STATION ROADSTANLEY J. LISOVICZ, JR.
MAYOR
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01 970
TEL. 978-741-1800
FAX 978-745-0343 -
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
12/23/04
Edward S Vaillencourt
5 Station Road
Salem, MA 01970
PROPERTY LOCATED AT 5 Station Road 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 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. to 7:00 p.m. and Friday 8:00 a.m. — 12:00 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 tenant's entire utility bills retroactive to the date of initial occupancy in cases in
which cross -metering has been proven to exist.
�or the Board of Health
+'Joanne Scott MPH, RS, CHO
Health Agent
Reply to
Pablo Valdez
Code Enforcement Inspector
w
CITY OF SALEM, MASSACHUSETTS
y, co
BOARD OF HEALTH
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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
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 15 1/2 Station Road
OWNER/AGENT: Conrad Correnti
ADDRESS: 15 Station Road
CITY/TOWN: Salem, MA ZIP CODE: 01970
CERT.# 554-02
FEE $25.00
DATE: 10/29/2002
UNIT #: 2nd floor
24 HOUR PHONE: 744-2343
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.
FOR THE BOARD fOF HEALTH
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT
CODE ENFORCEMENT INSPECTOR
CITY OF SALEM,'MASSAC,HUS.ETTS.
ova. BOARD OF HEALTH O 2
3 � 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY USOVICZ, JR.t
JOANNE SCOTT, MPH, RS, CHO
"'- MAYOR HEALTH AGENT
6
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE; CHAPTER II; 105 CMR 410.000` #
"MINIMUM STANDARDS OF FITNESS FOR HUMAN
"HABITATN
IO'. c/
PROPERTY LOCATED AT 2 67e)T10 / %P4'1 UNIT #
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
"z --R 'g-,- `OWNER/LESSfR .�y/�9D 6Sizrzevr/ MANAGER/AGENT
s s a _a No x ' - P.O Box / No P.O. Box
ADDRESS %� Sr�T/Dig% /z�/ ADDRESS
CITY/911041 CITY /yl ,4-
RESIDENCE PHONE BUSINESS PHIANF_(24ARS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS\S
51ROGM'USE i 1lt �7 _t;2 ,�j 3. 4= h u' h • t >„ 1 ri ; a
�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:
ADDIalA AITCCI!`#.IATI IDC nerc- /o �.y�o ��
M1
INSPECTORS USE ONLY
DATE-"OFINITIA'INSPECTION 'U� DATE.OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: T/ -a-l-DATE FEE PAID: / 0
TYPE OF UNIT: DWELLING —OTHER— CHECK #— 3 kCHECK DATE Z0.11 oz
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