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APPLETON STREET 1_t CITY OF SALEM, MASSACHUSETTS « BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978)741-1800 KIMBERL EY DRISCOLL FAX(978) 745-0343 MAYOR ]PIONNF`, SA,EM.COM JANE:!'DIONNI!; AC"I'ING Hu'AI.;II-I AGIiNf CERTIFICATE OF FITNESS CERTIFICATE #452-08 DATE ISSUED: 9/11/2008 Property Located at: 9 Appleton Street UNIT# 1 Owner/Agent: Joanne Wright Address: 9 Appleton Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-6712 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 AN DIONN� Y� ACTING HEALTH AGENT CW ENFORCE INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR 1scly SALEM.COM JOANNE SCOTT, 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." I EE: $50.00 PROPERTY LOCATED AT UNIT# -)1S THIS U DISIGNA ED RICHT LEFC FRO OR BACK PLEASE CIRCLE ONE OWNERILESSER�J C� �/� t• -' C =ERlAGENT NO P.O. BOX ADDRESS "`✓✓✓ADDRESS �} /� CITY,STATE,ZIP UJ -fti /� / 7 CITY, STATE,ZIP / '" ( A— (� RESIDENCE PHONE / t I J�4� 1 ( BUSINESS PHONE(24HRS) 3 �' b 3 BUSINESS PHONE TOTAL NUMBER OF ROOMS. ROOM USE: 1. 2. 3. 4. 5. 6. 7. 8. 9. 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 SIGNATURE --ti- G DATE J� Gr1 Inspectors use only Date on initial inspection: l Date of reinspection: Date of issuance of certificate: Date fee paid: 7 Type of unit: Dwelling Other Checc,l£# Check date: g f 1 J 1 D Notes: (ON S c,Lj I ' ' moo( �1r�� `fit t, �)� 25 111 �I� r GU2 h f toCC� �lY ODW1� t G1U(Vt d Oy1 oY :)W) r GxAwL.4,qyir-z b tYk.v"e iia. r room em us-dl uvi��� Vsojd',�-w. ._.• �ector e 1FSafbrcemcnt CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 CERT.# 98-03 FEE $25.00 TEL. 978-741-1800 D FAX 978-745-0343 ATE: 03/11/2003 STANLEY USOVICZ, JR. ,JOANNE SCOTT, MPH, R5, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 11 Appleton Street UNIT #: 1F OWNER/AGENT: Rodney Maurice ADDRESS: 11 Appleton Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-2436 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 NOR BUILDING RELATED CODES. FOR MORE INFORMATION CALL 978-741-1800 . PR THE BOARD OF HEALTH u JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR o CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • a 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 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 // O -Ir UNIT#-LF IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER �o dig r Qt kpl/;:Ze MANAGER/AGENT-SC k+ td No P.O. Box No P.O. Box ADDRESS I ADDRESS / CITY P vy CITY / RESIDENCE PHONE;M '7 /l/_a`/-lkUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: 3 ROOM USE: 1. �! f 2.BrW^kt 34'u /P 4. 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 1 G DATE INSPEC RS USE NLY DATE OF INITIAL INSPECTION 3 -/f-0 3 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:- / ( -03 DATE FEE PAID:/1 —0 3 TYPE OF UNIT: DWELLING OTHER_ CHECK# 0 6 O CHECK DATE .--(I - NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CERT.# 418-97 3 FEE $25.00 DATE: 07/09/97 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 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 11 Appleton Street UNIT #: 1R OWNER/AGENT: Rodney Maurice ADDRESS: 11 Appleton Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-2436 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 p CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tet:(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". ` � UNIT PROPERTY LOCATED AT OWNER/LESSER #, e MANAGER/AGENT �o ADDRESS ADDRESSJ4, CITY e byl_ CITY _ RESIDENCE PHONE 7``!7 ~ �. 