WOODSIDE STREETWOODSIDE STREET
i
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970
JOANNE SCOTT, MPH, RS. CHO
HEALTH AGENT
Date: August 1, 1994
Edward J. JR./Elaine G. McNiff
58 Longbow Road
Danvers, MA 01923
PROPERTY LOCATED AT—4 Woodside Street UNIT
Dear Sir/Madam:
NINE NORTH STREET
Tel: (508) 741-1800
Fax: (508) 740-9705
It has come to our attention, that you are about to allow rental of a dwelling unit at the above address.
It is incumbent upon you as owner(s) to contact the City of Salem Health Department to apply for a Certificate of
Fitness before any vacant dwelling unit is rented or occupied.
Each dwelling unit must be inspected and certified by the Salem Health Department prior to allowing occupancy
in accordance with Chapter III, Sections 127A and 1278, of the Massachusetts General Laws, 105 CMR 400.000:
State Sanitary Code, Chapter I: General Administrative Procedures and 105 CMR 410.000: State Sanitary Code,
Chapter It: Minimum Standards of Fitness for Human Habitation, and in accordance with Chapter 11, Article XIII
of the City of Salem Code of Ordinances, Section 2-334, Certificate of Fitness.
There is a twenty-five (25) dollar fee payable by check, or money order to the City of Salem Health Department
This fee is payable at the time of inspection. Inspection will not be performed without receipt of
payment.
Failure to comply with this procedure, will result in a fine of twenty (20) dollars per day for every day that the
dwelling unit is occupied without approval of the Code Enforcement Division of the Salem Health Department.
Contact this department within 24 hours of receipt of this notice. (508) 741-1800 Monday thru Wednesday from
8:00 a.m. - 4:00 p.m., Thursday 8:00 a.m. - 7:00 p.m., or Friday 8:00 a.m. to noon to schedule an appointment
for an inspection.
SEE ENCLOSED SECTION 105 CMR 410.354 METERING OF GAS & ELECTRICITY
Very truly yours,
FOR THE BOARD OF HEALTH
.C -P MPH,RS,CHO
.HEALTH AGENT
11
REPLY TO:
PABLO VALDEZ
CODE ENFORCEMENT INSPECTOR
ROBERT E. BLENKHORN
HEALTH AGENT
508-741-1800
u
CITY OF SALEM HEALTH DEPARTMENT
BOARD OF HEALTH.
Salem, Massachusetts 01970
DATE: September 23, 1992
Elaine G. & Edward J. McNiff, Jr.
58 Longbow Road
Danvers, MA 01923
PROPERTY LOCATED AT 4 Woodside Street UNIT #
DEAR SIR/MADAM:
9 NORTH STREET
It has come to our attention, that you are about to allow rental of a dwelling unit
at the above address.
It is incumbent upon you as owner(s) to contact the City of Salem Health Department
to apply for a Certificate of Fitness before any vacant dwelling unit is rented or
occupied.
Each dwelling unit must be inspected and certified by the Salem Health Department
prior to allowing occupancy in accordance with Chapter 111, Sections 127A and 127B,
of. the Massachusetts General Laws, 105 CMR 400.000: State Sanitary Code, Chapter I:
General Administrative Procedures and 105 CMR 410.000: State Sanitary Code, Chap-
ter II: Minimum Standards of Fitness for Human Habitation, and in accordance with
Chapter II, Article XIII of the City of Salem Code of Ordinances, Section 2-334,
Certificate of Fitness.
There is a twenty-five (25) dollar fee payable by check, or money order to the City
of Salem Health Department upon issuance of Certificate.
Failure to comply with this procedure, will result in a fine of twenty (20) dollars
per day for every day that the dwelling unit is occupied without approval of the
Code Enforcement Division of the Salem Health Department.
Contact this department within 24 hours of receipt of -this notice. (508) 741-1800
Monday thru Wednesday from 8a.m. - 4p.m., Thursday 8a.m. - 7p.m., or Friday 8a.m. to
noon to schedule an appointment for an inspection.
SEE ENCLOSED SECTION 105 CMR 410.354 METERING OF GAS & ELECTRICITY
Very truly'yours,
FOR THE BOARD OF HEALTH
Robert E. Blenkhorn, C.H.O
Health Agent
REPLY TO:
PABLO VALDEZ'
Code Enforcement Inspector
ROBERT E. BLENKHORN
HEALTH AGENT
508-74 t- t B00
CITY OF SALEM HEALTH DEPARTMENT
BOARD OF HEALTH
Salem, Massachusetts 01970
DATE: September 18, 1991
Elaine G. & Edward J. McNiff, Jr.
