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CERT.# 298-98
3 FEE $25.00
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CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(978)741-1800
Fax:(978)740-9705
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 1 Oak Street UNIT #: Rear
OWNER/AGENT: Donald Bates
ADDRESS: 31 Settlers Wav
CITY -
/TOWN: Salem. MA ZIP CODE: 01970 24 HOUR PHONE: 745 3128
AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS
BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410 .000 : MASSACHUSETTS STATE
SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" .
THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE
SALEM HEALTH DEPARTMENT AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED.
MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410.000: MASSACHUSETTS STATE
SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" .
SECTION 410 .400 (B) : DWELLING UNIT (X) AND 410 .400 (C) : ROOMING UNIT
MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: .
NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR
OCCUPANTS UNDER 6 YEARS OF AGE.
FOR THE BOARD OF HEALTH
JOANNE SCOTT, MPH, RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
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WANTS TO SEE YOU RUSH
RETURNED YOUR CALL WILL FAX TO YOU
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CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
APPLICATION FOR CERTIFICTE OF FITNESS Fan:(508)740-9705
IN ACCORDANCE WITH STATE SANITARY CODE, .CHAPTER II , 105 CMR 410000 "MINIMUM
STANDARDS OF FITNESS FOR HUMAN HABITATION
PROPERTY LOCATED AT / ( J�CXQ-t+� UNIT #
i
OWNER/LESSER MANAGER/AGENT. Y
ADDRESS ADDRESS
CITY S Oi �7D 19�� CITY17
_
'RESIDENCE PHONE��$ � TS 3�a � BUSINESS PHONE (24 HRS.)
BUSINESS PHONE S/1q-/o1c,
TOTAL NUMBER OF ROOMS
ROOM USE: 1 .�2.�3. 4
5. 5. 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 TINE OF INSPECTION
APPLICANTS SIGNATURE T cGE9� DATE_
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION: DATE OF REINSPECTION _
DATE OF ISSUANCE OF CERTIFICATEDATE FEE PAID:
TYPE OF UNIT: DWELLING OTHER---
NOTES:
THER _NOTES: —
CODE ENFORCEMENT INSPECTOR
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CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO - NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Fax:(508)740-9705
RELEASE
In accordance with Massachusetts General Laws Chapter 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 author-
ized agents to inspect the residence identified below in accordance with the
aforementioned statutes, regulations and ordinances.
L. the event it is necessary that said inspection be done in my/our absence , 1/we
expressly authorize the same and for my/our successors and assigns hereby release
and discharge the City of Salem, Salem Board of Health and its authorized age:ats
frons any loss or injury sustained of whatever nature and description occasioned
by my/our absence during said inspection.
T.EI9A.`' /LESSEE OWNER/LESSOR
ADDRESS r Dl9�o ADDREsS— ----- j--
Dl 7d
ADDRESS OF UNI'P TO BE INSPECTED
DAT @.
� � — --
'&trml�
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(978)741-1800
Date: 04/29/98 Fax:(978)740-9705
Frederick Kelley
6 Oak Street
Salem, MA 01970
PROPERTY LOCATED AT 6 Oak Street UNIT # House
Dear Sir/Madam:
It has come to our attention, that you may be considering renting a dwelling unit
at the above address.
It is incumbent upon you as owner(s) to contact the City of Salem Health Department
to apply for a CERTIFICATE OF FITNESS before any vacant dwelling unit is rented or
occupied, or to notify us of your intent for this unit.
Each dwelling unit must be inspected and certified by the Salem Health Department
prior to allowing occupancy in accordance with Chapter 111, Sections 127A and 127B, of
the Massachusetts General Laws, 105 CMR 400.00; State Sanitary Code, Chapter 1: General
Administrative Procedures and 105 CMR 410.000; State Sanitary Code, Chapter 11: Minimum
Standards of Fitness for Human Habitation, and in accordance with Chapter 11, Article
XIII of the City of Salem Code of Ordiances, Section 2-334, Certificate of Fitness.
There is a twenty-five (25) dollar fee payable by check, or money order to the City
of Salem Health Department. This fee is payable at the time of inspection. Inspection
will not be performed without receipt of payment.
Failure to comply with this procedure, will result in a fine of twenty (20) dollars
per day for every day that the dwelling unit is occupied without approval of the Code
Enforcement Division of the Salem Health Department .
Contact this department within 24 hours of receipt of this notice. (508) 741-1800
Monday thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7 : 00 p.m. or
Friday 8:00 a.m. to noon to schedule an appointment for an inspection.
SEF 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
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CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS, CHO NINE NORTH STREET
HEALTH AGENT Tel:(978)741-1800
08/24/2000 Fax:(978)740-9705
Robert Frazier
8 Southwick Road
N. Reading, MA 01864
PROPERTY LOCATED AT 11 Oak 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
.inaccordance 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. TheDepartmentof 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.
JFTHE BOARD OF HEALTH REPLY TO
annex of , MPH,RS,CHO PABLO VALDEZ
Health Agent CODE ENFORCEMENT INSPECTOR
�ONmT4CERT.# 336-99
FEE $25.00
DATE: 06/30/99
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(978)741-1800
Fax:(978)740-9705
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 11 Oak Street UNIT #: 2
OWNER/AGENT: Robert Frazier
ADDRESS: 8 Southwick Road
CITY/TOWN: N. Reading, MA ZIP CODE: 01864 24 HOUR PHONE: 664-2789
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
! JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
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CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH, RS,CHO NINE NORTH STREET
HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tel: (978)741-1800
Fax: (978)740-9705
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT If QAK 57T.PEET UNIT#
IS THIS UNIT DESIGNATED RIGHT ON
AS GHT LEFT FRT BACK PLEASE CIRCLE ONE
OWNER/LESSER Roo , l�lgzlzy2 MANAGER/AGENT
No P.O. Box No P.O. Box
ADDRESS Sau��wlrK 4 ADDRESS
CITY Nv �E.4�/i1/ CITY
RESIDENCE PHONE 97o -66"7,9 9 BUSINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:_
ROOM USE: 1. 2.-3.-4.-
5.__6._7._8.
. 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 THIS FEE IS PAYABLE AT THE TIME OF INSPECTION.
APPLICANTS SIGNATURE _DATE
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION ,,,"- �?a 'q '7 DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: 6'30 -f? DATE FEE PAID:_4��— D -�S
TYPE OF UNIT: DWELLING OTHER_ CHECK #q5_7 CHECK DATE
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
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