WEST AVENUEWEST AVENUE
e
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970 -
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 5 West Avenue
OWNER/AGENT: CPT Realty Trust
ADDRESS: 50 Washington Street
CITY/TOWN: Haverhill, MA ZIP CODE: 01831
CERT.# 118-02
FEE $25.00_
DATE: 03/05/2002
120 Washington Street — 4'h Floor
Tel # (978)-741-1800
Fax # (978)-745-0343
UNIT #: 1
24 HOUR PHONE: 373-3024
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 MAYNOWBE 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 OF HEALTH
'JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT
CODE ENFORCEMENT INSPECTOR
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
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT 5 (.�//✓� UNIT #�
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
0 d_
OWNER/LESSER ��r//ZMANAGER/AGENT
LB�C�'��•Z%r✓C'� r
No P.O. Box No P.O. Box
ADDRESS i) ft ADDRESS
CITY ti /dl CITY /1 9
RESIDENCE PHONE GAG BUSINESS PHONE (24 HRS.) aZx
BUSINESS PHONE L
TOTAL NUMBER OF ROOMS � 2L
ROOM USE: 1. 2.
5. 6. 7. 8.
THERE IS A TWENTY-FIVE ($25. )DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SAL HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
>
APPLICANTS SIGNATURE, '� ✓ _DATE 3 (d -l6 Z
DATE OF INITIAL INSPECTION 3 - 5_ - 6 L DATE OF RE!NSPECT!ON
DATE OF ISSUANCE OF CERTIFICATE: � — '; -e"- DATE FEE PAID: � -5 — O L
TYPE OF UNIT: DWELLINOTHER_ CHECK # CHECK DATEv t'
CODE ENFORCEMENT INSPECTOR
9/28/98
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
CERT.# 484-97
FEE $25.00
DATE: 07/24/97
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 7 West Avenue
OWNER/AGENT: CPT Partners
ADDRESS: 80 Washinaton Street
CITY/TOWN: Haverhill, MA ZIP CODE: 01831
NINE NORTH STREET
Tel: (508) 741-1800
Fax: (508) 740-9705
UNIT #: 7-1
24 HOUR PHONE: 370-0894
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
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
#v1i_q_1
JOANNE SCOTT, MPH, RS, CHO NINE NORTH STREET
HEALTH AGENT Tel: (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 � ��� J'�V �� UNIT /
OWNER/LESSER_L.2\ V-'C.c`7?-I�tLf\J MANAGER/AGENT ��`
ADDRESS L
CITYjJT \ ��
'RESIDENCE PHONEORcl�
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: �1
ROOM USE: I. 2. 3.
5. 5. 7.
ADDRESS
CITY
BUSINESS PHONE (24 HRS.) _
4.
Q
THERE IS A TWENTY—FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE
CITY OF SALEM HEALTH DEPARTMENT THIS FEE I ABLE AT THE TIME OF INSPECTION
APPLICANTS SIGNATURE DATE_ �S
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION:_7�'�AZ DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTLFICATE:2__7�_l;� _j% DATE FEE PAID: 7. 9e
TYPE
e
TYPE OF UNIT: DWELLING OTHER
NOTES:
CODE ENFORCEMENT INSPECTOR
H
X
o �
s
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
W W W.SALEM.COM
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE # 218-06
DATE ISSUED: 4/22/06
Property Located at: 7 West Avenue UNIT # 2
Owner/Agent: CPT Realty Trust/ James Collett
Address: P.O. Box 2098
City/Town: Haverhill, MA Zip Code: 01831 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 THE BOARD OF HEALTH
JOANNE SCOTT MPH RS CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
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
Kimberley Driscoll HEALTH AGENT
Mayor
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT 7 4)cc l�t4if 7 LPl` UNIT # Z
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER L��Z rQ /- _ /1LJT MANAGER/AGENT 6�7Pvrr
No P.O. Box n _ No P.O. Box i
CITY fG�iG`� CITY
r
C,
/_2
azo-(��
RESIDENCE PHONE BUSINESS PHONE (24 HRS.)IFZP Z?K7Z�
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. ' ' 2.Z-JOL- 3._06M 4. J
50- W07- 7. ee-3 06e -
THERE
. 6e
THERE IS A TWENTY-FIVE ($25.00) D LAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALE EAL DEPA THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION. ---) /6---�
APPLICANTS SIGNATURE
,y Z -0 & DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE4(- 27,,&C DATE FEE PAID: '- a �-
TYPE OF UNIT: DWELLING %OTHER_ CHECK # �c 6 Y CHECK DATE
CODE ENFORCEMENT INSPECTOR
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
s 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
W W W.SALEM.COM
Kimberley Driscoll JOANNE SCOTT, MPH, RS, CHO
Mayor HEALTH AGENT
4/4/06
CPT Realty Trust/ James Collett
P.O. Box 2098
Haverhill, MA 01831
PROPERTY LOCATED AT 7 West Avenue Unit 2
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.
