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BOARDMAN STREET 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 01/31/2001 Donna & William Lawnsby 4 Silver Street Salem, MA 01970 PROPERTY LOCATED AT 1 Boardman 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; 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. ,4R�✓THE �BOARD 01 HEALTH REPLY TO oann_ e o t, MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR CERT.# 365-97 FEE $25.00 3 7t IAFDATE: 06/10/97 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: 1 Boardman Street UNIT #: 2 OWNER/AGENT: Peter Wona ADDRESS: P.O. Box 1092 CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-1737 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 3 rn� CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT NINE NORTH STREET Tei:(508)741-1800 APPLICATION FOR CERTIFICTE OF FITNESS Fax:(508)740-9705 IN ACCORDANCE WITH STATE SANITARY' CODE, CHAPTER II , 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT ol N, UNIT f � OWNER/LESSER ' MANAGER/AGENT ADDRESS ADDRESS CITY c C'�/ �M, G L �* CITY 'RESIDENCE PHONE ' `- .� `1 ?y "; BUSINESS PHONE (24 HRS.) BUSINESS PHONE co 1 — C; ' TOTAL NUMBER OF ROOMS: ' ROOM USE: 5. 6. 7. B. 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 . _ __.� L.�.JCDATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION: ,� `] DA1'E OF REINSPECTION DATE OF ISSUANCE OF C.ERTiFICATE: 4;�! /b -'� "7 DATE FEE PAID: - C, TYPE OF UNIT: DWELLING OTHER NOTES : CODE ENFORCEMENT INSPECTOR __ MRS CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(508)741-1800 Date: 06/03/97 Fax:(508)740-9705 Peter Wong P.O. Box 1092 Salem, MA 01970 PROPERTY LOCATED AT 1 Boardman Street UNIT # 2 Dear Sir/Madam: It has come to our attention, that you may be considering renting a dwelling unit at the above address. It is incumbent upon you as owner(s) to contact the City of Salem Health Department to apply for a CERTIFICATE OF FITNESS before any vacant dwelling unit is rented or occupied, or to notify us of your intent for this unit. Each dwelling unit must be inspected and certified by the Salem Health Department prior to allowing occupancy in accordance with Chapter 111, Sections 127A and 127B, of the Massachusetts General Laws, 105 CMR 400.00; State Sanitary Code, Chapter 1: General Administrative Procedures and 105 CMR 410.000; State Sanitary Code, Chapter 11: Minimum Standards of Fitness for Human Habitation, and in accordance with Chapter 11, Article XIII of the City of Salem Code of Ordiances, Section 2-334, Certificate of Fitness. There is a twenty-five (25) dollar fee payable by check, or money order to the City of Salem Health Department. This fee is payable at the time of inspection. Inspection will not be performed without receipt of payment. Failure to comply with this procedure, will result in a fine of twenty (20) dollars per day for every day that the dwelling unit is occupied without approval of the Code Enforcement Division of the Salem Health Department. Contact this department within 24 hours of receipt of this notice. (508) 741-1800 Monday thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7 :00 p.m. or Friday 8:00 a.m. to noon to schedule an appointment for an inspection. SEE ENCLOSED SECTION 105 CMR 410.354 METERING OF GAS & ELECTRICITY. Very truly yours, FOR THE BOARD OF HEALTH REPLY TO Joanne Scott, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR M I E U WERE OUT TO, DATf��Oa TIME 0AM� DEP M OF PHONE AREA CODE NUMBER EXTENSION FAX PAGER MOBILE E-MAIL TELEPHONED j�--11 CAME TO SEE YOU 1J PLEASE CALL WANTS TO SEE VOU 'Q WILL CALL AGAIN ❑ URGENT RETURNED VOUR CALL❑ WILL FAX YOU ❑ MESSAG OPERATOR 23-021 200 SETS CARBONLE 23-421 400 SETS 3 gj CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO NINE NORTH STREET H101 LT}2ff&1T Tel:(978)741-1800 Date: // x/99 Fax:(978)740-9705 Keith & Carol Chapman 4 Boardman Street Salem, MA 01970 PROPERTY LOCATED AT 4 Boardman 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 l: General Administrative Procedures and 105 CMR 410.000; State Sanitary Code, Chapter 11: Minimum Standards of Fitness for Human Habitation, and in accordance with Chapter 11, Article XIII of the City of Salem Code of Ordiances, Section 2-334, Certificate of Fitness. There is a twenty-five (25) dollar fee payable by check, or money order to the City of Salem Health Department. This fee is payable at the time of inspection. Inspection will not be performed without receipt of payment. Failure to comply with this procedure, will result in a fine of twenty (20) dollars per day for every day that the dwelling unit is occupied without approval of the Code Enforcement Division of the Salem Health Department . Contact this department within 24 hours of receipt of this notice. (508) 741-1800 Monday thru Wednesday from 8:00 a.m. - 4:00 p.m. Thursday 8:00 a.m. - 7 :00 p.m. or Friday 8 :00 a.m. to noon to schedule an appointment for an inspection. SEE ENCLOSED SECTION 105 CMR 410.354 METERING OF GAS & ELECTRICITY. Very truly yours, F AOR THE BOARD/O,FJF HEALTH REPLY TO Joanne Scott, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR goo CITY OF SALEM9 MASSACHUSETTS BOARD OF HEALTH y, 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 �s Y TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#: 362-03 DATE ISSUED: 7/22/2003 Property Located at:: 6 Boardman Street UNIT#: 2 Left Owner/Agent: Keith R. Chapman Address: 4 Boardman Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 745-2672 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. 