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PHELPS STREET PHELPS STREET u v CITY OF SALEM, MASSACHUSETTS 1P 130ARll OF HEALTH 120 WASHINGTON STREET,4."FLOOR PublicHCAlth PreveN.l'rMnota Pml¢I. TEL. (978) 741-1800 Fax (978) 745-0343 KIMBERLEY DRISCOLI, lramdin@salem.com LARRY R\MDIN,RS/REHS,CI 10,CP-FS MAYOR HI?Al.:rl-I AGENT CERTIFICATE OF FITNESS CERTIFICATE#201-14 DATE ISSUED:6/9/2014 Property Located at: 2 Phelps Street UNIT#2 Owner/Agent: Debra Ingemi Address: 4 Ancient Rubbly Way City/Town: Beverly, MA Zip Code: 01915 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 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. ^ ;FB ARD EALTH LARRY RAMDIN HEALTH AGENT SANITARIAN 7 CITY OF SALEM, MASSACHUSETTS �1LJ/J d0H BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR PabHcHealth Prevent.Promam.Pra,eel. TEI_. (978)741-1800 FAX(978) 745-0343 KIMBERLEY DRISCOLL Iramdin@salem.com MAYOR - - LARRY RANIDIN,RS/REHS,CHO,CP-I-IS HEALTI-I AGbNT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" / FEE: $50.00 PROPERTY LOCATED AT ,2 PhelvS UNIT#_A IS /THIS UNIT DISIGNAT AS RIGHT LEFT FRONT OR BA PLEASE CIRCLE ONE OWNER/LES ,S /ER �,��t-,0L""�� �"c-ye h I' MANAGER/AGENT ADDRESS N U rt l// YPAV wUu/ ADDRESS CITY, STATE,ZIP �Qtgf ly l Q� \� CITY, STATE,ZIP RESIDENCE PHONE 9�_�� 9j(a 14 BUSINESS PHONE(24HRS) BUSINESS PHONE ft 2�� 7 0 TOTAL NUMBER OF ROOMS:_ / /� ROOM USE: 1 ! 2. .JIB f 3 enti l� 4 pfd S bd 6. 7. 8. 9 10 THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION p APPLICANT'S SIGNATURE ` JOZ DATE 0 I Inspectors use only Date oh initial inspection:_ -1 _ ./.._ _.. Date of reinspection: Date of issuance of certificate: Date fee paid- Type of unit: Dwelling Other Check# Check date: Notes: 0 Code gneokdmeni Inspector CITY OF SALEM, MASSACHUSETTS P BOARD OF HEALTH IIF$ 120 WASHINGTON STREET, 4TH FLOOR isq SALEM, MA 01970 -" F TEL. 978-741-1800 FAX 978-745-0343 KIMBERLEY DRISCOLL JSCOTT@SALEM.COM MAYOR .JOANNE SCOTT HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#201-08 DATE ISSUED: 5/1/2008 Property Located at: 5 Phelps Street UNIT# 1 Owner/Agent: Maureen Cavanaugh Address: 5 Phelps Street#2 City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-3352 An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II" Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OFJ� 4"N-Xlf - JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CqS8 ENFORCE ENT INSPECTOR �t CITY OF SALEM, MASSACHUSETTS • • BOARD OF HEALTH 120 WASHINGTON STREET,e FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978)745-0343 MAYOR 1SCOTF&A[IN COM JOANNE SCOTT, HEALTH AGENT Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMA HABITATION." PROPERTY LACATED AT Tle_zS Jy . .S� UNIT# � ��✓ � IS THIS UNIT DIISS�IGNATED A RIGHT LEFT FRONT OR B�PLEASE CIRCLE ONE WJ O NER/LESSER / /�¢i"r.,r/ MANAGER/AGENT NO P.O. BOX ADDRESS J'Ae_,e., St ADDRESS CITY,STATE,ZIP /'/ CITY,STATE,ZIP /i9 O/i 7 d RESIDENCE PHONEBUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2m.Ib�m 2. 3. 4. 411e,7_5. A JciM 6. 7. e,n8. 9. 