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PARK STREET PARK STREET o. i d 'S CITY OF SALEM, MASSACHUSETTS ;. BOARD OF HEALTH s 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 "Ne 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#489-06 DATE ISSUED: 10/11/2006 Property Located at: 1 Park Street UNIT# 1 Owner/Agent: Leocadio Fraluciso Address: 3 Park Street 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 HEALTH del JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CRY OF SALEMv MASBACtiUSETFS '�—. BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR "'tttJJJ��✓✓/ 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�� L� -UNIT # / IS THIS UNIT DESIGNATED AS_RIGHT LEFT FROM BACK PLEASE CIRCLE ONE OWNEWLESSER EOCc2tt 'J_ LCIgWAGERIAGENT No P.O. Box No P.O.Box ADDRESS Fc)yk f / ADDRESS CITY -fC7.��i-/ CITY RESIDENCE PHONE BUSINESS PHONE (24 HRS.) BUSINESS PHONE % d – �7 TOTAL NUMBER OF ROOMS: Y ROOM USE: i._ L�. .- 2'--l---.3.-._dam. -4 - 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 SIGNATUREQAlE_�0,- //- 005 INSPECTORS U�-C}NLY DATE OF INITIAL INSPECTION, f - I 6 G DATE OF REINSPECTION - - DATE OF ISSUANCE OF CE=RTIFICATE A0-- L DATE FEI- PAID.. ./0 - TYPE OF UNIT DWELI_I,NOTHER CHECK 0 /(} CHECK DATE & �( C l b / NOTES.. CODE ENFORCEMENI INSPECTOI1 901/98 a CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET. 4TH FLOOR SALEM, MA 01970 CERT.# 589-02 FEE $25.00 TFL 978-741-1800 DATE: 11/19/2002 FAX 978-745-0343 STANLEY USOVICZ, JR JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 1-3 Park Street UNIT #: 1 OWNER/AGENT: Leocadio Francisco ADDRESS: 1 Park Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-4381 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 A / JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR vg�o CITY OF SALEM, MASSACHUSETTS 6 �. BOARD OF HEALTH 3 e 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 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT /3�G2Y,c X/ UNIT# IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER,(–� OCC dle2 UY_�Z.b1r ,,.,ANAGER/AGENT No P.O. Box No P.O. Box ADDRESS ADDRESS CITY CITY RESIDENCE PHONE BUSINESS PHONE (24 HRS.) BUSINESS PHONE 7Vc/ TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3. 4. 5. 7. 8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE f ,99 /,s—�'9ATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION //-lq`16' DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE-,ZZ-/e ?i DATE FEE PAID- TYPE AIDTYPE OF UNIT: DWELLIN f—OTHER CHECK# /S6a CHECK DATE 6c NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS M . BOARD OF HEALTH 120 WASHINGTON STREET,4'r FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR D(Ria-NBAUM(rZ)SAI.FM.cOM DAVID GRE ENBAUM A(n]NG HI?Affui A(3LN,r CERTIFICATE OF FITNESS CERTIFICATE # 178-10 DATE ISSUED: 4/16/2010 Property Located at: 2 Park Street UNIT# 1 Owner/Agent: Ana Diaz Address: 2 Park Street#2 CitylTown: Salem, MA Zip Code: 01970 24 Hour Phone: 744-6983 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 DAI RE A M) ACTING HEALTH AGENT CODE ENFORCEMENT INSPECTOR calf W wKv cQfi . is rc a d3- s6 w", rJ ��° CITY OF SALEM, MASSACHUSETTS • _ • BOARD OF HEALTH 120 WASHINGTON STREET,4T°FLOOR o0 TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGRLENBAUMnSALEM.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 ,c, PROPERTY LOCATED AIF R 1 lC 5 � {� �9 ! UNIT#-- IxxS THIS UNIT- D GNATED AS RIGHT LEFT FRONT OR A�PLEASE CIRCLE ONE OWNER/LESSER ✓`nom MANAGER/AGENT NO P.O. BOX ADDRESS �W16 64 , /A, ADDRESS CITY, STATE,ZIP � �(41 p tln CITY, STATE, ZIP/IA O 170 RESIDENCE PHONE q78- '7qq (o`193 BUSINESS PHONE(24HRS) BUSINESS PHONE I 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 /2- /L/�I DATE Insnectors use onlv Date on initial inspection: 40"Uho o Date of reinspection: Date of issuance of certificate: lD Date fee paid: LA ('�U Type of unit: Dwelling__L/O"_Other Check#L/G,SS 3 / Check date: /A 1116 Notes: P(4+(C Or ropl/)U G ) Code E c ent Inspector 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 02/15/2001 Fax:(978)740-9705 Jorge Barzola 2 Park Street Salem, MA 01970 PROPERTY LOCATED AT 2 Park 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. F RF Ri�ARD O� F, HEALTH REPLY TO oanne Scott'J�M'JePMH•,RS�,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR b 3 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT 01/25/2000 Tel:(978)741.1800 Fax:(978)740-9705 Geoffrey Colby 2 Park Street Salem, MA 01970 PROPERTY LOCATED AT 2 Park Street UNIT # 3 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. FOIZRTHE /BOARD F HEALTH REPLY TO t ICCJoanne Scott, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR ce DI City of Salem, Massachusetts f • F i m Board of Health }�� ,{� MA 01970 120 Washington Street, 4th Floor, Salem, Prevent, Promote, pGi�i�ecl 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-15-346 DATE ISSUED: 10/20/2015 Property Located at: 6 PARK STREET UNIT#2 Owner/Agent: Juan A. Guzman Address: 6 Park Street Unit#1 City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 745-7609 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 SANITA AN f r a-_ r III '�•... _ham_�� '�,� CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4'"FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR LL AAMDIN S' Um— ]M LARRY R.AMDIN,RSfRr1IS,CHO,t:3'-IS HrAlml 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" �y FEE: $50.00 PROPERTY LOCATED AT >ro `c j t.K JY "i O mn M-P,,h l 01 0 UNIT#-2-fj-- IS THIS UNIT DISIGNATED AS L"TFRONT OR SA PLEASE CIRCLE ONE OWNERR.ESSER t,`.S. 1.4alV\ Ix MANAGER/AGENT NO P.O.BOX ADDRESS G Pyr 1 ADDRESS CITY, STATE,ZIP4 nM 1 YV�I'`O (9 1Y CITY, STATE,ZIP RESIDENCE PHONE_A lj q 5`L 0 7_q BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: t ROOM USE: 1. zwwrti 2. 6 7. 8. 9. 10. C1 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—4* -a DATE I b l i g 1 ( Je- Inspectors use only Date on initial inspection:IP-1 C.1/201.5' Date of reinspection: Date of issuance of certificate:J.-0/19/`2-0 S. Date fee paid:JOI Zgl.2oj�- Type of unit: Dwelling—Other Cbeck#1025 Check date: 1.Df2C//20-LS Notes: ro ti � wn nws � f lr a�tf1 ViA -Fnr,n screens K,44tt ..,:,J0+M 1ockS ii 1 f n reel 0 soon 4e+LieA V;+Ckfv) ha.S �vf"14ow wA 1-J(4L+ aces hod' jinc vp, fo4rV \,1;4ow kklx1 'orlb )I'll?- vP. of cement pector� / r 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#553-07 DATE ISSUED: 11/13/2007 Property Located at: 6 Park Street UNIT#3 Owner/Agent: Juan Guzman Address: 6 Park Street 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 JOA E SPH, RS, CHO HEALTH AGENT CODE ENFORCEM///ENTENT INSP2CTOR � o 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 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 6 P03 _d . M A0 UNIT#a IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSERv. � MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS r PQrxV ��. ADDRESS CITY , 1 QW MA 0 I q� V CITY RESIDENCE PHONE Q 18 (1/iS 0q,BUSINESS PHONE (24 HRS.1 BUSINESS PHONE TOTAL NUMBER OF ROOMS: 13 ROOM USE: 1. 2. 3. 4. 5. 6. 7. 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 I _ DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION '/ - 3 o ] DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: II 'I3 a LATE FEE PAID: TYPE OF UNIT: DWELLING eTHER_ CHECK # CHECK DATE NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 " CITY OF SALEM, MASSACHUSETTS IV BOARD OF HE.-\LTH _ 120 WASHINGTON STREET 4`'FLOOR PublicHealth f Prevent Promote Protect. TEL. (978) 741-1800 Fax(978)745-0343 KIMBERLEY DRISCOLL lramdinOsalem.com - LARRY R,\MDIN,125/RISI-IS,CI 10,C13-11's MAYOR HEAL:rfl AGENT CERTIFICATE OF FITNESS CERTIFICATE#36-14 DATE ISSUED:2/12/2014 Property Located at: 9 Park Street UNIT#1 Owner/Agent: Elizabeth Bozadian Address: 20 Clark Avenue City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 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 LARRY RAMDIN HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS ` BOARD OF HEALTH 120 WASHINGTON STREET,41°FLOOR PublicHealth Prevent Promote.Protea. TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL Iramdinnn salem.com - LAlilil"R,\AIDIN,RS/RI?I-1S,CI 10,C]'-FS MAYOR HEAL;PI f tiC I?N"1' 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 L PROPERTY LOCATEDAT ? � �l U/ 9 i ? UNIT# IS THIS UNIT DI /GNATED AS RIGHT LEFT/FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER E—h Z Cr /J ( �� fii ZGi tom)(MANAGER/AGENT NO P.O. BOX ''II ,, ADDRESS .� C (A r fill t 1/1 of Ic— ADDRESS CITY, STATE,ZIP �` 7 L WLR/ �1(�/ ,rl CITY, STATE,ZIP () r `I �7� RESIDENCE PH04 J 7 � : T/— U 7 BUSINESS PHONE(24HRS) BUSINESS PHONE \ TOTAL NUMBER OF ROOMS: ROOMUSE: 1. bP--, 2. 3. � 4, �tt)iN. jCt�1�r�G��1^/(�Iktl^\ i �i11/1 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 FE Pi IS PAYABLE NY THE TIME O INSPECTION APPLICANT'S SIGNATUREwvi DATE Insn ctors use only Date on initial inspection: c�I Ia,I IU Date of reinspection: t � t Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check# C Check date: 2 Notes: Code Rtrnt Inspector 0`�ND City of Salem, Massachusetts f � t Board of Health 120 Washington Street, 4th Floor, Salem, Publ�CHe81th MA 01970 Present,Promote Protect 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-16-330 DATE ISSUED: 9/1/2016 Property Located at: 9 PARK STREET UNIT#1 Owner/Agent: Elizabeth Bozarjian Address: 20 Clark Avenue Cityfrown: Salem, MA Zip Code: 01970 24 Hour Phone:(976) 741-3046 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 incompliance 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-'Z � &Jeyl rosy Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN i CITY OF SALEM, MASSACHUSETTS Y BOARDOFHEALTH 120 WASHINGTON STREET',4`"FLOOR TEL(978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR na INOSALF-MCOM dDZ jt /Y a Gif(7 f. CT YYI LARRY RAMDIN,RS/RENS,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" FEE: $50.00 PROPERTY LOCATED AT UNITli �-IS THIS rUNIT IS`IGGNNATED AS$I�LEFT TFRONT OR BACK.PLEASE CIRCLE ONE OWNER/LESSER 1- ;fi tYJ(f � 'i7�?1i6} t /aaNAGERIAGENT NO P.O.BOX (� ADDRES-qzD t -(fit vk- 6' ml �- ADDRESS CTTY, STATE,ZIPS/P. M7 CITY, STATE,ZIP RESIDENCE PHONE �� 7/ ,30 t�(o BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ((� �� ROOM USE:^- 1.�Y9it 2 &Jy0VWA3 V0VA4! °uNr15. l�t (� YRYJ �G}�u��l L(L(Gr"y 6.ejoA (1 T & 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THISA_Y�AB TIME OF INSPECTIRN APPLICANT'S SIGNATURE 0) 1� � ) — DATE r Insnecfcfis u �on3v Date on initial inspection: D%A4Qj r Date of reinspection: Date of issuance of certificate:DQIQ,�-6 Date fee paid: 02 04/wau Type of unit: Dwelling V Other Check# 29O Check date: 63910112 1-4 Notes: C e f cement Ins m vg . onoi CITY OF SALEM9 MASSACHUSETTS BOARD OF HEALTH �IFo 120 WASHINGTON4TH 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 #221-08 DATE ISSUED: 5/15/2008 Property Located at: 9 Park Street UNIT#2 Owner/Agent: Robert& Elizabeth Bozargian Address: 20 Clark Avenue 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 JO N�MPH, RS, CHO 44 HEALTH AGENT E ENFORCEMENT INSPECTOR • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"°FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR isco rKasni,FN1.COM JOANNE SCOTT, HEALTH AGENT Application for Certificate of Fitness 11 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FIITNESS FOR HUMA HABITATION." PROPERTY LACATED AT 9 �aAy-- 5" UNIT# o2_ IS THI"NIT ISIG9NA/T�EpD AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER Il ZGcKJ�� q KJV�I NZO TAANAGER/AGENT NO P.O. BOX 1, ,� 1 ADDRESS a0 CICtA t — EIV le 1i 5 -I( eWL ADDRESS CTTY,STATE,ZIP S p,/Pi A.,t IM l7 CITY,STATE,ZIP RESIDENCE PHONr 9 Td)7 Lf l-5 0 BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: So ROOMUSE: I. 11uj,K))20C)W� . b4Ck2q 3. ��'�� 1�4. 1�DDbY15. �e��Oal✓J 6. ba-AiY60917. 8. 9. 10. THERE IS A TWENTY-FIVE($25)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THUS FEE EIIS,PAYABLE AT LTHE TIME OF INSPECTION APPLICANTS SIGNATURE ��,UN�' � _ _ �l/ !�11 - DATE Jf0& / Insne ors use only Date on initial inspection: 5 ' �/ Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check# c7 CT� Check date: !D ] O Notes:n", iult 0U) tto (iVi (now �� not iv1 : 10c� Dn (�indnc J I✓1 CCA ckn j �cA ,r a" luihd��jn 5ink (min kale (on DA in `� a'ul� room. 46�deOEorc�—!Inspector CITY OF SALEM, MASSACHUSETTS • BOARD OF HEALTH 120 WASHINGTON STREET,4°1 FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR IMANCINF p$ALF.M.COM JANE;C NtANCINI ACTING HEALTH ACuNT CERTIFICATE OF FITNESS CERTIFICATE # 102-09 DATE ISSUED: 2/26/2009 Property Located at: 9 Park Street UNIT#3 Owner/Agent: Elizabeth Bozargian Address: 20 Clark Avenue 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 9 NET MANCINI ACTING HEALTH AGENT CODE ENPORCEME T INSPECTOR • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4°'FLOOR TEL. (978) 741-1800 K ,1BERLEY DRISCOLL FAx(978) 745-0343 MAYOR IDIONNE;na 3N.8M.CONI 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." I/ FEE: $50.00 D/• k PROPERTY LOCATED AT 7 U/ �W UNIT#� IS THIS/U'NIT ISIGNATED AS RIGHT.LEFT FRONT OR BACK PLEASE/C�IRCrL�E�O/N,E OWNER/LESSER L-1 f 2,rtb � VV 7-a- 0�g Y) MANAGER/AGENT !"C k I C� NO P.O. BOX / ADDRESS ;�(7 da- r,(- Ale/ ADDRESS CITY, STATE,ZIP 5 r1l,7 61W 6161 A 0 I CITY, STATE,ZIP RESIDENCE PHONE �� 7 0 ) 7 V I-,30 V 61�' BUSINESS PHONE(24HRS) Ce. 11)�L l BUSINESS PHONE d) �/ 7L9 o7cleq TOTAL NUMBER OF ROOMS: `T /� ROOM USE: 1. �I V f orl yo0q, Y-1, ( // W 3. 