PARADISE AVENUE PARADISE AVENUE
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is
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
CERT.# 162-03
SALEM, MA 01970 FEE $25.00
TEL. 78-74 1 0343 DATE: 04/23/2003
FAx 978-745-0343
STANLEY USOVICZ, JR. ,JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 11 Paradise Avenue UNIT #: 1
OWNER/AGENT: Angelo Meimeteas
ADDRESS: 123 1/2 Boston Street
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 740-1854
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
JOANNE SCOTT, MPH,RS,CHO
HEALTH,AGENT CODE ENFORCEMENT INSPECTOR
i
1
ti CITY OF SALEM, MASSACHUSETTS
� BOARD OF HEALTH Q
• 120 WASHINGTON STREET, 4TH FLOOR
e 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 ! / P I J I S L' A L/ UNIT#
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE�CIIRCLEe ONEn d -A
OWNER/LESSER fgoo jjo U�lelwl�Qfi�QMANAGER/AGENT � 1�.YO MP-1�1e,1C0.S
No P.O. Box nn �Ilo P.O. Box
ADDRESS fa 3 �6 DDRESS
CITY__ ✓-)Lc e7m CITY
RESIDENCE PHONE 978-7'f074 BUSINESS PHONE (24 HRS.) —7Ei
BUSINESS PHONE 017 f - 76 ) "Cn;2-9 4
TOTAL NUMBER OF ROOMS: S
ROOM USE: 1. gPcQ QfN12. eclRA 3_1�e4t 4. tl
5. c c` 6. 7. 8.
THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM H LTH DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATURE DATE
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION N - ' 3 —0 S DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: 3 —03 DATE FEE PAID:
TYPE OF UNIT: DWELLINGbeOTHER_ CHECK# /76 o CHECK DATE �a 3
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98