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266 CANAL STREET, BUILDING 2 - WATER & SEWER SUBMETER CERTIFICATES MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2201 #Of units in bldg.65 City/Town: Salem MA zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. l William Lane ;L1141-1 8318 12/10/2025 �r c� Licensed Plumber's Name Plumber'Signature License# Date OWNER CERTIFICATION I certify that: (1) This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3) The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4) The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLPk44�� Pft&,_Representative 12/10/2025 Name of Owner Si nature of Owner Date LJThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Depar11guC�EIVED Prior Owner's Signature Date DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II(the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2202 #Of units in bldg.65 Cil\/Town: Salem MA zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: NMT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. ❑ The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane �;.; /'f 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date _ OWNER CERTIFICATION I certify that: (1) This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)1 will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date submitted to Local Health 186§22- I'''� Depart CEIVED Prior Owner's Signature Date C DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitari Code, Chapter II the"Housing Code" ),the following,dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2203 #Of units in bld,.65 City/Town: Salem MA zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ✓❑I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. ❑ The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, § 22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L C. Date Submitted to Local Health 186§22- Departgl: D Prior Owner's Signature Date tC E I V E DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Cha;ter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2204 #Of units in bldg.65 City/Town: Salem MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION 1 certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane /�` 8318 12/10/2025 Licensed Plumber's Name Plumber'Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLPN`Representative 12/10/2025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L C. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date BECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II(the"Housing:Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2205 #Of units in bld .60 City/Town: Salem MA zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: NMT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane _ ;; : �/ 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)1 will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING cl iR^^CTMING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Si ature of Owner Date LlThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- V DepattOEI` ED Prior Owner's Signature Date DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM- BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code"),the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2206 #Of units in bldg.65 City/Tow_ n: Salem MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: NMT VerSaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter William Lane �� /,,� 8318 12/10/2025 t Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTVENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 1 211 0/2 02 5 Name of Owner Signature of Owner Date The pro has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date SUbmltted t0 Local Health perty 186§22_ Department:CEIVED Prior Owner's Signature Date DEC 1.0 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2207 #Of units in bldg.65 Citv/Town: Salem MA Zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: NMT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L .c. 186,§22(p),does not require the installation of a submeter. William Lane 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPART ENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin K4� Owner's The Residences on Canal Street,LLP � �Representative 1 211 0/2 02 5 Name of Owner Si_gnature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- DeparfWCEIVED Prior Owner's Signature Date DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitarj,Code, Chapter II(the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2208 #Of units in bldg.65 City/Town: Salem NLA, Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ 1 have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane 8318 12/10/2025 - Licensed Plumber's Name Plumber' Signature License# Date_ OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin AWOwner's The Residences on Canal Street,LLP -Representative 12/10/2025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALE&4 BOARDOFHEAL H MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II(the"Housing Code"),the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2209 #Of units in bldg.65 Citv/Town: Salem MA Zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186, §22(p),does not require the installation of a submeter. William Lane „';:'; r 8318 12/10/2025 Licensed Plumber's Name Plumber' Si,-,nature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL H ALTH DEPART ENT PRIOR TO INITIATING SUBMFTFRING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP N`Representative 12/1012025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Depar E I VED Prior Owner's Signature Date DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanita Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2210 #Of units in bl&...65 City/Town: Salem MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION 7�ify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane /y ,j 8318 12/10/2025 �. - --T—r Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP4&V.— Representative 1 211 0/2 02 5 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Depart R�C E I V E D Prior Owner's Signature Date DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2211 #Of units in bldg.65 City/Town: Salem MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VerSaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane ��st, 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and. complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMFTERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLPYVL�� Pva i�Representative 12/10/2025 Name of Owner Si nature of Owner Date LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§zz- DepartREC E I V E D Prior Owner's Signature Date "' DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is elipjble for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2212 #Of units in bl&.65 City/Town: Salem MA zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane y, 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPART ENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP &tK � _Representative 1211012025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2213 #Of units in bldg.65 City/Town: Salem MA zi code: 01970 i EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane i' 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)1 will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP i Representative 12/10/2025 Name of Owner Signature of Owner Date LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Departure-*.. Prior Owner's Signature Date RECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter H(the"Housing Code" ),the followin.' dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2214 #Of units in bldg.65 City/Town: Salem Mp, zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: NMT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane 1, 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Kwv�- �_Representative 1 211 0/2 02 5 Name of Owner Si nature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitai •Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2215 #Of units in bld_.65 City/Town: Salem MA zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane i_ 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPART ENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, _ Kristen Poulin Owner's The Residences on Canal Street,LLP � �Representative 12/10/2025 Name of Owner Signature of Owner Date LJThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Cha )ter H(.the"Housing Code" ),the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2216 #Of units in bldg.65 City/Town: Salem MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. 