PIEDMONT STREET PIEDMONT STREET
o
uD " City of Salem, Massachusetts
A& kI
Board of Health
120 Washington Street, 4th Floor, Salem, FublicHealth
O 'Preveot. Promote. Protect.
MA 01970
978 741-1800 Fax. 978 745-0343
Kimberley Driscoll Tel. � � � � Larry Ramdin, MPH, REHS,CHO
Mayor health@salem.com Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE#: GHL-17-42
DATE ISSUED: 2/17/2017
Property Located at: 22 PIEDMONT STREET UNIT#2
Owner/Agent: Arlene Craig
Address: 5 Wadden Court
City/Town: Marblehead, MA Zip Code: 01945 24 Hour Phone:(781) 631-6451
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.
EGagakis
Larry Ramdin, MPH, REHS, CHO SANITARIAN
HEALTH AGENT
I
CITY OF SALEM, MASSACHUSETTS
a
BOARD OF HEALTH
120 WASHINGTON STREET,4`"FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR LRAMDIN@ALHM.COM
L;ANRY RAMDIN,ILS/RE:HS,CI-IO,CP-F5
H({AL.Pi I ACiE,N r
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"
-1 (� FEE: $50.00
PROPERTY LOCATED AT as V eJ VOCAi UNIT# /
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWNER/LESSER azltz C " MANAGER/ AGENT
NO P.O.BOX
ADDRESS---` i���R/ ADDRESS
CITY, STATE,ZIP LQ CITY, STATE, ZIP
RESIDENCE PHONE �,/7� ✓` BUSINESS PHONE(24HRS)
BUSINESS PHONE�a —L 3f— !Qt
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2. OR 3. 4.( 5. J
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 �L �� ��� DATE
Inspectors use only
Date on initial inspection: �a� �� Date of reinspection: a
Date of issuance of certificate: Date fee paid:
Type of unit: Dwelling Other Check# 3V5 Check date: lta,61/11
Notes:
7 ` Q
Code MorckVent Inspector
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
Eric Stone
5 Piedmont Street
Salem, MA 01970
PROPERTY LOCATED AT 5 Piedmont 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 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 . F HEALTH REPLY TO
Joanne Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
i
i
�e
CITY OF SALEM BOARD OF HEALTH
Salem,,Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS, CHO NINE NORTH STREET
HEALTH AGENT Tel: (978) 741-1800
05/16/2001 Fax: (978)740-9705
Eric Stone
5 Piedmont Street
Salem, MA 01970
PROPERTY LOCATED AT 5 Piedmont 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. j
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.
R THE BOARD REPLY TO
oanne. Scott MPH RS, -..
, PABL O VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR.
t of Health of Salem - - / � t r�
QOaCCI - O M�i VED - LEFT NO ADDRESS ---••���...���� a t
lth �J ATTEMPTED - NOT KNOWN MAY 16'OI � � D
9 North Street ' ❑ UNCLAIMED ❑REFUSED `
y� O VACANT ONO MAILBOX
Salem, MA 01970-3928 rosrats giJ:r54U.S.POSSAIT
❑ DECEASED -
t
°
s os ❑ INSUFFICIENT ADDRESS
F'�oF O FORWARDING ORDER EXPIRED
e O NO SUCH STREET C7 NUMBER
(PEEL OFF-UPDATE CUSTOMER LIST)
IEric Stone
� �y �jgjf 5 Piedmont Street
(q�y; U y{yil!{ Salem, MA 01970
Mdy 2 _i 2005 `A
HEALTH DEPT. s1
ii:.•3'3—i°'rn 1.:< 13 �f�ttttti{��t�tttttt���ettt{it{i��rt+tr���ttit��ttet�t�t�t�ati
nl
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH, RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(978)741-1800
05/16/2001 Fax: (978)740-9705
Eric Stone
5 Piedmont Street
Salem, MA 01970 -
PROPERTY LOCATED AT 5 Piedmont 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. - 7:0'0 p.m. and. Fridag 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.
R THE BOARD/ REPLY TO
oanne Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR.
i .
I
i
�wn,
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET
HEALTH AGENT Tel: (978)741-1800
02/14/2001 Fax:(978)740-9705
Eric Stone
5 Piedmont Street
Salem, MA 01970
PROPERTY LOCATED AT 5 Piedmont 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.
OR THE BOARD HEALTH REPLY TO
Joanne Scott, MPH,RS,CHO PABLO- VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
V
v ~
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
:9 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
9qg TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
June 18, 2003
Steven Dawson
19 Piedmont Street
Salem, MA 01970
PROPERTY LOCATED 19 Piedmont Street Unit#2
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 1: General Administrative Procedures and 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. —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($20.00)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 tenants' 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
Joanne Scott MPH, RS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector
-Y
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
MAYOR HEALTH AGENT
05/09/2002
Steven Dawson & Joan O'Conner
19 Piedmont Street
Salem, MA 01970
PROPERTY LOCATED AT 19 Piedmont 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.