Fo he Board of Health
J anne Scott MPH, RS, CHO
Health Agent
Reply to
Pablo Valdez
Code Enforcement Inspector
CITY OF SALEM, MASSACHUSETTS
a BOARD OFHEALTH
S
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
STANLEY J. USOVICZ, JR. FAx 978-745-0343
MAYOR W WW.SALEM.COM
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE # 582-05
DATE ISSUED: 9/20/05
Property Located at: 15 West Avenue UNIT # 2
Owner/Agent: Kathleen Papalegis
Address: 15 West Avenue
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-741-4231
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
FORE BOARDOF HE
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
CODE ENFORCEMENT INSPECTOR
STANLEY 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
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
L9. PROPERTY LOCATED AT(110S ( ACX_ UNIT #
5
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE 2 A�
No P.O. Box " " No P.O. Box
ADDRESS _ ADDRESS
CITY �% t/-,, A- 0 (976 CITY
RESIDENCE PHONE`((�"W-Y)A BUSINESS PHONE (24 HRS.) Cil 978-��( �a3�
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1.1�2.UVI�_^"3. U/_ 0X–A Ur0'"–
i
THERE IS A TWENTY-FIVE ($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM H ALTH DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATURE -w(/ _DATE
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION 8) lekw; DATE OF REINSPECTION_
DATE OF ISSUANCE OF CERTIFICATE: S 180 DATE FEE PAID: 8 8 of
TYPE OF UNIT: DWELLING OTHER_ CHECK # 2.252.—C HECK DATE glj
NOTES: i�,%PY-t\j1��-Rs.�L� _—'f�'M�SS IAJ�j1D�_mYj_(yG� SL1.�"e�,�1S
N $rA
CODE ENFORC WENT INSPECTOR 9/28/98
s s
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
May 7, 2003
Mary Garvey
17 West Avenue
Salem, MA 01970
PROPERTY LOCATED AT 17 West Avenue Unit # 1
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.
or the Board of He th
Joanne Scott MPH, RS, CHO
Health Agent
Reply to
Pablo Valdez
Code Enforcement Inspector
CERTIFICATE OF FITNESS
CERTIFICATE # 166-04
DATE ISSUED: 04/26/2004
Property Located at: 17 West Avenue UNIT # 2
Owner/Agent: Shane Osterberg
Address: 17 West Avenue
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-744-2461
An inspection of yourvacant Dwelling/Rooming Unit at the above address has been approved and is in
compliance with 105 CMR410.000: Massachusetts State Sanitary Code, Chapter If' 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 OF HEALTH
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CITY OF SALEM, MASSACHUSETTS
b
BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR.