56 Longbow Road
Danvers, MA 01923
PROPERTY LOCATED AT .4 Woodside..Street UNIT :O
DEAR SIR/MADAM:
9 NORTH STREET
It has come to our attention, that you are about to allow rental of a dwelling unit
at the above address.
It is incumbent upon you as owner(s) to contact the City of Salem Health Department
to apply for a Certificate of Fitness before any vacant dwelling unit is rented or
occupied.
Each dwelling unit must be inspected and certified by the Salem Health Department
prior to allowing occupancy in accordance with Chapter 111, Sections 127A and 127B,
of -the Massachusetts General Laws, 105 CMR 400.000: State Sanitary Code, Chapter I:
General Administrative Procedures and 105 CMR 410.000: State Sanitary Code, Chap-
ter II: Minimum Standards of Fitness for Hiiman Habitation, and in accordance with
Chapter II, Article XIII of the City of Salem Code of Ordinances, Section 2-334,
Certificate of Fitness.
There is a twenty-five (25) dollar fee payable by check, or money order to the City
of Salem Health Department upon issuance of Certificate.
Failure to comply with this procedure, will result in a fine of twenty (20) dollars
per day for every day that the dwelling unit is occupied without approval of the
Code Enforcement Division of the Salem Health Department.
Contact this department within 24 hours of receipt of'this notice. (508) 741-1800
Monday thru Wednesday from 8a.m. - 4p.m., Thursday 8a.m. - 7p.m., or Friday 8a.m. to
noon to schedule an appointment for an inspection.
SEE ENCLOSED SECTION 105 CMR 410.354 METERING OF GAS & ELECTRICITY
Very ttuly yours,
FOR THE BOARD OF HEALTH
to a
er M
Robert E. Blenkhorn, C.H.O.
Health Agent
REPLY TO:
PABLO VALDEZ,
Code Enforcement Inspector
µ
ROBERT E. BLENKHORN
HEALTH AGENT
508-74 t- t B00
CITY OF SALEM HEALTH DEPARTMENT
BOARD OF HEALTH
Salem, Massachusetts 01970
DATE: September 18, 1991
Elaine G. & Edward J. McNiff, Jr.
56 Longbow Road
Danvers, MA 01923
PROPERTY LOCATED AT .4 Woodside..Street UNIT :O
DEAR SIR/MADAM:
9 NORTH STREET
It has come to our attention, that you are about to allow rental of a dwelling unit
at the above address.
It is incumbent upon you as owner(s) to contact the City of Salem Health Department
to apply for a Certificate of Fitness before any vacant dwelling unit is rented or
occupied.
Each dwelling unit must be inspected and certified by the Salem Health Department
prior to allowing occupancy in accordance with Chapter 111, Sections 127A and 127B,
of -the Massachusetts General Laws, 105 CMR 400.000: State Sanitary Code, Chapter I:
General Administrative Procedures and 105 CMR 410.000: State Sanitary Code, Chap-
ter II: Minimum Standards of Fitness for Hiiman Habitation, and in accordance with
Chapter II, Article XIII of the City of Salem Code of Ordinances, Section 2-334,
Certificate of Fitness.
There is a twenty-five (25) dollar fee payable by check, or money order to the City
of Salem Health Department upon issuance of Certificate.
Failure to comply with this procedure, will result in a fine of twenty (20) dollars
per day for every day that the dwelling unit is occupied without approval of the
Code Enforcement Division of the Salem Health Department.
Contact this department within 24 hours of receipt of'this notice. (508) 741-1800
Monday thru Wednesday from 8a.m. - 4p.m., Thursday 8a.m. - 7p.m., or Friday 8a.m. to
noon to schedule an appointment for an inspection.
SEE ENCLOSED SECTION 105 CMR 410.354 METERING OF GAS & ELECTRICITY
Very ttuly yours,
FOR THE BOARD OF HEALTH
to a
er M
Robert E. Blenkhorn, C.H.O.
Health Agent
REPLY TO:
PABLO VALDEZ,
Code Enforcement Inspector
CITY OF SALEM HEALTH DEPARTMENT
BOARD OF HEALTH
Salem, Massachusetts 01970
ROBERT E.BLENKHORN
HEALTH AGENT
508-741-1800
DATE:A,,„,\ \,w
ti\c;S�
PROPERTY LOCATED AT �� a 1 �;�P c UNIT O Z
DEAR SIR/MADAM:
9 NORTH STREET
It has come to our attention, that you are about to allow rental of a dwelling unit
at the above address.
It is incumbent upon you as owner(s) to contact the City of Salem Health Department
to apply for a Certificate of Fitness before any vacant dwelling unit is rented or
occupied.
