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RAYMOND ROAD JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CERT.# 251-97 FEE $25.00 DATE: 04/23/97 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 1 Raymond Road OWNER/AGENT: Frank Connelly ADDRESS: 198 Faverweather Street CITY/TOWN: Cambridae. MA ZIP CODE: 02138 NINE NORTH STREET Tel: (508) 741-1800 Fax: (508) 740-9705 UNIT #: One 24 HOUR PHONE: 864-1860 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 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 Pending: Cover small hole in wall. All windows need locks & repair sashcords. VJ 64 It - CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS, CHO NINE NORTH STREET HEALTH AGENT - Tei: (508) 741-1800 APPLICATION FOR CERTIFICTE OF FITNESS Fax: (508) 740-9705 IN ACCORDANCE WITH STATE SANITARY: CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT OWNER/LESSERT" XJr~... 1__"` ir .ADDRESS i1Y "rcr. o�� / Y CITY RESIDENCE PHONE BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: I, - 2. 3. 5. 6. 7 I( UNIT #__int, rL- MANAGER/AGENT .(p7tn� ADDRESS CITY BUSINESS PHONE (24 HRS.) 4. 8. THERE IS A TWENTY-FIVE (25,00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DE..PA�RTMENT E IS PAYABLE AT THE TIM OF INSPEECTION APPLICANTS SIGNATURE_(�t��-,- INSPECTORS USE ONLY DATE OF INITIAL INSPECTION: I(- DATE OF REINSPECTION _ DATE OF ISSUANCE OF CERTIFICATE: _DATE FEE PAID:—_ TYPE OF UNIT: DWELLING OTHER _— NOTES: M CODE ENFORCEMENT INSPECTOR AJ /411 KIMBERLEY DRISCOLL MAYOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4T" FLOOR TEL. (978) 741-1800 FAX (978) 745-0343 Iratndin@salem.com CERTIFICATE OF FITNESS CERTIFICATE # 420-14 DATE ISSUED: 11/10/2014 Property Located at: 3 Raymond Road UNIT # 1 Owner/Agent: Richard Coffin Address: 15 Dunlap Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-2603 1P AxblicHealth rm."m. u."mnw. r.mca. LARRY RAbIDIN, RS/RIi.HS, C1 10, CP -FS HEAL PIi AG FIN I' 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 L LARR RAMDIN HEALTH AGENT r go ?j 'grjown i KI MBERLEY DRI SCOLL MAYOR LARRY RAMDIN, RSI REHS, CHO, CP -FS HEALTH AGENT iN\'4 11= If�if1A ,A 1� 4� CITY OF SkLEM, MASSACHUScTTS BOARD OF HEALTH 120 WASIINGTON SYREET, 4T" FLOOR TEL. (978) 741-1800 FAx (978) 745-0343 LRAMDI N AFALEM.COM Application f•r Certificated Fitness STANDARDSOF FITNESS FOR HUMAN HABITATIOW �• ISTHISUNITDISIGNATEDASRIGHTLEFT FRONT ORBACK PLEASECIRCLEONE OWNER/LESSERR160A (Xi't7 �CkO-C1) CUSery MANAGER/ AGENT C—ne Ni C6 e y NO P-0- BOX SID IS DCfn 10-o 54 CITY, STATE, ZIP So 1'e^—] , STATE, ZIP M f} 0 1 Q-7 a t tlomcEFffemE97L- i�{ S%2>o U 3 r Ii (2 r ice) BUSINESS PHONE TOTAL AshWREROF % ROOM USE: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. THERE T S A FIFTY ($50) DOLLARFEE, PAYABLE BY CHECK OR Nf ON1Y ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANT'S Inspectors use only Date on initial inspection:11�l (4 Date of reinspection: Date oTTsscanceofcerfifcafe: Dateieep d Typeof unit: Dwelling lairdall -� ,rjic -�-• • TE KIMBERL.EY DRISCOLL MAYOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4". FLOOR TEL. (978) 741-1800 FAx (978) 745-0343 Iramdin ,salem.com CERTIFICATE OF FITNESS CERTIFICATE # 323-14 DATE ISSUED: 9/22/2014 Property Located at: 3 Raymond Road UNIT # 3 Owner/Agent: Richard Coffin / Cheryl Casey Address: 15 Dunlap Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-2603 V PublicHealth e.<"om. r."mom. plmWt. LARRY RnD4DIN, RS/R];HS, CFIO, CP -FS I-IF,\i,'n f A(3 ENT 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 AGENT SANITARIAN KIMBERLEY DRISCOI-L MAYOR LARRY RANMIN, RS/REHS, CHO, CP -FS HEALTH AGENT it CITY OF)SALEM, MASSACHUSETTS- •i 1 BOARD OF HEALTH ;120 WASHINGTON STREET, 4" FLOOR TEL. (978) 741-1800 FAX (978) 745-0343 LRA.