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PALMER STREET 1-60 .''f PALMER STREET 1 '- &0 ==77r 6 t4 g 4i t y ♦ ^ V 4 k a CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET 4°1 FLOOR pRth rrcvmt.Promote.pw.e , TEL. (978) 741-1800 Fax(978) 745-0343 KIMBERLEY DRISCOLL lramdinasalem.com LARRY RAPIllIN,Rti/RI?.I-IS,CHO,CP-RS MAYOR HFAL,ii i A(il'',N I CERTIFICATE OF FITNESS CERTIFICATE#169-13 DATE ISSUED: 5/6/2013 Property Located at: 5 Palmer Street UNIT# 1 Owner/Agent: Florizel Soares Address: 6359 Jamesfield Ct. City/Town: Fairfield, OH Zip Code: 45014 24 Hour Phone: 978-257-4680 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 LARRY'FaMDIN HEALTH AGENT SANITARIAN • � 'Cs CI21 `JI'' JILLL:.I` . �LlSS1�Cr1V JE11J U BOARD Or RE .TIT 120 Wij SHLNGTON STREET,4`..FLOOR A11hCHealth TEL. (978) 741-1800 F_�x(978) 745-0343 h`1nMER.1-L 'DRISCOLL lxamdin @..salcm.cum 'MAYOR LARRY R,\NtD W,RS/RI-'I IS,CI30,f' I-ll:,kunI AGN I 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 T 5 Palmer Street Salem Ma. 01970 UNIT# IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER Florizel Soares MANAGER/AGENT NO P.O.BOX ADDRESS 6359 Jamesfield Ct.Fairfield Ohio 45014 ADDRESS CITY,STATE,ZIP Salem Ma.01970 CITY, STATE,23P RESIDENCE PHONE 978-257-4680 BUSINESS PHONE(24HRS) BUSINESS PHONF TOTAL NUMBER OF ROOMS: 8 ROOM USE: 1. 2. 3. 4. 5. 6. 7. 8. X 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEES IS PAYABLE kT THE F INSPECTION APPLICANT'S SIGNATURE ..tet DATE S/ ao 120 Insnectors use only Date on initial inspection: �� /1� 13 Date of reinspection: T Date of issuance of certificate: Date fee paid: qq Type of unit Dwelling Other Check# _Check date: l 1� Notes: i f, Flo Oy� CAS sockce s Susan �a<�aa5 TRANSMISSION VERIFICATION REPORT TIME 05/29/2013 23: 44 NAME FAX 9787450343 TEL 9787411800 SEP.. k 000B011341991 DATE.TIME 05/29 23: 43 FAX HO./NAME 919787449614 DURATION 00:00:19 PAGE(S) 01 RESULT OK MODE STANDARD ECM R 1 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH a 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#43-07 DATE ISSUED: 1/30/2007 Property Located at: 5 Palmer Street UNIT#2 Owner/Agent: Alicia Soars - c/o Allyson Kinney Address: 352 West Street City/Town: Reading MA Zip Code: 01867 24 Hour Phone: 617-909-6523 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 � Zi HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS $, BOARD OF HEALTH • e, 120 WASHINGTON STREET, 4TH FLOOR 3 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 �G�\�('�p kr 1� (0v1� UNIT#J3 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE O E OWNER/LESSER I�1�CF iC��DlMANAGER/AGENT (SSI n r No P.O. Boxny(�" o P.O. Box ADDRESS anf ,(11 IPI C1 C I—ADDRESS 2 J LOOP Ik S CITY A:IC �. PI (+ �h OI CITY Rf Cil i P) IV\I / RESIDENCE PHONEjjq�=X_7 '*_�1 BUSINESS PHONE (24 HRS.) G-1 (> '709 `Ul a31 BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 'v , B2. P a(w---3. ��2.C�IOdir4U 1 (00 Pti- 75. 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. nIP 1 APPLICANTS SIGNATURE \ (CLA �V DATE T INSPECTORS USE ONLY DATE OF INITIAL INSPECTION /- 3i -n7 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: I-Ibl'e7 DATE FEE PAID: TYPE OF UNIT: DWELLING OTHER_ CHECK # /6"CHECK DATE 1!161_02 NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSF"ITS BOARD OF HE.�i:rl I 120 WASHINGTON STREET,4°1 FL<u 1R TFL. (978) 741-1800 ICI -1131 1t1,FY DRISCOLI. I"AX (978) 745-0343 MAYOR Iramclin0salem.com LARRY RA MI)IN,RS/RP.I IS,('I 10,tP-I�S I-I I LV:I'I I AG b.N'I' CERTIFICATE OF FITNESS CERTIFICATE #011-12 DATE ISSUED: 1/11/2012 Property Located at: 5 Palmer Street UNIT#3 Owner/Agent: Alicia Soares Address: 6359 Jamesfield Court City/Town: Fanfield, OH Zip Code: 45014 24 Hour Phone: 513-829-6359 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. Fp!THE B A D OF HEALTH I LARRY RAMDIN � HEALTH AGENT CODE E CEMENTI SPECTOR �.�.as�, aa-r► fi �! �i78- ba1 - 1�all- CITY OF SALEM, ,'\Z:1SSAC:HF�ISI f-I'S BO( Ua D t qF Hi:-\i,-n i 120 W\SHINGTON STRIirT 4" H,(,)(w 11:1,. (978) 741-1801) KIIv11 IA0,1 a' DRISCOLL FAX (978) 745-0343 MAYOR RAMDINnO7.ti%j.n\i( 0,%i 1.;\IWN'RANI DIN, IZS/1t F1I.�,CI1 1,01-1;s I-In.\l:i"II AGI; I' 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 S Pd,11W;�- `_-�/r UNIT#___ IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER f ( /9,/ 75� ' MANAGER/AGENT NO P.O. BOX --�pp-- � pp ��, ADDRESS 636-1 _ a-me'.�tlold t r ADDRESS CITY, STATE,zip Fa�� shirrs .!5 0/q- CITY, STATE,ZIP RESIDENCE PHONE J13 UDq4.39'7 BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: t ROOM USE: LKII&Ae-n 2. A4A'ns 3. L R 4. 5. b. 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 SIGNATURE44if, llrDATE_—jL`"L4 Inspectors use onlv Date on initial inspection: �"^ )- ) Date of reinspection: Date of issuance of certificate: ) -11- 11., Date fee paid: Type of unit: Dwelling ✓ Other Check#-I f* ) Check date: 1 . )) ~ 12. Notes: JV Code Enforcement Inspector City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, PublicHealth MA01970 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-16-184 DATE ISSUED: 5/27/2016 Property Located at: 12 PALMER STREET UNIT#4 Owner/Agent: Dan Botwinik Address: 215 West Canton Street City/Town: Boston, MA Zip Code: 02116 24 Hour Phone:(617) 649-6948 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 &Jele0"a Larry Ramdin, MPH, REHS, CHO ,/ HEALTH AGENT SANITARIAN From:Management Fw:(617}649.6948 To: Fa*: +1 tM,7410696 P,g. 2 of 2.0"t2016 4:16 AM- - CITY OF Smx.m, IVASSACM-USETTS 12111 ,' .sii !xE r(7:x'4°I`Rrm,,4111,'3.iNlN TiIxL11IIi1iLE5'D}t1:iC:(31J, },:`,.�(�J%'8i 74t±..tt;1.; #.:nn} 1j.ryaYi71'!i,R,ti�t4t:Ftti,r'FI4;t,CJ'-1"S . Ift,.lt�ttdilGth( �h CCM&01'vnaf)rcon'1 - Application for Certil`icatt of Illness IN ACCOPDANCE W ITH STATE SANITARY CC DR,CIir1PTER I I,_100 CMR 410-000. "MINIMUM STANDARDS F FITNESS FOR HUMAN HABITA'T'ION": PROPERTY LOCATED AT 12 Falmer St,Salem MA 01970 UNTr#_-4� TS TTi}S li}4F1'UiSIt3N.S'T$U A:i R.1 ' l_� + N pR 1141"R.PLLiASl4 4'LRCt,6�17N1a i OWNF.R/I..•F-SSER_.2sga,!. 4twlnik _._._MANAGCRI AGENT :CeJF.O.HOX — ADDRESS 215 West Canton Ir} —ADDRESS,_Po BOX 55071 Suite 41505 4"tf'Y,STATE,"LIP ton 11 Q, 1L6 W— CITY,STATE,ZlP Boston MA 02205 RESIDENCEPHON> _617-649-G948. BUSINESS PHO NE(24HRS) 617-863-8335 BUSIXESS PHONE 617-649.8948 TOTALNUMBEROI ROOMS: 5— ROOM USE: 1.t:ivtnn Room 2Dinnin Rogm3._0edranm 1 4• Bedrco5. BattirQom 6. THERE IS A FIFTY(x;50)DOLLAR'FEE;PAYABLE BY CHECK OR MONEY ORDER TO THE MY OF&AL. m BOARD OFIWAL.7I1 TRIS ELLE IS PAYABLE AT THE TME OF INSPLCTTON APPLTCANSSIGNATURE, DATE lns ccectts use Onl .Date on initis[inspection: Date Of reinspection: Date.of issuance of certificate . 5125/Zo�-� U€tte kee paid:OS�25�2026 Mt3 Type of unit, Dwelling--- Othcr_ ___�_e4 ck#�7-'zti9�6-Check dow Notes: a _ I.ctrxt-S4t�e1G✓ t ^ Cale I♦orcemetit Inspector CITY OF SALEM, MASSACHUSETTS Bo.1RD OF HEALCH r 120 WASHINGTON STREET,4...FLOOR PablicHealth TEL. (978) 741-1800 F.\Z(978) 745-0343 KIMBERLEY DRISCOLL lramdin nsalem.com - _ L;\RR1'IL\RR)IN,Rti/RI:SI-IS,C.l-1O,CP-FS MAYOR HI \l.Sl1 AO ENT CERTIFICATE OF FITNESS CERTIFICATE #473-12 DATE ISSUED: 12/17/2012 Property Located at: 12 Palmer Street UNIT# 1 Owner/Agent: David Ramsey Address: 58 Gregory Island Road City/Town: Hamilton, MA Zip Code: 01936 24 Hour Phone: 978-473-1538 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 DF HEALTH LARRY RAMDIN 4qAl.� HEALTH AGENT SANITARIAN 10 'f CITY OF SALEM, MASSACHUSETTS L��J)j BwRD OF HEALTH 120 WASHING'rON STREET 4111 FLOOR Pa1blicHealth > lYe rnl 14omott P"t"' TEL. (978) 741-1800 FAx (978) 745-0343 KIMBEItLEYDRUSCOLL, L1-z Iramdin2salem.com MAYOR L LY RAIIDIN,RS/RFI-IS,(J 10,Cl'-FS H fSAl;1'I I AG j wr 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 I L �a�n,e J-� UNIT#__t IS THIS UNIT D SIGNATED AS RIGHT LEFT FRONT OR BAC PLEASE CIRCLE ONE OWNER/LESSERZ?,n/f 'e7 l Pc-7 MANAGER/AGENT NOP*0' OP.O. BOX ADDRESS Cr6 #f�Q�'� �J'1s: ' ADDRESS *POW CITY, STATE, ZIP / �"'�/ �1/ 6 CITY, STATE,ZIP/L RESIDENCE PHONE97&�o `y LS y S �� BUSINESS PHONE(24HRS) BUSINESS PHONE 978'• 41?ff TOTAL NUMBER OF ROOMS: �o ROOM USE: 1. e 1'� 2,i °� 3. L Jl ( 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 PAYABLE-'AT THE TIME OF INSPECTION �APPLICANT'S SIGNATURE- eDATE J Z, ' Z ` / Z Inspectors use only p 1 - Date on initial inspection: la�4 I i a Date of reinspection:�R I/ 7 k2 Date of issuance of certificate: Date fee paid: s'Type of unit: Dwelling OtherCheck#. Check t �7e: Notes: SII P,ieC ticce:l nIds 6'1 �rP eG C e 1 -,r_ �1.))t � �IceU Iv► T' `k r�nm w.u�fi ixr)� +. 0 e in czar nc��h rnl, ttr�t en 1i54tfi �e� wvar, rn bcec �roam ��-be reQc��ed, �l��tt in b::eck b4_ Cod r ement Inspector OOm VYI v be ft� ('15601 r191-00,Y-* ai oumd 1 �21h PSZ�I7Y1+v(o�c2fion;5�oc� rir �� IO2cP� v'�iV I C.Qr�(rls/ fceS (�l c�trecxed Bxe�'r �b ` p li S Ck� p6�\SJrI�1C , om mal'} (0 y vI• CITY OF SALEM9 MASSACHUSETTS % of BOARD OF HEALTH d � 120 WASHINGTON STREET, 4TH FLOOR \ Ro SALEM, MA 01970 s _..r TEL. 978-741-1800 �Q FAx 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#464-05 DATE ISSUED: 7/28/05 Property Located at: 12 Palmer Street UNIT# 1A Owner/Agent: David Ramsey Address: 58 Gregory Island Road City/Town: Hamilton, MA Zip Code: 01936 24 Hour Phone: 978-468-4983 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 H ALTH _ JO 7NE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSP TOR q CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH M 120 WASHINGTON STREET,4TH FLOOR � • r • i SALEM, MA 01970 TEL. 978-741-1800 (/ 1 0, FAX 978-745-0343 - �fy//�•(/w7 �(•`j STANLEY OVIGZ, 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" /f PROPERTY LOCATE D AT _J 2 a Lrs� 4e t� UNIT 4�^�y IS THIS UNIT DESIGNATED AS FjIGHT L EFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER j_ if 0IO PC? AV.; ll MANAGER/AGENT No P.O. Box, p ¢� J No P.O. Box ADDRESS ✓ D G-pQpM I$ /fid` _ ADDRESS CITY- je ^Lu � A - -CITY RESIDENCE PHONE¢, J 6F-Y7163USINFSS PHONE (24 HRS ) BUSINESS PHONE _ TOTAL NUMBER OF ROOMS 1 ( r ROOM US[" 1 ,b�V _ L — -- -6 --- —-7 - THERE IS A TWENTY-FIVE (525.00) DOLLAR FEE, PAYABLE 13Y CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DFP 4TMENT THIS FEE IS PAYABLE Al THE- TIME HETIME OF INSPECTION APPLICANTS SIGNATURE, INSPLCTC)FiS 115E UNI ' DATE OF INTI IAL INSPFCTIQN 7��) 7 '-0 D'� DAI'E OF Rf-!NSf"E(,I IOt. r All: OP ISSI1 NC F OF C61'+ l l! II::AI ! 7 d 7 b r DA/1 _/ELF 2 —vim TYPE OF 111V DI ELITNGf <)1Nf-I? ;;HECK ;. <� t?D (;Hi:(,K , ;AT(- ?-J2 -oV' t:'_)1)!.. EJ•II ("!'t 4 A41 1.11 IP1':1'f CITY OF SALEM9 MASSACHUSETTS y�- 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#: 311-03 DATE ISSUED: 7/7/2003 Property Located at:: 12 Palmer Street UNIT#: 1 Left Front Owner/Agent: Steve Trainor Address: 831 Shirlev Street City/Town: Winthrop. MA Zip Code: 02152 24 Hour Phone: 846-4570 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. 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. 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. FORD OF� ,J Joanne Scott, MPH, RS, CHO V Health Agent CODE ENFORCEMENT INSPECTOR i }t CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH p,J D rJ • 120 WASHINGTON STREET, 4TH FLOOR I / � ^JP SALEM, MA 01970 / TEL. 978-741-1800 x-14 W �� III °W FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO -1 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 la )gl il'A//�`Pk � - UNIT#L� IS THIS UNIT DESIGNATED AS RIGHT LEFT T FRON BACK PLEASE CIRCLE ONE OWNER/LESSER � y� IQQ MANAGER/AGENT �,tp/, No P.O. Box 99 /'r No P.O. Box ADDRESS ADDRESS7� c�/VR�r✓c� �� CITY zi , / CITY RESIDENCE PHONE BUSINESS PHONE (24 HRS.) BUSINESS PHONE 7 TOTAL NUMBER OF ROOMS: ROOM USE: 1. ? 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 DEPA TMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. o� / APPLICANTS SIGNATURE DATE 6k/ 03 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 7-7--e2.3) DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: 7- 7—J 3 DATE FEE PAID: 5 — 7— 0-:3 TYPE OF UNIT: DWELLIN OTHER_ CHECK# CHECK DATE?S�o� NOTES- CODE ENFORCEMENT INSPECTOR 9/28/98 i w r CITY OF SALEM, MASSACHUSETTS '+ BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 CERT.# 609-03 TEL. 978-741-1800 FEE $25.00 op FAX 978-745-0343 DATE: 12/12/03 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 1 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 12 PAL14ER STREET UNIT #: 1 RIGHT OWNER/AGENT: STEVEN TRAINOR ADDRESS: 831 SHIRLEY STREET CITY/TOWN: WINTHROP ZIP CODE: MA 24 HOUR PHONE; 617-543-3439 02152 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 NOR BUILDING RELATED CODES. FOR MORE INFORMATION CALL 978-741-1800. FO T�HpE�tB.OoARD OF HEALTH C��Z�' ""mac✓ ik�� JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT JEMEY W. VAUG '� HAN CODE ENFORCEMENT INSPECTOR * SMALL SECTION OUTSIDE SHOWER, NEEDS REPAIR. CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 NOV 2 5 2003 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO CITY OF SALEM MAYOR HEALTH AGENT 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". PROPERTY LOCATED AT IoL ��fliYl P UNIT# ZIAr r IS THIS (JNI T DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE re OWNER/LESSER MANAGER/AGENT No P.O. Box No P.O.Box 9 ADDRESS tl� ADDRESS CITY_/._/) Al /�R�p oj�/j Oq CITY O a I S� RESIDENCE PHONE BUSINESS PHONE (24 HRS.) BUSINESS PHONE5y3_i'� S c/ TOTAL NUMBER OF ROOMS: L� ROOM USE: 1. 1�2. C� 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 HEALT TIME OF INSPECTION. DEPARTMENT THIS FEE IS PAYABLE AT THE -41APPLICANTS SIGNATURE n/ _�-�-// / >�= DATE 2X ,,XINSPECTORS USE ONLY DATE OF INITIAL INSPECTION ///) 5e'/,-7- DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE _/i1-�fle? DATE FEE PAID: ///-j - �oZS— TYPE OF UNIT: DWELLING OTHER_ CHECK# CHECK DATE ii o� NOTES Ss�9<� Sernor a�rS:cl Ci6w cec� /1}i9.� CODIR-ffNFORCEMENT INSPECTOR 9/28/98 CONDIT City of Salem, Massachusetts 60 Wor a Board of Health 120 Washington Street, 4th Floor, Salem, 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-16-260 DATE ISSUED: 7/22/2016 Property Located at: 12 PALMER STREET UNIT#2 Owner/Agent: Dan Botwinik Address: 215 West Canton Street City/Town: Boston, MA Zip Code: 02116 24 Hour Phone:(617) 649-6948 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 YJe !rKJW5�1 Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN From:Marketing. Fax:(617)6496949 To. Fax +1 (97B)7410696 Page 2 of 3 07212016 1034 AM e CITY OF SALEM, MASSACHUSETTIV S BOARD of HEALTH 120 WASHINGTON STREET,4' FLOOR I 1> CHCBt , TEL.(978)741-1800 FAy(978)745-0343 I<=ERLEY DRISCOLL Icarndrn2szlem.com MAYOR LARRY RAMDIN,RS/KERS,CRO,CP-FS HEALTH AGENT 0. s✓q��fE 4�S" 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 12 Palmer St, Salem MA UNIT# 2 IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNERILESSER Ocelot Ooerations LLC MANAGERIAGENT Dan Botwinik NO P.O.B OR ADDRESS 215 West Canton St ADDRESS CITY, STATE,ZIP Boston MA 02205 CITY, STATE,ZIP RESIDENCE PHONE (617)649-6948 BUSINESS PHONE(24HRS) (617)649-6948 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 PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATE 07-21-16 InSDeetOf6 use only Date on Initial inspection: 0'7/21/?-n16 Date of remspection Date of issuance of certificate.0/111j (')1,6 Date fee paid. 0712-112,12 Type of unit Dwelling—A/—Other Check 910 3 Check date 0712—nr2n4�— Notes: C d of cementInspec City of Salem, Massachusetts r Board of Health 120 Washington Street, 4th Floor, Salem, PublicHeBIth It D MA01970 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-15-26 DATE ISSUED: 4/16/2015 Property Located at: 12 PALMER STREET UNIT#3 Owner/Agent: Dan Botwinik Address: 316 Lowell Street City/Town: Wilmington, MA Zip Code: 01887 24 Hour Phone:(617) 649-6948 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 0,-A4LJL 1 4�g Larry Ramdin, MPH, REHS, CHO =C </j �,, HEALTH AGENT SANITARIAN r n ?Y`° 1st,.iR1 t,l I tl. l .i.l.l FublicHeatth "Ft-t , (979) 741 I hOO 1 t Pl x, 74311; KI MBFRLE;Y DRISCOLL lrxrndiirfri. .,lcm.ct,m 1„li{it! a,\Nit �`, s/Itvt 1�;,cI lo, Ri<tti<nt Ibi i:riieim,N'r Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 Cbl I; 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" FEE: $50.00 PROPERTY LOCATED AT ti Y ` �/v �� __- '_....__.UNIT#_ a IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE MANAGER!OWNER/LESSER �T� t �'� c �tirii C, ._. _. .,. NO P.O.BOX ADDRESSPb g+X �� . '�`� ' ADDRESS 4~ CITY, STATE,ZIP V-C�S<`A MA c722 ox . CITY. STATE, Z11) RESIDENCE PHONEBUSINESS PHONE. (241IRS) BUSINESS PHON,(G, YA) &'a) �-&AA`8 _ TOTAL,NUMBER OF ROOMS: ROOM USE: 1. U14I - 1 2. Vl 3. �S -�__ --1_ 5T b. 7.2. &. - - 10. THERE IS A FIFTY($50)DOLLAR FEE, PAYABL� BY 'HECK OR MONEY ORDER TO THE CIT1' OF SALEM_ BOARD OF HEALTH THIS FEE IS PPA'YYAA LE AT HE, IME OF INSPECTION f APPLICANT'S SIGNATURE ''�'`� —DATE n�ectors use onl4 Date on initial inspection:.,'(..{-11! Date of reinspection:.. . . Date of issuance of certificate: 7 . ,,,,,- „__.__ Date fee paid: Type of unit; Dwelling_ -- Other --_-,_Check # ',�} U,-_--_, Check elate:_ (-�-�.,�, Notes: Coae\lEKfoc entInspeetor a CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970CERT.# 39-03 FEE $25.00 TEL. 978-741-1800 DATE: 02/03/2003 FAX 978-745-0343 STANLEY USOVICZ, JR JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 12 Palmer Street UNIT #: 3F OWNER/AGENT: Steven Trainor ADDRESS: 831 Shirlev Street CITY/TOWN: Winthrop, MA ZIP CODE: 02152 24 HOUR PHONE: 846-4570 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 . F/O}I2 THE BOARD OFF HEEAAL,TH�. 1 ff".s u✓ JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR Ye<•ti�..s','kv,�r»�.z' Pi.7r#`$ .. -,. '.h9t�'� .. '_' . '+i.,:, .. �`-�-'--'��$:1e,!';jb',A,fy,+dl!y. .,-=,�:'o. "I"°"*.�.. , ,, ptt ,,,�' ,-�� R e A CITY OF.SALEM MASSACHUSETTS° 1 ' �^ 6t" - _ • . EOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR ` SALEM, MA 01970 /1 qp� TEL 978-741-1800 i-AX 9711-/4.o-UJ4:3 STANLEY LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT -- I APPLICATION FOR CERTIFICATE OF. FITNESS, IN ACCORDANCEWITHSTATE SANITARY=CODE, CHAPTER 11,..105 CMR-41,0.000; x , e "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION,. PROPERTY LOCATED AT 11 /oup,41 V y UNIT#�,3 IS THIS UNIT ESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE ' OWNER/LESSER -7wX MANAGER/AGENT - - No P.O. Boic / No-P.O�Box.r ADDRESS �( � v elle 6 ' ADDRESS c / 3. CITY nxl ®a(Sa CITY ✓�� RESIDENCE—PHONE— -(yt^�- BU�SINESS-PHONE-.(2i4.HRS.) -' = BUSINESS PHONE sJ`... µ4..d � ':E.?t:d1.^�t�'. TOTAL-NUMBER OF ROOMS: ROOM USE: 1. 2- 3. /4.. ' 5. '6. 7.~ 8, j THERE IS A-TWENTY=FIVE.($25.00)AOLLAR FEE, PAYABLE;BY,CHECK OR,MONEY i - ORDER TO THE CITY OF SALEM HEALTH DEPARTMENTTHIS`FEE',IS='PAYABLE:AT;:THE :I TIME OF INSPECTION:. =..y APPLICANTS SIGNATURE ./ib ', ` .'