JR THE ARD OF REPLY TO
i
Joanne Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
3
CITY OF SALEM, MASSACHUSETTS
BOARD OI^H&1LTII
120 WASHINGTON SPRLrT,4:"FLOOR
T`EL. (978)741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYORnj IONNr ti V,1 -01\1
jAN1.i;T D10NNli
ACTING HEALTf-T AGENT
CERTIFICATE OF FITNESS
CERTIFICATE#609.08
DATE ISSUED: 11/25/2008
Property Located at: 21 Piedmont Street UNIT#DUPLEX
Owner/Agent: William H. &Jody R.Goodwin
Address: 8 Roslyn Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 781-608-3859
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 THE BWOF H
JAN T DIONNE
CTING HEALTH AGENT CODE ENFO CEMENT INSPECTOR
j
iI
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4"'FLOOR
TEL. ()78)741-1800
KIMBERLEY DRISCOLL FAX(978)745-0343
MAYOR IIJIONN,{�tiALE'M.COM
JANET DIONNE,
ACTING HEALTH AGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION."
FEE: $,550.00
PROPERTY LOCATED AT�- I C'rX V�CJ GQ f UNIT#
IS THIS UNIT
DISIGNADARIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE
Ollr �u �pe2
CckESSER g
MANAGER/AGENT _
ADDRESS Ill S r/7 V- 5UZ4"4 ADDRESS
I
CITY, STATE,ZIP tl SS Ol f7UCITY, STATE,ZIP
RESIDENCE PHONE of 7� 7YO-137b BUSINESS PHONE(24HRS)7 f/-�O�- 3 95-?
BUSINESS PHONE l 7f'
TOTAL NUMBER OF ROOMS:�`I �1 DD
ROOM USE: �!ft h K 2 1-1 y I n k 3 !�I YI1!dl424 !X!) of 5 iXc-601t
Awaq. S. V 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 OP INSPECTION
APPLICANT'S SIGNATURE—,4 44� DATE 4/ S aOPJ$9
Inspectors use only
Date on initial inspection: J I 2 Date of reinspection:
Date of issuance of certificate: )r^ 2 5 Date fee paid: ?1'_U —S
Type of unit: Dwelling__I Others Check#S 2lo�235�iO Check date:
Notes:
Code Enforcem nt Inspector
CITY OF SALEM, MASSACHUSETTS
. e
J BOARD OF HEALTH
120 WASHINGTON STREET,4� FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAx(978) 745-0343
MAYOR IDIONNE SALEM COM
JANET DIONNI
ACING HEALTH AGENT
Facsimile
Transmittal
To: J_`c , l 6e& v'rx
Fax #
RE: 021 Pi C)wtcv14
Date : f o2../.1-4)
Page(s): including this cover#
Message:
/7u
Board of Health News -----------------------------------------------------For Your Information
OFFICE HOURS:
Monday, Tuesday, Wednesday 8:00 AM to 4:00 PM
Thursday 8:00 AM to 7:00 PM
Friday 8:00 AM to 12:00 NOON
HP Fax Series 900 Fax History Report for
Plain Paper Fax/Copier Joanne Scott Salem BOH
978 745 0343
Dec 02 2008 12:12pm
t.ast Fax
D= MM T= Identification .ga= 42di
Dec 2 12:12pm Sent 919785940667 0:36 2 OK
Result:
OK - black and white fax
:i
;../ CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
e 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#288-05
DATE ISSUED: 5/4/05
Property Located at: 21 Piedmont Street UNIT# 1
Owner/Agent: William H. &Jody R. Goodwin
Address: 8 Roslyn Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 608-9816
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
�
JOAfU,JVE SCOTT, MPH, RS, CHO �" e
HEALTH AGENT COD ENFORCEMENT INSPECTOR
�
�
| ` CITY OF ����� MASSACHUSETTS
^ / ` `-
Bo*noopHEALTH
1eoWASHINGTON STREET, 4TH FLOOR
�
SALEM, m/\ u`yru
TsL� y7*'74` /000
FAX 978-745-0343
STANLEY usov/cz` JR, JOANNE SCOTT, MPH, IRS, c*o
� wa,nn HEALTH AGENT
APPLICATION FOR CERTIFICATE OFFITNESS
|0ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 1|, 10SCMR 410�800
"MINIMUM STANDARDS 0FFITNESS FOR HUMAN HAB(TAT|ON"
�
PROPERTY LOCATED AT / -UNIT#_�_
�
IS THIS UNIT K�ESIQNATEK} AS LEFT ��
�A�� �� ASE��IFl[�LE�����}
OWNER/LESSER WMa_
ADDRESS
CITY CITY
RESIDENCE PHONE W6BUSINESS PHONE (24HAS],________
BUSINESS pHD0E/ v/ &u» ~/
TOTAL NUMBER OFROOMS:
THERE IS A TWENTY-FIVE($25.00) DOLLAR FE I E, PAYABLE BY CHE/KOR MONEY
ORDER TO THE CITY OF SALEM HEALTH DEPARTR NTTHIS FEE IS PAYABLE ATTHE
TIME OF INSPECTION
APPLICANTS SIGNATURE DATE
` {-
DA
DATE OFRBNSPEST|0N
D8TEOF |SSUAN0E0FCERT|F|CATE: ATEFEE PA0i ,
TYPE 0FUNIT: DWELLOTHER_� CHECK# E -'
)- CHECK -r-
CODE ENFORCEMENT INSPECTOR 8/2098
|
CO City of Salem, Massachusetts1P
Board of Health
120 Washington Street, 4th Floor, Salem, PublicHealth
MA01970 Prevent, Promote. Protect.
Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343
Larry Ramdin, MPH, REHS,CHO
Mayor Iramdin@salem.com Health Agent
CERTIFICATE OF FITNESS
CERTIFICATE#: GHL-15-257
DATE ISSUED: 8/28/2015
Property Located at: 22 PIEDMONT STREET UNIT#1
Owner/Agent: Arlene Craig
Address: 5 Wadden Court
City/Town: Marblehead, MA Zip Code: 01945 24 Hour Phone:(781) 631-6451
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 pp ed 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.
FOR THE BOARD OF HEALTH
F�
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT //// /SANITARIAN
CITY OF SALEM, MASSACHUSET"I'S
BOARD OF HEALTH
120 WASHINGTON STREET',4"'FLOOR
TF1.. (978) 741-1800
KIMBERLEY DRISCOLL FAX (978) 745-0343
MAYOR LRAMD(N@,SALEM.eoM
LARRY RAMI)IN,RS/REI IS,(A IO,(T-I-S
HE,A]AI I A(,Ia,N.i
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION"
(� FEE: $50.00
PROPERTY LOCATED AT 52Jt S UNIT# I
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK.PLEASE CIRCLE ONE
OWNERFLESSORc�_ MANAGER/AGENT
ADDRESS ADDRESS
ADDRESS
CITY, STATE, ZIP CITY, STATE,ZIP
RESIDENCE PHONES ��! �� I BUSINESS PHONE(24HRS)7 � a
BUSINESS PHONE 2F11��31—q �6ca
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. L-60, 2 3. � U1 4
b. 7. 8. d'9. 10.
THERE IS A FIFTY($50)DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION
APPLICANT'S SIGNATURE I � t�� xi DATE � 3
InsDgctors us�onl
Date on initial inspection: NL 267-5— Date of reinspection:
Date of issuance of certificate:�I/L 2Q1- Date fee paid:o�;/�ZZ/Z
C2Z S�
Type ofunit: Dwelling 1 Ov ther �Check#_)O� Check date:OZ12a2-0 4 S
t
Notes: 1 See
C, rc entinsp for
Inspection of t;_.Vl r9 Me.O� Date OV2+7Time L.2
Name Address ry�p-q1"r .vnn,y1'� r ,o
Owner4r66 r Tel. No. M--�6a—yq�)p4 h(/
Type of Inspection r0Y #V h
PAJA. tl�-� eSS Inspector J��� 6
. L rarV
I ' I/Remarks and Violations are listed below:
I Q + WI-y>�A�✓ in IIJI ,^onyn hee SLrepm < re.P,2I.V2Z1
` �LeA✓' W l hAe)k4/_/ VLhn,�Yn0 M LA o Tr[L�!;,A Id lock!;
YlY�0/11 WEh676A/ 9M 46PIIJ -51&S f�Q, L$Qll "10—D St r.)S I .SIAII JI
Ls
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&&orr, hear re4r�IkVmse hasw wif[�_�_i_S--j
(� II r r I ✓
IQr ^�h lS wyn,,jm / h/ovl -�- )in�ralKar4T
ZSP r) L ItoNS- U,Ce- 6e_ Y'
Report Received by:
CITY OF SALEM, MASSACHUSETTS
v� a3R
� 'fr BOARD OF HEALTH
z120 WASHINGTON STREET, 4TH FLOOR
I �9' 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#154-08
DATE ISSUED: 3/27/2008
Property Located at: 22 Piedmont Street UNIT#2
Owner/Agent: Arlene Craig
Address: 5 Wadden Court
City/Town: Marblehead, MA Zip Code: 01945 24 Hour Phone: 631-6451
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 INSP TOR
CITY OF SALEM, MASSACHUSETTS
• • BOARD OF HEALTH
120 WASHINGTON STREET,4"FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAx(978)745-0343
MAYOR IscOTI&- nLFW 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."