1-1 The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane 74 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, § 22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fatness for Human Habitation, State Sanitary Code, Cha.)ter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2217 #Of units in bldg.65 City/Town: Salem MA Zi code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. �. William Lane ; 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPART ENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP _Representative 12/10/2025 Name of Owner Signature of Owner Date LlThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local health 186§22- Department: Prior Owner's Signature Date DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2301 #Of units in bldg.65 City/Town: Salem MA zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. r; William Lane 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SURMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP kA— _Representative 12110/2025 Name of Owner Signature of Owner Date LlThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date PEGEIVED 410-23-Submetering of Water and Sewer Certification Form 5-12-23 DEC 10 2025 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2302 #Of units in bldg.65 City/Town: Salem MA Zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VerSaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ 1 have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. i William Lane ,!�/digs , _ «{� 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP iu�N`Representative 12/10/2025 Name of Owner Si ature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date submitted to Local Health 186§22- I Department: Prior Owner's Signature Date RECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitai ,Code, Cha Ater II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2303 #Of units in bldg.65 City/Town: Salem MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. ❑ The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane ,y/j� i�r�,, 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, § 22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin wit,I I fir Owner's The Residences on Canal Street,LLP n N`Representative 12/10/2025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's S ignature Date RECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code"),the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2304 #Of units in bld ,65 Citv/Town: Salem MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VerSaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane ' , 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPART ENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP ��N`Representative 12/10/2025 Name of Owner Signature of Owner Date LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Depa AStEIVED Prior Owner's Signature Date DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2305 #Of units in bldg.65 City/Town: Salem MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane ,f�/�� 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)1 will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Si ature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L C. Date Submitted to Local Health 186§22- DeparPFut E I V E D Prior Owner's Signature Date CC DEC 110 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitarj,Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2306 #Of units in bld ,65 City/Town: Salem MA Zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. / , , i William Lane ' - f 8318 12/10/2025 �r Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPART ENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP MAN`Representative 12/10/2025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ),the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2307 #Of units in bld ,65 City/Town: Salem MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane { 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RFECEIVED DEC 1.0 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2308 #Of units in bldg.65 City/Town: Salem MA Zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: NMT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane ,�� %' tf, 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP iu��Representative 12I10t2025 Name of Owner Signature of Owner Date LlThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitari Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2309 #Of units in bld,.' 65 City/Town: Salem MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. 1%T 12/10/2025 William Lane 8318,fy, �,��, �,�,,� Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's h I A.11-1L PM. The Residences on Canal Street,LLP Representative 12l1012025 Name of Owner Signature of Owner Date LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Departgs ECEIVED Prior Owner's Signature Date DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanita,- ,Code, Cha Ater II(the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2310 #Of units in bldg.65 City/Town: Salem MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: NMT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1) This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3) The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4) The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's h I A frk p The Residences on Canal Street,LLP du IN`Representative 12/10/2025 Name of Owner Signature of Owner Date LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II(the"Housing Code" ,the following dwelling unit is eligible for submeterinL' water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2311 #Of units in bldg.65 City/Town: Salem MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane 8318 12/10/2025 Licensed Plumber's Name Plumber' Si,-,nature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP pft'. Representative 12/10/2025 Name of Owner Signature of Owner Date LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature DateMINAM DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Cha.)ter II(the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2312 #Of units in bldg.65 Citv/Town: Salem MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: NMT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPART ENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Signature of Owner Date LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date submitted to Local Health 186§22- Department: Prior Owner's Signature Date PECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2313 #Of units in bldg.65 City/Town: Salem MA Zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: NMT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane �'� �'`,,.