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2. Please complete the application below to request a Rental Unit Inspection. Incomplete applications will not be accepted. If you have any questions, please call (781) 397-7049 for assistance. Upon receipt of a completed application, the Health & Human Services clerk will contact you to schedule your inspection. Inspections are performed on Tuesdays and Thursdays. 

4. Application for Rental Unit Inspection

   In accordance with 9.16.020 of the Revised City Ordinances and Section 9, Dwellings, Malden Board of Health Rules and Regulations. 

6. Address of Dwelling Unit*
7. Unit or Floor Number*
8. City*
12. Owner/Company/Trust Name*
13. Phone Number*
15. Trustee/Owners Full Name*
16. Phone Number*
18. Email*
20. Address*
22. City*
23. State*
24. Zip Code*
28. Mailing Address must be provided if different (P.O. Boxes will not be accepted)
30. Address
32. City
33. State
34. Zip Code

36. I understand that I must comply with the Board of Health regulations and the State Sanitary Code, Chapter II, Minimum Standards of Fitness for Human Habitation, 105 CMR 410.000 any all other applicable, federal, state or local regulation, ordinance or by-law and that the issuance of this Certificate in no way releases the applicant from the obligation to obtain any other permits or licenses required by any local, state or federal regulatory authority. 

    I certify under the penalties of perjury that I, to the best of my knowledge and belief that the foregoing information contained in this application is true and correct.

38. Signature*
39. Date*
    Date
Leave This Blank:


41. 1. Receive an email copy of this form.
42. Email address

    This field is not part of the form submission.

43. Submit

* indicates a required field