8f�� eW W14. 601 0DI115. 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 WIff CC J DATE a/ZO��y Insne tors use only Date on initial inspection: 2.- 7 1, - 09 Date of reinspection: Date of issuance of certificate: 2,2\o c 9 Date fee paid: 2 - 2b'co 9 Type of unit: Dwelling ✓ Other Check# 3 i Check date: Z z b • a 9 ,N6tes: p Code Enforcement Ins ctor •OONDI}gett City of Salem, Massachusetts n Board of Health 120 Washington Street, 4th Floor, Salem, PublicHeaIth 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-15-133 DATE ISSUED: 6/2212015 Property Located at: 10 PARK STREET UNIT#1 Owner/Agent: Elizabeth Bozarjian Address: 20 Clark Avenue City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 741-3046 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 F� Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITAl!r1AN m CITY O SALFIM, MASSACHUSETTSBOARDC 1;HE'A1:IlI s 130 WASHING'I'UN STHj;1j.r,4 TI Fl.cx,lt 1'itl,. (978) 741-1800 KINIBFR1,IiY DRISCOLL FAX (978) 745-0343 MAYOR i.R.%-m)1N(aUSALEh[.CON[ LARin RANIDIN,iiti/tutlrS,CnO, HEALFtANENT ebD�trJi� vt �/!i ✓e ' coyYJ 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 n �n}� 1 PROPERTY LOCATED AT D �W I 5041 i 544 l/'P l 0)C��V UNIT#—L-- /IS THIS UNI DISIGNATED AS RIG LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER El!Zd�G 1 ) l,/t `I MANAGER/AGENT 0I,0 A e,r NO P.O.BOX 7� /f �� ADDRESS� I/ l�(J� Y� /7VP y��I LIP ADDRESS CITY, STATE, ZIP t>(AlrP 4A1//! /T!,/�/�� CITY, STATnE,ZIP v RESIDENCE PHONE(%�/� 4T/ -J// �b BUSINESS PHONI 24HRS�� BUSINESS PHONE TOTAL NUMBER OF ROOMS: Li VI Q � p � ROOM USE: 1.&40-0 . n IM 3.�'GI'cf oya Y-i L 1�5.6400W) 6,�atAvX(Y�7. 8. 9. 10. 0w) THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THISIS PAY BL AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATE i nsa ctors use only Date on initial inspection: �ZOlS Date of reinspection: Date of issuance of certificate 11)15- Date fee paid: 061.2- 2zl-5- Type of unit: Dwelling/V Other Check#201 Check date: 66/22/2r�1 S Notes: � .k�e} h ar } �onr �n �iy j r�f)m re., Hnlnrud Q rs '1 'r 0 flet nerd ko be ODm f� 1 '� Lmo,___/-_..SLI, Q�t(�[,�_I bz.{POOm /i nl.�I.�n } TO r �✓�Oo Iw�'I lT/'nvtuiiYr� Cq orc mens Spector f t 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. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#343-05 DATE ISSUED: 5/27/05 Property Located at: 12 Park Street UNIT# 1 Owner/Agent: Elizabeth Bozarjian Address: 20 Clark Street 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 JAN�TT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY dF�a�'ALEM, MA5SA.CHUSE'I [S BOARD OF HEALTH I • t20 WASHIt4GTON-STREET"4TH FLOOR SALEM, MA 01970 ' TEL. 978-741-1800 i FAX 978-745-0343 J J 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 4- IS THIS UNIT DESIGN LE DESIGNATED AS RIGHT FT FRONT BACK PLEASE CIRCLE ONE OWNERILESSER1l /So2/+,�Iw'WGIANAGEWAGENT No P.O. Box No P.O. Box ADDRESS-90—C-/,49-12- AVE, ADDRESS CITY R 4 G l c CITY RESIDENCEPHONERZY-7a5 ,) F ,Y`t BUSINESSPHONE (24HRS.). _—___ BUSINESS PHONF TOTAL NUMBER OF ROOMS ROOM USE 1- 2__3. 4- 5----�'-- --7. 8 THERE IS A TWENTY-FIVE ($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONLY ORDER TO THL CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THl- TIME OF INSPECTION ` APPLICANTS SIGNATURE _ - - '` -' / t)ATi..... .S_�7__._� INSPECTOR', USE ONLY DAT1_OFINITIAL INSPECIION $ J 'D_3�_ . -DAFE OF RE_-INSPSC(I'ON LYPI- OF UNI1 I)WEI_LIN(-,,%f )1'HGR Id' ll { '.l t4 (.UIN I NI )Iit.1 Ml NI IN'J'l 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. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#389-05 DATE ISSUED: 6/16/05 Property Located at: 12 Park Street UNIT# 1 L Owner/Agent: Elizabeth Bozarjian Address: 20 Clark Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-729-2989 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 ��___ J�� JO NE SCOTT, MPH, RS, CHO Q VCL HEALTH AGENT CODE ENFORCEMENT INSPE OR 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, RS, CHO �U^I MAYOR HEALTH AGENT G/T), BOARD OP h APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OFFITNESS �FOR �HUMAN HABITATIO ". PROPERTY LOCATED AT I r2 fia4k cam, CGI ( , YA 0/q-7O UNIT#L IS THIS UNIT DESIGNATED A��iiS RIGHT FT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER'7iLeYnD2ar)rufLMANAGER/AGENT 6r''� No P.O. Box ' No P.O. Box ADDRESS 2 D cja YIG &e ADDRESS CITY �-c'eA4V CITY ,��jj Ce 1144 RESIDENCE PHONE_I`'l�)IyJ'3bVh BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. P/ 3 P" 4. 5. 1! 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 JII_l� AWI/G GL/ DATE dr;211P,5� INSPECTORS USE ONLY DATE OF INITIAL INSPECTION,,; 3 y3� DATE OF REINSPECTION____ DATE OF ISSUANCE OF CERTIFICATE: 3 yj DATE FEE PAID TYPE OF UNIT DWELLING(/OTHER CHECK # --7 3CHECK DATE NOTES. CODE ENFORCEMENT INSPECTOR 9/28/98 r ' 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 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 oL residentiai 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 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 ager:�s from any loss or injury sustained of whatever nature and description occasioned by my/out absence during said inspection. TEP16:NT/LESSEE 041 R/i FS R. /a PWVL 4' d&41L Ave, , 10A I.Ds>>s - -- -- -- - - .;DDR°Ss 6(9": P.D`:` ESS OF DC].'1' .'1 �NFc PECTEn DATF Tenant Certification Form Required Federal Lead Warning Statement Housing built before 1978 may contain lead-based paint. Lead from paint,paint chips,and dust can pose health hazards if not managed properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978 housing, lessors must disclose the presence of known lead-based paint and/or lead-based paint hazards in the dwelling. Lessees must also receive a federally approved pamphlet on lead poisoning prevention. The Massachusetts Tenant Lead Law Notification and Certification Form is for compliance with state and federal lead notification requirements. Owner's Disclosure (a) Presence of lead-based paint and/or lead-based paint hazards(check(i)or(ii) below): (i)_ Known lead-based paint and/or lead-based paint hazards are present in the housing(explain). Owner/Lessor has no knowledge of lead-based paint and/or lead-based paint hazards in the housing. (b) Records and reports available to the owner/lessor(Check(i)or(ii) below): (i) Owner/Lessor has provided the tenant with all available records and reports pertaining to lead-based paint and/or lead-based paint hazards in the housing(circle documents below). Lt�ad Inspection Report; Risk Assessment Report; Letter of Interim Control; Letter of Complii. (ii) Owner/Lessor has no reports or records pertaining to lead-based paint and/or lead-based paint hazards in the housing. Tenant's Acknowledgment(initial) (c)I�YY Tenant has received copies of all documents circled above- (d) Tenant has received no documents listed above. (e).Tenant has received the Massachusetts Tenant Lead Law Notification. Agent's Acknowledgment(initial) (t)_Agent has informed the owner/lessor of the owners/lessor's obligations under federal and state law for lead-based paint disclosure and notification and is aware of his/her responsibility to ensure compliance. Certification of Accuracy The following paries have reviewed the information above and certify, to the best of their knowledge. that the information they have provided is true and accurate. t) Owwne /Lessor/ Date Owner/Lessor Date n Tenant Date Tenant Date Agent Date Agent Date Owner/Mana mg Agent Information-for Tenant (Please Prm't)f- AJ e r Name Sa, �?�nn Q� q `n) � CAI- 3b V A Apt. Cityrfown /_ip I e hone I (owner/managing agent)certify that 1 provided the l enant Lead Law Notification/Tenant Certification Form and any existing Lead Law documents to the tenant, but the tenant refused to sl'-,11 this certification The tenant gave the followme reason The Massachusetts I cad I.aw prohibui tent.tl chscrtnunaron. III,ludme n:(ua ng to rent to families with children or evtc7m families with children because of lead paint Contact the Childhood Lead Poisoning Prevention Program for inform.+unn on the availability of this form m other language~ Tenant and owner must each keep a completed and signed copv of this form c \wp50\lead 1995\f0rms\c1p95-17 wp Rev. 5/98 w home is checked for the most serious lead hazards,which must be fixed right away.The risk assessor would Five the landlord and you a written report of the areas with too much lead and the serious lead hazards. Lead inspectors and risk assessors have been trained- licensed by the Department of Public Health,and have experience using the state-approved methods for testing for lead paint. These methods are use of a sodium sulfide solution.a portable x-rav fluorescence machine or lab tests of paint samples. You can get a list of licensed lead inspectors and risk assessors from CLPPP__ In Massachusetts,what must the owner of a home built,before 1978,do if a child under six years old lives there? An owner of a home in Massachusetts built before 1978 must have the home inspected for lead if a child under six years old lives there, if lead hazards are found, the home must be deleaded or brought under interim control. Only a licensed deleader may do high-risk deleading work. such as removing lead paint or repairing chipping and peeling lead paint.You can get a list of licensed deleaders from the state Department of Labor and Workforce Development. Deleaders are trained to use safe methods to prepare to work,do the deleading. and clean up. Either a deleader, the owner or someone who works for the owner who is not a licensed deleader can do certain other deleading and interim control work. Owners and workers must have special training to perform the deleading tasks they may do. After the work is done, the lead inspector or risk assessor checks the home. He or she may take dust samples to test for lead,to make sure the home has been properly cleaned up. If everything is fine, he or she gives the owner a Letter of Compliance or Letter of Interim Control. After getting one of these letters. the owner must take care of the home and make sure there is no peeling paint. What is a Letter of Compliance? It is a legal letter under state law that says either that there are no lead paint hazards or that the home has been deleaded. The letter is signed and dated by a licensed lead inspector What is a Letter of Interim Control? It is a legal letter under state law that says work necessary to make the home temporarily safe from serious lead hazards has been done The letter is sgmed and dated by a hcensed risk assessor. It is good for one year, but can be renewed for another year. The owner mus; fully delead the home and get a Letter of Compliance before the end of the second year Where can I learn more about lead poisaninh". Massachusetts Department of Public Health Your local lead poisontw< prevention program Childhood Lead Poisunm i'revention Piogram ((-L'I'Pr) or your local Hoard cif Health (For more copies of this form. as well as a full range of information on lead poisomnr prevention. tenants rtgF.s U �, Consumer Product Safetv Coinniksion and responsibiluics under the Y1A Lead Law, ho\� to (Information about lead in consurner products) clean lead dust and chips. healthy foods to protc(t your 1-800-6-'8-2772 chtldren, ftnanctal help for owners, tiafc deleadm and renovation work, and soil tesum, U.S Environmental Protection Agency, Region I 617-755-9400, )-S00-53?-957i (Information about federal laws on lead) 617-56�-+420 Massa�huv('Its Np,trinxrnt of Labor and W orkfc,rce I)cvr lopmcni National Lead information Center (l,ist of licerecd dc':radcis) (Cencial Icad poisoning informa;ion) 617-969-7177, 1-800-4)�-0004 1-800-LEAD-FYI CITY OF SALEM, MASSACHUSETTS + + BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEi,. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGRRG.NIInUnlna AI.rM.CO%I DAVID GREENBAUM ACPINO Huim Ti-I AGENT CERTIFICATE OF FITNESS CERTIFICATE #630-09 DATE ISSUED: 12/11/2009 Property Located at: 12 Park Street UNIT#3 Owner/Agent: Elizabeth Bozarjian Address: 20 Clark Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-729-2989 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 AUX. ) !l' DAVID GREENBAUM ACTING HEALTH AGENT CODE RCEMENT INSPECTOR • CITY OF SALEM, MASSACHUSETTS r BOARD OF HEALTH 120 WASHINGTON STREET,4°1 FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR Dc;RE1;NBAUMr(bSA1XM.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." q' FEE: $50.00 IVf d J PROPERTY LOCATED AT �. l w �F� Y IX.Y�l i SG1 &W( �Y/J+ U 1 q 7b UNIT# IS THISUNIT IS"IGGNATED AS RIGHT LEFT'FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER EI I Z�,h e 1c�C) Z0 Y')/G l7MANAGER/AGENTNO P.O. BOX p 1, y� ADDRESS Zo �.1:/.f/t/fs<- &e ADDRESS CITY, STATE,ZIP cd7.ti[ PIW r M,� 0) � � CITY, STATE,ZIP RESIDENCE PHONE(qT6 / 4) -J O LA,(,, BUSINESS PHONE(24HRS) BUSINESS PHONE � X) -Zc/ - Z CI X C/ TOTAL NUMBER OF ROOMS: //II dd ff ROOMUSE: 1.L V>k9YhuW<2.