Each dwelling unit must be inspected and certified by the Salem Health Department
prior to allowing occupancy in accordance with Chapter III, Sections 127A and 127B,
of. the Massachusetts General Laws, 105 CMR 400.000: State Sanitary Code, Chapter I:
General Administrative Procedures and 105 CMR 410.000: State Sanitary Code, Chap-.
ter II: Minimum Standards of Fitness for Human Habitation, and in accordance with
Chapter II, Article XIII of the City of Salem Code of Ordinances, Section 2-334,
Certificate of Fitness.
There is a twenty-five (25) dollar fee payable by check, or money order to the City
of Salem Health Department upon issuance of Certificate.
Failure to comply with this procedure, will result in a fine of twenty (20) dollars
per day for every day that the dwelling unit is occupied without approval of the
Code Enforcement Division of the Salem Health Department.
Contact this department within 24 hours of receipt of•this notice. (508) 741-1800
Monday thru Wednesday from 8a.m. - 4p.m., Thursday 8a.m. - 7p.m., or Friday 8a.m. to
noon to schedule an appointment for an inspection.
SEE ENCLOSED SECTION 105 CMR 410.354 METERING OF GAS 6 ELECTRICITY
Very ttluly yours,
FOR THE BOARD OF HEALTH
koe.e<. r er
Robert E. Blenkhorn, C.H.O
Health Agent
REPLY TO:
e Z
Code Enforcement Inspector
CITY OF SALEM, MASSACHUSETTS
a ; BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1800
FAX 978-745-0343
WWW.SALEM.COM
Kimberley Driscoll ,JOANNE SCOTT, MPH, RS, CHO
Mayor HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE # 196-06
DATE ISSUED: 4/20/06
Property Located at: 8 Woodside Street UNIT # 1
Owner/Agent: Dulce Sepulveda
Address: 8 1/2 Woodside Street
City/Town: Salem, MA Zip Code: 01970 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 �' y
/ ✓ Zia
1
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
STANLEY USOVICZ, JR.
MAYOR
OF
130ARD OF HEALTH
120 WASHINGTON STREET.4TH FLOOR
SALEM, MA 01970
TEL. 978-741-1900
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".
J
PROPERTY LOCATED AT C(k
UNIT
IS�FHFS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNERALESSER MANAGER/AGENT
1�0 P.O. Box � k Ia �" P.O. Box — ----
ADDRESS \1WS\ C UIC \ O P.O. Box
CITY SQ \�-
0
RESIDENCE PHONE `1170 (-BUSINESS PHONE (24 HRS.)_
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: 5
ROOM USE: 1. 2._3--
5. 6. 7
/��oc
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
INSPECTORS_USE ONLY
DATE OF INITIAL INSPECTION
DATE 01= REINSPECTION
DATE OF ISSUANCE OF CER'T''-IFICATE 7 �' ° ° 4 DATL PLC PAID y F
� ay fd
TYPE OF UNIT` DWELLING Y O fHER CHECK ! /Q fLS' CFiFCK DATF
NOTFS /\
COU1 1 N1 01CI W N I IN`;I'1 C I c)I I
.�o CITY OF SALEM9 MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
gBp TEL. 978-741-1800
FAX 978-745-0343
STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
CERTIFICATE # 565-03
DATE ISSUED: 10/30/2003
Property Located at: 9 Woodside Street UNIT #: 1
Owner/Agent: Armando Brito
Address: 19 Vista Avenue
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-531-8774
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 11"
Minimum Standards of Fitness for Human Habitation'.
Therefore, this Certificate if 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 CRM 410.000.
Certificate valid for one year from date of issuance or until the current tenant vacates, whichever
is later.
This Certificate of Fitness if valid only if there is a valid Certificate of Occupancy
FOR THE BOARD OF HEALTH
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
< "/carr -
D NFO CEMEi INSPECTOR
r y
QMIrB
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
IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000
"MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION".
PROPERTY LOCATED AT 5 Ivo O & S i oc UNIT 4_1
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER hNA&AJVr)n M ATO MANAGER/AGENT
No P.O. Box No P.O. Box
ADDRESS I9 V i ST A A• VV ADDRESS
CITY SA LCA MUS CITY.
RESIDENCE PHONE 91 7455 733 BUSINESS PHONE (24 HRS.) 9 /-S-31-e 7
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: S
ROOM USE:
i
5. 6.7. 8.
THERE IS A TWEN -FIVE ($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY
ORDER TO THE CITY OF SALEM HEALTH DEPARTME T THIS FEE IS PAYABLE AT THE
TIME OF INSPECTION.
