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BENTLEY STREET City of Salem, Massachusetts IV r { m Board of Health 120 Washington Street, 4th Floor, Salem, PublicHealth MA01970 Prevent. Promote. Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, RENS, CHo Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE #: GHL-16.144 DATE ISSUED: 4/19/2016 Property Located at: 4 BENTLEY STREET UNIT#1 Owner/Agent: Donna Bryant Address: 35 Bush Hill Road City/Town: Sherborn, MA Zip Code: 01770 24 Hour Phone:(508) 655-2815 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. FOR THE BOARD OF HEALTH F-� Larry Ramdin, MPH, RENS, CHO HEALTH AGENT SANITARIAN 0 MCONDl¢,t�,e City of Salem, Massachusetts10 3 Board of Health 120 Washington Street, 4th Floor, Salem, PublicHeaI'th MA 01970 Prevent. Promote. Protect. Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, REHS, CHO Mayor Iramdin@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE* GHL-16-144 DATE ISSUED: 4/19/2016 Property Located at: 4 BENTLEY STREET UNIT#1 Owner/Agent: Donna Bryant Address: 35 Bush Hill Road City/Town: Sherborn, MA Zip Code: 01770 24 Hour Phone:(508) 655-2815 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. FOR THE BOARD OF HEALTH 0,—A4LA,--, Z�Z�Cde_ Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH -� 120 WASHINGTON STREET,4`"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOIJ- FAX(978) 745-0343 MAYOR DGEENBAUMSALEM.COM DAVID GREENBAUM, ` 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." QQ�� 1 l FEE: $50.00 PROPERTY LOCATED AT `C I BVI?�II 6 ft:�: UNTT# IS TRIS UNIT DISI ATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE1A A V)i0 OWNER/LESSERR YIJI&J f)CUamCiaaW MANAGER/AGENT Aeprkk IFCQ NO P.O. BOX {� ADDRESS 35 f (dsh Nis i f 1 c ADDRESS 111 IJ S�Ce,'1 CITY, STATE, ZIP 5h w ph �,Mo 4, 0 I Z 7 O CITY, STATE, ZIP - Q OI QZQ RESIDENCE PHONE 20 o '65 �� 9'15 BUSINESS PHONE(24HRS) q?�- O 5, -06 0 BUSINESS PHONE TOTAL NUMBER OF ROOMS: S ROOM USE: 1.pX.11 OM 2. 641601'I'1 3.t 1t/N 1'dM4.MAtyl 5 AzgM 6. 7. 8. V 9. 10 THERE IS A F IFTY($50)DOLLAR FEE, PAYABLE BY CHECK OR MONEY t!tORDER TO THE CITY OF SALEM BOARD OF HEAL.TH.:THIS FEE ISP Y TIME OF INSPECTION t / APPLICANT'S SIGNATURE DATE"[ '�4 [D Insnectors use only Date on initial inspection: ���(�6 Date of reinspection: Date of issuance of certificate: Date fee paid: Type of unit: ]Dwelling Other Check# 502 9 Check date: Notes: C e E o eo.e tinspector o CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 fisti,„g TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 7/25/05 Nicholas Osgood 4 Bentley Street Salem, MA 01970 PROPERTY LOCATED AT 4 Bentley 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. r the Board of He th Reply to Joanne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector nn11 VREE�T CITY OF SALEM BOARD OF HEALTHSalem, Massachusetts 01970-3928JOANNE SCOTT,MPH,RS,CHO NINE NORTH HEALTH AGENT Tel:(508)741-1800 Date: 03/25/96 Fax:(508)740-9705 Four Bentley Street Realty Trust, Anne Carey, Trustee 4 Commercial Street Marblehead, MA 01945 PROPERTY LOCATED AT 4 Bentley Street UNIT # 2 Q 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, (FFOJ�.R. THE BOARD OF HEALTH REPLY TO (Joanne Scott, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR u CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR 3 SALEM, MA 01970 CERT.# 202-02 TEL. 978-741-1800 FEE $25.00 FAX 978-745-0343 DATE: 04/12/2002 STANLEY USOVICZ, JR. ,JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 4 Bentley Street UNIT #: 3 OWNER/AGENT: Nicholas Osgood ADDRESS: 4 Bentley Street, Apt. 1 CITY/TOWN: Sales, MA ZIP CODE: 01970 24 HOUR PHONE: 741-0525 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 n,- CITY OF SAL::::.:, Cv„- .6ACHUSE:T T S ?6 d, 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 11, 105 CMR 410.000 "MINIMUM STANDARDS OF/FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT UNIT# �b IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE .- OWNER/LESSER A-' I< OJ�yoaek MANAGER/AGENT No P.O. Box - No P.O. Box ADDRESS `1 Q�Fa/�� j+ i��� J _ADDRESS CITY CITY RESIDENCE PHONE BUSINESS PHONE (24 HRS.) 74/ -J93t BUSINESS PHONE TOTAL NUMBER OF ROOMS: 7 ROOM USE: 1. 13cd. n 2. 14,q-4, 3. 5.-6.-7. 8. THERE IS A TWENTY-FI�}DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF M HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNA lJs - DATE s Z o s INSPECTORS USE ONLY DATE OF INITIAL INSPECTION(�=/ 2 T L DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:'�f 2-0--L DATE FEE PAID: `74 TYPE OF UNIT: DWELLING)�_OTHER_ CHECK# y 7 CHECK DATE NOTES: Chi CODE ENFORCEMENT INSPECTOR 9/28/98 +t1y, CITY OF SALEM, MASSACHUSETTS ..1l. BOARD OF HEALTH s $ 120 WASHINGTON STREET, 4TH FLOOR �Fq SALEM, MA 01970 - TEL. 978-741-1800 FAx 978-745-0343 KIMBERLEY DRISCOLL JSCOTT@SALEM.COM MAYOR JOANNE SCOTT HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#113-08 DATE ISSUED: 317/2008 Property Located at: 6 Bentley Street UNIT#2 Owner/Agent: Cheryl Tuttle Address: 9 Mariners Lane City/Town: Marblehead, MA Zip Code: 01945 24 Hour Phone: 631-3652 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 OFFHEALTHJ ANT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS n BOARD OF HEALTH /r, [ • • 120 WASHINGTON STREET, 4TH FLOOR V SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 JOANNE SCOTT, MPH, RS, CHO Kimberley Driscoll HEALTH AGENT Mayor 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 UNIT NO T BACK PLEASE CIRCLE Z IS THIS UNIT DESIGNATED AS RIGHT LEFT FRCLE ONE OWNER/LESSER MANAGER/AGENT No P.O. Box No P.O.Box ADDRESS_ / ADDRESS K CITY Q19_Io ,VCl 2 CITY h&ft _a_ 9y4.0 RESIDENCE PHONE BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS:__ ROOM USE: 1._ ZZ 2._VtL_3._ _f�4. 6fC_ 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 __DATE_ INSPE ORS USE ONLY DATE OF INITIAL INSPECTION S ECTION v DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:3 DATE FEE PAID:__=z P TYPE OF UNIT: DWELLINGOTHER_ CHECK # _ CHECK DATE NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 TO 081ta /(--5-9 7 Time /:90 WHILE �YOU 7 WERE OUT M �" _ �( of d 1-2 Phone Area Code Number Extension TELEPHONED q, PLEASE CALL CALLEDTOSEEYOU WILLCALLAGAIN WANTS TO SEE YOU URGENT RETURNED YOUR CALL Message -e4� /L��&-te OpwaE- AMPAD 23-21•200 SETS EFFICIENCY* 23421.100 SETS CARBONLESS 3 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 Date: 09/18/97 Fax:(978)740-9705 10 1/2 Bentley Street Realty Trust c/o Michael Hurney, Trustee 1 W. Orchard Street Marblehead, MA 01945 PROPERTY LOCATED AT 10 1/2 Bentley 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. 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 qa_#_1C_x1C1/' Joanne Scott, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS e BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 Kimberley Driscoll WWW.SALEM.COM Mayor JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#684-06 DATE ISSUED: 11/9/2006 Property Located at: 14 Bentley Street UNIT#2nd floor front(right) Owner/Agent: Philip F. Swiniuch Address: 14 Bentley Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 741-1841 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 JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SAMM, MASSACHUSETTS / 130ARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 JOANNE SCOTT, MPH, RS, CHO Kimberley Driscoll HEALTH AGENT Mayor APPLICATION FOR CERTIFICATE OF FITNESS IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER It, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABIITTATION°. // // ft PROPERTY LOCATED AT S _.UNIT #19n4 Y•v IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER&ESSPAill 12��f cue__ _MANAGER/AGENT_ No P.O. Bax No P.O.Box ADDRESS S __ ADDRESS CITY--c al2,ar1 j CITY_-- —__. RESIDENCE PHONE__?,Z�,- _ jj kOUSINESS PHONE (24 HRS.)