PLANTERS STREET PLANTERS STREET o
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CITY OF SALEM, MASSACHUSETTS
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BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, R5, CHO
MAYOR HEALTH AGENT
March 14, 2003
Florencia King
10 Planter Street
Salem, MA 01970
PROPERTY LOCATED AT 10 Planter Street
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
l Joanne Scott MPH, RS, CHO Pablo Valdez
Health Agent Code Enforcement Inspector
'f r
� ��CONOIT
CERT.# 759-00
FEE $25.00
a DATE: 12/01/2000
,pT,C7r1INK
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: 23 Planters Street UNIT #: House
OWNER/AGENT: Frank L. David
ADDRESS: 81 Bridge Street
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-1932
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 .
OR THE BOARD HH
v
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
is
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 fl, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNES ,FOR HUMAN HABITATION".
PROPERTY LOCATED AT J� 4` Pl _ 't
IS THIS UNIT DESIGNATED AS IGT EF FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER t/A 01 D L i )iLqf&_MANAGER/AGENT_
No P.O. Box No P.O.Box
ADDRESS7'fU3eLp65 _�C: � ._ADDRESS
CITY Fll1�� CITY
RESIDENCE PHONE �������c BUSINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. beO 2. �I-V' 3. De i\) 4. / lJ�
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 7 DATE
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION Z,,�- 0 u DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:y/,-�-0 -0 DATE FEE PAID: —o�
TYPE OF UNIT: DWELLING _OTHER. � CHECK#,��CHECK DATE
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
4
6 b
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
RELEASE
In accordance with Massachusetts General Laws Chapter ill ; 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.
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.
TENANTfLESSgE OWNER i.ESSO t/ i//c% f31t1
ADDRESS — m ADDRESS
ADDRESS OF UNIT TO BE INSPECTED
_ � z
DATE