APPLICANTS SIGNATURE DATE 10-30-0
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION /W-.70-03 DATE OF REINSPECTION .L/.n
DATE OF ISSUANCE OF CERTIFICATE: a o a_7 DATE FEE PAID: ///S -_/0j'3
TYPE OF UNIT: DWELLING ✓OTHER_ CHECK #_/G S- 7 CHECK DATE /o a a�
NOTES:
a��
CODE EKFOACIEMENTINS ECTOR
9/28/98
♦ w
STANLEY USOVICZ, JR.
MAYOR
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH,
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
TEL. 978-74 I -1800
FAX 978-745-0343
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
RELEASE
In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts
Regulations 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.
Ln the evert it is necessary that said inspection be done in my/our absence, 1/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 a.,pants
from any loss or injury sustained of whatever nature and description occasioned
by my/our absence during said inspection.
A _
TENANT/LESSEE OWNER/LESSOR
IS UiSiA _1 U SAtUm MAss 8!996
ADDRESS ADDRESS
9 wood Sik SAZCM MAYAS
ADDRESS OF UNIT TO BE INSPECTED
D--3o-v
DALE
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT, MPH, RS, CHO NINE NORTH STREET
HEALTH AGENT Tel: (508) 741-1800
Date; 06/28/95 Fax: (508) 740-9705
Margarida & Armando Brito
19 Vista Avenue
Salem, MA 01970
PROPERTY LOCATED AT 9 Woodside Street UNIT # 2
Dear Sir/Madam:
It has come to our attention, that you may be considering renting a dwelling unit
at the above address.
It is incumbent upon you as owner(s) to contact the City of Salem Health Department
to apply for a CERTIFICATE OF FITNESS before any vacant dwelling unit is rented or
occupied, or to notify us of your intent for this unit.
Each dwelling unit must be inspected and certified by the Salem Health Department
prior to allowing occupancy in accordance with Chapter 111, Sections 127A and 127B, of
the Massachusetts General Laws, 105 CMR 400.00; 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, and in accordance with Chapter 11, Article
XIII of the City of Salem Code of Ordiances, Section 2-334, Certificate of Fitness.
There is a twenty-five (25) dollar fee payable by check, or money order to the City
of Salem Health Department. This fee is payable at the time of inspection. Inspection
will not be performed without receipt of payment.
Failure to comply with this procedure, will result in a fine of twenty (20) dollars
per day for every day that the dwelling unit is occupied without approval of the Code
Enforcement Division of the Salem Health Department.
Contact this department within 24 hours of receipt of this notice. (508) 741-1800
Monday thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7:00 p.m. or
Friday 8:00 a.m. to noon to schedule an appointment for an inspection.
SEE ENCLOSED SECTION 105 CMR 410.354 METERING OF GAS & ELECTRICITY
Very truly yours,
F THE BOARD OF HEALTH
Joanne Scott, MPH,RS,CHO
HEALTH AGENT
REPLY TO
PABLO VALDEZ
CODE ENFORCEMENT INSPECTOR
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-16.465
DATE ISSUED: 12/13/2016
Property Located at: 14 WOODSIDE STREET UNIT #1
Owner/Agent: Juan Martinez
Address: 6 Cedar Grove Avenue
City/Town: Peabody, Ma
Zip Code: 01960
0
Public8ealth
Prevent. Promote. Protect.
Larry Ramdin, MPH, REHS, CHO
Health Agent
24 Hour Phone:
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 then: 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.
e�-
Larry Ramdin, MPH, REHS, CHO
HEALTH AGENT
KIMBERLEY DRISCOLL
MAYOR
LARRY RAMDIN, RS/RFI-IS, CHO, CP -FS
HEALTH AGENT
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET, 4O. FLOOR
TFL. (978) 741-1800
FAX (978) 745-0343
LRAMDIN a@SALeM.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 (jI 52-1 UNIT# S4111S DLSIGNATED AS RIGHT LEFT' FRONT OR BACK. PLEASE CIRCLE ONE
NO P.O. BOX '
ADDRESS .G 1^ ��YtJ,/yC` f�V e' / ADDRESS
CITY, STATE, ZIP Y� 1// Q� % �l% CITY, STATE, ZIP
RESIDENCE PHONE �U�I - aaQ �W - � l <9 3 BUSINESS PHONE (24HRS)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. (1
THERE IS A FIFTY ($50) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM
BOARD OF HEALTH THIS FEE IUAYABLE AT THE TIME OF INSPECTION
APPLICANT'S
TE /i-/ 3-16
�'�/� 2 h 1 Inspectors use only
Date on initial inspectiion:D/ 201 Cj��7V�.1�` f Date of reinsp
Date of issuance of certificate: L `D / L � W Q Date fee paid:
Type of unit: Dwelling Other Check
Inspector
JOANNE SCOTT, MPH, RS, CHO
HEALTH AGENT
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 14 Woodside Street
OWNER/AGENT: Percy Bruce
ADDRESS: P.O. Box 19
CITY/TOWN: W. Newfield, ME ZIP CODE: 04095
CERT.# 172-97
FEE $25.00
DATE: 03/24/97
UNIT 4: 2
24 HOUR PHONE:
NINE NORTH STREET
Tel: (508) 741-1800
Fax: (508) 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 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 o 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
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 LUJC -lVf y�—UNIT #
OWNER./LESSER Pr rC Y R/' Ur C MANAGER/AGENT i) t P`�yi C�
ADDRESS L1/I9/1-4 Tlz`lc� ADDRESS /w: %llayt -/� IVP -c
CITY 19 , N v
.,RESIDENCE PHONE
BUSINESS PHONE
CITY
BUSINESS PHONE (24 HRS.) _
TOTAL NUMBER OF ROOMS:
ROOM USE: 1. 1��4 2. 4 fl�
5.
