac;ENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" FEE: $50.00 PROPERTY LOCATED AT ,� ��' '�C� J UNIT# 0 IS THIS �UNIT t DISIIGNATED AS RIGHT LEFT FRONT ORB CI{ PLEASE CIRCLE ONE OWNER/LESSER�I I I4OSL/�w RIQ N /MANAGER/AGENT NO P.O. BOX 1 ADDRESS LW7 Q I� S d-- ADDRESS CITY, STATE,ZIP__5 J�9 kA-0--��,0( (OCITY, STATE, ZIP RESIDENCE PHON -�'I.�BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS F EIS PAYABLEAT THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATE S 6 Inspectors use only Date on initial inspection: Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check# ) Check date: l Notes: azA Code EVbr4kent Inspector �pNDST,, Y ► �° City of Salem, Massachusetts Board of Health a `m 120 Washington Street, 4th Floor Salem PablicHeaIll MA 01970 Prevent. Promote. Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHO Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE #: GHL-15-246 DATE ISSUED: 8/21/2015 Property Located at: 17 LEAVITT STREET UNIT#1R Owner/Agent: Mike Kantorisinski Address: 407 Essex Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 868-8190 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANI RIAN CITY OF SALEM, MASSACHUSETTS. BOARD OF HEALTH 120 WASHINGTON STREEP,a FLOOR TEL. (978)741-1800 VJN BERLEY DRISCOLL FAX(978)745-0343 _ MAYOR �xAetQmrfc2sAb:cons LARRY RAMDiN,RS/RpjaS,cm,CP-1'S HEALT►►AGM n• ' Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF ETTNESS FOR HUMAN HABITATION- FEE: Q FEE: $50.00 PROPERTY LOCATED AT tgLN i/l 5� UNIT# I 1S THIS UNIT DISIGNAT®AS RIMU UWT ORPLEASE CIRCLE ONE OWNER/LESSER�(MW K "Olk9110 ) MANAGER/AGENT ADDRESS �p 7 �en�_A� ADDRESS CITY, STATE,ZIP CJu �J� C13� CITY, STATE,ZIP &70 RESIDENCE PHONE BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3. 4. 5. Z 7. 8 9 10 THERE IS A FUUT($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THISIS PAY AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE i i, DATE91�711r VV Inspectors use OX& Date on initial inspection: n 5117,/=5' Date of reinspection: Date of issuance of certificate O 17�� Date fee paid:DX f 2�2 Type of snit: Dwelling Other Check#-M�_Cheek dater W1 7/ LLL : Notes: #ege tIns for r = D'" City of Salem, Massachusetts 9' Board of Health 120 Washington Street, 4th Floor, Salem, PublicHealth Prevent. Promote. Protect. MA 01970 Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, RENS,CHO Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE #: GHL-15-77 DATE ISSUED: 5/21/2015 Property Located at: 17 LEAVITT STREET UNIT#2 Owner/Agent: Mike Kantorisinski Address: 407 Essex Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 868-8190 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH 1v1�7�r� C/�'o,��DAId Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS • J ` BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978)745-0343 MAYOR LRAMDIN@G SN.13M.COM LARRY RIMDIN,RS/RHHS,C:HO,CP-FS Hli?ALTt[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 54- -.0, q— UNIT# 2. IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER H tIOSLAQ (h*k jbS/0I-`/ MANAGER/AGENT NO P.O. BOX ADDRESS YO-1 gl- ADDRESS CITY, STATE, ZIP 94A. CITY, STATE,ZIP 00-70 RESIDENCE PHONE BUSINESS PHONE(24HRS) BUSINESS PHONE I I j 96 j? iP1 Q(0 TOTAL NUMBER OF ROOMS:_ p ROOM USE: 1. 2. 3. 4. yvd � 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 PAY LE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATE Inspectors use only Date on initial inspection:-4-\,b 115 Date of reinspection: Date of issuance of certificate: Date fee paid:S o�o lls Type of unit: Dwelling Other Check#5 3�2 Check date: 5130 1's Notes: CZAA Code-EWrccUnt Inspector cJ -Z poNDlTa� City of Salem, Massachusetts ,2j m q Board of Health A 120 Washington Street, 4th Floor, Salem, PublicHea Ith MA 01970 Prevent. Promote. Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS,CHO Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE #: GHL-16.21 DATE ISSUED: 1/22/2016 Property Located at: 17 LEAVITT STREET UNIT#3 Owner/Agent: Mike Kantorisinski Address: 407 Essex Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 868-8190 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation'. Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH /�4 Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIA LJ '100 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4".FLOOR PuNcElH Protect, TEL. (978) 741-1800 Fax(978)745-0343 KIMBERLEY DRISCOLL Itamdin@salem.com LARRY RAMllTN,16/R1;1 IS,CHO,CP-FS MAYOR HI3A1:IU AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" FEE: $50.00 PROPERTY LOCATED AT 7 0 UNIT#—,3- _ IS THIS UNIT DISIGNATED AS RIGH EFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER G& )!��f MANAGER/AGENT NO P.O. BOX ADDRESS ADDRESS CITY, STATE,ZIP 5 d_tv� 9(.,– IU i , 7 d CITY, STATE, ZIP RESIDENCE PHONE BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS:__ ROOM USE: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS P YABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATE 1 I j—l6 Inspectors use only Date on initial inspection: 1 Date of reinspection: Date of issuance of certificate: 0 ` Date fee paid:014L31= Type of unit: Dwelling--V—/ Other Check# 005-976 Check date:a7?9 2 J r Notes: ar C#ffp orceme, Inspector r R CITY OF St1LF_,M, 1V[ASSACHUSF"1":CS Bor]RD OF'IJIYALn-t 120 WASHINGTON STREET 4".FLOOR P11��C .�tth e P111M.pin.. Pmlai. TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY 13RISCOLL Iramdin a sa.lem.com MAYOR L,\RRl'Iz�nmtN,RS/100-IS,(1110,ch-rs i1EdA0:111 A(;II,N'I' CERTIFICATE: OF FITNESS CERTIFICATE# 116-12 DATE ISSUED: 3/29/2012 Property Located at: 18 Leavitt Street UNIT# 1 Owner/Agent: Melissa Theriault Address: 66 Hart Street City/Town: Beverly, MA Zip Code: 01915 24 Hour Phone: An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II" Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH 0LA HEALTH AGENT SA I A CITY OF SALEM, MASSACHUSETTS BOARD OF H&1L1'H 120 WASHINGTON STREET,4°.FLOOR TEL. (978) 741-1800 hIM13}EiR.fXY DRTSCOLL FAX (978) 745-0343 MAYOR LHAMumnSATEN1.CONT I\]MYR.,Wd DIN, its/RI?1 is,C1 R),CIYN' 1-1Hh1;r1 1AGr;Nr Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" C' FEE: $50.00 l PROPERTY LOCATED AT O L e(,O i+ SA- , JG IP'M /VIA UNIT#� IS THIS UNIT DISIGNATED AS RIGHT —LEFT FRO TOR BACK PLEASE CIRCLE ONE OWNER/LESSER /V�P CA ll,�l A J�T MANAGER/AGENT NO P.O. BOX ADDRESS (4-S1- ADDRESS CITY, STATE, ZIP Pi rCf (—,Wm S, M A CITY, STATE,ZIP RESIDENCE PHONE_ BUSINESS PHONE(24HRS) BUSINESS PHONE _ TOTAL NUMBER OF ROOMS: CC�� __ ROOM USE: 1. L;v . 2. n.i 3. COwn 4. GeJ 5. Qn 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS P�YYA/BLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE----r/��ty� � DATE 3 Inspectors use only Date on initial inspection: D WW(0. Date of reinspection:, Date of issuance of certificate: Date fee paid: Type of unit/Dwelling Other Check# ,- O(o Check date: Lv Notes: ev hS Nd �'tJfh jo,,4o eV w s>�� dam• ►>, Ir�sena�wt; a ��, i', .