10. THERE IS A TWENTY-FfVE($25)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH TH IS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANTS SIGNATURE � nDATES 2, 17 Inspectors use only Date on initial inspection: �f� /Q� Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling Other Check#��/ Check date: I 6 Notes: Y Cmi -�o bQstnst t cmR�(�� @� Wlnjow_ In 4*io 2) C1m dS hc7{ Cie 9CW4 Timmer i ntl dp , arrJ Qhs ncl'IOYI bc- Y In YLtS _rK tT+ k Sed I COP.YV Owner hcS been asked+o Cct.11 Sa,al Gf�emrlt uJnen abave lens aTe codec ecl ode nforcement Inspector s. 8 i� Z4 CITY OF SALEM, MASSACHUSETTS q BOARD OF HEALTH - _ 120 WASHINGTON STREET, 4TH FLOOR ryn SALEM, MA 01970 Aq4 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 3/28/05 Thomas Barry Chafe 69 Kelley Street Haverhill, MA 01830 PROPERTY LOCATED AT 6 Phelps Street Unit 1 Dear Sir/Madam: It has come to our attention, that you may be considering renting a dwelling unit at the above address. In accordance with Chapter 11,Article XIII of the City of Salem Code of Ordinances, Section 2- 334,titled "Certificate of Fitness," each dwelling unit must be inspected and certified prior to allowing occupancy. The inspection will be conducted in accordance with 105 CMR 410.000; State Sanitary Code, Chapter 11: Minimum Standards of Fitness for Human Habitation. Please notify us if you do not intend to rent the unit. Please contact this department within 24 hours of receipt of this notice at 978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday thru Wednesday from 8:00 a.m. —4:00 p.m. Thursday 8:00 a.m. to 7:00 p.m. and Friday 8:00 a.m. — 12:00 p.m. Failure to comply with this procedure, may result in a fine of Twenty($20.00) dollars per day for every day that the dwelling unit is occupied without a Certificate of fitness. A$25.00 check payable to the City of Salem is required for each unit inspected at the time of inspection. A property owner is required to pay gas and electricity for residential tenants if there is not a written letting agreement stating the tenant is responsible for those utilities and if the meter(s) records electricity and gas use which is not used exclusively by that tenant. The Department of Public Utilities has billed property owners for their tenant's entire utility bills retroactive to the date of initial occupancy in cases in which cross-metering has been proven to exist. For the Board of Heal Reply to oanne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector .�o CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH :9 120 WASHINGTON STREET, ATH FLOOR f a- SALEM, MA 01 970 " TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#: 465-03 DATE ISSUED: 9/2/2003 Property Located at:: 7 Phelps Street UNIT#: 3 Owner/Agent: William Szikney Address: 7 Phelps Street# 1 City/Town: Salem MA Zip Code: 01970 24 Hour Phone: 978-740-6925 An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II "Minimum Standards of Fitness for Human Habitation". Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. This approval does not certify compliance with the State Lead Law for occupants under 6 years of age. For more information call 978-741-1800. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH 9 / el Joanne Scott, MPH, RS, CHO Health Agent CODE ENFORCEMENT INSPECTOR I CITY OF SALEM, MASSACHUSETTS a BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 /Y/^ 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 7 hHFLPS ST- UNIT# 3 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSERdILL.iAm P S2lK&.CV MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS 7 PHELPS Srt/ ADDRESS CITY SAt.-EM h CITY RESIDENCE PHONE YJ9-7yD -6 92-r BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3. 4. 