JOANNE SCOTT, MPH, RS, CHO
MAYOR
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE # 166-04
DATE ISSUED: 04/26/2004
Property Located at: 17 West Avenue UNIT # 2
Owner/Agent: Shane Osterberg
Address: 17 West Avenue
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-744-2461
An inspection of yourvacant Dwelling/Rooming Unit at the above address has been approved and is in
compliance with 105 CMR410.000: Massachusetts State Sanitary Code, Chapter If' 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 OF HEALTH
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
CITY OF SALEM, MASSACHUSETTS >'
BOARD OF HEALTH l 0
120 WASHINGTON STREET, 4TH FLOOR //,PSALEM. MA 01970 l
TEL. 976-741-1800
FAX 978-745-0343
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT 11 W P&)IF� UNIT # '
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER 5V)4 PYN MANAGER/AGENT
No P.O. Box No P.O. Box
ADDRESS Proz_- ADDRESS
CITY S(Hl�("r\CITY
RESIDENCE PHONE 4-N- 7q 4 ZQU k BUSINESS PHONE (24
BUSINESS PHONE T(R 2S7
TOTAL NUMBER OF ROOMS:
ROOM USE: 1,10 2.'Jt-OWaf�3. \41%` 4. ibektclm
5. z.ak 6. Bim "^I
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
INSPECTORS USE ONLY
RALE OF INITIAL INSPECTION li�'.)'L, O `F DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:��tlo --0-DATE FEE PAID: Y-- % b a
TYPE OF UNIT: DWELLING/�OTHER_ CHECK #. `, N CHECK DATE 4')'b z
CODE ENFORCEMENT INSPECTOR
9/28/98
CITY OF SALEM, MASSACHUSETTS
• BOARD OF HEALTH
120 WASHINGTON STREET, 4"' FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX (978) 745-0343
MAYOR DGRrrNBAUM@SAI.r;M.COM
DAVID GREENBAUM
ACTING HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE # 582-09
DATE ISSUED: 11/23/2009
Property Located at: 19 West Avenue UNIT # 2
Owner/Agent: John Antonopoulus
Address: P.O. Box 152
City/Town: Salem, NH Zip Code: 03079 24 Hour Phone: 508-843-5538
An inspection of your vacant Dwelling/Rooming Unit at the above address has been approved
and is incompliance 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 ff there is a valid Certificate of Occupancy.
FOR TH�EBOOA OF HEALTH
DAVID GREENBAUM
ACTING HEALTH AGENT CODE ENFORCEMENT INSPECTOR
KLMBERLEY DRISCOLL
MAYOR
DAVID GREENBAUM,
ACTING HEALTH AGENT
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4°1 FLOOR
TEL. (978) 741-1800
FAX (978) 745-0343
DGItEHNI3AUM@SAL1iM. 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 --Z
IS THIS
NO O. BOX -
AS RIGHT LEFT FRONT OR BACK, PLEASE CIRCLE ONE
AGENT
CITY, STATE, ZIP bra% CITY, STATE, ZII' /V •�Ob -2 9
19
RESIDENCE PHONE&4-:3---9/r - - 6'/ i- BUSINESS PHONE (24HRS) Sbt--,Pe/3 SS•3,A'
BUSINESS PHONE�O< -,?6 > Cl 3�
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 P Y E AT THE TIMF INSPECTION
APPLICANT'S SIGNATURE IA;;;e DATE
Date on initial inspection: 11la 3 /Q { Date of reinspection:
Date of issuance of certificate: Wd 3/0 i Date fee paid:
Type of unit: Dwelling e/Other Check # Check date: i a
- qs.�- 9/,�O , MJ113
(-661M -
' sQ/K SWv ollIn to 5< I—)albd
r4 zlees,
Code Enf cei ent Inspector
.MGo" W4.
,-or h u'S N)
-jt/',
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4'" FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX (978) 745-0343
MAYOR - DGRFENBAUM&ALEM.COM
DAVID GREENBAUM
ACTING HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE # 582-09
DATEISSUED:' 11/23/09
Property Located at: 19 West Ave Unit 2
Owner/Agent:: John Antonopoulos
Address: p0 Box 152
City/Town:: Salem NH ;;Q 3079 P4 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 THE BOARD OF HEALTH
i
D 1 R EBA
ACTING HEALTH HEALTH AGENT CODE E ORCEMENT INSPECTOR
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
05/03/2001
Jon & Adelaine Cahill
17 Stafford Road
Danvers, MA 01923
PROPERTY LOCATED AT 20 West Avenue UNIT # 1
Dear Sir/Madam:
NINE NORTH STREET
Tel: (978) 741-1800
Fac: (978) 740-9705
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 I: General Administrative
Procedures and 105 CMR 410.000; State Sanitary Code, Chapter II: 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) 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.
OR THE BOARH
JoanScot,�MPHRSC
O
Health Agent
REPLY TO
PABLO VALDEZ
CODE ENFORCEMENT INSPECTOR
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
05/07/2001
Jon & Adelaine Cahill
17 Stafford Road
Danvers, MA 01923
PROPERTY LOCATED AT 20 West Avenue UNIT # 2
Dear Sir/Madam:
NINE NORTH STREET
Tel: (978) 741-1800
Fax: (978) 740-9705
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 I: General Administrative
Procedures and 105 CMR 410.000; State Sanitary Code, Chapter II: 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 6:00
a.m. - 4:00 p.m.
