SOUTH MASON STREETSouth Mason Street
KIMBERLEY DRISCOLL
MAYOR
CTTY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4," FLOOR
I53L. (978) 741-1800 FAX (978) 745-0343
kamdin a,salem.com
CERTIFICATE OF FITNESS
CERTIFICATE # 166-12
DATE ISSUED: 4/26/2012
Property Located at: 7 South Mason Street UNIT # House
Owner/Agent: John Karedis
Address: P.O. Box 2018
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-375-4902
LARRY RANWIN, RS/RE0I-IS, 40, CP -FS
HEAL: f H �AG FNP
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
4XRgAM
IN
HEALTH AGENT
W2
SANITARIAN
KIMBERLEY DRISCOLL
MAYOR
LARRY R\MD1N, RS/REI1S, ('11o, CP -F5
HEALTIJ AGENT
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4"' FLOOR
TEL. (978) 74171800
FAX (978) 745-0343
LRAMDIN&ALEM 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 50U�C�1(iY1 �f UNIT#
&THUNIT DISIGNATTED AS RIGHT LEFT FRONT OR BACK PLEASECHICLEONE
OWNER/LESSER \ MANAGER/ AGENT
NO P.O. BOX ,,pper�ADDRESS M2� ennuFcc
CITY, STATE, ZIP --C �Aw / ��� CITY, STATE, ZII' O
RESIDENCE PHONE__U Vy�0��f�_BUSINESS PHONE (24HRS)_.T7 j L1 Ol b 2
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE:
3_ fs& } d &
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
A
Inspectors use only
Date on initial inspection: 4I x bj Date of reinspection:
Date of issuance of certificate: Date fee paid:
Type of unit: Dwelling Other Check # '1W2 Check date: /��Q- V
Notes:
,1.14
.•iT�,fz•!cement Inspector