� r►�dk�l1 0ell pl stcPt� + o�3KetSj Sw�e i� I�vu�r6om. Co rcement Inspector A4 ve'rLy0i'm -ceo vrbl4it}� co�lec* • r v��coemr� P, n < y � 9��/MlN6 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS, CHO NINE NORTH STREET HEALTH AGENT Tel:(978) 741-1800 07/06/2000 Fax:(978) 740-9705 Tracy Fagan 114 Hudson Street Northborough, MA 01532 PROPERTY LOCATED AT 18 Leavitt 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; 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 MPH,RS,CH0 PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR NDIT City of Salem, Massachusetts n Board of Health 120 Washington Street, 4th Floor, Salem, PilubliCHealth MA 01970 Prevent. Promote. Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS,CHO Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE#: GHL-15-395 DATE ISSUED: 12/1/2015 Property Located at: 19 LEAVITT STREET UNIT# Owner/Agent: Darius Gregory Address: 21 Leavitt Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(617) 510-0133 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation'. Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH .. Larry Ramdin, MPH, REHS, CHO - HEALTH AGENT SANITARIAN y / A CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR 1_RAMQfN SALEM. Q LARRY RAMDIN,RS/R19HS,CHO,(T-16 HEAI.mAGENT uw\� � ` At�t�C!V�� C ()�`/'/�1. JJJ J ' Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" C� "FEE: $510.00 PROPERTY LOCATED AT \ C esu\�C ,SCS ,ei V"��p� A- 6 l q q d UNIT# IS THIS UNIT DISIGNATED ASGRI HT LOT FRONT OR BAC PLEASE CIRCLE ONE OWNER/LESSER (1U 0'` MANAGER/AGENT NO P.O.BOX 1 ADDRESS of CITY, STATE,ZIP W11 (M G� G qO CITY,STATE,ZIP RESIDENCE PHONE1l 9) 510 20 Z>'-> BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. G,y,hh 2. Ge�� 3. &4rll— 4. VCW+ . 5. 171y10'kj lecc w� 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR AYAB BY BEC" Ol MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS IS PAYAB T T SPECTION APPLICANT'S SIGN —DAT.– use ATEuse only Date on initial inspectlon: Date of reinspection: Date of issuance of certificate: Z1/30/2015 Date fee paid: I- 130 alu- Type of unit:((Dwelling— 1Z Other rak� Check#I _Check date: 11130126L5'- _Notes::,�4- ktiny All 5,M4 letodtr Uat� W 'ler n,OCA' I' 'for L1LC CIJ7 sm1{c _x+ -U OF• moorcemen, spector 0. CITY OF SALEM, MASSACHUSETTS �! HEALTH AGENT 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 KIMBERLEY DRISCOLL JSCOTT@SALEM.COM MAYOR .JOANNE SCOTT HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#375-07 DATE ISSUED: 8/13/2007 Property Located at: 22 Leavitt Street UNIT# 1 Owner/Agent: Jean Martin Address: 24 Leavitt 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. FO THE BOARD OF HEALTH JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR r ` CITY OF SALEM, MASSACHUSETTS /J BOARD OF HEALTH - 7 �I �0 / • 120 WASHINGTON STREET, 4TH FLOOR J / SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 JOANNE SCOTT, MPH, RS, CHO - Kimberley Driscoll HEALTH AGENT Mayor APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT aI Z Z"c7_d. / UNIT# IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE f . 1r OWNER/LESSER 61e<7 7 0 )i% �MANAGER/AGENT No P.O. Box �, / _ No P.O. Box ADDRESS ac�e� f ADDRESS CITYu CITY RESIDENCE PHONBUSINESS PHONE (24 HRS.) BUSINESS PHONE_ Z TOTAL NUMBER OF ROOMS. J ROOM USE: 1,- to 2 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 AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE DATE_ INSPECTORS USE ONLY DATE OF INITIAL INSPECTION_$--_( 3 � 7 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:-_-l3_�7 - DATE FEE PAID ,-2;- > -o 7 TYPE OF UNIT DWELLd __OTHER CHECK j �� CHECK DATE NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 City of Salem, Massachusetts ~ f i Board of Health 120 Washington Street, 4th Floor, Salem, Ek lPrevent.PrOth MA 01970 Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHO Mayor health@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE#: GHL-17-78 DATE ISSUED: 3/22/2017 Property Located at: 22-24 LEAVITT STREET UNIT#1 Owner/Agent: John E. Martin Address: 24 Leavitt Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 979-7579 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates,whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age. Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4°1 FLOOR PublicHealth Prermt.Promote.v.oiee. TEL. (978) 741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL lramdin e salem.com LARRY IL\MllIN,RS/REIIS,CFfO,CP-IS MAYOR HLAIXIi AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" FEE: $50.0 / 0 PROPERTY LOCATED AT 12 - / ��GL ✓/ // 5/-r UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER�,V��j/j 12,;W,17h MANAGER/AGENT jZjz NO P.O. BOX T� ADDRESS <50q/77-e, ADDRESS CITY, STATE,ZIP-,*�1vin /117 L1/9'7d CITY, STATE,ZIP D/r'70 RESIDENCE PHONE BUSINESS PHONE (24HRS) /� BUSINESS PHONE 7 7p 9 �'/� //579 TOTAL NUMBER OF yR,OOMS:/ ROOM USE: 1.,/—/c 2. 3. 13/F 4. B 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS P LE A THE TIME OF INSPECTION /7 APPLICANT'S SIGNAT DATE / 1 �- Inspectors use only Date on initial inspection: I T _ Date of reinspection:2� Date of issuance of certificate: ,�.,, II R- Date fee aid: ��a'4� p Type of unit: Dwelling Other Check#Check date: Notes: Jai i pe Code Enf rcemen Inspector • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4'FLOORPUbHCmote.H pe9o,h TEL. (978) 741-1800 FAx (978) 745-0343 KIMBERLEY DRISCOLL Iramdin@salem.com MAYOR L,\RRY I2AMllIN,RS/RENIS,CIiO,CP-FS HEAL'i H 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/ouhabsence. 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/ourabsence during said inspection. Tenant/Lessee Owner/Lessor Address Address Address of unit to be inspected Date Updated W3/11 1 CITY OF SALEM, MASSACHUSETTS �1�y\'1^"'/CJI BOARD OF HEALTH 120 WASHINGTON STREET,41°FLOOR PublicmHeatth TEL. (978) 741-1800 Fax(978) 745-0343 KIMBERLEY DRISCOLL Iramdinna,salem.com I,;1RRY R;\bII)IN,RS/RF FIS,CI 10,CP-FS MAYOR HI3 A,t-1 A(,Ii.N'I' CERTIFICATE OF FITNESS CERTIFICATE#292-13 DATE ISSUED: 8/19/2013 Property Located at: 24 Leavitt Street UNIT#1 Owner/Agent: Jean Martin Address: 24 Leavitt Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-2202 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 O�LTH LARRY RAMDIN HEALTH AGENT SANITARIAN CITY OF SALEM MASSACHUSETTS BOARD of HEALTH 120 WASHINGTON STREET,4"'FLOOR , TEL.(978)741-1800 FAX(978)745-0343 KWBERLEYDRISCOL.L lramdin�}isalem.com MAYOR LARRY RAIvf)IN,Rs/RENS,CHO,Cr-FS HEALTH AGENT Application for Certifitate 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 1 PROPERTY LOCATED AT `1 LCX V I i " g�(�i' UNT1# IS THIS UNIT DISIGNATED AS RIGflT LEFT PRV3\F OR RACY PLEASE CIRCLE ONE ORTNER/LESSER_j � P,4-1'0 MANAGER/AGENT ADDRESS ) }�y� �,�/ L��,IJti ^�,( ' ADDRESS CITY,STATE,ZIP (TJO/`P�i7? CITY,STATE,ZIP RESIDENCEPHONE 9?,9 ?,4�/,�rZ;2dZ BUSINESSPHI}NE(24HRS) 1 BUSINESS PHONE 64 TOTAL NUMBER OF ROOMS: _ j ROOMUSE: i. G 2. 3 3. 4. ��l C'' 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 INSPE.CPLON APPLICANT'S SIGNATURE DATE---O;?