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MESSERVY STREET MESSERVX STREET u 8 A d 1 y t 4 ;f i 1 �j 1� t R i 1 CITY OF SALEM, MASSACHUSETTS e BOARD OF HEALTH s 120 WASHINGTON STREET, 4TH FLOOR nxe 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#94-07 DATE ISSUED: 3/14/2007 Property Located at: 2 Messervy Street UNIT# 1 Owner/Agent: Ronald & Barbara Sirois Address: Two MesservY Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-375-8232 An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter If' Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH J6ANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR 3-15-07; 9:47AM;GOVE LUMBER ; 19789214522 # 1/ 2 9 a CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH I • • 120 WASHINGTON 5TREET, 4TH FLOOR /T f SALEM, MA OI 970 1IVVII I TEL. 978.741-1 800 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 Seg; vIS THIS THIS UNIT DESIGNATED AS RIGH T LEFT FRONT BACK PLEASE CIRCLE ONE OWPOBOX ESSER&OWI�d 1. p�.viw dMANA�AGE NT /YM ' No P.O.Box ADDRESS 1^irao k--V!P {p . ADDRESS CITY_ nS. e-, Yl Mfg a/QQ 7D CITY is RESIDENCE PHONEi/ - 7 -23oSBUSINESSPHONE (24HRS.)`77r371-- ?2�32- j BUSINESS PHONE o I TOTAL NUMBER OF ROOMS: I ROOM USE: 1iz-V/p4t. 2. 1)1PJJ;u ' 5 ireAe-e-6. 7. 8. THERE IS A TWENTY-FIVE($25.00)DOLLAR FEE, PAYAB BY CHECK OR MONEY ORDER TO THE CITY OF SALE LTH DEPARTMEy HIS FEE IS PAYABLE AT THE TIME OF INSPECTION. �f APPLICANTS SIGNATU I PECTO USE DATE OF INITIAL INSPECTION ODATE OF REINSPECTION_ DATE OF ISSUANCE OF CERTIFICATE:` —07DATE FEE PAID: �7 TYPE OF UNIT: DWELLIN _OTHER_ CHECK#�'f I CHECK DATEJn / NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 3-55-07: 9:47AMi DOVE LUMBER , 19789214522 2f 2 s , i Tenant Certit'ication Form Required Federal Lead Warning Statement Housing built before 1978 may contain lead-baud paint. Lead from paint,paim 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 i (a) Presence of lead-baud paint and/or lead-based paint hazards(check(i)or(ii)below): (i)_�4_Known lead-based paint and/or lead-basedpaint hazards are present in the housin (explain). d, e G •- 'OforY ,g4 h/ ( (ii),Owner/Lessor has no kno edge of lead-based paint and/or d-based paint hazards i the housing. (b) Records and reports available to the owner/lessor(Check,(i)'or(ii)below): Owner/Lessor has provided the tenant with all available records and reports pertaining to lead-based paint and/or lead-based paint hazards in the housing(circle documents below). Lead inspection Report; Risk Assessment Report; Letter of interim Control; Letter of Compliance (ii)_V,1Dwner/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)_Tcnant has received the Massachusetts Tenant Lead Law Notification. Agent's Acknowledgment(initial) (f)_Agent has informed the owner/lessor of the owner's/lessor's obligations under federal and state law for lead-based paint r disclosure and notification and is aware of his/her responsibility to ensure compliance. Certification of Accuracy The following parties have reviewed the in rmation above and certify,to the best of their knowledge,that the information they have d is true and accurate. i r rtLessor Date Owner/Lessor Date F Tenant Date Tenant Date Agent Date Agent Date Owner/Managing Agent Information for Tenant (Please Print): Name ^� srreel Apt- -.. Cityfrown Gp Telephone I(ownedmanaging agent)certify that I provided the I enant Lead Law Notification/Tenant Certification Form and any, existing Lead Law documents to Qte tenant,but the tenant refused set sign this certification. rhe tenant gave the following I ht Ma4sachlliel S 1xild tare pr.d111111:rental disrriminutioo in,imline. Iviu u4;to rcin to taotitw,N%vith children or cviclinst I:unilies with children because of lead paint. Contact the Childhood Lead Poisoning Prevcntiun Program for InfoUI%Inuo use tier :rvailahilnv of thus loan in outer language,. Tenant and owner must each keep a completed and sit seed cnpv