�vtiK.4onw13.K ��4. �le�CYDbW1 S.r�edYLb14� 6.6?avr evtn 7.AN,r�Yr, VDbWl 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 fl APPLICANT'S SIGNATURE �A�IT4iIfi__ DATE fff Vlecto'rs use only Date on initial inspection: la, III /U q // Date of reinspection: Date of issuance of certificate: � I a II (U Date fee paid: /I A" Type of unit: Dwelling VOther Check# n� �I Check date: Id, /11 IU 1 Notes: * �mz Ail 1 bele NO-?, °I�7k- US3^ y�s_o �k- SnmQ (rn�� dawn -W 06Ulfi�0 rP nlaCe l( h1ti(J/bs, svrne. wo-4�r wu j. I1)((VA od nforcement Inspector �J (/l s10oc./ioA/ . CITY OF SALEM, MASSACHUSETTS r BOARD OF HEALTH 120 WASHINGTON STREET,4°1 FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR DG 81?NBAUm(ONALEM.c0 N1 DAVID GRF ENBAUM AC'11NG HrAIaI-I AG-;NT CERTIFICATE OF FITNESS CERTIFICATE#630-09 DATE ISSUED: 12/11/2009 Property Located at: 12 Park Street U IT# Owner/Agent: Elizabeth Bozarjian Address: 20 Clark Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-729-2989 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 AV�EENBAUM ACTING HEALTH AGENT CODE ENFORCEMENT INSPECTOR rpNDi� City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, PubliGHealth MA 01970 Prevent. P amore.t ro[eet. 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-17-289 DATE ISSUED: 9/7/2017 Property Located at: 14-16 PARK STREET UNIT#A Owner/Agent: Frank&Carla Valentino Address: 15 Wiswall Road City/Town: Newton, MA Zip Code: 02459 24 Hour Phone:(781) 799-5035 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. Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CITY OF SALEM, MASSA(CIIUSF_,"FYS << ' BOARD(*Hls.\1:CII �� LO\\%;\sntticrc�� 5rriu 'r 4'°Ft,(unz (978)741-1800 KIMBERLEY DRISCOLL F.\t(978)745-0343 MAYOR i e,�niniw'v`i.sai r\i rw 1.dhR1'R:\,\mw,izs/RPIis,(,ifo,(9'-I'S HI'M ]1-f A(;I?\Pt 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 14A Park STT4:,)-O—( Sn ifi\,A-i Mfr. UNIT# A IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT Ott BACK,PLEASE CIRCLE ONE OWNER/LESSERPMr-\t Sr GGtV lCA VAI-rel VID MANAGER/AGENT SG1YY1e NO P.O BOX _ 1/�-� ADDRESS iC; W 15 WM k , ADDRESS S U'MP CITY, STATE,ZIP NPlvUTVY1 M{3- 024501 CITY, STATE,ZIP -Sar` 2 RESIDENCE PHONE N/ A . BUSINESS PHONE(24HRS) 5arne BUSINESSPHONd7eC)7aQl 5035(CArtw) /((,P17 )877-V705CFMn,(L) TOTAL NUMBER OF ROOMS: ,S roorI)S t e4l n ROOM USE: 1. j312 2. {3R 3. 6R 4. LR 5. V.I rChCi'1 6. PATH 7. / 8. 9. / 10. i THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEMPAY LEAT HE TIM FINS UN APPLICANT'S SIGNATURE DATE 0910'I/I�- Insoectors use onlv Date on initial inspection: Date of reinspection: Date of issuance of certificate: 2�/] Date fee paid: Type of unit: Dwelling Other Check# 171Y1� Check date: Notes: Code Enforcement Inspector a, CFFY OF SAL.F.bT, MASSACHUSETTS f I 'L'HI.. (978)741-1300 KMIBERLEY DRISCOLL. I ,\x(978) 745-0343 MAYOR i itANIDN ir'av I N1 c,0\1 I,\iuw UNIDIK,RS/RI'I f�,(JR),(T-IS I-I I'.'V.1 FI.1GP.V t 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. 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. f-2 Tenant/Lessee Owner/Lessor I �� pCL r K's »>>ft O l 9 S Address Address Address on unit to be inspected q - ► - Zo I � Date Updated 5/23/11 D e City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, ht tliC,Health MA 01970 Pteveat. o not<. P.trCt 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-17-357 DATE ISSUED: 10/19/2017 Property Located at: 14-16 PARK STREET UNIT#B Owner/Agent: Frank&Carla Valentino Address: 15 Wiswall Road City/Town: Newton, MA Zip Code: 02459 24 Hour Phone:(781)799-5035 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 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. Note: This approval does not certify compliance with the state lead law for occupan der ears of age. Larry Ramdin, MPH, REHS, CHO f HEALTH AGENT SANITARIAN i CITY OF SALEM, MASSACHUSETTS r? ; BO,\alWI H1�:u:rlf �� 1^_0\\L.\suttvr t'ct� Srrlti a',4"'Pt.oc�Iz Tr'l- (978)741-1800 Kni fBF.RLEY DRISCOLL F:\x()78)745-0343 MAYOR iAANIlliN( s"AVCw 1.:\Ii R1'R:\NIDIN,RS/Iilil N,Cl fO,( P-rS H1:1\1A If.1C;IiV"t 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 RJR Park/ MASS.Ia SS. UNIT#�_ IS THIS UNIT DISIGNATED A RIGHT)LEFYE—RON OII BACK,PLEASE CIRCLE ONE OWNER/LESSER"'r\lt� Carie Va0'Q n0 MANAGER/AGENT OW rrerS hy)arOgaS . NO P.O.BOX ,� ADDRESS 1,C) WLSV all Pzoa.d ADDRESS CITY,STATE, ZIP NaN Ti0hi M N 6245q . crrY,STATE,ZIP RESIDENCE PHONE N{R . BUSINESS PHONE(24HRS) (7807(q qQ✓v 35 BUSINESS PHONE SaMQ Lu 17)6-n— 1 -705 TOTAL NUMBER OF ROOMS: ROOM USE: 1. LR 2. IR 3. 13th 4. 8R 5. bR 6. OK 7. Rhm 8. Rhin 9. KIT0%W- 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OFp SALEM BOARD OF HEALTH THIS FABW,AT T M PECTION DATE I D 1� 1 APPLICANT'S SIGNATURE �( ':�r. Inspectors use onlv Date on initial inspection: Date of reinspection- Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check# t 11111 i 1 Check date: Notes- Code Enforcement Inspector NC) -t�r�JAJ- v a Ca Y\-t 0 r i- CTTY OF SALEM, MASSAC:HUSETI'S Bo.\Ru(w HI,:u:ri I a 120 Wt\S11IVG'r0\S'Cpi[i±'1' 4'°F1.c OR Tel,. (978)741-1800 hL\Il3ERLEY DRISCOLL F,\t (918)745-0343 MAYOR I I:w1mwd)s f1 r\i CoM 1.um),R!\Rfl)IK,ILS/RI'I G,(;110,(T-I'S I-11'\11 If A(d,N[ 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 Updated 5Y23111 `° City of Salem, Massachusetts IN n m r q Board of Health 120 Washington Street, 4th Floor, Salem, Pu bliCHealthh Prevrnt Promote. Protect. MA 01970 Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS,CHO Mayor Iramd'tn@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE#: GHL-15-431 DATE ISSUED: 12/24/2015 Property Located at: 14 PARK STREET UNIT#A Owner/Agent: Frank&Carta Valentino Address: 44 Vernon Street#4 City/Town: Waltham, MA Zip Cade: 02453 24 Hour Phone:(781) 799-5035 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 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 Larry Ramdin, MPH, REHS, CHO SANITARIAN HEALTH AGENT CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4'FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR LwvMDJNQSALEnt.cob LARRYRAMDiN,RS/RhI S,mo,cmws HEAjm4 AG1iNT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" / I FEE: $50.00 1 ,, PROPERTY LOCATED AT l L4 PaYK S,7 {�iW�� I' t UNIT# A IS 7WS UW D1SI�GNATID A<RIGHT)Ud'T FJtONT OR IfgV�PLEASE CIRCLE ONE OWNmuLESSERhh1,. S rr, ivy va4\'Tin1 MANAGmAGENT '13 OT NO P.O.BOX I ' ADDRESS LIRA �V R{` ON 57. �-4 ADDRESS CITY, STATE,ZIP 1 4 W 'i7�y )CL M, M� 02453 CITY,STATE,ZIP RESIDENCE PHONE ��1 SD� �j —BBSas-r,re�� <;USINESS PHONE R05 . TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 5?,Z 3. 5C3 4. (—V, 5. K 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DO FEE AY BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS F I PA LE AT TIME OF INSPECTION I APPLICANT'S SIGNA _, DATE Inspectors use only Date on initial inspection: 12/21 Date ofreinspection: Date of issuance of certificate:TV21/2.015- Date fee paid: 122 20�5� Type of unit: Dwelling Other Check#1213 9 Check date:-�Z0124 t Notes:Snvog window; miSS�ha sCYeeA or lei✓' +'nv-n 5m--enC ementSpector CITY OF SALEM, MASSACHUSETTS r . BOARD OF HEALTH 120 WASHINGTON STREET,4"FLOOR TEL.. (978) 741-1800 I{IMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR ixaat1:NBAUMr7a.SA].1;N.co,n DAVID GRI?F.NBAUNI ACTING HEAL:PII Ac;]--',NT CERTIFICATE OF FITNESS CERTIFICATE#587-09 DATE ISSUED: 11/24/2009 Property Located at: 14Park Street UNIT#B Owner/Agent: Caria &Frank Valentino Address: 44 Vernon Street City/Town: Waltham, MA Zip Code: 02453 24 Hour Phone: 781-799-5035 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 HEALTH . I ) DAVID GREENBAUM ACTING HEALTH AGENT CODE EN RCEMENT INSPECTOR u� �S/�p + CITY OF SALEM, MASSACHUSETTS �re? 'OQ BOARD OF HEALTH 120 WASHINGTON STREET,4."FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGREENBAU?vinsva;m[.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. 'J FEE: $50.00 f� PROPERTY LOCATED AT I -i 1 Qr k- CS T UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE 1� OWNER/LESSER�hG i' F@I) / IpOn-T_n(T— MANAGER/AGENTI Dhni Valem n V ADDRESS 4L1 Ve /On Sr , A DT 1 4 ADDRESS CITY, STATE,ZIP W CAI�� /�� MPV 1 02 453 CITY, STATE, ZIP ��p RESIDENCE PHONE ��p� I ,) OL315 BUSINESS PHONE(24HRS) SU y v 1 L BUSINESS PHONE 56�• I— TOTAL NUMBER OF ROOMS: C1 ROOM USE: I. L.2 2. BR 3. BR 4. F5K 5. .PATH 6. BATH 7. RR 8. BR 9. k:I y)9/110. THERE IS A FIFTY($50)DOLLAR FEE,PAYAIM,E BY CHEC ONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE PAY ;LE T E F SPE ON APPLICANT'S : �� 7U DATE Ins_nectors use only Date on initial inspection: I I laq I U°I Date of reinspection: Date of issuance of certificate: llhqbg Date fee paid: I J I a -I IU CJ Type of unit: Dwelling Other Check# h1 u I kVAeck date: I 1 la N/G � Notes: Of() L)p H&+ IN&4-v 1 (Yl(k ,(Ll(e a/1 w ilid a J kip-0 .sveel?- J' p�X CI(t . firs AJECA n srrwt hCod, l�� r gniocg� C(.va (6f1SJ6 ut tt o J-?p S31- 101�- Code of cement Inspector i r 4 CT"IY OF S.1LEM NVASSAC:HUSI?TT'S ' 110ARD01-4it AL-1t1 PublicHea Ith 120 W.\5HIN<;I"C)N S'tRF.I,�;]' 4Fl.()Ult r.,.,„r i•„m•„ _r,,,i ,, TyI,. (978) 741-1800 F,\x 0978)745-0343 KLMBF_RI,EY DRI SCOt1, lramdin(a-),salcm.com l r\ItR\'1tANft)iN, ItS/1FISll5,(,i iC),t:I'-I5 MAYOR HI?,ll:1'f i At a?N' CERTIFICATE OF FITNESS CERTIFICATE#244-13 DATE ISSUED: 7/25/2013 Prop,oty Located at: 16 Park Street UNIT#B Ownor/Agent: Carla & Frank Valemtino Address: 44 Vernon Street Unit 4 city/'town: Waltham, MA Zip Code: 02453 24 Hour Phone: 781-799-5035 Purs jant 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 '.MR 410.000: Massachusetts State Sanitary Code, Chapter Il”Minimum Standards of Fitness for Human Habitation". Ther.=,fore, 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. FOF THE BOARD OF HEALTH L 111Y RAMDIN HEALTH AGENT QSA CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4`FLOOR PublicHealth r,Wbnt rIU111Jb PrdnC,. _ Tm_ (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL Iramdin&,salem.com MAYOR LnaRt linnlrnN,xs/Rttils,cfl(1,<:r-Fs Hi.m,,9 f AGENT ►e� e,7 �« sJt,O,�, _ J LxrlA Iv em61271 Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" �nn I� FEE: $50.00 C� Lam' y�n 1`A- (� PROPERTY LOCATED AT W ✓ PQ'� S�� CS0 OVI I v UNIT# (�� SIS (THIS UNITT DIISSII,GNATED, /AS RIGHT LEFT FitONT OR B�PCEIASSECICIRCLE ONE t 1 OWNER/LESsERI`�ILit�r[a0 BOX -t � �� rW— I(C001�I\ WNAGER/AGENTNOP' ADDRESS q 4 A�IT� �(Onn S I t � L4 ADDRESS CITY, STATE,ZIP 'V y-7�� 1 I y✓LGM , MN 022-4ITY, STATE, ZIP RESIDENCE PHONd- C> ��T��jl,C/50 3j,BUSINESS PHONE(24HRSf?� _)_7q 0i-5a3 5 . BUSINESS PHONE J Alf" _: TOTAL NUMBER OF L� C-7 ROOMS: 1� n ROOM USE: 1. P\ 2. �R, 3. E)K 4. bR 5. BIS 6. K.11' rV'1 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 FE PAY E/ INT� SP i APPLICANT'S SIGNATURE� A_ /l V 1/ � DATE 1�- vv Inspectors use only Date on initial inspection: ' l �Il Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check# Check date: Notes: Code E rcement Inspector r TRANSMISSION VERIFICATION REPORT TIME 08/01/2013 2: 36 NAME FAX 9787450343 TEL 9787411800 SERA 000S0N341991 DATE,TIME 08/01 22: 36 FAX NO./NAME 917817901271 DURATION 00: 00:19 PAGE(S) 01 RESULT OK MODE STANDARD ECM i t CITY OP SA1II;M, . MASSACHUSLM BOARD OFHEAiall 120 WASFIIN(:roN STRCa,4"`t').Ot oll .. (978) 741-1800 1%tM131iR1.E{Y I3IZISCt7Lf. FAX ()78) 745-0343 MAYOR kxindin(t olem.axn LARRY RANIDIN,kt\/12!{!IS,t:1 t(),t:P-i•l' Ifrw;mAclsN'r Facsimile Transmittal To: �JytLVG+ Gr r q�SA 14t IJW,tn Fax # RE: Bate Page(s): including this cover# Message: Board of Health News ----------- -- _------------------ ------__-Far Your Infonnation 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 PEPOPT TIME 08/01/2013 22: 38 NAME FAX 9787450343 TEL 9787411800 SER. # 000B0N341991 DATE,TIME 08101 22: 38 FAX NO./NAME 919787449614 DURATION 00: 00:8 PAGE(S) 02 RESULT OK MODE STANDARD ECM ( IMPORTANT MESSAGE ) FOR A.M. DATE C?` 03 TIME P.M. M OF 52 / LC k 0 n �J_ T ,n PHONE 4-,onn Ur.c.A/\OC Sty , X AREA CODE NUMBER /EANSION ❑ FAX :s /q d"�} ?� ❑ 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 WILL FAXTOYOU MESSAGE XR C �., - -L To SIGNED WrmFORM 4009 MADE IN U.S.A. z m IV s qq CITY OF SALEM, MASSACHUSETTS gyp, BOARD OF HEALTH • 720 WASHiNCTON STREET, 4TH FLOOR' CERT.# 4J3-03 SALEM, MA 01970 TEL 978-741-1$00 FEE $25.00 FAX 978-745-0343 DATE: 9/24/03 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, R5, CHO MAYOR HEALTH AGENT 11 CERTIFICATE OF FITNESS , PROPERTY LOCATED AT: 16 PARK STREET UNIT #: 1 OWNER/AGENT: JOHN S. MOONEY ADDRESS: 5211 HICKORY DRIVE CITY/TOWN: FORT PIERCE FL ZIP CODE: 34982 24 HOUR PHONE: " 772-460-4770 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 vft*,g-f-, Att;(� JOANNE SCOTT, MPH,RS,CFiO HEALTH AGENT CODE ENFORCEMENT INSPECTOR L CITY OF SALEM9 MASSACHUSETTS BOARD OF HEALTH r y, 120 WASHINGTON STREET, 4TH FLOOR a� Ira SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT Facsimile Transmittal Fax# '7e S3 A - /o' RE: //�� AZ4 K QST' Date Page(s): including this cover# Message: Board of Health News ---—------------------------------------------ For Your Information Office Hours: Effective September 12, 2003 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 Do Salem Residents Know ? —The Board of Health meetings are held the second Tuesday of the Month. HP Fax Series 900 Fax History Report for Plain Paper Fax/Copier Joanne Scott Salem BOH 978 745 0343 Sep 24 2003 2:1Opm Last Fax Date Time Twe Identification Duration Pae Result Sep 24 2:09pm Sent 99785328618 0:37 2 OK Result: OK - black and white fax PDA f . U T U.S. Postal Service CERTIFIED MAIL RECEIPT (Domestic Mail Only;No Insurance Coverage Provided) 0 a- Postage $ r M Certified Fee Postmark 11- Return Receipt Fee Here O (Endorsement Required) 0 Restricted Dehvery Fee (Endorsement Required) 0 1=1 Total Postage&Fees $ M Name(Please Print Clearly)(to be completed by mailer) IT Strew,APt No,or PO Box No. ______________---.....