-vmIJN @sALF,',I.COM 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 IS THIS UNIT NO P.O. BOX 3 DISIG D AS RIGHT LEFT FRONT OR BACK, PLEASE CIRCLE ONE .. e,,,Li MANAGER/ AGENT Ck e `y� cc'S ' AiNlRRBC .. t CITY, STATE, ZIP ?)CL IeM . © 19 76 CITY, STATE, ZIP RESIDENCE PHONE97�-74S—abig3 BUSINESS PHONE (24HRS) BUSINESS PHONE ' TOTAL NUMBER OF ROOMS: ROOM USE: THERE IS A FIFTY ($50) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANT'S nn Inspectors use only i ,,J , 1 , Date on initial inspection: Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: Dwelling—Other—Check # Check date: -11T Code En orc rJ nt Inspector KIMBERLEY DRISCOLL MAYOR LARRY RA_\IDIN, RS/REHS, CHO, CP -FS HEALTH AGENT CITY.OF SALEM, MASSACHUSETTS - BOARD BOARD OF HEALTH 120 WASHINGTON STREET, 4iH FLOOR TEL. (978) 741-1800 ' FAx (978) 745-0343 LRA.MDINO.SAL&M.COM q• Release r f In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ; State Sanitary Code Chapter II and Article XIII of the City of Salem Ordinance, undersigned owner/lessor and tenant/lessee of a unit of residential property, hereby authorize the Salem Board of Health or its authorized agents to inspect the residence identified below in accordance with the aforementioned statutes, regulations and ordinances. In the event it is necessary that said inspection be done in my/out absence. Uwe expressly authorized thesame and for my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of Health and its e authorized agents from any lose or injury sustained of whatever nature and description occasioned by my/out absence during said inspection. Tenant/Lessee 0 Address WgI Date Updated 523/11 >t ,4a i /z _ r Address u�a-t-`rnor\c� 1Z©Czc� � Address on unit to be inspected . +1_ t,, KIMBERLEY DRISCOLL MAYOR DAVID GRF'FNBAUM, RS ACTING HEALTH AGENT CITY OF SALEM, MASSACHUSETTS BOARD OF HFALTH 120 WASHINGTON STREET, 4"' FLOOR TEL. (978) 741-1800 FAx (978) 745-0343 UGREENRAUM([!�$ALr? M.COM CERTIFICATE OF FITNESS CERTIFICATE # 78-11 DATE ISSUED: 3/22/2011 Property Located at: 8 Raymond Road UNIT # R Owner/Agent: Harry Ogden C/O Jim Wersackas Address: 16 Bishop Lane City/Town: Lynnfield, MA Zip Code: 01940 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 THEI BOD OF HEALTH DAVID GREENBAUM, RS ACTING HEALTH AGENT CODE ENFORCEMENT INSPECTOR IQMBERLEY DRISCOLL MAYOR DAVID GREENBAum, RS ACTING HEALTH AGENT CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET. 4`° FLOOR TEL. (978) 741-1800 FAX (978) 745-0343 DGRL'P_NBAUM2SALEM. COM 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-0-- IS TSIS THIS UNIT NO P.O. BOX 7vi 5 2� UNIT#-jk2 AS RIGHT LEFT FRONT OR BACK PLEASECIRCLEONE MANAGER/ AGENT 1/ / ��2SfI l6 CITY, STATE, ZIP 06U7- 10-1A CITY, STATE, ZIP RESIDENCE PHONE /V/- V? 21557 BUSINESS PHONE (24HRS) / l-sn"69/ZU BUSINESS TOTAL NUMBER OF ROOMS: ROOM USE: /qy0 THERE IS A FIFTY ($50) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE IS PAYAIAE AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE �/% � 'W"17 e0� DATE 34219641 v Inspectors use only Date on initial inspection: 7 R11 Date of reinspection: 3 Date of issuance of certificate: ala /) Date fee paid: Type of unit: Dwelling--L--Other-Check # Check Code Enfor e I Inspector Kimberley Driscoll Mayor City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, MA 01970 Tel. (978) 741-1800 Fax. (978) 745-0343 Iramdin@salem.com CERTIFICATE OF FITNESS CERTIFICATE #: GHL-15-427 DATE ISSUED: 12/23/2015 Property Located at: 15 RAYMOND ROAD UNIT #1 Owner/Agent: Joel Livingston, Joseph V. Turone, & Joseph A. Tutrone Address: 42B Cherry Hill Drive City/Town: Danvers, MA Zip Code: 01923 [e] PublicHealth Prevent Promote. Protect. Larry Ramdin, MPH, REHS, CHO Health Agent 24 Hour Phone: (978) 884-6351 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 9 //t;0l SANITARIAN CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4" FLOOR TFL. (978) 741-1800 KIMBERLEY DRISCOLL FAX (978) 745-0343 MAYOR IYAAfIN AIPld, %a