3 I� BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OFROOMS: ROOM USE: I . KJ.. 2. A,, oi, 3. jV, t,P" 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 DE THIS FEE IS PAYABLE AT THE TIME OF INSPECT10N APPLICANTS SIGNATURE Q CDATE -7 7INSPECTORS USE ONLY DATE OF INITIAL INSPECTION: ,! _ DATE EOF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: �-Ce / DATE FEE PAID: TYPE OF UNIT: DWELLING OTHER NOTES: CODE ENFORCEMENT INSPECTOR L vat N 3 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: 07/01/97 Fax: (508)740-9705 Rodney & Heather Maurice 1.1 Appleton Street Salem, MA 01970 PROPERTY LOCATED AT 11 Appleton Street UNIT # 1R 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 r.rior 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 P•,cLninistrative Procedures and 105 CMR 410.000; State Sanitary Code, Chapter 11: Minimum -tandards of Fitness for Human Habitation, and in accordance with Chapter 11, Article call 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) 741-18QO Monday thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7 :00 p.m. or Enid-ry 8:00 a.m. to noon to schedule an appointment for an inspection. -tEE ENCLOSED SECTION 105 CMR 410.354 METERING OF GAS & ELECTRICITY. Var_ truly yours, kTO E< Ti{P, BOARD OF HEALTH REPLY TO :i c:ann- Scott, MPH,RS,CHO PABLO VALDEZ HE`-,LTH AGENT CODE ENFORCEMENT INSPECTOR T CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR n e SALEM, MA 01970 CERT.# 99-03 FEE $25.00 TEL. 978-741-1800 DATE: 03/10/2003 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 11 Appleton Street UNIT #: 2R OWNER/AGENT: Rodney Maurice ADDRESS: 11 Appleton Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-2436 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 NOR BUILDING RELATED CODES. FOR MORE INFORMATION CALL 978-741-1800 . FOR THE BOARD OF HEALTH JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR T o 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 APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". p PROPERTY LOCATED AT /i/.�b 10)Te +t S/ UNIT it a/1 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER/ cd q L4.)-/ ANAGER/AGENT S� `C. No P.O. Box No P.O. Box ADDRESS I ADDRESS CITY �S If kf CITY JA�� RESIDENCE PHONE?n 7yy-"a` BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: /Y ROOM USE: tlC,f 2.13cd►�j3. .�tdrIt- 4. � �Y. leAt 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 1 DATE INS ORS US ONLY DATE OF INITIAL INSPECTION / _ DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:3- DATE FEE PAID:_7-_4 iO3 _ TYPE OF UNIT: DWELLING,i OTHER_ CHECK# 6 0 CHECK DATE_3 -0' 3 NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CERT.# 455-99 FEE $25.00 DATE: 08/16/99 a � �MIN6 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Fax:(978)740-9705 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 13 Appleton Street UNIT #: 1 OWNER/AGENT: Stephen Saradnik ADDRESS: 13 Appleton Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 744-2051 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 i li Irk 0 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHONINE NORTH STREET HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tel:(978)741-1800 Fax:(978)740-9705 IN ACCORDANCE WITH STATE SANITARY CODE,CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT 5,� UNIT#_Z IS THIS UNIT DESIGNATEQ AS 1 EFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER MANAGER/AGENT No P.O.Box No P.O. Box • ADDRESSl3���e ADDRESS CITY J/ f �_�/yYl CITY _.__ i RESIDENCE PHONE��"7'r �57 BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 3. _4, 1✓ 5. THERE IS A TWENTY-FIVE($25.00)DOLLAR FEE,PAYABLE BY CHECK OR MONEY r ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTIO APPLICANTS Sl /DATE__�'/ INSPECTORS USE ONLY DATE OF INITIAL INSPECTIONb DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: 6 _DATE FcE3_ ,E PAID:_ TYPE OF UNIT: DWELLINGYOTHER_ CHECK#; `� 7 1.CHECK DATE -116 f`f NOTES: CODE ENFORCEMENT INSPECTOR 9/28198 ��,�01'181T 9 C CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, HIS, CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 08/31/2000 Fax:(978)740-9705 John Lowell & Emilienne Hastings 4 Dartmouth Place Boston, MA 02116 PROPERTY LOCATED AT 17 Appleton Street UNIT # House 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; 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 meters) 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. �FOR THE BOARDPF