--_-----..-...-. tr p ------------------------------------------------------------------------- PS Form •tr Certified Mail Provides: ■ A mailing receipt ■ A unique identifier for your mailpiece ■ A signature upon delivery - ■ A record of delivery kept by the Postal Service for two years Important Reminders. ■ Certified Mail may ONLY be combined with First-Class Mail or Priority Mail. ■ 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 may be requested to provide proof of delivery To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 38111 to the article and add applicable postage to cover the fee Endorse Tailpiece '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 o addressee's authorized agent Advise the clerk or mark the mailpiece with endorsement"Restricted Delivery'. ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail IMPORTANT:Save this receipt and present it when making aniinquiry. PS Form 3800,July 1999(Reverse) 102595-99-M-2087 o CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH M1 4 Irk 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. UISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT July 31, 2003 John S. Mooney 5211 Hickory Drive 9Qn29e?ouJ v� u140is �3 Fort Pierce, FL 34982 Dear Mr. Mooney: r In accordance with Chapter 111, Sections 127A and 127B, of the Massachusetts General Laws, 105 CMR 400.000: State Sanitary Code, Chapter 1: General Administrative Procedures and 105 CMR 410.000: State Sanitary Code, Chapter 11: Minimum Standards of Fitness for Human Habitation, an inspection was conducted of your property at 16 Park Street#1 conducted by Pablo Valdez, Code Enforcement Inspection of the Salem Board of Health, on July 29, 2003. An inspection of the dwelling unit at the above address has revealed that it does not comply with the Massachusetts State Sanitary Code Chapter 11: Minimum Standards of Fitness for Human Habitation. Therefore, a Certificate of Fitness cannot be granted from the Code Enforcement Division of the Salem Board of Health and the unit may not be rented or occupied until the noted violations have been corrected and a reinspection has been made. VIOLATIONS: SEE ENCLOSURE: ONE OR MORE OF THE NOTED VIOLATIONS MAY ENDANGER OR MATERIALLY IMPAIR THE HEALTH, SAFETY AND WELL-BEING OF THE OCCUPANTS. Please note that some of the necessary repair may require permits for the Building, Plumbing, Electrical, Fire or other City Departments. These must be obtained before the work is commenced. FOR THE BOARD OF HEALTH REPLY TO =cott Pablo Valdez Health Agent Code Enforcement Inspector Este es un documento legal importante. Puede que afecte sus derechos. Enclosure CERTIFIED MAIL 7099 3400 0009 4079 0542 JS/mfp t l } CITY OF SALEM HEALTH DEPARTMENT • t Salem, Massachusetts 01970 Page Of Date: Name o �j L' C fto O / Address: /�A- l� / Specified Time Reg.#410.. Violation(s) IZ K /bTL 7 P ti LI[J nv �C�%Z �p �a l ✓1 t/v c (2- — l /�� I I 1 1 1 I I i I 1 Page of Date: Name: Address: Specified Time Reg.#410.. Violation(s) I — I I I I I - I i I 1 I I 1 I I I I I ca CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 3 120 WASHINGTON STREET, 4TH FLOOR e 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 FOR HUMAN HABITATION". PROPERTY LOCATED AT _j_(0 PSK S 'j UNIT# I IS THIS UNIT DESIGNATED AS BRIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNEWLESSER 7Y)ti0 LSJ MOI:M MANAGER/AGENT No P.O. Box I NcP.O. Bcx ADDRESS 7 (-� MlC KO�N D (L ADDRESS CITY ( I, ea:f c e Fl- 3V�O- CITY RESIDENCE PHONE772. 'kd W?7t) BUSINESS PHONE (24 HRS.) BUSINESS PHONE / TOTAL NUMBER OF ROOMS: ti`s 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 SIGNATUREIn� \_ DATE �'"2S' � 3 RS USE LY DATE OF INITIAL INSPECTIOW-7 'J1-0 3 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: I-/0-0 3 DATE FEE PAID: TYPE OF UNIT: DWELLING OTHER_ CHECK CHECK DATE1` 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 FAx 978-745-0343 Kimberley Driscoll WWW.SALEM.COM Mayor JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#498-06 DATE ISSUED: 10/12/2006 Property Located at: 20 Park Street UNIT# 1 Owner/Agent: Claudia Chuber Address: 3 White Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-223-5761 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 � qr-v-� jt� 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 0 FAX 978-745-0343 JOANNE SCOTT, MPH. RS, CHO - Kimberley Driscoll HEALTH AGENT Mayor APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SAN11-ARY CODE, CHAPTER It, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT I r C^_S UNIT IS THIS UNIT DESIGNATED AS RIGHT LEFT FnONT BACK PLEASE CIRCLE ONE tgtK2 l _Lzt 46til � OWNER/LESSER C(�L&c_:r=%_Ci� MANAGER/AGENT No P.O. Bax No P.O.Box ADDRESS ADDRESS CITY CITY 74e4 3623BUSINcESS .PHONE ESi1)ENCE `PIA0IN EE , BUSINESS PHONE 1 M 744 6e>16 TOTAL NUMBER OF ROOMS e7- ROOM ROOM USE: i 1Ly�} ._ 2 C-i,--3'-5_- - -4 _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 . INSPECTORS USE ONLY, DATE OF INITIAL INSPECTION, 6 _ DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE I� `�S-n9 6DATF FEE PAID... TYPE OF UNIT. DWELLING, ' 'OTHER CHECK 0 CHECK DATE r � ,l Z er (� NOTES - CODE OTES _CODE ENFORCEMENT INSPEc,TOH P28/98 CITY OF SALEM, MASSACHUSETTS s 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#499-06 DATE ISSUED: 10/12/2006 Property Located at: 20 Park Street UNIT#2 Owner/Agent: Claudia Chuber Address: 3 White Streete 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 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 qz�f� JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR r�— CITY OF SALEM, MASSACHUSMTS ' 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 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 92 l� _.S UNIT#_ IS THIS UNIT DES! NATED AS RIGHT LEFT F9QNj BACK PLEASE CIRCLE ONE OWNER/LESSER C(aua-ta- MANAGER/AGENT No P.O. Box // No P.O.Box ADDRESS 3 ADDRESS CITY 50. L2W" CITY RESIDENCE PHONE179 744 -Q6?,,3 BUSINESS PHONE.) BUSINESS PHONE '9N 744- CDI C TOTAL NUMBER OF ROOMS:-,-C::,- ROOM USE: 1 , ! - 2 -- --3'- G�---4 - - 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 . " _! __-' DAIE_v` INSPECTORS USE ONLY DATE OF INITIAL INSPECTION_„f- � -0 � DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE fO _J}-3-06 DATE FEE= PAID -. /p,- ! �0 TYPE OF UNIT DWELLIN OTHER - CHc-CK !i '?(0_3q CHECK DATI` NOTES CODE ENFORCEMENI INt','PECTOR [i119H CERT.# 395-98 " FEE $25.00 3 � � 1�� f? DATE: 06/16/98 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1600 Fax (978)740-9705 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 22 Park Street UNIT #: 1 F14s-r'F-0O/L OWNER/AGENT: Stacy John Thomas ADDRESS: 9A Cottage Street CITY/TOWN: Cambridae. MA ZIP CODE: 02139 24 HOUR PHONE: 576-3414 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. M_AX.IMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410 .000 : MASSACHUSETTS STATE SAPIITARY 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: . fl-'[E: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR OCCUPANTS UNDER 6 YEARS OF AGE. F/OOR�' THE BOARD OF HEALTH ,iOANNE SCOTT, MPH, RS,CHO /h!"uG"� HEALTH AGENT CODE E><IFORCEMENT INSPECTOR �,Mcoxw A 9 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 05/02/2001 Stacy John Thomas 9A Cottage Street Cambridge, MA 02139 PROPERTY LOCATED AT 22 Park 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 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 O� REPLY TO oanne Scot , MPH,RS, HO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR �Mrt� CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970 02/21/2002 120 Washington Street JOANNE SCOTT, MPH, RS, CHO Tel: (978)741-1800 HEALTH AGENT Fax (978)745-0343 Barry Rosenberg 6 Ralph Road Marblehead, MA 01945 PROPERTY LOCATED AT 22 Park Street UNIT # 3 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 9f HEALTH REPLY TO oanne Sco t, MHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR v " ¢eNDIT 6� n � ��d11NB 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 04/23/2001 Stacy John Thomas 9A Cottage Street Cambridge, MA 02139 PROPERTY LOCATED AT 22 Park Street UNIT # 3 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 %III 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. O� HEALTH REPLY TO oanne Scott,, MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR ' vg,Ncoriolrko CERT.# 141-01 FEE $25.00 DATE: 03/26/2001 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: 22-24 Park Street UNIT #: 3 OWNER/AGENT: Marc Parella ADDRESS: 158 Allen Avenue CITY/TOWN: Lynn, MA ZIP CODE: 01902 24 HOUR PHONE: 823-0108 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 rl JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR y 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 OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT ?` )` -z yk S /�A/P � UNIT#3 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER kC , U ,4 MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS /S'J4/w� Xve ADDRESS CITY in /�n .2 _. CITY RESIDENCE PHONE �(k4 -d 3/3 BUSINESS PHONE (24 HRS.) 8-,3'3 '01 O,' BUSINESS PHONE TOTAL NUMBER OF ROOMS: / / ROOM USE: 1.12 ivn2. ,L� . /(��44 4. IfAt 5. 6. 7. 8, THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALE , LTH DEPARTMEN THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE.'' ��/ DATE G/ (5i' G' INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 3 'a (, --o 1 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: 3-a-& -v 1 DATE FEE PAID: 3 ' TYPE OF UNIT: DWELLINTHER_ CHECK# 17 (P CHECK DATE I NOTES: /l\ CODE ENFORCEMENT INSPECTOR 9/28/98 pDNDlr, City of Salem, Massachusetts Board of Health "4 120 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-15-212 DATE ISSUED: 8/5/2015 Property Located at: 24 PARK STREET UNIT#3 Owner/Agent: Jordan Rabb Address: 24 Park Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 239-9302 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 V—7A4� Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN i CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR LRAMDIN@MLEM.COM LARRY RAMDIN,RS/REBS,Clio,CP-IiS HEALTIIAGENT II _ Emw �w^llvZ Z 1 e/0-1 Y�00 . GOrr� 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 �� NN S�(eet UNrr# IS THIS UNIT+D�IS'I.G`N/AT®AS RIGS IM FRONT OR BACK PLEASE CIRCLE ONE OWNER/LFSSER-1(�A n I�N tai MANAGER/AGENT NO P.O.BOX t ' ADDRESS 24 OA�u Skf2 e r ADDRESS CITY, STATE,ZIP 5U 1e� 1 ��A 7`� CITY,STATE,ZIP RESIDENCE PHONE f� BUSINESS PHONE(24HRS) BUSINESS PHONE `1 ��- 2 3 7/ 4 3 L Z TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3. r0 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 Inspectors use only Date on initial inspection: OU)U/201,5 Date of reinspection: Date of issuance of certificate: A15- Date fee paid:07 1�/� Type of unit: Dwelling-_V Other Chec,lk# k?— Check date: 04//?�/ Dlr Notes: Il(' A�(�y✓1 ne_r ✓'onr oJ'1�Nn vir P- r1eads 4n Lyc x.✓in ll.nw J--V _ .rv. I f _ C ement#ector City of Salem, Massachusetts Q Board of Health 120 Washington Street 4th Floor, Salem PubliCHealth v 9 P,,.,m P,,.m, P,,,w o , MA 01970 Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHO Mayor health@salem.com Health Agent FITNESS CERTIFICATE F C O ESS CERTIFICATE#: GHL-16-291 DATE ISSUED: 8/9/2016 Property Located at: 29 PARK STREET UNIT#2 Owner/Agent: Jason Mclsaac Address: P.O. Box 68 City/Town: Boxford, MA Zip Code: 01921 24 Hour Phone: (781) 799-7107 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 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. Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age. /6JeffrBarosy Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS BOARD OF Hr-ATs TH 120 WASHING]ON SITErT-,4'"FLOOR TEL. (978) 741-1800 K MBERLEY DRISCOLL FAR(978)745-0343 MAYOR LIUN IINOSALF-XCOM LARRY RAMDIN,RS/REHS,CHO,CP-FS HEALTI-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" I/ FEE: $50.00 PROPERTY LOCATED AT a9 PGS 7(�y UIIT#_� -y IS THIS UNIT DIISIIGNATEED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER C26Y\ 1 ° `C . yS G G_C MANAGER/AGENT NO P.O.BOR ADDRESS �0)( D A vi a ADDRESS c( -7 3 Ca 10k�i 1U')(, CITY, STATE,ZIP CITY, STATE,ZIP ff),< ))1✓a\t).X.(/ RESIDENCE PHONE I � I -719 I IID 7 BUSINESS PHONE(24HRS)—a97—yq JR6 S� BUSINESS PHONE TOTAL NUMBER OF ROOMS: cn' �` I ROOM USE: 1. r` 2. sC 3. L'k[ N4. V` �5. 6. 7. 8. ti 9. J 10. THERE IS A FIFTY($50)DOLLAAZ FEE��AYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE JU AT THE TIME OF INSPECTIONAPPLICANT'S SIGNATURE 1� ! DATE T/ Inspectors use onlv Date on initial inspection: Ova��ln u Date of reinspection: Date of issuance of certificate: Date fee paid:' Q V-2-0g6 Type of unit: Dwelling Other el>eck# Check date: hV0q 014 Notes: *defo menispector CERT.