�'l _ , 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12110/2025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health ls6§22- Department: Prior Owner's Signature Date RECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2314 #Of units in bldg.65 City/Town: Salem MA zi code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. FV71 have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane ,�� ' ,--g 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP PftL0-"—Representative 12/10/2025 Name of Owner Signature of Owner Date LlThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2315 #Of units in bldg.65 City/Town: Salem MA zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186, §22(p),does not require the installation of a submeter. William Lane , .`r'i' 8318 12/10/2025 Licensed Plumber's Name Plumber' Si-gnature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3) The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, § 22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12t10/2025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2316 #Of units in bldg.65 City/Town: Salem MA zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane , , 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Signature of Owner Date LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2317 #Of units in bldg.65 City/Town: Salem MA zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VerSaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane ''` „ 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SURMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Signature of Owner Date LJThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health I86§22- Department: Prior Owner's Signature Date RECEIVED 410-23-Submetering of Water and Sewer Certification Form 5-12-23 DEC 10 2025 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code"),the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2401 #Of units in bldg.65 City/Town: Salem MA zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1) This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3) The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4) The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Si ature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date REeEiVED 410-23-Submetering of Water and Sewer Certification Form 5-12-23 DEC 10 2025 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2402 #Of units in bldg.65 City/Town: Salem MA zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: NMT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane °�/�� 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1) This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All Showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3) The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4) The water meter or submeter measures the water usage exclusive to this unit. (5) I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date 410-23-Submetering of Water and Sewer Certification Form 5-12-23 DEC 10 2025 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II(the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2403 #Of units in bld ,65 City/Town: Salem MA zip code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. ❑ The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. "/ William Lane ` 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 1 211 0/2 0 2 5 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RECEIVED 410-23-Submetering of Water and Sewer Certification Form 5-12-23 DEC 10 2025 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2404 #Of units in bldg.65 City/Town: Salem MA zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): F7I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. W1I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane , -' 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Si nature of Owner Date LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department. Prior Owner's Signature Date RECEIVED 410-23-Submetering of Water and Sewer Certification Form 5-12-23 DEC 10 2025 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II(the"Housing Code"),the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2405 #Of units in bldg.65 City/Town: Salem MA Zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION 1 certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. WIT have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane �,iea 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)1 will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMFTERING Signed under the pains and penalties of perjury, Kristen Poulin kAn= Owner's The Residences on Canal Street,LLP ft —Representative 12/10/2025 Name of Owner Signature of Owner Date :hroperty has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Healthls6§ Department: Prior Owner's Signature Date RECEIVED 410-23-Submetering of Water and Sewer Certification Form 5-12-23 DEC 10 2025 CITY OF SALEMI BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the "Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address. 266 Canal Street (Building 2) Unit# 2406 #Of units in bldg.65 Ci: /Town: Salem MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L .c. 186,§22(p),does not require the installation of a submeter. . . William Lane / / 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)1 will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP _Representative 1 211 012 02 5 Name of Owner Si ature of Owner Date LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RECEIVED 410-23-Submetering of Water and Sewer Certification Form 5-12-23 DEC 10 2025 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Cha)ter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address- 266 Canal Street (Building 2) Unit# 2407 #Of units in bldg.65 City/Town: Salem MA Zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186, §22(p),does not require the installation of a submeter. William Lane ,i' / 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date _ _ OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, § 22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The-Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Siunature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L TDepartment: ate Submitted to Local Health ls6§zz- Prior Owner's Signature DateRECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HE r.i TH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2408 #Of units in bid ,65 City/Town: Salem MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town, if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186, §22(p),does not require the installation of a submeter. r, William Lane 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 1211012025 Name of Owner Signature of Owner Date LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter H(the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2409 #Of units in bldg.65 Citv/Town: Salem MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: NMT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ✓❑ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ 1 have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town, if required,is attached. ,This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane ; ' 8318 12/10/2025 Licensed Plumber's Name Plumber' Sicnature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 1211=025 Name of Owner Si nature of Owner Date LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date I RECEIVED 410-23-Submetering of Water and Sewer Certification Form 5-12-23 DEC 10 2025 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2410 #Of units in bldg.65 City/Town: Salem MA Zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane ��',%� 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's h I A pm. 1. The Residences on Canal Street,LLP _. Representative 12/10/2025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: \/ (� Prior Owner's Signature Date — F—I a . . — ` DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitai •Code, Cha)ter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2411 #Of units in bldg.65 City/Town: Salem MA Zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: NMT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. �✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane ' ;� ,,. , 8318 12/10/2025 Licensed Plumber's Name Plumber'Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP �'(��Representative 12/10/2025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date 410-23-Submetering of Water and Sewer Certification Form 5-12-23 DEC 10 2025 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Cha;ter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2412 #Of units in bldg.65 City/Town: Salem MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ 1 have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1) This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3) The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4) The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL H TH DEPART T PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties ofperjury, Kristen Poulin g p p owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Signature of Owner Date LlThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2413 #Of units in bldg.65 City/Town: Salem_ MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 111 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1) This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3) The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4) The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING CI IRnnPTI:RING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 1 2/1 012 0 2 5 Name of Owner Si ature of Owner Date LlThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RECEIVED 410-23-Submetering of Water and Sewer Certification Form 5-12-23 DEC 10 2025 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Cha)ter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2414 #Of units in bldg.65 City/Town: Salem MA zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: NMT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached, This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane i1 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2026 Name of Owner Si ature of Owner Date The properly has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RELEIVEn DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II(the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2415 #Of units in bldg.65 City/Town: Salem MA zi code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT _ VerSaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ✓❑ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane % � 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPART ENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP � ��Representative 12/10/2025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date BECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2416 #Of units in bldg.65 City/Town: Salem MA Zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: NMT _ VerSaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. ❑ The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane f / 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, § 22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)1 will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanita, •Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2417 #Of units in bid: 65 City/Town: Salem MA zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VerSaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ITI have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. ❑ The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186, §22(p),does not require the installation of a submeter. William Lane , 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Po�—Representative 12/10/2025 Name of Owner Signature of Owner Date LlThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L C. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2501 #Of units in bldg.65 City/Town: Salem MA zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. 1-1 The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L .c. 186,§22(p),does not require the installation of a submeter. %di William Lane / 8318 12/10/2025 .-6 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Si ature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§zz- Department: Prior Owner s Signature DateRECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2502 #Of units in bldg.65 City/Town: Salem MA Zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VerSaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ 1 have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane /� � �astir 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Si ature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of AG.L c. Date Submitted to Local Health ls6§z2- Department:Prior Owner's Signature Date l RECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submeterint;water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2503 #Of units in bldg.65 City/Town: Salem MA Zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VerSaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required, is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. , William Lane 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, § 22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)1 will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Signature of Owner Date LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2504 #Of units in bldg.65 City/Town: Salem MA zi code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: NMT VerSaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane ,, L 8318 12/10/2025 Licensed Plumber's Name_ Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Si nature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date BECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2505 #Of units in bldg.65 Cit,,/Town: Salem MA Zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: NMT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. ❑ The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane � �tg u�.9 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)1 will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Si ature of Owner Date LlThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitar -Code, Cha)ter II(the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2506 #Of units in bld�.65 Citv/Town: Salem MA Zi`Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186, §22(p),does not require the installation of a submeter. William Lane !