HEALTH REPLY TO JnnSc6ft, MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR T CITY OF SALEM, MASSACHUSETTS + BOARD OF HEALTH 120 WASHINGTON STREET,4""FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR ecieNsnuMn ALeu.co K DAVID GRI31)NHAUM AcrING HI:?AI:;I'II ACvN'1' CERTIFICATE OF FITNESS CERTIFICATE#85-10 DATE ISSUED: 2/22/2010 Property Located at: 19 Appleton Street UNIT# 1 Owner/Agent: James A.Wilkins III Address: 19 Appleton 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 D I R ENBAUM ACTING HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS r BOARD OF HEALTH • Y 120 WASHINGTON STREET,4"`FLOOR TF.L. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR LJGRFFNiM'o @S L Nt.CONI DAVID GREENBAUM, --AcTm 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 / rl /�A�il / 'TU/c! J7— UNIT#_L_ IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER 3 /7J' / li//t/f/+�1 / MANAGER/AGENT NO P.O.BOX ADDRESS `�/q//%T Gctl S T ADDRESS CITY, STATE, STATE,ZIP--5;2 r RESIDENCE PHONE USINESS PHONE(2414RS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: 5- ROOM ROOM USE: 1 /Y/ / 2.. oaji P 3 e k,11 4. `/t//Y< 5• "Ia 6. 7. $. 9. 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 IN'SPECTION APPLICANT'S SIGNATURE /r ` � DATE a a Inspectors use only Date on initial inspection: CP1 )G /U Date of reinspection: tt Date of issuance of certificate: 0 10 Date fee paid: Type of unit: Dwelling_ Zother Check# _Check date: / 0 Notes: Cade Er Ient�_ 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 Kimberley Driscoll JOANNE SCOTT, MPH, RS, CHO Mayor HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#252-06 DATE ISSUED: 5/22/06 Property Located at: 25 Appleton Street UNIT# 1 Owner/Agent: Pablo Valdez Address: 25 Appleton Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 744-6114 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 ll" 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. �PR THE BOARD OF HEALTH JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR eagRo oa HEALTH t2o WAsNINGTON svit er.4TH moon SALEM.14A 01970 TEL.970-741-1800 FAX 978-745-0948 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 410.060 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION* PROPERTY LOCATED AT �Fi 0 .LJ >1 . _UNIT 41_ IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE i // OWNER/LESSER- 10 f 16 Z MANAGERIAGENT _ No P.O. Box //�� No P.O.Box ADDRESS_�S Pp,�A1 -----ADDRESS nz,,Z)__CITYv RESIDENCE PHONE? BUSINESS PHONE (24 HRS.)—_. ..— BUSINESS PHONE TOTAL NUMBER OF ROOMS: T ROOM USE: 1. -4,) THERE IS A TWENTY-FIVE ($25-00) DOLL AR FEE, PAYABLE BY CHECK OR MONEY ORDER 10 THE CITY OF SALEM HEALTH DEPARTtdIFNT THIS FEF IS PAYABLE AT THE TIME OF INSPECTION. J� APPI CANTS SIGNATURE 'Gz ? � DAT[: : o �/4/0 INS!>EC1C�RS USE ONl_l' DATE OF INITIAL INSPFCl ION� �a� � OAT I- OI- I ILINSi'TCI IQN DATt- Oi= 13SU ANCf O{- t:'t VIT1i ICAI { HAI I I I I_ PAI[) TYhi= 0I- UNI IIVVI ! HN'( (') III! I1 la i! CK !: �`"�" Cl it cK t'A I i r ,ui I IdI >ilt :I ii� Tai iraa '� ini; CITY OF SALEM, MASSACHUSETTS Y • BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FA�x(978) 745-0343 MAYOR ISCOTI SALEM.COM JOANNE SCOTT, HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#363-08 DATE ISSUED: 8/5/2008 Property Located at: 27 Appleton Street UNIT# 1 Owner/Agent: Adam Blanchard Address: 81 Pleasant Street City/Town: Wenham, MA Zip Code: 01984 24 Hour Phone: 978-468-1488 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 oneear from date of issuance or until the current tenant vacates whichever Y , is later. This Certificate of Fitness is valid only if there is a valid Certificate of Occupancy. FOR THE BOARD OF HEALTH f qANNETT, MPH, RS, CHO HEALTH AGENT CODE EN OR EMEN NSPECTOR . ar CITY OF SALEM, MASSACHUSErFfS fPf $O ARID OF HEALTH x 120 WASHINGTON STREET,4"'FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAx(978)745-0343 MAYOR 1•c:o2`i(,RS;iIEK CONI JOANNE SCOTT, HEALTH AGENT I Application for Certificate of Fitness IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER 11, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAAHABITATION." PROPERTY LACATED AT 27 ' r?pkto,i -�ttvQ-Iti First Floor UNIT# //I� IS THIS UNITT�DI/SIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE, OWNER/LESSER / 16lA#I [�/4n(4 4/< MANAGER/AGENT Na P.O.sox ADDRESS 8r 11 ADDRESS CIIY,STATE,ZIP Q7� E,ZIPaM Vq RESIDENCE PHONEgpz/ 0- b/ Y BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: 4 ROOM USE: 1 V& 2 QR 3 4. 