PROP Y LACATED AT - �)- 7 2�ZG UNIT#
I a Q
IS THIS UNIT DISIGNATED AS RIGHT CEFT FRONT OR BACK,PLEASE CIRCLE ONE
OWN R/L MANAGER/AGENT
NO P.O. BOX � )
ADDRESS S �!/( ADDRESS q
CITY,STATE,ZIPCITY,STATE,ZIP � / ��
RESIDENCE PHONE 7V G j� 6 50 BUSINESS PHONE(24HRS)
BUSINESS PHONE 2V -6�, �-5�I6�
TOTAL NUMBER''1OF ROOMS: J n /�
ROOM USE: 1.9( i- 2. 3. fl 4. �C
6.4gkr,M 7. S. 9. 10.
THERE IS A TWENTY-FIVE($25) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF
SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION
APPLICANTS SIGNATURE&&Z DATE
Inspectors use only
Date on initial inspection: ''.=c�? ' 041 Date of reinspection:
Date of issuance of certificate: j J- 7 d Date fee paid: 3 ';," 7 —0 r
Type of unit: DwellingOther Check# _%s Check date: 3 a 7 —d 1?Notes:
Code Enforcement Inspector
¢ CITY OF SALEM, MASSACHUSETTS
BOARD OF H&UTH
120 WASHINGTON STREET 4"FLOOR PubhCI3ea1th
Prevent.Promote.protect.
TEL. (978) 741-1800 FAk (978) 745-0343
KIMBERLEY DRISCOLL lram&i@salem.com
LARRY ILAMD7N,RS/RP.IiS,CFfb,CP-PS
MAYOR
CERTIFICATE OF FITNESS
CERTIFICATE#81-14
DATE ISSUED: 3/13/2014
Property Located at: 22 Piedmont Street UNIT#3
Owner/Agent: Arlene Craig
Address: 5 Wadden Court
City/Town: Marblehead, MA Zip Code: 01945 24 Hour Phone: 1-781-631-6451
Pursuant to the requirements of City of Salem ordinance Chapter 2 Article IV Division3, Section
705: Certificate of fitness of rented dwelling unit, apartment or tenement. An inspection of your
vacant Dwelling/Rooming Unit at the above address has been approved and is in compliance with
105 CMR 410.000: Massachusetts State Sanitary Code, Chapter II" Minimum Standards of
Fitness for Human Habitation".
Therefore, this Certificate is issued by the Code Enforcement Division of the Salem Board of
Health and the unit may now be rented and/or occupied.
Maximum Number of occupants, must comply with 105 CMR 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy.
FOR THE BOARD OF HEALTH
LARIMRAMDIN
HEALTH AGENT SANITAR
c n
9
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 Tec(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 oZo� -- �"' til r UNIT#
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER- MANAGER/AGENT
No P.O. Bax V No P.O. Box
ADDRESS ADDRES�S�n
GITY_7044 CITY -//tet'.
RESIDENCE PHONE BUSINESS PHONE (24 HRS.)
BUSINESS PHONE Al 7" T 116 O
TOTAL NUMBER OF ROOMS:: C/
ROOM USE: I.Lk 2. /`1 u^ 3. 4 4lgA'
5. 6. 7. 8.
THERE IS A TWENTY-FIVE(+ 0)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_,
IN
SPC US O Y
DATE OF INITIAL INSPECTION C� 3 DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: DATE FEE PAID: f
TYPE OF UNIT: DWELLING_OTHER_ CHECK 1,l---CHECK DATE
NOTES: —
OA&E T� 9/28/98
CODE �nff�S��F3CEMENT INSPECTOR
I
CITY OF SALEM BOARD OF HEALTH
Satem,Massachusetts 01974-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Fax:(508)740-9705
RELEASE
In accordance with Massachusetts General Laws Chapter Ii 1 ; Code of Massachusetts
Regulations 410.000 et. seq.; State Sanitary Code Chapter II and Article XIII of
the City of Salem Ordinance, undersigned owner/lessor and tenant/lessee of a unit
of residential property, hereby authorize the Salem Board of Health or its author—
ized agents to inspect the residence identified below in accordance with 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 agents
from any loss or injury sustained of whatever nature and description occasioned ,.,.
- by my/our absence during said inspection.
^� .`-?
Tu_ NT/LESS _ WNER/LESSOR
Tzr
ADDRESS
ADDRESS OF UNIT TO BE INSPECTED
D,ATfE F