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. 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 SALEM, MASSACHUSETTS ^ a BOARD OF HEALTH ��120 WASHINGTON STREET, 4TH FLOORSALEM, MA 01970 TEL. 978-741-1800 - FAX 978-745-0343 STANLEY LISOVICZ, 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 �`� m4� S / UNIT# IS THIS UNIT DESIGNATED AS RIGHT 6LEF FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER k--)11\ R- C�YZp'Mc?4 MANAGER/AGENT No P.O. Box No No P.O. Box ADDRESS _ 1 3d`�'r� nAQ 4 S7ADDRESS CITY .5'�e_ t CITY m RESIDENCE PHONE '/ 2' ""5 0�6 '"`BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. KN_t6len2. Pam 3. dell 4. Liviru�y tV64 5. bfJ 6. be�— 7. 6ecL 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—co- INSPECTORS ATEcoINSPECTORS USE ONLY DATE OF INITIAL INSPECTION 7 iJ a DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:7�J1 -.) 3 DATE FEE PAID: 7- -.x—2- - 0,3 TYPE OF UNIT: DWELLIN)(OTHER_ CHECK# 5-3'.) 7 CHECK DATE 2- NOTES: f CODE ENFORCEMENT INSPECTOR 9/28/98 -: CERT.# 432-00 i FEE $25.00 4 DATE: 07/05/2000 9�'C/hMRW 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: 8 Boardman Street UNIT #: 1 OWNER/AGENT: Mary Bates ADDRESS: 4 Vista Avenue CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-4183 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 D O F HEALTH Lke-__ JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR n z ���7MIIVE Dp`" 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 Fax:(978)740-9705 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER Ii, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT i 6Qd k'd 'Y o UNIT# IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER 6t MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS / <<S ADDRESS CITY- l�hr�` [ CITY RESIDENCE PHONE l ��` 1 �3 BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS::: ROOM USE: 1. 6 ej /J � �2.&4 ( . 0 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. /� J� L / APPLICANTS SIGNATURE 1 ' GL !�J DATE /�� � INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 5_--0-0 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: 6�-ero DATE FEE PAID:? TYPE OF UNIT: DWELLING OTHER_ CHECK# /7Rg CHECK DATE NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 6 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,RS,.CHO NINE NORTH STREET HEALTH AGENT Tel:(50B)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. L•i the event it is necessary that said inspection be done in my/our absence, !/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/LES FIn A DI�ESSC. P,DDI P.DDRE.,S UNIT To BE IN PECTED DATE r CERT.# 434-97 3 FEE $25.00 DATE: 07/15/97 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: 8 Boardman Street UNIT #: 1 OWNER/AGENT: Mary Bates ADDRESS: 4 Vista Avenue CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-4183 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. R THE BOARD OF HEALTH / JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR r CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970.3928 JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET HEALTH AGENT NINE (508)741-1800 APPLICATION FOR CERTIFICTE OF FITNESS Fax:(508)740-9705 IN ACCORDANCE WITH STATE SANITARY'CODE, -CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT.. " ( /� 1 UNIT # OWNE LESSER ( �j� *� ^ ,•�r.,m ADDRESS C 1 ! S CITY { ' ' RESIDENCE PHONE J:— �� BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: JfJ ROOM USE: 1 ._ 1lDn 2.A4 . 7. 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 LL q DATE��� — INSPECTORS USE ONLY DATE OF INITIAL INSPECTION: DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: —/S—`'( 7 DATE FEE PAID:; /-5— TYPE —TYPE OF UNIT: DWELLING }�" OTHER NOTES:_____—c- CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH s 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 e TEL. 978-741-1800 STANLEY J. USOVICZ, JR. FAX 978-745-0343 MAYOR wW W.SALEM.COM JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE#613-05 DATE ISSUED: 10/3/05 Property Located at: 8 Boardman Street UNIT#2 Owner/Agent: Mary Bates Address: 8 Boardman 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 TE BOARD OF HEALTH �I JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • • 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 _� GSI UNIT#z IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER MaN. bC, MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS PiY�ZX �a n ADDRESS C" R-a A& CITY RESIDENCE PHONE BUSINESS PHONE (24 HRS.) BUST SSE PHONE TOTAL NUMBER OF ROOMS:—(P---- ROOM USE: 1.� 2.&A71 _3. 4. 