5. 6 LR 7 Qg 8 9. 10. THERE, IS A TWENTY-FIVE($25) 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 APPLICANTS SIGNATURE - /YL DATE S Inspectors use only Date on initial inspection: �d l S Date of reinspection: t Date of issuance of certificate:S G Date fee paid: ,'_I ' L c� Other Check# 5S 1 Check date: Odell U r'Z� 5 C R S� Valp star i City of Salem, Massachusetts lug " Board of Health �,'{� 120 Washington Street, 4th Floor, Salem, PV PPreoent Promote, Pinup MA 01970 Wt 978 741-1800 Fax. 978 745-0343 Kimberley Driscoll Tel. t } i � Larry Ramdin,MPH, RENS,GHQ Mayor health@salem.com Health Agent I CERTIFICATE OF FITNESS CERTIFICATE#: GHL-17.144 DATE ISSUED: 5/12/2017 Property Located at: 27 APPLETON STREET UNIT#2 Owner/Agent: Daniel Blair Address: 27 Appleton Street#1 City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(857)203-1268 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 data 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. Y Larry Ramdin, MPH, RENS, CHO SANITARII HEALTH AGENT CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120\VASHINGTON STREET,4:� FLOOR TEL. (978) 741-1800 KIAIBERLEY DRISCOLL FAX(978) 745-0343 M.AYOR LFLUIDIIN@SALEnI.COM LARRY RA:\-IDL\,RS/REHS,CHO,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: $50.00 PROPERTY LOCATED AT 2-� A PP1,2-Ar`\ S�. UNIT# 2-- IS THIS UNIT DIS G ATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER jDay iI6 I, tCLt.r MANAGER/AGENT NO P.O. BOX ADDRESSV-\ lJ h tA , ADDRESS CITY, STATE, ZIPS 114A 019-70 CITY, STATE, ZIP RESIDENCE PHONE 5 203-1214$ BUSINESS PHONE(24HRS) / �`7�� 203' 12(o$ T BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: I. wfOlS(1'M ): bed(-0()M3. bedfOOM4. ktkke-► 5. I Iv105 6, fc)OM 7.din itno 8 Svyt rPJ©yym 9 10 THERE IS A FIFTY ($50) DOLLAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH THIS FEE ISPAYABLEAT THE TIME OF INSPECTION APPLICANT'S SIGNATURE�J�,�� — DATESII 1.7 Inspectors use only Date on initial inspection: �Z Date of reinspect ion: Date of issuance of certificate:VLV ! Date tee paid: S�ZZD17 Type of unit: Dwelling—�ZOther Check#022 Check date: a/2027 Notes: f *dn mens In ctor CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH �-A."�•D- - 120 WASHINGTON STREET,4� FLOOR TEL. (9',8) 741-1800 KIAIBERLEY DRISCOLL Fax(978)743-0343 VfAY OR LRA2\IDIi;QSALE.\1.CON1 LARRY RAXIDLN,RS/REHS,CHO,CP-FS HEALTH AGENT Release In accordance with Massachusetts General Laws Chapter 1 11; 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. Uwe 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 277 An le" s-I. UA1* 1 Address Address 2--? Aw)?dovt 14. N - 2 Address on unit to be inspected Date Updated.'V23/11 CITY OF SALEM, MASSACHUSETTS • BOARD OF HEALTH 120 WASHINGTON STREET,4"'FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR IMANCINIgSALEM.COM JANET MANCINI ACTING HEAi-rj i AGLNT CERTIFICATE OF FITNESS CERTIFICATE#118-09 DATE ISSUED: 3/6/2009 Property Located at: 29 Appleton Street UNIT# Owner/Agent: Michael Passanisi Address: 226 Boxford Road City/Town: Rowley MA Zip Code: 01969 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 ll" 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 ET MANCINI wt/I ACTING HEALTH AGENT CODE ENFORCEMENT IPSPECTOR q • CITY OF SALEM, MASSACHUSETTS 0 I J BOARD OF HEALTH 120 WASHINGTON STREET,4°i FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR IDIONNEnSAI.EM.COM JANET DIONNE, .ACTING 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 a % !