of This form. iupilRlcad l'lry$lfnrtatitclptti-}? np Rae. $1918 _ o CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH . � :9 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 Aqg TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT November 2, 2003 Sarah Calland 12 Messervy Street Salem, MA 01970 PROPERTY LOCATED 12 Messervey Street Unit#1 It has come to our attention, that you may be considering renting a dwelling unit at the above address. In accordance with Chapter 11,Article XIII of the City of Salem Code of Ordinances, Section 2-334,titled "Certificate of Fitness," each dwelling unit must be inspected and certified prior to allowing occupancy. The inspection will be conducted in accordance with 105 CMR; State Sanitary Code, Chapter 1: General Administrative Procedures and 105 CMR 410.000; State Sanitary Code, Chapter 11: Minimum Standards of Fitness for Human Habitation. Please notify us if you do not intend to rent the unit. Please contact this department within 24 hours of receipt of this notice at 978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday thru Wednesday from 8:00 a.m. —4:00 p.m. Thursday 8:00 a.m. —7:00 p.m. and Friday 8:00 a.m.—4:00 p.m. Failure to comply with this procedure, may result in a fine of Twenty ($20.00)dollars per day for every day that the dwelling unit is occupied without a Certificate of Fitness. A$25.00 check payable to the City of Salem is required for each unit inspected at the time of inspection. A property owner is required to pay gas and electricity for residential tenants if there is not a written letting agreement stating the tenant is responsible for those utilities and if the meter(s) records electricity and gas use which is not used exclusively by that tenant. The Department of Public Utilities has billed property owners for their tenants'entire utility bills retroactive to the date of initial occupancy in cases in which cross-metering has been proven to exist. For the Board of Health Reply to Joanne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector CITY OF SALEM, MASSACHUSETTS + ( BOARD OF HEALTH 120 WASHINGTON STREET,4°'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR 1Dt0NNe:a sALPW cont JANET DIONNE ACTING H I�.AI;IT-I AG HNT CERTIFICATE OF FITNESS CERTIFICATE#560-08 DATE ISSUED: 11/12/2008 Property Located at: 14 Messervy Street UNIT# 1 Owner/Agent: Edward Palmeira Address: 1 The Greenway City/Town: Middleton, MA Zip Code: 01949 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. 4FO THE BOA D F HEALTH ANE DIONNE ACTING HEALTH AGENT CO NFORCEM N INSPECTOR CITY OF SALEM, MASSACHUSE'I"TS * BOARD OF HEALTH it X 120 WASHINGTON STREET,4"'FLOOR TEL. (978)741-1$00 K MLiERI,EY DRISCOLL FAX(978)745-0343 MAYORUIONNL' S .Eh,COM JANET DIONNE, ACTING HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION." FEE: $50.00 PROPERTY LOCATED ATIz,f / '�✓ � �CrI'U✓/ UNIT# 'y ISS THIS DNJT DISIGNATED AS RIGIFf LEFT FRONT OR BACK PLEASE CIRCLE ONE, OWNER/LESSER MANAGER/AGENT V r3f NO P.O.BOX y ADDRESS f �1y/: 1�� [m."fv ADDRESS CITY, STATE,ZIP / "/i �LG 6 CITY, STATE,ZIP RESIDENCE PHONE ��I< ?��'Q�// BUSINESS PHONE(24HRS) BUSINESS PHONE �� TOTAL NUMBER OF ROOMS: ROOM USE: 1.kAl c 2. / � 3. 4Q4 4. ()1(�— 6. 7. 8, 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE,BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE XT HE TIME OF INSPECTIONAPPLICANT'S SIGNATURE C2GDATE Inspectors use only Date on initial inspection:` -.40s Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check# Check date: Notes: Code Enforcement Inspector �c NDI t� CITY OF SALEM9 MASSACHUSETTS BOARD OF HEALTH ` R 120 WASHINGTON STREET, 4TH FLOOR i ro SALEM, MA 01970 mns TEL. 978-741-1800 FAX 978-745-0343 KIMBERLEY DRISCOLL JSCOTT@SALEM.COM MAYOR JOANNE SCOTT HEALTH AGENT Facsimile Transmittal To: ,V- — cut. u-zmt "P-k) Fax # RE: Date : �� � l�, �C�� 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 03.43 Nov 14 2008 10:25am