. :�i�— DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION-2$) 3a;..Zl DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:2 -3 -v1, DATE FEE PAID- TYPE OF UNIT: DWELLING OTHER_ CHECK# / 7 / CHECK DATE > 5 NOTES: I g -- � . . . 'a '•,. �; dl§' x CODE ENFORCEMENT INSPECTOR 9/28/98, , 4 , City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, Fill . Hea]dth MA 01970 P"`$`l p`°" c pm"". 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-17-381 DATE ISSUED: 11!6(2017 Property Located at: 12 PALMER STREET UNIT#4 Owner/Agent: Dan Botwinik Address: 215 West Canton Street City/Town: Boston, MA Zip Code: 02116 24 Hour Phone:{617}649-6948 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 occupa under 6 years of age. Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SAN RIAN .� From:New England PropertFex (817)649-6946 To: Fax. (978)741-0898 Page 2 of 3 11A2I2017 4:02 PM %r CITY,OF SALEM, MASSACHUSETTS BOARD OP H[,AT.TH 120 WASHINGrON STRFIRT,4"'Fik)OR TEi.('978)741-1800 KiMBERLEY DRISCOLL FAX(978)745-0343 MAYOR I.RAMDINCNSAI Sv\LC(J:A LARRY RAMDIN,RS/RE115,CHO,CP-FS HF.AT.('H 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 2 1 D mfmer s+ UNIT# !'� C> IS THIS { vI H�I,S�UNIT DISIGNNAT-E`D_AyS MIGHT T FRONT OR BACK PLEASE CIRCLE ONE W ONWLESSER lel0 UJI(TIK�/(J�Vf ANAGER/AGENT NO P.O.BOX tn� f� ,( ADDRESS r,0 917(55044 tf'-O#4 .r-05 ADDRESS CITY,STATE,ZIP t'"n. MA 022C5-50?J CITY,STATE,ZIP t RESIDENCE PHONE C? BUSINESS PHONE(24HRS1(339),2cj39LS ) BUSINESS PHONE (6f�)b63,�/O3S TOTAL NUMBER OF ROOMS: `T ROOM USE: 1. a4hwM � 2. tVOt'1 3,P64r Dfn 4. ItVt( TCtJfM. & 7- 8. 9. 10, TIRE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE �A—T�THE TIME OF INSPECTION / APPLICANT'S SIGNATURE __ 1e/-;x,— DATE Inspectors use only Date on initial inspection-.--.-_ --_- Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other `LA1 (�Check# Check date: I Notes: MO .l.{ rA-ay ag42)1(7�i Code Enforcement Inspector From:New England PropeRFax (617)649.6949 To. Fax: (978)741-0696 Page 3 of 3 1 VD22017 4'02 PM �T CITY OF SALEM, MASSACHUSETTS BuAR13 ai'HL uxii 120 WASHiNCTON STRrCr,4"'Fr,(�oR Tri..(978)741-t 800 1ti1,NWERLh'YDR7SCOLL 1'ax(978)745-0343 MAYOR r.RAhQ1NgSAl Mco 1 LARRY R9 MDtN,RS/RF.HS,CHO,CP-YS Hr,,u-T}i AGLNT ' Release In accordance with Massachusetts General Laws Chapter 111;Code of Massachusetts Regulations 410.000 et. Seq. ; State Sanitary Code Chapter 11 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.Uwe 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. kalec,f IDahcouh Van "iniv- Tenant/Lessee Owner/Lessor - Pd 0ox5S®91 r�:CM# 5C6-,Pos r7 MA 0?2t�S- Address Address PakrC�, 54M PJA 011-70044 Address on unit to be inspected Date Updmed 5@3/11 CITY. OF SALEM. MASSACHUSETTS BOARD OF FIFff.'F'F[ - 120 WASHINGTON STREET,4"`FLOOR- - TF:L..(97%741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR - )MANCINIf[I`✓�SALEWCOM JANET"CINI ACTING HLAun-T AG1sN"I' GEI�FIH6A�E-0E-FF�(ESS CERTIFICATE#167-09 DATE ISS"P 4/x/;009 l Property Located at: 12 Palmer Street UNIT#3 Rear(#4) Owner/Agent: DaYid-Raplsey Address: 50 Gregory Island Road GVTeam:.Hamilton MA Zlp Code-_11198224-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 Ir', Minimum Standardse€Atnessfor A=he ' ton". Therefore, this Certificate is issuedyEnforcement Division of the Salem Board of HealWand4heuaii 'ed. I 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.svalid only it of-Q" ncy. FOR THE BOARD OF HEALTH A �� J MANCtNt ACTfNG-HEALTF FAG'ENrC NI ECTQR, CITY OF SALEM, MASSACHUSETTS I� • BOARD OF HEALTH l b 1 120 WASHINGTON STREET,4°1 FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAx(978)745-0343 MAYOR 1D10NNHnSA1.1:N1.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." rI _ n FEE: $50.00 PROPERTY LOCATED AT 11:9 � UNIT#—q— y�IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER O'g 7��"�� MANAGER/AGENT ADDRESS S-r `-�y�j�' `lam '/�"'l ADDRESS CITY, STATE,ZIP b�' CITY, STATE,ZIP oo RESIDENCE PHONE 97 Yr`,z/6F�� SS 3 BUSINESS PHONE(24HRS) C BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. A-1- 2. 4 3. R ' 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 PAYAB E AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE--- DATE 4)/Z InSDectors use onlv Date on initial inspection: y" Z -c S Date of reinspection: Date of issuance of certificate: L) " Date fee paid: C/-?--a g Type of unit: Dwelling t/ Other Check# Check date: Y 2--31 1 Notes: 1?Ravl�)211 5�1d.-4s Faz +ave sn ®11v av \6UCor• ode Enfor ement Inspec r City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, PlubIiCHealth 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-17-385 DATE ISSUED: 11/13/2017 Property Located at: 12 PALMER STREET UNIT#5 Owner/Agent: Dan Botwinik Address: 215 West Canton Street City/Town: Boston, MA Zip Code: 02116 24 Hour Phone:(617) 649-6948 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. e �- /� - o Larry Ramdin, MPH, REHS, CHO ` HEALTH AGENT SANITARIAN From.New England Propert Fax:(617)648-6948 To: Far: 1978)741-0696 Page 2 of S 111092017 924 AM CITY OF SALEM, MASSACHIJSETTS BOARD of HP AJ:YH 120 WASHINGTON STRI:PT,4"'rLOOR "ha..(978)741-1800 KI NIBERLEY DRISCOLL FAX(978)745-0343 MAYOR 1B3A31LYC&' 11 ^'.moi- LARRN'RAMDIN,RSJRPRS,C,HO,CP^F3 .HFAufftAGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER 11, 105 CMR 410.000 'MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION' _, ,�j- _t�f_ FLEE:$50.00 PROPERTY LOCATED AT k2 Pm- UNIT# IS Tat�s-�UNILT DL47GiUm AsiR dirr LST FRONT OR BACK.PLEASE CIRCLE ONE _ OWNERILESSER n / !UJr n ik MANAGER/AGENT NO P.O.BOX ADDRESS PO f7t sgo9l FCM 415057 ADDRESS CITY,STATE,ZIP Pbs Dnr MA M205-5031 CITY,STATE,ZIP RESIDENCE PHONE BUSINESS PHONE(24HRS) BUSINFSSPHONF. t 6F9)8G38335 TOTAL NUMBER OF(ROOMS: 4 ROOM USE: Z•I7ed rL 1M 2, U /a, k 4.610jF00n. 6. 7. 8, 9. 11 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'SSIGNATURF t` .+ DATE:1..i ` —0 Insnectors use only Date on initial inspection: Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling��, Other Check# Check dale: l 1 Notes: IW 1 tl Or OAA��,,^I�� Code Enforcement Inspector From:New England Frapart Fax:i811)86&8949 To: Far:.(978)741-0893 Page 3 of 3 111M2017 824 AM 1' CITY OF SALEM,MASSACHUSETTS BOAAD OF REALTH 12014 01IN;TON STRERT,4"'FLOOR G TE:t..(978)741-1800 K MBERLEY DRISCOLL FAX(978)745.0343 MAYOR... . MRRY R WDN,RSI RENS,CN S,CF-FS . 144,tv.Vf AGENT In accordance with Massachusetts C.jateral Laws Chapter I 11;Code of Massachusetts Regulations 410.000,et.Seq. ; State Sanitary Code Chapter 11 and Article XIII of the City of Salem Ordinance,undersigned owner/lessor and tenant Icssee of a unitof 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,regulation's and ordinances. In the event it is necessary that said inspection be doge in mylout absence.I/we.expressly authorized thesameand 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 doting said inspection. t Gtd w/Y!i k Tenam/Lessee Owner/l.,cssor � S?C18ox �SC�`}O �N1 Address Address 42 a�m�rS . a1t�m MA m� Address unit to be inspected - Date apbawd 5n3n1 - r " CITY OF SALEM, MASSACHUSETTS BOARD OF HF\LTH 120 WASHINGTON STREET,41O FLOOR TFj_. (978) 741-1800 I�IIvi13FRLLY DRISCOLL FAx (978) 745-0343 MAYOR Ixamdin(o).salem.com LARRY R,\NIDIN,RS/RI?I IS,CI IO,CP-I S Hr„V;n I A(iFNF £CRTIfI£.1m Er .'ITHE£€ CERTIFICATE# 198-11 DATE ISSUED: 6/22/2011 Property Located at: 15 Palmer Street UNIT#2 Owner/Agent: Linda Locke Address: 1 Pickering Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-5135 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 1t LARRY RAMDIN HEALTH AGENT CODE ORCEMENT INSPECTOR 1 CITY OF SALEM, MASSACHUSETTS i BOARD OF HEALTH 120 WA,HINGTON STREET,41°F1..0C7R Tea.. (978) 741-1800 KIMBERLEY DRISCOLL FAX (978) 745-0343 MAYOR I.RA>\RDIN(a)SAI.u.M.cOM LwtRr RANIDIN,RS/RH fS,CI IO,(T-FS HI?AI:I'I I A(,,I?N'I' 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 G m P r UNIT#CZ IS THIS UNIT DI IGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER I ,( / oz--Clese MANAGER/AGENT NO P.O. BOX �— ADDRESS �" //��2,��✓I/I� S/ ADDRESS ✓ CITY, STATE,ZIP /�� Gyr� A14- CITY, STATE, ZIP RESIDENCE PHONE "/ /O ��r' 5)30—BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBEROF ROOMS: /� ROOM USE: I // lA 17 2.f9K24l irm 3�'lL Ag,, 4�y 5. 6. A3 IW 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 DAYABLE AE OF INSPECTION yy APPLICANT'S SIGNATURE DATE Inspectors use only Date on initial inspection: oldaI/,I Date of reinspection: �— Date of issuance of certificate: 111 lay /// Date fee paid: If Type of unit: Dwelling �Other Check#_Check date:/� 10 'd1� 1 Notes: /�'(%/1/:i raf h� - l 1.U-PlP/l, o- bGC- J YDS . Cod or ment Inspector 0 �OON9IT4 City of Salem, Massachusetts 10 i � W Board of Health s q 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, REHS, CHO Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE#: GHL-15-114 DATE ISSUED: 6/10/2015 Property Located at: 15-1/2 PALMER STREET UNIT#1 Owner/Agent: Eric Easley Address: P.O. Box 4542 City[Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 745-5892 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 ARIAN ay 13 1512:12a North East Realty 978-7455892 p.1 VV/LV/ LV1V LV.L, JIVf�JVJ�J • ^.^� ` "' CITY OF SALEM, MA.SSA.CHUSE'TTS BOARD OF HEILTH 120 msmNGTON$TRSBT,4"'FIOOR TEL (978)741-1800 LSIMBF.RT_FV DRISCOLL F,kx(978)745-0343 MAYOR [�jj{t;j+Y.9ALM �AS,P1.CUTS DAvm GREv4BAuwL AcnNG HEALTH e1GENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FnNESS FOR HUMAN H"MATION." FEE:850.00 tOPERTY LOCATED AT � /�``P� S� UNIT# � ,ppISTfI13i1NITDtO" '.tTFD RTOA� Q$Qf�O CTC MVASECMCLL+ONE WNER/LESSI$t1L6/1 4r4 fir,°oC��11 MANAGER/AGENT P.O.BOX p 7DFMS `- �oQ?G �/�>" z ADDRESS W,STATE,ZIP S ✓`�/� d/??U CI7y,STATE,ZIP 35IDINCB PHONE BUSINESS PHONE(24HRS) JSINESSPHONE(4 ?a) ?Ys ' )TALNUMBER OF ROOMS: y )OMUSE; I. 'Oe—Q 2 P 3. J 4 5. 6. 7. S. 9. 10. .'ERE IS AF=($50)DOLLAR FEE,PAYABLE SY CHECK OR MONEY ORDER TO THB CITY OF SALEM )ARD OF HEALTH THIS FEB IS PAYABLE AT THE TWE OF WEC79N / 'PLICANT'S SIGNATURE DATE I ;�spectors use a t�,yi, .te on initial inspection: g[ �I �J� Date of reinspection ' r .te of issuance of cadfl ate: Date fee paid: pe of unit: Dwelling Other Check#5q? a Checkdate; 5/13/15 tes: do eat Inspector 2010.06.272t21 9797450343 Paget CITY OF SALEM, MASSACHUSETTS Lf BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR PI1b11CHCR Ith Yrevem.Promom Ywlttt TEL. (978) 741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL hmindin(a�salem.com L,\Rlil'RA6IUIN,RS/RLSI f5,C410,CP-I,9 MAYOR H1;2\1xlI AG I?NT CERTIFICATE OF FITNESS CERTIFICATE#214-13 DATE ISSUED:6/25/2013 Property Located at`. 15 1/2 Palmer Street UNIT# 1 Owner/Agent: C.J. Coop. LLC Address: P.O. Box 4542 City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-5892 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. �OR THE BOA D OF ALTH LARRY RAMDIN V HEALTH AGENT SANITARIAN /t CITY OF SALEM, MASSACHUSETTS 10 g*3 BOARD OF HEALTH v 120 WASHINGTON STREET,4TM'FLOOR PablicHaeelth TEL. (978)741-1800 FAX(978)745-0343 KIMBERLEY DRISCOLL Iramdinnnsalem.com LARRY R�NMIN,R.S/REI-IS,CHO,(T-US MAYOR HCiAr;rH 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" /SJ/Z FEE: $50.00 A PROPERTY LOCATED AT P14 !/o*�!L S�— � �. /� UNIT# IS THIS OMT DISIGNATED AS RIGHT LEFT FRONT OR BACK.PLEASE /CIRCLE %ONE � / OWNER/LESSER C :---r MANAGER/AGENT �on NO P.O.BOX ADDRESS ADDRESS • �oX YS Ll Z ADDRESS CITY,STATE,ZIP CITY, STATE,ZIP / RESIDENCE PHONEY ) BUSINESS PHONE(24HRS) g2�19 1 BUSINESS PHONE(r��/ TOTAL NUMBER OF ROOMS: e ROOM USE: 1. 1� 2. dl-r 3. Z12--I"� 4. Ze—z 5. �o 6. 7. 8. 9. 10. s 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 THE TIME CTION APPLICANT'S SIGNATURE DATE Inspectors use onlv Date on initial inspection: Date of reinspection: Date of issuance of certificate: A Date fee paid- i , Type of unit: Dwelling Other Check#—6b)0 k Notes: ��77��ttttt Code Enforcement Inspector City of Salem, Massachusetts m q Board of Health 120 Washington Street, 4th Floor, Salem, 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-16-234 DATE ISSUED: 7/6/2016 Property Located at: 15.5 PALMER STREET UNIT#2 Owner/Agent: Eric Easley Address: P.O. Box 4542 City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 745-5892 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 � Je ey Blarosy Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN VVI GY18ViV GV.GT of VfTJVJ9J __ n. CITY OF SALEK MASSACHUSETTS BOAPM OF HEALTH IM W.SSHINGTON STREET,47"FLOOR TEL(978)741-1800 KBOERLEY DRISCOLL Rax(978)745-0343 MAYOR J2=hM._Na_AUMQa)3A hf-COAL DAVEDGAEM& K ACTING HEALTH AGENT Application for Certifiente of Fitness IN ACCORDANCE?WITH STATE SANITARY CODE,CHAPTER 11, 105 CMR 414.000 `Y�M STANDARDS OF F+UNESS FOR HUMAN HABITATION" //FEE:SSO.00 ZOPEELTYIIOCATEDAT �� "e2 UNIT# Z IIS�STatrstMTDsMMTMABMWLMMWO)tU MtAftCIRCESONE Wl�t/LESSML9Vo L sf e�/�, MANAGRt/AGENT )P.O:BOX / 7DRESS �� . =x y5�o/ Z AMUSS :1'Y,STATIq ZIP CFPY,STATE,ZIP MMENCEPHONE BUSFDMNPHONE(2MS) ( �'22) 7Y�SSSS'Z isms PHONE )TALNUMBM OF ROOMS: ?OMUM. 1. -9!e--e 2. 3. Lv, q �k S. 7. R. 9. 10. MMEIS AF=(ESO)DOLLARFBI},PAYABLE BYCHSCKORMONEY ORDFILTO THBCITY OF SALEM )ARD OF HEALTH THIS FES IS PAY TIME N 'PLICANrS SIGNATURE DATE Insnc�etois nse only �aninitialinspe on 6/3D/� X26 Dateofrenspectiou: teofissuazteeofaati '��1��/31 .6 _ Date fee paid.L21S/2at1C pe of uair 0dw Cheek# G, 3 y Check date:0 7/02/2-01ti' tes: 201HS-272W 9787450943 Pagel �QNDTV City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, 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-16-266 DATE ISSUED: 7/26/2016 Property Located at: 15-1/2 PALMER STREET UNIT#3 Owner/Agent: Eric Easley Address: P.O. Box 4542 City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 745-5892 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 rey ar Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CrrY OF SALFIV4 MASSACHUSEM BOARD OF HEILTR -. 12{)WdSHINGtY1N 57'Rfib7[',4'"kLgnR TEG(978)741-1800 I1tLI?Y DRISCOLL FAX(978)745-0343 MAYOR CONI DAITUDGRE04DAUK ACnNG FbRaTKAGh�Ii T AppReadon for Cerdficate of FIMess IN ACCORDANCE WITH STATE SA'NrrARY CODE,CHAPTER 11, 105 CMR 41&000 "Meamum STANDARDS OF FITNBSS FOR HUMAN HABITATION." /FEE:$50-00 10FULTYLOCATEDAT / �� fez Sum tJrarr# �tsj�tlsaD�rmT�as1� !� ,�nsscm�aso�va PVNER/I,ESSEIt O�cW"cv4 G�sv AAV WAXWERIAGENT :IDXWS Giza.. U Z/s -/ z' ADDPMS fiY,STATE,ZIP._< x„ O / 7°C[I'Y,STATE,w 3SIDENCE PHONE BDSRMS PHONE( (,9;7,g :Js1NESS PHONE )TALNL>MB1Rt.OF ROOM& ))MUSE: 1. a. G,ul�s 3. 4, 6. 7. S. 9. 10. IEREIS AFIFTY{$5t})DOLLAR M PAYABLE BYCHECKORMONBY ORDERTO THECITYOF SALEM )ARU OF HBALTE THIS EM IS PAYABLE AT TRETIMBOF gar it 'FLIGANT'S 3IQdA.TURIr ��'•�? C►ATE 11 Inane aniv to aninitialDMofr ioVection: to of is6uance ofcetti8ca�: �/7�,�� - Date fm pe of moan: DwMIM.„�Othes Chwko i'2.q�— mock date:—QZLY,&o.t.0 tes: 3a 2010 0&27ztz 9767450343 Pagel D0 City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, Pt1 [th MA 01970 Prevent.Pfineut<. Protect. KimberleyDriscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS,CHO Mayor health@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE#: GHL-17-102 DATE ISSUED: 4/3/2017 Property Located at: 17 PALMER STREET UNIT#1 Owner/Agent: Marie Gagnon Address: 8 Cleary Lane City/Town: Topsfield, MA Zip Code: 01983 24 Hour Phone:(978) 884-8856 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. jaw. Larry Ramdin, MPH, REHS, CHO HEALTH AGENT I SANITARIAN CITY OF SALEM, MASSACHUSETTS 2E p llO:vtD of Ht=,ALrtt � 120WASInN(;f0NSTIZE171;r 4"`F1'o')lAECEIVED Ti-u,. (978) 741-1800 KIMBERLEY DRISCOLL FAX (978)745-0343 MAYOR IRAMFANn�A,.,:A,I(ON4 APR 032017 L IM-R:ANIDIN,RS/RF.lts,cxo,(:P-J=S CITY OF SALEM HEAI;rI]AGENT BOARD OF HEALTH Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER t 1, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" FEE: $50.00 PROPERTY LOCATED AT \—\ S-75— UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER Marie Gagnon MANAGER/AGENT NO P.O.BOX ADDRESS 8 CleaN Lane ADDRESS CITY, STATE,ZIP Topsfield, Ma 01983 CITY, STATE,ZIP RESIDENCE PHONE 978-887-8856 BUSINESS PHONE(24HRS) BUSINESS PHONE 978-887-8856 TOTAL NUMBER OF ROOMS: ROOM USE: 1.�'-1T` "�2, Tom-'TL 3. k-31-2�Cr 4.1;2� 5. > 6. VSA—7 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 A ' TIME OF INSPECTION APPLICANT'S SIGNATURE �---� DATE Insuectors use only Date on initial inspection: 5 1J� l Dateof rein specti n: Date of issuance of certificate: LIN 9— Date fee paid: Type of unit; Dwelling_3/—Other Check# hT3 Check date: 3 36 �r1 Notes: A Code En orcemenf Inspector CITY OF SALEM, MASSACHUSETTS + • BOARD OF HEALTH - - 120 WASHINGTON STREET,4°'FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR IDIONNI?(a�sAl.r'm.com JANETDIONNE - - ACTING Hj7.Aj:n-I AOI7,Nl' CERTIFICATE OF FITNESS CERTIFICATE #597-08 DATE ISSUED: 11/25/2008 Property Located at: 17 Palmer Street UNIT# 1 Owner/Agent: Marie gagnon Address: 8 Cleary Lane City/Town: Topsfield, MA Zip Code: 01983 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 BO F HEALTH yA E1 DIONNI= ACTING HEALTH AGENT CODE ENFORCEMENT SPECTOR I I ZA-N-N� �1}Aas\L1 I I � � i CITY OF SALEM, MASSACHUSETTS Cosa, BOARD OF HEALTH 120 WASHINGTON SIRE ET,4"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 J� MAYOR iscurrriSAN:n4.COM JOANNE SCOTP, HEALTH EENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMA HABITATION" PROPERTY LACATED AT i— fit+ s=SC S: UNIT#-�_ IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER t- V97-x'rt (-Y� v( CN) MANAGER/AGENT NO P.O.BOX ADDRESS N ADDRESS CITY,STATE,ZIP N CRSG'�icU�+ T-Atr CITY,STATE,ZIP RESIDENCE PHONE QZg - %8, -$8s Io BUSINESS PHONE(24HRS) BUSINESS PHONE I TOTAL NUMBER OF ROOMS: �D ROOM USE: 1.\5+'v% 2. V,c.0 3. 13¢-> 4.Lsv CT5. 6. 7. 8. 9. 10. THERE IS A TWENTY-FIVE($25) 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 , APPLICANTS SIGNATURE ` _ DATED Inspectors use only Date on initial inspection:. 1 Zti -G S Date of reinspection: Date of issuance of certificate: //- Z6 ' Date fee paid: /)-L6 -'0T Type of unit: DwellingOther Check# 10I'\. Check date: 11`7A -d� Notes: ode Fnforceinent In vector HP Fax Series 900 Fax History Report for Plain Paper Fax/Copier Joanne Scott Salem BOH 978 745 0343 Nov 25 2008 S:OOpm Last Fax Date TimeTwe Identification Duration pages Result Nov 25 S:OOpm Sent 919788877692 0:25 1 OK Result: OK - black and white fax HP Fax Series 900 Fax History Report for Plain Paper Fax/Copier Joanne Scott Salem BOH 978 745 0343 Nov 25 2008 5:02pm Last Fax Date Time Tvoe Identification Duration PaW Rtgdj Nov 25 5:01pm Sent 919787449614 0:36 2 OK Result: OK - black and white fax CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"FLOOR TEL. (978) 741-1800 HIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR iDiONNFOSALENLCOM JANET DIONNE ACTING HEALIII AGENT Facsimile Transmittal Fax # -Vw/ �lQu " a RE: L Pr��l Date : / L , ��"�l 11 Page(s): including this cover# o� 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 �w CERT.