5. _6._______T_8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE ? t o DATE S/ ZO INSPECTORS USE ONLY DATE OF INITIAL INSPECTION -2 'd 3 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATEq- a 3 DATE FEE PAID: TYPE OF UNIT: DWELLING OTHER_ CHECK# /2-G CHECK DATE1 .3 NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 o CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 3 + 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 - FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT RELEASE In accordance with Massachusetts General Laws Chapter III ; Code of Massachusetts Regulations 410.000 et. seq. ; State Sanitary Code Chapter II and Article XIII of the Cit; of Salem Ordinance, undersigned owner/lessor and tenant/lessee of a unit of residential property, hereby authorize the Salem Board of Health or its author- ized agents to inspect the residence identified below in accordance with the aforementioned statutes, regulations and ordinances. L. the event it is necessary that said inspection be done in my/our absence, i./we expressly authorize the same and for my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of Health and its authorized agen s from any loss or injury sustained of whatever nature and description occasioned by my/our absence during said inspection. T.uNAN'! %LESSEE OWNER/iESSOR nD�Ss� ADDRESS l 7 ADDRESS OF UNIT TO F. INSPECTED D^+TE CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 3' -� 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# 193-05 DATE ISSUED: 3/21/05 Property Located at: 16 Phelps Street UNIT# 1 Owner/Agent: Phelps Realty Trust Address: 17 Mill Brook Lane City/Town: Topsfield, MA Zip Code: 01983 24 Hour Phone: An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter 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 FRDM, :ESCONDIDORVRESORT FAX NO. :7507405982 Mar. 15 2005 10:13AM P2 II cm OF SAL.FMI,MASSACHUSCM 60ARD OF HEALt" 120 WASHINGTON SC1S(.4TH FLOOR GAtEM,MAC TCL 078.741.1800 FAX 9784415-0543 — 3TANL4T W"ViC2,Jit. JOANNG scorn MPH, H5.GHO - MATOM 618ALTH AdeNT 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 (9 ehf I QS-5 ' UNR 41 IS THIS UNIT DESI NATED A' R T LEFT F,,��R{O..NT g� PLEASE CIRCLE ONE- OWNMESSEq /ur �inNAGERrAC�ENT Nej . ��C)(). AADVR �` ANo o a sp! p1iP:l( c -Y A R/�Q j l�j $ CITY- c iw m ICI RESID�BNCE-PHO-1 RE-g 2&--)7{-511?� BUSNEn PHONE(24 HaS,) ;14--()(D 6USINGSS PHONE'T 2$"`7) t S/414- TOTAL NUMBER OF ROOMS.._, ROOM USE: 1,4I:�y1;M THERE IS A TWENTY-FIVE(525.00)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE LS PAYABLE AT THE TIME OF INSPECTION- APPLICANTS SIGN/;TURE —±`akL<!��� _,.....OATE INSPECTQBS 15_ FONLY RATE OF INITIAL INSPFCTION,,.._?—/ ?-? -�, .DATE OF REINSPECTION. ,,,_ DATE OF ISSUANCE OF CERTIFICATE:.?._-�7 'z'�DATE FEE PAID: ,j •- / 7 "8.0 TYPE OF UNIT: DWELL .OTHERCHECK n 3q S4 „CHECK DATE ' NdYES: CODE ENFORCEMENT INSPECTOR s,z8t98 i� FR04 :ESCONDIDORl1RESORT FOX NO. :7607405982 Mar. 15 2005 10:14RM P3 _y... ..fir.. . t Crry of,SALE^MASSACHWK M 90AR8 OR HrAi_Trr I10 WASMMIrr"al"r,"..arM'.F%.*" SALAW. MA 014110 TEt. 678-74 4.180o�Qp • FAY 676-74"$43 - STANLAY USOYIcr.JR. JoANNe SCOTT, MPH. RS. CM0 MAYOR HEALTH AGGNT I RELEASE In uouxdance vith.tsassachueacts Ceneral Laws Chapter 1I1; Code of it3aaachusoCts Pegulations 410.000 at. ael, ; State Sanitary Coda Chapter It and Article Y.ill of the City of Salem Otdinance.