4 c THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE � j DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION ip •�DATE OF REINSPECTION_ _ DATE OF ISSUANCE OF CERTIFICATE: 0_0 DATE FEE PAID:-f 3 TYPE OF UNIT DWELLI�OTHER_ _ CHECK #3_.0 3 CHECK DATE_ NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS '$ BOARD OF HEALTH - • • 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 - STANLEY LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO - MAYOR HEALTH AGENT RELEASE In accordance with Massachusetts General Laws Chapter III ; Code of Massachusetts R.?gulatiocs 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. I'n the event it is necessary that sai-d 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 ahen:s from any loss or injury sustained of whatever nature and description occasioned by my/our absence during said inspection. ADUT:Ess ADDRs ADT?HESS OF UNIT Tr) BE INSPECTED CITY OF SALEM, MASSACHUSETTS '� BOARD OF HEALTH • 120 WASHINGTON STREET, 4TH FLOOR `� SALEM, MA 01970 CERT.# 140-03 FEE $25.00 TEL. 978-741-1800 DATE: 03/31/2003 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 8 Boardman Street UNIT #: 2 Front OWNER/AGENT: Mary Bates ADDRESS: 8 Boardman Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-4183 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 . FO�RTHE BOARD OF HEALTH JOANNEI ✓SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR I` aCITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 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 � fr � �� UNIT#_ IS THIS UNIT DESIGNATED AS RIGHT LEFT 6N BACK PLEASE CIRCLE ONE OWNER/LESSER MANAGER/AGENT No P.O. Box r No P.O. Box ADDRESS 'i� ADDRESS CITY sS; �P VYl CITY RESIDENCE PHONET LV ITS -$93—BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1.K"10 2.W.' ll 3. 1 (ldm llrA uy�I CIUS��/ 8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. p , Ar APPLICANTS SIGNATURE 1 YlXkl4"`�/T DATE 31 3I -03 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION ?w-3J —yy DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: 'N --�$ DATE FEE PAID: _T - .A) -03 TYPE OF UNIT: DWELLING/OTHER_ CHECK# 7 7 5� CHECK DATE NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 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 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 Cit; 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, 1/we expressly authorize the same and for my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of Health and its authorized agents from any loss or injury sustained of whatever nature and description occasioned by my/our absence during said inspection. TENANT/LESSEE OWNER/iESSCR � ADDRESS --— ADDRESS OF UNIT 'T)—BE INSPECTED -- 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#278-06 DATE ISSUED: 5/31/2006 Property Located at: 8 Boardman Street UNIT#3 Owner/Agent: Mary P. Bates Address: 8 Boardman Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: 978-745-4183 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 If' 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 qz,-X� JET] -+rs(7(", JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD HEALTH STREET, � 120 WASHINGTON STREET, 4TH FLOOR � e SALEM, MA 01970 TEL. 978-74 1-1800 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 TC UNIT#3 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER� 2� n?�� MANAGER/AGENT No P.O. Box —T No P.O. Box ADDRESS 2 692A /00IIF4) S�l ADDRESS CITY S20 )e UA `�601 f2 / ?!-b CITY RESIDENCE PHONE?79 SS BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1__ 2. C_--3. a4.� 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 SIGNATUR(/)// DATE INSPE RS USE ONLY DATE OF INITIAL INSPECTION 3h6 b, _DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: ;37/-y,6DATE FEE PAID: S'5'l— d_ TYPE OF UNIT: DWELLI�ko THER_ CHECK# (_ CHECK DATE NOTES: CODEENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH Illrrr��� 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 9qG TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 8/9/05 S.J. Saltzman 137 Front Street Marblehead, MA 01945 PROPERTY LOCATED AT 9 Boardman 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. F9Pjhe Board of Healt _ Reply to Joanne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector CERT.# 718-99 19 o- FEE -$25.00 DATE: 12/02/99 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: 11 Boardman Street UNIT #: 1 OWNER/AGENT: Marie BeauUre ADDRESS: 11 Boardman Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-8541 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��coNorrt��� '�'c6ynu6 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 Fax:(978)740-9705 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT I/ ,��� /�%y/U/Cl/� S UNIT# IS THIS UNIT DESIGNATED^ASRIIGHT LEFT RONT BACK PLEASE CIRCLE ONE OWNER/LESSER I Y &k, l& y-o� MANAGER/AGENT No P.O. Boz No P.O. Box ADDRESS ADDRESS CITY /n,4 CITY RESIDENCE PHONE q7k 1I V 85y1BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: 1J ROOM USE: 1. 2. 3. 4. 5. 6.-7.-8. THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE /& DATE Z INSPECTORS USE ONLY DATE OF INITIAL INSPECTION /,,;L -1- - f ( DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:/.2 ',I- f DATE FEE PAID: / 1 -' .2- ' jf 7 TYPE OF UNIT: DWELLING "/ OTHER CHECK# 3 3CHECK DATE NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 IMPORT T MESSAGE: '' 1 FO: A.M. DATE TIME P.M. M V 0 OF � PHONE AREA COOE NUMBER EXTENSION ❑ FAX D MOBILE AREA CODE NUMBER TIME TO CALL CAME TO SEE YGO WILL CALL AG.QIN �;'" VU11N75 t0 SEE 10U e =RUSH z, r REf1JRN®YOUR CALL£ `` _-. 1MLl FAlt TYJ .