_,—___, BUSINESS PHONE—_-_—-- TOTAL _— TOTAL NUMBER OF ROOMS: ROOM USE: 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 _~ � 1WPECTOR$ 11SE dNLY DATE OF INITIAL INSPECTION %_ _ DATE OF REINSPECTION DATE OF ISSUANCE OFCERTIFICATE/1 f 10(,9 DATE FEE PAID TYPE OF UNIT: DWELLING OTHER CHECK 11 CHECK DATE NOTES:. _.. . CODE FNFORCEM17NT INSPECTOR 9128'98 co CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 �" - TEL. 978-741-1800 FAX 978.745-0343 KIMBERLEY DRISCOLL JSCOTT@SALEM.COM MAYOR JOANNE SCOTT HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#248-08 DATE ISSUED: 5/29/2008 Property Located at: 14 Bentley Street UNIT#2nd floor rear Owner/Agent: Philip F. Swiniuch Address: 14 Bentley Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 741-1841 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 J NNE SCOTT, MPH, RS, CHO *'!C HEALTH AGENT ENFORCEMENT INSPECTOR • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4" FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAx(978) 745-0343 MAYOR ISCO'rr e SAI.rM11.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 HUMA HABITATION." PROPERTY LACATED AT `���N L ' 1uj (— UNIT# ?"� •" IS THIS UNNITDISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER3H/N (1 P I• J UI'Iy I U e.H MANAGER/AGENT NO P.O. BOX !1 ADDRESS ILI Io�r�T�eY �fi ADDRESS CITY,STATE,ZIP 19LOL90w {N 5143 0 !47° CITY,STATE,ZIP RESIDENCE PHONE / ,7 & 7` j, 143y i BUSINESS PHONE (24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: Sr ROOMUSE: 1. j!4fje h 2. ad Qit 3. Kn ed Aw 4. &J Qrs 5.11/117p �v6" 6. 7. 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_ �,& r c�i DATE Inspectors use only Date on initial inspection: � 1— Date of reinspection: Date of issuance of certificate: ' Date fee paid: Type of unit: Dwelling Other Check#�lpl/l Check date: W30.165< Notes: kAo-)+ wtnl 6u.�% ` 6' .ugyt onit cue nc* Lr)dl'j0zorfealy - pwher I,.till_ -�jXiha wihdaW3. 06de Enforcement Inspector ��CONUIT n CERT.# 549-00 FEE $25.00 DATE: 08/24/2000 �Q7MfNB 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: 14 Bentley Street UNIT #: 4 Right OWNER/AGENT: Philip F. Swiniuch ADDRESS: 14 Bentley Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 741-1841 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 v c, CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT APPLICATION FOR CERTIFICATE OF FITNESS Tel:(978)741-1800 ' - IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 Fax:(978)740-9705 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT l �/ Sf a� UNIT#-I IS THIS UNIT DESIGNATED AS IGH LEFT FRONT BACK PLEASE CIRCLE ONE OWNE ESSER �lli.,� / SWl�✓lL)c H MANAGER/AGENT No Box No P.O. Box ADDRESS Q/l`I �J������ ADDRESS CITY U aArm CITY 'A 11 VPl7/,?7 0 RESIDENCE PHONE 7LI 484 I BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: b� ROOM USE: 1. K,T 2. (3 R 3. 5.46.-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 DATE 2/C 2004 SPEC TO14S USE ONLY DATE OF INITIAL INSPECTION 8'a b ' DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: DATE FEE PAID: R TYPE OF UNIT: DWELLING OTHER_ CHECK# R 3 CHECK DATE-dam' a NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH i 120 WASHINGTON STREET, 4TH FLOOR . SALEM, MA 01970 CERT.