WOODBURY COURTWo�abury Coor+ 1
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
health@salem.com
CERTIFICATE OF FITNESS
CERTIFICATE #: GHL-16-426
DATE ISSUED: 10/31/2016
Property Located at: 10-U1 WOODBURY COURT UNIT #1
Owner/Agent: Barry Lyons
Address: 124R Holworthy Street
Cityrrown: Cambridge, MA
Zip Code: 02138
Publicxealth
Prevent. Promote. Protect.
Larry Ramdin, MPH, REHS, CHO
Health Agent
24 Hour Phone: (617) 755-7348
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
EGagakis
SANITARIAN
KIMBERLEY DRISCOLL
MAYOR
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4M FLOOR
TEL. (978) 741-1800 FAX (978) 745-0343
Iramdin@salem.com
PublicHealth
Pment. %omorc. %elect. '
LARRY RAMDIN, RS/REHS, Cf 10, CP -FS
HEALTH AGENT
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
IS TI
NO P.O. BOX
ADDRESS
RIGHT LEFT FRONT OR BA PLEASE CIRCLE ONE
IN
AGENT ��A r, ))eVe p l( V�COX
CITY, STATE, ZIP (1�(? - 02131 CITY, STATE, ZIP
RESIDENCE PHONE BUSINESS PHONE (24HRS)5p�
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 TIES FEE IS PAYABLE AT THE TIME OF INSPECTION
APPLICANT'S SIGNA
Inspectors use only
Date on initial inspection: I (�,aO �I� Date of reinspection:
Date of issuance of certificate: Date fee paid: 1 Dl; S
Type of unit: Dwelling Other Check # I. tl Check date: 10 07a
Notes:
Code &Iordent Inspector