THERE IS A TWENTY—FIVE (25.00)
DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE
CITY OF SALEM: HEALTH DEPARTMENT
THIS FEE
SSS PAYABLE
AT THE TIRE OF INSPECTIIOON
APPLICANTS SIGNATURE L i;1.
(I
,1�
7
DATE_
v
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION: DATE OF REINSPECTION p
DATE OF ISSUANCE OF CERTIFICATF.:-,7k7=2 7 DATE FEE PAID:
TYPE OF UNIT: DWELLING OTHER
NOTES:
CODE ENFORCEMENT INSPECTOR
KIMBERLEY DRISC011
MAYOR
CITY OF SALEM, MASSACHUSETTS
BOARD OF FIEALTH
120 WASHINGTON STREET, 4... FLOOR
TEL. (978) 741-1800 FAx (978) 745-0343
Iramdin @salern.com
CERTIFICATE OF FITNESS
CERTIFICATE # 263-14
DATE ISSUED: 7/29/2014
Property Located at: 14 Woodside Street UNIT # S2
Owner/Agent: Juan Martinez
Address: 14 W000dside Street S1
City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 781-244-2188
L,ARRI' R MI)IN, RS/ ItFI IS, (:I IO, CP -RS
III:;\ I; I'I I A(71 {N I'
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
RAMDIN
HEALTH AGENT
1
a�
KIMBERLEY DRISCOLL
MAYOR
LARRY RAN DIN, RS/RF.FIS, C:HO, CP -FS
HF.A ;iTi AGENT
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASFUNGTON STREET, 4"' FLOOR
TEL. (978) 741-1800
FAX (978) 745-0343
tram lin c ta„rm�. aim
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 14 Woodside St UNIT# S2
IS THIS UNIT DISIGNATED AS RIGHT L,EIT FRONT OR BACK, PLEASE CIRCLE ONE
OWNER/LESSER Juan Martinez MANAGER/ AGENT Owner
NO P.O. BOX
ADDRESS 14 Woodside St ADDRESS Ant S1
CITY, STATE, ZIP Salem. MA 01970
RESIDENCE PHONE 978594-0263 BUSINESS PHONE (24HRS) 781244-2188
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: 8
ROOM USE: L 2 3. 4. 1
6. 7. 8. 2 10.
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 SIGURE DATE /^ a%— 1 /
Inspectors use only
Date on initial inspection:
Date of issuance of certificate: 7-
Type of unit: Dwelling v Other
Notes:
Code Enforcement Inspector
Date of reinspection:
Date fee paid:
Check # f 221�)sc� Check date: -71U-)\, !
KIMBERLEY DRISCOLL
MAYOR
LARRY R1\N[DIN, RS/RENS, CHO, CP -FS
HEALTH AGENT
CITY OF SALEM, MASSACHUSETTS
BOARr) OF 1-IEALTH
120 WASHINGTON STRL'F r, 4"" F1,00R
Release
T)�L. (978) 741-1800
FAX (978) 745-0343
lramJJ salem.cnm
In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 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 authorized agents to inspect
the residence identified below in accordance with the aforementioned statutes, regulations and ordinances.
In the event it is necessary that said inspection be done in my/out absence. I/we expressly authorized the same and
for my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of Health and its
authorized agents from any lose or injury sustained of whatever nature and description occasioned by my/out absence
during said inspection.
Tenant/Lessee Owner/Lessor
Address Address
Address on unit to be inspected
Date
Updated 5/23/11