� z " •._ a ... .._.. _... .. _._:A . , .,... ME$SAGE no { c.1 v 'r n 'Edrnnn4 S,Frac r�kxxb�S� V VM 0 SIGNED ' t^ - Wbp FORM n6 P1626e r ar _ narn� �: _ I ►s1` ��-- ruCA4 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH :9 120 WASHINGTON STREET, 4TH FLOOR 'I so SALEM, MA 01970 N�Ae TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT January 14, 2004 MaryAnn Sullivan & Edmunds Graczyk 12 Tomahawk Lane Danvers, Ma. 01923 PROPERTY LOCATED 12 Boardman Street 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 1: General Administrative Procedures and 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.—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($20.00)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 tenants' 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 Reply to Joanne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector ��coxor,� �ciynygtr CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS,CHO _ NINE NORTH STREET HEALTH AGENT 07/30/99 Tel:(978)741-1800 Mary Ann Sullivan & Edmund Graczyk Fax:(978)740.9705 12 Tomahawk Lane Danvers, MA 01923 PROPERTY LOCATED AT 12 Boardman 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; 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. R THE BOARD _HE . REPLY TO oanne Scott, MPH,RS,CHO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR CONN, CERT.# 435-00 3 < s n FEE $25.00 DATE: 07/06/2000 q�PPofNa fA 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: 12 Boardman Street UNIT #: 3 OWNER/AGENT: John Sullivan ADDRESS: 12 Tomahawk Lane CITY/TOWN: Danvers, MA ZIP CODE: 01923 24 HOUR PHONE: 777-0809 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 • conmlr 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 Fax: (978)740-9705 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS/FOR HUMAN HABITATION". PROPERTY LOCATED AT / f15C0�1ZY�1YJ/1✓IO UNIT# IS THIS UNIT DESIGNATED ASiRIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS R/ ADDRESS CITY !1✓IrGr�) CITYQI�Z_3 RESIDENCE PHONE 272-0060��_BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. )?R�_2.6O�3. L K: 5. L' .-6. P 7. 8. .THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DE RTMENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE DATE OU INS E O S SE ONLY DATE OF INITIAL INSPECTION 7 ,r� —00 DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: DATE FEE PAID: TYPE OF UNIT: DWELLING /�OTHER_ CHECK# 72 i7 CHECK DATE� o NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 74 4 R CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH, RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 10/19/99 Fax:(978)740.9705 Mary Ann Sullivan & Edmund Graczyk 12 Tomahawk Lane Danvers, MA 01923 PROPERTY LOCATED AT 12 Boardman 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 i in accordance with 105 CNet; 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. ,APR THE BOARDY�H _ REPLY TO oanne Sco MPH,RS,CHO PABLOVALDEZ Health Agent CODE ENFORCEMENT INSPECTOR ND ,� City of Salem, Massachusetts On Board of Health 120 Washington Street, 4th Floor, Salem, P«vent.ProPubCgH6alProth MA 01970 Kimberley Driscoll Tel. (978) 741-1800 Fax. (978) 745-0343 Larry Ramdin, MPH, RENS,CHO Mayor health@salem.com Health Agent CERTIFICATE OF FITNESS CERTIFICATE M GHL-16-313 DATE ISSUED: 8/24/2016 Property Located at: 12.5 BOARDMAN STREET UNIT#1 Owner/Agent: Zoe Karademo Address: 7 112 Church Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone:(781) 405-7122 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. Note: This approval does not certify compliance with the state lead law for occupants under 6 years of age. &2 Jr Baros Y Larry Ramdin, MPH, REHS, CHO HEALTH AGENT SANITARIAN RECEIVED 08/11/2016 02:46PM 9767450343 Salem Health Dept From:CBRB SALEM 978 745 5706 08/11/2016 14!44 #188 P.001/001 CITY OF SALEM, N ASSACHUSETFS BonRD OF I IUAla'H 120 WAS]IING ON Srar_el, 4°`FLooiz T1-t- (978)741-1800 KINMIiRLEY DR1SC01:1., FAN (978)745-0343 b'IAYOR LxAMI)INA.SAtfin/Con, LARIO RAMDIN,RS/totl5,Clio,('P-PS I-lrncrtl;�cr.n r 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 j 7_ Z �;G c�V1 4 t t UNIT# IST UNIT DISIGNATED AS RIGHT LEFT FRONT OR BACK,PLEASE CIRCLE ONE OWNER/LESSER )rcoggt- C V—if MANAGER/AGENT Z ��(✓L(�V1111 NO P.O.BOX ADDRESS ADllRESS, vt GPiI�r CITY,STATE,ZIP CITY,STATE,ZIP 1 �� �hV RESIDENCE PHONE BUSINESS PHONE(24HRS) !" ' 'it, n VA- BUSINESS S BUSINESS PHONE TOTAL NUMBER OF ROOMS: pp ROOMUSE: L)Ny!� 2. t>I1Nh 3. C1 ` 4. V2J.L 5. De.� 6. 7. 1� 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 1 A AT THE TIME OF INSPECTION APPLICANT'S SIGNATURE DATE I Inspectors use only Date on initial inspection: 2-Wt Date of reinspection: Date of issuance of certificate: // Date fee paid:.� �. 2D�. Type of unit: Dwelling Other Check# b Check date: Notes: LIn � w ac e— Co#yllcernent Ir for CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH a e 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS CERTIFICATE# 150-05 DATE ISSUED: 3/2/05 Property Located at: 14 Boardman Street UNIT# 1 Owner/Agent: Juliana P. LeBalle Address: 14 Boardman 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 �!I JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH • • 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 UNIT#� IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSEREMANAGER/AGENT No P.O. Bo�c'I (� No P.O. Box ADDRESS 1IN, 1J�)Oi�PY kn ADDRESS y� , CITY �)A l 1 rrII CITY I I bl RESIDENCE PHONE "�7 BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: Z ROOM USE: 1. E 5. 