PALFREY COURT PALFREY COURT
U
• CONO/T
vs. CERT.# 68-99
FEE $25.00
DATE: 02/09/99
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: 6 Palfrey Court UNIT #: 3rd Floor
OWNER/AGENT: Jones Company c/o Joe Jones
ADDRESS: 147 Colon Street
CITY/TOWN: Beverly, MA ZIP CODE: 01915 24 HOUR PHONE: 922-7935
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 / 96 dy
q4�1"C-jLkl
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
FEB 03 '99 10:40 AH SALEM HEALTH +508709705 Page 2
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 09970-3928
JOANNE SCOTT,MPH,RS.CHO NINF NORTH S1RE[7
HEALTHAGENlAPPLICATION FOR CERTIFICATE OF FITNESS Tet:(978)741-1800
Far: (978)740-9705
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000
'MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT _ PSD t�P3pj V 699" COURT#_ .
IS THIS UNIT DESIGNATED_AS.RIGHT LM FROM BACK PLEASE CIRCLE ONE
Joe Jones, AEP, CFP, CLU
e ANAGE GENT__-,_
e466- (978)
147 Colm Sheet -
i Beverly, MA 01915 N O%
22-7935-Fax(978)W-1968 '__—ADDRESShttp:/A"vww.jonesco.com_ ------- "_` CITY —_._.....
RESIDENCE PHONE..___—__—___ USINE$$ PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:_ _
ROOM USE: 1. ......-Z 3. pr 4.
Q
THERE IS A TWENTY-FIVE($25.00)DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM EALTH DEPARTM N THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATURE ;,
fffl ��ss
IN P q S.U.S-E_QNLY
DATE QF INITIAL INSPEC=1ON.._ _DATE OF REINSPECTION_
DATE OF ISSUANCE OF CERTIFICATE'. '. _DATE FEE PAID:- � f
TYPE OF UNIT: DWELLINCy_OTHER__.. CHECK#-(` V CHECK DATE )LS, I�f
NOTE . ((
CODE ENFORCEMENT INSPECTOR 9/2Rt9t3