��P�e 74 S't UNIT# IS THIS UNIT DISIGN�ATED AS RIGHT LEFT FRONT OR BACK PLEASE CIRCLE ONE OWNER/LESSER i//rC 14 z° / / C�SSOiJ/5� MANAGER/AGENT NO P.O.BOX / ADDRESS jd(2� o�d �✓Id ADDRESS CITY, STATE,ZIP /�a �✓��y / err6? CITY, STATE,ZIP RESIDENCE PHONE 11f � 'O 160 BUSINESS PHONE(24HRS) BUSINESS PHONE 27�PS 3 / — �G� TOTAL NUMBER OF ROOMS: '_ ROOM USE: 1.�/fGhl/1 2. I�ih • RM 3. 1,/1/,IeM 4. © f-f(CC 5 d 6. 7. mac,/ 8.1-2Ly.t 9 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 PAV E ATAIE T E F INSPECTION APPLICANT'S SIGNATURE J DATE ,6 Inspectors use only Date on initial inspection: 2- 2 t -0 °1 Date of reinspection: 3- • o Date of issuance of certificate: 3 "o ' a n Date fee paid: Type of unit: Dwelling 1 ' Other Check# 1441 Check date: 2.' 2-C. o g Notes: Code Enf cement ector CITY OF SALEM, MASSACHUSETTS ' BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 ^A FAX 978-745-0343 STANLEY J. LISOVICZ, JR. .JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 1/12/05 Kevin G O'Connell 31 Appleton Street Salem, MA 01970 PROPERTY LOCATED AT 31 Appleton Street 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 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 in which cross-metering has been proven to exist. For tre Board of Health , Reply to Joane Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR . o SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 1/13/05 Kevin G. O'Connell 31 Appleton Street Salem, MA 01970 PROPERTY LOCATED AT 31 Appleton 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. 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. For the Board of Health t � Reply to J1oanne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector a CITY OF SALEM, MASSACHUSETTS "�� BOARD OF HEALTH 3 120 WASHINGTON STREET, 4TH FLOOR n . SALEM, MA 01970 TEL. 978-74 1-1 800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 06/27/2002 Regina Murphy 43 Appleton Street Salem, MA 01970 PROPERTY LOCATED AT 43 Appleton Street 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 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 eo exist. FOR THE BOARDi' HEALTH REPLY TO Joa�tt, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR y.,. i CERT.# 691-96. 3 FEE $25.00 DATE: 1 10/03/0/03/ 96 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 CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 57 Appleton Street UNIT #: House OWNER/AGENT: David Walker ADDRESS: 31 Edae Wood Street CITY/TOWN: Mansfield CT ZIP CODE: 24 HOUR PHONE: 744-5691 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 OFFICE USE ONLY CERT / �j' alP c . 11 DATE: 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 CERTIFICATE 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 rj') — p 1 MT ; U"� c? v OWNER/LESSER— L� j �i J MANAGER/AGENT ADDRESS ADDRESSIn�� ��.ylt _4 1nv\ s CITY ��l�:hs�� ��I\ CScf� l \ CITY 'S{\ ��\DtY' , X\ �V RESIDENCE PHONEne�V� �(��j� BUSINESS PHONE (24 HRS.)Z� BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1 . �,� ��g 2. 5. r�i 6. {� �.7. 8. THERE IS A TWENTY-FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEAL PARTI UPON COMPLIANCE AND ISSUANCE OF CERTIFICATE. APPLICANTS SIGNAT GC1 ( �(y- DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION: DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: Z,�'Z) . � � � DATE FEE PAID: TYPE OF UNIT: DWELLING OTHER NOTES: CODE ENFORCEMENT INSPECTOR zip TO ❑ AM Oate 8' d Time �' uG EaPM WHILE YOU WERE OUT M �✓vt.Jzlz- Of S2 � . Phone U —t Area Code Number Extension TELEPHONED PLEASE CALL CALLED TO SEE YOU WILLCALLAGAIN WANTS TO SEE YOU JURGENT RETURNED YOUR CALL Message ,moo-rnv . Operator AMPAD REORDER ®EFFICIENCY® #23400 K R 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: 08/09/96 Fax:(508)740-9705 David Walker 421 Whitney U-106 U-Conn - Storrs, CT 06268 PROPERTY LOCATED AT 57 Appleton Street UNIT # 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 �l-fi,C.Cf Joanne Scott, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR 3 