6. 7. & 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. r APPLICANTS SIGNATURE � DATE -LI 95- - __4- - 4 INSPOSE ONLY DATE OF INITIAL INSPECTION__. . -0 DATE OF REINSPECTION____ _ DATE OF ISSUANCE OF CERTIFICATE �_'�- g 'DATE FEE PAID:._ TYPE OF UNIT DWELLING OTHER CHECK a CHECK DATE Z NOTES %(\ CODE ENFORCEMENT INSPECTOR 9 2tr 98 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH e 120 WASHINGTON STREET, 4TH FLOOR SALEM, MA 01 970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. LISOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT 2/10/05 Juliana P. LeBalle 14 Boardman Street Salem, MA 01970 PROPERTY LOCATED AT 14 Boardman 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 cases in which cross-metering has been proven to exist. ,�or the Board of Health Reply to /Joanne> MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector CERT.# 318-98 FEE $25.00 DATE: 05/22/98 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: 18 Boardman Street UNIT #: 1 OWNER/AGENT: Allison & Moe Kelley ADDRESS: 313 Ivey Park Lane CITY/TOWN: Norcross, GA ZIP CODE: 30092 24 HOUR PHONE: 740-8853 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 DOFF HEALTH L&V ��"/ " JOANNE SCOTT, MPH,RS,CHO 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 Tei:(978)741-1800 APPLICATION FOR CERTIFICATE OF FITNESS Fax:(978)740-9705 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT 19 40G/c�t4)//h f �R�f 77 UNIT# IS THIS UNIT DESIGNATED ASIR GHT LEFT R T BACK PLEASE CCIIR�CL�E ONE s� f���✓ OWNER/LESSER c Ui B MANAGERIAGENT ADDRESS .313 �-✓ey ISG/� �':l! G ADDRESS 67) l ,kz_s 11IJ CITY iIh✓ErUs5 b1 6012 clTYS , (Iu,M 1 0,1 �-/A U(f Z RESIDENCE PHONE '7104(11- ��S B c('/1 S PHONE (24 HRS.) q7�- 116'r 3 'S BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. k14(,t• 2. & d 3. hel<) 4. L I' 5. 61;1 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 % %/-Av DATE S �' INSPECTORS I E ONLY DATE OF INITIAL INSPECTION DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATES-14-z FPDATE FEE PAID: TYPE OF UNIT: DWELLING_OTHER NOTES: CODE ENFORCEMENT INSPECTOR 5/19/98 ry 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: 04/07/98 Fax:(978)740-9705 Maurice & Allison Kelley 18 Boardman Street Salem, MA 01970 PROPERTY LOCATED AT 18 Boardman 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 Joanne Scott, MPH, RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR April. 111 1997 City of Salem Board Of Health We do not own the property at 18 Boardman St, Salem, Ma any longer. Property was sold. �¢ lI Jozef & Barbara Mroz APR 16 1997 Mrs. Barbara C. Mroz U fw u,:, 1 :-AL . x. 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: 04/03/97 Fax:(508)740-9705 Jozef & Barbara Mroz 18 Boardman Street Salem, MA 01970 PROPERTY LOCATED AT 18 Boardman 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 O�� REPLY TO Joanne Scott, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR gy � 3 CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT Tel:(978)741-1800 Fax: (978)740-9705 05/23/2001 Allison & Maurice Kelley 2659-G Barracks Road Charlottesville VA 22901 PROPERTY LOCATED AT 18 Boardman 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; 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. R THE BOARD OF HEALTH REPLY TO anne Sco , H,R HO PABLO VALDEZ Health Agent CODE ENFORCEMENT INSPECTOR r CERT.# 317-98 3 - FEE $25.00 DATE: 05/22/98 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: 18 Boardman Street UNIT. # : 2 OWNER/AGENT: Allison & Moe Kelley ADDRESS: 313 Ivey Park Lane CITY/TOWN: Norcross, GA ZIP CODE: 30092 24 HOUR PHONE: 740-8853 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 I A JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR y 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 APPLICATION FOR CERTIFICATE OF FITNESS Fax:(978)740-9705 IN ACCORDANCE WITH STATE SANITARY CODE, CHAPTER II, 105 CMR 410.000 "MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION". PROPERTY LOCATED AT /ii` ; �ORlrG�`n a,,, S-/ UNIT#- 2 IS THIS UNIT DESIGNATED ASIR GHT LEFT FRONT BACK PLEASE CIRCLE ONE � v OWNER/LESSER 4j//i!,4/MANAGER/AGENT' �'� ADDRESS /3 �✓u �✓I�, /l ADDRESS ✓07 c �tsS Gr f "f CITY A/c✓ hiss CITY RESIDENCE PHONE?26 qq BUSWESS'PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: -� ROOM USE: 1. 2. 4. L! 5. d, 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 ./ Cy APPLICANTS SIGNATURE / DATE / INSPEfCTORS USE ONLY DATE OF INITIAL INSPECTION�_,-?Z — g�F DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATES-a';?-/VATE FEE PAID: TYPE OF UNIT: DWELLING OTHER NOTES: CODE ENFORCEMENT INSPECTOR 5/19/98 Anri.l 11, 1997 At? of Salem Poard Of Health We do not own the property at 18 P,oardman St, Salem, Ma any longer. Property was sold, KIX Sozef & Parbara Mroz Mrs. P.arbara C. Mroz ' 3 f�' SIF 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: 04/03/97 Fax:(508)740-9705 Jozef & Barbara Mroz 19 Boardman Street Salem, MA 01970 PROPERTY LOCATED AT 18 Boardman Street UNIT # 2 Dear Sir/Madam: It has come to our attention, that you may be considering renting a dwelling unit at the above address. - It is incumbent upon you as owner(s) to contact the City of Salem Health Department to apply for a CERTIFICATE OF FITNESS before any vacant dwelling unit is rented or occupied, or to notify us of your intent for this unit. Each dwelling unit must be inspected and certified by the Salem Health Department prior to allowing occupancy in accordance with Chapter 111, Sections 127A and 127B, of the. Massachusetts General Laws, 105 CMR 400.:00;: State,.Sanitary-Code, Chapter 1: General Admini.strative;,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 Sal-em 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 H ALT, REPLY TO. -Joanne..Scott;,^MPH RS,CHO ,-.,: , , PABLO VAL.DEZ T ..:,HEALTH,AGENT-; issi..