# 183-97 � 3 - FEE $25.00 DATE: 03/27/97 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 Palmer Street UNIT #: lst floor left OWNER/AGENT: Henry T- Gaanon Realtv ADDRESS: 16 Lockwood Lane CITY/TOWN: Toosfield. MA ZIP CODE: 01983 24 HOUR PHONE: 887-8406 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 HEALTHDEPARTMENTAND 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 1997 0 Y .Jr :AtAAI 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 17 Palmer c5+1rcc+. UNIT t 13'I"fir Left OWNER/LESSER 44enry -r. Gagnon keal+V MANAGER/AGENT Ifenrq T.. &agoM ADDRESS Io LCC�WOOD LAI& ADDRESS JAME CITY Tb PS F►ElJ) I rnA 01983 CITY 'RESIDENCE PHONE (5O8) �S7'8o�O BUSINESS PHONE (24 HRS.) BUSINESS PHONE / TOTAL NU2�ER OF ROOMS:'• (V ROOM USE: I . 2. 3. 4 . 5. 6. 7. 8. THERE IS A TWENTY-FIVE (25.00) LLAR FEE, PAYABLE BY CHECK OR HONEY ORDER TO THE CITY OF SALEH BEALTH DEPARTMENT THIS FEE IS AYABLE AT THE TIME OF INSPECTION APPLICANTS SIGNATURE / G DATE—_"— J INSPECTORS USE ONLY DATE OF INITIAL INSPECTION: �j .� )DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: 2j - ? - �l DATE FEE PAID: TYPE OF UNIT: DWELLING OTHER NOTES : CODE ENFORCEMENT INSPECTOR CERT.# 188-97 3 FEE $25.00 DATE: 03/27/97 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 CERTIFICATF. OF FITNESS PROPERTY LOCATED AT: 17 Palmer Street UNIT #: 1st floor richt OWNER/AGENT: Renry T. Gaanon Realtv ADDRESS: 16 Lockwood Lane CITY/TOWN: Toosfield, MA ZIP CODE: 01983 24 HOUR PHONE: 887-8406 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 DEPARTME11T 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 PITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 Ji)ANNE SCJ i I,L;:', ', CHS, HEALTH AGENT NINE NORTH STREET Te):(508)741.1800 APPLICATION FOR CERTII'ICTE OF FITNESS Fax:(508)740-9705 IN ACCOPDANCE WITH STATE SANITARY CODE, ERAPTER II, 10.5 CMR_ 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION", PROPERTY LOCATED AT 53 HarbOy' 5Wec-L t MITI lar Rt�{{ r OWNER/LESSER NZV N T C7QC,Y 0r) PMlfq MANAGER/AGENT ADDRESS I(0 LOCKWCOD LIll11£ / ADDRESS .SAME CITY //_Moor IE LD I MA 049,83 CITY. RESIDENCE PRONE BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: I. 2. 3. 4 . S. G. 7. 8. THERE IS A TWENTY-FIVE (25.00) DOT ,R FEE, PA ABLE BY CHECK OR HONEY ORDER TO THE CITY OF SALEKBEALTH DEPARTMENT IS FEE I AYABLE AT THE TIM OF INSPECTION APPLICANTS SIGNATURE / DATE 3�1j2 INSPECTORS USE ONLY DAZE OF INITIAL INSPECTION: . 3 �� -�. DATE OF REINSPECTION DATE OF ISSUANCE OF CERT`IFIICATE: 3 7 �, 7 DATE FEE PAID: a 7- f TYPE OF UNIT: DWELLING ,,/ OTHER NOTES: 7" CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • i 120 WASHINGTON STREET, 4TH FLOOR 633-03 SALEM, MA 01970 CERT. FEE $25.00 1 TEL. 978-741-1800 DATE: FAX 978-745-0343 12/30/03 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, R5, CHO MAYOR HEALTH AGENT 1 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 19 PALMER STREET UNIT #. 1 OWNER/AGENT: MARIE GAGNON ADDRESS: 16 LOCKWOOD LANE CITY/TOWN: TOPSFIELD ZIP CODE: 01983 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 r 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 NOR BUILDING RELATED CODES. FOR MORE INFORMATION CALL 978-741-1800. FOR T� OF HEALTH JOANNE SCOTT, MPH,RS,CHO a�% _/ _ HEALTH AGENT FRS W. VADGH d CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS t 3� BOARD OF HEALTH lO ' • i 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL, 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR JOANNE SCOTT, MPH, RS, CHO DEC 30 2003 MAYOR HEALTH AGENT CITY (.F SALEM BOARD OF HEALTH APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER It, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT ICC UNIT#_ IS THISIUNITDESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER_j!�)139.Tc MANAGERtAGENT No P.O. Box No P.O. Box ADDRESSS, , octcwc>y�_L-1.�a ADDRESS CITY "rc)-- r a 1 r+ CITY RESIDENCE PHONE BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTA! NIA-49!;P,OF ROOMS: ROOM USE: 1. .5 .1.12.act_�_3. 3ZC) 4. R r� 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 /� 1_•lac cL ._ mss' L^^ DATE INSPECTORS USE ONLY/ /� DATE OF INITIAL INSPECTION DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: ,V/7010.7 DATEFEE PAID.__/��° TYPE OF UNIT: DWELLING ZOTHER— CHECK # YJ 9'7 CHECK DATE .441 gas- NOTES: /V_A, CODE @NF&EMENT INSPECTOR 9/28/98 ! �pND1T� City of Salem, Massachusettslu n ! Board of Health 120 Washington Street, 4th Floor, Salem, PubliCHea[th 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-16-143 DATE ISSUED: 5/3/2016 Property Located at: 19 PALMER STREET UNIT#2 Owner/Agent: Marie Gagnon Address: 8 Cleary Lane City/Town: Topsfield, MA Zip Code: 01983 24 Hour Phone:(978) 884-8856 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 0,---� Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN • CITY OF SALEM, MASSACHUSETTS a/ BOARD OF HEALTH �Y 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGRAENBAUM[nl SN.LW.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 AT C' Sr- UNIT# a- IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER"MW.mx-*- MANAGER/AGENT NO P.O. BOX ADDRESS b ADDRESS CITY, STATE,ZIP'i 0�5� � f ��✓� D kCITY, STATE,ZIP RESIDENCE PHONE 4� -�$1 —$$f b BUSINESS PHONE(24HRS) I I BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 4. +3S-T> _ 5. 3� 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 FEEIS PAYAB_EAT-.$3E TIME OF INSPECTION lW/ APPLICANT'S SIGNATtDATE y�Z-�°( 19O Inspectors use onlv Date on initial inspection: (DY'12�2n2I Date of reinspection: Date of issuance of certificate:C)V 2.2-09 ✓L Date fee paid: '05-1 5 2120. Type of unit: Dwelling---V—/—Other Check# Check date: `t/ 11(o Notes: d E forcemept�Inspector CITY OF SALEM, MASSACHUSETTS • + BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR 13GRFENBAUMnaSALEM.COM DAVID GRFFNBAUM ACTING Hii.ALTI-I A(;i,NT CERTIFICATE OF FITNESS CERTIFICATE#27-10 DATE ISSUED: 1/22/2010 Property Located at: 19 Palmer Street UNIT#2 Owner/Agent: Marie Gagnon Address: 8 Cleary Lane City/Town: Topsfield, MA Zip Code: 01983 24 Hour Phone: 887-8856 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 WD BAUIv1 �� ACTING HEALTH AGENT CODE ENO GEMENT INSPECTOR • ` a CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4°1 FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978)745-0343 " MAYOR 1SC0'rr0,SALE1%i.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 FITNESS FOR HUMAN HABITATION." FEE: $50.00 PROPERTY LOCATED AT \�V �aL4-A S -- Sr UNIT# off. IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSERI--k' " _%— MANAGER/AGENT NO P.O.BOX ADDRESS S ADDRESS CITY, STATE, o t°h8 3 CITY, STATE,ZIP RESIDENCE PHONE BUSINESS PHONE(24HRS) BUSINESS PHONE I TOTAL NUMBER OF ROOMS: ROOM USE: 1.Rin 2. S%�D 3. 1'3X-+1D 4. L� 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT-THE-TW OF INSPECTION APPLICANT'SSIGNATU$T— \�� L DATE I IzS�ID Inspectors use onlv Date on initial inspection: 16 , , h U Date of reinspection: Date of issuance of certificate: 1 /0)3 /10 Date fee paid: /6?A //0 Type of unit: Dwelling ✓Other Check# .16119 Check date: //a s-ho Notes: Code Enfo ent Inspector CITY OF SALEM, MASSACHUSETTS < _ BOARD OF HEALTH 120 WASHINGTON STREET,4°1 FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR iSCOTMsSA .ENI.COM JOANNE SCOTT, HEALTH 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 inspeefion. Teinant/Lessee Owner/Lessor Address Address Address on unit to be inspected Date I `•" ''� "',Y`f%•.'+�' H: tar''+ST'?.'�-:ra?"`c": {o':!''a. ^"' -af"w."r '."s. ?r,, ...A, h CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET 4"FLOOR Pt1j1�1CH@81th STREET, Prevent.Promote.Protect. TEL. (978) 741-1800 Fax(978)745-0343 KIMBERLEY DRISCOLL Iramdinasalem.com - LAIta1'R,\MI)IN,RS/REI IS,CI IO,CP-Rti MAYOR CERTIFICATE OF FITNESS CERTIFICATE#139-14 DATE ISSUED:4/24/2014 Property Located at: 19 Palmer Street UNIT#3rd floor Owner/Agent: Mary Gagnon Address: 8 Cleary Lane City/Town: Topsfield, MA Zip Code: 01983 24 Hour Phone: 887-8856 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 Y MDI / HEArtH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS BOARD OF HEFT 120 WASHINGTONN STREET,,4"'FLcx)x /J TEL. (978) 741-1800 1QMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGtBENBAUb1@SA1.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 1 4 9`AS:—, 3 T`9 5—�' UNIT#-3 _ IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK.PLEASE CIRCLE ONE OWNER/LESSER 1-� - MANAGER/AGENT NO P.O. BOX ADDRESS L �ss� �—� ADDRESS CITY, STATE,ZIP "T��sx-+7 f Trla- CITY, STATE, ZIP RESIDENCE PHONE BUSINESS PHONE (24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: S ROOM USE: 1. 2. 3. F-ge11 4. Y,€1? 5. 61 V-TL--, 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/ Inspectors use onlv Date on initial inspection: Date of reinspection: Date of issuance of certificate: L) ' 1 II 1 Date fee paid: V,2A -)U Type of unit: Dwelling l Other Check#)3q-2-) Check date: q-Z�L iq Notes: Code Enforcement Inspector r AND CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 3 * 120 WASHINGTON STREET, 4TH FLOOR < 51 SALEM, MA 01970 CERT.# 322-02 , FEE $25.00 TEL 978-741-1800 D Fax 978-745-0343 ATE: 06/17/2002 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 20 Palmer Street UNIT #: 2 OWNER/AGENT: Brtito Realtv ADDRESS: 17 Canal Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-7727 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 q"Ilx�"11�1 1, 1 JOANNE SCOTT, MPH,RS,CHO //o/ -1 HEALTH AGENT C E EMFORC`EI�7ENT INSPIFCTOR Mag 22 02 10t31a Joanne Scott Salem BOH 978 745 0343 P. 3 r -Cf"OF 5 tkE1' '` 9ACti1UsETTS " _ aOA.RD OF-HEALTHfY "-?20 WASHINGTON SVWMCL 4TH FLOOR 1t 1�olra� 17 +t ++ VAX 978-24 -0343 Y t N 1 /q ll'u',Jf 5T9Yt/CEY'f)SOVTCT„-'.JR. "" . JOAN NG',Y�,v, , Za�Z 'MAYON Hep, -[H. +T I SALEM OF HEALTH APPLICATION FOR CERTIFICATE OF FITNESS -IN`ACCORDANCEAIIRR:STATE SANITARY CCYf7E,CHAPTER EI, 105 CMR 410.000 WfNWW, STANDAFtg OFRTNN•MSV AN HA=A N4 PROPERTY tv�eu cu a,.,,o�v ' /L 2/� � UNIT# v a2 YeY°'r1 IS' UNi'r u' FRO 969K�SASE CIRCLE ONE � C,wMFR1lESSER-- �� l ' -7ulANAGifiRJA4GN,T _. N*IP.O:8a1c I � r 1to'R:O BaX -ADDRESS' ES5 •".._. CtTv--' ` '� earn Ov jq j' 1�IS77 �P k36L Hf 9fF�tdCE P�ttON€ [IONE(24 HR`3.) - BUSYFlL�P2{U1SIEf TOTi4L@IG ftGfli THERE PAYABLE BY CHECK OR MONEY .ORDERIO'TtW-,M'Y"'QEiSAY.I`.ttEFtEAi:TIs wzsq�TH19 FEE IS"YABLE AT THE TI F.OF INSPE 111 -RPP D��E � DATE) INSPECTORS USE ONLY EIATEOF k'iSk}AdiCEi3F-G€ft`PtFiC`ATE:_:.�L7lB�'"t)A.T•FFLL-FA1D:__�¢�1..7"lrQ-�f TYPE-aF tm°'Q1igELt u AiRbtiau_-CW=K-4 2 '--CHECK DATE �+�s� ---"O:Fc-,�ieNT INSPEC�OR 918196 _' MDOND1T,t� City of Salem, Massachusetts a Board of Health lu 120 Washington Street, 4th Floor, Salem, PublicHea Itb MA01970 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-15-215 DATE ISSUED: 8/7/2015 Property Located at: 21 PALMER STREET UNIT#3 Owner/Agent: Marie Gagnon Address: 8 Cleary Lane City/Town: Topsfield, MA Zip Code: 01983 24 Hour Phone:(978) 884-8856 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 Wth 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 0,—�� Larry Ramdin, MPH, REHS, CHO I HEALTH AGENT /// � SA ARIAN • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR I)GREENBAUMnaSALEM.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 �;)L 3 ax-) Z UNIT#— IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER MANAGER/AGENT NO P.O. BOX ADDRESS L�-'3iy L� ADDRESS CITY, STATE,/.1r r vwssa i 0 %q FGZ CITY, STATE,ZIP RESIDENCEPHONE - cgQs�o BUSINESS PHONE (24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: 7 ROOM USE: 1. -V-xx-�w� 2. t em 3. C n 4. 5. 77V-3> 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 DATE InsDectors use onlv Date on initial inspection: 07/_77/) r)15- Date of reinspection: Date of issuance of certificate/, nL� Date fee paid: QY/o,4/2112,5' Type of unit: Dwelling Other Check#( Check date:_) Notes: Cod fo• ement Ins ctor 0o CITY OF SALEM9 MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 p' FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#: 366-03 DATE ISSUED: 7/8/2003 Property Located at:: 20 Palmer Street UNIT#: 3 Left Owner/Agent: Paul Harris Address: P.O. Box 953 City/Town: Pepperell, MA Zip Code: 01463 24 Hour Phone: 273-3277 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. 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. 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, CH• Health Agent CODE ENFORCEMENT INSPECTOR ' CITY OF SALEM, MASSACHUSETTS " '� BOARD OF HEALTH r i 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". ,/f� PROPERTY LOCATED AT 'Z10 QA�4rC�1 CN�EUNIT# �� IS THIS UNIT DESIGNATED AS RIGHT LEFT R NT BACK PLEASE CIRCLE ONE OWNER/LESSER MANAGER/AGENT No P.O. Box r� No P.O.Box ADDRESS l 3 ADDRESS CITY Mk P/Ifk,CITY RESIDENCE PHON _BUSINESS PHONE (24 HRS.) l7E' 27-_� - 32 'T?- BUSINESS PHONF TOTAL NUMBER OF ROOMS: tf/ ROOM USE: 1. &b I 2. �t) Z 3. 1` b 34. 1-/d"n/ R«C 5. 1 e 6. 7. 8. THERE IS A TWENTY-FIVE{$25 DOLL AYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SA- M HEALT PAR T THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. / j APPLICANTS SIGNATURE I 1 INSPECTPOSS WSE ONLY DATE OF INITIAL INSPECTION ,7/ r / ATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE- 4_ DATE FEE PAID: TYPE OF UNIT: DWELLING_ OTHER-_ CHECK#_ a CHECK DATE NOTES:_'!? Qm�s fRZ, ` N rr F3Jrt_ �C 5 r� S 1fC �t l c�i�`r +.r✓ q-(1&__7 ?�t.. Zqr1. Yt'I On CODE ENFORCEMINT INSPECTOR 9/28/98 I 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 RELEASE In accordance with Massachusetts General Laws Chapter 111 ; Code of Massachusetts R:agulations 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. Ia the event it is necessary that said inspection be done in my/our absence, !/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 shents -from any loss or injury sustained of whatever nature and description occasioned by my/our absence during said inspection. b�I4 TENANT%LESSEE. OIWAR/LESSOR ADDRESS ADDRESS ADDRESS OF UNIT TO BE INSPECTED -- CaNU1T A 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 05/15/2001 Lola Eanes 28 Rear Putnam Street Beverly, MA 01915 PROPERTY LOCATED AT 20 Palmer Street UNIT # 4 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 i 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 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 $25.00 check payable to the City of Salem is required for each unit inspected at the i time of inspection. A property owner is required to pay gas and electricity for residential tenants if there is not a written letting agreement stating the tenant is responsible for those utilities and if the meter(s) records electricity and gas use which is not used exclusively by that tenant. The Department of Public Utilities has billed property owners for their tenants' entire utility bills retroactive to the date of initial occupancy in cases in which cross-metering has been proven to exist. 40S RTHEBOARD 0 HEALTH REPLY TO anne co , - MPH,RS,CHO - PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR I m �?� CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4...FLOOR PI1t111CHP.8 it$ TFL. (978) 741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL tramdinnnsalem.co>n 1,,MMY RAMIAN,RS/RN IS,(1110,c P-RS MAYOR HI-{:V:1 H Ac I;,N'1' CERTIFICATE OF FITNESS CERTIFICATE #336-12 DATE ISSUED: 8/20/2012 Property Located at: 21 Palmer Street UNIT#2 Owner/Agent: Marie Gagnon Address: 8 Cleary Lane City/Town: Topsfield, MA Zip Code: 01983 24 Hour Phone: 978-887-8406 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 --------------- -------- ----------- ---- - ------------------ - -------- RY RAMDIN ) HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS r > BOARD OF HEALTH � 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGRHHNBAUMOSALHM.C01\1 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: $50.00 PROPERTY LOCATED AT o'1 � �os..� Z ST UNIT# eg - IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER MANAGER/AGENT NO P.O. BOX ADDRESS ADDRESS CITY, STATE,ZIP 4D F�CITY, STATE, ZIP RESIDENCE PHONE �1� —�$�— ��' �k BUSINESS PHONE (24HRS) 1 BUSINESS PHONE t 1 TOTAL NUMBER OF ROOMS: 6 ROOM USE: 1.qA-T> 2. P,7c-7 3. 7 4. 5. t �� 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 C-- APPLICANT'S SIGNATURh✓ _ DATE Inspectors use onlv Date on initial inspection: Date of reinspection: Date of issuance of certificate: 2b—I L Date fee paid: Type of unit: Dwelling (/ Other Check# 1 3 L Check date: Notes: ALpector 0 9� A �Iy p CITY OF SALEM, MASSACHUSETTS r BO,\Rl)(lr HEALTFI 120 W:\tiI nNG'1'()N Sl'lie;E:l' 4"' FLOOR Publiclie8lth T[-"u- (978) 741-1800 FAX (978) 745-0343 KIN113RR1..E?Y DRISCOLL kamdin(a�,salcm.com L.\RRl'R,\N1UIN,RS/RN IS,CI fO,(;P-I�S MAYOR H I'.A1.1'FI AG I SN'I' CERTIFICATE OF FITNESS CERTIFICATE#287-12 DATE ISSUED: 6/21/2012 Property Located at: 21 Palmer Street UNIT#3 Owner/Agent: Marie Gagnon Address: 8 Cleary Lane City/Town: Topsfield, MA Zip Code: 01983 24 Hour Phone: 978-887-8856 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 idwl. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH LlRkY RAMDIN HEALTH AGENT .SANITARIAN • CITY OF SALEM, MASSACHUSETTS . BOARD OF HEALTH 120 WASHINGTON STREET,4...FLOOR TEL. (978) 741-1800 I INMERLEY DRISCOLL FAX (978) 745-0343 MAYOR DGRITNBAUNI SALEM.CO'M 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 3 cr_r] f� UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK.PLEASE CHICLE ONE OWNER/LESSER MANAGER/AGENT NO P.O. BOX ADDRESS a C- � L� ADDRESS CITY, STATE,ZIP+DVS CITY, STATE,ZIP RESIDENCE PHONE BUSINESS PHONE (24HRS) < BUSINESS PHONE TOTAL NUMBER OF ROOMS: S 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 PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATT TPI DATE I�;l Insroectors 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: Y Notes: 4emCod cent Inspector 1MP0F�TA�jINT /MESSAGE I A.M. DATE nn /7 �I�a TIME P.M. IV M `QA(`0 l�C'�ZIY1 OF C� w� p PHONF v'.� %? b�/ U$5C AREA CODE NUMBER EXTENSION ❑ FAX Cl MOBII F AREA CODE NUMBER TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU f WILL CALL AGAIN WANTS TO SEE YOU I RUSH RETURNED YOUR CALL I WILL FAX TO YOU ' MESSAGE ��/i/1n_ � /� kopc(3 CPA -CV JA4�cl' // it . , Q end 4 (o�,�)IAO "?t4(pwl IYB - ('ex � SIGNED � ONNERSAL. 48005 MADE IN U.S.A S310N TRANSMISSION VERIFICATION REPORT TIME 07/19/2012 03: 37 NAME FAX 9787450343 TEL 9767411800 SER. # 000S0N341991 DATE.TIME 07/19 03:37 FA". HO./NAME 919788877692 DURATION 00: 00:0 PAGE i S) 01 RESULT 04; MODE STANDARD ECM CITY OF SALEM9 MASSACHUSETTS 3 BOARD OF HEALTH - q 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 HIIYB TEL. 978-741-1800 FAX 978-745-0343 - STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#29-05 DATE ISSUED: 1/14/05 Property Located at: 21 Palmer Street UNIT#3rd Floor Right Owner/Agent: Marie Gagnon Address: 16 Lockwood Lane City/Town: Topsfield, MA Zip Code: 01983 24 Hour Phone: 887-8406 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 �� pp JONE SCOTT, MPH, RS, CHOP HEALTH AGENT CODE ENFORCEMENT INSPECTOR 1 . . y o+mr CITY OF SALEM, MASSACHUSE'iTS BOARD OF HEALTH 3 + 120 WASHINGTON STREET, 4TH FLOOR a SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO l/7- ` 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\ F>A _cC �% UNIT#t) IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER 6—dia=-v_ MANAGERIAGENT No P.O. Box No P.O. Box ADDRESS `-tS ADDRESS CITY CITY RESIDENCE PHONE 419 191n gsst> BUSINESS PHONE (24 HRS.) BUSINESS PHONE 9-18--881- id8 n b TOTAL NUMBER OF ROOMS: 5 ROOM USE: 1. cwl 2.L_%TN(r 3.r3gD. 4.'VSVJ�> 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��/."