Failure to comply with this procedure, may result in a fine of Twenty (20) 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.
,40PR THE BOARD HEA TH
oanne Scott, MPH,RS,CHO
Health Agent
REPLY TO
PABLO VALDEZ
CODE ENFORCEMENT INSPECTOR
• ! CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4"' FLOOR
TEL. (978) 741-1800 FAx (978) 745-0343
KIMBERLEY DRISCOLL Iramdin@salem.com
MAYOR
CERTIFICATE OF FITNESS
CERTIFICATE # 332-13
DATE ISSUED: 9/17/2013
Property Located at: 20 West Avenue UNIT # 3
Owner/Agent: Chad & Lyndey Rudicel C/O Zoe Karademos
Address: 71/2 Church Street
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 781-405-7122
PublicHealth
PrevvOl. Promote. Prolttt,
LARRY RANIDIN, RS/RFHS, C:HO, CP -FS
HF:AI. PTI AGENT
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
LA40 RAMDIN
HEALTH AGENT
�. _/.✓aair p
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4m FLOOR
TEL. (978) 741-1800
FAX (978) 745-0343
LRAMDIN SALHMCOM
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 o QG1 dV(Z —UNIT#=
IS THIS UNIT DLSIGNATED AS
IUG�HT LEFT FRONT OR BRCS PLEASSE CERCLE ONE
OWNER/LESSER Cum ��YO+71 ��-'�`*� MANAGER/AGENT L(��
NOP.O.BOX t/s`j, A/ Cf'- oioOE
ADDRESS L, O GAN s' Po 2--, t/Cg47 AnnuFcc -7/A ( l l lrrLn C-4--
CITY, STATE, ZIP C1TY, STATE, ZIP Sd L a rf \ tT ac , O
RESIDENCE PHONE .�7 Y- 35V - 9-.i 7/ BUSINESS PHONE (24HRS) S ( `7
BUSINESS PHONE 57V -35S - Galc[Kv Bewn �
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2. 3. 4 5.
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 TBE OF INSPECTION/
APPLICANT'S
Inspectors use only
Date on initial inspection: 3 Date of reinspection:
Date of issuance of certificate: Date fee paid:
Type of unit: Dwelling. Other -Check#� ( Ip �� Check dater �5 I
S///3
CITY OF SALEM, MASSACHUSETTS
a BOARD OF HEALTH
s 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
STANLEY J. USOVICZ, JR. FAx 978-745-0343
MAYOR W W W.SALEM.COM
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE # 583-05
DATE ISSUED: 9/20/05
Property Located at: 24 West Avenue UNIT # 2 Back
Owner/Agent: Fawn Lumbert
Address: 15 Lochstead Avenue
City/Town: East Falmouth, MA Zip Code: 02536 24 Hour Phone: 774-769-9297
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 THERE BOARD OF
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
CODE ENFORCEMENT INSPECTOR
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
HEAT-TH AGENT
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED ATS_
UNIT HoZ
IS THIS UNIT DESIG(�NATE5 AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER h- Ltd j�h qq
No P.O. Box ' ,l -L—MANAGER AGENT
A.DDRESS� l..ww /� seta (}i q No P.O. Box
-- / U� AnnRGcc
--CI FY ---
RESIDENCE PHONE SU o 8 �0-3106 —BUSINESS PHONE (24 HRS.)y_% qj
BUSIiJESS PHONE-'SoI' #-n- 07
TOTAL NUMBER OF ROOMS
ROOM USE1f 3J-1)._._ 4 UV(ii<t�[%1i
THERE IS A TWENTY-FIVE (525.00) 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
NSPECT ORS U E ONLY
DATE OF_INITI_AL INSPECTIOIV q— (— Ti
DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE
TYPE OF UNIT DWELLING OTHI=R
NOTES
c61`v 'o` 41fJT .>r FcroR
DATE FEE PAIt7 a5--
(--HFCK::1-� CHECK DATE
INC"���
SEP:A+91005
CITY OF SALEM
BOARD OF HEALTH
a
STANLEY 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, R5, CHO
HEALTH AGENT
03/11/2002
Robert, Valerie Hiltanen & Maria Vincent
28 West Avenue
Salem, MA 01970
PROPERTY LOCATED AT 28 West Avenue 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 the State Sanitary Code, Chapter II: Minimum Standards of Fitness
for Human Habitation.