- undersigned ownerl Ieasor and tenant/leesec of a unit of residential property, hereby alltherixe the Satan Entrd of Health or its auehor- iaod agent-& to iflapatt the residence identifiedbelow in accordance with Isle aia'rementioned statutes, regulatioas and ordinanees. - Li the event, it is necessary that Said inspection be done in my/our aUstnce, itwe Txprelssly sutharl;c.the same and for my/our succestots and asci;ns hereby releaso and dischasgo the £3:ty of Salem, Sale% board of Health and its authorired a;,enr, Crow a6y loss or injury sustained of umarevar natureanddescriprion octaeioned by R,y/nur ahcao.ce duties said inapeeri-an. '[�•\OhTf".iS`ES T� �i O't1:E RI")fl_ SSS A14RiiS4 C•P I't i'rr tt!; 5„srf.C,SEIt FROIn. :ESCONDIDORURESORT FAX NO. :7607405982 Mar. 15 2005 10:13RM P1 'i I ,.1 PHELPS REALTY TRUST 17 MILL BROOK LANE TOPSFIELD MA 01983 ( 978 )771 -5113 (978 ) 771 - 5122 FACSIMILE TRANSMITTAL SHEET TO: JOANNE SCOTT FROM: DAVID JOHANSON COMPANY: CITY OF SALEM DATE: MARCH 14. 2005 BOARD OF HEALTH fAX S: 878.745-0343 TOTAL S OF PAGES: 3 RE: APARTMENT INSPECTION FOLLOWING IS AN 'APPLICATION FOR CERTIFICATE OF FITNESS' FOR AN APARTMENT WE'RE ADVERTISING FOR RENT AT- 16 PHELPS ST- FIRST FLOOR SALEM PLEASE CONTACT- NELLJOHANSON 18 PHELPS ST- FIRST FLOOR SALEM 978-314-0621 FOR ENTRY TO THE APARTMENT AT 16 PHELPS ST AND ANY OTHER QUESTIONS YOU MIGHT HAVE REGARDING THIS APARTMENT. NELL WILL HAVE THE $25 FEE REQUIRED FOR THIS INSPECTION. SINCE NO ONE HAS MOVED INTO THIS APARTMENT THE 'RELEASE' HAS NOT BEEN SIGNED BY A TENANT/LESSEE. ANY REPORTS TO BE ISSUED AS A RESULT OF THIS INSPECTION SHOULD BE FORWARDED TO NELL JOHANSON AS SHE WILL BE SHOWING & RENTING THIS APARTMENT FORME AND AS A RESULT WILL HAVE COPIES OF THESE FORMS MADE TO GIVE TO THE NEW TENANT. 15�' i' � ,` ,,._. �- i C���l ��� ti�r� � 1 � �- �`'� v���`` 5 � i ,\ c CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH a 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 2/15/05 Phelps Realty Trust 17 Mill Brook Lane Topsfield, MA 01983 PROPERTY LOCATED AT 16 Phelps Street Unit 1 Dear Sir/Madam: It has come to our attention, that you may be considering renting a dwelling unit at the above address. In accordance with Chapter 11,Article XIII of the City of Salem Code of Ordinances,Section 2- 334, titled "Certificate of Fitness," each dwelling unit must be inspected and certified prior to allowing occupancy. The inspection will be conducted in accordance with 105 CMR 410.000; State Sanitary Code, Chapter 11: Minimum Standards of Fitness for Human Habitation. Please notify us if you do not intend to rent the unit. Please contact this department within 24 hours of receipt of this notice at 978-741-1800, to schedule an appointment for an inspection. Our office hours are Monday thru Wednesday from 8:00 a.m.—4:00 p.m. Thursday 8:00 a.m. to 7:00 p.m. and Friday 8:00 a.m.— 12:00 p.m. Failure to comply with this procedure, may result in a fine of Twenty($20.00)dollars per day for every day that the dwelling unit is occupied without a Certificate of fitness. A$25.00 check payable to the City of Salem is required for each unit inspected at the time of inspection. A property owner is required to pay gas and electricity for residential tenants if there is not a written letting agreement stating the tenant is responsible for those utilities and if the meter(s) records electricity and gas use which is not used exclusively by that tenant. The Department of Public Utilities has billed property owners for their tenant's entire utility bills retroactive to the date of initial occupancy in cases in