=1 �"i -.- • CODE ENFORCEMENT-INSPECTOR - f oftiCITY- OF-SALEMo. MASSACHUSETTS BOARD OF HEALTH 1.20 WASHINGTON STREET, 4TH-FLOOR SALEM-,-MA 01970 TEL..978,74:1-1800. FAX 978-745-0343 STANLEY J. USOVICZ; JR. JOANNE--SCOTT,-MPH,-IRS, CHO MAYOR HEALTHAGENT 4/21/05 Stephen DePaulo 25 Boardman Street Salem, MA 01970 PROPERTY LOCATED AT 25 Boardman Street htnit 1 Dear Sir/Madam: It hascometo our attention,that-you may be considering-rentinga 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 Fitnessfor-Human-Habitation. Please notify us if you do not intend tor the,unit. Please contact this departmentwithin24-hours-of receiptof this notice at978-741-1800,toschedule-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 am.-1200 p.m. Failure to comply with this procedure,may resultin afine of Twenty�$20.00)_dollars-per day for every day that the dwelling-unit is occupied withouta Certificate of fitness. A$25,00 check payable totheCity 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 written letting agreement stating the tenant is.responsiblefor those utilities and if the meter(s)records electricity and gas use which isnot used exclusively by that tenant The:Departmentof Public Utilities has billed property owners for their tenantsentire-utflity bills-retroactive to the date of initial occupancy in cases in which cross-metering has been proven to exist. For of alth Reply to Joanne-Scoff MPH, RS,CHO Pablo Valdez Health Agent Code Enforcement inspector r e CERT.# 130-01 C _ FEE $25.00 DATE: 03/15/2001 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: 25 Boardman Street UNIT #: 1 OWNER/AGENT: Stephen DePaulo -= ADDRESS: 25 Boardman Street 1 CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-6876 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" . I 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 I - 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 conmrr 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 � S 50Aa014j4& .57— UNIT# 1 IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT ACK PLEASE CIRCLE ONE OWNER/LESSER Srer�tiPx, 0.Op'0Ir MANAGER/AGENT No P.O. Box No P.O. Box ADDRESS S— Scllq L®/L1!9& T7 ADDRESS CITY 4" CITY RESIDENCE PHONE BUSINESS PHONE (24 HRS.) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 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 DEPAR ENT THIS FEE IS PAYABLE AT THE TIME OF INSPECTION. APPLICANTS SIGNATURE DATE 3 S 1 INSPECTORS USE ONLY DATE OF INITIAL INSPECTION 5 -( S 'OI DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE. 4 S ti DATE FEE PAID: TYPE OF UNIT: DWELLINrTHER_ CHECK# a , a- CHECK DATE,3�' '-Lr_E-'_'j NOTES: CODE ENFORCEMENT INSPECTOR 9/28/98 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 4. 9? 120 WASHINGTON STREET, 4TH FLOOR ffi SALEM, MA 01970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY J. USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT June 11, 2003 Christee Snell 26 Boardman Street Salem, MA 01970 PROPERTY LOCATED 26 Boardman Street Unit# 1 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 1: General Administrative Procedures and 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. —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 ($20.00)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 tenants'entire utility bills retroactive to the date of initial occupancy in cases in which cross-metering has been proven to exist. For of Fi� Reply to Joanne Scott MPH, RS, CHO Pablo Valdez Health Agent Code Enforcement Inspector f , CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH, RS,CHO NINE NORTH STREET HEALTH AGENT 02/07/2000 Tel:(978)741-1800 Fax:(978)740-9705 Christee Snell 26 Boardman Street Salem, MA 01970 PROPERTY LOCATED AT 26 Boardman 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 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. OBOARD 0 HEALTH REPLY T0. Joanne Scott, MPH,RS,CHO PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR CERT.# 42-98 3 ' FEE $25.00 R 1�. . �F 4 DATE: 01/27/98 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: 26 Boardman Street UNIT #: 2 OWNER/AGENT: Christee Snell & Pam Franco ADDRESS: 28 Boardman Street CITY/TOWN: Salem, MA ZIP CODE: 01970 24 HOUR PHONE: 745-1019 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 BOA/RD OF HEALTH aA L&Y JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR r a t}��p CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT,MPH,AS,CHO NINE NORTH STREET HEALTH AGENT Tei:(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 LOCATEDAT 1 Zb 30ctrc/n,,-.1 S-1-, UNIT # 2- OWNER/LESSER CArIST2k' �nQ,l l/ �an� �ranGo MANAGER%AGENT p [dy22I ADDRESS 2k ADDRESS Zg gog rpt mac✓` CITY �?w�ewi CITY lerv, RESIDENCE PHONE BUSINESS PHONE (24 ERS,) '9YS'-1D/q j BUSINESS PHONE 7 J S 1019 TOTAL NUMBER OF ROOMS:— 41 _ ROOM USE: 1 . bylnj P_m 2. Pjnin3 F—,vi ,4c,i�_4. Bp�ryD,� 5. ) 6. 