Please notify us if you do not intend to rent the unit.
Please contact this department within One Week 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. -
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 ,,,.iliacs has billed property _c_
tenants' entire utility bills retroactive to the date of initial occupancy in cases in
which cross -metering has been proven eo exist.
O`� ::� �O HEALTH
S
Joanne Scott, MPH,RS,CHO
HEALTH AGENT
REPLY TO
PABLO VALDEZ
CODE ENFORCEMENT INSPECTOR
Kimberley Driscoll
Mayor
Property Located at:
Owner/Agent:
Address:
City of Salem, Massachusetts
Board of Health
120 Washington Street, 4th Floor, Salem,
MA 01970
Tel. (978) 741-1800 Fax. (978) 745-0343
health@salem.com
CERTIFICATE OF FITNESS
CERTIFICATE #: GHL-16-297
DATE ISSUED: 8/12/2016
30 WEST AVENUE UNIT #
Brooke Morrisey
244 High Street
City/Town: Topsfield, MA
Zip Code: 01983
D
PublicHealth
Prevent. vrwnote. Prcron.
Larry Ramdin, MPH, RENS, CHO
Health Agent
24 Hour Phone: (978) 471-9066
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.
Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age.
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT
1Ajef f 5rXaroksy�
SANITARIAN
F
KIMBSRI.EY DRISCOLI:
MAYOR
LARRY RAMDIN, RS/RENS, CHO, CP -FS
HEALTI-t AGENT
CM70F OF SALEM, MASSACI-IUSETTS
BOARD OF HEALTH
120 WASHING'T'ON STREET, 4" FLOOR
TEL. (978) 741-1800
FAX (978) 745-0343
LRANf )1N0$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�� �V `1 �1� S w — `— UNIT# �-
IS THIS 'UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK, PLEASE CIRCLE ONE
OWNFR/f.FCCF�,�f ' o, �'+r���st MAMAI-Fu) Ar.Fnrr
NO P.O.ADDRESS
SS �5�� ��
ADDRESS rL"A1l � � O S •-W\ ADDRESS
CITY, STATE, ZIP���� �����CITY, STATE, ZIP
RESIDENCE PHONE BUSINESS PHONE (24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE:
THERE IS A FIFTY ($50) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALT F$E I YABLE AT THE TIME OF INSPECTION
APPLICANT'S
II -2m (,/
Inspectors use only
Date on initial inspection:a4lI,= Date of reinspection:
9�p g
Date fee paid: awl/20111
Check date:
ti
r a CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
3 120 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: 30 West Avenue
OWNER/AGENT: Brooke Morrissey
ADDRESS: 244 High Street
CITY/TOWN: Toosfield, MA ZIP CODE: 01983
CERT.# 603-02
FEE $25.00
DATE: 11/22/2002
UNIT #: 1 Front
24 HOUR PHONE: 617-743-2515
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 OF HEALTH
v
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT
CODE ENFORCEMENT INSPECTOR
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000
"MINIMUM STANDARDS OF%FITNESS
FOR
j HUMAN HABITATION
PROPERTY LOCATED AT "" �ry Ve-- UNIT #
IS THIS UNIT DESIGNATED AS RIGHT LEFT RONT ACK PLEASE CIRCLE ONE
OWNER/LESSER It )(Q6(q mdmJA MANAGER/AGENT 56W -e -
No P.O. BoxI I I I No P.O. Box
ADDRESS 7cfq klq ADDRES�Sq
CITY Id (JS�Ia. CITY IVIN 7
RESIDENCE PHONX9ff7' (0 Z BUSINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2. 3.4._
THERE IS A TWENTY-FIVE ($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM HEAL H DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATURE 5 DATE/( 0 Z
INSPECTORS IISE ONLY
DATE OF INITIAL INSPECTION �/�� 2 —0 Z DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: - DATE FEE PAID:
TYPE OF UNIT: DWELLING _OTHE� CHECK # $ % CHECK
CODE ENFORCEMENT INSPECTOR
9/28/98
CITY OF SALEM, MASSACHUSETTS
o
BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
✓ G�
a
SALEM, MA 01970
-
TEL. 978-741-1800
FAX 978-745-0343JOANNE
✓
STANLEY USOVICZ, JR.