# 719-97 ' Al. FEE $25.00 X11. . 1F DATE: 10/21/97 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: 29-31 Park Street UNIT #: 2L OWNER/AGENT: James M. Coan ADDRESS: 45 Northridae Road CITY/TOWN: Ipswich. MA ZIP CODE: 01938 24 HOUR PHONE: 356-5468 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 L65".." JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR n Jjy�p . CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tet(508)745-1800 APPLIGATION 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". 7)� PROPERTY LOCATED AT f � � {� F UNIT # OWNER/LESSER hk p. Xr ( (�y}(2 71 MANAGER/AGENT ADDRESSi��/l�4 ADDRESS ru CITY j�J/t/fCITY RESIDENCE PHONE J I .�O `tj� BUSINESS PHONE (24 HRS.) BUSINESS PHONE / — 76 2 �f TOTAL NUMBER OF ROOMS: / ROOM USE: i, wol 5. 6. 7, g, THERE IS A TWENTY–FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEH HEAL HT THIS FEEIS P�A,++YABLE AT THE TIME OF INSPEGTIO APPLICANTS SIGNA DATE jt INSPECTORS USE ONLY DATE OF INITIAL INSPECTION:/;�) - (%`�~� DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: fn j ! '7 7 DATE FEE PAID: r TYPE OF UNIT: DWELLING jr- OTHER NOTES: '�"� CODE ENFORCEMENT INSPECTOR IM RTANT MESSAGE ) FOR _ n ^ DATE (^ TIME�� M OF PHONE AREA COOS NUMBER EXTENSION ❑ FAX ❑ MOBN F AREA CODE NUMBER TIME TO CALL TELEPHONED PLEASE CALL CAME TO SEE YOU WILL CALL AGAIN 14� R •�....WILL F.IfWW . ANTS TO SEE YOU RUSH ETURNED YOUR CALL . ... AX7DYOU MESSAGE r�,,l)Y9, l)✓1S t9ltu2_0 Ml 4 / i 0 SIGNED fL 4� FOR OErvIJ,}tJ S A z 0 m cn 1 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH jp 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 WiAj 4LI) S i ' L/ \k) i,hj CI'a IJ CERTIFICATE OF FITNESS 06 CERTIFICATE#262-06 DATE ISSUED: 5/24/2006 ( _ Property Located at: 29-31 Park Street UNIT# 1 Left t� Owner/Agent: Jordan Castro 'n Address: 2 Station Road City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 617-913-1860 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 JO NNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR S. r�..w •y .. _ ,.: \/ll i ��` . fWr�+ MSOM BOARD OFHEALTH Li +✓7� 120 WASHINGTON STREET,4TH FLOOR SALE►!. NA 01970 TEL-.970-7411-1600 ' 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 It, 105 CMR 410.000 'MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION'. PROPERTY LOCATED AT�. `��S 1 Y �k l UNIT 4-tL, IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE EE1CIRCLE ONE OWNER/LESSER�1(5'P Lkk)C -A`�® MANAGERfAGENT- `\ -- NO P.O. Ba No P.O.Bax ADDRESS 1mC v) "@ Tl ADDRES�S� /� CITY sA-l ,P Kik CITY l V\_A 1 , RESIDENCE PHONE f�_A2�WSINESS PHONE (24 HRS.) A1:i_l q 1800 BUSINESS PHONE II TOS.TAL NUMBER OF ROOMlY' 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 SAL EM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE INS.PE_CT_ORS USE ON! Y a DATE OF INITIAL INSPECTION _ 'v DATE OF REINSPEC LION DATE OF ISSUANCE OF CER1lFI ATI_S'� s .b HAIL FI-L PAID �__ ) 7 TYPE OF UNIT DWLU INC O1 HCH C F:CK V'l _? (A!F-CK OATF NOIFS C(A)I I NI 01WI ml IVI THAI'! (:IOf; f 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 #263-06 DATE ISSUED: 5/24/2006 Property Located at: 29-31 Park Street UNIT# 1 R Owner/Agent: Jordan Castro Address: 2 Station Road City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 617-913-1860 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}HI[� JO NE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR _ �/( 5�"f0•b s!i'.v'it"Ainr• -;'��: ,•tll'•SIM1as.�/y� Ali, ail sill Ly,11 �IJ.. i,l� WWA".' CHtJIS 5 .. Bomo OF HEALTH • 120 WASHINGTON$T11EET,4TH FLOOR SALEM,MA 01970 TEL. 975-741-tSOO FAX 975-745.0343 STANLEY USOV/CZ,JR. JOANNE SCOTT. MPH, RS, CHO MAYOR HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER If, 105 CMR 410.000 'MINIMUM STANDARDS OF^FITNESS FFOORj HUMAN HABITATION*. PROPERTY LOCATED ATC1�' `FTOR _ 1 UNIT # In IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNERlLESSER CAF AF VQ NAGERtAGENT No P.O. Box } No P.O.Box ADDRESS rel .� I t\�1 '"h1_ C� ADDRESS CITY �4i `-1 CITY (VA RESIDENCE PHONE91E C; 1q 1q� ?- �--U��SINESS PHONE (24 HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS. ROOM USE: THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SAI E HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE ___ _-_ ___ _ _ .____ ,__PATE„�_- L N Et;TOt'iS USE- ONLY DAl E OF INITIAL INSPEC;TION,� } O DATE= OF REINSPECTION DATE OF ISSUANCE= OF CFRTIFICATFJ _ ' 'I)ATI FL:[_ PAID TYPE OF UNIT DWFIA.ING OI HFA CHECK V ? 3 if-CK DATE. NOTES, COUI 1, NI 0I W(Ml NI IN';Pl tIIOI "' '• i • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 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#264-06 DATE ISSUED: 5/24/2006 Property Located at: 29-31 Park Street UNIT#3 Owner/Agent: Jordan Castro Address: 2 Station Road City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 617-913-1860 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 J ANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR 1 Y14i' IAylll !J,IIJg;- a^/M,' '' .. .. 'Ci3"YOFS'/0.tF..MGEit)SEt1"5 SOARDHFJU-TH 120 WASHINGTOHIMCM SN TIIEET•4TH FLOOR SALEM, MA 01970 TEL. 979-741-1800 FAX 978-74S-0343 ' STANLEY USOYICZ,JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER It, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HHUMAN HABITATION". PROPERTY LOCATED AT 0_0 - rk i'� 1y 1 ----UNIT k 113 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER(LESSER �U1 `Jf Ste) CPN ANAGERtAGENT No P.O. Box S _ No P.O.Box ADDRESS rl i PtTR_Al� ADDRESS CITY SPS,� i____. CITY RESIDENCE PHONA 1,4P3,k0SINESS PHONE (211 HRS.)__ __ BUSINESS PHONE , �. �tti J AS�v 0 _ TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3 4 5 6 7 8. THERE IS A TWENTY-FIVE{525.00} DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SAL HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. �} APPLICANTS SIGNATURE _ _ _ _DAT= 5-L) IN PECTORS USE ONLY DATE OF INITIAt. INSPECTION b `_17'( -0 6, DATL OF REINSPECT ION DATE OF ISSUANCE 01= CER1lFI(-,ATI' [)Al [ F1=1'. 1)All) J` J7 � o � TYPEOFUNII DWIA-11N OTHER CHFCK11 alFCt< tmrl- S NOT["S COD I NI OIW(�W NI N!WI c, I( )I; I v 3 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET 4r"FLOOR PI1b.1CHe81tIl > Prevent.Promote Protect TEL. (978) 741-1800 FAX(978)745-0343 KIMBERLEY DRISCOLL Iramdinnasalem.com LARRY RnMOIN,Its/REr IS,ctio,CP-FS MAYOR H73Al;fti AGENT CERTIFICATE OF FITNESS CERTIFICATE#377-13 DATE ISSUED: 10/22/2013 Property Located at: 31 Park Street UNIT# 1 Owner/Agent: 29 Park Street LLC Address: 20 Sagamore Street#3 City/Town: Lynn, MA Zip Code: 01902 24 Hour Phone: 617-851-5608 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. eR THE BOA OF H LARRY RAMDIN I� HEALTH AGENT SANITARIAN - x a- r.+�a-•""a i-+b�•tge ...fyiiNi+�r ... s w.tzr i . ., , ... CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET 4"'FLOOR PublicHealth Prevent.Promote.Protect. TEL. (978)741-1800 FAX(978)745-0343 KIMBERLEY DRISCOLL lramdinO.salem.com MAYOR Lr\RRl'1L\btDIN,RS/RI;HS,CI IO,CP-I5 HEALTH AGENT A 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 O Z PROPERTY LOCATED AT - I P�� -,!:Zi �Ci - n'2-vK U UNIT# -i l - IS THIS UNIT DISIGNATED A�_6rRIGH�!<�FRONT R BACK PLEASE CIRCLE ONE /r OWNER/LE,SSER ' q Pa r'k S6 l11 u Y\CL� l-LC MANAGER/AGENT NO P.O. BOX ADDRESS 3 ADDRESS CITY, STATE,ZIP ft vi vI M A - c) )q O Z CITY, STATE,ZIP RESIDENCE PHONE BUSINESS BUSINESS PHONE(24HRS) cM -� BUSINESS PHONE -}Lc VI-0 TOTAL NUMBER OF ROOMS: (-I ROOM USE: 1. 6r1o'��, 2. � 3. fw-d 2 4. 16i4CL¢h5. 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 FE7 AT THE TIME OF INSPECTION APPLICANT'S SIGNATUREJ,L / DATE 10IZ2Il s InsDectors use only Date on initial inspection: )u-7-T,)`1 Date of reinspection: Date of issuance of certificate: l o -22 3 Date fee paid: /d -t2-• t'2 Type of unit: Dwelling 1/ Other Check# 3 j Check date: )a ZZ,�V-) Notes: Code Entorcement Inspector City of Salem, Massachusetts UrR rim lnh� AMP va MIFBoard of Health 120 Washington Street, 4th Floor, Salem, PuWrHealth MA 01970 P`"`"`. Promote Protect. 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-17-335 DATE ISSUED: 10/10/2617 Property Located at: 32 PARK STREET UNIT#1 Owner/Agent: Darius Gregory Address: 21 Leavitt Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(617) 510-0133 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. Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN >r' Cn Y OF SALEM, MASSACHUSETTS BOARD OF HEALTH {p� 120 WASHINGTON STRE T,4"'FLOOR TEL (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR LRA] D]NOSAUM.CDM LARRY RAMDIN,RS/RHHS,CHO,CP-PS 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 LOCATEDAT Pca()r, C� cSN\eW\, MA WOK) UNIT# I his T_HIS uNrYnISIGNATED As mcm LEFT FRONT OR BAC PLEASE CIRCLE ONE OWNER/LESSER k 9 'm &t' C 3 'CQ Cpl MANAGER/AGENT()nO(t ADDRESS ADDRESS r3efcG°d �}�� CITY,STATE,ZIP CITY,STATE,ZIP (eVv\- O(G/3 C) RESIDENCE PHONE(C6 4 n ) J d i 3 BUSINESS PHONE(24HRS) 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,PAY LE BY OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS YABLE T OF INSPECTION APPLICANT'S SIGNATURE DATE IInspectors use only Date on initial inspection: Date of reinspection: Date of issuance of certificate: Date fee paid Type of unit Dwelling Other (wreck# ' 1 Check date: Notes: , Code Enforcement Inspector p e �o CITY OF SALEM9 MASSACHUSETTS BOARD OF HEALTH - $ 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 '9B TEL. 978-741-1800 p�nB FAX 978-745-0343 STANLEY J. USOVICZ, JR. .JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#463-05 DATE ISSUED: 7/26/05 Property Located at: 32 Park Street UNIT# 1 Owner/Agent: Robert Bozarjian Address: 20 Clark Avenue 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 Cade, 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 r JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS 90AR0 OF HEALTH • 120 WASHIHGTok STREET. 4TH FLOOR SALEM, MA Oi970 TEL. 978-741-1800 FAX 976-745-0343 STANLEY USOVICZ, JR ' JOANNE SCOTT, MPH, RS, CHO MAYOR HEAt TH AGENT APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH ST ATF SANI IARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"- PROPFRTY LOCATED AT IS THIS UNIT DESIGG/NAl ED AS RIGHT LEFT FRONT 13ACK PLEASE CIRCLE ONE OWNEWLESSER-0('Up 2fi � lZi RrJ MANAGER/AGENI No P.O. Box No P.O.Box ADDRESS :;10 r'f,�!2 JL A Y'e- ADDRESS CITY C 57 a CITY RESIDENCE PHONE__ BUSINESS PHONE (24 HRS.) BUSWESS PHONE TOTAL. NUMBER OF ROOMS ROOM USE 1 c---- 2 -----,--_ j� 5- - ---L'- ----7. -- 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 Al THE TIME OF INSPECTION. �"� APPLICANFS SIGNAT E - ./;K_. - _WroT J)ATL 7 (r'oo INSPECT OR'i (M[ ONLY D l E Oi RJi7IAL INSPFCIION DATE OF DAT!- {lc l!"",1 t`.t t,!-{il ll=i }l l-� l� 'p� D•^.l u- 1=6i. t'All., �r18 � zza -iYPF OF UNI", D\lYt--1-1-ft Ol'HI-R CiILUK b �� lAir J i NtIIF'� t .t rl>i t.N'r14;t .i tii I'•, I Iiv ti'rf c.l t)ti ""+'""', I I � r CITY OF SALEM MASSACHUSETTS BOARD OF HEALTH z120 WASHINGTON STREET, 4TH FLOOR a. SALEM, MA 01970 - TEL. 978-74 t-1800 - �pHINB FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#63-05 DATE ISSUED:2/1/05 / Property Located at: 32 Park Street UNIT# 1 Owner/Agent: John E. Martin Address: 24 Leavitt Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-2202 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 Iy JO NNE SCOTT, MPH, RS, CHO "47 �,s% •x' HEALTH AGENT CODE ENFORCEMENT INSPEC°fOR ` 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 pg" _ I/NIT #j IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSERc fifaPhV MANAGER/AGENT Na P.O. Box / / } -/ No P.O.Box ADDRESS �l LC'IlI / ADDRESS �J CITY_SA� VAR M` 7Z) CITY RESIDENCE PHONETY . f5- ),2-O a BUSINESS PHONE (24 HRS )_ '— — BUSINESS PHONE" r TOTAL NUMBER OF ROOMS C{ ` n ROOM USE 1. 2.---/—/ _3. 4. — I> 5. _6.- 7. 3. 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. - r1t� APPLICANTS SIGNATURE '` t �-- DAlE__ I vv NSPECTORS USE ONLY DATE OF INITIAL INSPECTION �- 3._ _ � °-�'-- _DATE OF REIN:iPEGTiON— -- -- --- DATE OF ISSUANCE OF CERTIFICATE /" 3/ o �' DATE I EE PAIN TYPE OF UNIT DWELLING OTHER GHLCK N 4F3.5J CHECK DATE NOTES CODL ENFORCLMIENT IN',;PECTOR 91� 1'313 i City of Salem, Massachusetts � 3 Board of Health 120 Washington Street, 4th Floor, Salem, PrubliCHealth Prevent.Promote.Pmtect. 19 MA 0 0? Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Lary Ramdin,MPH, REHS,CHO Mayor health@salem.com Health agent CERTIFICATE OF FITNESS CERTIFICATE#: GHL-17-336 DATE ISSUED: 10/10/2017 Property Located at: 32 PARK STREET UNIT#2 Owner/Agent: Darius Gregory Address: . 21 Leavitt Street Cityrrown: Salem, MA Zip Code: 01970 24 Hour Phone:(617) 510-0133 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. Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CPI's' OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREhT,4°"FLOOR TEL (978)741-1800 KIMBF.RLEY DRISCOLL FAX(978)745-0343 MAYOR LRAMDTN a(1SALEM.CDM LARRY RAMDIN,RS/RF.HS,CHO,CP-PS 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" Ql� FEE: $50.00 PROPERTY LOCATED AT J� �k Sk 1i'11�' () ) 9 UNrr#� IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BAC PLEASE CIRCLE ONE OWNER/LESSER�IV, I1c2f�Jr` i MANAGER/AGENT � A/04'n L� NO P.O.BOX U �1 1 I^ ADDRESS II ADDRESS Lc1 d K V'eJ CITY,STATE,mp�l vx NA O(9 � ,k `t1CITY,STATE,ZIP f 6, Mtt OL CEq-0 RESIDENCE PHONE BUSINESS PHONE(24HRS) 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 TD THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURA DATE I C11 �I I Inspectors use only Date on initial inspection: Date of reinspection: Date of issuance of certifidate: L Date fee paid: Type of unit: Dwelling Other Check# 1'"t I Check date: Notes: Code Enforcement Inspector CITY OF SALEM9 MASSACHUSETTS BOARD OF HEALTH A&W�` 1p 120 WASHINGTON STREET, 4TH FLOOR a SALEM, MA 01970 fis s TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#252-04 DATE ISSUED: 06/11/2004 Property Located at: 32 Park Street UNIT#2 Owner/Agent: John & Jean Martin Address: 24 Leavitt Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-2202 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 ENFORCEMENT INSPECTOR I CITY OF SALEM, MASSACHUSETTS �� BOARD OF HEALTH Q 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 _� L 1pa UNIT#a) IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER—t7A'e.jkI C- MANAGERIAGENT Box / L No P.O. Box ADDRESSL{aa,. > % S� ADDRESS CITY ;iv f� m CITY 510 RESIDENCE PHONE BUSINESS PHONE (24 HRS.) BUSINESS PHONE--�7-5 .,-7u S' 02 O� 1 TOTAL NUMBER OF ROOMS: ROOM USE: 1.� 2._�Ot-3.tAC�0-4. Fti 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. IV / APPLICANTS SIGNATURE 0- 7% DATE ( / INSPECCTORS`USE ONLY DATE OF INITIAL INSPECTION !O /// J v DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE��F��-DATE FEE PAID:./ //- �x TYPE OF UNIT: DWELLING _OTHER_ CHECK If 'y3� CHECK DATE NOTES: / CODE ENFORCEMENT INSPECTOR 9/28198 City of Salem, Massachusetts m Board of Health 120 Washington Street, 4th Floor, Salem, PuW€ccHealth MA 01970 Present 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-17-337 DATE ISSUED: 10/10/2017 Property Located at: 32 PARK STREET UNIT#3 Owner/Agent: Darius Gregory Address. 21 Leavitt Street City/Town. Salem, MA Zip Code: 01970 24 Hour Phone:(617) 510-0133 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. Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CM OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL(978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR LRAMDIN(a)SAM&COM LARRY RAMDIN,RS/RF.HS,cuo,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" 2\ FEE: $50.00 PROPERTY LOCATED AT J 0\ PAfF Sf' a 6Nft Nl rtO UNIT# THISUNIT DMGNATED AS RIGHT LEEP FRONT OR BAC PLEASE CIRCLE ONE ( � r/. OWNER/LESSER �fY 1�S Grt e rnM MANAGER/AGM 0. ` ADDRESS ADDRESS' 65,--�+ u a-i c) CITY,STATE,ZIP CII'Y,STATE,zwOt t 6wN v // 'A— RESIDENCE PHONE //' {� 2 BUSINESS PHONE(24HRS) BUSINESS PHONH ( D J I �� C / � l TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLV.BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE YAB A TIME OF INSPECTION APPLICANT'S SIGNATURE `/ \I DATE Inspectors use only Date on initial inspection: Date of reinspection: Date of issuance of certificate: _ Date fee paid: Type of unit: Dwelling Other Check# I�1 Check date: Notes: Cade Enforcement Inspector d[;UND!} City of Salem, Massachusetts 1 Board of Health 120 Washington Street, 4th Floor, Salem, PublicHeatth 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-15-400 DATE ISSUED: 12/4/2015 Property Located at: 32 PARK STREET UNIT#3 Owner/Agent: Todd Stacy Address: P. O. Box 1022 City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(617) 519-7388 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, i Larry Ramdin, MPH, REHS, CHO / HEALTH AGENT SANITARIA CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL.(978)741-1800 l KmERL.EY DRISCOLL FAX(978)745-0343 ' MAYOR 1 x MI OSA7 M M.COM LARRY RAMDA9,RVRMS,030,CP-IS HEAL771 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: 550.00 PROPERTY LOCATED AT POIC k 4- UNIT# IS THE UNff DISIGNATED AS RIGHT i"T rr ORASG ,FLFASE CIRCLE ONE OWNER/LESSER MANAGER/ ENT NO P.O.BOX -= L-ja' 1 ADDRESS ADDRESS D Cf D CITY,STATE,ZIP Q,I� V ' I� CITY,STATE,ZIP RESIDENCE PHONE �Q j /' I ' BUSINESS PHONE(24BRS) BUSINESS PHONE L TOTAL NUMBER OF ROOMS: 1 ROOM USE: 1. 13 �� 2. I'k U 3. AC� 4. A)� 5. P9 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 PIN TIME OF INSPECTION f APPLICANT'S SIGNATURE t1ATE '� r IlWectQrs_nse.tlnlY Date on initial inspection: 017/22/20L5- Date of reinspection: Date of issuance of certificate: C17/J_t/ULS Date fee paid: 01 S Type of unit: Dwelling �/ Other—Check# Check date:-.1,1 1/30/2015— Notes: ate:_1,11/3©/2015— Notes:/ size Akar td t;400r Irtspectiopof OLA "ae4mo.Aa Date07=Z2121 Time 113Da � p Nam- Address 32-Par 5-Pre .+ APIW--? t c+ Owner ITnArl_ S+0Lr- Tel. No. /y Typeof Inspection Cer+4r�fe� n-F F�'w�2SS Inspector Jegl-e- f�rot� ( ' Remarks and Violations are listed below: / / I6c en m rti kit-f3 4,0M �. -fir,k -+'CrpimeQi �o Lye- -� �rLrc�iwe L zc J0. Tm b, Ie- weevt IW(I1-a d "l_ 0'0/- (ge.,.A- 130 of- + kwfh) _La-7`Z m I ra�f 1' i,xj'v✓'e ne_J5 4-6 dr_ eo- +Lal 0:j�1Ynlig VV ( V\ ow I vi AECI of v j TO b gt4rno.« nee,]( u,e-t.. SGrir rn . YdOr9m CIOSe1'+ -Fn t/on� or1{ Gr_ ho-5 S�orn, u��ne- W;}]. y011e rn 4-Or irr�/ter��nitl7l . - �carnnn n-iornox,de dtfe-doieel&,e +n be, wi-Fkv 0FF-"i ,Meath bedim kiq— eii T/o in rs �Crj�&"nna, t.-: ALw [A,A,4 Sc.v'e e.n AzeA Report Received by: "N City of Salem, Massachusetts f • i. Board of Health tp 120 Washington Street, 4th Floor, Salem, PaWicHeialth 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-17-148 DATE ISSUED: 5/18/2017 Property Located at: 34 PARK STREET UNIT#1 Owner/Agent: John E. Martin Address: 24 Leavitt Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 979-7579 ' 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. Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSE1-1 S BOARD OF HEALTH 120 WASHINGTON STREET,4T"FLOOR 'I"EL. (978) 741-1800 RZMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR LRAMDIN(&SALBM.COM LARRY RAMDIN,RS/RF-HS,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" {� �� FEE: $50.00 PROPERTY LOCATED AT 3 G/ f t kk �' UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER I o/� N I-TPk r l NY- t,� MANAGER/AGENT NO P.O.BOX ADDRESS ADDRESS CITY, STATE,ZIP CTA L0,M n/fl 7D CITY, STATE,ZIP RESIDENCE PHONE 97 1 BUSINESS PHONE(24HR06,11 Q 7�q 17 7 S79 BUSINESS PHONE N/#9" / TOTAL NUMBER OF ROOMS: /n ROOM USE: 1. 4k 2. 1 3. 4. 1ir-xl 5. Gec 6. )c 4-1— 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 ISP YABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURtF�. P) i QJ() b4~— DATE—f/6;4/ l - f p InSDectors use onlv rr Date on initial inspection:`J I ICS p i Date of reinspection: Date of issuance of certificate: r! . lel I� � Date fee paid: s-/7. /7 Type of unit: Dwelling Other Check# (/N� Check date: J 1r7— I-- �,*7 ✓�D,mo Notes: ��^i P�(1 m) bathnh (, R Y 1(, 17J Code of cement sector k CITY OF SALEM, MASSACHUSETTS IV" BOARD OF HE,9LTH 120 WASHINGTON STREET,41°FLOOR PI1bI1CHealth Crrarnl Prmmlc Prnlrcl TEL. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL tramdinnsalem.com LnIRiR) IRnnmiN,iRs/Kiri is,ci uO,(:r-rs MAYOR HvAl;rii M;itNr CERTIFICATE OF FITNESS CERTIFICATE# 165-12 DATE ISSUED: 4/26/2012 Property Located at: 34 Park Street UNIT# 1 Owner/Agent: Jean Martin Address: 24 Leavitt Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-2202 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 LAR MDIN HEALTH AGENT SANITARIAN aCITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4""FLOOR TEL. (978) 741-1800 + K AOERLEY DRISCOLL FAX(978) 745-0343 MAYOR LIL\MOIN(@D ALC?M.COM LARRY RANIDIN,RS/RN IS,(7 10,CP-FS I-II?,;\L:1'II AGI?N'1' 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: $50.00 ` PROPERTY LOCATED AT 3 Y / �!v If lL UNIT# / 11S THIS UNIT DISI�G/N/ATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER C, d h !"l c7/1�, �I MANAGER/AGENT—d2 0� NO P.O. BOX / L 11 ADDRESS �. y G Va "I S F ADDRESS CITY, STATE,ZIP Sc� /a on CITY, STATE, ZIP RESIDENCE PHONE q 7 �r 7 ,f 5-fid uZ BUSINESS PHONE(24HRS) BUSINESS PHONE �7 Sr — �Y TOTAL NUMBER OF /ROOMS: ROOM USE: 1. �. �� 12 2. V// 4 N. F 3. rlfa 4. �e 5. 'e d 6. ISP.) 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 �n� G %t, DATE a / Inspectors use only Date on initial inspection: G 1a6 f I'a Date of reinspection: Date of issuance of certificate: 7 Date fee paid: Type of unit: Dwelling Other Check# (0 / �_ Check date: Notes: (6� �O I a ddf*6y)cz1 Cn d derl'm^ Coe orcemnt Inspector �oND1T,t City of Salem, Massachusetts ' a 610 W{ i q Board of Health 120 Washington Street, 4th Floor, Salem, PubliCHea Ith MA01970 Prevent. Prnmote. Prntert 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-16-62 DATE ISSUED: 2/26/2016 Property Located at: 34 PARK STREET UNIT#2 Owner/Agent: John E. Martin Address: 24 Leavitt Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978) 979-7579 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 O� Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS BOARD OF HF 1LTH 120 WASHINGTON STREET,4"'FLOOR erePmoH di TEL. (978)741-1800 FAX(978) 745-0343 KIMBERL.EY DRISCOLL lramdin(a-).salem.com MAYOR LARRY RAAIDA,RSf RENS,CHO,CP-7"+S Hu,+L��i i AcEN�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 3 (-n I� _ UNIT# IS!!THIS UNI ISIGNATEfD AS RIGA LEFT FRONT ORB PLEASE CIRCLE ONE OWNER/LESSER ` \/ d A n r Y) MANAGER/AGENT NO P.O. BOX Y1 �/ I ADDRESS c�- ,4,e ,Vj LT !S;-4, ADDRESS CITY, STATE,ZIP J/p ),em CITY,STATE,ZIP %`76 RESIDENCE PHONE ? t Q 9 t/� 7�7 7 BUSINESS PHONE(24HRS) ti1J�r� BUSINESS PHONE AA TOTAL NUMBER OF ROOMS: �O ROOM USE: 1. 14 2. L_ �? _3. R.-- 4. 7;r 5. 8 h G. e%A)M6 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 f JTIME OF INSPECTION APPLICANT'S SIGNATURE - G y(/l .� DATE—�23/Ai r Insnectors use oniv Date on initial inspection: 0,?J2f� i2b Date of reinspection: Date of issuance of certificate:�)27_�. J2n- _ Date fee paid:0.212.3/"Pi Type of unit: Dwelling--V—/ Other Check# 3 Check date: 02-12312,O W Notes: �• cement eetor �coNni?� r f_, City of Salem, Massachusetts Lai Board.of Health "m 120 Washington Street, 4th Floor, Salem, PtlbliCHealth 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-17-168 DATE ISSUED: 6/14/2017 Property Located at: 34 PARK STREET UNIT#3 Owner/Agent: John E. Martin Address: 24 Leavitt Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(978)979-7579 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. C'. -�- �- Larry Ramdin, MPH, REHS, CHO Gil HEALTH AGENT / SANITARIAN CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STTj-4 ET,4"'FLOOR Tal_ (978)741-1800 KIMBERLEY DRISCOLL FAX (978) 745-0343 MAYOR LRAMDINOO_ SALF_M.COM LARRY RAMDIN,RS/RFHS,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" 'FIE—E: $50.00 PROPERTY LOCATED AT (��/ / c l , UNIT#2 - � IS THIS UNCI'DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER—�I 6 A In_JL a. MANAGER/AGENT7\ I LVI.QM ✓� NO P.O.BOX ADDRESS ?/Y I�/!� ADDRESS ~� CITY, STATE,ZIP c�A kbe-'l x4n CITY, STATE,ZIP RESIDENCE PHONE A BUSINESS PHONE(24HRS) IVf BUSINESS PHONE TOTAL NUMBER OF ROOMS: `1 ROOM USE: 2. 3. la-tt 4. lefQ 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 PA A (�T�T, /TIME OF INSPECTION / APPLICANT'S SIGNATURE'— �/�� L[A.v� DATE'4/�- / Inspectors use onlv Date on initial inspection: l 1LI 4 /! Date of reinspection: Date of issuance of certificate: Date fee paid: /11 Type of unit: Dwelling Other Check# J Q, Check date: (� - �Z- /7 Notes: n Code EnforcementIns r v y 0 CITY OF SALEM, MASSACHUSETTS BOARD OF HF_)�LTH 120 WASHINGTON STREET o F11-1.141°FLOUR Ith i To- (978) 741-1800 FAX (978) 745-0343 KIMBERLEY DRISCOLL lratndin n saleln.coln L;\RRl'R;\N[UIN,IiS/RliliS,(.I IO,(;1'-I'5 T✓Lcx- - - - 1-1PALI I A(,[SN I CERTIFICATE OF FITNESS CERTIFICATE#339-12 DATE ISSUED: 8/21/2012 Property Located at: 34 Park Street UNIT#3 Owner/Agent: Jean Martin Address: 24 Leavitt Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-2202 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 LAR AMDIN HEALTH AGENT *ANITARIAN CITY OF SALEM, MASSACHUSETTS BOARD ofF HEAT-'I1--1 " 120 WASHINGTON STREfl.T,4°i FLOOR TEL. (978) 741-1800 10'N113ERLEY DRISCOLL FAX(978)745-0343 MAYOR 1AAN@1N rni snJ.reN1 CONI L M)'RANDIN,RS/1UHS,0110,t:P-i5 I-I1;.A1 xi 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" yFEE: $50.00 PROPERTY LOCATED AT s .Y /1 7 UNIT#IS TJJHIS UNIT DISIGNAT�ED AS(RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER lltw- H !� O'f c7°` r. MANAGER/AGENT NO P.O. BOX J ADDRESS .`i' .�El• �! ADDRESS CITY, STATE,ZIP CITY,��_✓1 l'I CITY, STATE,ZIP__ ,f1-!�Z1ri RESIDENCE PHONEkBUSlNESS PH0NT F(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. t `1'_ 2. 5. _ rr ✓ 3. ' ; I r 6. 7 8. 9..1 to. ' 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 r -a //:.: DATE"* ' f �f Insveetors use only Date on initial inspection: (/ Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: elling_.: Other Check#.,.—Check date:___ Notes: Co cement Inspector i n ti 10 f„ ? CITY OF SALEM, MASSACHUSI:''I"1'S r— BOARD OF I-II dlXH 120 WASHINGTON STRI3ET,4.