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: 10/21/96 Fax:(508)740-9705 Lawrence Ippoliti 64 Appleton Street Salem, MA 01970 PROPERTY LOCATED AT 64 Appleton Street UNIT # House 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. SRF 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 t, + s CITY OF SALEM, MASSACHUSETTS � BOARD OF HEALTH 120 WASHINGTON STREET,4m FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR 1)Glil:liNBAUM(ll7,SAI.14:M COM DAVID GREMNBAUM ACTING HI:?ALni AGI'.NT CERTIFICATE OF FITNESS CERTIFICATE#376-10 DATE ISSUED: 8/12/2010 Property Located at: 65 Appleton Street UNIT#House Owner/Agent: Gene Collins Address: 63 Appleton 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 IP' 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 DAVID GREENBAUM ACTING HEALTH AGENT COPY ENFORC5Mt-WINSPECTOR • 1 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4°i FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL F1.1' (978) 745-0343 MAYOR DGREF.NisnuM( SA1.rM.CONI DA�7D GREENBAUM, ACTING HEAI.THAGENT 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 6S n� � $5t UNIT# IS – ��THIS UNIT DISIdNA AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNEWLESSER ll`e� �/ 1 h S MANAGER/AGENT NO P.O. BOX __Ah 1 ADDRESS �_AhM, e oh1��� ADDRESS CITY, STATE,ZIP �i I4 w� Y 1 ) A 0 >� CITY, STATE,ZIP RESIDENCE PHONE / a 3 1 � ) BUSINESS PHONE(24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS:— ROOM USE: 1. le 1 `' 2. 1 V i''9 6. 7. 8. 9. 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 PA ABLE AT THETIMEOF INSPECTION APPLICANT'S SIGNATURE �X DATE � 7 / `� Inspectors use only ,2Ff'Ff- f 1` Date on initial inspection: 2� /d Date of reinspection: (a Ito Date of issuance of certificate: _ Date fee paid: U(J1 Type of it: Dwelling Other Check# Notes. _Check date: / . cX bon U 0 U a Code or em n pector V1, Vox- lov ee�,s h hor j wz-f. .�ulw Au" fo -f1 xIvros. TRANSMISSION VERIFICATION REPORT TIME : 08/15/2010 21:49 NAME : FAX : 9787450343 TEL : 9787411800 SER. # : 000BON341991 DATEJIME 08/15 21: 38 FAX NO./NAME 919784539150 PAGE(S) DURATION 00: 00:33 RESULT OK MODE STANDARD ECM CITY OF SALEM, MASSACHUSETTS r • BOARD OF HEALTH 120 WASHINGTON STREET,4°1 FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGREENBAUMnRSALEM.CQM DAVID GREENBAUM ACTING HEALTI-I AGENT Facsimile Transmittal Fax# CWILD �j 53 - 2150 RE: GS A-bq`f+' ON 2JL" tl Date : (Fo (��i I �y Page(s): including this cover# Message: Board of Health News --------------------------------------------------------For Your Information OFFICE HOURS: Monday, Tuesday, Wednesday 8:00 AM to 4:00 PM Thursday 8:00 AM to 7:00 PM Friday 8:00 AM to 12:00 NOON CITY OF SALEM, MASSACHUSETTS + BOARD OF HEALTH z 120 WASHINGTON STREET,4""FLOOR TEL. (978) 741-1800 KBOERLEY DRISCOLL FAX(978) 745-0343 MAYOR DGRlTNBAUMQSA1,hM.CQM DAvlll GRHG.NRAUM A("I'1NG HI AL'n i A(&M' M' Facsimile Transmittal To: Q , � �C) Fax # /L 3 9 5 RE: Date Page(s): including this cover# Message: as tisl L y0a_S swc1R4 Board of Health News ----------------------------------------------------------------For Your Information OFFICE HOURS: Monday, Tuesday, Wednesday 8:00 AM to 4:00 PM Thursday 8:00 AM to 7:00 PM Friday 8:00 AM to 12:00 NOON CITY OF SALEM, MASSACHUSETTS r • BOARD OF HEALTH 120 WASHINGTON STREET,4:"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978)745-0343 MAYOR DGREENBAU@SAITIM COM DAVID GREFNRAUM ACTING HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#376-10 DATE ISSUED: 8/12/2010 Property Located at: 65 Appleton Street UNIT#House Owner/Agent: Gene Collins Address: 63 Appleton 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 Il" 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 �� DAVID GREENBAUM ACTING HEALTH AGENT CO NFORC M - INSPECTOR TRANSMISSION VERIFICATION REPORT TIME 08/24/2010 01: 41 NAME FAX 9787450343 TEL 9787411800 SER. # 000BON341991 DATEJIME 08/24 01:40 FAX N0. /NAME 919784539150 DURATION 00:00:21 PAGE(S) 02 RESULT OK MODE STANDARD ECM