# 144-03 FEE $25.00 TEL. 978-741-1800 DATE: 04/03/2003 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 16 Bentley Street UNIT #: 1 OWNER/AGENT: Harbor Rental ADDRESS: 111 Derby Street . CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 741-9378 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 r JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR u CITY OF SALEM, MASSACHUSETTS ��- ��6 BOARD OF HEALTH 3 120 WASHINGTON STREET, 4TH FLOOR e 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 XG �2 .v7LC �j y UNIT#� IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER/ /LI2ZD e,N L MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS ��� /J,�� � y _ ADDRESS CITY S,J',k,±!y 7lt /�/r2 2-0 CITY RESIDENCE PHONE BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: L ROOM USE: 1._ /�- 2. —3. 4f 1-5 5 _6. T. 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 SIGNATUREDATE 3 �J INSPECTORS USE ONLY DATE OF INITIAL INSPECTION!j- 3 - b 3 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: Y- 3 d 3 DATE FEE PAID. - "c S TYPE OF UNIT: DWELLIN�(OTHER_ CHECK# / b CHECK DATEY�S NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 C .�ONWT 2 ����MIIY6 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 01/29/2001 Henry Peper 1 Gregory Street Marblehead, MA 01945 PROPERTY LOCATED AT 16 Bentley 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. 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 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 to exist. OR THE BOARH REPLY TO oann � P ,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR v CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 ! 01/28/2000 Fax:(978)740-9705 Henry Peper 1 Gregory Street Marblehead, MA 01945 PROPERTY LOCATED AT 16 Bentley 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. 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 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 to exist. OR THE BOARD F H TH REPLY TO '}{ ;� ' Joanne Sc tt, MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR CERT.# 830-96 FEE $25.00 DATE: 11/29/96 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: 16 Bentley Street UNIT #: 3 OWNER/AGENT: Henry Peoer ADDRESS: 1 Gregory Street CITY/TOWN: Marblehead, MA ZIP CODE: 01945 24 HOUR PHONE: 631-4827 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,CHOG— HEALTH AGENT �C E E - RCE MENT INSPECTOR r a G3b{ CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970=3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(506)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 ! (,9 CUJ// S� UNIT / OWNER/LESSER /4t1Lr_yr MANAGER/AGENT ADDRESS1 Q r (!�/ ADDRESS CITY (,i_q �CT d-t q f! CITY RESIDENCE PHONE (y I < �y . L�� BUSINESS PHONE (24 HRS.) BUSINESS PHONE — TOTAL NUMBER OF ROOMS: 4� ROOM USE: 1. 2. 3. 6A 4 . —7. 8, THERE IS A TWENTY-FIVE (25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM'HEALTH DEPARTMENT TH. FEE IS PAYABLE AT THE TIME OF IINNSSPEC�TJION f APPLICANTS SIGNATURE DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION:_C,4/n, DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:_ /- DATE FEE PAID: TYPE OF UNIT: DWELLING ke' OTHER NOTES: CO,PC-,nFOR9EWNT INSPECTOR,,--- CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-'jK8 `.A.. JOANNE SCOTT,MPH,RS,CHO t '` 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 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. In the event it is necessary that said inspection be done in my/our absence, I/we expressly authorize the same and formY/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-:. Ai_ t 9'I` . . Z. TENANT/LESSEE OWNER/LESSOR l v,.4 Le ►2 Qv---, 5-- ADDRESS ADDRESS �� ADDRESS OF UNIT TOB INSPECTED DATE i