_� or DATE✓� INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 124010'•__/ // DATE OF REINSPECTION ,r DATE OF ISSUANCE OF CERTIFICATE: (u1 o DATE FEE PAID: ILIA404 TYPE OF UNIT: DWELLING�6THER_ CHECK# CS5 L CHECK DATE/ NOTES: I ` CODE EFORCEMENT INSPECTOR 9/28/98 a coxw CITY OF SALEM, MASSACHUSETTS vg '� BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR E SALEM, MA 01970 CERT.# 323-02 TEL, 978-741-1800 FEE $25.00 �G FAX 978-745-0343 DATE: 06/17/2002 STANLEY USOVICZ, JR JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 22 Palmer Street UNIT #: I OWNER/AGENT: Brito Realtv ADDRESS: 17 Canal Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-7727 AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410.000: MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE SALEM BOARD OF HEALTH AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED. MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410 .000 : MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . SECTION 410.400 (B) : DWELLING UNIT (X) AND 410.400 (C) : ROOMING UNIT MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: . NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR OCCUPANTS UNDER 6 YEARS OF AGE. FOR MORE INFORMATION CALL 978-741-1800 . FOR THE BOARD OF HEALTH JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT C6E--E�RL'EMENT INSPECTOR May 22 02 10:31a Joanne Score Salem BOH 976 745 0343 p•4 rt CITY OF SALEM, IV ASSACHUSEWS ; Bcxqv* "ARD a .F{J1ccTH 0WASNTNGTON SYHEET..k7"N.ELOOR':, - SALEM-MMI'819''3Q_ TEL 978-M-1-18fl0- JUN 172002 STAN LEM'HSOVIG'7.:":fR--' JOAN ttE"SCVrr.-MPM';R5CHC/ CITY OF SALEM-. MAYOR' k1EAi.T t AGGar •••• ALEM BOARD OF HEA " 1 393 rod.' APPLICATION FOR CFH i'IFICATE OF FITNESS ATE,&JMAPIY�E,CHAP3ER IIIJI ,1.05 OMR 41 B.00Q t _ WINIIVIU STANOATIOS OFRTNESS F HUMAN HA$MXpN'`-' pR6PEr+r 1 L&Adki to til UNIT#_L 13°TtiC `:+uua+ca t�i1P L ��R//iGitT/�G:� EHM BACK PLEASE CIRCLE ONE FLES rNm& 96lt 3A1 f /rww&;l ;.;;MANAGE.AfAGENT_ NO P1):Box' no Na'P:0.BOY -.ADDRESS 0 eev-4"j -'ADDRESS•: RESIBwCEPImF- 77.e7 BOSIME38 IIoNE(2+/+4F _)=1 Sp0 -641f-,r30 sus4N4ssPE#eNE-' - 5. R"-�_-- 7__ � THERE— ITVMWY r 0AXA,9LE'B*-CH9CK OR MONEY ORDER TO THE aff OF'Sita:Ei< SEALTEi L WARTMUNT TMSfEE IS PAv*gLF-AT THE TIME 0F'INSPECTION: DATE �7a/ 0 7-- l/ IIV'.]''4M4/11C1d vc1�:�L�,L-' D TF F INITIAL INSPECTIQ d o DATE OF REINSPECTION ni�4 DATE OF ISSUANCE OF CERTIFICATE: DATE FEE PAID: !o / 1a? ... . TYPEOFUNIT: DWELLING r!'OTHER_,_ CHECK* 13 L/( CHECK DATE I11 �a .Stine¢,.. ci.« o..✓c L,. ;..er,. t�a.'SSt .. .. .......... ., ..__T...., CO�Qil�RCi;&T INSPECTOR 9(2$188 1 _ co CITY OF SALEM, MASSACHUSETTS % BOARD OF HEALTH 9 120 WASHINGTON STREET, 4TH FLOOR Asa SALEM, MA 01970 �sgeP' TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#: 365-03 DATE ISSUED: 7/8/2003 Property Located at:: 22 Palmer Street UNIT#: 1 Left Owner/Agent: Paul Harris Address: P.O. Box 953 City/Town: Pepperell, MA Zip Code: 01463 24 Hour Phone: 273-3277 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. 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. 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 )c Joanne Scott, MPH, RS, CHO Health Agent CODE ENFORCEMENT INSPECTOR qp, CITY OF SALEM, MASSACHUSETTS / �y 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 '5-1 UNIT# I Pyr_) IS THIS UNIT DESIGNATED iAS1 RIGHT L�FRONT BACK PLEASE CIRCLE ONE OWNERILESSER 'A.Ih.I I MANAGER/AGENT No P.O. Box 19 5,3 No P.O. Box ADDRESS �s ADDRESS CITY *Q s r t ?CITY RESIDENCE PHONE r7f, -Ya3-(o09R, BUSINESS PHONE (24 HRS.) 97F-Z73 -3Z 7? BUSINESS PHONE_ _ J TOTAL NUMBER OF ROOMS: `71 y 1 ROOM USE: 1. l.�Vl n " '22� 1 3. Ian i 4. A-1-ln/1GDM1 8. THERE IS A TWENTY-FIVE($25.00) DOLL E, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM D A M NT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS: �. lL� DATE 1`1I3 /0.3 INSPECTORSS SE ONLY DATE OF INITIAL INSPECTION f V,-3, DATE OF REINSPECTION as o3 DATE OF ISSUANCE OF CERTIFICATE: 7A/0� DATE FEE PAID: 7 - as-d 3 TYPE OF UNIT: DWELLING _OTHER_ CHECK# CHECK DATE NOTES: Qlw -rb 5Cfry-n5 rz-) vcr, ,�s �srn CODE ENFORCEMENT INSPECT R 9/28/98 J 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 RELEASE In accordance with Massachusetts General Laws Chapter III ; 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 tile aforementioned statutes, regulations and ordinances. In the event it is necessary that said inspection be done in my/our absence, i/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 shen.; -frorn any loss or injury sustained of whatever nature and description occasioned by my/our- absence during said inspection. TENANT SEE OWNER/LESSOR 101 A- ON-6,S ADDRESS A DRESS PA-L_1M� C ADDRESS OF UNIT V() BE INSPECTED oA•ie--- � -- rp14D City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, 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-16-342 DATE ISSUED: 9/6/2016 Property Located at: 23 PALMER STREET UNIT#1 Owner/Agent: Marie Gagnon Address: 8 Cleary Lane City/Town: Topsfield, MA Zip Code: 01983 24 Hour Phone:(978)884-8856 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. &Jeffr sy Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN o CITY OF SALEM, MASSACHUSETTS 1 Bo,uw of+HEAj,rt-t 120WAST-ITNC,roNSrlli.rr 4"'FI,OOR TEL (978)741-1800 KIMBERLEY DRISCOL L �* w��® FAX (978)745-0343 MAYOR I1,RWDINOSATr.Ai(ONT LARRN'R:\NIDTN,iIS/ItFiFIS,Ci-I0,CP-I--S SES' HEALT1i Ac ENT J OF NFp�TN y, r1r 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 a--Z, S�a�.�c-L �T UNIT#---) _ IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER Marie Gagnon MANAGER/AGENT NO P.O.BOX ADDRESS 8 Cleary Lane ADDRESS CITY, STATE,ZIP TOpsfield, Ma 01983 CITY,STATE,ZIP RESIDENCE PHONE 978-887-8856 BUSINESS PHONE(24HRS) BUSINESS PHONE 978-887-8856 TOTAL NUMBER OF ROOMS: ROOM USE: 1. ZTLAj \—V/ 3. S7s -z�Y - 4. 17�'a3A 5.96-�a7 6. T2, 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 THE TIME OF INSPECTION APPLICANT'S SIGNATUR DATE 1 2+4 b Inspectors use onlv Date on initial inspection: Date of reinspection: Date of issuance of certificate:O 40-f,4 ?p Date fee paid:l>q%0212a Type of unit' Dwellin Other Check# iy�Jr� Check date: Notes: Iof cement I ector F r • k CITY OF SA L EXI, NALASSA ;HUSE"T'TS 13t>AM)OF t-IF:u.rl i 120 W\SIIING'I'()N S'IRI?l'i-t' 4"'I;LOUR �tib�{CHP �h Tfai- (978)741-1800 F \\ (978) 745-0343 KIMBERLEY DRISCOLL tramdin(Ovsa cm.con - 1.,\RRl'R;\1117IN, R;+/RI.3(5,Ct7U,(:N-I MAYOR 11 a;v a I I AG RN r CERTIFICATE: OF FITNESS CERTIFICATE#334-12 DATE ISSUED: 8/20/2012 Property Located at: 23 Palmer Street UNIT# 'I Owner/Agent: Marie Gagnon Address: 8 Cleary Lane City/Town: Topsfield, MA Zip Code: 01983 24 Hour Phone: 978-887-8856 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 It" 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 B ARD OA HEALTH LARRY RAMDIN _ HEALTH AGENT SANITARIX CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH I 120 WASHINGTON STREET,4`FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL PAX(978) 745-0343 MAYOR DG1WFNBAUNf(a� A]17_M COM DAVID GREENBAUM, ACTING HEALTH AGENT �ti �o q1l %v 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 --Xj UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSERMANAGER/AGENT NO P.O. BOX ADDRESS ADDRESS CITY, STATE,ZIPt✓ a %°.%Z CITY, STATE,ZIP RESIDENCEPHONE BUSINESS PHONE (24HRS) I BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. T34—> 2. 9,+7 3. 7 4. 5. T>u-gf- 6.t—✓ 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 SIGNATURF,—� --,c DATE Inspectors use only Date on initial inspection: !S — ZO- I ) Date of reinspection: Date of issuance of certificate: �-- 10 — )q— Date fee paid: `C .-LO Type of unit: Dwelling ✓ Other Check# ) Check date: Notes: Code Enforcement Inspector TRANSMISSION VERIFICATION DEPORT TIME : 08121/2012 03: 41 1IAME . FAX : 9787450343 TEL : 9787411800 SEP.. # : 000&0N341991 DATE,TIME 08121 03: 41 FA;; NO. /NAME 919788877699 DURATION 00:00:18 PAGE(S) 01 RESULT 04, MDDE STANDAP.D ECM TRANSMISSION VERIFICATION REPORT TIME 08/22/201 04:41 NAME FAX 9787450343 TEL 9787411800 SERA 000BOH341991 DATE,TIME 08/22 04: 41 FAX NO. /NAME 919788877692 DURATION 00:00:17 PAGE(Ss 01 RESULT OV MODE STANDARD ECM a , ?, CI' Y OF SAL.E1NI, NL\SSICHUSE'TTS IV BOARD OR HEALTH 120 WASHINGTON STREET,4...FLOUR PublicIieaIth TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL, liatndinnsalem.com - L:\Rlty R,\NfD]N,RS/RISIIS,CI IU,(T-FS MAYOR I-IIS.\1:1'11 A(;vN'r CERTIFICATE OF FITNESS CERTIFICATE #319-12 DATE ISSUED: 8/3/2012 Property Located at: 50 Palmer Street UNIT#4 Owner/Agent: Lafayette Housing Limited Partnership Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-4961 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 Occu ncy., FOR THE BOARD OF HEALTH LARRY RAMDIN HEALTH AGENT S RIAN CITY OF SALEM MASSACHUSETTS .��k1.•.,_ �1�/i BOBRD OP HEALTH D` A,pi2 120 WASHINGTON S'1REET,4"1 FLOOR LEL. (978) 741-1800 KII\-fBERI,FY DRISCOI,L FAX (978) 745-0343 M,WOR LRAMDINna� A]_;Nf(ONE LAlut1'RANW)IN,BLS/RF]IS,C[f0,(T-PS H!'AU'rf I AGENI 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 50 PALMER ST.. SALEM MA 01970 UNIT# 39 � IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE NORTH SHORE COMM OWNER/LESSE LAFAYETTE HOUSING LIMITED PARTNERSHIP 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: 2 ROOM USE: I.LIV. 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 //�T �� DATE S�' � �A Inspectors use onlv Date on initial inspection: � (/ J Date of reinspection: 1 — Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check# k2 Check date: Notes: / Code ent Inspector CITY OF SALEM, MASSACHUSETTS « 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#358-06 DATE ISSUED: 7/20/2006 Property Located at: 29 Palmer Street UNIT# 1 Owner/Agent: Vito Venuti Address: 1 Tomah Drive City/Town: Peabody, MA Zip Code: 01960 24 Hour Phone: 978-977-3352 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 otst� 4� a JOANNE SCOTT, MPH, RS, CHO 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 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 .1 q AaA mor ST. UNIT#� IS THIS UNIT DESIGNATED ASIR GHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER IMP lkl)IA MANAGER/AGENT No P.O. Box No P.O.Box ADDRESS / Y a,�� tOve _ADDRESS CITY _f) 6IA� CITY c� RESIDENCE PHONEq BUSINESS PHONE (24 HRS.) 335 BUSINESS PHONE _)7 � ,33, QQ_ TOTAL NUMBER OF ROOMS: ROOM USE: 1"'-t- `in. 2. Ltu3. cfiMW t. 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 ��V_ DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION -7--h v (-, DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: (DATE FEE PAID:--?— TYPE AID: 7—TYPE OF UNIT: DWELLIN _OTHER_ CHECK# 7 5 CHECK DATE jam_ 4 NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 ' vgngoNU1T r CERT.# 259-01 a _ q FEE $25.00 ye' a.• DATE: 05/18/2001 �/MIS CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT Tel (978)741-1800 Fax: (978)740-9705 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 29 Palmer Street UNIT #: 1 Left OWNER/AGENT: Scott Galber ADDRESS: 9 Belleair Drive CITY/TOWN: Swampscott, MA ZIP CODE: 01907 24 HOUR PHONE: 592-4462 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 JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR 1 O' �7MINB� 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 II, 105 CMR 410 000 "MINIMUM STANDARDS OFFITNESS FOR HUMAN HABITATION'. T PROPERTY LOCATED AT L J iv°/� UNIT#_�ze IS THIS UNIT DESIGNATED AS RIGHT pp t3 LEFT FRONT CK PLEASE CIRCLE ONE OWNER/LESSER�C� -DC Z MANAGER/AGENT No P.O. Box No P.O. Bax ADDRESS 9 R£LL£'>`I& IXIVE ADDRESS CITY J LJ�.1111&_11.1111&011 /114 �t x/07 CITY RESIDENCE PHONff 70 z BUSINESS PHONE (24 HRS.} BUSINESS PHONE 7� 7y/ 1 b �� TOTAL NUMBER OF OF'ROOMS: ROOM USE: 1. /' (/ 2. 4LV_3. 4. 5._ 6. T 8. _ THERE IS A TWENTY-FIVE($2 . DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SAL M ALTH ARTMENT HIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE DATE f./ INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 5__-1 8 -0 7 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:,T"/ 1'5'`"a/ DATE FEE PAID: TYPE OF UNIT: DWELLING �THER_ CHECK# Ill g CHECK DATE NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 3 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 III ; Code of Massachusetts Regulations 410.000 et. seq. ; State Sanitary Code Chapter II and Article XIII of the Cit; 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. Ln the event it is necessary Lhat said inspection be done in my/our absence, i-/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 agents ,,ora any loss or injury susLained of whatever nature and description occasioned by my/our absence during said inspection. tr_aANT/LESSEE. UWNEx ", SSOR B L ADDPi �S - -- DDx°SS ADDRESS OF UNIT TO BE INSPECTED 571 r: -- ��ONWT 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 03/29/2001 Scott Galber 9 Belleair Drive Swampscott, MA 01907 PROPERTY LOCATED AT 29 Palmer Street UNIT # 1L 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 W HEALTH REPLY TO oanne Sco tt, MPO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR �axo 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 08/05/2002 Scott Galber 9 Belleair Drive Swampscott, MA 01907 PROPERTY LOCATED AT 29 Palmer Street UNIT # 1 Right 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. OR THE BOARD HEA TH REPLY TO Joanne Scott, MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR - �• goNDIT '. vQ� Q CERT.# 562-00 n ro f M FEE $25 .00 DATE: 08/30/2000 Be�IMINE 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: 29 Palmer Street UNIT #: 1 Right OWNER/AGENT: Scott Gelber ADDRESS: 9 Belleair Drive CITY/TOWN: Swampscott, MA ZIP CODE: 01907 24 HOUR PHONE: 592-4462 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. f/JF,7YR THE BOARD OF HEALTH V Q Lde5,,,11 JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR I� f f• � a�`co r�� -� 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 Tei:(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 UNIT# IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER C"6 i a i L �,j MANAGER/AGENT No P.O. Bo No P.O. Box ADDRESS l 13EE UA } ADDRESS CITY � ✓l� � /�^ A o�y�/ CITY RESIDENCE PHONEsI,2` bJ 2 BUSINESS PHONE (24 NRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: Z ROOM USE: 12. ryJn/r'3, 4. 5. 6. 7. S. THERE IS A TWENTY-FIVE($2 .00) OLLA FE , PAYABL BY CHECK OR MONEY ORDER TO THE CITY OF SALE ALTH EP RTMENT T IS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE DATE 3�>a� INSPECTORS USE ONLY DATE OF INITIAL INSPECTION ( - -� 0 – v `' DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE ra''10 C � DATE FEE PAID: TYPE OF UNIT: DWELLING/OTHER— CHECK#__34 ` ' 3 c NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 w CITY OF SALEM, MASSACHUSETTS o ; 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#237-06 DATE ISSUED: 5/12/06 Property Located at: 29 Palmer Street UNIT#2 Owner/Agent: Vito Venuti Address: 1 Tomah Drive City/Town: Peabody, MA Zip Code. 01960 24 Hour Phone 978-314-0594 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 s JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR I Yhi � i,l 1 .1 ii r_i raSYi.rli.l.. I,:.I soma of 12o wASNeNcroN smEETeer,4TN PwoR GALEN.IAA 01970 T0-976.7414600 FAX 976.745.0349 ' STANLEY US"CZ.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 'ag rV14= 1S`T UNIT VQ_ IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER-VL [Z_V�pA,;t MANAGER/AGENT No P.O. Box No P.O.Box ADDRESS--�-Mo- r, .G iti ty,rg _ADDRESS CITY -!�O-AAO JrJJCITY RESIDENCE PHONE ( 127 �4iUSINESS PHONE (24 HRS)- 7'Zk- qq osgt BUSINESS PHONE �� 77 3 " 35 / TOTAL NUM3ER OF ROOMS -�-- ROOM USE 14 IA:VJR�yt„2_ jiR��wt3 . �-(W.✓ S �'�� 6 7 £3 THERE. IS A TWENTY-FIVE ($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THL CITY OF SALEM HEALTH DF-PARTMENT THIS FFF IS PAYARI-F AT THf' TIME OF INSPECTION. APPLICANTSSiGNATURF INS hE.0 I C`'fi.S l_l`;[ ONI V DAI F OF INI ITAL INSPEC 110N s- j� r 0 6 i)ATC OF Iii CJSI'I'C i r lhi OA.TI= Oi" i`.SIIA'J';i (V Ci illli 11 ,All ✓ 06 tvrll i I i I`-r11) S 1'YPI Oi UN11 IW ! t jNS01111tH la ll ,..!'. ,' ( /W 0111 l. l)AII S � : I Y ', l i'�i r :i it .l i.11 li i iJ •I , rl . 'r 1@0 CITY OF SALEM, MASSACHUSETTS ,..,iya`' 13oARD OF HENI:CH ]20 W-\SHINGTON STRP:I-T,4.. Fij a iR 1'I_.I- (978) 741-1800 I I I13L.RLL1'llRISCOI:L. FAX (978) 745-0343 MAYOR Iramdinnsalcm.coin Lmuo, RA\1DIN,RS/RkI IS,(.I 10,( ],-IS CERTIFICATE OF FITNESS CERTIFICATE#405-11 DATE ISSUED: 10/25/2011 Property Located at: 32 Palmer Street UNIT# 1 Owner/Agent: Mario Chiuccariello Address: 38 Church Street City/Town: Winchester, MA Zip Code: 01890 24 Hour Phone: 617-312-6825 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. FORD OF HEALTH LARRY RAMDIN HEALTH AGENT CODE ENFORCEMENT INSPECTOR I AWL C 1TY OF SALEM, NIASS:kCI IUSE-M * BOARD OF HE\1;1'1-1 120 WASHINCIONSrRE T,4 ill f'll Tul.. (978) 741-1800 KIt 411FRIXY DRISCOLL F.\.\ (978) 745-0343 L..\12121'lt:\tIl)IA,ItS,1(11IF,CI!t),(T-I'S �l IAG AGI(N'I 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 2- llf� Pn .��m rte, �T UNIT#j_ IS THIS ENJT DISIGNATED AS RIGHT LEFT FRONT OR BAC PLEASE CIRCLE ONE OWNER/LESSER��.-n (.xF�MANAGERIAGENT �_ NO P.O.BOX ADDRESS JJAI 11J� ADDRESS CITY, STATE,ZlP_(A1k:, 11 PA �'j Lam- CITY, STATE,ZIP RESIDENCE PHONE I `7 ,,._BUSINESS PHONE(24HRS) +r/7 BUSINESS PHONE_ � �I/,Q �� TOTAL NUMBER OF ROOMS: ROOM USE: 1, 2. 3. 4. 5. 6. S P). 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 ATTHE IME OF INSPECTION J J APPLICANT'S SIGNATURE 11?A1 .t�� `.L, ccs�� DATE Inspectors use only Date on initial inspection: /(J ,) r-//1 / Date of reinspection: Date of issuance of certificate: 10k J l 1l Date fee paid:-)U!! Type of unit: Dwelling V Other Check#<�Check date: Notes: C e Enfor ent Inspector (' IMPORTANT MESSAGE + FOR A.M. DATE TIME P.M. OF 3 PHONF AREA CODE NUMBER EXTENSION ❑FAX ❑MOBII F AREA CODE NUMBER TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU RUSH RETURNED YOUR CALL' I(WILL J�FAX T,OaYOU ME�S�SAGF_ �A 1F- l£+ N h{ a�.+� SIA✓t�i..u�Z 9- 8 - `fS3 915 b SIGNED tt NiVERSAL_ 48005 MADE IN U S A. Y i NOTES CITY OF SALEM, MASSACHUSETTS u BOARD OF HiLu:rji 120(Y✓ASI UNGTON STREET,4°1 FLOOR Ti' ,I_ (978)741-1800 K1M13E1,11C,HY'DRISCOLL F.\\(978) 745-0343 MAYOR Iratndin(adsalem.cotn LARRY RAM AN, K5/KIST IS,CI J(),(T-15 III;•\7:I'I I AGISN'I' Facsimile Transmittal To: Fax # C111 CA �_�3 �o jd RE: SA br 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 : 10/27/2011 05: 24 NAME : FAX : 9787450343 TEL : 9787411800 SER.# : 000S0N341991 DATEJIME 10/27 05:23 FAX NO./NAME 919784539150 DURATION 00: 00:25 PAGE(S) 02 RESULT OK MODE STANDARD ECM 1`, r CITY OF SALEW, MASSAUIUSETTS BOARD OF I[EUX14 120WASF[IN(,I' NST'Riv[?r,4"'1�I,cx)R 'I'lil.. (9`78)741-1800 1iI Y[I7}iRI.L'.7'i�lt[SC;c)LI. F.1\()78) 745-0343 MAYOR IramdinO..salem.coin LARRY RANIDIN,RS/R11 IS,O R t,C114S 11FAI;I'I I MINT Facsimile Transmittal To: Fax # RE: Date Page(s): including this cover# Z Message: Board of Health NewsYour 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 i CITY O SALJ M, MASSACHUSEITS Y � =c4K sr�� BoARn OF 11E:,U,il I 12019, .Si-II (;']'ON S'I'RGf:i' 4"'1'J d x n( Ti-,,i_ (978)741-1800 I:iM1aliRI.f:1' i3RtSC:()LI_ F,\,\ (978) 745-0343 MAYOR Iramdinrd.sa1e(n.com JA R RYRANID}N,Rif RVI IS,(AR),(A14S Facsimile ,� Transinitfal To: '� �J1 G Z �i~i I Fax # � uD� RE: Date i 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 10/27/2011 21:54 NAME FAX 9787450343 TEL 9787411800 SER. # 000BON341991 DATEJIME 10/27 21:54 FAX NO. /NAME 919784539150 DURATION 00:00:25 PAGE(S) 02 RESULT OK MODE STANDARD ECM TRANSMISSION VERIFICATION REPORT TIME : 10/27/2011 22:09 NAME : FAX : 9787450343 TEL : 9787411800 SER. # : 000BON341991 DATEJIME 10/27 22:08 FAX NO./NAME 919784539150 DURATION 00:00:31 PAGES? 03 RESULT OK MODE STANDARD ECM CITY OF SALEM, MASSACHUSETTS i BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR o' SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 KIM13ERLEY DRISCOLL JSCOTT@SALEM.COM MAYOR JOANNE SCOTT HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE #623-07 DATE ISSUED: 12/20/2007 Property Located at: 32 Palmer Street UNIT#B-1 Owner/Agent: Dario Gonzales Address: 32B Palmer Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 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 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 J ANNE SCOTT, MPH, RS, CHO L� HEALTH AGENT CODE ENFORCEMENT INSPECTOR ' CITY OF SALEM, MASSACHUSETTS • BOARD OF HEALTH 3 120 WASHINGTON STREET, 4TH FLOOR v 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 _moi �. C3 A I Nl E Q S UNIT# IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER_ A P j b '3tl11 -4[e MANAGER/AGENT No P.O. BoxNo P.O. Box ADDRESS QAl I M F JZ 57` ADDRESS CITY_S-A le tfj M 4- - 6 /97 d CITY RESIDENCE PHONE�7.P-7Y� USINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: C ROOM USE: 1._� _2. 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 r'� _ DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION DATE OF REINSPECTION - t DATE OF ISSUANCE OF CERTIFICATE:/_] -),0-d "DATE FEE PAID:--t TYPE OF UNIT: DWELL ING/\�_OTHER_ CHECK# / YDS CHECK DATE D—0 7 NOTES: l 12 LA �� CODE ENFORCEMENT gVSPECTOR 9/28/98 re � o CITY OF SALEM, MASSACHUSETTS g BOARD OFHEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 .9Bq TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE# 111-04 DATE ISSUED: 03/25/2004 Property Located at: 32 Palmer Street UNIT#2 Owner/Agent: Linda A. Zimirowski Address: 18 Glenwood Circle City/Town: Lynn, MA Zip Code: 01902 24 Hour Phone: 595-1818 An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliancewith 105 CMR 410.000: Massachusetts State Sanitary Code,Chapter 11"Minimum Standards of Fitness for Human Habitation". Therefore,this Certificate if 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 CRM 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates,whichever is later. This Certificate of Fitness if valid only if there is a valid Certificate of Occupancy. FF RTHE OF HEALTH V JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR t CITY OF SALEM, MASSACHUSETTS o`1 "J: '� BOARD OF HEALTH • i 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". � .7 PROPERTY LOCATED AT .)/t relMeW UNIT#� IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE MANAGER/AGENTVNE� ESSERL''14A- bbr S / No P.O. Box No P.O. Box ADDRESS I., /-r j�elvulz1e Li de ADDRESS CITY Z Y&,,dZ , dli/l4 CITY RESIDENCE PHONE /� S96-/SiP BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS- ROOM USE: 1. 2. _3. 4. 5. -,6. _7. 8. t� 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 SIGNATUREGf�/lu� C -�e�r� DATE a75 Q� INSPECTORS'USE ONLY , DATE OF INITIAL INSPECTION 3 > ° DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE;�r-,�-s DATE FEE PAID: 3 a L �o y TYPE OF UNIT: DWELLING _OTHER ^ CHECK#-1 9 h CHECK DATE 3 2i v NOTES: CODE ENFORCEMENT INSPECTOR 9128/98 City of Salem, Massachusetts Board of Health ��.� ��i �L MA 01974 H 120 Washington Street, 4th Floor, Salem, p Cpt 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-17.142 DATE ISSUED: 5/12/2017 Property Located at: 35 PALMER STREET UNIT#1 Owner/Agent: Michael O'Brien Address: 56 Hampshire Street City/Town: Methuen, MA Zip Code: 01844 24 Hour Phone:(781)572-6623 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 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. nc . Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age. Larry Ramdin, MPH, REHS, CHO fir HEALTH AGENT SANITARIAN CTTY OF SALEM, MASSACHUSETTS BOARD OF HEAI:rrI 120 WASHINGTON STREET,4T"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR I RAMDINnaSALEM.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" r FEE: $50.00 PROPERTY LOCATED AT 3 �A 6!M6q S+ • � /1 _ UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER M#C W6-S f P-0&2 1 kr1� MANAGER/AGENT � NO P.O.BOX 7 J ADDRESS 56 �,4�SU ec: f • ADDRESS S-4It�� CITY, STATE,ZIP CITY, STATE,ZIP f-PitU�e VVI ely RESIDENCE PHONE ��',I -�7 '�� S BUSINESS PHONE(24HRS) * � BUSINESS PHONE SA P-R , TOTAL NUMBER OF ROOMS: Y ROOM USE: 1. 32 2. ' (>e- N 3. C1 4. 4 d 5. 6.7144-, 7. I J L n 8. /a,I.,`. 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 T E OF INSPECTION APPLICANT'S SIGNATURE DATE �l�f7 / Inspectors use only Date on initial inspection: Sl1_.�./2n17 Date of reinspection: Date of issuance of certificate:S/z1/�2D?_7 Date fee paid: 5-11-112-017Type of unit: Dwelfing�Other Check# A Check date: Notes: rl ment Inspe r CITY OF SALEM, MASSACHUSETTS ' • BOARD OF HEALTH 120 WASHINGTON STREET,4`FLOOR TEL. (978) 741-1800 ICIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR DGI2181iNBAUM lni SAi.G1,1.COR1 DAVID Gii'.P'.NRAUM ACTING HFAI.11"1 AGVNT CERTIFICATE OF FITNESS CERTIFICATE#316-10 DATE ISSUED: 6/24/2010 Property Located at: 35 Palmer Street UNIT# 1 Owner/Agent: Puma Partmers, LLC Address: 20 Washington Avenue#1 City/Town: Waltham, MA Zip Code: 02453 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 O� IDIUM ACTING HEALTH AGENT CODE EN R EMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"`FLOOR TEL.(978)741-1800 KIM13ERLEY DRISCOLL FAX(978)745-0343 MAYOR I W REENRAUM(a SALEM,.COM DAVID GREENBAUM, ACTING HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MMMUM STANDARDS OF FITNESS FOR HUMAN HABITATION." 1 FEE: $50.00 Ast ROPERTY LOCATED AT ,D r UNIT# �- IS THIS UNIT DISIGNATED AS RIGHT I��GH IFRO OR BACK PLEASE CIRCLE ONE p IWNERJLESSER P., a ` � //L� 1.�, oT— AGERJ AGENT o w, D P.O.BOX S)DRESS V✓�sl+ �P�Cs l ` 1 ADDRESS l J 'ITY, STATE,ZIP tela ? —inAw AAA 02--4$3CITY, STATE, ZIP ESIDENCE PHONE BUSINESS PHONE(24HRS) fl 9 g O '—7 S USINESS PHONR c OTAL NUMBER OF ROOMS: OOM USE: 1. Q 2. ? �Z"3. 4. 6. R 2 7. 9. tx� c-p 10. HERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM OARD OF HEALTH THIS FEE IS P%AYYABLE AT THE TIME OF INSPECTION PPLICANT'S SIGNATURE �/"`� 3,15 �� I — Insnectors use only ate an initial inspection: (3 �, �� > Date of reinspection: ate of issuance of certificate: �a Date fee paid: ofunit:—Dwelliug_�c7ther Check # —t —+�—c necx(tate: - !/G rtes: -jQrA J61MIsveelL In d (A� v4CheA. a n P1 & U roli4 n G,A4An) d orp - )de Enforcement Inspector S t� CITY OF SALEM, MASSACHUSETTS 0 o BOARD OF HEALTH s 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#56-06 DATE ISSUED: 2/14/06 Property Located at: 35 Palmer Street UNIT# 1 Front Owner/Agent: Mecedes Hernandez Address: 469 Walnut Street City/Town: Lynn, MA Zip Code: 01905 24 Hour Phone: 781-842-4730 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 JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR ,.r CITY OF SALEM, MASSACHUSETTS / BOARD OF HEALTH • • 120 WASHINGTON STREET, 4TH FLOOR 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 :f Ca%M�. '�_\ UNIT#� IS THIS UNIT DESIGNATED AS RIGHT LEFT RO BACK PLEASE CIRCLE ONE I' \TSS\`\ OWNER/LESSERANAGER/AGENT No P.O. Bo No P.O. Box ADDRESS � ADDRESS CITAI p (� QCS1 �� CITY RESIDENCE PHON � C�12� \�USINESS PHONE (24 HRS.) BUSINESS PHONRC1 �� TOTAL NUMBER OF ROOMS: ROOM USE: 'I 'CC/l 2 3.._ &�_ _4 � 5�sy �s 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 SIGNATWQA XN_'t._ _ TE� INSPECTORS USE ONLY DATE OF INITIAL INSPECTION _�. %/ 0 - V V DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:; -1 C- o c DATE FEE PAID: ti3 �- o - ct TYPE OF UNIT: DWELLING OTHER_ CHECK# CHECK DATE NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 _ JOANNE SCOTT, MPH, RS, CHO Kimberley Driscoll HEALTH AGENT Mayor RELEASE In accordance with Massachusetts General Laws Chapter III ; Code of Massachusetts Regulations 410.000 et. seq. ; State Sanitary Code Chapter II and Article XIII of the Cit;• 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. In the event it is necessary Lhat said inspection be done in my/our absence, !/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 a.penis from any loss or injury sustained of whatever nature and description occasioned by my/our absence during said inspection. TENANT/LESSEE LV 1�k ADDRESS ADIIRESS OF UNrl' 1'o1 BF. TNISPECTED + CITY OF SALEM, MASSACHUSI XTS BOARD oi, HEALTH 120 WASHINGTON STREET,4O'FLOOR P11I1I1CHealth TEI.. (978)741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLI, Isamdina.salem.com L.\Itltl'R.1t`IUIN,RS/R1 i.l IS,CI IU,CP-I+S MAYOR Hli,il;l'rt t1GF{K'i' CERTIFICATE OF FITNESS CERTIFICATE#288-14 DATE ISSUED: 9/2/2014 Property Located at: 35 Palmer Street UNIT#2 Owner/Agent: Dan Botwink Address: 20 Washington Avenue#1 City/Town: Waltham, MA Zip Code: 02453 24 Hour Phone: 703-980-7518 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 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 OF HEALTH LA RAMDIN HEALTH AGENT SANITARIAN i CITY OF SALEM, MASSACHUSETTS BOARD or HEALTH 120 WASHINGTON STREET,4"'FLOOR P111)l1CHCAIt}i rr<.em.wemm .rmm TEL. (978)741-1800 FAX(978)745-0343 IiIMBERLEY DRISCOLL Iramdin([dsalem.com MAYOR LARRY Rt\DfDIN,RS/REI-IS,CIIO,CP-PS HEALTH AGENT /� l vP' t1 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 35 PALMER ST UNIT#2 IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSERDAN BOTWINIK MANAGER/AGENT JUAN HEREDiA NO P.O.BOX 316 LOWELL ST ADDRESS ADDRESS CITY, STATE,ZIP WILMINGTON, MA 01887 CITY, STATE,ZIP RESIDENCE PHONE BUSINESS PHONE(24HRS)617 649-6948 BUSINESS PHONE 617 649-6948 TOTAL NUMBER OF ROOMS:6 ROOM USE: L LIVING 2,DINING 3,BEDROOM 4,BEDROOM 5,BEDROOM 6.BEDROOM 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 JUAN HER EDIA DATE SEPT 2, 2014 r7 Inspectors use only Date on initial inspection: I'� IIU Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check,,—V6—check date: Notes: Code En orc nt Inspector CITY OF SALEM, MASSACHUSETTS �S° � BOARD OF HF:u,"n-1 120 WAS1 IINGTON STREET,4. . TF:L. (978) 741-1800 hIn'fBLRL,EY DRISCOLL. FAX (978) 745-0343 MAYOR 1mindin(a),salcm.com I,,\RRY R\NfDIN,RS/1z1:1 IS,(;11(1, I II?,\I,n I AGISNT CERTIFICATE OF FITNESS CERTIFICATE #475-11 DATE ISSUED: 11/9/2011 Property Located at: 35 Palmer Street UNIT#3 Owner/Agent: Dan Botwinik Address: 20 Washington Street#1 City/Town: Waltham, MA Zip Code: 02453 24 Hour Phone: 786-879-1097 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 fQ� LAR HEALTH AGENT CODE ENFORCEMENT INSPECTOR C ry oil S,\]J,., i, MASSr,CHUSE C.I'S 1411\I m9:111',.\I:III 1211 WASI I INGI I4\Slltl(1 il',9°'1'I111W 'Ihl..0178)741 14u0 KINHWRL W DIt IS(,c III, FAN(979)745-W43 \I:\1'(11t II<M� MIIIi�i(r�.411•�1114 L 11t It\'It\A1111\,Pp/It b.l h,I,I n 1,1 I'-I III.\CI'I I,U:I,YI Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER 11, 105 CMR 410.1100 "MINIMUM STANDARDS 01'FITNESS FOR HUMAN HABITATION" FEE:$50.00 PROPEMI'Y LOCATED AT SS PAt_t`/lVZ STQ.Ec_'C 6AL4,4rA MA o1�1�-o UNIT#--L_ ISTHISUNITDISIGNATEDASRICIITLEFI'FRONTOR AC'K PLEASKCIRCLKONF. OWNER/LEssrR OAr.1 py3fwlr3\IC MANAGER/AGENT J JAI.1 NE(GF.D\A NO P.O.BOX ADDRESS 20 wndN,.,iGT.,�� _.t -1 nuuaEss 67.o Ly». dells �w_.�v CITY,STATE.ZIP MIN 0249-S rITY,STATE,ZIP Maa/o52. MA, 02IV6 RESIDENCE PHONE BUSINESS PHONli(24HR5) �;-ii�G SA-0\ 10q} RUSINrss PHONr X03 °i Bo :V5'19 TOTAL NUMBER OF ROOMS: S ROOM USF,: 2. 944 v o1.,.. 3. L,vl,.-4. 6. 7. R_ 9_ 10. ` THERE tS A F'll'I'Y($50)D01,LAR FEF,PAYABLE BY CI IECK OR MONrY ORDER TO'I'FlE CI'PY OF SALEM BOARD OF HEALTHTHIS I IS FEr IS PAYABLE AT TF TIM R OF INSPECTION APPLICANT'S SIGNATURE / ``Z DATE 11 Inocctom ust:only. ��— Uale on initial inspcction: Datc of reinspcction. Dateof issuance ofceeiticatc: 9 I I___-____7�(� Date f�c paid: _ 'type of unit: Dwelling Uthu_ Check B�013—Check date: Notes: to)F/\. LV\J( 04- IAC44pr Curie Enf I l a nl Inspector " CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET 41H FLOOR PubPiicHealth STREET, Prevent.Promote Protect TEL. (978)741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL IramdinCa�salem.com L t,RRY RAAIDIN,RS/RF1IS,(1110,CP-FS MAYOR H1;,v:r1l A(,,ENT CERTIFICATE OF FITNESS CERTIFICATE#18-14 DATE ISSUED: 1/23/2014 Property Located at: 36 Palmer Street UNIT# 1 Owner/Agent: Jose 0 Santos Address: 110 Augustus Street Ci /Town: Revere MA Code: 0215124 Hour Phone: 617-955-9064 tY t Zip 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 LAR DIN I HEALTH AGENT M CITY t)F SALEM, MASSACHust:,,T-rs B iu>of ET£4 xiI 120 WASHINGTON STRI3CT,4"`P'1,001E `1'ti.I,. {978) 741-1800 i;1M11131tI,L:Y l>R[SCOT T. 17,1\{978)745-0343 MAYOR Irrun i d n@Uemsom LARRY RANIDIN,ft5/tU{I1S,t;i f(7,CP-ISS . T1h,ll.'17!AGKN'r Facsimile Transmittal To: ;5Un(A A s AGS - t JUS�Jel Q � Fax # t r r Date Page(s): including this cover# Message: Board of Health News --- – --- - — --- – -- For Your information (OFFICE HOUR;i: 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 VERIFICATIOH REPORT | | � � | � � TIME : 01/28/2814 22:53 � NAME : � FAX : 9787450S43 TEL �� 9787411800 � � SER.# : 00088N341991 � � � DATE TIME 01/20 22:52 � FAX �NO. /NAME 919787449614 � DURATION 08:W8:27 � PAGE(S� 02 � RESULT OK MODE u/*nu*Rv ECM / m CITY OF SALEM, MASSACHUSETTS 1 BOARD OF HEALTH 120 WASHINGTON STREET,4`'FLOOR RiblicHedth Prevent.Promote Protect TEL. (978) 741-1800 FAX(978)745-0343 KIMBERLEY DRISCOLL lramdinna.salcm.com MAYOR L.'\1tItY 1L\ [DIN,Rti/RIiI-IS,CI IO,CP-I'S HISAL r1I ADEN-I' : 5 U � �a o5 Application for Certificate of Fitness —I IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" q� FEE: $50.00 PROPERTY LOCATED AT S1 LEI UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER 1t1�£' CJ ' �� MANAGER/AGENT NO P.O. BOX `Jd ,r ADDRESS / I C) (n�/,^I Cu S7 Uf cST ADDRESS CITY, STATE,ZIP V� 6" - G /�1 CITY, STATE,ZIP t_ Z t RESIDENCE PHONE UJ Fr 5S- I ro�0 L/ BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. IM 7. 8. 6V y r� 4. 10. b 5. 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 f APPLICANT'S SIGNATURE C)' �� o/ DATE InSDectors use only Date on initial inspection: �/ U_��/�II/J Date of reinspection: Date of issuance of certificate: Date fee paid: 11 Type of unit: Dwelli g Other Check#_Check date:efr 1 , Notes: Code rc ent Inspector . , . CITY OF SALEM, MASSACHUSETTS BOARD OF I IE f TH ..- 120 WASHINGTON STREE'C 4°"FLOt}R th Prevent.Promale Froltcl. TEL. (978)741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL 1ramdvn(&,salem.com _ LARRY RANIDIN,RS/REI IS,CHO,CP-3'S MAYOR LARRY A(;FNT CERTIFICATE OF FITNESS CERTIFICATE#008-15 DATE ISSUED: 1/21/2015 Property Located at: 36 Palmer Street UNIT#2 Owner/Agent: Jose O. Santos Address: 110 Augustos Street City/Town: Revere, MA Zip Code: 0215124 Hour Phone: 617-955-9064 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 DwellinglRooming 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 .. '�.i•fF'p1 LARRY RA DIN f _ HEALTH AGENT SANITARIAN TRANSMISSION VERIFICATION REPORT TIME 01/29/2815 84:48 NAME : FAX 9787458343 TEL 978741180B SFR. # 008B8N341991 DATE,TIME 01/29 94:48 FAX NO./NAME 919787449614 DURATION 00:90:17 PAGE(S) Ml | RESULT OK | MODE STANDARD ECM � � � � CITY OF SALEM, MASSACHUSETTS (f, BOARD OF HEALTH 120 WASHINGTON STREET,4°.FLOOR �mA TEL. (978) 741-1800 V J KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR LRANfow&il nf,eNl.CONl LARRY R,\NIDIN,RS/RH fS,Cl fO,CP-FS H13N: ii 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 36 nPrGnnER hPT2 5T 54 Lim NIA- Ol(t-10 UNIT# Z IS THIS UNIT 61SIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER c � 05G v' 5A/4T0S MANAGER/AGENT NO P.O. BOX ADDRESS /to /fit/c(2 STv S S T ADDRESS CITY, STATE, ZIP (Z GN�r2 Ivl {�rr d� S CITY, STATE, ZIP RESIDENCE PHONE �U l�' C1 SS 1 6 y BUSINESS PHONE(24HRS) BUSINESS PHONE //-- TOTAL NUMBER OF ROOMS: v ROOM USE: 1. 2. 13.1 UCD"0< 5. 6. 7. T 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE (0 DATE / /; I bs Inspectors use only Date on initial inspection: J' Z -)S Date of reinspection: Date of issuance of certificate: ^ Z1. 1$ Date fee paid: )' v-IJ Type of unit: Dwelling '� Other Check# So g Check date: 1-2j-Ir Notes: n' Code Enforcement Inspector CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET 4`..FLOOR PubliCHealth -- STREET, Prevent Promote Pml[vl TEL. (978) 741-1800 Fax(978) 745-0343 KIMBERLEY DRISCOLL tramdinna salem.com MAYOR Lr\IIItY]t;\6fDIN,RS/RFI IS,CI 10,(;P-FS - 1-IHAL'n I AGP,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. n - Tenant e ee Owner/Lessor 36 V9642- T ApfiZ 36 PA MER- ( 't- A?T- 2 Address 5AteM. W ©1 cl 7O Address 5 pfLF M , A4 A • 019-10 Address on unit to be inspected Date Updated 523/11 —. .� 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. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE# 133-05 DATE ISSUED: 2/25/05 Property Located at: 36 Palmer Street UNIT#3 Owner/Agent: Catalina Pena Address: 36 Palmer Street#1 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 Cade 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 INSPI!CTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH VO 120 WASHINGTON STREET, 4TH FLOORSALEM, MA 01970Ob TEL. 978-741-1800 JL 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 '36 �Ke2 UNIT#3 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER CGL�R �J�Q MANAGER/AGENT No P.O. Box I t. �C No P.O. Box ADDRESS cADDRESS CITY c STA I�+-1 �cI CITY RESIDENCE PHONE !o S BUSINESS PHONE (24 HRS.) BUSINESS PHONE �/0 -3U0a TOTAL NUMBER OF ROOMS: q ROOM USE: 1. 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 �G '' DATE a-as-bS INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 2 - �- 3 -c� -)ATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:Z '✓ 3 9 a DATE FEE PAID: 7 TYPE OF UNIT: DWELLING'J__�THER_ CHECK# p �CHECK DATE -2- 'a 3 ` v� NOTES- �' CODE ENFORCEMENT INSPECTOR 9/28/98 nnwafoi CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOORCERT.# 237-02 SALEM, MA 01970 TEL. 978-741-1800 FEE $25 .00 FAX 978-745-0343 DATE: 05/06/2002 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, R5, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 38 Palmer Street UNIT #: 1 OWNER/AGENT: Jose Baez ADDRESS: 36 Perkins Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 825-0031 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 THF H BOARD OEAL - - lz JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR v4t cltiy tr; 'LE MASSACHU-S TTS 0 1; H E A LT H 120 WASHINGTON STREET, 4TH FLOOR SALE M,�.M A 0,1.,9,70-2� TEL. 978-741-i8o6 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE ScoTT, MPH, RS, CHO MAYOR HEALTH AG.ENT 440 APPLICATION FOR CERTIFICATE.OF FITNESS IN ACCORDANCE WITH STATE SANITARY cobE,64A- P'T� Ell 11, 105 CIVIR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABiTATiONa. PROPERTY LOCATED AT e- /L� UNIT IS THIS UNIT DESIGNATED AS RIGHT LEFT.,FRONTiBAC 4oPLEASE CIRCLE ONE "MANAdtA-/AdE OWNER/LESSER Nt�' ' NdP:O-,.i3ox : ' ADDRESS e a- ADDRE§S�! r 7 o CITY -�RESIDENCE PH ONE� 9-797 (Z�,?-�S�AAJBUSINE .0,b1�1E.(24HRS.) J- 2 'M§: C, -USE: U, a-" OM' -11,� D 5' tk�b§ ATWENTY-fIVE($25.00)DOLLAR 0EE-i'.1P AYABLEZY-CHEC�-ORMONEY -AT-THE- -,ORD*',t6,T,, ,."-[T'Y-OFSALE.M�HEALTHD-EPA.RTMENTTHIS'FEEIS*PAYABLE '. i'TIME OF.INSPECTION. APPLICANTS SIGNATURE �- -ll 0 1-"- f?" DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION DATE OF REINSPECTION DAT OF iSSU EfEi�PAID:5' El ANCE OF CERTIFICATE. DAT -TYPE OF UNIT-..:DWELLINeTHER -jGHECK A CHECK DATES-7�-o -t 57( NOTES: -9/28/98t,,:p, p Z Wr 44 i�� 4 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH ° • 120 WASHINGTON STREET, 4TH FLOOR - SALEM, MA 01970 .yqW TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. ,JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 04/11/2002 JMJ Realty Trust c/o John Fisher 414 Ocean Avenue Marblehead, MA 01945 PROPERTY LOCATED AT 38 Palmer 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 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 9t HEALTH REPLY TO oanne 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 Kimberley Driscoll WWW.SALEM.COM Mayor JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE# 181-06 DATE ISSUED: 4/10/06 Property Located at: 40 Palmer Street UNIT# 1 Owner/Agent: Jose Baez Address: 36 Perkins Street#1 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 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 H JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR - *. xj+.. n.... i. ^. �yry•;e•:�•yp l2fY'y�,i:... xi y�,�5S jr.yYi I'- I•.�` 'u Y:I-1, i i 5 i.l,:. 11.l r A,6r bic y�4 Yb� .��sIK:Q; Em .. .,.. `Gt7Y Off'SAt.EIM; eoARO OF 14CALTH 120 WAS141RCTON STREET,4TH FLOOR SALEM./4A 01970 TEL.978-741-1600 FAX 978-74S-0343 - STANLEY UsOYICi.JR. JOANNE SCOTT. MPH, R'S, 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_ � �Lf'—,/7 S % UNIT Nf, IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER\ R,g_.mS_ Z MANAGER/AGENT No P.O. Box No P.O.Box ADDRESS__ _/'o /, /A,, , SADDRESS RESIDENCE PHONE-q"- _per;/ BUSINESS PHONE (24 BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1._�� 2 _ 3-_. -- 4 -----_ THERE IS A TWENTY-FIVE(525.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SAIEMHEALTH DEPARTMENT THIS FEE IS PAYABLE Al THE TIME OF INSPECTION. APPLICANTS SEGNAI"URE �C9 5� ' rZ/,____-_— -_ -DATE '-_ �� - D-,/, INSP1ErTORS I ISlz ONLY DATE OF INITIAL INSPECTION , }^f G DATE OF REINSPI-CT ION DATE OF ISSUANC:F OF CER 1-!FICATI--q—, —( ()Alt FEF I''AID TYPE OF UNII DWFI_LIN OiliER CHLCK u / ! St CIICCI< DATF v _ NOIF"S COI)I- I-NI UIiCE MI NI IN!Wi , :I OI; CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTI-I 120 WASHINGTON STRLFT,41°FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR DGRIII;:NRAUM( .SAf.F1NI.CO%-I D;\VID GRI Ii.NBAUM ACTING Hi3AI;1'1-1 AGENT CERTIFICATE OF FITNESS CERTIFICATE#413-09 DATE ISSUED: 8/24/2009 Property Located at: 50 Palmer Street UNIT# 1 Owner/Agent: Salem Harbor Developers, LLC Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-4961 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 BOAk RD OF HEALTH /� DAVID GREENBAUM ACTING HEALTH AGENT CCWENFORCEKMNT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL.(978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR 7osYpls ns.caret JOANNE SCOTT, HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMA HABITATION." FEE: JO PROPERTYLACATEDAT 50 PALMER STREET, SALEM, MA 01970 UNIT# 1 IS THIS UNIT DISIGNATED AS RIGHT LEFT FRON,AOR BACK PLEASE CIRCLE ONE OWNERILESSER Salem HArbarTtev - op r%,LL,C MANAGER/AGENT Salem Property Manaaers NO P.O.BOX ADDRESS 102Lafayette Street ADDRESS102 Lafavette Street CTTY,STATE,ZIP Salem. 1•LA 01970 CTTY,STATEZIPRAIam. MA_. 01g2D RESIDENCE PHONE BUSINESS PHONE(24HRS) 978 745-4961 BUSINESSPHONE_2 7d5-8071 TOTAL NUMBER OF ROOMS: Al ROOM USE: l til 4...., 2. kt t� 3. �iAw_ 4. QSU,*4 5. 6. 7. 8. 9. 10. THERE IS A SEVEN Y-FIVE($75)DOLLAR FEE,PAYABLE BY CHECK.OR MONEY ORDER.TO THE CITY OF SALEM BOARD OF HEALTH 7.E ATTHETIMEOFINSPECTIONAPPLICANTS SIGNATURE DATE i O Inspectors use only Date on initial inspection: 2U X4109 Date of reinspection: Date of issuance of certificate: _ Date fee paid: / ) Type of unit: Dwelling Other_ Check# Check date: X151 �f Notes: nforcement Inspectd� — CITY OF SALEM, MASSACHUSETTS + , BOARD OF HEALTH 120 WA sHINGTON STREET,C FLOOR Tom..(978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOREcco r�QM.COM JOANNE SCOTT, HE LTH 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. �. r-% G u-C F_�cral I I aT t ( lot' too. C..Lr, Tenant/i essee Owner/Lessor 6o -Pa I re 4w4- i4 W.a. Address n Address U1 Address on unit to be inspected Date I M CITY OF SALEM, MASSACHUSETTS + • BOARD OF HEALTH 120 WASHINGTON STREET,4°1 FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR D(:RIiI'.NIIAunI(a)SAi2'.M.COnt DAVID GREI-NBAUNI ACTING HEALTI-I AGINT CERTIFICATE OF FITNESS CERTIFICATE #414-09 DATE ISSUED: 8/24/2009 Property Located at: 50 Palmer Street UNIT#2 Owner/Agent: Salem Harbor Developers, LLC Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-4961 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 I AVID GREENBAUM � - ACTING HEALTH AGENT C ENFORC T INSPECTOR CITY OF SALEM, MASSACHUSETTS ( f BOARD OF HEALTH 120 WASHINGTON STREET,4"`FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-034A MAYOR ]Sr'orNnlcnr M.COM JOANNE SCOTT, HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER 11, 145 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMA HABITATION." FEE: Za-)O PROPERTY LACATEDAT 50 Plamer Street _ Gaipm- MA n19-7n UNIT#__2__ IS THIS UNIT DISIGNATED AS RIGHT LEFT FR_. ONT OR BACK.PLEASE CIRCLE ONE OWNER/LESSER Salem HArbornev Topers .LL(-- MANAGER/AGENT Salem Property Manaaers NO P.O.BOX ADDRESS 102Lafavette Street ADDRESS102 Lafavette Street CITY,STATE,ZIP $Belem. MA 41974 CTTY,STATEZIP cap MA URIA- .._._ RESIDENCEPHONF BUSINESS PHONE(24HRSI 978 745-4961 BUSINESS PHONEA78- U55-8471 TOTAL NUMBER OF ROOMS: ROOM USE: LK4ctu,. 2.`6cu 4,*A 3.Lie.20A 4.WkAA1 5.o UA4 6.b"" 7. 8. 9. 10. THERE IS A SEVEN'T'Y-FIVE($75)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 APPLICANTS SIGNATUR 1 DATE Inspectors use only Date on initial inspection: slat!lcxi Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check# Check date:e_AzvQq _ _ Notes: e Enforcement Ins ect r CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,e FLOOR TEL.{978)741-1800 KIMBERI EY DRISCOLL FAX(978)745-0343 MAYORt d4TLC41S TZM,COM JOANNE SCOTT, HEALTH 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 theevent it is n 'd ev necessary that said coon be done in /out absence. Uwe expressly authorized the same and for > my/out � Y 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. li 1�Yt lS0'M2"� %,)rl%P.1A i'i&r6r .11 i,..L..C— Tenant/L ee v/( Owner/Lessor CIO ` A.`0\444 io a L �4- . Address Address Address on unit to be inspected Date 'f CITY OF SALEM, MASSACHUSE'ITS BOARD OF HEALTH 120 WASHINGTON STREET,4°'F],OOR TEL. (978)741-1800 KIM ERLEY DRISCOL.L FAx(978) 745-0343 MAYOR DGRFF.NBAUN1GSALriDLC0M DAVID GREBNBAUM ACTING HL:AJAII AGG.N'1' CERTIFICATE OF FITNESS CERTIFICATE#404-09 DATE ISSUED: 8/24/2009 Property Located at: 50 Palmer Street UNIT#3 Owner/Agent: Salem Harbor Developers, LLC Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-4961 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 HEALTH i � DAVI GREENBAUM a ACTING HEALTH AGENT NFORC NT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 920 WASHINGTON STREET,4T"FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR JScor*sn,Zx 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 FITNESS FOR HUMA HABITATION." E: JO PROPERTY LACATED AT 50 Palmer Street. nla^7n UNIT# 3 IS TMS UNIT DLSIGNATED AS RIGHT LEFT FRO OR BACK PLEASE CIRCLE ONE OWNER/LESSER Salem HArbornevPlOnerq .T.LC_ _MANAGER/AGENT Salem Prooertv Manaaers NO P.O.BOX ADDRESS 102Lafavette Street SDDRESS102 .Lafavette Street CITY,STATE,ZIP Salem MA 01970 CPPY,STATEZIP salem,, Mn 019 D RESIDENCE PHONE BUSINESS PHONE(241IRS) 978 745-4961 BUSINESS PHONEj78- 745-8071 TOTAL NUMBER OF ROOMS: ROOM USE: I.K4� l t-v. a oA 4J?&44 5.tt,144. j 6.,;"-u. 7. 8. 9. 10. THERE IS A SEVENTY-FIVE($75)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 APPLICANTS SIGNA DATE /9 Inspectors use only Date on initial inspection: Rh1410G Date of reinspection: Date of issuance of certificate: Date fee paid: 1 Type of unit: DweUin& __Other Check# Check date: 7<-h� Nates: e Enf ent ect r CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET`,C FLOOR TEL.(978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR COM j O ANNE SCOTT, HEALTH AGENT Release In accordance with Massachusetts General Laws Chapter 111;Code of Massachusetts Regulations 410.000 et. Seg. ; State Sanitary Code Chapter II and Article XIII of the City of Salem Ordinance,undersigned owner/lessor and tenant/lessee of a unit ofresidential 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 Address Address Address on unit to be inspected - Date ii — r, CITY OF SALEM, MASSACHUSETTS Y BOARD OF HEALTH 120 WASHINGTON STREET,41°FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DG EENBAUNIna SALFW.CONI DAVID GREENBAUM ACTING HRAI;PI-I AGIi,NT CERTIFICATE OF FITNESS CERTIFICATE#415-09 DATE ISSUED: 8/24/2009 Property Located at: 50 Palmer Street UNIT#4 Owner/Agent: Salem Harbor Developers, LLC Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-4961 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 I D BktCl t l/ A TING HEALTH AGENT CO NFOR T INSPECTOR r- • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4:'FLOOR TEL (978)741-1800 Y MBERLEY DRISCOLL FAX(978)745-0343 MAYOR I&MM25M em 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 FITNESS FOR HUMA HABITATION" FEE: JO PROPERTY LACATED AT 50 Palmer Street . Salem MA 639,7P UNIT# 4 TS THIS uNIT DISIGNATED AS RIGHT LEFT'FRONT OR RACK PLEASE CIRCLE ONE OWNERILESSERSalem HArbarTflev-lo gzzjs.r MANAGER/AGENT Salem Prooerty Managers NO P.O.BOX ADDRESS 102Lafavette Street ADDRESS102 .Lafavette Street CTCY,STATE,ZIP Salem. MA 01970 CTIY,STATEZIP ca em.MA nl 79 n RESIDENCE PHONE BUSINESS PHONE(24HRS) 978 745-4961 BUSINESS PHONEj78— 7d5-8071 TOTAL NUMBER OF ROOMS: 4 ROOM USE: LkXCLA,,, 2. Lk,► 9.- 3. t&tAA 4. B L4.4n 5. 6. 7. 8. 9. 10. THERE IS A SEVENTY-FIVE($75)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 APPLICANTS SIGNATUR� DATE ? Insvectors use only Date on initial inspection: Date of reinspection: Date of issuance of certificate: 71_ Date fee paid. Type ofunit: Dwelling Other Check it Check date: �It7fJ� Nates: J e Fnforc=ent r r TA- CITY OF SALEM, MASSACHUSETTS i • • BOARD OF HEALTH 120 WASHINGTON STRESS',4"`FLOOR MEL(978)741-18W KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR COM j OANNE SCOTT, HEALTH 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. Tenant/Lessee Owner/lessor Address Address Address on unit to be inspected Date CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4°f FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR DGzr.rcNBAUM(@SAlasncconl DAVID GRuENBAUM ACTING HEALrH AGI-'.NT CERTIFICATE OF FITNESS CERTIFICATE#416-09 DATE ISSUED: 8/24/2009 Property Located at: 50 Palmer Street UNIT#5 Owner/Agent: Salem Harbor Developers, LLC Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-4961 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 OFHEALTH DAVID GREENBAUM ACTING HEALTH AGENT CWENFORCEMEXT INSPECTOR F. CITY OF SALEM, MASSACHUSETTS ( C� BO.ARD OF HEALTH 120 WASHINGTON STREET,e FLOOR TEL.(978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR 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 FITNESS FOR HUMA HABITATION° FEE: JO PROPERTY LACATED AT 50 Palmer street , Salm, b¢A-039r3 UNff# 5 IS Tms IRYIT DISIGNATED As RIGHT LEFT FRoNT OR BACK PLEASE CIRCLE ONE OWNER/LESSER Salem HArbartteveloggrs.LL MANAGER/AGENT Salem Praaerty managers NO P.O.BOX ADDRESS 102Lafavette Street ADDRESS102 Lafavette Street CITY,STATE,ZIP Salem. MA 0 70 CTPY,STATEZIP QAPm_ MA—_.01Q70 _, _ RESIDENCE PHONE BUSINESS PHONE(24I IRS) 978 745-4961 BUSINESS PHONE21E= 7A5-8071 TOTAL NUMBER OF ROOMS: d ROOM USE: 1.u�t l.�c.� 2 L .J.2 ti t 3. a+. 4. AaA*l 5. 6. 7. 8. 9. 10. THERE IS A SEVENTY-FIVE($75)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH S FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANTS SIGNATURE t �"" DATE ell-7101 J Insvectors use only Date on initial inspection: 1�Iaq//dal Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: DwellinP Other Check# J`l Check date:_ Notes: v ale& e Enforcement In • . r • CITY OF SALEM, MASSACHUSETTS BOAR OF HEALTH 120 WASHINGTON STREET,4m FLOOR TEL.(978)741-18(x? KEOERLEY DRISCOLL FAX(978)745-0343 MAYOR ?amm2mLmd COM JOANNESCOTT, HEALTH 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 Xlll of the City of Salem Ordinance,undersigned owner/lessor and tenant/lessce 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. Uwe 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 Address Address Address on unit to be inspected Date CITY OF SALEM, MASSACHUSETTS ' BOARD OF HEALTH 120 WASHINGTON STREET,41°FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR DGRI.TN13 A UMnS,\i,r:M.CO M DA\111)GRFj;NAAUM ACTING HliAl:1'1-1 AGI:N'T CERTIFICATE OF FITNESS CERTIFICATE #403-09 DATE ISSUED: 8/24/2009 Property Located at: 50 Palmer Street UNIT#6 Owner/Agent: Salem Harbor Developers, LLC Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-4961 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 THBOARD LIKE ALTH DAVID GREENBAUM ACTING HEALTH AGENT C ENFOR ENT INSPECTOR i • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,e FLOOR TEL.(978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR ja oTy�1__SA:m.COM JOANNE SCOTT, HFALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMA HABITATION." FEE: $X,)O PROPERTY LACATED AT 50 Palmer Steet, Salem.Ma 01970 UNIT# 6 IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER Salem HArbornev?loners .LLf MANAGER/AGENT Salem Praoerty Manaaers NO P.O.BOX ADDRESS 102Lafavette Street ADDRESS102 Lafavette Street CTTY,STATEZIP Salem. MA 01970 CITY,STATE,ZIP &ajem, _ A_, n � RESIDENCE PHONE BUSINESS PHONE(24HRS) 978 745-4961 BUSINESS PHONE 2 745-$071 TOTAL NUMBER OF ROOMS: ROOM USE: 1.K.14.„, 2.11.,n -L-o-A 3.L%r0 .fM 4. %1#,4,, 5.6.1..0+4. 6.1tXa.4s1 7. 8. 9. 10. THERE IS A SEVENTY-FIVE($75)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTUMUS FEE IS PAYABLE e}T THE TIME OF INSPECTION / APPLICANTS SIGNA lj/ l DATE (2 1A.� Inspectors use only Date on initial inspection: 196 Z!/Ocl Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling—.,Other Check# 7Y Check date:_ ail ),10 l I Notes: V a e Enforcement ect CITY OF SALEM, MASSACHUSETTS • • BOARD OF HEALTH 120 WASIUNGToN STREET,C FLOOR TEL.(978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR =Q r4 FM.COM JOANNE SCOTT, HEALT14 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. Tenant/Lessee Owner/Lessor Address Address Address on unit to be inspected Date 4 S ` t CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4'..FLOOR r blicHealth 1-EL. (978) 741-1800 FAx(978) 745-0343 KIMBERLEY DRISCOLL ltamdin(asaleln.coln - L[\RRl"RAti(UIN,RS/RIi:r15,CI fO,CP-I+5 MAYOR H i cw;PI I AG r.NT CERTIFICATE OF FITNESS CERTIFICATE#427-12 DATE ISSUED: 10/1/2012 Property Located at: 50 Palmer Street UNIT#7 Owner/Agent: Salem Point L.P. Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-4961 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 LAR AM IN � l HEALTH AGENT SANITARI J, ,. 7 . it ; CITY OF SALEM, MASSACHUSETTS 2�. :t. M,. I oAm OF HEALTH 120 WASHING G l ON STREET,d"`FLOOR TEL. (978) 741-1800 KINIBERLIY DRISCOLL FAX(978) 745-0343 MAYOR LRAMDIN(<SAJ XNLc0Nf 1.,.ARRT RA�tniN,RS/R1,7 IS,(J 10,CP-FS Hh::\1.,n t ,WENT 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 50 PALMER ST.. SALEM MA 01970 UNIT# 7 IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE NORTH SHORE COMM OWNER/LESSE LAFAYETTE HOUSING LIMITED PARTNERSHIP 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:—2 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 DATE Insnectors use onlv Date on initial inspection: I O I I I a� Date of reinspection: I ' Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check# Check date: Notes: Code ement Inspector w. CITY OF SALEM, i'vLASSACHUSETTS BoARD or, HEALTI 1 - 120 WASHINGTON STREET,4p.FLOOR TEL. (978) 741-1800 KINIBi:RLEY DRISC:OLL FAZ(978)745-0343 MAYOR DGI rr:NRAUNIaWsA1,17NI.cuN1 DAVID GRFF.NBAUM ACTING HF;AIa'1-I AGI?N'I' CERTIFICATE OF FITNESS r r CERTIFICATE If 382-09 DATE ISSUED: 8/12/2009 Property Located at: 50 Palmer Street UNIT#8 Owner/Agent: Salem Harbor Developers, LLC Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-4981 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 BOO�ARD F HEALTH � f DAVID GREENBAUM f ACTING HEALTH AGENT CODE�IF RCEMENT INSli�ECTOR r • CITY OF SALEM, MASSACHUSETTS BOARD of HEALTti 3�a-d9 120 WASHINGTON STREET,4'"FLOOR TEL.(978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR rscorrlrsnrFM.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 FITNESS FOR HUMA HABITATION." PROPERTY LACATED AT ,.SO PA I mer' .ST, Ar1-0� M. � UNIT# IS TMS UNIT DISIGNATED AS IG LEFT FRONT OR HACK.PLEASE CIRCLE ONE Salem Harbor Developers{ LC MANAGER/AGENT Salem Property Managers OWNER/L.ESSER__.. _._-- NO P.O.BOX ADDRESS102 Lafayette Street ADIyREs5102 Lafayette Street CITY,STATE,ZIP Raem.�L CTTY,STATE,ZIF Salem, MA 01970 RESIDENCEPHONE BUSINESS PHONE(24HRS) (978) 745-4961 BUSINESSPHONE (978) 745-8071 crr;L7-y&o-3 TOTAL NUMBER OF ROOMS: ROOM USE: 3. P44A.4 4.PjpUA" 5. 6. 7. 8. 9. 10. THERE IS A SEVENTY FIM$75)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 APPLICANTS SIGNATURE �� DATE ! j Incoectors use only Date on initial hupection: !Ic 1P�/ Date of rein�actiof: j Date of issuance of certificate: (1 I/d�� 1 p,Da�te fee i : �/ 14.5 Type of unit: Dwelling Other Check# 0"iCheek date: K1 !/J0 9 ` Notes: L den � hl� Code Enforc CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASMNGTON STREET,47 FLOOR TEL.(978)741-1800 KMERLEY DRISCOLL FAX(978)745-0343 MAYOR I46ICOM JOANNE SCOTr, HEALTH AGENT Release 1n accordance with Massachusetts General Laws Chapter 111;Code of Massachusetts Regulations 410.000 et. Seq. ; State Sanitary Code Chapter U and Article XH of the City of Salem Ordinance,undersigned owner/lessor and tenantAessee of a unit of residential property,hereby authorize the Salem Board of Health or its authorized agents to inspect the residence identified below in aocordance with the aforementioned statutes,regulations and ordinances. in the event it is necessary that said inspection be done in my/out absence. Uwe 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; Address Address c Address on unit to be inspected Date CITY OF SALEM, MASSACHUSETTS BOARD OF HF ALTx 120 WASHINGTON STREET,41°FLOOR TLL. (978) 741-1800 KIMI3ERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGR]:[:NI3AUNr(ni j\fa NI.(:ON D;\vu)GRI'TNBAUNI ACTING HF,Ami I AGF.N'r Facsimile Transmittal To:ySsa n,W Fax # L/ 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 HP Fax Series 900 Fax History Report for Plain Paper Fax/Copier Joanne Scott Salem BOH 978 745 0343 Aug 14 2009 12:35pm Last Fax Date Time Twe Identification Duration Paces Result Aug 14 12:34pm Sent 919787454345 0:35 2 OK Result: OK - black and white fax l • CITY OF SALEM, MASSACHUSETTS a BOARD OF HEALTH 120 WASHINGTON STREET,41°FLOOR TEL. (978) 741-1800 ICNIBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGRF1"NilAuntna s LenLconl DAVID GRI;ENBAUM ACTING HI ALai i AGGN'I' CERTIFICATE OF FITNESS CERTIFICATE#402-09 DATE ISSUED: 8/24/2009 Property Located at: 50 Palmer Street UNIT#9 Owner/Agent: Salem Harbor Developers, LLC Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-4961 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 //Luk DAVID GREENBAUM _ ACTING HEALTH AGENT CW,.YENFORCENT INSPECTOR 71 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4:m FLOOR TEL.(978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR j5Coz0&M=.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 FITNESS FOR HUMA HABITATION." FEE: SZ 20 PROPERTY LACATED AT 50 Paj m r Strea4 Salem- mA nig-7 UNIT# 9 IS THIS UNIT DISIGNATED AS RIGHT LErr FRONT OR BACK PLEASE CIRCLE ONE OVJNER/LESSER Salem HArborn,?vAlop��MANAGER/AGENT Salem PTODerty Manaoers NO P.O.BOX ADDRESS 102Lafavette Street ADDRESS102 Lafavette Street CTIY>STATEZIP Salem. MA 0197„0 CTTY,STATEZIl'�i�m, MA nla7n RESIDENCE PHONE BUSINESS PHONE(24HRS) 978 745-4961 BUSINESS PHONE_%78— 745-8071 TOTAL NUMBER OF ROOMS: "'f' ROOMUSE: Lhi,44-.K, 2. Liv,txliroR3.6.L� 4.T,1-rtu- 5. 6. 7. 8. 9. 10. THERE IS A SEVEN'T'Y-FWE($75)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEAL FEE IS PAYABLE THE TIME OF INSPECTION APPLICANTS SIGNATURE n DATE Inspectors use only Date on initial inspection: �2 Lf !n� Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling--Other—_--Check# d, L- Check date: f>� Notes: e Enforcement Ins for < f • CITY OF SALEM, MASSACHUSETTS BoARD of HP L,TH 120 WASIONGTON STREET,4.`FLooR TEL.(978)741-1800 KWERLEY DRISCOLL FAX(978)745-0343 MAYOR to Tnnt.COM jOANNESCOTT, HEALTH 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 ofresidential 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. Uwe 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 OwnerlLessor Address .Address Address on unit to be inspected Date CITY OF SALEM, MASSACHUSETTS ' + BOARD OF HEALTH 120 WASHINGTON STREET,4"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR D(7RE1;NRAUMaS Al A{M.(OM DAv1D GRL'.R.NBAUnI ACTING:HEALII-I AGFNP CERTIFICATE OF FITNESS CERTIFICATE#418-09 DATE ISSUED: 8/24/2009 Property Located at: 50 Palmer Street UNIT# 10 Owner/Agent: Salem Harbor Developers, LLC Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-4961 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 THHE��BOA> OF HEALTH A "" ' ° .J DAVID GREENBAUM ACTING HEALTH AGENT CTE�ORCNT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON S'.tREE"r,4"'FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR uco rQsmzK 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 FITNESS FOR HUMA HABITATION." SEE: JO PROPERTY LACATED AT 50 Palmer street , sa l em„ ma 01 @ 7 n UNIT#_,.19__ IS THIS UNIT DISIGNATEp AS RIGHT LEFT FR_ ON7 OR BACK PLEASE CIRCLE ONE OWNER/LESSER Salem HArborev?loRgxz •r>< c MANAGER/AGENT Salem Property Manaaers NO P.O.BOX ADDRESS 102Lafavette Street ADDRBSS102 Lafavette Street CITY,STATE,ZIP Sa 0m MA Q1970 CTTY,STATEZEP Gat P, ,. ntA n197n .. RESIDENCEPHONE BUSINESS PHONE(241IRS) 978 745-4961 BUSINESS PHONE-%2B----2A5---8k71/ TOTAL NUMBER OF ROOMS: to ROOM USE: 1kvirc>1.,., 6 BA-4-.1 7. 8. 9. 10. THERE IS A SEVENTY-FIVE($75)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEAL S FEE IS PAYABL T THE TIME OF INSPECTION APPLICANTS SIGNA E DATE C}I�A! Inspectors use only Date on initial inspection: 8hyA hnt Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling.__Other Check# _Check date:��/0-- /j� Notes: ode Enforcement p for CITY OF SALEM, MASSACHUSETTS • PIN BOARD OF HF ALTH 120 WASHINGTON STREET,4"`FLOOR T'EL(978)741-1800 KTMBERLEY DRISCOLL FAX(978)745-0343 MAYOR ISQQTr&AAMN COM JOANNE SCOTT, HEALTH 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. Uwe 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 Address Address Address on unit to be inspected Date 1 CONDiT,t � City of Salem, Massachusetts IV q Board of Health 120 Washington Street, 4th Floor, Salem, PablicHea ith MA01970 Prevent. Promote Protect. 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-1670 DATE ISSUED: 3/3/2016 Property Located at: 50 PALMER STREET UNIT#11 Owner/Agent: North Shore CDC Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 825-4018 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 / JJG� HEALTH AGENT ! // SANT RIAN � ll CITY OF S.A�l-EM, N'l 1SSACHIISE'ITS � . lit1. IMorHE,\LT11 1201 ASI-uNG'1'0� ST1tLL"r 4"' FUX1R TEL. ()73) 741-180(1 K1RfBERLEY DRISCOLL F\x()78) 745 0343 MAYOR I-RAAIDINONAJ.l Af.Cf;M 1,-tlttil'R:11t177N,R�i'It7:I-3S,C}-I<s,t;l'-!'5 I'1fi.1CCM 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 50 PALMER ST.. SALEM MA 01970 UNIT# 11 _ IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE NORTH SHORE COMM. OWNERILESSE SALEM HARBOR DEVELOPERS, LLC MANAGER/AGENT DEV. COALITION NO P.O. BOX ADDRESS 102 LAFAYE TTE ST. ADDRESS 102 LAFAYETTE ST. CITY, STATE,ZIP SALEM. MA 01970 CITY, STATE,ZIP SALEM. MA 01970 RESIDENCE PHONE, BUSINESS PHONE(241IRS) 978-745-4961 BUSINESS PHONE 978-825-4010 TOTAL NUMBER OF ROOMS: 4 ROOM USE: I.LIV. ROM 2. KITCHEN 2. BEDRM 3. BEDRM 4. 5. 6. T 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 PlkWLE IIAT THE TIME OF INSPECTION APPLICA'NT'S SIGNATURE Il DATE -3/// 2o/ 6 Inspectors use only Date on initial inspection:_03&j /ja, Date of reinspection: Date of issuance of certificate,,>yo Date fee paid: 03/02/261 Type of unit: Dwelli-- Other Check# 2,2,? Check date: 0'?/62-12b 14 Notes: Ca e fo ement In ctor I I y r CITY OF S.M.,EM, h'U1SSACHlitiZ,'I'TS 1;()ARD()r HF_1LTi-i 120�X%.1 H�tic,rz Srxr_Lr 4'II PLO rnz 'I*EL (97 8) 741-1800 KiNMERLEY MSCO.LL FAX (978)745-0343 MAYOR 1 te:v:rt i Ac 1-,.NT Release In accordance with Massachusetts General Laws Chapter i 11; 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 mylout absence. 1/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. i t! &i ,P -1 Rc&(60r `13eVe�0�3QY5. LC, lk—�)4 � /ro�er anaSerS Tenant/Lessee Owner/Lessor d,6 -PlMEr 51. ala !oa- 01(�7o . Address Address 5J�.�, 1'? A of��.ta /� i {{'� ,5© -"Imes- Sf• 1'1(11. /I Safe) PO 019 ? v Address on unit to be inspected 1 31, 1 ,E Dail t Updated 5/23/11 CITY OF SALEM, MASSACHUSETTS + . BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR DGREENBAUNIna SN.EN(.COM DAVID GREENBAUNI ACTING HI.rV.TI-1 AGENT' CERTIFICATE OF FITNESS CERTIFICATE#420-09 DATE ISSUED: 8/24/2009 Property Located at: 50 Palmer Street UNIT# 12 Owner/Agent: Salem Harbor Developers, LLC Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-4961 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 F HEALTH I \J DAVID GREENBAUM �� e� ACTING HEALTH AGENT CODeENFO�NT INSPECTOR CITY OF SALEM, MA.SSACHUSE"ITS Bo Am OF HEALTH 1 I 120 WASHINGTON STREET,4:m FLOOR I TEL. (978)741-1800 K1T%4BERLEY DRISCOLL FAX(978)745-0343 MAYOR j,%M 8 SA AM.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 FITNESS FOR HUMA HABITATION." FEE: SX-)O PROPERTYLACATWAT 50 Palmer Street, Salem, MA 01970 UNIT#_j._ IS THIS UNIT DISIGNATED AS RIGHT LEFT FRO T OR RACK.PLEASE CIRCLE ONE OWNER/LESSERSalem HArborTnev?lopgrz LL MANAGER/AGENT Salem Property Managers NO P.O.BOX ADDRESS 102Lafavette Street ADDRkSS102 Lafavette Street CTTY,STATE,ZIP Salem. MA Q1970 CTTY,STATE,ZIP aalem, ntA 0197n _ RESIDENCE PHONE BUSINESS PHONE(24HRS) 978 745-4961 BUSINESSPHONEg7$— 745-$0711 TOTAL NUMBER OF ROOMS: 7 ROOM USE: 1.�;}moi. _. 2.��y.�41na.1m 3. R"" 4. VA-t," 5. 6. 7. 8. 9. 10. THERE IS A SEVENTY-FIVE($75)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH S FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANTS SIGNATUttk L z/,'0- DATE /7 6 ItlsDectors use only Date on initial inspection: Pate Date of reinspection: Date of issuance of certificate: -� Date fee paid: Type of unit: Dwelling_Other Check#"a/.. 7 Chock date: Notes: �Cede Enforcement or r • CITY OF SALEM, MASSACHUSETTS RPM BOARD OF HEALTH 120 WASfUNGTON STREET,4m FLOOR T)R- (978)741-1800 KMERIHY DRISCOLL FAX(978)745-0343 MAYOR ySCOTDRSAMM.COM JOANNESCOTT, HEALT14 AGENT Release In accordance with Massachusetts General Taws Chapter 111;Code ofMassachusetts 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 ofresidential 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. Uwe 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 Address Address Address on unit to be inspected Date I - CITY OF SALEM. MASSACHUSETTS y/ BOARD OF HEALTH 120 WASHINGTON STREET,4r"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FA%(978) 745-0343 MAYOR txaa a:wsnuM�ilsM a:nccom DAVID GREF.NBAUM ACTING HI-�ll:TH AGENT CERTIFICATE OF FITNESS CERTIFICATE#421-09 DATE ISSUED: 8/24/2009 Property Located at: 50 Palmer Street UNIT# 13 Owner/Agent: Salem Harbor Developers, LLC Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-4961 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 COPY ENFORCE-KENT INSPECTOR I CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 1 ( ( V 120 WASHINGTON STREET,4T"FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR Iz orrRa�� ,t t.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 FITNESS FOR HUMA HABITATION." FEE: SZOO PROPERUNIT# Street. m, a42 13 IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER Salem HArbornQvQloPe.� MANAGER/AGENT Salem Property Manaaers NO P.O.BOX ADDRESS 102Lafavette Street ADDRESS102 Lafavette Street CITY,STATUIP Salem. MA 01970 CTTY,STATEZIP,Sgjem_ Mn n19'7Q _ RESIDENCEPHONE BUSINESS PHONE(241IRS) 978 745-4961 BUSINESS PHONEg78- 7d5-8071 TOTAL NUMB // ER OF ROOMS: t( ROOM USE: I"1101- 211u.ILMI 3.g io. fan d.l�L t ►A 5. iR,Lt (_> 4�► 7. 8. 9. 10. THERE IS A SEVEN'T'Y-FIVE($75)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANTS SIGNATURE DATE �e) Inspectors use only Date on initial inspection: gI?4 /?lot Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check# "q C."> Chock dater Notes: - e Enforcement�or r .. r" CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHING ON STREET,e FLOOR TEL.(978)741-1800 KWERLEY DRISCOLL FAX(978)745-0343 MAYOR IWO_MQQaA=.COM JOANNESCOTT, HEALTH AGENT Release In accordance with Massachusetts General Laws Chapter 111;Code of Massachusetts Regulations 414.000 et. Seq. ; State Sanitary Code Chapter R 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 i . Address Address Address on unit to be inspected Date CITY OF SALEM, MASSACHUSETTS r 'I BOARD OF HEALTH - 120 WASHINGTON STREET,4".FLOOR TEL. (978) 741-1800 HIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR I)GRI I',NII ALIpInSALL:M1LCOM DAVID GREENBAUM ACTING HGALTii AGF.N,r CERTIFICATE OF FITNESS CERTIFICATE #401-09 DATE ISSUED: 8/24/2009 Property Located at: 50 Palmer Street UNIT# 14 Owner/Agent: Salem Harbor Developers, LLC Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-4961 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 W' 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 T�A�F HEALTH I DAVID GREENBAUM /Qo2 SM ACTING HEALTH AGENT CLOIIELENFOR ENT INSPECTOR • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4:m FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR. )sco 5.10ETt.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 FITNESS FOR HUMA HABITATION." FEE: SX—)O PROPERTY LACATED AT 50 Palmer Street. Salem. MA 01970 UNIT# 14 IS THIS UNIT DISIGNATED AS gigiu LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSERSalem HArbornev?lo _ex_ ,LLC MANAGER/AGENT Salem PrODerty Managers NO P.O.BOX ADDRESS 102Lafavette Street ADDRESS102 Lafavette Street CITY,STATEZIP aajem MA 07970 CTTY,STATE,ZIP- lem., Mn f)197n , RESIDENCE PHONE BUSINESS PHONE(24BRS) 978 745-4961 BUSINESS PHONE_%I - 745-80/7_] TOTAL NUMBER OF ROOMS: 1P ROOM USE: 1.9344., 2.KQ. Q,&A 3. La .0,+.. 4. 5.044-ri 6.P4-LK 7. 8. 9. 10. THERE IS A SEVEN'T'Y-FIVE($75)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH E IS PAYABLE AT THE TIME OF INSPECTION APPLICANTS SIGNATUREf DATE f / Inspectors use only Date on initial inspection: �Z/a� !o q Date of reinspection: Date of issuance of certificate: Date fee paid: / Type of unit: Ihvelling� , Other Check# a D Check date: Notes: Gv1F`nforc=cnt p or CITY OF SALEM, MASSACHUSETTS ` BOARD OF HEUTH 120 WASHINGTON STREET,C FLOOR TEL.(978)741-1800 K-MBERLEY DRISCOLL FAX(978) 745-0343 MAYOR WM &aTaM com jOANNESCOTr, HEALTH AGENT Release In accordance with Massachusetts General Laws Chapter 111;Code ofMassachusetts 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 ofresidential 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. Uwe expressly authorized the same and for my/our suers 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 Address Address Address on unit to be inspected Date City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, PublicHCalth 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-16-26 DATE ISSUED: 1/27/2016 Property Located at: 50 PALMER STREET UNIT#15 Owner/Agent: North Shore CDC Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 825-4018 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 L4, Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAPF i g i CITY OF SALEM, NLA sSACHUSETTS BOARD OF HEALTH 120 W'ASH1NGT(1N S"rREL:T 4". FLo()R TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 LwOR LIZAAID[N(a�S.MY.M.CoM L.-\RRl'RA DIN,RS/IiI I-IS,(:I-iU,(:])-PS HH,\LLH 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 50 PALMER ST.. SALEM MA 01970 UNIT# 15 IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE NORTH SHORE COMM. OWNER/LESSE SALEM HARBOR DEVELOPERS. LLC 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 2. BEDRM 3. BEDRM 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 PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATE Inspectors use onlv Date on initial inspection: I [-AS IIO Date of reinspection: Date of issuance of certificate: g , Date fee paid: Type of unit: Dwelling JI l Other Check# 1 Check date: Notes: A - #(6-R6- Code EtWorce ent Inspector V10mcr &w1�sti�cdc,rn) r 400 CITY OF SALEM, MASSACHUSETTS 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#608-05 DATE ISSUED: 9/29/05 Property Located at: 51 Palmer Street UNIT# 1 Owner/Agent: Lafayette Housing Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-4961 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 OFHEALTH JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR r G' It CITY OF SALEM, MASSACHUSETTS ♦! BOARD OF HEALTH , \n , 120WASHINGTONSTREET, 4TH FLOOR < SALEM, MA 01970 TEL. 978-741-1800 C n I . FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT / co € y'T APPLICATION FOR CERTIFICATE OF FITNESS y IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED ATS I _/'Jb_&yv," _s& UNIT#1 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER Lafay tte-lians' nT_MANAGER/AGENT3alem Progezty Managers, No P.O. Box No P:O. Box ADDRESSin') T.afayo++o c+ ADDRESS102 Lafavette Street CITY-,, Salem CITY Ra11 am RESIDENCE PHONE BUSINESS PHONE (24 HRS.p78- 745-4961 BUSINESS PHONE 978 745-4961 TOTAL NUMBER ROOMS ROOM USE: 1. � 2.� _ C� 3. 4. 5J&j 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 DATF INSPECTORS USE ONLY DATE OF INITIAL INSPECTION - Y -0-7, DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:',1�3 DATE FEE PAID: % a -Z- TYPE TYPE OF UNIT: DWELLING//�OTHER_ CHECK# / / CHECK DATE_f1 -y.Le Y NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 t CITY OF SALEM9 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#506-07 DATE ISSUED: 10/12/2007 Property Located at: 53 Palmer Street UNIT#2 Owner/Agent: Lafayette Housing Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-4961 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 W' 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 ccupancy. FOp THE BOARD OF HEALTH JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR _ CITY OF SALEM, MASSACHUSETTS ... '� BOARD OF HEALTH i 120 WASHINGTON STREET, 4TH FLOOR � r 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 UNIT# IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER_,Lafavette HousinctLPMANAGER/AGENT Salem Property Managers No P.O. Box No P.O. Box ADDRESS 1n9 T.afavette Street ADDRESS102 Lafavette Stret CITY Galem, Ma 01970 CITY Salem, MA 01970 RESIDENCE PHONE BUSINESS PHONE (24 HRS.) 978-745-4961 BUSINESS PHONE 978-745-8071 TOTAL NUMBERR OF ROOMS: L/)ROOM USE: 1 .I 2. � 4;&,-A---4. eWO� — 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 N /WO >SPE TORS USE ONLY DATE OF INITIAL INSPECTION /D ' I L v DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE lU - z °7 DATE FEE PAID: o ' /D - D 7 TYPE OF UNIT: DWELLIN ' OTHER CHECK# 1, CHECK DATE Z V —v� NOTES - CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS 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#610-05 DATE ISSUED: 9/29/05 Property Located at: 53 Palmer Street UNIT#3 Owner/Agent: Lafayette Housing Address: 102 Lafayette Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-4961 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 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH / i 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 II/V/1_J III U TEL. 978-741-1800 FAX 978-745-0343 STANLEY U-OVICZ, 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 Fw HUMAN HABITATION". PROPERTY LOCATED AT , ' )Z) UNIT#_3 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER Lafayette HrniGina MANAGER/AGENTSalem Property Managers , No P.O. Box No P.O. Box ADDRESSI ng T.Af;%y, i-+A cF ADDRESS102 Lafavette Street CITY.-. Salem CITY sal em RESIDENCE PHONF BUSINESS PHONE (24 HRS.p78- 745-4961 BUSINESS PHONE 978 745-4961 TOTAL NUMBER OF ROOMS,: ROOM USE: 14(d�' 2. (1v�, 3. 444tw4. 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 INSPECTORS USE ONLY DATE OF iNI T iAL INSPECTION ' ?11'--v ' DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE. -a S_ " J' DATE FEE PAID: TYPE OF UNIT: DWELLIN9(�OTHER_ CHECK# // 3 b' CHECK DATE Z e NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 o CITY OF SALEM, MASSACHUSETTS y 3� BOARD OF HEALTH C � = 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#546-05 DATE ISSUED: 8/25/05 Property Located at: 54 Palmer Street UNIT# 1 Owner/Agent: Carlos Huaman Address: 21 Southwick Street#2 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 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. FORTH E BOARD OF HEALTH JOAA�COTT, PH, RS, CHO HEAL AGENT CODE ENFORCEMENT INSPECTOR I ?? OS 0259p Joanne Scatt Salem BOH 978 745 0343 P. 2 " CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • • 124 WASHINGTON STREET, 4TH FLOOR { �f -Inn SALt M, MA 01970 TEL. 978-741,1800 FAX 978-745-0343 STANLEY USOVIC7, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGCN'I APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAAN� HABITATION". y� PROPERTY LOCATED AT_�2 / �%� �[LIPCLFrT UNIT#, —h - --1 - IS THIS UNIT DESIGNATED AS RIGHT LEFT F ON BACK PLEASE CIRCLE ONE OWNERILES�SP-R_L.C�-i (:If _A)WAax{ --MANAGERIAGENT. ADDRESS Box Si �,� 11 y}�i �k caL.<—, ADDRESSi„_..._. .�_. CITY. r?.6--on?a CITY— _ RESIDENCE PHON,E�y;;��""�� BUSINESS PHONE (24 HRS.)_.— BUSINESS PHONE �._q.V_=�, ,5 _ TOTAL NUMBER OF ROOMS: 4 av-oov�-- ROOMUSE: to " , 28 11 � 3UVXW4.UU1tAq M" THERE IS A TWENTY-FIVE($25.00)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEIA HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPFCTION. APPLICANTS SIGNATURE -- . .DATE c122I c INSPECTORS USE ON[ Y DATE OF INITIAL INSPECTION r �U'_/7DATE OF REINSPECTION. ...... - DATE OF ISSUANCE OF CERTIFICATE:- r DATE FEE PAID: TYPE OF UNIT: DWELLIN OTHER_ CHECK#_Z,�_ f _CHECK DAT --?iZ- NOTES CODE ENFORCEMENT INSPECTOR 9/28198 1I g 17 OS 02: 59p Jeanne Scott Salem BOH 978 745 0343 p. 3 CITY OF SALEM, MASSACHUSETTS a BOARU OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR 9ALMM. MA 0107 TEL. 978.741-1800 IrA% 978-745.0343 - SI'ANLEY USOVIC'Z-1n' JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT RELEASE in accordance with Massachusetts General Laws Chapter IIf ; Code of Massachusetra Rnpulatinr.a 410.000 Or. seq. ; State Sanitary Code Chapter 1I and Article %I11 of the City of: Salem Ordinance, undersigned owner/lessor and tenant/lessee oP a UDIL of residential property, hereby authorize the Salem board of health or its author- ize[ afenttl to in9perr the residence identified below in accordance with the aiorementioaed statutes, regulations and ordinances. In the evert it is necesRnrp that' said inspection be done in my/our absence, 1/we expressly .guthorizc the same and for my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of 9ealth and its authorised a,-etc! ! f:-om any loon or i.ojury sust.,ined of whatever nature and description occasioned by my/our absence during said inspection. '7'" i:tTll.0+s£r 0*dNER i°SSCK � lu1i1?iESS ADDRESS o 690 ADDRESS OF UN)'I' TT-15' IN>l'liCTr:D .. .iC—..r'! C(aal - --- -- --- kv- fI I rr CITE' OF SALEM, MASSACHUSETTS b lir)ARI)O1� HF\I:1I i 1�0`V.\SffINGT(INSI'RIIi'I' 41=Ux)R T a.. (978) 741-1800 11DiBG1t1,125' llRIS�X>1,1.' FAX (978) 745-0343 `»OR lramdin(a�salem.cnm 1'A18121" R,\,,\I1)IN,RS/1i :.11 S' I 1-11::,\i,j I A(I1 \"I' CERTIFICATE OF FITNESS CERTIFICATE#364-11 DATE ISSUED: 9/28/2011 Property Located at: 56 Palmer Street UNIT# 1 Owner/Agent: Jupiter II LLC Address: 12 Main Street City/Town: Medford, MA Zip Code: 02155 24 Hour Phone: 781-595-0100 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 D OF HEALTH /pA LARRY RAMDIN HEALTH AGENT CODE ORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH ' 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 K NIBERLEY DRISCOLL FAX(978) 745-0343 N/LwOK uenau Nnsnu.r.Lcon LARRI RANfl)IN,RS/IZFI-IS,CI Rl, HFAi jI A(;vxI' Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" j / FEE: W150.00 PROPERTY LOCATED AT ,I b I�W Lm N t J UNIT#—,L ISIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER rll®o {/d' � I'L G MANAGER/A�GGENTJ 1"Ager t� i0f/�� ADDRESS �Z YYIAJN�—S) ADDRESS 1/� U.e IIAI CITY, STATE, ZIP P7e9/ 19/Ld1 )VA D7//_f CITY, STATE, ZIP ��/'rwl�, "d/U 0007 RESIDENCE PHONE ✓ BUSINESS PHONE(24HRS) 7/ ��f �)O 0 BUSINESS PHONE lb FSf d/0 0 TOTAL NUMBER OF ROOMS: S1 ROOM USE: 1. VeA 2. 3. 7'e 0 4. b)V rl 5. F#r 6. 7. 8. 9. t/ 10. THERE IS A FIFTY($50)DOLLAR FE , P L Y C ECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS P LE E F INSPECTION APPLICANT'S SIGNATURE _ DATE Inspectors use onlv Date on initial inspection: ��l('� Date of reinspection: Date of issuance of certificate: q 11 Date fee paid: Type of unit: Dwelling / Sa Check date: C i 11 Notes: C e Enfo cement Inspector t CITY OF SALEM, MASSACHUSETTS 10 B(),1RD OF HF ALTH 120 WASHINGTON STREET,4°.FLOOR PablicHealth , TEL. (978)741-1800 FAx(978) 745-0343 KIMBERL.EY DRISCOLL Iramdin rnisalem.com MAYOR L,\RRl'R.\1lUIN,RS/lilt IS,CFIO,CP-I+S I Iu,\Ln 1 AG HNT CERTIFICATE OF FITNESS CERTIFICATE#266-14 DATE ISSUED: 7/31/2014 Property Located at: 56 Palmer Street UNIT#2 Owner/Agent: Jupiter Two LLC Address: 12 Main Street City/Town: Medford, MA Zip Code: 02155 24 Hour Phone: 781-595-0100 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 Certrficate 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 OFHEALTH LA44 RAMDIN HEALTH AGENT SANITARIAN I� I e o � CITY OF SALEM, MASSACHUSETTS BOARD OF HE:\LTH 120 WASHINGTON STREET 4...FLOOR PubHcHeaM STREET, plly `Pmmam.pw.e '. TEL. (978)741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL lramdinna.salem.com MAYOR LARRY lt,\DiUIN,RS/REI-IS,CI K),CP-I'S HFC,\i;n I 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 �� — Z ! `"I Wl eA, 9 0.I - UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE / OWNER/LESSER MANAGER/AGENT Z" Oc ' NO P.O. BOX ADDRESS /Z. 19:7""VADDRESS 1;>7'Ed r0 yZD CITY, STATE, ZIP 0 2 1-5 '5 ''� v rdn� CITY, STATE,ZIP O 2 /.S.J5 RESIDENCE PHONE 791—545 " d /0-0 BUSINESS PHONE(24HRS) BUSINESSPHONE TOTAL NUMBER OF ROOMS: 40 7 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 AT THE TIME OF INSPECTION APPLICANT'S SIGNATURR_ " __ - -,,� DATE Inspectors use only Date on initial inspection: h I31 '�4 Date of reinspection: Date of issuance of certificate: Date fee paid: n Type of unit: Dwelling Other Check# :/nCheck date: 130 I I Notes:Ulf' N1 ouuy 1`Ze4 ,re !Je L^.1'Ono[di Cod n cement Inspector CITY OF SALEM, MASSACHUSETTS BOARD oi;HEA1 XII 120 WASHINGTON STRUT,4°1 TEL. (978) 741-1800 KiM13ERLEY ll12iSCOL,L FAX (978) 745-0343 LVLtWOR Immdui a.salenixom LARRY RMIAN,RS/1w.1 IS,f.l I(�,f 1)-1'S HR.ACH I AGI::N'I' CERTIFICATE OF FITNESS CERTIFICATE #468-11 DATE ISSUED: 11/7/2011 Property Located at: 56 Palmer Street UNIT#3 Owner/Agent: Jupiter II LLC Address: 12 Main Street City/Town: Medford, MA Zip Code: 02155 24 Hour Phone: 781-581-8060 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 d LAR � HEALTH AGENT CODE ENFORCEMENT INSPECTOR 's • � CITY OF SALEM, MASSACHUSETTS ) • @ BOARD OF HEALTH 120 WASHINGTON STREET,4r..FLOOR TEI•. (978)741-1800 KIMBERLEY"DRISCOLL, FAX(978) 745-0343 MAYOR LRAMIANOSA1.VNI. cn<I LARRY RAMIAN,RS/RH IS,CI 10,CP-FS I I H,V:I'I I AGI•:N'r 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(O .11,9.4114e-k UNIT# �IS THIS UNIT D19IGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE - OWNER/LESSER J t/Pl%�� LGA✓ MANAGER/AGENT IAow---/ 1�gV40'*A.11 Re,-� Pe NO P.O. BOX j47 ADDRESS y� JG ADDRESS � �I �✓ C, CITY, STATE,ZIP /U/�0/"G/ , �'12�t 07-If CITY, STATE,ZIP Jf f�,�n'PfG°� RESIDENCE PHONE BUSINESS PHONE(24HRS1 �✓ �d d BUSINESSPHONE 7F,/ TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FE ABLE B CHECI OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS P ABLE AT ECTION APPLICANT'S SIGNATURE / DATE InsDectors use onlv Date on initial inspection: III 1 I I I Date of reinspectior �� Date of issuance of certificate: d I'I I I I Date fee paid: 1 Type of unit: DwellingOther Check# ,S3 3 Check date: 11 /7/11 , Notes: C e Enfor ent Inspector • CITY Or SALEM, MASSACHUSETTS $ BOARD OF HEALTH 120 WASHINGTON STREET,41°FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx (978) 745-0343 MAYOR 1AANJ1nNaSA1.FN1.(0N1 LARRY R,\NIDIN,1ZS/RIiI IS,010,CP-FS HFAL 11A(;FN,r Release In accordance with Massachusetts General Laws Chapter 11;; 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. 4Tenant/ e Owner/Lessor Address Address Address on unit to be inspected Date Updated 5/23/11 CERT.# 685-97 3 + FEE $25.00 DATE: 10/01/97 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 _U:RTTFICATE OF FTTNESS PROPERTY LOCATED AT: 56 Palmer Street UNIT #: 4 OWNER/AGENT: Aser Frisch ADDRESS: P.O. Box 621 CITY/TOWN: Swampscott. MA ZIP CODE: 61907 24 HOUR PHONE: 592-8858 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 t ) MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: . NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LFAD LAW FOR OCCUPANTS UNDER 6 YEARS OF AGE. FOR THE BOARD OF HEALTH aA Lk� JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR i t a�7 ' CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,AS,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 (�(!� UNIT I l OWNER/LESSER_ 1 &L MANAGER/AGENT < �1 ' ADDRESS �(j Z ADDRESS CITY ��Gec�C–, '`� YZ14C)� CITY RESIDENCE PHONE BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: �} ROOM USE: 1. 2. 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 S FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANTS SIGNATURE DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION: DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: /6) –f—4'7 DATE FEE PAID: TYPE OF UNIT: DWELLING OTHER NOTES: CODE ENFORCEMENT INSPECTOR l ' v � 1n CERT.# 293-98 3 �€^ FEE $25.00 DATE: 05/14/98 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: 58 Palmer Street UNIT #: 1 Front OWNER/AGENT: Michael Donahue ADDRESS: P-O- Box 462 CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 307-3727 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,/OFF HEALTH e JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR 0 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET Tel:(978)741-1800 HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Fax:(978)740-9705 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESSS FOR HUMAN HABITATION". �� PROPERTY LOCATED AT �� I'AU7i 1� S7 UNIT#!I / IS THIS UNIT DESIGNATED ASIR GHT LEF F O BACK PLEASE CIRCLE ONE OWNER/LESSER /UHAFC- ,hvAm,�F_ MANAGER/AGENT `< 111A ADDRESS P-7 l oX 41(07 ADDRESS CITY SALEM/ CITY RESIDENCE PHONE \ BUSINESS PHONE (24 HRS.) BUSINESS PHONE( ' ',?A TOTAL NUMBER OF ROOMS: ROOM USE: 1. I�p ,�2.lzedwom3.i 4. vs� ru fti 5.I6 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 ^,"I7r41eI77,F INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 11 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATElV /C>DATE FEE PAID: J l Y TYPE OF UNIT DWELLING OTHER NOTES: CODE ENFORCEMENT INSPECTOR 5/19/98 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. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 1/24/05 Michael Donahue c/o Brian Bridge RE TR P.O. Box 4522 Salem, MA 01970 PROPERTY LOCATED AT 58 Palmer Street Unit 1 R 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 All 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 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. to 7:00 p.m. and Friday 8:00 a.m. — 12:00 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 tenant's entire utility bills retroactive to the date of initial occupancy in cases in which cross-metering has been proven to exist. the Board of Healt Reply to oanne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4°1 FLOOR TEL. (978) 741-1800 IQMBERLEY DRISCOLL FAti(978) 745-0343 MAYOR Dciirr.NB,wNIOr ,\r.nNI.CONt D,\vru GRFENBAum,RS ACTING HL,11:11i AGIiNT CERTIFICATE OF FITNESS CERTIFICATE #388-10 DATE ISSUED: 8/16/2010 Property Located at: 58 Palmer Street UNIT#2 Owner/Agent: Carlos Huaman Address: 21 Southwick Street#1 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 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 HEALTH ttm DAV ACTING HEALTH AGENT CODE ENFEMENT INSPECTOR `& CITY OF SALEM. MASSACHUSETTS �b BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR WRE1:NRA1-1m0e LE .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 tOPERTY LOCATED AT C VAS \z� r\rsc>� UNIT# I5 THIS_UNIT11DISIGNATED AS RIGHT LEFT FRONT O AC PLEASE CIRCLE ONE WNERAMSER C('cv I v� t- -4,M&4�\ MANAGER!AGENT )P.O. BOX `� ff 3DRESS 2 I Saj V u C17 �'� 1 ADDRESS TY, STATE,ZIP 5r.,\k,% wi► 0 Ckt +O CITY, STATE, ZIP �} iSIDENCE PHONE "2 I b ' 2 4.� BUSINESS PHONE(24HRS) 7SINESS PHONE )TAL NUMBER OF ROOMS:-A �..�' `` )OMUSE: I.'kGAW-n 2.A�lS`Ar�3M 3bAvr)3N\ 4.�X-,( DrA\5.P)tAxzu y\, 6. 7. 8. 9. 10. ERE IS A FL1 Y($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BARD OF HEALTH THIS FEE IS-PAYLE AT THE TIME OF INSPECTION I J ` PLICANT'S SIGNATURE gJ DATE Inspectors use only e on initial inspection: X /l& ro. Date of reinspection: e of issuance of certificate: t� �J l�p //,, Date fee paid: 9/j(p/f o Wo ie of unit: Dwelling Other Check# 10 & q& G�/ Check date:_��f&, es: e EnforcInspector CITY OF SALEM, MASSACHUSETTS • BOARD OF HEALTH 120 WASHINGTON STREET,41 'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR D6RI?I?Ni1AUMnp 5A1.liM.COM11 DAVID GItIi.ENBAUM ACTING HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#275-10 DATE ISSUED: 6/9/2010 Property Located at: 58 Palmer Street UNIT#3 Owner/Agent: Carlos Huaman Address: 21 Southwick Street#2 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. FOR THE BOARD OF HEALTH i D VIA D GR ENBA ACTING HEALTH AGENT CODVNFORCEML2NT INSPECTOR CITY OF SALEM, NIASSACHUSETTS BOARD OF HEALTH 120 W-ASHINGTON STREET,4O.FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978)745-0343 MAYOR DGREENBAUM(70 SALEM.COM DAVID GREENBAUM, ACTING HFALTH 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." �p (� q FEE: $$55`0.00 'n ,,r PROPERTY LOCATED AT J D 1"C Le-V- !S `S�Q eAA4 P 1()' nt` 06 UNIT# S IS THIS UNIT DISI'�GgqNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER� .00 f. omuA-c-cuk/� MANAGER/AGENT c �P ADDRESS � JU010"F�'" 'kJkL%�^r�F/_�L�`,ADDRESS CITY, STATE, ZIP �Q� �7i`S/Vt�}(3 IgZ)CITY, STATE,ZIP RESIDENCE PHONE C)e4B s�O' b 1� I BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. LV )�M 2. 101, 3. 'R ICA 4. sru- 5. 8 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 PAYABE,AT THE TIME 'O�F^ INSPECTION APPLICANT'S SIGNATURE ( U,M ag5 /�- o-e l-l� DATE 6 -q- 10 InSDectors use only Date on initial inspection: <(CI ( 10 Date of reinspection: -t Date of issuance of certificate: Date fee paid: t / Type ofDwelling Other Check# )77 Check date: Notes: l t: V lea!vim- l �n(oc7iv! �kWt 47 )W k-5+ f i Y T-AEf i),0 +U C e nforcement Inspector CITY OF SALEM, MASSACHUSETTS .� BOARD OF HEALTH 93 120 WASHINGTON STREET, 4TH FLOOR CERT.# 182-03 SALEM, MA 01970 FEE $25.00 .� TEL. 978-741-1800 DATE: 05/02/2003 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 58 Palmer Street UNIT #: 3 Front OWNER/AGENT: Bainbridae Realtv Trust ADDRESS: P.O. Box 4522 CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 590-1479 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 NOR BUILDING RELATED CODES. FOR MORE INFORMATION CALL 978-741-1800 . FOR THE BOARD �OF `HEALTH � V JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR i 1 CITY OF SALEM, MASSACHUSETTS j- BOARD OF HEALTH a 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY LISOVICZ, 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 FORHUMANHABITATION". PROPERTY LOCATED AT ��7�'�FK UNIT# 3 IS THIS UNIT DESIGNATED ASRIGHT LEFT RON BACK PLEASE CIRCLE ONE OWNER/LESSER AIA-I 01196 ;?ft/ MANAGER/AGENT No P.O. Box /y"' 1 No P.O. Box ADDRESS 5b & `/S�Z ADDRESS CITY SAW,-7 /7/4 o/c3'�G CITY RESIDENCE PHONE BUSINESS PHONE (24 HRS) S� 1_)G�L/77� BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1.Znni__v`nn. Z 2. CLA 3. ; 4. �n 5. x_6. 7. 8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEA1 T- RTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE 6 it lee DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION a -n DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: 5"'D- '01, DATE FEE PAID: -5-- a 3 TYPE OF UNIT: DWELLING OTHER_ CHECK# CHECK DATES -o> NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 C11'Y C?I' Sn1..1=?l\9, 1VIt\tiSAt:;IiUSE'I"1'S BOARD OF I{HAL11I 120 WASHI NGT ON S i'REFx,4`..FLOOR �C�Ith. EL. {978) 741-1800 FAX ()78)745-0343 KIMSERLEY DWSCOLL lramdinnsalem.com - LARRY IiAnID1N,x$f Rtil IS,CH), CERTIFICATE OF FITNESS CERTIFICATE#103-12 DATE ISSUED: 312012012 Property Located at: 58 Palmer Street UNIT#4 Owner/Agent: Carlos Huaman Address: 21 Southwick Street#2 City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-210-8189 An inspection of your vacant Dwelling/Rooming U,*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 OF HEALTH LARK `RAMDIN ' I�� 7✓ i HEALTH AGENT CODE ENFORCEMENT INSAECTOR TRANSMISSION VERIFICATION REPORT TIME 03/22/2012 21: 59 NAME FAX 9787450343 TEL 9787411800 SEP..# 000BON341991 DATE,TIME 03122 21:59 FAX HO. /NAME 919783364799 DIURATION 00: 00: 22 PAGE{S} 01 RESULT OK MODE STANDARD ECM i � � �� '� � � � �� ..•ma'"'"r __---- • CITY OF SALEM, MASSACHUSETTS J B0,1RD OF HEAI.,I'Fi 120 WASHINGTON S'CRHF'I',41°FI.00IZ TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX (978)745-0343 NL\YOR 1.RANIDIN(a.sm.Itrol.c(mI I..AIIRY RAMDIN,IISIRHI IS,(:I 10,(:P-PS HFAL I'I I A(11;N'1' Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITAIRY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" qq FEEL: $50.00 PROPERTY LOCATED AT �() PbJ �"1� 5 1 L� /q 0191 UNIT# Ll �. IS THIS UNIT DISII-GNATED.AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWN /LESSER � I CXS �,�t� (�ZAA MANAGER/AGENT NO P.O. BOX �11 '' `— ADDRESS "N�I�R�\Cc� ADDRESS CITY, STATE,ZIP '-�A el A MI/�1 Dl '�40 CITY, STATE,ZIP M RESIDENCE PHONE BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. VI K 2. LP— 3. BZ 4. 32 03 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 1 c,X � APPLICANT'S SIGNATURE K I( wxu1 ' DATE Insnectors,use onlv Date on initial inspection: Date of reinspection: Date of issuance of certificate: -2_s - 1Z Date fee paid: 3"'2,0 -YL Type of unit: Dwelling ✓ Other Check# Check date: Z - ?�-W Notes: Code Enforce ent Inspector I