1. 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 TIM OF INSPECTION APPLICANTS SIGNATURE � GAG 12 Y it DATE4&271q g --- INSPECTORS —YINSPECTORS USSE ONLY DATE OF INITIAL INSPECTION: p DATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE:_Z,-)� 7 DATE FEE PAID: f / TYPE OF UNIT, DWELLING OTHER_ NOTES: CODE ENFORCEMENT INSPECTOR co T CITY OF SALEM, MASSACHUSETTS vg BOARD OF HEALTH 3 120 WASHINGTON STREET, 4TH FLOOR 2 S CERT.# 219-02 e SALEM, MA 01970 FEE $25.00 TEL. 978-741-1800 �p�'nrr8 DATE: 04/25/2002 FAx 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, R5, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 33 Boardman Street UNIT #: 1 OWNER/AGENT: Tanin Sasaluxanon ADDRESS: P.O. Box 3919 CITY/TOWN: Peabody, MA ZIP CODE: 01961 24 HOUR PHONE: 531-3725 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 CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH r 120 WASHINGTON STREET, 4TH FLOOR SALEM,'MA 01 970 TEL. 978-741-1800 FAX 978-745-0343 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT j 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 \t` Gti S UNIT IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LES SER '�AN 10 5PIejStLt')':VANAGER)AGENT No P.O. Box . NO P.O.Box ADDRESS PO ��kADDRESS CITY P GA 4>s 9 cITY Nt \ b o RESIDENCE PHONES 1 ` �.� f BUSINESS.PHONE (24 HRS.) BUSINESS PHONE' ' .; - F TOTAL NUMBER OF ROOMS. 'x r r u. ( 3 3 t ROOM USE to 2 , 1-<.. 3 . 4 i i 5. {. 6: 7.y 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 `j TIME OF INSPECTION. F` p APPLICANTS SIGNATURE DATE INSPECTORS USE ONLY DATE OF INITIAL INSPECTION L DATE OF REINSPECTION iISSUANCE OF C% �#i . � DATE OF ERTIFICATE:( ;��'`- ' DATE FEE PAID: 4 TYPE OFUNIT: .DWELLING X OTHER ` ' CHECK 14 CHECK DATE -e ' O'�1 I NOTES: CODE ENFORCEMENT INSPECTOR 1 I°" 9/28/98.` , t �� oxwr CITY OF SALEM, MASSACHUSETTS �. BOARD OF HEALTH u 120 WASHINGTON STREET, 4TH FLOOR Y - SALEM, MA 01970 CERT.# 220-02 TEL. 978-741-1800 FEE $25.00 9e� FAx 978-745-0343 DATE: 04/25/2002 STANLEY USOVICZ, JR. JOANNE SCOTT, MPH, RS, CHO MAYOR HEALTH AGENT CERTIFICATE OF FITNESS PROPERTY LOCATED AT: 33 Boardman Street UNIT #: 2 OWNER/AGENT: Tanin Sasaluxanon ADDRESS: P.O. Box 3919 CITY/TOWN: Peabody, MA ZIP CODE: 01960 24 HOUR PHONE: 531-3725 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/T�{HSE BOARD OF HEALTH 01 JOANNE SCOTT, MPH,RS,CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR I - - CITY OF SALEM, MASSACHUSETTS r t BOARD OF HEALTH. 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 pHUMAN HABITATION". PROPERTY LOCATED AT 3 roti . UNIT# IS THIS UNIT DESIGNATED AS RIGHT LEFT FRONT BACK PLEASE CIRCLE ONE OWNER/LESSER r """p' S�S'p�LUr-('\ M NAGER/AGENT No P.O. Box No P.O. Box ADDRESS �o �° � � � ADDRESS � �`,t` CIN cR "' ti �`. CITY RESIDENCE PHONE BUSINESS PHONE (24 HRS.) BUSINESS PHONE - r: TOTAL NUMBER OF ROOMS: ROOM USE: 1. 2. 5 THERE IS A TWENTY-FIVE($25.00) DOLLAR FEE, PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM HEALTH DEPARTMENT THIS FEE IS PAYABLE AT THE sl TIME OF INSPECTION. APPLICANTS SIGNATURE DATE a INSPECTORS USE ONLY e DATE OF INITIAL INSPECTIONDATE OF REINSPECTION DATE OF ISSUANCE OF CERTIFICATE: DATE FEE PAID: TYPE OF UNIT:" DWELLINGA"--OTHER_ CHECK# /G fia CHECK DATE°C .I NOTES: T�� r:. z .CODE ENFORCEMENT INSPECTOR 9/28/98 > 1 .; E :�' m � � CITY OF SALEM BOARD OF HEALTH Salem, Massachusetts 01970-3928 JOANNE SCOTT, MPH,RS,CHO NINE NORTH STREET HEALTH AGENT Tel:(978)741-1800 03/02/2001 Fax: (978)740-9705 Steven & Magdalena Fabiszewski 35BoardmanStreet Salem, MA 01970 PROPERTY LOCATED AT 35 Boardman Street UNIT # 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 BOARD QF HEALTH - REPLY TO Joanne Scott, MPH,RS,CHO - PABLO VALDEZ HEALTH AGENT CODE ENFORCEMENT INSPECTOR ii 11 • CITY OF SALEM, MASSACHUSETTS BOARD OF HEAL:rH 120 WASutNGTON STREF-r,4"'FLOOR TEL. (978)741-1800 KIMBERLEY DRISCOLL PAR(978) 745-0343 MAYOR Isco rrr� �a la M.COM JOANNE SCOL r, HEALTH A GENT CERTIFICATE OF FITNESS CERTIFICATE#316-08 DATE ISSUED:7/15/2008 Property Located at: 39 Boardman Street UNIT#1 Owner/Agent: Marie Kauczynski Address: 21 Shore Avenue 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 Ifthere is a valid Certificate of Occupancy. FO THE BOARD OF JiEALTH F JOANNE SCOTT, MPH, RS, CHO f _ HEALTH AGENT CODE ENO CEMENT INSPECTOR • CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4".FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR ISCOTr e SA1A.A.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." FES$ 0 PROPERTY LACATED AT 39deZUiJ9 1ffA% ,&, UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT OR BAC PLEASE CIRCLE ONE OWNER/LESSER MANAGER/AGENT NO P.O. BOX ADDRESS 0A ADDRESS CITY,STATE,ZIP ZAhg, �270CITY,STATE,ZrP RESIDENCE PHONE�7 0 JS T �BUSINESS PHONE (24HRS) BUSINESS PHONE TOTAL NUMBER OF ROOMS: ROOM USE: 1. K,a6-ti t-:�V2. 54 0'W-/;7 3. lh Nrs ry4. P ' Q Cr 5. 6 M'C- C 6. 7. 8. 9. 