SCENIC AVENUESCENIC AVENUE
1,
KIMBERLEY DRISCOLL
MAYOR
CITY OF SALEM, MASSACHUSETTS
BOARD OF HFA -\I: l r
120 WASHING1ON STREET, 4"' FLOOR
,TEL. (978) 741-1800 FAX (978) 745-0343
liamdinnsalem.com
CERTIFICATE OF FITNESS
CERTIFICATE # 399-12
DATE ISSUED: 10/3/2012
Property Located at: 2 Scenic Terrace UNIT #
Owner/Agent: Amy & Tedd Manley
Address: 8 Hilltop Road
City/Town: Danvers, MA Zip Code: 01923 24 Hour Phone:
lu
PublicHea Ith
Prevent. Promote. Protect.
LARRY UMIAN, RS/W;'I IS, (1110, (;P -I S
I IFAL II A(1 LNT
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 IPt
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
LARR AMDIN
HEALTH AGENT
ICIMBERLEY DRISCOLL
MAYOR
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4°1 FLOOR
TEL. (978) 741-1300 FAX (978) 745-0343
Itamdin@s,,ilem.com
PalllxeHealit 1
Prevent Promnif. Pratf[t.
LARRY RAD'IDIN, RS/REI IS, CHH, CP -FS
Huliu,- Tf AG ENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR ,410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION4
FEE: $50.00
PROPERTY LOCATED
IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT
PLEASE CIRCLE
OWNER/LESSER ER/ AGENT
NO P.O. BOX
ADDRESS � ',C -n ADDRESS
UNIT#
CITY, STATE, ZIP__ v ��/CJ�C CITY, STATE, ZII' x- \P\ .O� A
RESIDENCE PHONE '2k"y a2j_ (1�J J BUSINESS PHONE (24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE:
THERE IS A FIFTY ($50) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS FEE IS PAYABLE AT THE TIME OF INSPECTION
APPLICANT'S
Inspectors use only
Date on initial inspection: Date of reinspection:
Date of issuance of certificate: _ Date fee paid:
Type of unit:
Notes:
Inspector
KIMBERLEY DRISCOLL
MAYOR
CITY OF SALEM, MASSACHUSETTS
BOARDOFHEALTH
120 WASHINGTON STREFT, 4"' FLOOR
TEL. (978) 741-1800 FAX (978) 745-0343
Irandinna,salem.com
Release
IV
)P9PlHI1C �Blth
r' i. rr�mmc. rmac.
LARRY RANIDIN, RS/RN IS, CHO, U -F$
HI_.AI. I I AGF.N'r
In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ;
State Sanitary Code Chapter II and Article XIII of the City of Salem Ordinance, undersigned owner/lessor and
tenant/lessee of a unit of residential property, hereby authorize the Salem Board of Health or its authorized agents to
inspect the residence identified below in accordance with the aforementioned statutes, regulations and ordinances.
In the event it is necessary that said inspection be done in my/out absence. I/we expressly authorized the same and for
my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of Health and its
authorized. agents from any lose or injury sustained of whatever nature and description occasioned by my/out absence
during said inspection.
Tenant/Lessee
Address
Date
Owner/Lessor
Address
Address on unit to be inspected
KIMBERLEY DRISCOLL
MAYOR
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4"" FLOOR
TEL. (978) 741-1800 FAx (978)'745-0343
h-arndin@saleirn.com
salem.com
CERTIFICATE OF FITNESS POLICY
IaYIIDIiCIIeAIth
rrwem. rromnm. rmm�i.
LARRY RANIDIN, RS/R1;'FIS, CHO, CP -]',S
HI:AI:rH AGVNT
1. A Certificate of Fitness inspection is required for all rental units older than 5
years, per City of Salem ordinance;
2. A Certificate of Fitness is good for 1 year or the life of the tenant, whichever is
longer;
3. A Certificate of Fitness inspection may be obtained by calling or coming into the
Health Department and requesting an appointment;
4. Appointments must be requested at least 24 hours in advance pending an open
appointment;
5. No "same day" appointments will be granted;
6. All appointments are subject to the schedule of the inspector;
7. A rental unit will be considered occupied when either the previous tenant or the
current tenant has belongings in the unit. In the case of an occupied unit, either
the tenant whose belongings are in the unit must be present at the time of
inspection, OR have signed a release statement allowing the Board of Health to
inspect the unit.
8. Please allow at least one week turnaround time for the Certificate to be issued,
especially at the end of the month;
9. A Certificate of Fitness will be granted when:
a. An inspection has been conducted by a Health Department employee
b. An application has been filled out and a check or money order has been
received
10. If you have any questions, please contact the Health Department
co
2
STANLEY J. USOVICZ, JR.
MAYOR
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
November 7. 2003
Horizon East Realty TR
184 Paulson Road
Newton, MA 02158
PROPERTY LOCATED 14 Scenic Avenue
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
qdL�Joanne Scott MPH, RS, CHO
Health Agent
Reply to
Pablo Valdez
Code Enforcement Inspector