Last Fax Date Time Twe Identification Duration Pages Result Nov 14 10:24am Sent 919787449614 0:36 2 OK Result: OK - black and white fax 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 JSCOTT@SALEM.COM MAYOR JOANNE SCOTT HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#613-07 DATE ISSUED: 12/12/2007 Property Located at: 14 Messervy Street UNIT#2 Owner/Agent: Edward Palmeira Address: 1 The Greenway City/Town: Middleton, MA Zip Code: 01949 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 ��� zzd�p-� JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR l� - CITY OF SALEM, MASSACHUSETTS a BOARO OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR _ SALEM, MA 01970 Tet. 978-741-1800 FAX 978-745-0343 I� JOANNE SCOTT, MPH, RS, CHO Kimberley Driscoll HEALTH AGENT 6� � 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 -,� _ f bR _UNIT# ' IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER 49fl"RI"4j I"lf MANAGER/AGENT No P.O. Box No P.O.Box ADDRESS #( Q ADDRESS _ CITY / �/ ���C�/��I� /7 GI ,9y- RESIDENCE PHOOT.�7�BUSINESS PHONE {24 HRS.}_ _ BUSINESS PHONE _ TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2- 5__ _6. .5__-6. — THERE IS A TWENTY-FIVE($25.40) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTM�ENQT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. !Oy��/`- �2^f�"�� APPLICANTS SIGNATURE ( DATE INSPECTORS USE ONLY A E O INITIAL INSPECTION /�,i-© + DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: TATE FEE PAED:- �-10� TYPE OF UNIT: DWELLING OTHER— CHECK # �fD CHECK DATE Z;2 _L - a� NOTES: _ CODE ENFORCEMENT INSPECTOR 9128198 A CERT.# 377-01 FEE $25.00 'ay DATE: 08/13/2001 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO 120 Washington StreetHEALTH AGENT Tel: (978)741-1800 Fax: (978)745-0343 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 17 Messervy Street UNIT #: 1 OWNER/AGENT: Arthur Turcotte ADDRESS: 13 West Circle CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-0688 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. l FOR THE BOARD OF HEALTH JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR Nw 61 3 - n � CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH, RS,CHO 120 Washington Street HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tel:(978)741-1800 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 Fax:(978)-745-0343 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT UNIT#4 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER &Z1.A_k I A,%,�MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS l 3 hJsA-ate _ ADDRESS CITY &_t inn CITY `&,t _ RESIDENCE PHONE USINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS:_ ROOM USE: 1._64A4)v­ 2. d 3. 5.-6.-7.-8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. r APPLICANTS SIGNATURE_Q.n ,«�T�wweiww DATE '3 2-6 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 9 '3 _-Z DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: Y /5'z>/ DATE FEE PAID: S - 3 --:> TYPE OF UNIT` DWELLING,�_OTHER_ CHECK# S q;1 7 CHECK DATE 9-3 -'f NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CERT.# 491-97 3 FEE $25.00 DATE: 07/28/97 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(508)741-1800 Fax:(508)740-9705 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 17 Messerw Street UNIT #: 2 OWNER/AGENT: Valma & Arthur Turcotte ADDRESS: 13 West Circle CITY/TOWN: Salem MA ZIP CODE: 01970 24 HOUR PHONE: 744-0688 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. THE BOARD/�/ H JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR �` c6XO OFFICE USE OlFLY mac•' .. „c r4P .. .. CERT__ ERT ~� J' DATE' CITY OF SALEM, HEALTH DEPARTMENT BOARD OF HEALTH Salem, Massachusetts 01970 ii08ERi-E,8L£NKHBRN- - 9 NORTH STREU HEALTH AGENT , 508-741-1800 APPLICATION 'FOR CERTIFICATE OF FITNESS AN ACCORDANCE WITH STATE SANITARY' CODE; ;CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT V UNIT I OWNERJLESSER:V A L IM I�"B �{P. i I CJ R' Tu 2 C 0 T?E MANAGER/AGENT I ADDRESSl.37 Gu f 5 =T G!p_-'C' C L' !