10. THERE IS A LAR FEE,PAYABLE BY CHECK OR MONEY ORDER TO THE CITY OF SALEM BOARD OF HEALTH T�HIS FEE IS PAYABLE AT THE TIME OF INSPECTION APPLICANTS SIGNATURE //(�4l✓ ¢T� DATE Inspectors use on1X Date on initial inspection: 1- 1 S' O y Date of reinspection: Date of issuance of certificate: -1- )!3 -Or Date fee paid: 1-)S -( Type of unit: Dwelling Other Check#J-J' L 1 toS Check date: 7)) b' Notes: Su0 Code Enforcement Inspector 3 CITY OF SALEM MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4`FLOOR TEL. (978) 741-1800 KINMERLEY DRISCOLL FAX(978) 745-0343 MAYOR ISCOI'I: SAI LM.COM JOANNE SCOTT, HEALTH AGENT Release In accordance with Massachusetts General Laws Chapter-111; Code of Massachusetts Regulations 410.000 et. Seq. ; State Sanitary Code Chapter II and Article XIII of the City of Salem Ordinance, undersigned owner/lessor and tenant/lessee of a unit of residential property, hereby authorize the Salem Board of Health or its authorized agents to inspect the residence identified below in accordance with the aforementioned statutes,regulations and ordinances. In the event it is necessary that said inspection be done in my/out absence. I/we expressly authorized the same and for my/our successors and assigns hereby release and discharge the City of Salem, Salem Board of Health and its authorized agents from any lose or injury sustained of whatever nature and description occasioned by my/out absence during said inspection. Tenant/Lessee Owner/Lessor Address Address Address on unit to be inspected Date Inspection of 3S P>C14Q7 Yv,Q,3 Date _(3�r Time Name Address Owner Tel. No. Type of Inspection_ C 1— 1 Inspector 1) _ GEN Z ( ' I Remarks and Violations are listed below: 1S Yr 0mr-� ;L -N M(aC��n Report Received by: Inspection of 3r1 i�cTa27 ry,t> J ST Date 1 -�1 _0�( Time I ' ) 1 Atv- St Name Address Owner Tel. No. Type of Inspection_�, 1- 1 Inspector I) CN Z\:L t-l-,%Gl �M ( ' 1 Remarks and Violations are listed below: rj1 ? IG i C. ;.rte I S Y- S S s t-•I Ln f} SLI lJ 1� .fi -TI H7 J' I i aJ(,1 OQ�cJ Y' t] _3—) ny__�,� oc� I rC or��•l. l n `'�� 2�i�P2- -^„V'1 '/t�lr•E7t-,C',t� SC,�.\Vhll 1 N �''l \, f ��G�� i Report Received by: �'/ ` n'a_ ' I CITY OF SALEM, MASSACHUSETTS BOARD OF HEALTH 120 WASHINGTON STREET,4:"FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLJ FAx(978) 745-0343 MAYOR MANCINI(l173ALFINLCOM JAN F f'MANCIN I AC'T'ING HI ALII-I AGI3N"f CERTIFICATE OF FITNESS CERTIFICATE#85-09 DATE ISSUED: 2/12/2009 Property Located at: 39 Boardman Street UNIT#2 P Owner/Agent: Edward Kawzynski Address: 21 Shore Avenue 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 t 4NET MAN TNI Clll ETMANCINI ACTING HEALTH AGENT CODE ENFORCEMENT INSPECTOR CITY OF SALEM, MASSACHUSETTS + • BOARD OF HEALTH 120 WASI'IINGTON STREET,4ui FLOOR TEL. (978) 741-1800 KIMBERLEY DRISCOLL FAX(978) 745-0343 MAYOR ]DIUNNE aisALEM.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 h1 Fit PROPERTY LOCATED AT �� (�nAl2Ij.��,_, �' CF!( —w, � ch 1 q� D UNIT# IS THIS UNIT DISIGNATED AS RIGHT LEFT FRONT R BACK,PLEASE CIRCLE ONE OWNER/LESSER Eb KAY✓G? P)Skj^ MANAGER/AGENT NO P.O. BOX ADDRESS � ADDRESS CITY, STATE,ZIP_ �'fl L t—hn /VA 191170 CITY, STATE, ZIP RESIDENCE PHONE/-y Y 7�/S-5 �/ BUSnIF,SS PHONE(24HRS)Sfl.-r t BUSINESS PHONE .SAmE TOTAL NUMBER OF ROOMS: �o ROOM USE: 1.13AIAAW 61 2. k i`h 9t) 3. De--V 4. 6.da6bXMi 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 g(��}�',tT(t.(.GQ kAW at.�jb.(4 L,1i_ DATE GEaL4f Insuectors use only Date on initial inspection: ,Z--1-L- d �' Date of reinspection: Date of issuance of certificate: Z 1'L -o Date fee paid: 1- )1- 09 Type of unit: Dwelling ✓ Other Check# 6 Check date: 2 12- o Notes: Code Enforcem t Insp r I CITY OF SALEM, MASSACHUSETTS � _ • BOARD OF HEALTH 120 WASHINGTON STREET,4`FLOOR TEL. (978) 741-1800 KIMI3ERLEY DRISCOLL FAx(978) 745-0343 MAYOR IDIONNBna SALFM.COM JANET DIONNE, ACTING HEALTH AGENT Release In accordance with Massachusetts General Laws Chapter 111; Code of Massachusetts Regulations 410.000 et. Seq. ; State Sanitary Code Chapter II and Article XIII of the City of Salem Ordinance, undersigned owner/lessor and tenant/lessee of a unit of residential property, hereby authorize the Salem Board of Health or its authorized agents to inspect the residence identified below in accordance with the aforementioned statutes, regulations and ordinances. In the event it is necessary that said inspection be done in my/out absence. I/we expressly authorized the same and for my/our successors and assigns hereby release and discharge the Cit of Salem Salem Board of Health and its Y authorized agents from any lose or injury sustained of whatever nature and description occasioned by my/out absence during said 'inspection. Tenant/ s Owner/Lessor 3q aQPW-bMA,) ST 21 SGFl.e_ &ke 01R7o Address sALZ't+1MA• 01470 Address 3y BnftiarnAlu sT SJtCr✓ , pA,4 . A fT � (2,xd Fes) Address on unit to be inspected Date CITY OF SALEM, MASSACHUSETTS HEALTH AGENT 9t 120 WASHINGTON STREET, 4TH FLOOR ffiffi 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#368-07 DATE ISSUED: 8/7/2007 Property Located at: 40 Boardman Street UNIT# 1 Owner/Agent: Ge orge Charos Address: 40 Boardman Street City/Town: Salem, MA Zip Code: 01970 24 Hour Phone: An inspection of your vacant Dwelling/Roaming 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 1THE BOARD OF HEALTH F JOANNE SCOTT, MPH, RS, CHO HEALTH AGENT CODE ENFORCEMENT INSPECTOR Ak 1 i i ,__ . _--,''� ---J'f ,� ----`' 1---, .-----�� .-� :---p � ` �-- ,�----- �----- _---�`'` _-----' _---" ..--