ADAMS STREET b
m CERT.# 60-02
FEE $25.00
DATE: 02/06/2002
AMINE
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-
JOANNE SCOTT, MPH,RS,CHO 120 Washington Street— 4`" Floor
HEALTH AGENT Tel # (978)-741-1800
Fax# (978)-745-0343
CERTIFICATE OF FITNESS
i
PROPERTY LOCATED AT: 5 Adams Street UNIT #: 1
OWNER/AGENT: Douglas Sanville
ADDRESS: 5 Adams Street
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-2854
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
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
r
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
a
120 WASHINGTON STREET, 4TH FLOOR60-
SALEM, MA 01970 I _ �/
TEL. 978-741-1800 I�
FAX 978-745-0343
STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
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 HUMAN HABITATION".
PROPERTY LOCATED AT �5 UNIT#
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER_�).. a� „. .��� MANAGER/AGENT �
No P.O. Box —S No P.O. Box
ADDRESS SA�1�+„ S� ADDRESS
CITY S I 1 CITY
RESIDENCE PHONE '1719- _7y5 ads'' BUSINESS PHONE (24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: y
ROOM USE: 1._K 2. L6 3. e ?I 4. 6k
5. 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.
APPLICANTS SIGNATURE DATEQz16Xqj
INSPECT RS USE ONLY
DATE OF INITIAL INSPECTION DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:Z -v 'BATE FEE PAID: Z Z-
TYPE OF UNIT: DWELLING�OTHER_ CHECK# 4f 6 7.6 CHECK DATE�'�l
NOTES:
CODE ENFORCEMENT INSPECTOR 9/28/98
d para CITY OF SALEM, MASSACHUSETTS
"gam BOARD OF HEALTH
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
CERT.# 155-02
s" FEE $25.00
�0�'nns TEL. 978-741-1800 D
FAx 978-745-0343 ATE: 03/20/2002
STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATEOFFITNESS
PROPERTY LOCATEDAT: 6 Adams Street UNIT #: 2
OWNER/AGENT: Gina &. Daniel Wronkowski.
ADDRESS: 6 Adams Street
CITY/TOWN: Salem, MA ZIP CODE.: 01970 24 HOUR PHONE: 741.-5221
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 -
JOANNE SCOTT, MPH,RS,CHO -
HEALTH AGENT - CODE ENFORCEMENT INSPECTOR
1 «' CITY OF SALEM, MASSACHUSETTS _ �-
'� BOARD OF HEALTH O
120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970
y6,4 TEL. 978-741-1800
FAX 978-745-0343
STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR 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".
PROPERTY LOCATED AT \n ! UNIT#—I
IS THIS UNIT DESIGNATED AS
RIGHT LEFT
FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSERi�LyN,�_ csi u MANAGER/AGENT
No P.O. Boaa r �` No P.O. Box
ADDRESQS llC�m 1 CL� ADDRESS
CITY c`r\�iy� CITY
RESIDENCE PHONE A -N\ 1\-( BUSINESS PHONE
(24 HRS.)
BUSINESS PHONE
TOTAL NUMBER OF ROOMS: 5
ROOM USE: 1.\�A\&(N 2L. ' 3�1�t�
,6 r 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. ^ ��
APPLICANTS SIGNATURE rt� AT\Y� �t�DATE�1',�"'_f.___�
INSPECTORS USE ONLY
DATE OF INITIAL INSPECTION DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:�3 '&-- DATE FEE PAID: Z —M2 —ni
TYPE OF UNIT: DWELLING4)OTHER_ CHECK#3 L`- CHECK DATE?_ 10
NOTES: (�
CODE ENFORCEMENT INSPECTOR 9/28/98
aoxol CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
+. 120 WASHINGTON STREET, 4TH FLOOR
e 93
� 1 SALEM, MA 01970 CERT.# 386-02
_
TEL. 978-74 1-1800 FEE $25.00
�c FAX 978-745-0343 DATE: 07/30/2002
STANLEY U50vICZ, JR. JOANNE SCOTT, MPH, RS, CHO
MAYOR HEALTH AGENT
CERTIFICATE OF FITNESS
PROPERTY LOCATED AT: 7 1/2 Adams Street UNIT #: 1
OWNER/AGENT: Clara M. Ellis & Claire M. Pelletier
ADDRESS: 7 1/2 Adams Street
CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-0285
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
JOANNE SCOTT, MPH,RS,CHO
HEALTH AGENT CODE ENFORCEMENT INSPECTOR
co - CITY-OF SALEM, MASSACHUSETTS
'BOARD OF HEALTH
3 120 WASHINGTON STREET, 4TH FLOOR
SALEM, MA 01970 IJ
TEL. 978-741-1800
FAX 978-745-0343
STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO
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 HUMAN HABITATION".
PROPERTY LOCATED AT �/ az � UNIT#
IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE
OWNER/LESSER- MANAGER/AGENT
No P.O. Box / No P.O. Box
ADDRESS 7 /�/ id/ 6/ ADDRESS
CITY Sl ✓t-- CITYA'a4�/ 6/97d
RESIDENCE PHON 'f J BUSINESS PHONE (24 HRS.)T
BUSINESS PHONE -
f ,
`TOTAL NUMBER OF ROOMS
* F
� A
ROOM USE: l %�.2 L oani 3.•Ma's 4:`/?
e
• .fix { ... : ��4 � � .
5 6 ' 7 8•
THERE,IS`A TWENTY+IVE:($25.00) DOLLAR FEL PAYABLE BY.CHECK OR MONEY
ORDER TO.THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE ,
TIME OF INSPECTION.) ;. s
APPLICANTS SIGNATURE DATE--/ �
� ,zT
' `'INSPECTORS USE ONLY
DATE OF INITIAUNSPECTION 2 -3 Oro L DATE OF REINSPECTION
DATE OF ISSUANCE OF CERTIFICATE:7" o wZ DATEFEE PAID
TYPE OF UNIT: DWELLIN OTHER_ CHECK#5_/6 / ' .CHECK DATE'2 - 3 o -c, v
NOTES:
I ..A
i
9/28/98
CODE ENFORCEMENT INSPECTOR
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PLEASE CALL ❑ WANTS TO SEE YOU �❑
:WILL CALL AGAIN ❑ URGENT
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OPERATOR
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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: 02/19/98 Fax: (508)740-9705
Cynthia & Alfred Bedard, Jr.
14 Adams Street
Salem, MA 01970
PROPERTY LOCATED AT 14 Adams Street UNIT # 3
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,
FOR THE BOARD OF HEALTH REPLY TO
Joanne Scott, MPH,RS,CHO PABLO VALDEZ
HEALTH AGENT CODE ENFORCEMENT INSPECTOR