2-4 Howard Street Inspection Notice 4-27-2012 �.
CITY OF SALE'M, MASSACHUSETTS
BOARD Or HEALTH
120 WASHINGTON STREET,4!�`FLOOR PublicHealth
Prceenl.Promote. Protect.
TEL. (978) 741-1800 FAX(978) 745-0343
KIMBERLEY DRISCOLL hamdin@salem.com
LmR1tY Rr1IMD1N,RS/R:E?115,CI10,CP-I:i'S
MAYOR HEIAI.I'I I EAGF N'T
4/27/2012
John Lenzi
99 Lafayette Street
Marblehead, MA 01945
2-4 Howard Street
Dear Owner:
The Salem Board of Health, Building and Fire Departments are scheduling yearly
inspection of all establishments licensed as lodging houses.
The Salem Licensing Board will review inspection and re-inspection reports in
accordance with its license renewal procedures. The inspection will include dwelling
units and common areas, therefore each tenant must be present or he/she must sign the
enclosed release form which will allow the inspectors to enter the unit.
Your Lodging House at 2-4 Howard Street has been scheduled to be inspected on
Wednesday 6/13/2012 at 9:00:00 AM
Thank your for your anticipated cooperation.
Sincerely,
Larry Ramdin
Health Agent
cc: Michael Lutrzykowski, Assistant Inspector of Buildings
Lt. Erin Griffin, Fire Prevention
Robert St. Pierre, Chairman, Salem Licensing Board
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Fax:(508)740-9705
RELEASE
In accordance with Massachusetts General Laws Chapter Ill ; Code of Massachusetts
Regulations 410.000 et. seq. ; State Sanitary Code Chapter II and Article XIII of
r_Iie 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 that said inspection be d.on.e in my/our absence, I/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 agents
from any loss or injury sustained of whatever nature and description occasioned
by my/our absence during said inspection.
TENANT/LESSEE OWNER/LESSOR
ADDRESS ADDRESS—
ADDRESS OF UNIT TO BE INSPECTED
DATE
CITY OF SALEM, MASSACHUSETTS
BOARD OF HEALTH
120 WASHINGTON STREET,4'"FLOOR
TEL. (978) 741-1800
KIMBERLEY DRISCOLL FAX(978) 745-0343
MAYOR 1MANCINI(1 SALFM.CUM
JAN1-',T MAN(;1NI.
AC'I'1NCi HI:.U:1'FI A(l''Nl'
RELEASE
In accordance with the State Sanitary Code Chapter II; Chapter 2-705 of the City of
Salem Ordinance; Mass General Laws, Chapter 140, Section 25; Mass General Laws,
Chapter 148, Section 4; and CMR 780.115.6 the undersigned owner/lessor and
tenant/lessee of a unit of residential property, hereby authorize the Salem Board of
Health, Salem Licensing Board, Salem Fire Prevention, Salem Building Inspector and
other City departments or their 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/our 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, Salem Licensing Board, Salem Fire
Prevention, Salem Building Inspector and their authorized agents from any loss or injury
sustained of whatever nature and description occasioned by my/our absence during said
inspection.
nant/Lessee Owner/Lessor
Address Address
.r
Address of unit to be inspected
Dat
t.
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Fax:(508)740-9705
RELEASE
In accordance with Massachusetts General Laws Chapter III ; Code of Massachusetts
Regulations 410.000 et. seq. ; State Sanitary Code Chapter II and Article XIII of
tiie City of Salem Ordinance, undersigned owner/lessor and tenant/lessee of a unit
or 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 that said inspection be done in my/our absence. I/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 agents
from any loss or injury sustained of .whatever nature and description occasioned
by my/our absence during said inspection.
` e�r�z
TErlr� /Lr.SSE"r.' Caw R/i.FSSOR -- ----_—i
ADDRESS � ADDRESS
ADDRESS OF UNIT TO BE INSPECTED
ll'TE
i
CITY OF SALEM BOARD OF HEALTH
Salem, Massachusetts 01970-3928
JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET
HEALTH AGENT Tel:(508)741-1800
Fax:(508)740-9705
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
or 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.
Li the event it is necessary Chat said inspection be done in my/our absence, I/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 agents
from any loss or injury sustained of whatever nature and description occasioned
by my/our absence during said inspection.
/IC_'IVI`V\ Dot 0.v�
TENANT%LESSEE OWNER/LESSOR
ADDRESS ADDRESS
Sf /6t,
ADDRESS OF UNIT TO BE INSPEC ED
_6
DATE