/,)3 Inspectors use only Date on initial inspection: Dote of reinspection: Date of issuance of certificate:: Date fee paid: Type of unit: Dwclling / Other Check# tG Check date: Notes: Code Enforomeat Inspector CITY OF SALEM, MASSACHUSETTS HEALTH AGENT qQ 120 WASHINGTON STREET, 4TH FLOOR a SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 KIMBERLEY DRISCOLL JSCOTT@SALEM.COM MAYOR JOANNE SCOTT HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#488-07 DATE ISSUED: 9/28/2007 Property Located at: 27 Leavitt Street UNIT# 1 Owner/Agent: Joanne E. & Frederick W. Moir Address: 8 Mace Place City/Town: Lynn, MA Zip Code: 01902 24 Hour Phone: 598-0747 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 HE L�rV w 14y'q-y- JO NE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR k f CITY OF SALEM, MASSACHUSETTS a BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO - MAYOR .� HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT A-7 h ea ✓ale Sfi, UNIT # IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE i OWNER/LESSER4'RE.D +7�klN2 1"I0f MANAGER/A NT No P.O. Box n No P.O. Box ADDRESS 8 MACE d LACE ADDRESS CITYLv.Ajt\/ CITY RESIDENCE PHONE �USINESS PHONE (24 HRS.) BUSINESS PHONE S 10-t - TOTAL NUMBER OF ROOMS: ROOM USE: 3. 1111 Y1 4.�4� 5. T)2- 6. 7.-8.— THERE . 8.THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE DATE q - 2-13 0 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION !q } �� '� 7 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: --0-'7 DATE FEE PAID: TYPE OF UNIT: DWELLING/OTHER_ CHECK#CHECK DATE?- NOTES: AT -NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM,.MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR �x�4AUMAMLEN OM DAviD GREENBAum ACTING HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#601-09 DATE ISSUED: 11/23/2009 Property Located at 27 Leavitt Street UNIT#2 Owner/Agent: Joanne E. &Frederick W. Moir Address: 8 Mace Place City/Town: Lynn, MA Zip Code: 01902 24 Hour Phone: 598-0747 An inspection of your vaunt 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 I H A,., ACTING HEALTH AGENT CODE ERFORCEMENT INSPECTOR ( M1 • CITY OF SALEM, MASSACHUSETTS B():\RD O� HEAL H 120 WASTT IINGTO.N Srar:F.r,4T" FLOOR TES... (978) 741-1800 KIMB.ERLEY DRISCOIS. FAX (978) 745-0343 MAYOR DGRL LNBAUM(jt)S,UJr M.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 st' UNIT# �I O IS THIS UNIT DDISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE JOWNER/LESSERSOCCme, �I`YC�2yIGk W MOIGANAGEV(24HRS . NO P.O.BOXA' _ ADDRESS I ' 1 1: PNt�C ADDRESS CITY, STATE,ZIP �!h � ,M/t �y� I �I ° Z CITY, TA RESIDENCE PHONE SSI 'S g / 7 BUSINESS PHON BUSINESS PHONE n O? f TOTAL NUMBER OFrr-O''ROMS: (� I / ROOM USE: 1.. I"Crk� 2. 01 P1I'A` 3. kIVI� 4. ��P�i Ad 6. 7. 8. 119. 10. THERE IS A FIFTY($50)DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABL AT,TIHE�TIME OF INSPECTION YD APPLICANT'S SIGNATURE U DATE ! I Zae JJ Inspectors use only Date on initial inspection: o /a Date of reinspection: Date of issuance of certificatef 03/09 Date fee paid: Type of unit: Dwelling ✓d Uther Check# 0 I Check date: L- /01 ((h Notes: �1ernrt..� �� nan- _ ouxgra_ (/ o'o/) r r Code Enfor em n nspector CITY OF SALEM, MASSACHUSETTS BOARD OF HEAL f 120 WAS[IINGTON SrRF;sr 4T"I'i.<i0 z Teat- (978) 741-1800 KTMBERLEY DRISCOLL FAX (978) 745-0343 MAYOR COM DAVID GREENBAUM, ACTING HEMI-I AGENT Release In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ; State Sanitary Code Chapter II and Article XIII of the City of Salem Ordinance, undersigned owner/lessor and tenant/lessee of a unit of residential property, hereby authorize the Salem Board of Health or its authorized agents to "'inspect the residence identified below in accordance with the aforementioned statutes, regulations and ordinances. In the event it is necessary that said inspection be done in my/out absence. I/we expressly authorized the same and for my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of Health and its authorized agents from any lose or injury sustained of whatever nature and description occasioned by my/out absence during said inspection. \k4V\- �o Q h�� 1. I'V��✓ I c L,l, J 1 014 Tenant/Lessee + Owner/Lessor Address Address �7 J,s/-� 2a Address on unit to be inspected 210 Date ilk`°ND City of Salem, Massachusetts f • lug. i Board of Health 120 Washington Street, 4th Floor, Salem, PUth MA 01970 Prevent.Promote. Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS,CHo Mayor health@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE #: GHL-16-349 DATE ISSUED: 9/15/2016 Property Located at: 35 LEAVITT STREET UNIT#2 Owner/Agent: Jasmin Jimenez Address: 78 Moffatt Road City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 210-5931 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 then: 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. J re sy Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4'"FLOOR TEL. (978)741-1800 IUMBERLEY DRISCOLI. FAX(978)745-0343 MAYOR LUMM&ALEMCOM LARRY RAMDIN,RS/RENS,CHO,CP-FS HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITA'T'ION" ! FEE: $5WO PROPERTY LOCATED AT 3 r t"t g' ' UNIT# 2- IS IS THIS UNIT D'LSI`GNATED AS RIGHT LEFT FRONT OR C ,PLEASE CIRCLE ONE OWNER LESSER `:- W') V n \MeMZ MANAGER/AGENT- NO ANAGER/AGENTNO P.O.BOX ADDRESS S fy)Qr k100 . ADDRESS CITY,STATE,ZIP . xY � CITY,STA TE,ZIP RESIDENCE PHONE - , BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: 3 ROOM USE: 1 2. 3. 4. 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYAB BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH 4 DATE THIS IS PAYABLE TIME OF INSPECTION / APPLICANT'S SIGNA C3W� ,„„ vectors us Date on initial inspectiow-0 Date of reinspection: Date of issuance of certificate:dq/ 2A1Date fee paid:tDV..all Type of unit: Dwelhng_,/'_Other Check# j2, Check date: 0 l T 0 Notes: orcernent ector d CITY OF SALEM, MASSACHUSETTS ., d. 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 #333-06 DATE ISSUED: 6/29/2006 Property Located at: 47 Leavitt Street UNIT# 1 L Owner/Agent: Shawn Shea c/o Joe Parrello Address: 20 Locust Street City/Town: Danvers, MA Zip Code: 01923 24 Hour Phone: 978-750-1003 X209 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. ✓ R THE BOARD O HEALTH LZ � JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR f CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 3�J • • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 JOANNE SCOTT, MPH, RS, CHC} 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 49�_ ? ��q- {. _ __.._UNIT IS THIS UNIT DESIGNATED ASIR GHT L FT FRONT BACK PLEASE CIRCLE ONE � OWNER/LESSER=SA� =S��e� MANAGEWAGENT�dn�._(r� NO P.O. BOX NO P.O.BOX ADDRESS ADDRESS a0 l rrwl d' e� CITY RESIDENCE PHONE BUSINESS PHONE (24 HRS.) ?2;� `25-71 BUSINESS PHONE TOTAL NUMBER OF ROOMS:_._ ROOM USE: 1 Gi �._ cPaq3 — ,4. zn�. 5.--6._ THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE% _� _DATE_e INSPECTORS USE ONLY DATE OF INITIAL INSPECTION/%4" —D _.DATE OF REINSPECTION___ DATE OF ISSUANCE OF CERTIFICATE.__-�(2--DATE FEE PAID:_( TYPE OF UNIT: DWELLING,.VOTHER_ _ CHECK i _ _ !_CHECK DATE NOTES: �� CODE ENFORCEMENT INSPECTOR 9128198 A CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET 4P"FLOOR ii��lCHea1�1 STREET, prevent.promote.P/OICCt. TEL. (978)741-1800 FAx(978)745-0343 KIMBERLEY DRISCOLL kamdinQssalem.com L.1RRY RAMllIN,RS/RFyIiS,C1 10,CP-FS S MAYQR HI;A] AGENT CERTIFICATE OF FITNESS CERTIFICATE#446-14 DATE ISSUED: 12/12/2014 Property Located at: 47 Leavitt Street UNIT#1 Right Owner/Agent: 47 Leavitt Limited Liability Company Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-4961 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/Roaming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Coale, 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. f`OR THE BOA" D OF LARRY RAMDIN HEALTH AGENT SANITARIAN A 9 CITY OF SALENT, MASSACHUSETTS yq6 -1Iic>1RD carHEALTH 120 V"ASHING ON S"I'REET' 4... FLOOR TEL. ()78) 741-1800 KI MERLEY DRISCOLL F,1X(978) 745-0343 �1 1YOR [AAibIDIN(I1sALIN Cou LARItl R-�Hjr .Aj RS/�( R7'I13EN-Itiy3y!S" Hl3'.,\I tlI 1 0,� U,� 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 47 Leavitt Street, Salem, MA 01970 UNIT# 1R IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE NORTH SHORE COMM. OWNER/LESSE 47 Leavitt Limited Liability Company MANAGER/AGENT DEV. COALITION NO P.O. BOX ADDRESS 102 LAFAYETTE ST. ADDRESS 102 LAFAYETTE ST. CITY, STATE, ZIP SALEM. MA 01970 CITY, STATE,ZIP SALEM, MA 01970 RESIDENCE PHONE BUSINESS PHONE(24HRS) 978-745-4961 BUSINESS PHONE 978-825-4010 TOTAL NUMBER OF ROOMS: 4 ROOM USE: LLIV. ROM 2.KITCHEN 3. BEDRM 4. BEDRM 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 I4EALTH THIS FEE 1S PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE �` 1 1 DATE z Zai Inspectors use only Date on initial inspection: 0'2/I �l U Date of reinspection: Date of issuance of certificate: Date fee paid: )) Type of unit: Dwelling Other Check#Check date: JW Notes: Code En e to nspector f 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# 180-06 DATE ISSUED:4/10/06 Property Located at: 47 Leavitt Street UNIT#2L Owner/Agent: Leavitt Street Realty Trust Address: 20 Locust Street City/Town: Danvers, MA Zip Code: 01923 24 Hour Phone: 978-750-1033 An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter IP' Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates,whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEE�rALTH1 /�� ^�✓"� �C �n � JOA NE SCOTT, MPH, R5, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR Mer 28 06 03: 20P Joanne Scott -Salem BOH 978 745 0343 P. 2 ,J / CITY OF SALEM, MASSACHUSETTS 1166 BOARD OF HEALTH 120 WA3HIN6TON STREET, 4TH FLOOR SALEM, MA 01970 TEL, 978-741-1800 f Ax 976-745-0943 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-H1ABITAATION". PROPERTY LOCATED AT _UNIT# LoZ IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSERZ&Yl0,ac..,l-Rs (. to i-y1ANAGER/AGENT j" tpL No P.O.Bax No P.O.Box ADDRESS e 9 /,qzG _5r,r eL ADDRESS_AP,G��ut�� •� CITY_1�/2�,*!1 '!AA LZlq2 —CITY 7>, "? RESIDENCE PHONE 8USINkSS PHONE{24 HRS.} 'r�o3J BUSINESS PHONE TOTAL NUMBER �OF/ROOMS: ROOM USE: 1.tK e¢ILeN,.2.Zjd,6 a-13.A�r/� 5---6' —.._.. T..._.... — --6. THERE IS A TWENTY-FIVE($26.00) 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 G � —DATE 21 a 6 INSPECTORS USEI Y_ QL DATE OF INITIAL INSPECTIO(y,_I.(��_=5 z ,DATE OF REINSPECTION.- DATE OF ISSUANCE OF CERTIFICATE:Y_tC_;v 4- _DATE FEE PAID:_, TYPE OF UNIT: DWELUN�OTHER, CHECK#, J'!c _1—CHECK DATE NOTES; CODE ENFORCEMENT 14SPECTOR 9l2ts/98 City of Salem, Massachusetts V yr o� { e i 9rN c Board of Health 120 Washington Street, 4th Floor, Salem, PHealth F�IMINY.DD ublic Prevent. Promote. Protect. MA 01970 Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHO Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE #: GHL-15-28 DATE ISSUED: 4/17/2015 Property Located at: 47 LEAVITT STREET UNIT#2R Owner/Agent: 47 Leavitt LLC Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: (978) 825-4010 Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation'. Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH Larry Ramdin, MPH, REHS, CHO Jam' HEALTH AGENT SANITARIAN r CITY OF SALEM, MASSACHUSETTS g� BOARD OF HEALTH vw h 120\k'-YSHiNGT<w STREET,4''"FLOOR TEL. ()78) 741-1800 KI1v18ERLEY DR.ISCOLL FAX(978) 745-0343 MAYOR La n2uwnsALr:u.cou LARRY RAYMDrv,RS/RP.[IS,(J IO,CP-FS HE:V:1'f-f AG[tNT 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 47 Leavitt Street, Salem, MA 01970 UNIT# 2R IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE NORTH SHORE COMM. OWNER/LESSE 47 Leavitt Limited Liability Company MANAGER/AGENT DEV. COALITION NO P.O.BOX ADDRESS 102 LAFAYETTE ST. ADDRESS 102 LAFAYETTE ST. CITY, STATE, ZIP SALEM.MA 01970 CITY, STATE,ZIP SALEM, MA 01970 RESIDENCE PHONE BUSINESS PHONE(24HRS) 978-745-4961 BUSINESS PHONE 978-825-4010 TOTAL NUMBER OF ROOMS: 4 ROOM USE: LLIV. ROM 2.KITCHEN 3. BEDRM 4. BEDRM 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 ` ) h DATE i4 �O IS Inspectors use only Date on initial inspection: �6 (15 Date of reinspection: Date of issuance of certificate: Date fee paid: / Type of unit: Dwelling Other Check# o�L{ Check date:�//lglg Notes: Code�t Inspector CITY OF SALEM, MASSACHUSETTS m11. BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 KIMBERLEY DRISCOLL JSCOTT@SALEM.COM MAYOR JOANNE SCOTT HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#620-07 DATE ISSUED: 12/18/2007 Property Located at: 68 Leavitt Street UNIT#1 Owner/Agent: John Linger Address: 62 Leavitt Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 744-9664 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 O JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR i f CITY OF SALEM, MASSACHUSETTS 1 BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR /� n 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 JITe-fi-tli � _U NIT#� IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER JONAII�InST� MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS b:PkI 1' t f' 1:,� ADDRESS /P&L S CITY 66/ C-'M_ C) 2lV CITY RESIDENCE PHONEVk-7(7dSc/'72 BUSINESS PHONE (24 HRS.) PA-7,0i BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1 1 2. 3._ 4._ 5._�6. 7.J__8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY . ORDER TO THE CITY OF SALEM HE LTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE _DATE_ INSPECT GS USE ONLY DATE OF INITIAL INSPECTION /J -1 o —D7DATE OF REINSPECTION_ ___ DATE OF ISSUANCE OF CERTIFICATE: �'� Y DATE FEE PAID:_ / � —[ � TYPE OF UNIT: DWELL/OTHERCHECK # _ �/CHECK DATE C, NOTES: — — CODE ENFORCEMENT INSPECTOR 9/28/98 r r t CERT.# 114-98 FEE $25.00 DATE: 02/24/98 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 68 Leavitt Street UNIT #: 2 OWNER/AGENT: John Linger ADDRESS: 62 Leavitt Street CITY/TOWN: Salem- MA ZIP CODE: 01970 24 HOUR PHONE: 744-9664 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 7-77 3u FEB 2 G 1999 CITY OF SALEM PITY OF SALEM BOARD OF HEALTH HEALTH DEPT �( Salem, Massachusetts 01970-3928 t 1 l�jo JOANNE SCOTT,MPH,RS,CHO HEALTH AGENT NINE NORTH STREET Tet:(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 HABITATIIO�N". PROPERTY LOCATED AT' g I e#V U .7 I UNIT #_�_ OWNER/LESSER }o(lyV MANAGER/AGENT ADDRESS L��/,fAd, ff' J` ADDRESS CITYY t;1? (1/t M,A - 0476 , CITY - RESIDENCE PHONE -71Y/ BUSINESS PHONE (24 HRS.) SUSINEss_PHONH 7 P/, ' -- TOTAL NUMBER OF ROOMS: - ROOM USE: 1. cot, 2._- _ �j�G�- 3. C�- 4. 1, 8, THERE IS A TWENTY-FIFE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM'HEALTH DEPAR . NT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANTS SIG NATORE DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION:__, eLk 9- DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: a-�f�jy:j .DATE FEE PAID: a- TYPE OF UNIT: DWELLING OTHER" U /q NOTES: CODF ENFORCEMENT INSPECTOR