251 Loring Ave, Unit1 r ti 's City of Salem, Massachusetts
W Board of Health
120 Washington Street, 4th Floor, Salem, PU
Health
MA 01970 Prevent. Promote. Protect.
Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, RENS, CHo
Mayor health@salem.com Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE#: GHL-17-130
DATE ISSUED: 5/312017
Property Located at: 251 LORING AVENUE UNIT#1
Owner/Agent: Gary Pierce
Address: 9 Oakview Avenue
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:
Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division 3, Section 705: Certificate of fitness of
rented dwelling unit, apartment or tenement. An inspection of your vacant Dwelling/Rooming Unit at the above address has
been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum
Standards of Fitness for Human Habitation'.
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now
be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age.
os
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT SANITARI N
r.c
CITY OF SALEM, MASSACHUMTTS
• m BOARD OF HEALTH
12D WASH I NGTON SrREET,41" FLOOR
TEL.(978)741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR LRAMDINO)SALEM.COM
LARRY RAMDIN,RJ REH$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"
r�
FEE: $50.
200
PROPERTY LOCATED AT j 40 r iyq Ayo - UNIT#
ISTHISUNITTDISIGNATEDASRIG TLEFTFRONTORBACK;PLEASECIRCLEONE
OWNERILESSERC7�Fly r"I L`A 'S MANAGER/AGENT
NO P.O.BOX
ADDRESS R OR KVt to) YPi ADDRESS Jf�_
CITY,STATE,ZIP �YAUrn CITY,STATE,ZIR5d�L£JI 01 COO
RESIDENCEPHONE q l?" '4 d BUSI NESS PHONE(24HRS)
BUSINESS PHONE I ! T q T9- TO luX
TOTAL NUMBER OFROOM&— �
ROOM USE: 1. K It
2j)1 iJ iNj 3.�Wl u y 4.1 - 5. ?d-�
6. 7. 18. It 9. 10.
THERE ISA FIFTY($50)DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS FEE IS PAY EATTHETIMEOF INSPECTION
APPLICANTSSIGNATURE e DATE ° I
I nmectors use only
Date oninitiat inspection: 471)i7 Dated reinspection:
Dated issuanceof Dertificae:S102120_t7 Datefeep id: S�CJ2�ZDy_�
Typeofunit: Dwelling—V—Other Check# Check date S/DZ12.L7
Notes
or inw&or