SCOTT, MPH, RS, CHO -
l/f////_
MAYOR
HEALTH AGENT
APPLICATION FOR CERTIFICATE OF FITNESS
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000
"MINIMUM STANDARDS OF%FITNESS
FOR
j HUMAN HABITATION
PROPERTY LOCATED AT "" �ry Ve-- UNIT #
IS THIS UNIT DESIGNATED AS RIGHT LEFT RONT ACK PLEASE CIRCLE ONE
OWNER/LESSER It )(Q6(q mdmJA MANAGER/AGENT 56W -e -
No P.O. BoxI I I I No P.O. Box
ADDRESS 7cfq klq ADDRES�Sq
CITY Id (JS�Ia. CITY IVIN 7
RESIDENCE PHONX9ff7' (0 Z BUSINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 2. 3.4._
THERE IS A TWENTY-FIVE ($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM HEAL H DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATURE 5 DATE/( 0 Z
INSPECTORS IISE ONLY
DATE OF INITIAL INSPECTION �/�� 2 —0 Z DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE: - DATE FEE PAID:
TYPE OF UNIT: DWELLING _OTHE� CHECK # $ % CHECK
CODE ENFORCEMENT INSPECTOR
9/28/98
,
o �
n
STANLEY 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
RFf. F.A SF.
In accordance with Massachusetts General Laws Chapter III; Code of Massachusetts
Riegulations 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 author-
ized agents to inspect the residence identified below in accordance with the
aforementioned statutes, regulations and ordinances.
In the event it is necessary Lhat said inspection be done in my/our absence, !/we
expressly authorize the same and for my/our successors and assigns hereby release
and discharge the City of Salem, Salem Board of Health and its authorized apes --s
from any loss or injury sustained of whatever nature and description occasioned
by my/ ur. absence'duringsaid inspecti.or..
x�t.�/""„ 'IW�CG 1j�lfs�02
ft, NANIf'/-LE SSEE OH ER/i FSSOR
len, Xp�&/� kv
ADDRESS ---- --- ADDRESS --
_est r�c zc k�r
ADDRESS OF UNIT TO BE fNSPECTED
DATE
,J
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
CERT.# 692-00
FEE $25.00
DATE: 10/31/2000
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 32 West Avenue
OWNER/AGENT: Chuck Watts
ADDRESS: 32C West Avenue
CITY/TOWN: Salem, MA ZIP CODE: 01970
UNIT #: 32
24 HOUR PHONE: 744-0123
NINE NORTH STREET
Tel: (978) 741-1800
Fax: (978) 740-9705
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 OF HEALTH
OANNE SCOTT, MPH,RS,CH0
HEALTH AGENT
Qzaj:��
CODE ENFORCEMENT INSPECTOR
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS, CHO NINE NORTH STREET
HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tel: (978) 741-1800
Fax: (978) 740-9705
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT -3' �L �- A JiI UNIT # 02-
IS
2
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
/J
OWNER/LESSER //6el- Z� /nMANAGER/AGENT
No P.O. Box/ No P.O. Box
ADDRESS c3,9—G �i%s 7L ADDRESS
CITY J�fN/1�(/l CITY
RESIDENCE PHONE �NZID/ g-3 BUSINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:i
ROOM USE: 1. K 2. 3. 4. 3
THERE IS A TWENTY-FIVE ($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM HEALTY, DEPARTMENT THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATUREDATE /O '3
INSP TORS USE ONLY
DATE OF INITIAL INSPECTION f0 -?,(-0 d DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:,2Q-31-11 z DATE FEE PAID: – Z ( – � a
TYPE OF UNIT: DWELLING OTHER— CHECK # O'a % CHECK DATE lo ( –c3
NOTES: zvalto A, dzz 57ov riv/ ch ,4• gna 14
CODE ENFORCEMENT INSPECTOR
9/28/98