^ " ADDRESS CITY :. . A L`(_'Yk CITY I RESIDENCE-.PHONE l¢4`.^(} BUSINESS PHONE (24 HRS.) BUSINESS PHONE ct TOTAL ,NUMBER OF ROOMS. I i ROOM.:USE: -;I . 2. 3. 4. 5. 6. 7. 8. j THERE IS A TWENTY—FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT UPON COMPLIANCE AND ISSUANCE OF CERTIFICATE. APPLICANTS SIGNATURE�j/�Xt � ���cc/ C_< f�� DATE 46 Z S 4` IN PELT RS USE ONLY DATE OF INITIAL INSPECTION: 17 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFIICA779TF,:T. DATE FEE PAID:� � TYPE OF UNIT: DWELLING VOTHER y NOTES: — CODE ENFORCEMENT INSPECTOR • 3�� CERT.# 492-97 3 � FEE $25.00 DATE: 07/28/97 ar 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: 17 Messerw Street UNIT #: 3 OWNER/AGENT: Valma & Arthur Turcotte ADDRESS: 13 West Circle CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-0688 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 p lge-plc-x�'01)� JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR OFFICE USE ONLY .,. CERT,. lK 3 J DATE' I CITY OF SALEM. HEALTH DEPARTMENT BOARD OF HEALTH Salem, Massachusetts 01970 fl48EAi-E.8L-ENKHORN- _ _ 9 NORTH STREZI 14EALTH AGENT 508441-1800 APPLICATION FOR CERTIFICATE OF FITNESS .IN ACCORDANCE WITH STATE SANITARY'CODE, CHAPTER "II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN RABITATION". I PROPERTY LOCATED AT (/�!j'g '-^�,- 2 fL-li/ UNIT # I OWNER/LE_SSER,VALN2A /�(LTKUCE. TV P–00 rE MANAGERAGENT ADDRESS " "'!:3 'LL F_ 5".:T ;'CI IZ C'( l= + ADDRESS GIC. CITY CITY .-.... .. � � y;r-yu _yt,� p�._„__... RESIDENCE PHONE '7BUSINESS PRONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS - ROOM-:USE 1. 2 3. 4. 5. 6 7 B i THERE IS A TWENTY-FIVE (25.00) DOLLAR FEE PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM'HEALTH DEPARTMENT UPON COMPLIANCE AND ISSUANCE OF CERTIFICATE. APPLICANTS SIGNATURE /�^� ./�/t { vDATE T iz 6 Z” INSPECTORS USE ONLY DATE OF INITIAL INSPECTION:- z DATE OF REINSPECTION` DATE OF ISSUANCE OF CERTIFICATE: DATE FEE PAID:y 7 / TYPE OF UNIT: DWELLINGVOTUER NOTES: CODE ENFORCEMENT INSPECTOR a 3 uy� CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(508)741-1800 Date: 07/10/97 Fax:(508)740-9705 Valma M. Turcotte Nominee Trust 13 West Circle Salem, MA 01970 PROPERTY LOCATED AT 17 Messervy 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. It is incumbent upon you as owner(s) to contact the City of Salem Health Department to apply for a CERTIFICATE OF FITNESS before any vacant dwelling unit is rented or occupied, or to notify us of your intent for this unit. Each dwelling unit must be inspected and certified by the Salem Health Department prior to allowing occupancy in accordance with Chapter 111, Sections 127A and 127B, of the Massachusetts General Laws, 105 CMR 400.00; State Sanitary Code, Chapter 1: General Administrative Procedures and 105 CMR 410.000; State Sanitary Code, Chapter 11: Minimum Standards of Fitness for Human Habitation, and in accordance with Chapter 11, ArticleI. XIII of the City of Salem Code of Ordiances, Section 2-334, Certificate of Fitness. There is a twenty-five (25) dollar fee payable by check, or money order to the City of Salem Health Department. This fee is payable at the time of inspection. Inspection will not be performed without receipt of payment. Failure to comply with this procedure, will result in a fine of twenty (20) dollars per day for every day that the dwelling unit is occupied without approval of the Code Enforcement Division of the Salem Health Department. Contact this department within 24 hours of receipt of this notice. (508) 741-1800 Monday thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7:00 p.m. or Friday 8:00 a.m. to noon to schedule an appointment for an inspection. SEE ENCLOSED SECTION 105 CMR 410,354 METERING OF GAS & ELECTRICITY Very truly yours, FOR THE BOARD OF HEALTH REPLY TO Joanne Scott, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR