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PARALLEL STREET PARALLEL STREET CITY OF SALEM9 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#396-04 DATE ISSUED: 08/26/2004 Property Located at: 1 Parallel Street UNIT# 1 Owner/Agent: 3JS Salem Realty Trust Address: 1 Malone Drive City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 617-908-0116 An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR410.000: 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 OF HEALTH JOANNE SCOTT, MSH, RS, CHO �- 90 14a-y HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS 9 '� BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 4FAX 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 / / A�44w J � UNIT# f IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEAAS/SE����CIRCLE ONE OWN ER/LESSE 6f " MANAGER/AGENT �� sd/YlE,S No P.O. Box / No P.O. Box ADDRESS / /off- r ADDRESS CITY ��e�,�.�+�7yfA� 06V�r7O CITY q RESIDENCE PHONE'// f'7V_0/ BUSINESS PHONE (24 HRS.)6I7- ieP-D/Uo BUSINESS PHONE TOTAL NUMBER OFF ROOMS: ROOM USE: 1.V 2. 3. 4. ' 5. 6. 7. 8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE=USE PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF EE IS PAYABLE AT THE TIME OF INSPECTION. t� APPLICANTS SIGNATUREDATE DATE OF INITIAL INSPECTION DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: a- -ItO DATE FEE PAID:"' 4 TYPE OF UNIT: DWELLING OTHER_ CHECK#_ �Q-q CHECK DATE p NOTES: �. 4e is CODE ENFORCEMENT INSPECTOR 9/28/98 III SENDER: COPPLETE THIS SECTION COMPLETE THI&SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. azure item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse V Addressee so that we can return the card to you. R. ec i d by(Printed Name) C. Da of Def ery ■ Attach this card to the back of the mailpiece, or on the front if space permits. D. Is elivery address different from Rem f s 1. Article Addressed to: If YES,enter delivery address below: 0 No Three Js Realty Trust 1 Malone Drive Salem, MA 01970 3. Service Type ti 0 Certified Mail 0 Express Mail (1 Parrallel St. 411) PV 0Registered O Return Receipt for Merchandise ❑ Insured Mail 0 C.O.D. 4. Restricted Delivery?(Extra Fee) ❑yes z. Article Number , . , 7003,-3110 0005 1992 (Transfer from service IabeQ PS Form 3811,August 2001 Domestic Return Receipt - 102595-02-M-1540 , A UNITED STATES POSTAL SERVICE J'FifstMail US S j g"s 0s 8,Fees Paid - - — PertNo.G--1 • Sender: Please prinf'y66rAarria, address;-and-Z]P+4-in this box JY ,%D OF HEALTH M, MA 01970 AUG 2 3 2004 CITY OF SALEM AQ.A.RQQF= i4FzAI1H Ifilillidlilk till 1w.111ilit IMPORTANT MESSAGE FOR V ' I A.M. DATE(} 2� u 4' TIME M k Ji9�J ��ITL Q OF PHONE \D (-A- 90% O t AREA CODE NUMBER EXTENSION O FAX O MOBILE AREA CODE NUMBER TIME TO CALL TELEPHONED j PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE.YOU RUSH RETURNED YOUR CALL WILL FAX TO YOU MESSAGE 4-11�1 LS C9�� fT- QCc�,1 SIGNED 41%psFORM 4009 MARE IN LLS. NOTES IMPORTANT MESSAGE 'FOR DATE a TIME ra'� P.M. M OF / PHONE AREA CODE NUMBER EXTENSION ❑ FAX ❑ MOBILE AREA CODE NUMBER TIME TO CALL TELEPHONED PLEAISE CALL. CAME TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU RUSH RETURNED YOUR CALL WILL FAX TO YOU MESSAGE SIGNED vropFORM 4009"' ' MARE IN U 0 NOTES o Cul , kA 6vs . �n �n Ca tons kad yo kv, -2 "z, sl i I a Postal t c RECEIPTCERTIFIED MAILM Coverageru (Domestic Mail Only,No insurance i Provided) o ru L a pomp $ L7 Cenl$ed Fee M Postmadc O Return Reclept Fee (Endorsement Required) Here M "as"cted Delivery edFee ra (Entloreemant Requir ) ra M Total Postage R Fees ,$ M q en ro Q _—_................._. ------------------ ry Siree6 N6 PO 3't6%ZtP+4 l Certified Mail Provides: receipt Amailing zowwrm`oosceoiad ■ A unique idenfifier for your maepiece ■ A record of delivery kept by the Postai Service for two years Important Reminders: ■ Cerbfied Mea may ONLY be combined with First-Class Mahe or Priority Mailer.) ■ Certified Mail is not available for any class of international mail. • NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. • For an additional fee,a Return Receipt ma be requested to mvide,proof of delivery.To obtain Return Receipt service,please complete antl attach a Retum Receipt(PS Form 3811).to the article and add applicable postage to cover the fee.Endorse matipiece'Return Receipt Requested'.To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt Is required. • For an additional fee, delivery may be restricted to the addressee or addressee's authorized aggant.Advise the clerk or mark the mailpiece with the endorsement HastrictedDelivery". • if a postmark on the Certified Mail receipt is desired,ptease presentthqe arti- cis at the post office for postmarking. If a postmark on the Cer ifie7l Mail receipt is not needed,detach and affix lapel with postage and"lay. IMPORTANT:Save this receipt and present it when making as Inquiry. Internet access to delivery information Is not available an mail addressed to APO$and FPOs. CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR o' SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT August 17, 2004 1 Three Js Realty Trust 1 Malone Drive Salem, MA 01970 Dear Sir/Madam: In accordance with Chapter III, Sections 127A and 127B of the Massachusetts General Laws, 105 CMR 400.00; State Sanitary Code, Chapter 1: General Administrative Procedures and 105 CMR 410.00: State Sanitary Code, Chapter 11: Minimum Standards of Fitness for Human Habitation, an inspection was conducted of the property 1 Parrallel Street#1 conducted by Pablo Valdez, Code Enforcement Inspector on Wednesday August 11, 2004 @ 10:45 a.m. Notice: if this rental unit is occupied by a child or children under the age of 6 years, it is the property owner's responsibility to notify tenants of lead related reports and tests, and to ensure that this unit complies fully with 105 CMR 460:000: Regulations for Lead Poisoning Prevention and Control. For further information or to request an inspection, contact the Salem Board of Health at 978-741-1800. You are hereby ORDERED to make a good-faith effort to correct the violations listed on the enclosed inspection report. Failure on your part to comply within the time specified on the enclosed inspection report will result in a complaint being sought against you in Salem District Court. Time for compliance begins with receipt of this Order. Should you be aggrieved by this Order, you have the right to request a hearing before the Board of Health. A request for said hearing must be received in writing in the office of the Board of Health within 7 days of receipt of this Order. At said hearing, you will be given an opportunity to be heard and to present witness and documentary evidence as to why this Order should be modified or withdrawn. You may be represented by an attorney. Please also be informed that you have the right to inspect and obtain copies of all relevant inspection in investigation reports, orders and other documentary information in the possession of this Board, and that any adverse party has the right to be present at the hearing. Please be advised that the conditions noted may enable the occupant(s) to use one or more of the statutory remedies available to them as outlined in the enclosed inspection report form. For the Board of Health Reply to: Lk Joanne Scott Pablo Valdez Health Agent Code Enforcement Inspector CERTIFIED MAIL 7003 3110 0005 1992 0236 NOTE: Enclosed please find check #3023 dated 1/5/2004. Please replace check at time of re-inspection. CITY OF SALEM HEALTH DEPARTMENT • r „! Salem, Massachusetts 01970 Page of / Date���� Name:T q1�2 E-S Address: / 4 /e wc'- �— S97D Specified Time Reg.#410.. Violation(s) / / nJ A1 44 li rW .• .l. No til) — L ��. CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH C120 WASHINGTON STREET, 4TH FLOOR CERT.# 129-02 SALEM, MA 01970 TEL. 978-741-1800 FEE $25.00 FAX 978-745-0343 DATE: 03/13/2002 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 8 Parallel Street UNIT #: 2 OWNER/AGENT: Piotr Fila ADDRESS: 8 Parallel Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-6976 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 FS' CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741 1800 1 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 FITNESA FOR HUMAN�7 HABITATION". PROPERTY LOCATED AT UNIT# 2 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER RL-11—MANAGER/AGENT No P.O. Box / ���No P.O. Box ADDRESS Pil✓ I/C( Z�/ t�ADDRESS CITY CITY CCITY RESIDENCE PHONE 1-ro 74 w �USWVESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. L )�14 3. YN1 4. el P-) 5. w, 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. D__APPLICANTS SIGNATURE � � DATE `77 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION�� -� 77 �' DATE OF REINSPECTION -Oy D � DATE OF ISSUANCE OF CERTIFICATE: _DATE FEE PAID:�- 1 3 TYPE OF UNIT: DWELLING OTHER CHECK# 7 3 5 CHECK DATE NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 .l . CITY OF SALEM, MASSACHUSETTS a 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, R5, CHO MAYOR HEALTH AGENT 03/07/2002 Elizabeth & Piotr Fila 8 Parallel Street Salem, MA 01970 PROPERTY LOCATED AT 8 Parallel Street UNIT # 2 Dear Sir/Madam: It has come to our attention, that you may be considering renting a dwelling unit at the above address. In accordance with Chapter 11, Article XIII of the City of Salem Code of Ordinances, Section 2-334, titled "Certificate of Fitness, " each dwelling unit must be inspected and certified prior to allowing occupancy. The inspection will be conducted in accordance with the 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 One Week 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. 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 eo exist. IF R THE BOARD OF HEALTH REPLY TO anne Scottt, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR r. CITY OF SALEM MASSACHUSETTS BOARD OF HEAI.TII 120 WASHINGTON STREET,4."FLOOR PublicHealth TEL. (978) 741-1800 FAX(978) 745-0343 KIMBM,EY DRISCOL.L tramdinnsalem.com LAttItY RAMDIN,RS/RFI-JS,C1 10,Cl'-fiS MAYOR Hr'AI,1'1 I AGI W1' CERTIFICATE OF FITNESS _____ _T—CERTIFI.CATE#306_1.3 DATE ISSUED: 8/22/2013 Property Located at: 12 Parallel Street UNIT# 1 Owner/Agent: Antonio J Rocha Address: 23 Pettingale Road City/Town: Amherst, NH Zip Code: 0303124 Hour Phone: 978-505-7210 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 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 LA RAMDIN HEALTH AGENT SANITARIAN CITY OF SALEM,MASSACHUSETTS BOARD OF HEALTH i 120 WASHINGTON STREET,4"'FLOOR TEL.(978)741-1800 FAX(978)745-0343 KIMBERLEYDRiSCOLL lramdW aIem.com MAYOR LARRY RAMllIN,RS/RENS,CHO,CP-PS HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER 11, 105 CMR 410.000 "MIINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" Ct11 11 t FEE. $50.0 PROPERTY LOCATED AT a Y aV-� 1 Q t S{v eek UNIT#_„�_ IS THIS UNIT DISIGNATED AS RIGHT I OR RAC&PLEASE CIRCLE ONE OWNER/LESSERhtov�".� koc\,�l, MANAGER/AGENT NO P.O..BOX y ,, ADDRESS a' Pe 1\' Ytr ADDRESS CITY,STATE,ZIP—IML IML4 ©� �CITY,STATE,ZIP RESIDENCE PHONE °12 Z- �-"7) ((� BUSINESS PHONE(24BRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: r. ROOM USE. 1. �� 2. �,eC� 3. �-i Js1� 4. , tC�,ey1 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 SIGNATUREDATE _U,101 3 Im�ots use only Date on initial inspection: ' 2 2 ` 17 Date of reinspection Date of issuance of certificate: ��t Date fee paid: 7n," Z Type of unit: Dwelling-,� Other Check 0clYCheck date: 10 __. Notes: Code Enforcement Inspector CITY OF SALEM, 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#548-07 DATE ISSUED: 11/7/2007 Property Located at: 12 Parallel Street UNIT#2 Owner/Agent: Robert Vaillancourt Address: 12 Parallel Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-3850 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 �iEALTH JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT C EM i CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH Qu 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 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION'. e� PROPERTY LOCATED AT I etn�, .,_ UNIT it IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER_RdQrCna YrLPQ �_ MANAGERIAGENT—_________ No P.O. Box No P.O. Box ADDRESSj�� .Q_ .----- _ADDRESS_ CITY��_ _—CITY RESIDENCE PHONE 1.8 19$ 3$S O`BUSINESS PHONE (24 HRS)___—_ BUSINESS TOTAL NUMBER OF ROOMS ROOM USE: 1�14n.ev(, 2, (i1Y In 3. _ 4 S. 6 ---- 7 THERE IS A TWENTY-FIVE(525.00) DOLLAR FEE, PAYABLE BY CHECK OR N40NEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THIE TIME OF INSPECTION. APPLICANTS SIGNATUR '.—__."_�_' _- CrAn�,naL�$-E�a�Xt.�a4x�t^ FS,2,ta,rvm✓� INSPECTORS USE ONLY DATE OF INITIAL INS,PECT(ON )-1_-- _ -1)-'-L-,_DATE OF REINSPEC TION DATE OF ISSUANCE OF CERTIFICATE//- 7 - _ L_.DATE FEE PAID__ JI, 7 ti 7 TYPE OF UNITDWELLING OTHER _ CHECK � . U CHECK DATE l) 7 NOTES. CODE ENFORCEMENT INSPECTOR %23?98 CERT.# 167-97 3 FEE $25.00 ftp M. DATE: 03/20/97 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: 15 Parallel Street UNIT #: House OWNER/AGENT: Rose Ball ADDRESS: 4 State Street CITY/TOWN: Peabody. MA ZIP CODE: 01960 24 HOUR PHONE: 531-2313 AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410 . 000 : MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE SALEM HEALTH DEPARTMENT AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED. MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410 .000 : MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . SECTION 410 .400 (B) : DWELLING UNIT (X) AND 410 .400 (C) : ROOMING UNIT MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: . NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR OCCUPANTS UNDER 6 YEARS OF AGE. FOR THE BOARD OF HEALTH JOANNE SCOTT, MPH, RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR A & CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tei:(508)741-1800 APPLICATION FOR CERTIFICTE OF FITNESS Fax:(508)740-9705 IN ACCORDANCE WITH STATE SANITARY CODE, .CH,kPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION PROPERTY LOCATED AT . UNIT # OWNER/LESSER,' K ,/ C' ,f L [_ _ MANAGER/AGENT ADDRESS T ���/�=-( �j/ ADDRESS CITY i CITY RESIDENCE PHONE 3 BUSINESS PHONE (24 HRS.) BUSINESS PHONE -S 3 - ( G u &5,15— TOTAL 5,15 -"TOTAL NUMBER OF ROOMS:_ f ROOM USE: I. 2_ 3. 4. f� 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 DEP TMENT THIS FEE IS PAYABLE AT THE TIM OF INSPECTION r7 APPLICANTS SIGNATURE /et„ 63 CC�Q�L_.-. DATE L3_ / f INSPECTORS USE ONLY DATE OF INITIAL INSPECTION: Q - Y DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: ' - �"Z) -�� C � � DATE FEE PAID: TYPE OF UNIT: DWELLING OTHER_ NOTES: ���� CODE ENFORCEMENT INSPECTOR