which cross-metering has been proven to exist. For the Board of Health Reply to Jaenne Scott MPH, RS Pablo Valdez Health Agent Code Enforcement Inspector y 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#238-06 DATE ISSUED: 5/12/06 Property Located at: 17 Phelps Street UNIT# 1 Owner/Agent: Joseph Callahan Address: 21 Glendale Road City/Town: Marblehead, MA Zip Cade: 01945 24 Hour Phone: An inspection of our vacant Dwelling/Rooming/Roomin Unit at the above address has been approved P Y 9 9 Pp 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. THE BOARD OF EALTH "+ JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR Er. 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 .4 ) A4(e_1qS --51, UNIT # / IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNEWLESSER�S&d L�214,4d4AI MANAGER/AGENT o P. Box No P.O. Box ADDRESS dl 6f461✓7i AC4 AZ ADDRESS CITY,/2WO64)✓ A� CITY RESIDENCE PHONE_ BUSINESS PHONE (24 HRS.) BUSINESS PHONE9 3(e o 8-70-}- TOTAL NUMBER OF ROOMS: h ROOMUSE: lt07#AA/_ 2'Diwl&-3.._1.11/ry1=._4.fS _-- 5 -- 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 SIGNATUi9_ INSPECTORS USE ONLY DATE OF INITIAL INSPECTION S- I I —e ',- DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE. 5—�1- '� �' DATE FEE PAID: OTHER CHECK a `9 q CHECK DATE TYPE OF UNIT: DWELLIt�I� O ER C E K �I NOTES. /� CODE ENFORCEMENT INSPECTOR 9128"M CITY OFA $ LEM MASSACHUSETTS d 6 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 #239-06 DATE ISSUED: 5/12/06 Property Located at: 17 Phelps Street UNIT#3 Owner/Agent: Joseph Callahan Address: 21 Glendale Road City/Town: Marblehead, MA Zip Code: 01945 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 JOA NE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR s :• J r., • ' .. CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA O1970 TEL. 978-741-1800 _ Q 6 FAX 978-745-0343 4 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 %-� pdb�/!S S 'T UNIT# 3 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER,/,.5/r/F/ i �44/1Al MANAGERIAGENT No P.O. Box No P.O. Box ADDRESS& D//C/t 10 ADDRESS CITY MW C t /-/F/&D CITY RESIDENCE PHONE BUSINESS PHONE (24 HRS.) BUSINESSPHONE�.,L&760 970?- TOTAL NUMBER OF ROOMS: ROOM USE: 5.A)f P _6._ -- 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. F^,/ APPLICANTS SIGNATUR / -� �J_jDATE_ INSPECTORS USE ONLY DATE OF INITIAL INSPECTION S--// �' DATE OF REINSPECTION _ DATE OF ISSUANCE OF CERTIFICATE ° (-DATE FEE PAID: r�/ 1 -_ TYPE OF UNIT DWELLINk,,-_`bTHER CHECKft ?? - 9 CHECK DATE NOTES CODE ENFORCEMENT INSPECTOR ?2ti/98 c CERT.# 399-01 FEE $25.00 DATE: 08/16/2001 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO 120 Washington Street HEALTH AGENT Tel: (978)741-1800 Fax: (978) 745-0343 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 20 Phelps Street UNIT #: 1 OWNER/AGENT: Teodoro & Maria Ortega ADDRESS: 20 Phelps Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 977-3000 AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410 .000: MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . THEREFORE, THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE SALEM BOARD OF HEALTH AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED. MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410.000 : MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . SECTION 410.400 (B) : DWELLING UNIT (X) AND 410.400 (C) : ROOMING UNIT MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: . NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR OCCUPANTS UNDER 6 YEARS OF AGE. FOR MORE INFORMATION CALL 978-741-1800. FOR THE BOARD OF HEALTH 7 JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR n 2 � 1 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH,RS,CHO - 120 Washington Street HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tel:(978)741-1800 Fax: (978)-745-0343 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS/FOR HUMAN HABITATION". / ! PROPERTY LOCATED AT ` UNIT#1 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER I/ DR12566 MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS 16_ g-S T ADDRESS CITY CITY-_o!Q" RESIDENCE PHONEg�8)7y$:SaS� BUSINESS PHONE (24 HRS.)�77 3080 X3 S13y BUSINESS PHONE TOTAL NUMBER OF ROOMS: ��/5 ROOM USE: 1.AdrM 2"NX 3. E7 /DO 4. 6 Ulla 9.00(10 5. l 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. 0 APPLICANTS SIGNATURE &44 DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION b'�f '�'V// DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: / -� DATE FEE PAID: b 6I TYPE OF UNIT`. DWELLING V OTHER_ CHECK#,-,2170 CHECK DATE tY-j 6 7J J NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CERT.# 823-97 d� FEE $25.00 DATE: 12/09/97 o' ��M1rB 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: 20 Phelps Street UNIT #: 2 OWNER/AGENT: Maria & Teodoro Orteaa ADDRESS: 20 Phelps Street, Apt. 1 CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-5050 AN INSPECTION OF YOUR VACANT DWELLING/ROOMING UNIT AT THE ABOVE ADDRESS HAS BEEN APPROVED AND IS IN COMPLIANCE WITH 105 CMR 410.000 : MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . THEREFORE, . THIS CERTIFICATE IS ISSUED BY THE CODE ENFORCEMENT DIVISION OF THE SALEM HEALTH DEPARTMENT AND THE UNIT MAY NOW BE RENTED AND/OR OCCUPIED. MAXIMUM NUMBER OF OCCUPANTS, BASED ON 105 CMR 410.000: MASSACHUSETTS STATE SANITARY CODE, CHAPTER II, "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION" . SECTION 410.400 (B) : DWELLING UNIT (X) AND 410.400 (C) : ROOMING UNIT MINIMUM SQUARE FOOTAGE FOR SLEEPING PURPOSES: . NOTE: THIS APPROVAL DOES NOT CERTIFY COMPLIANCE WITH THE STATE LEAD LAW FOR OCCUPANTS UNDER 6 YEARS OF AGE. FOR THE BOARD OF HEALTH JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR µ y CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(508)741-1800 APPLICATION FOR CERTIFICTE OF FITNESS Fax:(508)740-9705 IN ACCORDANCE WITH STATE SANITARY' CODE, CHAPTER II, 105 CMR 4 10.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED ATSIF OWNER/LESSER e04/D e, �rJ�G `l e_ MANAGER/AGENT ADDRESS��.S. �7 _G�..._ ADDP.ESS CITY RESIDENCE PHONE6/71J 7 .S6 BUSINESS PHONE (24 HRS.) BUSINESS.PHONE 9713000 cx7 S�a04 — TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3. 4 . 5.--6.-7. 8. THERE IS A TWENTY-FIVE (25,00) DOLLAR FEE, PAYABLE CHECK OR MONEY ORDER TO THE CITY OF SALEM' HEALTH DEPARTRTTMMEENN�T—THI'ySS FEE IS PAYAB THE TIME OF INSPECTION APPLICANTS SIG NATTR2Fuf 7riDo2u� 2 ��DATE fpZJ —� i INSPECTORS USE ONLY DATE OF INITIAL INSPECTION: - / - �-7 DA'Z'E OF REINSPECTION DATE OF ISSUANCE OF CERTiFICATE:Z_�L 7- f 7 DATE FEE PAID: TYPE OF UNIT: DWELLING(�OTHE�R NOTE CODE ENFORCEMENT INSPECTOR • - "M CITY OF SALEM, MASSACHUSETTS a ; 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#524-06 DATE ISSUED: 10/26/2006 Property Located at: 22 Phelps Street UNIT# 1 Owner/Agent: Edith Boisvert Address: 22 Phelps Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-0904 