°FLOUR P1ib11CHC81t;}i TEL. (978) 741-1800 Fax (978) 745-0343 KIMBERLEY DRISCOLL hmrndinasalcm.com LARRY RAmIDIN, MAYOR Rs/Rea HenI:ri r AaN r CERTIFICATE OF FITNESS CERTIFICATE # 164-12 DATE ISSUED: 4/26/2012 Property Located at: 35 Park Street UNIT# 1 Owner/Agent: Mario Oscar Address: 35 Park 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 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 LAO RAMDIN HEALTH AGENT ANITARIA~� TRANSMISSION VEPIFICATION REPORT TIME 05/01/2012 22:08 NAME FAX 9787450343 TEL 9787411800 SERA 000BON341991 DATE,TIME 05/01 22:08 FAX NO. /NAME 919787449614 DURATION 00:00: 28 PAGES) 02 RESULT OK MODE STANDARD ECM + CITY OF SALEM, MASSACHUSE'I-I:S 130[.\m)of,, H[!.v:nr 120 tXl,\St[IN(.t'ON S'IRBBT,4"'Fl.00iJ KIMBERLP•Y DRISCOLL 1't?J,. (978) 741-1800 MAYOR F,\\" (978)745-0343 IKaindin@salcin.com I_.n Rltl'It,\AfLJ1N, ltS/w;'I IS,(:1 Jt), FI!•.,\1;1'11 A(A N'r Facsimile Transmittal To: l ' If��V� `�G'PaN�k/ %:) Q Fax # RE: J� /6 6,f !cP)t574, � 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 /,�� bov5ir� ``� can�ax Alun dJ CITY OF SALEM, MASSACHUSETTS ��- >`,� B<\Axn OF HEALTH V 120 WASHINGTON STREET,4O.FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR I RANIDIN sAl.r.NI.CONI LARRY RANInIN,RS/RISI-IS,CI10, HI?,\1:191 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" cFEE: $50.�t00 PROPERTY LOCATED AT �lp )AI Ak s I M MR UNIT#--L— IS THIS/UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER—&RIO l (SC4e, MANAGER/AGENT NO P.O. BOX ADDRESS RX' PAR. S-1— /� /� ADDRESS CITY, STATE,ZIP SAM I°`�n a 01 7() CITY, STATE,ZIP RESIDENCEPHONE-9jg `1,699 BUSINESS PHONE (24HRS) BUSINESS PHONE 979- 7,,39- 0f TOTAL NUMBER OF ROOMS: ROOM USE: 1. /QA 2. RA 3. .RD 4. QItiUlU A 5. K(TCf1E4 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 I PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATUREAGtM n kf,,\ DATE \\j v Inspectors use onlv Date on initial inspection: �:)6 /� ; Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling _QttherCheck#I1;)J6?dV$1Check date: Notes: n ' "4 (_jjC JO�'t d +. 6Y) W6,0 t-8 awC VYl(--)v'2S Idl. 04y CR.ry, C d of rcement Inspector City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, 1?nblicHealth Prevent. Promote Protect 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-17-261 DATE ISSUED: 6/25/2017 Property Located at: 35 PARK STREET UNIT#2 Owner/Agent: Mario Oscar Address: 21 1/2 Goodell Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(976) 7444689 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 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. Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age. Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN MO Se,owZ2ZQ �M4l 1 co �vl W U, Pi Gl- DF CPTY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"FLOOR TEL (978)741-1800 KIMBERLF,Y DRISCOLL FAX(978)745-0343 MAYOR LRAMDINQSALEM.C.0M LARRY RAMDIN,RS/RRHS,CHO,CP-FS }J� HEALTH AGENT V Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER 11, 105 CMR 410.000 "NIDVIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" c� FEE: $50.00 PROPERTY LOCATED AT 3S PA 2 IC S T iJN1T#_ Z, IS THIS UNrr DISIGNATED AS RIGHT LEFT FRONT OR BAC PLEASE CIRCLE ONE OWNER/LESSER oaG A 2 MANAGER/AGENT NO P.O.BOX ADDRESS } /1 ADDRESS CITY,STATE,ZIP lYa L M . 1 I A CITY,STATE,ZIP RESIDENCEPHONE 7Z� "7u`! `"Lb c7 BUSINESS PHONE(24HRS) 932-42/()- Z Z1,1— BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. B tb 2. ,R �h 3. g FA 4. LW1M(A 5. V—LT(KE) I 6. 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR E,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE AYABLEAT THE TIME OF INSPECTION APPLICANT'S SIGNATURE CAM 6 00' DATE Inspectors use onlv Date on initial inspection: Date of reinspection: Date of issuance of certificate: �� ( ��} Date fee paid: 7) �1 rT Type of unit: Dwelling Other Check# qq lq Check date: 'r, � �'-1' Notes: Code Enforcement Inspector Inspection ofJ _ Date --� Tiime I Names 'v1_r_7_fl�(`� (�_,��{� Address II_1//-- Owner Tel. No Type of Inspection Inspecto A_Xf)1 l '6)_ ( ' ) Remarks and Violations are listed below: t cn c _- ? , 1DetZ r,o in Y,CryYn ��TAc r - r r l I IY11,n j j) Pul5i CAAA J �, ?�/l, l► Report Received by: �v��corlu;rko� a r �9F��HINE� CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel (978)741-1800 07/26/2000 Fax (978) 740-9705 Rene Tremblay 16 Charnock Street Beverly, MA 01915 PROPERTY LOCATED AT 35 Park 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 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 lettingagreement statin the tenant is responsible for those 4 4 P 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. REPLY TO Jjoane XS-cott, MPH,RS,CH0 PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR CERT.# 637-97 3 FEE $25.00 DATE: 09/11/97 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: 35 Park Street UNIT #: 2 OWNER/AGENT: Rene Trembles ADDRESS: 16 Charnock Street CITY/TOWN: Beverly. MA ZIP CODE: 01915 24 HOUR PHONE: 922-2338 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 Lk� JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR 4 p i fAA �n'oy CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tet:(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 3 y= / .4t;t ht' 5 T UNIT #.0 OWNER/LESSER [� �^� �i?�.I�j�lI i MANAGER/AGENT K-51jA- ADDRESS /g, (6141 .0 4rot 17 j?�' ADDRESS v—y-�'�-^— CITY 3 �b �f.�q �' r � CITY RESIDENCE PHONE J 2J -_1 ;US' BUSINESS PHONE (24 HRS.) BUSINESS PHONE S JI6 — TOTAL NUMBER OF ROOMS: g� ROOM USE: I. fi�sY.1 2. �i j Ino 3,X O 9010 4 . {3 0 1 0 E► /� 5004 XVAf 6. 7. THERE IS A TWENTY-FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM' HP,ALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANTS SIGNATURE DATE gINSPECTORSr.USE ONLY DATE OF INITIAL INSPECTION: ` ��C 1 7 DA'Z'E OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: g /r r "Z 7 DATE FEE PAID: TYPE OF UNIT: DWELLING OTHER NOTES : CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH a 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 "0 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#478-06 DATE ISSUED: 10/5/2006 Property Located at: 38 Park Street UNIT# 1st floor Owner/Agent: Frank Ouellette Address: 25 Donovans Way City/Town: Middleton, MA Zip Code: 01949 24 Hour Phone: 978-858-4644 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 77 :• CtTy OF SALEM, MASSACHUSETTS X Q' BOARD OF HEALTH R 7 7 + 120 WASHINGTON STREET, 4TH FLOOR �,14+M_v SALEM, MA O1970 1 V'+' TEL. 978-741-1600 JOANNE ASCOTT, MPH, RS, CHO I �/ Kimberley Driscoll HEALTH AGENT Ill Mayor APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER If. 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT_� Q.f .__Ss_. --UNIT #J- IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE � JIOWNER/LESSER _ MANAGER/AGENT No P.O. Bax No P.O. Box ADDRESS c�.) D(�A"�OVQ�StWtIADDRESS CITY tY dl'at yy� CITY-- / 1 ----.------- worlC ��>j�_J8�- . RESIDENCE PHONa1/_ BUSINESS PHONE (24 HRS ) BUSINESS PHONE TOTAL NUMBER OF ROOMS > F ROOM USE 1..- {- - ` - -3 --- - - - �. --tom!.--b--�--7 ---- ----- f3 --- ---- - 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 SIGNATURF= -- - - - �J _.DATL�O`S'_ r Y0 INSPECTORS USE ONLY DATE OF INITIAL INSPECTIO-N—, �O DAIE OF REINSPECTION -v 6 DATE OF ISSUANCE OF CFRTIFICATF/T_—bra.-o(o DATE FCL- PAID /D " TYPE OF UNIT DWFLLINC f 1 Ol IiGR CNE',:K ' ("HE_CK DAl F 'la ' S NOTFS- 'X` .:ODE LNr0RCI Mi__NI Ii�5PLC Olt S'tl" tl rj I U d' u .w { CITY OF SALEM, MASSACHUSETTS BOARD of HEALTH 120 WAS[IINCTON STRFF;r 4"' FLOOR PablicHealth TFL.. ()78) 741-1800 FAX (978) 745-0343 1 IMBERLEY DRISCOLL liaindinasalein.com LARRY RAMDIN,Rs/REI IS,(:1-10,(-.11-FsMAYOR CERTIFICATE OF FITNESS CERTIFICATE #223-12 DATE ISSUED: 6/1/2012 Property Located at: 38 Park Street UNIT#2 Owner/Agent: Frank Ouellette Address: 25 Donovans Way City/Town: Middleton, MA Zip Code: 01949 24 Hour Phone: 978-858-4644 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 / LARK RAMDIN HEALTH AGENT SANITARIAN 0 CITY OF SALEM, MASSACHUSETTS BOARD c>FHEAI.TH Dv 120 WASHINGTON S'IRRFT,4:`FLOOR TFr_ (978) 741-1800 KIMBERLEY DRLSCOLL FAX(978) 745-0343 1b WOR LRAM DIN(WSALr\f.(.Crbr LARRY R1iM)IN,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" cc'' FEE: $50.00 PROPERTY LOCATED AT o () 2/( jZ �S� _ ? � UNIT# IS THIS UNIT DISSI�IGNATT1E�D AS�R�IGGHT�LEFr FRONTO BACK,PLEASE C LE ONE OWNER/LESSER 2 I\ ( 4 /1{MANAGER/AGENT NO P.O.BOX ADDRESS L�ayl G j2'is ��2 ADDRESS l 0/1,19 CITY, STATE,ZIP C�d ✓�, CITY, STATE, ZIP RESIDENCE PHONE 9 2'fr 7?) Y O< BUSINESS PHONE(24HRS) BUSINESS PHONE '?7 (V 2C J fC V G (,(V TOTAL NUMBER OF ROOMS: 6 ROOM USE: 1. 2. U l 3. 8.0 4. d")P l 5. d( J -� 6. 7. 8. 9. 10. THERE IS A FIFTY($50) DOLLAR FEE, PAYABLE BY CHECK M NEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYZT THE TIME INS CTION ?? APPLICANT'S SIGNATURE DATE cl/ Ins_nectors 11s t1 / r Date on initial inspection: I� 1 1 a Date of reinspection: Date of issuance of certificate: Date fee paid- Type of unit: Dwelling Other Check#_qQ Check date: �'.vv, , Notes: Co'de'Vhf4ap6ement Inspector CITY OF SALEM, MASSACHUSETTS a rT BOARD OF HI?AI.TH 120 WASFIINGTON STREET,4°1 FLOOR TEL. (978) 741-1800 K1MBF,RLEY DRISCOLL FAs(978) 745-0343 LNZr1YOR LR\INmIN(d),SAITALCOM LARRY RASIDIN,RS/RENS,CHO,CP-FS I-IE:ALTH AGENT Release In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ; State Sanitary Code Chapter H 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 rlessor S2 /ems �`1 �} a ?� r ��%rr f'f t-) H lT ,�- J �a 110Vz� ,r 12/� / Address Address V f IT Address on unit to be inspected Date / Updated 5/23/11 TRANSMISSI0H VERIFICATION REPORT TIME 06/06/2012 03: 31 NAME FA`; 9787450343 TEL 9787411800 SER. # 000B0N341991 DATEJIME 06/06 03: 31 FA" NO./NAME 919788581461 DURATION 00: 00:27 PAGE(S) 02 RESULT OK MODE STANDARD ECM m � e• i? CITY OF SALEM, MASSACHUSE TS BO.1RD OF HE.-\LTH 120 WASHINGTON STRFFT,4"'FLOOR PublicIiea ith Ta.. (978) 741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL llatndinnsaleni.com - L,\Rlil�R,-\�IUIN,RS/RVI IS,CI I(1,(:11-1;SMAYOR HI{r\j xi I A(iI SN'I' CERTIFICATE OF FITNESS CERTIFICATE#222-12 DATE ISSUED:6/1/2012 i Property Located at: 38 Park Street UNIT#3 Owner/Agent: Frank Ouellette Address: 25 Donovans Way City/Town: Middleton, MA Zip Code: 01949 24 Hour Phone: 978-858-4644 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 EALTH '' LARRY RAMDIN HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS (��/f��/ I� BOARD OF HEALTH /TJX/ 120 kVASHLNGTON S'rRRL'f,4`FLOOR V Tm.. (978) 741-1800 KIMBERL.EY DRISCOLL FAX(978) 745-0343 NLXYOR LRANmmO)MLrsLCOM LARRY RAMDIN,RS/REHS,CHO,CP-FS I-IE.ALTH AGENT 1�40 1 It<3526 91(40 Application for Certificate of Fitness CACI gt�t(c Flo IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 cAti "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" f, FEE: $50.00 nil /n PROPERTY LOCATED AT 11 e�l �_ 1 ,`�le ! /. 4- UNIT# _ IS THIS UNIT DIS+IGNATEDASRIGHT LEFT FRONT OR B�PLEASE CIRCLE ONE OWNER/LESSER 6Lv11` D(/.2 6.1--el MANAGER/AGENT NO P.O.BOX r ADDRESSaklD V2 ti v (/ ADDRESS CITY, STATE, ZIP [ OI 1 U ( 1 �rrY, STATE,ZIP RESIDENCE PHONE 7 �V((0 �^ BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: �( /( ROOM USE: 1. KI_r 2. L 3. (,1 t J 4. I[ ) 5. 6. 7. 8. 9. 10. THERE IS A FIFTY ($50)DOLLAR FEE,PAYABLE BY H CK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAY_4AE AT711 T E OF INSPECTION APPLICANT'S SIGNATURE DATE-6�/� Lectors use only Date on initial inspection: C/L4 ka Date of reinspection: Date of issuance of certificate: Date fee paid: i Type of unit: Dwelling-----Other—Check#Check date: Notes: CbVE&6rcement inspector CITY OF SALEM MASSACHUSETTS BOARD OF HEALTH 120 WAST IINGTON STREET,4"'FLOOR Ter-.. (978) 741-1800 K1MBERLEY DRISCOLL FAx(978) 745-0343 MAYOR LR NfD1N(a)SAI-r.NI.co.Ni LARRY R.MMIDIN,RS/REHS,CHO,CP-FS HEALTH AGENT - Release In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ; State Sanitary Code Chapter H 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/LesseeO r ssor nx cJ �, �.Q n(I k-1 Address Address S Y9 S�Ae," a l27 G un g Address on unit to be inspzected Date / Updated 5/23/11 CITY OF SALEM, MASSACHUSETTS BOARD OF HF'- LTH 120 W.\SHINGTON STRrLET,4"' FU a xi TFL. (978) 741-1800 ILII 113L'RL L Y DRISCOLL FAX(978) 745-0343 MAYOR lxamdin(@salem.com L.\RRY RA NLDIN,RS/REI IS,CI 10,CP-15 HFAL I'll AGFN7' CERTIFICATE OF FITNESS CERTIFICATE #485-11 DATE ISSUED: 11/1/1811 Property Located at: 40 Park 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. FO T ARD OF HEALTH LARRY RAMDIN HEALTH AGENT CODE ENFOR INSPECTOR i �� CQ�r(�t Gtt G� /��a„�n�le�/I --•------ ij . • CITY OF SALEM, MASSACHUSETTS BOARD OF.HEALTH 120 WASHINGTON STREET",47H FLOOR TEL(978)741-1800 IUMERLEY DRISCOLL FAX(978)745-0343 MAYOR LSCOWC&M YN.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: $50.00 PROPERTY LOCATED AT +-J l) �[:t d(, <1'7T2 2-T uwr#_� _ LS ms UNIT DisiGNATED AS RIGHT LE:rr ItRONT OR$ACK PLEASE CIRCLE ONE OWNEIVLESSER V I*n kbt j t A-t-! MANAGER/AGENT SgvW7.0 NO P.O-BOX ADDRESS ADDRESS CGG2. CITY,STATE,ZIP_t'ep ,Ay 1 MA 0 CTTY,STATE,ZIP R-PsIDENCE.PwNE—f-27 7'7- 3 3 So-)- BuslNEss PHONE(24BRs)-j:X—?77-3 3 S a - --- ----- - -- -------..-_:_-,--.-_ --- TOTAL NUMBER OF ROOMS: ROOMUSE: 2. /-VL5 O. 4.rVjfowv 5. 6. 7. U 8. 9. 10. T EREIS AFIFTY($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 I,--��- �1f.