VARNEY STREETVARNEY STREET
CITY OF SALEM9 MASSACHUSETTS
BOARD OF HEALTH
a
� 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01 970
9B TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE #: 457-03
DATE ISSUED: 8/28/2003
Property Located at:: 5 Varney Street UNIT #: 2
Owner/Agent: Richard Sousa
Address: 5 Varney Street # 2
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-740-0527
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.
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.
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
Joanne Scott, MPH, RS, CHO
Health Agent
V
CODE ENFORCEMENT INSPECTOR
STANLEY LISOVICZ, 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
APPLICATION FOR CERTIFICATE OF FITNESS
\7v/1�.p
I
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION'.
PROPERTY LOCATED AT ef� UNIT #
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
No P.O. Box
P.O. Box .
nnoece
CITY 6 P�°i v CITY
RESIDENCE PHONE!2� GSZ�BUSINESS PHONE (24 HRS.)
BUSINESS
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. b1�' ,*T2. ✓' 3.r5-� 4._keY
5.7V6. 7
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
DATE OF INITIAL INSPECTION e'^ a8__ �3 DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:�7 0)3 DATE FEE PAID: S(ti 3
TYPE OF UNIT: DWELLINJOTHER_ CHECK # S 3 5 CHECK DATff3- �J �3
CODE ENFORCEMENT INSPECTOR
9/28/98
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
-, 29 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
KIMBERLEY DRISCOLL JSCOTT@SALEM.COM
MAYOR
JOANNE SCOTT
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE # 223-08
DATE ISSUED: 5/16/2008
Property Located at: 11 Varney Street UNIT # 1
Owner/Agent: Chris Cantone
Address: 11 Witchcraft Road
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 617-480-8004
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
VOAINE
FORTHE BOARD OFHEALTH
OTTSC,`MPHPH, RS, CHO
HEALTH AGENT
V 11
• CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4"' FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX (978) 745-0343
MAYOR ISCOTI&ALF.M. COM
JOANNE SCOTT,
HEALTH AGENT
Application for Certificate of Fitness
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMA HABBITATION."
PROPERTY LACATED AT /L 1 ARN0 3- - - ShAe-t j M A [q i '77p UNIT# /
IS THIS UNIT DISIGNYrED AS RIGHT LEFT FRO OR BACKPLEASE CIRCLE ONE
OWNER/LESSER (22jR i S Ml' O le_ MANAGER/ AGENT
NO P.O. BOX 1� pp
ADDRESS // W i ichCA is RD g ADDRESS
CITY,STATE,ZII' ` �� M ('1 0 1 "70 CITY,STATE,ZIP
9:7P-7'1
RESIDENCE PHONE L :7 P-7 Y I^ ALIS 6 BUSINESS PHONE (24HRS) G l 7-V PO-Pac%
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. ago 2. i -Z 3. 1-k-0 4. I-NiAIC 5. 14', IrLAI
G 7 o n v in
THERE IS A TWENTY-FIVE($25) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF
SALEM BOARD OF HEALTH THIS IS AYABJE ATS TIME OF INSPECTION
APPLICANTS
Inspectors use only
Date on initial inspection: S - V a Date of reinspection:
Date of issuance of certificate: S -16 - OT Date fee paid:
Type of unit: Dwelling Other Check # 18`11, Check date: S 1 b a C
Notes: Rzgn, ,1 V�j4 , N )y %-,ZL 1,
Enforcement
. a
coN�w CITY OF SALEM, MASSACHUSETTS
>Sva BOARD OF HEALTH
- $ 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
96grnNg TEL. 978-741-1800
FAX 978-745-0343
KIMBERLEY DRISCOLL JSCOTT@SALEM.COM
MAYOR
JOANNE SCOTT
HEALTH AGENT
Facsimile
Transmittal
To: :�)5 f
Fax #
RE: 1 i ]l
Date : �/��o�
Page(s): including this cover # O�
Board of Health News----------------------------------------------------------------For Your Information
OFFICE HOURS:
Monday, Tuesday, Wednesday 8:00 AM to 4:00 PM
Thursday 8:00 AM to 7:00 PM
Friday 8:00 AM to 12:00 NOON
HP fax Series 900
Plain'Paper Fax/Copier
DW T= I= Identification
May 20 11:41am Sent 919787449614
Result
OK - black and white fax
Fax History Report for
Joanne Scott Salem BOH
978 745 0343
May 20 2008 11:42am
0:36 2 OK