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. FO THE BOARD OF EALTH . ate- '� -- Zan,, JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS , ^� BOARD OF HEALTH �V 120 WASHINGTON STREET, 4TH FLOOR a 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 9 Qn �� /J4r UNIT# C IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER AA ,' .ki &avu,-e MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS a P n Phi. Sa-{- ADDRESS CITY a..Q g_w 60- CITY RESIDENCE PHONE 64 � BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3_1 4. . 5. 6. 7. 8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE DATE 4 D INSPECTORS USE ONLY DATE OF INITIAL INSPECTION W- &•(5%j DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: IQ-L6•T51y DATE FEE PAID: )a- zv%L TYPE OF UNIT: DWELLING--4 OTHER_ CHECK# NSCHECK DATE /IS LV e4 6 NOTES: S 7 2 I GP A\L i1 49-sw*n 43Qi �M �1aZA��y� CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS ' BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT Kimberley Driscoll Mayor RELEASE In accordance with Massachusetts General Laws Chapter III ; Code of Massachusetts Regulations 410.000 et. seq. ; State Sanitary Code Chapter II and Article XIII of tiie City of. Salem Ordinance, undersigned owner/lessor and tenant/lessee of a unit of residential property, hereby authorize the Salem Board of Health or its author— ized agents to inspect the residence identified below in accordance with the aforementioned statutes, regulations and ordinances. In the event it is necessary that said inspection be done in my/our absence, 1/we expressly authorize the same and for my/our successors and assigns hereby rel<asc and discharge the City of Salem, Salem Board of Health and its authorized a.gcnta from any loss or injury sustained of whatever nature ani description occasioned by my/out absence during said inspection. TEdA,NTT/LESSEE OWNER/iFSSOP. Ai)➢HESS ADDRESS A.DDkESS OF UNIT 1'0 11? iNSPECTIEU Ca��T n � CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 120 Washington Street JOANNE SCOTT, MPH, RS,CHO Tel: (978)741-1800 HEALTH AGENT 08/06/2001 Fax: (978)745-0343 Pied Family Trust c/o Roger & Martha Pied 23 Phelps Street Salem, MA 01970 PROPERTY LOCATED AT 23 Phelps 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. ' FOR THE BOARD OF HEALTH REPLY TO Joanne Sc tt, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR CFFY OF SALEM, MASSACHUSETTS BOARD OF HEALTH lu 120 WASHINGTON STREET 4 "FLOOR PI1t111C�P.81th - STREET, rre.em.Ymmow:Proec[. TEL. (978) 741-1800 Fax(978) 745-0343 KIMBERLEY DRISCOLL liamdin(7a=,salem.com LARRY 1LAb113IN,RS/RU ITS,CHO,CRFS MAYOR Hr.AI:rH AGENT CERTIFICATE OF FITNESS CERTIFICATE#462-12 DATE ISSUED: 11/29/2012 Property Located at: 23 1/2 Rear Phelps Street UNIT# Rear Owner/Agent: Estate of Linda Grimes Address: 17 Cressy Street City/Town: Beverly, MA Zip Code: 01915 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 Occ ncy. FOR THE BOARD OF HEALTH LAR MDIN HEALTH AGENT NITARIAN CITY OF SALEM, MASSACHUSETTSASSACHUSETTS ��1- BOARD OF H&-1LTH 10 120 WASHINGTON STREET,4141 FLOOR Public Health IYc.enf.Pmmnte.Prol¢f. TEL. (978) 741-1800 FAX(978) 745-0343 I IMBERLEY DRISCOLL Iraiiidin@salem.com MAYOR L/\RI25'Rr\1`'Il)1N,RS/REFIS,CI 10,(T-FS Hv,\j;f[i 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* FEE: $50.00 PROPERTY LOCATED AT 01✓/� ^ ' 5 19� cam" UNIT# IS THIS UNIT DISIGNATE//D��AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER tr��;1S� 6r l:4 A, ( j�i�`�p MANAGER/AGENT - Gl ��p C�S ADDRESS ADDRESS CITY, STATE,ZIPCITY, STATE, ZIP 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 TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT-THE TIME OF INSPECTION APPLICANT'S SIGNATURE � DATE Inspectors use only ` ✓/ Date on initial inspection: Date of reinspection: t v Date of issuance of certificate: Date fee paid: ¶¶ II nn Type of unit: Dwelling Other Check#_JUL—Check date: Notes: Code or t Inspector CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH s 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAx 978-745-0343 Kimberley Driscoll www.SALEM.COM Mayor JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE# 18-06 DATE ISSUED: 1/11/06 Property Located at: 26 Phelps Street UNIT# 1 Owner/Agent: Peter LaBonte Address: 31 St. Anns Avenue City/Town: Peabody, MA Zip Code: 01960 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 q `' JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET. 4TH FLOOR SALEM, MA 0I970 TEL, 978-741-1600 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO H 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 AS RIGHT !.EFT FRONT BACK_ PLEASE CIRCLE ONE OWNER/LESSER MANAGER/AGENT—,—,—_ No P.O. Box No P.O. Box ADDRESS--,76✓��-Z��,---ADDRESS- CITY xlraoli-e,4611 RESIDENCE PHONEf%'8097--�d� }SINESS PHONE (24 HRS )-- BUSINESS PHONE TOTAL NUMBER OF ROOMS i—,4110" ROOM USE: THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE DATE 1111�11drc INSPECTORS USE ONLY DATE OF INITIAL INSPECTION/-"­/(-0 , _DATE OFRFINSPECTION., ) / ."!-/ 6� DATE OF ISSUANCE OF CERTIFICATE:F: 1j)q6(o DAZE FEE PAID TYPE OFUNIT: DWELLI�KOHAFR C]FiFCK V CHECK DATE 6 NOFS FS DL CLMLNI IN`rl-CIOH Qi, 8i'M CITY OF SALEM9 MASSACHUSETTS BOARD OF HEALTH 6, 92 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#457-04 DATE ISSUED: 10/06/2004 Property Located at: 29 Phelps Street UNIT# 1 Owner/Agent: Edith Boisvert Address: 22 Phelps Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-0904 An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with 105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II" Minimum Standards of Fitness for Human Habitation'. Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of Health and the unit may now be rented and/or occupied. Maximum Number of occupants, must comply with 105 CMR 410.000. Certificate valid for one year from date of issuance or until the current tenant vacates, whichever is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy: F R THE BOARD OF HEALTH JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR 1 CITY OF SALEM, MASSACHUSETTS �A`� BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-74 1-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, R5, 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 o2 S UNIT#� IS THIS UNIT DESIGNATED AS RIGHT'LEFT ONT BACK PLEASE CIRCLE ONE OWNER/LESSER MANAGER/AGENT No P.O. Box,, o p No P.O. Box ADDRESS ��I �� ADDRESS CITY CITY v�151- RESIDENCE PHONE j 7$ I y�" 090� BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. L 2. t� 3. 4. R •P- 5._8. 6. 7. 8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE g d(�� Ubu o G ( DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION /O '6 y l DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE-DATE FEE PAID: 16 '(i a `� TYPE OF UNIT: DWELLINrOTHER_ CHECK# 13�"�CHECK DATE /O - /� y NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98