� DATE-412�?h— Inspectors 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: Notes: 'acie tsid�� ent 1rspei;tor TRANSMISSION! VERIFICATION REPORT TIME 12/01/2011 22: 23 NAME FAX 9787450343 TEL 9787411800 SEP.. # 000BON341991 DATEJIME 12101 22:23 FAX NO./NAME 919787449614 DURATION 00:00:28 PAGE(S) 02 RESULT O1/, MODE STANDARD ECM CITY (7F SALEM, N1ASSACHLJSL 1"i:S Bo,uw oiz HILuxi-I 1201X/Atil-IIN(;]'ON STRE[T,4"' F].00It KIMBERLEY DRISCOLL Tl-1'. (978) 741-1800 MAYOR F.\\(978) 745-0343 Iraindin ansal(An.com LARRY RA MD IN, Rs/It[;I IS,CI I(1,CP-I•S 111 WMA I I A(;I SNI' Facsimile Transmittal To: _-7—1 ejei✓1 Fax # Cf IS( RE: Date Page(s): including this cover# Message: Board of Health News For Your Information OFFICE HOUR:>: 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 P CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"FLOOR 00 TEL. (978) 741-1800 HI1�II3P,RLEY DRISCOLL FAX(978) 745-0343 MAYOR DC;Rf FN1AA1JMnSAU?Af.C(Al DAVID GREE,NBAUNI ACTING HEALHI AGENT CERTIFICATE OF FITNESS CERTIFICATE #314-10 DATE ISSUED: 6/29/2010 Property Located at: 40 Park Street UNIT#2 Owner/Agent: 41 Salem St LLC Address: P.O. Box 17 City/Town: Revere, MA Zip Code: 0215124 Hour Phone: An inspection of your vacant Dwell in ng/Rooming Unit at the above address has been approved 9 9 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 OF HEALTH �U'� l DAVID GREENBAUM ACTING HEALTH AGENT U&t ENFO C NT INSPECTOR CITY OF SALEM, MASSACHUSETTS • J BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGRrr.NBAUMnaSALEM.COM DAVID GREENBAUM, ACTING HEALTH AGENT Application f pp cation or 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) Aek UNIT#�_ IS THIS /UNIT DISIIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER �'�( SQ/rsl./fll . LLC MANAGER/AGENT NO P.O. BOX JI ADDRESS t�7; 0 966x ! REss �. / �v�✓L S CITY, STATE,ZIP A(,e/L(. CITY, STATE, ZIP /)�A SS UoZ/s f RESIDENCE PHONE BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3. 5. 6. 7. 8. 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 E OF INSPECTION APPLICANT'S SIGNATUREDATE ✓✓✓ Inspectors use only Date on initial inspection: a�/ n Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwe'llin'g Other Check# Check date: Notes: Tw\ VN4 WC9�`2X c �r �b 1Y11h c�f 0C)"- Codc�EKfbrcernent Inspector � 4 CITY OF SALEM, MASSACHUSET"T"S + , BOARD OF HEALTH 120 WASHINGTON STREET,4"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR DCRi 1;N13AUMQSAra:M.Coh[ DAVID GRr i-*,NBAUM ACTING HEAl.:17I AGI„,N,r CERTIFICATE OF FITNESS CERTIFICATE #288-10 DATE ISSUED: 6/21/2010 Property Located at: 40 Park Street UNIT#3 Owner/Agent: 41 Salem St. LLC Address: P.O. Box 17 City/Town: Revere, MA Zip Code: 02151 24 Hour Phone: 781-322-5648 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 HEALTH I d A,,.. DAVID GREENBAUM ACTING HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"FLOORi F 61 TEL.(978)741-1800 tt7t'� I0I14BERL.EY DRISCOLL FAX 978 745-0343 i MAYOR Lx;jtF.r BAUM@SALEM 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." 1 J /� / FLEE: $50.00 `ROPERTY LOCATED AT y 0 l�T2ft I UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK.PLEASE CIRCLE ONE ')WNERtLESSER 34 MANAGER/AGENT_Si/A-)-et 'O P.O. BOX .DDRESS PtyCsx' 1� ADDRESS 1 :TTY, STATE,ZIP 'R(vf CTTY, STATE,zip /'U-5 S oa(s ESIDENCE PHONE BUSINESS PHONE(24HRS) USINESS PHONE OTAL NUMBER OF ROOMS: `I OOM USE: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. HERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM OARD OF HEALTH THIS FEE IS13AYA13LE AT VE TIME OF INSPECTION 1/ PPLICANT'S SIGNATURE/,/L� // DATF t J J ll Insnectors use only ate on initial inspection: + l Date of reinspection' I tV t a !10 �7 J ate of issuance of certificate: , j c� ��0 Date fee paid: 16b U i Mo-of unit:-Dwwelliug Lr/OthrCheck — Chi nate: 0 .3tes: 1Ufl14VIn hc re K3W, h UIL S �t/'t✓ � Ct t ffl tDJ 1<� _—�Srntr �n �t2t� (INhU I LX NrI0k�<�C AZwaJ )de En rc ent Inspector TRANSMISSION VERIFICATION REPORT TIME : 06/22/2010 03: 13 NAME : FAX : 9787450343 TEL : 9787411800 SER.# : 000BON341991 DATEJIME 06/22 03: 12 FAX NO. /NAME 919787449614 DURATION 00:00:23 PAGE(S) 02 RESULT OK MODE STANDARD ECM CITY OF SALEM, MASSACHUSETTS + r BOARD OF HEALTH 120 WASHINGTON STREET,4"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL Fax(978) 745-0343 MAYOR DCRri;NBALJMnsALENLCONI DAVID GREI NHAUM ACTING HEAL'n I AGR.N'r Facsimile Transmittal Fax# ql %- '�u'-1 961 L. RE: y/> f CA SA wl � 3 Date Page(s): including this cover# Message: r 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 CITY OF SALEM, MASSACHUSETTS 130ARD OF HEi\1X1 I 120 WASHING ON STRP,12 r,4''' i-'LO )R KITNIBERLEY DRISCOLL TEL. (978) 741-1800 MAYOR FAx(978) 745-0343 lramdin(a)s-dem.com L ARRY RA11D1N,RS/RI:I IS,CI 10,CP-15 H1?,\L,n I AGISN'1' CERTIFICATE OF FITNESS CERTIFICATE #484-11 DATE ISSUED: 11/18/2011 Property Located at: 41 Salem Street UNIT# 1 Owner/Agent: Vito Venuti Address: 1 Tomah Drive Cityffown: Peabody, MA Zip Code: 01960 24 Hour Phone: 978-977-3325 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 HEALTH AGENT COTIF ENFOR INSPE OR ------------ l� CITY OF SALEM, MmsACHus=s�slj BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL.(978)741-1800 KDdBF.Rl.EX DRISCOILL FAX(978)745-0343 MAYOR 1SCOTna SALEM.COM JOANNE SCOTT, HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "NIINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION." (� 1 FEE: $50.00 PROPERTY LOCATED AT / ' Qt,�/0TCeQT "Nm— L-is THIS UNIT DL4IGmm As RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNEMESSER V J td �/P'1ju+:" MANAGERI AGENT NOP.O.BOX ADDREssj—j -ro_��t2 �a.�. �1.I�i v Q - ADDRESS CAr�4� CITY,STATE,W-.- PR 1 .11JMA 19 � O CITY,STATE,ZIP Q'oY-- .- RESII'ELICE PHONE -335aBUSINEss PxoNE(z41IRs) 91fj- 97 73 Sc'-?- BUSIlVESS PHONES _. - - _ - TOTAL NUMBER OF ROOMS: S ROOM USE: llAdf3 (Cmrn 2.6ii& wl 3.Reb�Rairn 4. 'F �t'>sirn 5.1 �(2�nlve 6. - v 7. 8. 9. 10. THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE /l / moo, - - - -- DATF-14 f— pij/yy In use only Date on initial inspection. C i 1$ 1 Date of reinspoction: Date of issuance of eertiEcate: Date fee paid: Type of unit: Dwelfing Other Cheek# Check date: Notes: CITY OF SALEM, MASSACHUSETTS 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#236-06 DATE ISSUED: 5/12/06 Property Located at: 42 Park 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 JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR 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 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 ya P� G T UNIT# IS THIS UNIT DESIGNATED AS RIGHT LEFT_ FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER-/L4Lrt-1 MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS I 77rJr1 vc- ADDRESS CITY 9 mal I CITY RESIDENCE PHONE�7P��77�, 'i3S� BUSINESS PHONE (24 HRS.) 7,?- -ds l?t/ BUSINESS PHONE 97P--A 77-33a / TOTAL NUMBER OF ROOMS:__ ROOM USE: 1 LiVI�2. i7C�en 3.�a ra�r, 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 SIGNATUREL9� HATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION J! - P DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE-::S- a� DATE FEE PAID: TYPE OF UNIT: IDWELLL _OTHER_ CHECK# CHECK DATE.S-jj NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 5 CITY OF SALEM, MASSACHUSETTS + ♦ BOARD OF HEALTH 120 WASHINGTON STREET,4'N FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR DGREENBAUM(l SAr.EM.COM DAVID GREENBAUNI ACTING HEAL j I AGENT CERTIFICATE OF FITNESS CERTIFICATE# 170-10 DATE ISSUED: 4/15/2010 Property Located at: 42 Park Street UNIT#3 Owner/Agent: Vito Venuti Address: 1 Tomah Drive City/Town: Peabody, MA Zip Code: 01906 24 Hour Phone: 978-314-0694 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 4MJ NBdUM ACTING HEALTH AGENT CODE ENFO MENT INSPECTOR p� � �`� Ge/'�I � fiG V ��> i 70 �0 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4'N FLOOR TEL.(978)741-1800 KIMSERI I✓Y DRI COIL FAX(978)745-0343 MAYOR yrQ31@SAW COM JOANNE SCOTT, HEALTH AGENT . Iy t Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINDAUM STANDARDS OF FITNESS FOR HUMAN HABITATION" FEE: $50.00 PROPERTY LOCATED AT T �C�c I�, �l i"i Q 2 1z.uT#3 IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACIL PLEASE CIRCLE ONE OWNER/LESSER Vi�b 1/0,N c tt MANAGEWAGENT 400t-C NO P.O.BOX ADDRESSits ADDREss _�t°'� CITY,STATE,ZIP TA6 e y/ IW A. n 19 K,O CTTY,sunT zip AGCY"e RESIDENCEPHONEgW-`�7-7r33Sa BUSINESS PHONE(24HRS) 7�-q-77-335oZ - TOTAL NUMBER OF ROOMS: 7 ROOM USE: L 9,*f6eO 2. 1 1\i" Kaoh3. RPc,(rbom 4AZ44(-oon., 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*/.S�C� Insnec tors use only Date on initial inspection: Date of reinspection: Date of issuance of certificate: y Its ho Date feepaid: q11010 10 Type of unit: Dwelling dZ Othcr_Check# 06(0 Checkdate: yI/SIIO Notes: —Fat tV4 fO brdO AOSWfif 0 , WL016nl Arm . rc=ent Inspector CITY OF SALEM, MASSACHUSETTS „ m 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# 19-07 DATE ISSUED: 1/16/2007 Property Located at: 42 Park Street UNIT#4 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. FORQ-J-b BOARD OF H LTH da—e�,(t71/� , 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. 976-741-1800 FAX 978-745-0343 JOANNE SCOTT, MPH, RS, CHO Kimberley Driscoll HEALTH ACEN, Mayor APPLICATION FOR CERTIFICATE OF FITNESS W ACCORDANCE WITH S1 ACE SANITARY CODE, CHAPTER 11, 105 CMR 410 000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION', PROPERTY LOCATED AT GLf' S . UNIT #� IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OVJNERILESSER _ MANAGER/AGENT No P.O. Bax No P.O.Box ADDRESS_. 10 { �1 t i V8 __. ADDRESS CITY_ P 01�NAI _C!TY._ -_-- RESIDENCE PHONE� 'q J 33r�S�fS1NESS PHONE (24 HRS )3j-,> �y-©S7 BUSINESS PHONE'97g'77-7`33�Jt7�^___ TOTAL NUMBER OF ROOMS.__ ROOM USE: I ntaj 2IJVI'lri 5 a'Cfftn"+4 5 6 J 7 £3 THERE IS A TWENTY-FIVE ($25.00) DOLLAR FEE. PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPAf11 HENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. + APPLICANTS SIGNATURE .- -A l/ (<�I� -- --DATE_.ILII7f[� INSPECTORS USE C?MLY QAC OF INITIAL t SPECTI_O,N,_1 _- �" y�, C)ATE OF REINSPECTION DATE OF ISSUANCE OF CFRTIFICATF DAT E FEF PAID f j �' --v 7 TYPE OF UNIT DWELLAvC OTHLR_ _ CHF(--'' 14 `J CHECK ;SATE NOTES I� CODE ENFORCEMENT INSPEC 1011 t2H'y8 ` y�rkF CITY OF SALEM, MASSACHUSI;T"1'S BOARD OF HF._11.TI-1 120WASHINGTt)N S`rREFT,4...FLOOR �� TEL. (978) 741-1800 FMK(978) 745-0343 KIMBERLEY DRISCOLL Iram6ina salem,com Lf :�tttt�'tt.1MUIN,RS RI(I IS,Cl IO,(T-FS' S' MAYOR HI i;V.;I'I I A(I Ir.N7' CERTIFICATE OF FITNESS CERTIFICATE# 101-12 DATE ISSUED: 3/15/2012 Property Located at: 44 Park Street UNIT#3 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 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 LARRY AM. HEALTH AGENT CODE ENFORCEME1`HUSPECTOR I • CITY OF SALEM, MASSACHUSETTS $ BOARD OF HEALTH 120 WASHINGTON STREET,4'"FLOOR TEL. (978)741-1800 KIIvIBERLEY DRISCOLL FAX(978)745-0343 MAYOR ISCOTr&AL6hf.COTS n JOANNE SCOTT, HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 '%IINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION." FEE: $50.00 PROPERTY LOCATED AT 7 �I 'Po-(-K '-li'te'r UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNERILESSER Vi-r6 V2nJkri MANAGER/AGENT Sa1,--e NO P.O.BOX ADDRESS ADDRESS SQI'4, CITY, STATE,ZlPg�CFFY, STATE,ZIP PESfDEIICE PfiOiv—E7 ^�79-�77 33S, BUSINESS PHONE(24HRS) �?�335� BUSINESS PHONE ` 7-9n-2a7-.335 TOTAL NUMBER OF ROOMS: b f '1LP4 -gsii1 ROOM USE: 1.1�eD r 6aM 2.1ZEil fisarvt 3./h R & +4. RPTireaw� S.�c�r45r� 6. k,;*aeN 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 only Date on initial inspection: (�_�(t� Date of reinspectior Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check#—a / / Check date: Notes: r i I t ;ode entlnspector I . CITY OF SAI. FM, MASSACHUSF; -PS 120 WASHING ONSTRr "r,4`1FldHOR KIMBERLEY DRISCOLL Ilst,. {978}741-18(H) FAx" (978)745-0343 MAYOR IraindinOsalcm.com L\RRY RANIDIN,RS/ItEf IS,(:I 10,CP-(6 IIt:Almi A(WNT Facsimile Transmittal To: Fax# Dined `? ' f�Ct(01 y 1 RE: T G' - S'-+ � Date : nn Page(s): including this cover# C 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 03/20/2012 02:11 NAME FAX 9787450343 TEL 9787411800 SER. # 000S0N341991 DATEJIME 03/20 02:10 FAX NO./NAME 919787449614 DURATION 00: 00: 27 PAGE(S) 02 RESULT OK MODE STANDARD ECM 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# 359-06 DATE ISSUED: 7/20/2006 Property Located at: 44 Park Street UNIT#4 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 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. FO ,T��HE BOARD OF HEALTH 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 0 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 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION°. PROPERTY LOCATED AT UNIT# IS THIS/UNIT DESIGNATED'ASIR GHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER 1.11 te) VP A/Ut i MANAGER/AGENT No P.O.Box No P.O.Box ADDRESS� _ADDRESS CITY ��a_��t 1 CITY RESIDENCE PHONE q 7,?-.i4-6S7�BUSINESS PHONE (24 HRS.) 27 7 -335,- BUSINESS PHONE 2g=977- 33,5X TOTAL NUMBER OF ROOMS: 6 ROOM USE: 1. Jl41' 2. p, . 4. R R3Sw 5. 6. atcL 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 /&�IZ iv f� DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 7- Yo (,-' DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:-7,,9v —Z) L DATE FEE PAID: TYPE OF UNIT: DWELLING OTHER CHECK# �C�- CHECK DATE NOTES: CODE ENFORCEMENT INSPECTOR 9128/98