/%/�C;;s _j 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L.c. 186, § 22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin I. - Owner's The Residences on Canal Street,LLP LAPS _Representative 12/10/2025 Name of Owner Signature of Owner Date —EJThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2507 #Of units in bld-,.65 City/Town: Salem MA zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane 8318 12/10/2025 Licensed Plumber's Name Plumber'Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTME T PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 12/10/2025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitaiy Code, Chapter II(the"Housing Code"),the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2508 #Of units in bld=.65 City/Town: Salem MA zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: NMT VerSaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane -- 1'r- 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP &kn= pm �—Representative 12/10/2025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date submitted to Local Health 186§22- Department: Prior Owner's Signature Date REGRIVEn DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2509 #Of units in bld:_.65 City/Town: Salem MA Zi p Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter William Lane 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin ,kOwner's The Residences on Canal Street,LLP �hil �Representative 12/10/2025 Name of Owner Signature of Owner Date LiThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date 410-23-Submetering of Water and Sewer Certification Form 5-12-23 DEC 10 2025 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2510 #Of units in bldt?.65 City/Town: Salem MA zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. i William Lane 8318 12/10/2025 Licensed Plumber's Name Plumber' Si_qnature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)1 will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP _Representative 12/10/2025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date submitted to Local Health 186§22- Department: Prior Owner's Signature Date RP VED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L. c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Cha ?ter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2511 #Of units in bldg.65 City/Town: Salem MA zip Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: NMT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane 8318 12/10/2025 r - Licensed Plumber's Name Plumber' Signature License# Date _ OWNER CERTIFICATION I certify that: (1) This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3) The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4) The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP Representative 1211012025 Name of Owner Si ature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RECEIVED 410-23-Submetering of Water and Sewer Certification Form 5-12-23 DEC 10 2025 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ),the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2512 #Of units in bldg.65 City/Town: Salem MA zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VerSaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. William Lane �; /�' 4 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1) This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, § 22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)1 will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SURMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's wfir On. The Residences on Canal Street,LLP Am W N`The 12I10/2025 Name of Owner Signature of Owner Date LlThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date RECEIVED DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, § 22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code" ,the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2513 #Of units in bldg.65 City/Town: Salem MA Zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services.The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VerSaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186, §22(p),does not require the installation of a submeter. William Lane "�� " 8318 12/10/2025 Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1)This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads,faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy,a written rental agreement that clearly provides for the separate charging of water and/or sewer service,and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTMENT PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's h Air The Residences on Canal Street,LLP PUM6.—Representative 12/10/2025 Name of Owner Signature of Owner Date LJThe property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date Submitted to Local Health 186§22- Department: Prior Owner's Signature Date DEC 10 2025 410-23-Submetering of Water and Sewer Certification Form 5-12-23 CITY OF SALEM BOARD OF HEALTH MASSACHUSETTS DEPARTMENT OF PUBLIC HEALTH SUBMETERING OF WATER AND SEWER CERTIFICATION FORM In accordance with M.G.L.c. 186, §22 and 105 CMR 410.000:Minimum Standards of Fitness for Human Habitation, State Sanitary Code, Chapter II the"Housing Code"),the following dwelling unit is eligible for submetering water and sewer. PROPERTY INFORMATION Address: 266 Canal Street (Building 2) Unit# 2514 #Of units in bldg.65 City/Town: Salem MA Zi Code: 01970 EQUIPMENT INSTALLATION INFORMATION 105 CMR 410.130(C)requires the installation of water conservation devices prior to a dwelling unit becoming eligible for submetering for water and/or sewer services. The devices must meet the following specifications: Showerheads with maximum flow rate not to exceed 2.5 gallons per minute(gpm) Faucets with maximum flow rate not to exceed 2.2 gallons per minute(gpm) Ultra-low flush toilets not to exceed 1.6 gallons per flush(gpf) The submetering equipment used to measure the quantity of water used for each dwelling unit and common area must meet the standards of accuracy and testing of the American Water Works Association or similar accredited association. A Massachusetts licensed plumber must install the toilets and submetering equipment. Submetering equipment information: N MT VersaMag Manufacturer Model# LICENSED PLUMBER CERTIFICATION I certify that(check all that apply): ❑✓ I have installed or inspected the submetering equipment listed above and have determined that they meet accepted plumbing standards. ❑✓ I have installed or inspected all the toilets in this unit and have determined that they meet accepted plumbing standards. The plumbing permit issued by the city/town,if required,is attached. This dwelling unit is connected directly to a meter installed by a water company and,in accordance with M.G.L.c. 186,§22(p),does not require the installation of a submeter. /r) ,,4 L. William Lane 8318 12/10/2025 //.y:��ti � Licensed Plumber's Name Plumber' Signature License# Date OWNER CERTIFICATION I certify that: (1) This dwelling unit is eligible for submetering of water and/or sewer usage in accordance with the water submetering law (MGL c. 186, §22). (2)All showerheads, faucets and toilets in this dwelling unit meet the conservation standards specified above. (3)The water submeter(if present)measuring the use of water in this dwelling unit was installed by a licensed plumber and complies with the standards of accuracy and testing required by the water submetering law(M.G.L. c. 186, §22). (4)The water meter or submeter measures the water usage exclusive to this unit. (5)I will provide to the tenants of this dwelling unit,prior to occupancy, a written rental agreement that clearly provides for the separate charging of water and/or sewer service, and a copy of this certification form. (6) All information included on this certification is true and accurate to the best of my knowledge. THIS FORM MUST BE FILED WITH THE LOCAL HEALTH DEPARTME T PRIOR TO INITIATING SUBMETERING Signed under the pains and penalties of perjury, Kristen Poulin Owner's The Residences on Canal Street,LLP &AK- 91�� Representative 12/10/2025 Name of Owner Signature of Owner Date The property has been transferred to the owner above and the unit remains in compliance with the requirements of M.G.L c. Date submitted to Local Health 186§22- Department: Prior Owner's Signature Date 410-23-Submetering of Water and Sewer Certification Form 5-12-23 DEC 10 2025 CITY OF SALEM BOARD OF HEALTH