LARRY RAMDIN, RS/RTJTS, 010, (T -TS Hra mi 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 AS- Ralywkor\d iZD Nl,A UNIT#-_ IS THIS UNIT DISIGNATED AS GA LEFT FRONT OR PLEASE CIRCLE ONE -3K-PA OWNER/LESSER Soal ;mac �s}� ��°hv�Ntrke arv. MANAGER/ AGENT NO P.O. BOX ADDRESS y% fl e I F1;11 Dr ADDRESS CPlY, STATE, ZIP---DlA' , &� Y � 3 CITY, STATE, ZIP jv may) a SIcF-( RESIDENCE PHONE USINESS PHONE (24HRS) Jo zlJ BUSINESS PHONE 5 mP TOTAL NUMBER OF ROOMS: S ROOM USE: 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 TAR TIME OF INSPECTION APPLICANT'S Inspectors use only TE 1�-I-1 Date on initial inspection: 1Date ofreinspection: Date of iDate fee paid: Type of unit: Dwelling 'V Other Check # 10102 30-� Check date: L2,*1: S-- Tiler/F _ ./i5 ...�c✓ Kimberley Driscoll Mayor City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, MA 01970 Tel. (978) 741-1800 Fax. (978) 745-0343 Iramdin@salem.com CERTIFICATE OF FITNESS CERTIFICATE #: GHL-16-148 DATE ISSUED: 5/6/2016 Property Located at: 38 RAYMOND ROAD UNIT #2 Owner/Agent: Romau Chanaj Address: 23 Princeton Street City/Town: Peabody, MA Zip Code: 01960 [e] PublicHealth Prevent. Promote, Protect. Larry Ramdin, MPH, REHS, CHO Health Agent 24 Hour Phone: (978) 532-6987 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 SANITARIAN KIMBERLEY DRISCOLL . MAYOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4' FLOOR TEL. (978) 741-1800 FAX (978) 745-0343 lramdin@salem.com LARRY RA MDIN, RS/RENS, CHO, CP -FS HL'AL111 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� IS THIS UNIT Uk qg ()� V) CI -J(aj� t ED AS RIGHT LEFTFRONT OR BACK. PLEASE CIRCLE ONE P o'L CITY, STATE, ZIP. RESIDENCE PHONE '1P /Y `JAS L BUSINESS PHONE 53 2 (.93Z STATE, ZIP, PHONE (24HRS) Sqw e 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 AMID TIME OF INSPECTION APPLICANT'S TE Inspectors use only t Date on initial inspection: 0 ylgzL2� Date of reinspection: Date of issuance of certificate: Date fee paid:Qe{/7R/1F Type of unit: Dwelling Other Check # S 4`39 Check date:OW12420I Code Enforcement Inspector Irspection of �PCAd4leAl Date Name J Addri o Owner / Tel. I Type of Inspection C2r +I i"ICA. Qi n� �l "i Ae�# Inspe (' Remarks and Violations are listed below. 0. 4�111111111 Willi Report Received by: a 11 --al. Report Received by: a Kimberley Driscoll Mayor City of Salem, Massachusetts Board of Health 120 Washington Street, 4th Floor, Salem, MA 01970 Tel. (978) 741-1800 Fax. (978) 745-0343 Iramdin@salem.com CERTIFICATE OF FITNESS CERTIFICATE #: GHL-15-316 DATE ISSUED: 10/212015 Property Located at: 51 RAYMOND ROAD UNIT #2 Owner/Agent: Tesia Vasiliou Address: 45 Dale Street CitylTown: Swampscott, MA Zip Code: 01907 lu x h Prevent. Promote. Protect. Larry Ramdin, MPH, REHS, CHO Health Agent 24 Hour Phone: (978) 319-7644 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 IAN KIMBERLEY DRISCOLL MAYOR LARRY RAhHAN, RS/RIiHS, {330, CP-tS HEREIN AGENT CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 41" FLOOR TEL. (978) 741-1800 Fax (978) 745-0343 L$AMDIN&AI HM COM 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 i bv,4ma4d Km J UNIT# ,/ TH1�SUN DISIGNA�TTEDfASRIG LEVrFRONTORBACK PLEASE �CIRCLE ONE OWNER/LESSER (_l � ,41 ��6 S � (11 � 1/ l / MANAGER/ AGENT J Q NO P.O. BOX CITY, STATE, ZIP uV G� In �V/�CfJ/ �/ CITY, STATE, ZIP / ' (� i/i a�/� RESIDENCE PHONE 18 0 `i" -t " BUSINESS PHONE (24HRS} (�!` Jj) BUSINESS PHONE S TOTAL NUMBER O))F,,ROOMS- ROOM USE: I . l` -L F'�!"'� ! 2.�A Vl ' 3. 4. THERE IS A FIFTY ($50) DOLLAR -FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS F IS PAY T THE E OF INSPECTION APPLICANT'S SIGNATURE DATE IMectors use only Date on initial inspection: 10102121115 Date of reinspection: Date of issuance of certificate: 10/0 JZ S Date fee paid: 2 t71n [zt�ZS— Type of unit: Dwelling__-,/ Other Chcck #_24 ,—Check date: 1-0/01- 00�05plknt.Insp or